Midterm 1 Flashcards

1
Q

What are the most important features of the body’s milieu interieur?

A

most important features of the body’s internal environment: stable, compensates + equilibrates organs of the body against changes in the external environment with different systems

ex) temperature regulation, pH balance, ion concentration

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2
Q

Explain what homeostasis is and why it is central to the study of physiological systems.

A

maintaining internal environment; exists in a system when its critical parameters are successfully regulated

ensures maintenance of optimal conditions for cellular function and adapt to external changes (react to stimuli) by integrating multiple systems; understanding disease

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3
Q

Example of physical law and empirical relationship.

A

Poiseuille’s Law: resistance to flow in a tube is inversely proportional to radius^4; constriction, smaller radius, increased resistance, reduction in blood flow

Starling’s Length-Tension Diagram for the heart: increase in end-diastolic volume (heart chamber more blood) causes increase in systolic pressure (force of contraction)

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4
Q

What are the basic elements of the feedback control pathway and what is its function?

A

coordinating center with set-point, command signal, effector, detector, feedback to achieve homeostasis

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5
Q

Example of negative feedback

A

Control of Mean Arterial Pressure
1. coordinating center: medulla receives signal for low BP
2. command signal: efferent pathways send signals down the nerves to heart + blood vessels to increase HR + vasoconstriction
3. effector: heart and vessels
4. detector: baroreceptors
5. feedback: afferent pathways

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6
Q

What are the functions of the cellular plasma membrane?

A
  1. separates cell’s contents from the environment
  2. enable formation of cells into tissues and organs
  3. enable solute transport
  4. enables cell excitability (electrical activity)
  5. enables signaling and communication
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7
Q

What are the chemical properties of phospholipids and how does this allow for self-assembly into membranes? What properties do membranes have as a result?

A

amphipathic: hydrophobic fatty acid tails, glycerol backbone, phosphate group (negative charge), hydrophilic head group

self-assembly into a fluid bilayer with selective permeability forms a barrier in aqueous environment

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8
Q

What molecules are impermeable, permeable, and semi-permeable to the membrane?

A

Impermeable: charged substances (ions, amino acids, proteins), larger polar molecules (glucose)

Semi-permeable: small, polar molecules (water)

Permeable: hydrophobic molecules (O2, CO2, steroid-type hormones like cholesterol/testosterone)

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9
Q

What is the relationship between electrochemical gradients and the direction of movement of ions across membranes?

A

ions move down their electrochemical gradient: difference in concentration and difference in charge (electrical potential (V) difference)

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10
Q

What are the roles of integral membrane proteins?

A
  1. facilitate molecular transport (pores, channels, carriers, pumps for H2O soluble)
  2. serve as adhesion molecules
  3. anchor the cyotskeleton to the membrane
  4. act as receptors
  5. act as enzymes
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11
Q

Explain the differences between the nature of molecular movement (how flux varies with concentration gradient) through pores, channels, and carriers.

A

Pores: non-gated channel (always open), passive diffusion, selective for ion or molecule; for uncharged, flux is proportional to concentration gradient

Channels: can be voltage or ligand gated, passive diffusion, selective for particular molecule (often ions), flux is always proportional to concentration gradient

Carriers: 2 doors that are never open at the same time, GLUT1 glucose transporter; saturation point (no active sites open) above which flux can’t rise (enzyme kinetics)

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12
Q

What are the roles of integral proteins in cell adhesion (specifically in tight and gap junctions)?

A

tight junction: prevents solvent passage between cells (form barriers)

gap junction: cell to cell communication (form channels to synchronize activity)

  • includes integrins, cadherins, and claudins
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13
Q

What are the different categories of receptor proteins and how do they play a role in transduction of signals across membranes?

A
  1. Ligand-gated channels: bind specific molecule that causes conformational change (allows ions to pass)
  2. Receptors with catalytic activity: upon ligand binding, have enzymatic activity (often receptor tyrosine kinase, insulin)
  3. G-protein coupled receptors: upon ligand binding, activates an associated G-protein
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14
Q

What are the special properties of G-protein-coupled receptors and explain why their structure provides diversity and modularity of signaling?

