midterm Flashcards
1
Q
explain the atrial stretch reflex
A
- increase blood volume
- increase venous return
- increase atrial pressure (filling)
- stretching baroreceptor of atrial wall
- increase signal firing to medullary control center
- inhibition of SNS
- result in renal vasodilatation, decrease BP (decrease vassopression and increase ANP), increase HR
2
Q
result of atrial stretch reflex
A
result in renal vasodilatation, decrease BP (decrease vassopression and increase ANP), increase HR
3
Q
blood velocity increase or decrease with a higher cross-sectional area
A
decrease
4
Q
which blood vessel as the higher velocity and slowest velocity
A
H: aorta
L: capillaries
5
Q
blood flow become slower or faster the further away of the heart and why
A
slower to aid in O2 exchange, allow the O2 to have time to go out of the blood and reach cells
6
Q
in laminar flow, the greatest velocity is found where and why
A
in the center of the vessel because there’s less resistance in the center
7
Q
in laminar flow, the lowest velocity is found where and why
A
along the vessel wall, because there’s higher resistance along the vessel wall
8
Q
in turbulent flow, the greater the cross-sectional area, the _ the velocity
A
lower
9
Q
in turbulent flow, the greater the blood flow, the _ the velocity
A
greater
10
Q
what is laminar flow
A
linear velocity
less amount of friction, highest velocity is found in the center
11
Q
if the Reynold number is lower than 2100 which type of flow do we have
A
laminar
12
Q
what is turbulent flow
A
happen if vessel is block by at theroscleritic plaque
13
Q
if the Reynold number is higher that 4000 which type of flow do I have
A
continuous turbulent
14
Q
in anemia you have which type of blood flow and explain
A
Low hemtocrit = blood less viscous = reynaud number increase = increase CO = turbulent flow
15
Q
in thrombus which type of blood flow do we have and explain
A
Decrease diameter = reynaud number increase = turbulent
16
Q
if velocity increase, Reynaud number increase or decrease
A
increase
17
Q
if density increase, Reynold number increase or decrease
A
increase
18
Q
if viscosity decrease, Reynold number increase or decrease
A
increase
19
Q
if Reynold number is between 2100 and 4000 which type of flow do we have
A
transient turbulence
20
Q
what is cardiac contractibility
A
Instrinsic ability of the myocardium to pump in the absence of change in preload and afterload
21
Q
cardiac contractibility is altered by and which part of
cns has the more important effect
A
- Can be altered by: neural, humoral or pharmacological influence
- SNS has MOST importance effect
22
Q
factor influence vascular resistance
A
viscosity -> proportional to resistance
blood vessel length -> longer vessel have more resistance than shorter vessel
blood vessel radius -> narrower = more resistance
23
Q
what happen with blood flow if resistance increase
A
decrease
24
Q
what happen with blood in vasoconstriction
A
decrease vessel radius -> increase resistance = decrease blood flow
25
what happen with blood flow and resistance in anemia
ischemia reduce red blood cell = decrease blood viscosity = decrease resistance = increase blood flow
26
what happen if a blood clot or blockage develop in artery
decrease artery radius = increase resistance = decrease blood flow
27
role of RBC in blood velocity
increase in RBC result in increase viscosity of blood = reduce blood velocity
28
what happen with blood velocity with polycythemia
increase in RBC = increase viscosity = increase resistance = decrease blood velocity = decrease blood flow
-> increase BP
29
what happen with blood viscosity in anemia
decrease RBC = decrease viscosity = increase velocity
30
factor influencing blood velocity
hematocrit
plasma protein
diameter of blood vessel
temperature;
31
determinant of blood pressure
total peripheral resistance
CO
blood viscosity
blood volume
32
what happen in blood viscosity if plasma protein decrease
decrease
33
result of hypoabulminaena
decrease albumin
decrease resistance
increase blood flow
decrease BP (immediate response) but at the end = unchanged
turbulent flow
34
physiological effect of anemia
increase CO
increase HR
increase contractility (active)
decrease systemic venous return (passive)
increase venous return (passive)
35
effect on anemia on circulation
decrease blood viscosity = decrease in resistance (added tissue hypoxia-vasodilation) = increase in CO = increased pumping workload on the heart
