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HES 111 > Midterm I stuff > Flashcards

Midterm I stuff Flashcards

1
Q

what compartments recieve blood from veins

A

atria

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2
Q

what part of heart ejects blood into arteries

A

ventricles

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3
Q

What are the major systemic veins?

A

sup and inf vena cava

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4
Q

why are ventricles larger w thicker walls

A

because they are stronger pumps

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5
Q

wharts the major systemic artery

A

aorta

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6
Q

major vessels of pulm circuit?

A

r and L pulm arteries and veins

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7
Q

which atria is larger

A

the right is larger, thinner, more anterior

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8
Q

What are right and left ventricles seperated by?

A

interventricular septum

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9
Q

what are the valves between the atria and ventricles

A

Atrioventicular valves (AV valves)
Tricuspid - on right side
Bicuspid/mitral - on left side

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10
Q

What are the valves between ventricles and pulmonary arteries

A

Semilunar valves (Also tricuspid)
- Pulmonary valves - between r ventricle and pulm trunk
- aortic valve: between left ventricle and aorta

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11
Q

what is the purpose of valves

A

keep blood flowing in one direction

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12
Q

Blood flows in response to - —- gradients

A

pressure

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13
Q

what happens when pressure in ventricle is high (greater than aorta or atrium)

A

Pushes aortic valve open, if greater than atrium closes atrioventricular valves (tricuspid or biscupid(mitral)

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14
Q

what happens when pressure in aorta is greater than ventricle

A

closes aortic semilunar valve

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15
Q

what happens if pressure in the atrium is greater than ventricle

A

Opens AV valves

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16
Q

Describe the steps of blood flow thru the heart

A

1) blood in systemic capillaries delivers oxygen to body
2) systemic veins bring deoexygentaed blood back to right atrium
3) Blood passes to right ventricle thru tricuspid valve
4) then thru pulmonary valve to pulmonary veins (pulmonary trunk)
5) to pulmonary capillaries in lungs where blood becomes oxygenated
6) pulm veins returns oxygenated blood to left atrium
7) blood goes from left atrium thru bicuspid (mitral valve) to left ventricle
8) left ventricle pumps thru aortic valve to aorta
9 ) aorta delivers blood to systemic capillaries and body

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17
Q

what are the two types of cells in the myocardium

A

myocytes - majority (99%)
pacemaker cells - 1%

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18
Q

what is the source of force production of the heart muscle?

A

myocytes

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19
Q

what generates spontaneous, rythmic action potentials

A

pacemaker cells

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20
Q

do pacemaker cells contribute to the contractile force of the heart

A

no - just a signal for myocyte contraction

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21
Q

what joins myocytes together?

A

intercalated discs

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22
Q

what connects pacemaker cells to contractile cells?

A

Intercalated discs

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23
Q

what are intercalated discs made of?

A

Desmosomes: hold the cells together
Gap junctions; allow ions to pass rapidly form one call to another

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24
Q

What are the steps of the cardiac conduction system?

A

1) SA node generates AP potentaial which spreads to atrial cells and AV node
2) after AV node delay, AP goes to AV bundle and then to right and left bundle branches
3) ap spreads from bundle branches along purkinje fibers to contractile cells of ventricles

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25
Q

What is the purpose of the delayed conduction thru the AV node?

A

Allows atria to fully depolarize (and contract) before the ventricles, giving ventricles time to fill up w blood.

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26
Q

steps of pacemaker action potentails

A

1) Slow initial depol phase: HCN channels open in response to membrane hyperpolarization –> this leads to more Na+ in then K+ out leads to depolarization to threshold

2) Full depol Phase: Ca2+ via ca channels leads to depol phase

3) Repol phase: K+ out via K+ channels, repolarization

4) Min potential phase: HCN open again in resp to hyperpol from K+ flowing out and cycle repeats

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27
Q

What inititiates the HCN channels to open in pacemaker action potentials

A

during the final phase K+ flow out and hyperpolarize opening HCN channels

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28
Q

Action potentials are transmitted from ___ to ___ through _____

A

from pacemaker cells to myocytes thru gap junctions

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29
Q

what are the steps of myocyte action potentials

A

1) rapid depolarization phase: Na+ rushes into cell via Na+ channels

2) initial repolarization phase: Na+ channels close, K+ open, K+ leaves causing some repolarization
3) plateau phase: Ca2+ comes, via opening og ca channels, in while K+ is going out, causing balance:
- Lengthens AP to 200-300: Keeps HR slow enough to allow time for heart to fill w blood before next contraction
4) Repolarization phase: Na+ and Ca2+ channels closee as K+ continue to exit = repol

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30
Q

What does the plateau phase allow for in myocyte action potentials?