A

Receptor consists of 7 membrane spanning segments; has diverse extra + intracellular sides (ligands + G-proteins) == highly modular and versatile signaling

  1. ligand binds to GPCR
  2. receptor interacts with G-protein (alpha, beta, gamma) to promote conformational change that exchanges GDP for GTP
  3. activates effector pathway
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15
Q

What is the difference between autocrine, paracrine, and endocrine signaling? How do these modes of signaling require signaling ligands with different properties?

A

autocrine: cell releases signal that act on receptors on the same cell (cancer promotes own growth); short-lived, bind quickly

paracrine: localized, limits activity of signal to desired area (NMJ); short-lived

endocrine: long-range; hormones that travel through the bloodstream; stable, high-affinity receptors

signaling molecules or ligands include:
1. amines (epinephrine)
2. peptides and proteins (insulin)
3. steroids (estrogen)
4. small molecules (AA, nucleotides, gasses)

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16
Q

What is the distribution of body fluids in body compartments? What are the concentration of ions in each?

A

intracellular fluid: 25 L; [Na+] = 15 mM, [K+] = 120 mM, [Cl-] = 20 mM
- separated by plasma membrane

extracellular fluid
- blood plasma (separated by capillary endothelium): 3 L; [Na+] = 142 mM, [K+] = 4.4 mM, [Cl-] = 102 mM
- interstitial fluid: 13 L; [Na+] =145 mM, [K+] =4.5 mM, [Cl-] =116 mM
- transcellular fluid (separated by epithelial cells): 1 L; variable ion concentration

Total = 42 L
Every compartment has equal osmolarity (290 mM)

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17
Q

How do concentration differences, electrochemical potential, and membrane permeability contribute to rate of transport across biological barriers?

A

Concentration Differences
- molecules move from high to low concentration
- chemical potential energy created from gradient = RTln([Xin]/[Xout])

Electrochemical Potential
- Combines concentration gradient and electrical gradient (high to low potential)
- Drives ion movement across membranes

Membrane Permeability
- Lipid Bilayer: Permeable to small, nonpolar molecules
- Transport Proteins: Required for larger, polar molecules
- Membrane fluidity impacts permeability

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18
Q

What parameters affect the rate of transport for uncharged solutes?

A

Fick’s Law: Jx (mol/t*area) = Px(Cout-Cin) = Px([Xo]-[Xin])

permeability coefficient (Px) = DB/dx
diffusion coefficient (D): rate
barrier thickness (dx): membrane
partition coefficient (B): solubility of molecule in lipid

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19
Q

What is the principle of bulk electroneutrality?

A

the number of positive charges in the overall solution must be the same as the number of negative charges

all fluid compartments must satisfy this

deviations of this occur at membranes at undetectable numbers of molecules

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20
Q

How does an ionic gradient generate an electrical potential energy across the membrane?

A

total driving force = voltage driving force + concentration driving force

  1. typical cell has high K+ inside
  2. Bulk electroneutrality says each K+ has a negative counterion
  3. K+ channels open, they travel down their gradient outside the cell
  4. K+ separated from their counterion
  5. electrical potential energy increases across the membrane until it’s equal and opposite to the chemical potential energy
  6. membrane voltage where equilibrium occurs is Nernst potential
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21
Q

How do you calculate the Nernst potential for an ion knowing extra and intracellular concentrations?

A

Vm (Vin-Vout) = Ex = -RT/zF (ln [X]in/[X]out)

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22
Q

How does net electrochemical driving force determine the direction of ion movement through a membrane?

A

Driving force = Vm - Ex

when DF < 0, cations enter the cell, anions exit

when DF > 0, cations exit cell and anions enter

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23
Q

What is the role of the Na-K-ATPase pump in establishing gradients of sodium and potassium?

A

pumps 3 Na+ out, 2 K+ in using ATP
1. Na+ in
2. ATP hydrolyzed, closing pore
3. extra pore opens, Na+ released
4. K+ binds
5. P lost, closing pore
6. ATP binds, K+ released

ouabain poisons ATPase

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24
Q

How are voltage differences across membranes produced?

A

selective ion permeability
- movement of small # of molecules produces a large change in V

ΔV = Q/C

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25
Q

How do secondary active transporters use energy stored in concentration gradient to drive movement of other molecules?

