Lab 5: Intro to Cardio Vasc Phys

Question 1

What causes the heart sounds
lubdub

Answer 1

-turbulent backwash of blood in heart chambers and large arteires which follow the closure of the heart valves

LUB: closure of atrioventricular (AV) valves at the beginning of ventricular systole
-when ventricles contract, backflow against valves cause them to close and bulge backwards towards atria, and elastic ventricles cause blood to backsurge to ventricles, which make the noise

DUB:
closure of semilunar values (aortic vakve on left, pulmonary on right) after ventricular systole
-again, backsurging blood revertebrate against walls and make vibrations in the pulmonary artery and aorta

Question 2

Where to place stethescope to hear heart sounds LUB

Answer 2

5th left intercostal space on left margin of sternum (tricuspid area)_

Question 3

Where is your radial pulse? Where is your carotid pulse

Answer 3

on wrist, on neck

Question 4

When is carotid pulse heard, when is radial pulse

Answer 4

Carotid: heard after the first heart sound, because this carotid artery is closer to heart so there is minimal delay

Radial: felt slightly after the carotid becaiuse this has an additional distanc eit must trvel from aorta to arm

Question 5

where to hear heart sound DUB

Answer 5

2nd left or right intercostal space

Question 6

Blood presure determination

Answer 6

using ausculatory method

-use sphygmomanometer to hear the appearance and disapearence of Korotokoff sounds from the brachial artery

what is the firstkorotokoff sound:
-blood rushing back thru constricted artery with each systole (contraction) of the heart

What is systolic pressure:
pressure of the cuff when thefirst korotokoff sound is heard

when is second korotokoff sond heard:
-when there isa disapearance of the rushing because it reaches equilibrium withdiastolic pressure and blood flow normalnow

What is dyostolic pressure
-pressure of cuff when sound disapeears (2nd korotokoff sound)

Question 7

what does the sphygmomanometer constist of

Answer 7

compression bag surrounded by cuff (toapply pressure to arm)

inflating bukb for creating pressure

manometer to measure pressure

a valve which can be used to delflate pressure in controlled manner

Question 8

Ausculatory method steps

Answer 8

1. Subject sits and cuff applied just (2-3cm) above elbow, arrow on cuff(or rubber tube) should be over brachial artery

2.Place sthesthecope over aretey on part just under elbow

3. Pump cuff to 140 mmHg rapidly, then release at 2-3mmHg per heartbeat until a sound is heard, SYSTOLIC PRESURE

4.

Question 9

Systolic pressure:

DIasoltic pressure represents:

Answer 9

represents work done by left ventricle to overcome resistance of entire circ system

represents the condition of the arteryies bc theis is min pressure they are sbjecteive to

Question 10

what is high blood pressure

Answer 10

160/95 mm of Hg, more thant 3 times. aday its higher than this

Question 11

Pulse pressure meaning and calculation

Answer 11

difference in systolic and diastolic pressure

=Sys-dia

Question 12

Cardiac output and eqn

Answer 12

the measure of how well the heart is delivering blood to circ system

what causes it to be reduced:
-diseases like hypertension, cardiomyopathy, heart faikeure

what causes it to be increase:]
-diseases like infection and sepsis

EQN
cardiac output (Liters of blood ejected from left ventricle in a min)= (heart rate)(stroke volume)
Q=HRxSV

-increases due to increase in heart rate (60-180)

Question 13

SV

Answer 13

Stroke volume

EDV-ESV
(end di volume -end sys)

usually 70-120ml (1.7 factor)

OR calculated by
SV=101-(0.50xsyspressure)-(1.09xDiaP)-(.61xAge)

Question 14

What is cardiac output regulated by

Answer 14

1)O2 demand
-as rate of metabolsim increases, demand for o2 increases and cardiac output increases

2)Change in Circ System(dia of vessels)
-vasoconstrictors/vasodialators
-ie if vasoconstrict are present in systm, diameter of vessels decreaess so increased resistance in vessels and system so decreased cardiac output
-changes mediated thru symp and parasymp nervous system

3)Breathing
-affects intrathoraic pressure
-during inhalation this intrathoraic pressure decreases, allowing ventricles of heart to fill more during diastole (so INCREASES CARDIAC OUTPUT)

Question 15

change in cardiac output in response to breathing is known as

Answer 15

stroke volume variation

Question 16

Medical tools to determine cardiac output

Answer 16

MRI, Doppler Ultrasound, Impedance Cardiigraphy, thermodilution techniques

Question 17

Since it is hard to measure BP with sthestcope and pressure cuff, what do we use to assist students

Answer 17

pulse transducer, records appearance and disappearance of pulsatic blood flow (indicate when systolic and dia pressures are)

Question 18

Equip

Answer 18

Same
+PPG-320 Pulse Transducer
+BP-220 Non-invasive blood pressure transducer
Stethescope

Question 19

BP-220 and PPG320 set up and Software Setup

Answer 19

PPG- PT port on ixta roam

BP: need additional tube to connect,and connect thru A2 port

Start Software:
same
1)Human Circulation File and click Cardiac Output

Question 20

how to calibrate BP-220

Answer 20

1) if signal of pulse channel upside down, click down arrow next to channel title