A

allows enough time for the heart to fill w blood before the next contraction and prevents tetanus (another AP)

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31
Q

what does chronotropic mean?

A

Heart rate

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32
Q

Does the parasmpathetic ns have a positive or negative chronotopic effect?

A

negative

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33
Q

Does sympathetic nervous system have a positive or negative chronotropic effect

A

positive

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34
Q

does contraction and relaxation of the myocytes need to be in perfect synchrony?

A

Yes. and facilitate filling and blood flow from atria ventricles, and then out via the aorta or
pulmonary arteries

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35
Q

what is preload?

A

The amount of stretch of the sarcomeres in the ventricular muscle cells (myocytes). Before contraction

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36
Q

What is the perfect sequency an synchrony a result of? (3 reasons)

A

1) delay at av node
2) gap unction allow eletrical signal to spread quick thru myocytes
3) orientation of myocytes

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37
Q

How does increased preload affect blood pressure?

A

Increase in preload increases edv –>incr SV, Incr CO, Incr blood pressure

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38
Q

where are the electodes on a 3 lead ecg

A

RIght arm (-, -) , left arm( +, -), left leg (+, +)

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39
Q

What are the 3 diffferent waves of the ECG and what does each represent

A

P wave - atrial depolarization
QRS complex - Ventricular depolarization (masking atrial repol)
T wave - Ventricular repolarization

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40
Q

What does the R-R interval represent on an ECG

A

duration of cardiac cycle

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41
Q

what does P-Q represent

A

duration of atrial repol and AV node delay

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42
Q

What does Q-T interval represent?

A

entire duration of ventricular action potential

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43
Q

what does the s-t segment represent

A

ventricular plateau phase

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44
Q

The cardiac cycle describes not electrical events but ____ events of the heart

A

mechanical

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45
Q

what rep contraction what rep relaxation of heart

A

contraction - systole
relaxation- diastole

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46
Q

Do atrial and ventricular systoles and diastoles occur at same or different times why?

A

The occur at different times due to the AV node delay.

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47
Q

Do both sides of the heart work at different times or simulataneosly

A

simulataneosly

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48
Q

what are the 4 main phases of the cardiac cycle

A

filling, contraction, ejection, relaxation

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49
Q

What horomone binds inside a cell and why?

A

Lipid based/steroid molecules because they are hydrophobic therefore can pass thru membrane

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50
Q

if BP drops below normal range waht happens in terms of symp ns

A

Increased activity of sup ns

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51
Q

What happens during the ventricular filling phase?

A

Blood flows down the pressure gradient from atria to ventricles.
Atria in systole
Ventricles in diastole
AV valves open
semilunar valves are closed

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52
Q

Isovolumetric contraction Phase

A

ventricular systole
atrial diastole
all valves closed

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53
Q

what the state of the atria and ventricles during ventricular ejection. Which valves open and closed. FLow of blood?

A

ventricles in systole
atria in diastole
AV valves closed
SL valves open
Blood is ejected into pulm artery and aorta

54
Q

What is end diastolic volume?

A

total amount of blood in ventricles at the end of ventricular diastole

55
Q

At rest how much blood is pumped into each ventricle

A

70ml

56
Q

what is end systolic volume? How much is it at rest

A

the amount of blood remaining in ventricle at the end of ventricular ejection
at rest about 50ml

57
Q

what the state of the atria and ventricles during isovolumetric Relaxation:. Which valves open and closed. FLow of blood?

A

ventricles in diastole
atria in diastole
all valves closes
blood is not being ejected or enter - remains constant

58
Q

what is stroke volume?

A

Volume of blood ejected out of left ventricle in one heart beat

59
Q

what is cardiac output

A

volume of blood pumped out of left ventricle in one minute (L/min)

60
Q

What is venous return>

A

volume of blood returning to heart in one min

61
Q

whats the formula for SV? Resting is?

A

EDV-ESV. 70mL

62
Q

What is formula for CO? whats resting?