A
  1. co-transporters: 2Na/Glucose enter together; harness the electrochemical potential of certain ions (Na) to drive influx of other solutes against concentration gradients
  2. exchangers: 3Na/Ca exchanger; energy of Na gradient to drive Ca out of the cell
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26
Q

Why can a cell attain a Vm between -100 mV and +130 mV depending on permeability of the membrane?

A

the cell has different types of channels in different amounts; the Vm is determined by averaging the contributions of all ions

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27
Q

How do you calculate the flux of ions from GHK equation?

A

J = P x (Cout-Cin) /Δx

J = Pk (Ckout-Ckin) + Pna (Cnaout-Cnain) + ….. / Δx

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28
Q

Describe voltage-gated K+ and Na+.

A

K+: resting state (inside closed), open active state (slow, repolarization)

Na+: resting state (outside closed), active state (fast), inactivated state (slow, inside closed)

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29
Q

What are the phases of the AP?

A
  1. Below threshold (< -50 mV), all channels closed, at Vm
  2. Depolarization: (-50 mV to +30 mV): stimulus raises above -50 mV, Na+ channels open and K+ triggered (delay)
  3. Repolarization: (+30 mV to -70 mV): plateau, Na+ channels inactive, K+ channels open
  4. Hyperpolarization: slow closing of K+ channels
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30
Q

Compare and contrast the differences in outcome for graded and action potentials.

A

graded potentials: local triggering events cause gated channels to open, creating local change in Vm
- can be depolarizing or hyperpolarizing
- stronger stimulus produces larger GP
- spread is limited along membrane because current leaks/charges disperse
- can trigger AP if intense or long enough

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31
Q

Describe molecular basis for action potential’s all or none, non-decremental, and capable of propagation.

A

All-or-none: Once the threshold is reached, voltage-gated Na⁺ channels open fully, triggering a complete action potential

Nondecremental: shape and magnitude is constant along the membrane; delay between stimulus and response increases with distance

Propagation:
- An action potential triggers automatic propagation in excitable cells
- In contiguous conduction, local current spreads to neighboring sites, triggering new action potentials.
- Local current loops could initiate action potentials in both directions.
- Refractory periods prevent new action potentials, ensuring one-way propagation in nerves.

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32
Q

How does the AP propagate?

A

myelinated axon: current passes through Nodes of Ranvier quickly where Na/K channels are concentrated for APs; reduces leakage of current

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33
Q

What is the difference between absolute and relative refractory periods?

A

absolute: second response is not possible (entire portion above threshold) because Na+ channels are open or inactive

relative: second response is possible if strong stimulus (below threshold + hyper); K+ channels open

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34
Q

Describe spatial and temporal summation in the neuron.

A

spatial: inputs from multiple different neurons amplify signal

temporal: same axon fires multiple times

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35
Q

Differences between electrical and chemical synapses

A

Electrical: signals directly propagate from one cell to another through gap junctions, fast transmission, synchronized activity (cardiac + smooth muscle)!

Chemical: signal transmitted with neurotransmitters released into synaptic cleft, slower, unidirectional, more modulation

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36
Q

Steps of NT release into synaptic cleft?

A
  1. NT synthesized and packaged into vesicles at axon terminus
  2. AP arrives at the presynaptic terminal
  3. V-gated Ca2+ channels open and Ca2+ enters
  4. Rise in Ca2+ triggers fusion of synaptic vesicles with the presynaptic membrane
  5. NT diffuse across the synaptic cleft and bind to receptors on the post synaptic cleft
  6. Bound receptors activate postsynaptic cell
  7. NT broken down by acetylcholinesterase, is taken up by the presynaptic cleft or other cells, or diffuses away
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37
Q

ionotropic vs. metabotropic receptors and how they function in synapses?

A

ionotropic: directly opens with 2 ACh binding, allowing ions to flow through and depolarize membrane; fast!
- muscle contraction
Ex) Nicotinic AChR + serotonin (cations)
DEPOLARIZE (excitatory postsynaptic potential)

metabotropic: GPCRs activate G-protein that triggers intracellular signaling pathway (second messengers like cAMP); slow
- decrease HR
Ex) Glycine, GABA (anions)
HYPERPOLARIZE (inhibitory postsynaptic potential)

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38
Q

What is end-plate potential (EPP) and how is it measured?

