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AP2 > Lecture 2/11 - Cardiac > Flashcards

Lecture 2/11 - Cardiac Flashcards

Test 2

1
Q

What is the main pressor in the CVS that is released in the blood?

A

NE

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2
Q

What is the Epi:NE ratio?

A

4:1

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3
Q

NE/Epi are released by ________ and put in circulation by the _______

A

nerves

adrenal gland

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4
Q

What are our pressure sensors (baroreceptors)? Where are they located?

A

Carotid baroreceptors: bifurcation of the carotid arterty (carotid sinus)

Aortic baroreceptors: aortic arch

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5
Q

The carotid baroreceptors are in the ______ and attached to the _______ via the __________ nerve

A

neck

brain stem

Glossopharyngeal

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6
Q

What are our protected circulatory beds? (2)

A

Coronary circulation
Central nervous system
(honorary mention: kidney –> will divert blood from here to protect other 2)

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7
Q

What is the main system we can shunt blood from?

A

GI

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8
Q

What are things that increase CO?

A
  1. Increase HR
  2. Vasopressin (modulated by osmolarity; increases SVR more than NE/Epi)
  3. Aldosterone (Activation of RAAS; part of SNS)
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9
Q

Where are stretch receptors reflexes located?

A

Large veins leading up to atria & in the atria

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10
Q

How does atria stretch/pressure reflex affect the kidneys?

A

Receptors detected increased volume in atria dt increased stretch/pressure in viens or atria –> Decreased SNS tone –> increased UO –> decreased blood volume

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11
Q

What does the atria stretch/pressure reflex help with?

A
  1. prevent overstretching in acute compensation state
  2. Prevent coagulapathies dt decreased circulatory rate (volume overload that heart cant keep up with)
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12
Q

The increase in output from the kidney involving stretch/pressure in the atria is via __________

A

Direct neural signal

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13
Q

What is ANF and ANP?

A

ANF: atrial natriuretic factor

ANP: atrial natriuretic peptide

These are both the same hormone

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14
Q

ANF/ANP is formed in the _______ atria. What causes this?

A

Right
(can be formed in the left as well, but mostly right)

When the atria is overstretched –> ANF/ANP released

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15
Q

What does ANP/ANF do?

A

Get rid of sodium –> increases urine output

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16
Q

What does BNP stand for?

A

Brain naturetic peptide

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17
Q

BNP is formed in the _____. What causes this?

A

Ventricles stretched out = increase release in BNP

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18
Q

What is BNP used for? What does its numbers indicate?

A

Used to gauge heart failure treatment

Decrease BNP = getting better (less strain on ventricle)
Increase = more strain

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19
Q

Plasma is _______ of ECF

A

1/4 to 1/5

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20
Q

ISF is ________ of ECF

A

3/4 to 4/5

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21
Q

What is the oncotic colloid pressure in the blood?

A

28 mmhg

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22
Q

What are the colloids that make up the pressure in the blood?

A

Albumin
Fibrinogen
Immunoglobulins

23
Q

Hematocrit is _____

24
Q

Where does fluid normally shift from during blood loss to the cardiovascular system?

25
What do we need to do as treatment during hemorrhage?
Best treatment: replace what is lost
26
How much NS stays in the CVS when given? Where does the rest go?
1/4 to 1/5 The rest goes to ISF
27
What are two molecules that we should use in place of blood products or albumin if we need to give colloids? What are these?
Dextran Hetastartch Large sugar molecules that produce plasma oncotic/colloid pressure These are considered synthetic colloids --> they stay in the CVS
28
What is the stretch-relaxation response? What is its MOA?
Property of the large veins to temporarily increase BP --> then DECREASE BP **when given IV fluids quickly** Smooth muscle in the large veins become too tight/distended (BP increases) --> smooth muscle senses this --> smooth muscle relaxes in response to this (BP decreases)
29
With the stretch-relaxation reflex, _____% of the IV fluids stay in the CVS system
20-25%
30
What is the reverse stretch relaxation response? What is its MOA?
if hemorrhage --> ANS makes the smooth muscles in the veins CONSTRICT/TIGHTEN
31
What is the strongest reflex response?
CNS ischemic response
32
What causes the CNS ischemic response. What are the responses to try to help?
**low brain/brain stem perfusion** for a few minutes from **very low BP** Maximal level of these responses to try to increase BP: SNS reflexes NE/Epi SVR Contractility HR Vasopressin RAAS/aldosterone ANF/ANP reduction
33
What is shock?
Tissue dysfunction to all parts of the body that need nutrients that aren't currently being delivered
34
What is a problem that we see would cell necrosis dt shock?
-Hyperkalemia (cell explodes --> intracellular K released) -Acidosis
35
What organ goes bad the earliest with shock?
Liver
36
What are ways to measure cardiac output?
PA catheter Flow track Fick's equation
37
What is Fick's equation?
CO (L/min) = (lungs O2 consumption per minute (mL O₂/min)) / (Arterial oxygen content - Venous oxygen content (mL O₂/L blood)) Ex) 250 ml O2/min / (200 ml O2/min - 150 ml O2/min) --> 5L/min
38
1 dL = ___ L
.1 L
39
1 dL = ___ ml
10 mL
40
Normal arterial blood oxygen value:
20 ml O2/dL **200 ml O2/L** <-- use this number
41
Normal venous blood oxygen value:
15 ml O2/dL **150 ml O2/L** <-- use this number
42
Normal oxygen consumption in lungs value:
250 ml O2/min
43
What is Digoxin? What do we need to know about it for this lecture for the test?
Na/K ATP inhibitor Cardiac glycocide/digitalis Helps: assist diuretics --> decrease blood volume Used when the body's compensation still wont allow heart to meet CO demands -Last effort drug -Used even for a few days used to let heart heal
44
What pathologies do you not have any cardiac reserve?
Severe coronary thrombosis Severe valvular disease
45
What is cardiac reserve?
Amount of CO you can get above normal
46
You have a max cardiac reserve of ______% in a healthy adult. The CO is ____.
400% 25L (Take normal CO of 5 --> multiple that by 400% --> add that to the original 5) **some can reach 30 L or 500%**
47
You have a max cardiac reserve of ______% in an athlete. The CO is ____. Why?
600% 40L (Take normal CO of 5 --> multiple that by 600% --> add that to the original 5) Reason: body building/training
48
What pathologies have reduced cardiac reserve from normal?
Old age Mild valvular disease Diphtheria Moderate coronary disease ------------------- No cardiac reserve: Severe coronary thrombosis Severe valvular disease
49
T/F: Old age can decrease cardiac reserve
T
50
What is the most common valve disease?
Aortic stenosis
51
_____% of people have congenital bicupid valves
1-2%
52
What valve already has 2 cusps?
Mitral valve
53
What valve generally has congenital bicupid valves?
Aortic

AP2 (21 decks)

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