A

SV x HR - 70x70 = 4900ml (around 5 L)

63
Q

What are the 3 main factors that affect stroke volume?

A

Preload, contractility, afterload

64
Q

What is preload?

A

amount of stretch of sarcomeres in ventricular myocytes before contraction - det by EDV

65
Q

How does preload affect SV? 2 factors that influence edv?

A

Higher preload = Higher volume of blood in ventricle (EDV) = more stetch on ventricle myocytes and more potential for actin-myosin overlap e
1) length of time ventricle spends in diastole
2) amount of bood returning to heart from systemic circuit (venous return)

66
Q

How does contractility increase SV?

A
  • Greater force of contraction = more blood ejected = lower ESV = greater SV
67
Q

what are inotropic agents?

A

agents that affect contractility

68
Q

What is afterload?

A

the force ventricle must overcome in order to eject blood into arteries

69
Q

How does afterload increase SV?

A

Lower afterload = ventricle pumping against lower resisistane = lower ESV

70
Q

What happens to the three factors that affect stroke volume when stroke volume decrease?

A

low preload (muscle cells less stretched) , low contractility (heart contracts more weakly), high afterload (ventricle pumping against a higher resistance)

71
Q

What are chronotropic agents?

A

Factors that influence HR

72
Q

Under normal conditions what determines HR?

A

The rate at which SA node generates AP

73
Q

What is a positive chronotropic agent? what does it include?

A

ANything that increases rate at which SA node fires (incr HR)
includes sympathetic nervous system, horomones, elevated body temp

74
Q

What is a negative chronotropic agent? and examples

A

Anything that decrease the rate of SA nod firing
included parasympathetic nervous system and decreased body temp

75
Q

How does sympathetic NS reg Cardiac output

A

Epinephrine and norepinephrin incr HR and contractility of myocytes which increases SV and HR. positive chronotropic and Inotropic effect.

76
Q

How does parasympathetic NS regulate CO?

A

Acetylcholine targets SA node and decreases HR
- Negative chronotropic effectf

77
Q

what are presuure resevoirs

A

arteries

78
Q

what are volume resevoirs

A

veins

79
Q

What is the site of variable resistance

A

the arterioles

80
Q

are there more arteries or veins

A

veins

81
Q

what holds more blood, arteries or veins?

A

veins hold much more blood than arteries (70%)

82
Q

what are the wall layers of arteries and veins from innermost to outermost

A

innermost - tunica intima
middle - tunica media
outer - tunica externa

83
Q

what layer of the arteries and veins contains smooth muscle?

A

tunica media

84
Q

what does contraction of the arteries or veins lead to vs relaxation?

A

contraction –> vasoconstiction –> decreased diametre

Relaxation –> vasodilation —> increases diameter

85
Q

veins have ____ wals, ____ elastic fibres, ____ smooth muslcle and ____ lumen

Most arteries have much thicker _______ (wall) and more ___ laminae (due tonhigher bp the ssee)

A

VEINS = thinner walls, less elastic fibres, less smooth muscle, larger lumen

Most arteries have much thocker tunica media more internal and external elastic laminae.

86
Q

Whats a main role of tunica media

A

controlling blood flow and blood pressure

87
Q

what is the fucntion of elastic arteries? primarily made up of?

A

Condict blood under high pressure to organs. Elastic laminae.

88
Q

what type of arteries are pulmonary arteries

A

elastic

89
Q

what arteries reg bP and control blood flow to organs?

A

muscular arteries

90
Q

wha tunics are arterioles made of?

A

all 3

91
Q

what is the main function of arterioles?

A

control blood to tissues, feed capillaries

92
Q

Main fucntion of venules?

A

drain capillary beds

93
Q

main function of veins

A

return blood to heart

94
Q

what is blood flow thru capillary bed based on?

A

tissue needs - skel msucles need more o2 more capillary beds

95
Q

what is blood flow thru tissues regulate dby?

A

1) opening/closing of precapillary sphincters
2) vasoconstriciton/dilation of arterioles

96
Q

What is the equation for blood flow?

A

Blod pressure gradient (deltap)/resistance

  • bp gradient creates the blood flow
  • the total resistance is the impedence to blood flow
97
Q

what is the current (I) equation

A

= voltage gradient (delta v) (delta v)/ Resistance

98
Q

What is the main determinant of flow rate of blood?