A

depolarization of the postsynaptic NMJ due to release of ACh

voltage-clamp: holds Vm constant and measures the current triggered by ACh

linear IV curve because channel is non-specific to cations (Pk=PNa)

39
Q

Name three muscle types and compare them.

A
  1. Skeletal: movement of bones, respiration; striated sarcomeres; voluntary; largest internal organ (30-50% mass of body); fibers innervated by one motor neuron, contain myofibrils with sarcomeres
  2. Cardiac: pumping blood; striated sarcomeres; involuntary
  3. Smooth: control of hollow organs (stomach, blood vessels); non-striated; involuntary

in common: excitable cells (APs), intracellular Ca2+ triggers contraction, force generated by myosin-actin

40
Q

What is the anatomy of the sarcomere? List main proteins and role they play in muscle contraction + regulation

A

thin filaments (actin) act as the track for thick filaments (myosin) pull to generate force

tropomyosin: wraps around actin to block myosin-binding sites at rest

troponin: complex that binds to Ca2+ which moves tropomyosin away from actin’s binding site

contractile proteins only produce force in region of thick and thin filament overlap

41
Q

Give steps of Crossbridge Cycle

A
  1. ATP binds to myosin, dissociates actin-myosin complex
  2. ATP is hydrolyzed, causing the myosin head to cock
  3. A cross-bridge forms and the myosin head binds to a new position on actin
  4. P is released; myosin heads change conformation, leading to a power stroke (filaments slide past one another)
  5. ADP is released
42
Q

What is EC-Coupling?

A
  1. membrane depolarization opens the L-type Ca2+ channel in the T-tubule membrane
  2. mechanical coupling between the L-type Ca2+ channel and the Ca2+ release channel (ryanodine receptor) in the SR causes the Ca2+ release channel to open
  3. Ca2+ exits the SR and activates troponin, leading to muscle contraction
43
Q

What is the neural control of muscle?

A

motor units: single motor neuron innervating multiple fibers; fibers contract as a group

motor neuron pool: all motor units innervating a given muscle

44
Q

How can a muscle’s force output be adjusted?

A
  1. temporal or frequency summation: force builds towards tetanus (sustained contraction)
  2. spatial summation: more or larger motor units
45
Q

Isometric vs. isotonic contraction?

A

Isometric: muscle length stays constant, tension increases

Isotonic: muscle changes length, tension stays the same

46
Q

How does the muscle relax?

A

ATP binding to myosin releases it from actin

  1. Na-Ca exchanger pump extrude Ca2+ from the cell
  2. SERCA (SR Ca2+ ATPase) drives reuptake of Ca2+ into SR
  3. Ca2+ is bound in the SR by calreticulin and calsequestrin
47
Q

Describe length-tension and force-velocity relationships in muscle behavior

A

length-tension: initial length of the muscle fiber affects the force (there is an optimal length that produces the greatest tension because actin and myosin filaments are perfectly aligned for max cross-bridging)

force-velocity: muscle force varies with the speed of contraction; max velocity, force is minimal

48
Q

What are the morphological classifications of neurons?

A
  1. Pyramidal: pyramid-shaped, prominent dendrite, cognition
  2. Bipolar: two processes (one dendrite, 1 axon), interneuron
  3. Unipolar: Single process with two branches, sensory neurons
  4. Multi-polar: Star-shaped, involved in local processing, can be excitatory or inhibitory, motor neuron
49
Q

What are the functional classifications of neurons?

A

afferent: transmit info from peripheral receptors to CNS (uni +bi)

interneurons: connect sensory and motor neurons within the CNS

efferent: CNS to muscles (multi)

“Affter you sense, you effect change”

50
Q

Major glial cells and their functions

A
  1. Astrocytes (CNS): provide lactate, take up K+, regulate NT, modulate blood flow, structural support
  2. Oligodendrocytes (CNS): myelin production
  3. Microglia (CNS): phagocytosis
  4. Schwann cells (PNS): myelin production
51
Q

CNS vs. PNS (anatomical) and Somatic vs. Autonomic (functional)

A

CNS: brain + spinal chord; oligos; axons cannot regenerate

PNS: peripheral ganglia; sensory
receptors; peripheral portions of spinal and cranialnerves (except optic), both
afferent and efferent; Schwann; axons can regenerate

ANS: portions of CNS/PNS; visceral functions HR, BP, T, digestion, reproduction

52
Q

Breakdown of ANS

A

Sympathetic: preganglionic neurons from T1-L3 and synapse in para or prevertebral ganglia

Parasympathetic: preganglionic neurons originate from brainstem and sacral spinal cord and synapse with postganglionic neurons near target organs

53
Q

Important brain regions.

