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OLD "MBS 603" > Lecture 2 -- Exam 2 > Flashcards

Lecture 2 -- Exam 2 Flashcards

1
Q

When are all chambers are of the heart relaxed?

A

late diastole

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2
Q

When does first heart sound happen?

A

after atrial systole (AV valve closing)

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3
Q

What isovolumic ventricular contration?

A

when ventricles contract and but not enough force to open semilunar valves open and AV valves are closed

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4
Q

When are all the heart valves closed?

A

isovolumic ventricular contration

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5
Q

When does the semilunar valves finally open?

A

ventricular ejection (enough pressure has build up in ventricles)

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6
Q

When does the second heart sound happen?

A

after ventricular ejection (semilunar valves closing)

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7
Q

What is isovolumic ventricular relaxation?

A

ventricles are relaxed (low pressure) and semilunar valves close

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8
Q

What are the 5 steps of the cardiac cycle?

A
  1. last diastole
  2. atrial systole
  3. isovolumic ventricular contration
  4. ventricular ejection
  5. isovolumic ventricular relaxation
    start again
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9
Q

In a Wigger Diagram, when does electrical events happen relative to the mechanical events?

A

before mechanical events

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10
Q

What is the first small pressure bump on the Wigger’s Diagram?

A

atrial contraction (atrial systole / depolarization / P wave)

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11
Q

What is the very tall hump on the Wigger’s Diagram?

A

ventricular contraction (ventricular systole / depolarization / QRS complex)

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12
Q

What is the reason for the small hump in aorta pressure right BEFORE the ventricles contract on the Wigger’s Diagram?

A

pressure building in ventricles causes semilunar valves to bulge into aorta

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13
Q

What is the reason for the small hump in aorta pressure right AFTER the ventricles contracr on the Wigger’s Diagram?

A

elastic recoil of aorta

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14
Q

What is the reason for the small dip in atrial pressure right after the atrium contracts?

A

AV valves closing

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15
Q

Where on the Wigger’s Diagram does the AV valves close?
(use photo)

A

A

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16
Q

Where on the Wigger’s Diagram does the AV valves open?
(use photo)

A

D

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17
Q

Where on the Wigger’s Diagram does the semilunar valves close?
(use photo)

A

C

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18
Q

Where on the Wigger’s Diagram does the semilunar valves open?
(use photo)

A

B

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19
Q

What is the first upward curve of volume on the Wigger’s Diagram?

A

blood entering ventricles

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20
Q

What occurs at the peak of the volume curve on the Wigger’s diagram?

A

ventricular isovolumic contraction

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21
Q

What is the lowest point on the volume curve on the Wigger’s Diagram?

A

ventricular isovolumic relaxation

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22
Q

What is diastole?

A

relaxation
- heart filling with blood

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23
Q

What is systole?

A

contraction
- heart ejecting blood

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24
Q

What is stroke volume?

A

volume of blood ejected out of left ventricle every cycle

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25
Q

What is afterload?

A

the force against which the heart has to contract to eject the blood

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26
Q

What is preload?

A

initial stretching of the cardiac muscle prior to contraction (due to blood filling ventricles)

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27
Q

What is Frank-starling mechaism of the heart?

A

heart’s ability to change its contraction force, and therefore stroke volume, in response to changes in venous return

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28
Q

What does the Frank-Starling curve indicate?

A

left ventricle’s muscle can stretch as pressure/volume increase but only to a certain point the myosin cannot attach to each other for contraction

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29
Q

As end-diastole volume increased the myocardium stretches more which increases/decreases contraction and stroke volume

A

increase contraction
increase stroke volume

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30
Q

What is contractility?

A

ability of cardiac muscle cells to develop force at any given length (known as inotropism)

31
Q

What is inotropism?

A

ability of heart modify its muscular contractility

32
Q

Regarding calcium, how does a heart muscle contraction occur?

A
  1. action potential allows Ca2+ influx
  2. Ca2+ enters SR then leaves
  3. high amounts of Ca2+ in cytosol allows for contraction
33
Q

Regarding calcium, how does a heart muscle relax after contraction occur?

A

Ca2+ in cytosol enter SR or is pumped out of cell with opposing Na+ gradient (Na+ entering cell)

34
Q

How does Ca2+ enter the SR?