A

pressure gradient

99
Q

What is blood pressure?

A

outward force that the blood exerts on the walls of blood vessels (mmHg)

100
Q

What are the three things resistance is determined by?

A

Vessel radius, length, viscocity

101
Q

What is the velocity of blood flow equation?

A

1 / cross sectional area

102
Q

Total cross sectional area increase as artries bracnh into…

A

smaller vessels

103
Q

As total cross sectional area increase what happens to velcocity

A

velocity slows down

104
Q

where is blood velcocity slowest? why?

A

in capillaries, to allow more time for effective gas and nutrient exchange

105
Q

What is systolic pressure - at rest?

A

pressure of blood against artery wall during systole (120mmHg)

106
Q

what is Diastolic pressure - at rest?

A

the pressure of blood against the artery walls during diastole - 80mmHg

107
Q

what is the pulse pressure?

A

difference betwee systolic and diastolic BP - Sp-Dp - 120-80 = 40

108
Q

What dos systemic arterial bp represent?

A

the driving pressure of blood thru arteries -MAP

109
Q

what is the MAP equation

A

MAP = diastolic pressure + 1/3 (systolic pressure – diastolic pressure)

110
Q

when is pulse pressure gone on the graph? what does the black line mean?

A

when it reaches the arterioles – cap – venules – to veins– venacavae

black line is MAP

111
Q

What are the three factors that determine BP?

A

Peripheral resistance, CO, blood volume

112
Q

as peripheral resistance increase what happens to BP?

A

also increases

113
Q

what are the three things that impact peripheral resistance?

A

Blood viscocity - more viscous more molecule resistance to motion - blood has high viscocity bc of protein and cells

Blood vessel length - longer blood vessel = gerater Resistance = more pressure to propela long long vessel

Blood vessel radius - as radius increases resitance decreases, so inverse

114
Q

How does hight blood viscocity impact BP?

A

more viscous= more resistance to motion = more peripheral resistance = higher BP

115
Q

what is a reason that resistance in pulm circuit is less than systemic

A

Blood vessels are longer in systemic so reseitance is grater

116
Q

How does cardiac output impact BP

A

Increase in cardiac output leads to increase in BP

117
Q

How does blood volume imapct BP?

A

when blood contains more water, volume invrease, increase in blood volume means increase in pressure therfore increase in BP

118
Q

which circiuit does pressure remain relatively low and stable?

A

pulmonary

119
Q

in systemic circuit whre is the highest pressure? where is the lowest

A

highest is arteries than arterioles, lowest is venules and veins

120
Q

where does MAP decrease rapidly

A

arterioles

121
Q

2 mechanisms of venous return

A

valves - ensure one way flow
Skeletal muscle pump - skel muscle squeeze deeper veins to propel to heart (vasoconstirciton)

122
Q

What three systems is BP under regualtion by?

A

nervous, endocrine and urinary

123
Q

where is short term maintenance of BP? where is long term maintenance? what sytems?

A

Short term - nervous ssystem - ANS. - periph resistance and CO ( think HR and SV) - Norepinephrine and epinephrin

Long term - kdineys and endocrine sytem
- increases the water lost as urine changinging blood volume
horomones act on kdiney to manage fluid retention eg ADH

124
Q

give an example of how the endocrine system plays a role in the cardiovascular.

A

Endocrine releases ADH (anti-diuretic horomone) which alter fluid retention in the kidney therfore changinf blood volume and impacting blood pressure.

125
Q

How does Nervous system impact HR?

A

symp neurons release epinephrine and norepinephrine which increase HR and contractility and therfore cardiac output -

also cause vasocontriviton of arteriooles which increases perip resistance

126
Q

Which ssytem in the ANS decreases bp and why?

A

Parasympthetic decrease heart rate decreaseing CO and therefore blood pressure

127
Q

what are baroreceptors?

A

specialized mechanoreceptors found in walls of aortic arch and common carotid artery which respond to stretch in the artery wall

128
Q

where are baroreceptors found?

A

aortic arch and common carotid artery

129
Q

what is the baroreceptor reflex (in terms of increase in Bp)

A

Increased BP –> increased wall stretch –> increaseed firing of AP via cranial nerves of sns –> to medulla for integration –> output to lower bp

130
Q
A

HES 111 (3 decks)

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