A

frontal (primary motor), parietal (somatosensory), occipital (visual), temporal (auditory)

Cerebral hemispheres: higher functions

Cerebellum: 50% of CNS neurons; receives extensive visual, auditory, vestibular input and directs motor output; balance/motor control/coordination

Thalamus: relay station; integrates and filters sensory information

Hypothalamus: connects to autonomic nervous system for control of blood pressure, heart rate, digestive system; release hormones

Medulla: controls BP, HR, respiration, digestions

54
Q

Function of CSF, composition, and basic features of flow.

A

cushions brain and spinal chord, delivers nutrients, maintains homeostasis

water, ions (Na+, K+, Ca2+, Mg2+), protein

choroid plexus produces CSF in lateral ventricles, 3rd ventricle, 4th ventricle, into subarachnoid space, superior sagittal sinus

55
Q

Describe the organization of the circulatory system and how blood flows.

A

RA–> RV–>lungs –>LA–>LV–> aorta

2 circulatory loops
1. pulmonary: RV–> pulmonary artery–> lungs–>gas exchange in pulmonary capillaries–> pulmonary veins –> left atrium
2. systemic circulation: LV–> aorta-> arteries–> arterioles–>capillaries–>venules–>veins –> vena cava –> RA

56
Q

Relationship between pressure, flow, resistance in vessels.

A

driving pressure = (P1-P2) =ΔP = FR

flow = ΔV/Δt = A*v

total flow = cardiac output = HR*SV

57
Q

What are the different types of pressure?

A
  1. driving pressure = axial pressure difference (vessel) ΔP = F R
  2. transmural pressure = radial pressure difference (wall)
  3. hydrostatic pressure = static pressure head ΔP = pg (h1 - h2)
58
Q

Differences between laminar and turbulent flow.

A

laminar: fluid particles move in parallel layers with minimal mixing; velocity profile is parabolic

turbulent: fluid particles move in a chaotic, irregular patterns; velocity profile is flatter in the middle

59
Q

Describe viscosity? Blood’s viscosity?

A

Fluid’s resistance to flow
- For Newtonian fluids (water, air), the relationship between stress and shear is linear (viscosity is constant)

n = shear stress (force/area) / shear rate (Δv/Δx)

blood is non-Newtonian = viscosity changes
- at low shear rates (slow flow), viscosity is higher due to increased interactions between RBCs
- at high shear rates (fast flow), the viscosity decreases

60
Q

What affects blood’s viscosity?

A

hematocrit: higher hematocrits RBC%), viscosity increases because of cell deformation

vessel radius: for small vessels, viscosity decreases steeply with decrease in radius

61
Q

What is Hagen-Poiseuille?

A

F = ΔP (pi r^4 / 8nl)
R = 8 n l / pi r^4

resistance most sensitive to changes in radius

62
Q

How does arterial blood pressure vary with time? What is the relationship between systolic, diastolic, mean arterial, and pulse pressures?

A

Systole: pressure is highest during ventricular contraction

Diastole: pressure drops during ventricular relaxation

Pulse pressure = SP - DP

MAP: average pressure in the arteries during a cardiac cycle; overall driving pressure for blood flow

63
Q

Explain how gravity (hydrostatic pressure), vessel compliance, viscous resistance,
and inertia contribute to transmural and driving pressures

A

Gravity: ΔP = ρ g Δh

Compliance: ΔVolume / ΔP

Viscous Resistance: ΔP = F R

Inertiance: ΔP depends on acceleration/deceleration of flow

64
Q

What is the relationship between aggregate cross-sectional area and mean linear velocity?

A

Flow is constant (A1v1 = A2v2…)
Atot is not constant, so MLV gets much slower in capillaries

65
Q

What is the difference between transmural pressure profiles of systemic and pulmonary circulation?