2)if pulse signal noisy, hold the pulse transudcer to ur finger tighter

3) record data for10 seconds of the cuff just on table

Question 21

Unit conversion

Answer 21

1) move cursor to left of screen and another to the right
2)click v2-v1 on right side of BP channel, click SET OFFSET
3) Set mean value to 0, click “apply calculated offset for this block to all blocks” and “apply units to next recorded nlock”

Question 22

General procedure:

Answer 22

1)Place on cuff and pulse transucer
2)click record
3)inflate cuff until pulse wavers and disapeeras
4) onceit disappears, released cuff presure at rate of -10mmHg / second
5) release until gauge reads 20mmHg
6)record additional 30 seconds after
7)stop

Question 23

How to get Systolic pressure, diastolic and heart rate from the data

Answer 23

Sys: place cursor on the first pulse that reappears after pulse gone
(will be value1)

Diastolic: place cursor on the first largest pulse after systolic
(will be value 2 on table)

Heartrate: place a cursor just after the dia and a cursor 10 seconds later
-value will be the mean (average heart rate after BP determine)

FInd stroke volume using eqn and find cardiac output (ml/min) = Stroke Volume (ml/beat)xHeartRate (beats/min)

Question 24

what will we test all these things for

Answer 24

sitting
reclinging
standing
sitting after exercise
sitteing after 30 s exercise
“” 60 sec
“ 90 sec “
120 sec

Question 25

How does sys and dia p compare for sitting recling and standing

Answer 25

Sitting
sys: may slight decrease or stable cuz not much graviy to work against
dia: stabl

Reclinging:
sys: again decrease or stable cuz no gravity really to work against
doa; stable

Standing
sys: , initial drop when first stand sinve gravity, slightly increased compared to the other two cuz have to work against gravity to maintain it
dia: might increase to maintain flow
higher resistance in entrire circ system so keft ventricle has to work more

Question 26

How does heartrate compare

Answer 26

similar to pressures.

lowest at reclining
highest at standing bc need to make sure blood going to brain so need to pump against gravity

Question 27

Diving reflex is what

Answer 27

-air breathing animals developed ways for them to survive while submerged under water
do this by…
-using stored o2, decreasing o2 consumption and using anerobic metabolism (and aquatic res if possible)

Question 28

What is selectice peripheral vasoconstriction

Answer 28

prioritizes where oxygen is delivered (going to highest priorities… brain, heart and adrenal glands)
-other organs use local stores or anaerobic metanolis

-since vasoconstrict increases BP, BP is maintained by reduction in its cardiac output (by decreasing heart rate)

Question 29

Submersion hypothermia

Answer 29

-drowning in cold water
-young skinny ppeople survived while being drowned for 1 hour because it cooled the core of the individual

usualy only can do diving reflex for 2-3 mins

-dr martin niemeroff (did stuff with cold water drowing kids)

Question 30

Diving reflex setup

Answer 30

same everything, no BP220 cuff tho
open human heart, Diving Reflex

Question 31

how to data analysis for this

Answer 31

have max min mean, so just put cursors around data and do it , should be in function table already

also sometimes heart rate at certain points like apnea (stop breathing)

Question 32

What are we doing for Diving reflex

Answer 32

1) Resting Heart Rate
2)Heart rate and apnea (holding breath for as long as possible, apnea means when u stop brething)

Question 33

how do subjects max and min heartvrates while resting compare to heart rates while holding breath

Answer 33

initislly increase then decrese lower due to diving reflec

so max and min will be better in holdign breath (better as in lower for min and higet for max)

Question 34

what temps water

Answer 34

25, 15, 5

Question 35

what happens when face submerged in water

Answer 35

decreases heart rate

may have a initial quick increase due to the shock (symp systemn will increase it) but this is brief and the decreased heartrate is wayyyyyy more prominnent

Question 36

what causes the cahnge in heartrate

Answer 36

initial :symp system having fight for lgiht resone

diving reflex is the main cause fo the lowered heart rate, conserving 02, preserving it

Question 37

how does mammlian dibing reflex help a person wjo falls into cold wter

Answer 37

prioritizes the important organsn called selective peripheral vasoconstriction

Question 38

hyperemia def

Answer 38

increased amt of blood frow to organ

Question 39

valves help overcome pressure of gravity how

Answer 39

by divingbblood in viens in these lower limbs into many segments

Question 40

Repiratory pump and skeletal muscle pump

Answer 40

-resp: squeezes and releases presure to hep force blood toward the heart during inhalation

skeletal: properls blood forward from limbs to truunk

Question 41

Active hyperemia (arterial) vs passive (venous) vs reactive

Answer 41

-when there is an unusual demand such as increased waste products, increased blood flow in that area occurs

-when venous drainage of an area is distrupted so blood accumulates ratherthan drains

reactive:
apply ice pack to constrict then dialaite when removed allowing more