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PT 509 Physiology > Lecture 2 > Flashcards

Lecture 2 Flashcards

1
Q

Circulation of blood flow through the heart…

A

Starting at lungs…

1) Has O2, through Pulmonary being
2) Left atrium
3) Mitral valve
4) Left Ventricle
5) Aortic valve through Aorta
6) Out to the body
7) Superior/Inferior Vena Cava pumps back to…
8) Right atrium
9) Tricuspid valve
10) Intro Right Ventricle
11) Pulmonary artery to get more O2

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2
Q

Left side pumps to…

A

Peripheral Circulation organs (trunk, LE)

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3
Q

Right side pumps to…

A

Back to Pulmonary Circulation (lungs) to pick up more O2

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4
Q

Left side has more muscle why?

A

Has to pump blood to the rest of the body (greater surface area)

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5
Q

Prenatal Period: Days that link with placenta?

A

13-15 days

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6
Q

Prenatal Period: Heart?

A

20-50 days

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7
Q

Prenatal Period: When can you hear a heart beat?

A

8 weeks

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8
Q

Prenatal Period: Heart tubes?

A

3 weeks

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9
Q

Prenatal Period: L/R chambers?

A

5 weeks

4 chambers by 7 weeks

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10
Q

What is the additional structure in the fetal heart?

A

Foramen Ovale, you don’t need the circulation to the lungs

This should closed at birth, PFO.

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11
Q

Summary of infant vs adult heart?

A

Everything increase in size.

  • heart volume
  • cardiac muscle fibers
  • vascularization
  • maturation of myocytes
  • LV wall
  • arteries/veins
  • blood volume
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12
Q

Do males or females have a great cardiac output/stroke volume?

A

Males

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13
Q

Cardiac output?

A

Blood out per minute

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14
Q

Stroke volume?

A

Blood out per beat

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15
Q

What is the most different in adulthood?

A

Veins thicken

  • intimal
  • compromises blood pumping ability
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16
Q

Who has a great risk in mortality?

A

Women has an earlier onset

- changes in estrogen

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17
Q

Syncytium?

A

Heart can function effectively

- generate it’s own function

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18
Q

Intercalated disk?

A

A gap that allows ions to diffuse and action potentials to get carried through the junction

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19
Q

Cardiac Muscle Action Potential difference?

A

It has a plateau, for slow calcium channels

- heart auto-rhythm

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20
Q

What are the 5 phases of cardiac AP?

A

0) Fast Na channels open then slow Ca channels
1) K chnanels open
2) Ca channels open more
3) K channels open more
4) Resting membrane potential

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21
Q

Refractory period?

A

Period between two action potentials
“rest period”
- allows heart to fill with blood
- allows greatest potential to eject blood

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22
Q

Networking web is called…

A

Sarcoplasmic reticulum

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23
Q

What carries/transmits the AP along plasma membrane?

A

T-tubules

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24
Q

What channels open to allow depolarization to occur?

A

Calcium

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25
Q

Ca binds to…

A

troponin to allow actin & myosin to bind

- contraction occurs

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26
Q

Relaxation…

A

Pump to pump Ca back in

ATP needed

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27
Q

Systole:

A

contraction/emptying of the heart

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28
Q

Diastole:

A

Relaxation/filling of the heart

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29
Q

Phases of Cardiac Cycle:

A

1) Artial systole, contraction forces blood into relaxed ventricles
2) Atrial systole ends, Atrial diastole begins
3) Ventricular systole, first phase, contraction pushes AV valves closed but enough pressure to keep semilunar valves closed
4) Ventricular systole, second phase, ventricular rises and exceeds, the semilunar valves open and blood is ejected
5) Ventricular diastole - early, ventricles relax, pressure drops, blood flows back, valves closed, bloods flows back to aorta
6) Ventricular diastole - late, all chambers relax, ventricles fill passively

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30
Q

The cardiac cycle happens in how many millisec?

A

800 ms

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31
Q

What is the average amount of blood?

A

5L/min

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32
Q

End diastolic:

A

amount of blood left in ventricles after diastole, relaxation

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33
Q

End systolic:

A

amount of blood left in ventricles after contraction

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34
Q

Ejection volume:

A

amount of blood that is ejected out the heart t the rest of the body

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35
Q

Ejection fraction:

A

about 60%

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36
Q

Cardiac output

A

HR * Stroke Volume

5L/min

37
Q

Where are AV valves attached to?

A

Chordae tendinae

  • Tricuspid (right)
  • Mitral (left)
38
Q

Papillary muscle

A

attached to chordae tendinae

- contract during systole and helps prevent back-flow

39
Q

Heart pumping is regulated by…

A

Autonomic effects

  • Sympathetic
  • Parasympathetic
40
Q

Sympathetic stimulation causes…

A

increased HR
- 180-200 bpm
- CO: 15-20 L/min
tachycardia can decrease CO, not enough time to fill during diastole

41
Q

Parasympathetic stimulation causes…

A

decreases HR

  • 20-40 bpm
  • Vagus n.
42
Q

What are the two types of cardiac muscle cells?

A
  • Contractile, mechanical work, does not initiate own AP

- Auto-rhythmic, do not contract, initiates AP

43
Q

SA node in R atria also called?