decrease viscosity -> decrease peripheral resistance -> increase blood flow -> increase venous return -> increase CO -> increase HR
36
what happen with plasma volume in dehydration
decrease
37
physiological effect of dehydration - hypovolemia
decrease plasma volume -> increase hematocrit and decrease mean circulation filling pressure -> increase blood viscosity and decrease venous return -> decrease cardiac output -> decrease VO2 max (decrease O2 delivery to tissue) -> increase SVR
38
abnormal thermoregulation of dehydration
decrease skin blood flow, decrease sweat rate, increase core temperature
39
what happen physiologically with chronic lung disease
lung impairment -> hypoxia -> low blood O2 -> stimulation of liver and kidney -> erythropoietin release in bloodstream -> stimulation of red bone marrow -> increase red blood cell -> increase O2 carrying capacity
arterial hypoxia -> increase erythropoietin -> increase RBC -> increase blood capacity -> increase blood viscosity -> decompensated erythrocytosis -> poor o2 delivery to muscle-> increase fatigue
40
explain blood dooping procedure
1. athlete donate blood
2. blood is centrifuge
3. red blood cell are force to the bottom
4. liquid part of the blood is draw off the tube and reinfected in athlete
5. RBC is stored (or frozen)
6. a day before competition, RBC are re-injected in the athlete -> blood can carry more O2 = more endurance
41
blood dooping advantage and disadvantage
increase O2 level in blood
increase energy availability
risk of bacterial infection
sharing needle increase risk of hepatitis and HIV
blood clot, stroke, heart failure
42
what is EPO
an hormone produced in kidney that stimulate bone marrow to produce extra RBC -> artificial EPO can't be differentiate from natural EPO
43
proven effect of blood doping
increase max oxygen uptake
increase time to exhaustion
increase performance in endurance event
44
risk of blood doping
increase blood viscosity
blood clotting
heart failure
blood matching error
hepatitis
HIV
45
what is the difference between the 2 blood doping technique
EPO go to long bone and stimulate RBC production
46
explain the 4 phase of valsava maneuver
1. onset of strain
- increase intrathoracic pressure
- increase SBP
- decrease coronary artery blood flow
2. continued strain
- decrease SBP
- increase HR
3. release of strain
- decrease intrathoracic pressure
- decrease SBP
4. recovery
- increase SBP
- decrease HR
47
physiological response of valsava maneuver
expire against closed glottis -> increase intrathoracic P -> decrease venous return -> decrease cardiac output -> increase SNS, decrease PNS = increase HR
48
what happen when valsava is stop
Role of PNS in valsava: increase BP -> increase depolarization of carotid and aortic baroreceptor -> increase stimulation to vagus and glossopharyingeal -> increase PNS -> decrease HR
49
role of SNS in valsava
Role of SNS in valsava : Decrease BP -> decrease depolarization of carotid aortic receptor -> decrease signal to NTS -> increase SNS -> increase HR
50
why people can pass out from valsava
if vagus nerve is too munch stimulate = pass out
to munch alteration in BP can decrease amount of O2 to the brain
51
how munch SBP and DBP increase in cold pressor test
sBP - 20mmhg
DBP- 10
52
what happen when the body is in contact with a painful cold stimuli
cause massive discharge of the SNS and release epinephrine -> trigger arterial constriction, increase HR and increase cardiac contractility -> increase BP
53
neural pathway of CPT
cold pressor test trigger peripheral nociceptor -> stimulate hypothalamus -> stimulate RVLM in medulla oblongata -> stimlate SNS -> increase HR and stroke volume -> increase total peripheral resistance and CO -> increase arterial pressure
54
which nerve is stimulate with diving reflex
trigeminal
55
what happen with heart rate and BP during diving reflex
slow down drastically (bradycardia), vasoconstriction = increasein BP
56
three factor include in mammalian diving reflex
bradycardia, peripheral vasoconstriction, blood shift
57
explain physiology of diving reflex
1. Cold water stimulus on face
2. Depolarization of opthalmic, maxillary and madibular nerve merge into trigeminal nerve
3. Trigeminal nerve (afferent pathway) synapse in the pons (brainstem)
4. Sensory nucleus of trigeminal n send signal to vagus nerve (efferent pathway)
5. Vagus nerves decrease HR
Initial stimuli = cold to the face region
1.Receptor of the face (3 nerves) merge into trigeminal = inibithed respiratory center
2. Respiratory center inhibit respiratory muscle = apnea