A

Systemic: much higher pressure from LV, arterioles have the greatest resistance (smaller diameter)

Pulmonary: low pressure, low resistance for gas exchange

66
Q

Compare axial pressure dissipation in arterioles vs, capillaries?

A

-ΔP along arterioles is greater compared to capillaries because they have higher resistance (series)
- capillaries have larger cross-sectional area and lower resistance due to parallel arrangement

67
Q

What does capillary pressure depend on? How does vasomotion affect this?

A

Pc depends on ratio of postcapillary to precapillary resistance (Rpost/Rpre)
- typical ratio is 0.2 to 0.42 (post is lower than pre)

vasomotion: constriction or dilation of arterioles or venules affects the pressure profile in vascular bed, but systemic pressures remain constant

68
Q

What is the distribution of blood volume?

A

85% systemic, 10% pulmonary, 5% heart chambers

15% high pressure, 80% low pressure, 5% heart chambers

20% systemic arterial, 65% systemic venous, 10% pulmonary, 5% heart chambers

69
Q

Describe the composition of blood vessel walls.

A

arteries: smooth muscle, thick wall, elastic and collagen fibers; low compliance (pressure and volume linear)

veins: less smooth muscle and elastic fibers; much more distensible (accommodate more volume); high compliance (pressure doesn’t change as volume does)

70
Q

How does aging affect arteries?

A

aging reduces arterial compliance, making them stiffer

71
Q

Difference between active and passive tension?

A

Active: smooth muscle contraction

Passive: relaxed state of vessel; increases with collagen stiffness

72
Q

What are the types of capillaries?

A

continuous, fenestrated (leak), discontinuous

73
Q

Describe water movement across capillaries.

A

Hydrostatic Pressure Difference (ΔP): Drives water movement across the capillary barrier; varies along the length

Osmotic Pressure Difference (Δ𝜋): Depends on protein concentration (mainly albumin)

Starling Equation: Quantifies the effect of pressure differences on water flow across capillaries

Net flow of water is normally outward from capillaries; interstitial fluid is collected and returned to circulation by the lymphatic vessels

74
Q

What are the characteristics of cardiac cells that allow for the spread of electrical activity?

A

gap junctions connect cardiac cells forming a syncytium: efficient spread of electrical activity through the heart; long APs

75
Q

How do AP shapes differ among sites in the heart?

A

SA + AV node: pacemaker potential from If; depolarization from Ca2+ influx (not Na+), no plateau

atrial muscle, ventricular muscle, Purkinje fibers: cells remain at rest until stimulated; rapid depolarization due to Na+; maintained by Ca2+ during plateau; longer

76
Q

Steps of electrical activation of the myocardium

A
  1. SA Node
  2. Atrial muscle
  3. AV node
  4. Bundle of His
  5. Left/Right bundle branches
  6. Purkinje fibers
  7. Ventricular muscle
77
Q

Describe the steps of the cardiac AP (phase 0-4) and the currents responsible for each phase.

A

Phase 0, Upstroke: rapid depolarization due to Na+ influx (largest in heart)

Phase 1, Rapid Repolarization: K+ efflux

Phase 2, Plateau: Ca2+ influx (slow) balances K+ efflux (VERY slow)

Phase 3, Repolarization: K+

Phase 4, Diastole (rest): resting potential, Na/K activity

78
Q

How does the heart repolarize?

A

Ventricular APs: late-activated regions have shorter APs (endo larger than epi)

Sequence:
activation: ENDO–> EPI
repolarization: EPI–> ENDO

79
Q

Why are INa and ICa primarily responsible for refractory period?

A

the inactivation of both currents prevents rapid, successive APs to allow the heart to refill with blood
- INa: inactive state where it cannot be reopened until repolarization
- ICa: inactivate more slowly than Na channels

79
Q

How do you alter the pacemaker rate?

A
  1. Altered rate of depolarization (decrease If, slower depol, more time to reach threshold)
  2. Altered K+ conductance at rest (opening GIRK+ channels: more -Vm)
  3. Altered AP threshold (changing properties of ICa, depol at lower V)
80
Q

Describe the pacemaking ability of the SA node and the If.