A

@ 2nd action potential
Ca2+ is built up in cytosol PLN unbinds for SERCA2 channel allowing Ca2+ into SR

35
Q

How does Ca2+ NOT enter the SR at the first action potential?

A

adenylate cyclase makes cAMP which makes PKA
PKA phosphorylate PLN which inhibits SERCA (Ca2+) channel preventing Ca from entering SR

36
Q

Why is Ca2+ not allowed to enter SR at first action potential?

A

need to build up lots of Ca2+ in cytosol first

37
Q

Once a lot of Ca2+ has entered SR via SERCA channel what happens?

A

Ca2+ quickly leaves SR and muscle contracts

38
Q

What are pressure volume loops?

A

relates changes in pressure to changes in blood volume in heart

39
Q

On a pressure volume loop, what does A-B mean?
(see image)

A

ventricles filling

40
Q

On a pressure volume loop, what does B-C mean?
(see image)

A

ventricles filling

41
Q

On a pressure volume loop, what does C-D mean?
(see image)

A

ventricular isovolumic contraction

42
Q

On a pressure volume loop, what does D-E mean?
(see image)

A

ventricles eject blood

43
Q

On a pressure volume loop, what does E-F mean?
(see image)

A

pressure falls since ventricles just contracted

44
Q

On a pressure volume loop, what does F-A mean?
(see image)

A

ventricular isovolumic relaxation

45
Q

On a pressure volume loop, where does the mitral valve close?
(see image)

A

C

46
Q

On a pressure volume loop, where does the mitral valve open?
(see image)

A

A

47
Q

On a pressure volume loop, where does the aortic valve close?
(see image)

A

F

48
Q

On a pressure volume loop, where does the aortic valve open?
(see image)

A

D

49
Q

On a pressure volume loop, where is the end systolic volume?
(see image)

A

X axis (A)

50
Q

On a pressure volume loop, where is the end diastolic volume?
(see image)

A

X axis (C)

51
Q

On a pressure volume loop, how do you find the stroke volume?
(see image)

A

distance from ESV to EDV

52
Q

If you were to increase the EDV, how would that affect contractility?

A

increases contractility

53
Q

If you were to increase contractility , how would that affect venous return?

A

increase venous return

54
Q

If you were to increase the contractility, how would that affect stroke volume ?

A

increase stroke volume

55
Q

If you were to increase the preload, how would that affect blood ejection?

A

increase ejection

56
Q

If you were to increase the preload, how would that affect stroke volume?

A

increase stroke volume

57
Q

If you were to increase the preload, how would that affect end-diastole volume?

A

increase EDV

58
Q

If you were to increase the afterload, how would that affect stroke volume?

A

decrease stroke volume

59
Q

If you were to increase the afterload, how would that affect end-systole volume?

A

increase ESV
(more blood will be left over after contraction = increased volume)

60
Q

If you were to increase the afterload, how would that affect blood ejected?

A

decrease blood ejected

61
Q

If you were to increase the preload, how would that affect venous return?

A

increased venous return

62
Q

Under steady state, cardiac output should = _________ return

A

venous return

63
Q

How is heart rate determined?

A

rate of depolarization

64
Q

What 2 factors determine stroke volume?

A

force of contraction (contractility and EDV)

65
Q

What is mean arterial pressure?

A

average blood pressure in a patient’s arteries during a single cardiac cycle

66
Q

How do you calculate MAP (mean arterial pressure)?

A

diastolic pressure + (pulse pressure) / 3

67
Q

How do you find pulse pressure?

A

systolic pressure - diastolic pressure

68
Q

What 2 ways can blood pressure be regulated?

A

fast response (via cardiovascular system) and slow response (via kidneys)

69
Q

Where in the brain is BP controlled?

A

medulla and hypothalamus

70
Q

What is the baroreceptor reflex?

A

primary way BP is regulated

71
Q

Where are the 2 baroreceptor reflexes located?

A

carotid sinus
aortic arch

72
Q

How do the baroreceptors detect changes in BP?

A

detects bulging of artery not pressure itself

73
Q

What 3 things on pressure volume loops can be tweaked to change the shape of the loop?

A
  1. contractility
  2. pre-load
  3. after load

OLD "MBS 603" (22 decks)

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