3. Respiratory stimulated CV center in medulla oblongata = stimulated arteriol = vasoconstriction = redirection of blood to brain and heart
4. Medulla oblongata also inhibit para sympathetic system = decrease in HR = bradycardia = help to balance vasoconstriction and reduce energy. Consumption or heart
58
driving reflex in seal
- Increase in CO2 is the first thing happening = increase in lactic acid due to O2 consumption
- When CO2 reach about 60%, brain receive a stimulus to activate the respiratory center
- Respiratory center send a message to diaphgram to contract
- Inhale/exhale = decrease in CO2
- Vasoconstriction stop = increase in lactic acid
58
what is myocardial ischemia
relative reduction in blood flow in coronary artery of the heart
Increase plaque in coronary artery = increase arterial resistance = decrease blood flow
O2 demand > O2 supply
59
what is angina and symptom
cause from insufficient blood flow to heart due to narrowing of coronary artery
Symptom: chest pain/pressure dull or sharp, shortness of breath. Sweating, feeling weak,nause
60
when does symptom occurs in angina
Symptom occur following physical exertion, heavy meal, cold weather of emotional stress -> because body need more blood and oxygen than when at rest, so heart need to pump harder to meet the demand = people will have chest pain -> pain go away at rest
Sometime pain occurs at rest
61
what is referred pain
- Due to synapsing of visceral and somatic sensory neuron at the same interneuron as they enter spinal cord
62
what is angina pectoris
: pain resulting from heart damage, often felt as stimulation of nociceptor in the left arm
63
what is pulmonary hypertension
Vasoconstriction = thickening of pulmonary arterial walls = increase resistance to blood flow = increase strain of the right ventricule = right ventricule enlargement
- Increase in preload and afterload = increase BP
64
what is mean pulmonary artery pressure
14
65
range of pulmonary hypertension at rest and during exercise
rest: > 25
exercise: >30
66
explain why there's exercise limitation in pulmonary hypertension
Right vascular dysfunction= afterload mismatch, right ventricule dilatation = functional tricuspid valve regurgitation
Skeletal muscle dysfuncion = decrease capillarization = decrease oxidative enzyme activity = muscle fiber hyperthrophy
67
how can exercise limitation during pulmonary hypertension can be improve
improve by drug therapy that reduce right ventricular afterload and by exercise training by increasing capillary density and oxidative enzyme activity
68
what is PAD or PVD
occlusive disease of artery of the lower extremity
69
most common cause of PAD/PVD
atherothrombosis
arthertis
aneurysm, embolism
70
pathophysiology of PVD
arterial narrowing -> decrease blood flow = pain
pain result from an imbalance between supply and demand of blood flow that fails satisfy ongoing mechanism requirement
71
if aorta or iliac artery is obstructed ischemia result in
buttock, hip, thigh
72
femoral artery result in ischemia where
thigh, calf
73
popliteal artery occlusion result in ischemia where
calf, ankle foot
74
how do we calculated ankle brachial index (ABI)
aBI= lower extremity systolic pressure / highest brachial artery systolic pressure
75
what are the range of PAD severity
normal: 0.95-1.3
mild: 0,75-0.94
moderate: 0,5-0,74
severe: <0,5
76
what is the most severe peripheral arterial disease
vascular blockade
77
why is intermittent claudication important
atherosclerosis -> restriction in blood flow -> pain in calf
atherosclerosis -> coronary disease or stroke -> heart attack -> reduced life expectancy
78
nitroglycerin action
- decrease pain of ischemia
- increase venous dilation
- decrease venous blood return to heart
- decrease preload and cardiac oxygen consumption
- dilates coronary arteries
- increase cardiac collateral flow
-> severe headache can occurs due to lack of blood flow to the brain area
79
what are the effect of calcium channel blocker
vascular smooth muscle relaxation -> vasodilatation
decrease inonotropic effect (contractility) -> decrease CO
decrease chronotropic effect -> decrease HR
decrease dromotopric effect
-> decrease in BP
80
effect of beta blocker on the heart
decrease heart rate
decrease afterload
decrease wall stress
decrease heart contractility
result in reduction of myocardial oxygen demand
81
impact of diuretic
increase NACO3 -> increase H20 secretion -> increase NA excretion -> increase NACl excretion -> increase urine production