A

cardiac pacemaker

  • used if compromised
  • placed lead at RV
44
Q

What is the pathway of a heartbeat?

A

SA node sets pace

1) Internodal pathway
2) AV node
3) Left/right bundle of His
4) Purkinje fibers

45
Q

P wave

A

atrial contraction

46
Q

QRS

A

ventricular contraction

47
Q

T wave

A

ventricular repolarization

48
Q

Aorta:

A

transports blood to tissues under high pressure

49
Q

What drives gas exchange?

A

Pressure differences

50
Q

Arteries

A

stronger, thicker, smooth m., able to push under high pressure

51
Q

Veins

A

lead to capillaries for gas exchange, controls blood to capillaries to allow exchange to happen, sensitive to pressure

52
Q

Arterioles

A

Control site for blood flow

Major resistance site of the circulation

53
Q

Capillaries

A

Major site of water and solute exchange between blood and tissues

54
Q

Inferior/Superior vena cava, veins/venules, venous sinuses

A

Returns blood to heart under low pressure
Serves as a reservoir of blood
Controls rate to go back up

55
Q

Pulmonary circulation is:

A

site of oxygen and carbon dioxide exchange

56
Q

Higher pressure is found…

A

arterial tree

57
Q

Lower pressure is found…

A

venous side

58
Q

Where do large pressure drops?

A

arteriolar-capillary junction

59
Q

Blood pressure

A

the force exerted by the blood against any unit area of vessel wall

60
Q

Korotkoff sounds

A

systolic - tapping
diastolic - muffled
…when disappeared these sounds will disappear

61
Q

Blood flow

A

quantity of blood that passes a given point in the circulation in a given period of time

62
Q

Turbulent flow

A

means something is wrong

increases stress in bv

63
Q

Normal flow is…

A

laminar flow

64
Q

Atherosclerosis

A

plaque on walls
CO decreases
BP increases

65
Q

Arteriosclerosis

A

hardening of walls
CO decreases
BP increases

66
Q

Venous valves/pump

A

Gets blood back to the heart

Open and closes by muscle contraction

67
Q

Angiogenesis

A

growth of new blood vessels

1) ischemic tissue
2) rapidly growing tissue
3) tissue with high metabolic rates

68
Q

Angiogenic factors (protein):

A

vascular endothelial cell growth factors (VEGF)

fibroblast growth factor (FGF)

69
Q

Local Control of Blood Flow

A

Each tissue controls its own blood flow in proportion to its needs

70
Q

What do tissue needs?

A

1) O2
2) Nutrients
3) CO2, H, metabolites removal
4) Transport hormones

71
Q

Vasoconstrictors

A

Norepinephrine/epinephrin
Angiotensin
Vasopressin
Endothelin

72
Q

Vasodialiators

A 
Bradykinin
Serotonin
Histamine
Prostaglandins
Nitric Oxide
73
Q

Autonomic Nervous System

A

Sympathetic

Parasympathetic

74
Q

SNS

A

controls circulation

  • all vessels except pre-capillaries
  • increase vascular resistance
75
Q

PNS

A

regulates heart function

  • vagal n.
  • HR
76
Q

Artial Baroreceptor Reflex

A

short term regulation of arterial pressure

reflex initiated by these receptors, located on walls of large systemic arteries

77
Q

A rise in baroreceptors causes…

A

signals to vasomotor center (VMC), brain/medulla

78
Q

Feedback signals are sent via ANS to…

A

circulation to reduce BP

79
Q

Where are baroreceptors located?

A

Carotid sinus

Aortic Arch

80
Q

Signals are transmitted through which nerves?

A

Hering’s
Vagus
Glossopharyngeal…
(Don’t need to know this)

81
Q

Increase in extracellular fluid volumes (ECFV) causes…

A

increase in blood pressure

increase in sodium excretion

82
Q

Sodium married to Chloride (salt)…

A

Salt loves water

83
Q

ADH

A

anti-duretic hormone, vasosuppresent, released from posterior pituitary gland (near brain)

retains water

84
Q

Effect of ECFV on Arterial Pressure

A

Increased ECFV
Increased blood volume
Increased mean circulatory filling pressure
Increased venous return of blood to the heart
Increased CO
Increased arterial pressure
increased urine output

85
Q

Renin-Angiotensin System (RAS)

A 
Decreased arterial pressure
Renin (kidney), secretes hormone
Converted to Angiotensinogen
Converts to 1
Converts 1 to 2 by ACE
2 acts on kidney to retain salt & water OR vasoconstriction
BP increases
86
Q

Why is RAS important?

A

Maintains normal BP during changes in Na intake

87
Q

Right heart failure

A 
peripheral tissues
edema
ascites
pulmonary HTN
RV failure
88
Q

Left heart failure

A

CHF
pulmonary edema
troubled breathing
orthopnea

Ischemic heart disease
HTN
Aortic/Mitral disease
Myocardial disease

89
Q

RAS Effect of Na

A

Increase salt intake
Increase extracellular volume
Increase arterial pressure
Decrease renin/angiotensin
Decrease renal retention of salt/water
Return of extracellular volume almost to normal
Return of arterial pressure almost to normal

PT 509 Physiology (9 decks)

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