A

SA node: spontaneous depolarization due to funny current If; NO NA+ CHANNELS

If
- activated by hyperpolarization, does not inactivate, does not conduct at +Vm
- spontaneous activity: slowly depolarizes, triggering ICa

81
Q

Describe ECG and how the basic Lead I ECG signal is created.

A

Represents the electrical activity of the heart as it de/repolarizes during each cardiac cycle; AP produce extracellular currents–> potentials

  1. P wave: SA/AV node, atrial depolarization
  2. QRS complex: ventricular depolarization, triggers contraction
  3. T wave: ventricular repolarization

PR interval: time from start of P wave to beginning of QRS complex (time from SA to AV node)

ST segment: ventricle are depolarized = plateau phase

QT interval: time from start of QRS to T wave = total ventricular depolarization and repolarization

Lead I: measure V differences between right arm and left arm

82
Q

Explain cardiac excitation coupling and how this differs from skeletal ECC.

A

Calcium-induced calcium release (CICR)
- depolarization opens V-gated Ca2+ channels
- EC Ca2+ enters the cell, triggering the release of more Ca2+ from the SR

skeletal: CaV1.1, RyR1, mechanical coupling (1:1)
cardiac: CaV1.2, RyR2, Ca2+ coupling (1:many)

83
Q

Blood flow through the heart

A
  1. Blood flows from the body into the right atrium via the superior and inferior vena cavae.
  2. Passes through the tricuspid valve into the right ventricle.
  3. Pumps through the pulmonary valve into the pulmonary arteries to the lungs.
  4. Oxygenated blood returns to the left atrium via the pulmonary veins.
  5. Flows through the mitral valve into the left ventricle.
  6. Ejected through the aortic valve into the aorta and then to the body.
84
Q

Cardiac cycle phases for the left ventricle

A
  1. Ventricular filling: blood flows from atrium into ventricle, low pressure
  2. Isovolumetric contraction: mitral valve closes, pressure rises
  3. Ventricular ejection: aortic valve opens, blood moves out of LV
  4. Isovolumetric relaxation: aortic valve closes, LV relaxes, LA fills
85
Q

Define cardiac output, stroke volume, HR, and work.

A

CO = stroke volume * HR

SV: amount of blood ejected by the ventricle during contraction

HR: bpm

work: P*V

86
Q

What is the Windkessel concept?

A

elasticity of aorta contributes to near-continuous flow in capillaries (even during diastole)

87
Q

Differences between L and R Ventricle?

A

LV: thicker wall to generate higher pressure

RV: thinner walls; lower pressure

volume stays constant

88
Q

How is cardiac muscle contractibility regulated?

A

intrinsic:
- Frank-Starling relationship: increase force based on length of fibers (increased Ca2+ sensitivity)
- Force-frequency relationship: increase force with increased HR

extrinsic:
- positive inotropic agents: alter intracellular Ca2+ levels increases
ex) increase EC [Ca2+], decrease EC [Na+], increase HR
- negative inotropic agents: block Ca2+ channels

89
Q

Why is MAP essential?

A

ensures every organ has required access to blood flow
- if high enough, flow for each organ can be adjusted by local vascular resistanceHo

90
Q

How is MAP controlled?

A

Baroreceptor reflex
1. coordinating center: medulla
2. command signal: efferent pathways
3. effector: heart and vessels (bradycardia, vasodilation)
4. detector: baroreceptors
5. feedback: afferent pathways

91
Q

Steps of baroreceptors to autonomic control of BP

A
  1. baroreceptors located in cartoid sinus and aortic arch get stretched by increase in BP, leading to increased firing of APs
  2. signal received by medulla
  3. effectors:
    - parasympathetic postganglionic neurons: heart releases ACh in SA/AV nodes, bradycardia; vessels release ACh, vasodilation
    -sympathetic postganglionic neurons (response to decrease in BP): heart releases norepinephrine–> tachycardia + Ca2+ release increase; vessels also release nor, vasoconstriction
92
Q

General difference between Parasympathetic/Sympathetic Effectors

A

Parasympathetic activity causes
bradycardia, vasodilation, and
decreases MAP

Sympathetic activity causes tachycardia, greater contractility,
vasoconstriction, and increases MAP