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Physiology I Block 4 > Muscle Blood Flow > Flashcards

Muscle Blood Flow Flashcards

1
Q

what controls skeletal muscle blood flow

A

local regulation - its more powerful than sympathetic stimulation

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2
Q

sympathetic nerves release NE at what receptors to cause vasoconstriction

A

alpha

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3
Q

only place there are beta 2 receptors on blood vessels is:

A

skeletal muscles

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4
Q

what does EPI do to skeletal muscle

A

vasodilation or lesser effect of NE

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5
Q

EPI does cause vasodilation in

A

skeletal muscles

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6
Q

at onset of exercise, signals are transmitted to:

A

Skeletal muscles to cause contraction and to

VMC to increase sympathetic discharge.

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7
Q

you have increased sympathetic discharge before exercise because

A

your VMC will start to increase the sympathetic discharge

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8
Q

VMC increase in sympathetic discharge is important before exercise b/c

A

you’ve created pressure head to push the blood through tissues

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9
Q

increase in smpathetic discharge causes

A

heart stimulation
arterioles of peripheral circulation contracted except for exercixing muscles, brain, and coronary ciruclation
veins constricted to increase venous return

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10
Q

arterioles of peripheral circulation will contract in response to sympathetic discharge, except:

A

muscles
brain
coronary circulation

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11
Q

if veins dont decrease their compliance, what happens during exercise

A

CO cannot increase enough to meet needs of body

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12
Q

how much pressure changes depends on

A

what type of exercise you do

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13
Q

type of pressure change regarding diastolic and systolic has to do with

A

type of exercise

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14
Q

exercise under tense condition using only a few muscles does what to arterial pressure

A

large increase in arterial pressure - non-working muscles are constricted

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15
Q

bench press or curls, what happens

A

blodo vessels to legs are constricted, blood vessels of exercising muscles dilated

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16
Q

whole body exercises, like dancing, what happens to blood pressure compared to say, doing curls

A

BP will not go up as much b/c all the muscles are vasodilated

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17
Q

what happens to BP in whole body exercise

A

systolic higher
diastolic lower
b/c all the vessels are open

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18
Q

the more muscles you’re using what happens to rpessure

A

more muscles you use, the smaller the increase in pressure

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19
Q

flow = ?

A

change in pressure/resistance

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20
Q

Q =

A

DeltaP/R

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21
Q

if venous return doesn’t increase during exercise, what is the highest cardiac output you can achieve

A

see graphical analysis pg 7

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22
Q

during exercise w/ sympathetic stimulation, what do you see happen to splanchnic, renal, and skin blood vessels during exercise

A

they constrict

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23
Q

what happens to brain and coronary blood vessels during exercise

A

not much change

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24
Q

what happens to non exercising muscle vessels during exercise

A

constriction, but not as much as in splanchnic, renal, and skin

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25
Q

why do exercising muscles dilate when there is sympathetic stimluation throughout the whole body?

A

they release their local dilators, which overcome the effect of sympathetic stimulation

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26
Q

skeletal muscles - sympathetic muscles do what to them

A

constrict

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27
Q

if exercising muscles are working, what will happen

A

local dilators will overcome the sympathetic stimulation

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28
Q

the only muscles dilated in exercise are

A

the ones that are working

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29
Q

the more muscles you have working the less

A

constriction you have of blood vessels

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30
Q

what does venous return have to do when you have more exercising muscles

A

has to increase

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31
Q

skeletal muscles have what receptors

A

alpha and beta

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32
Q

skeletal muscles have alpha and beta receptors, so what is effect of sympathetic stimulation

A

almost negilible b/c they will counteract each other

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33
Q

right and left coronary arteries exit

A

at root of aorta

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34
Q

above valve of aorta

A

coronary arteries come off of

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35
Q

look at coronary arteries on pg 9

A

pg 9

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36
Q

noneo fthe heart gets blood from

A

blood in the chamber

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37
Q

there is oxygenated blood in left chamber, will it go to heart

A

no

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38
Q

where does heart get oxygenated blood

A

the coronary system

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39
Q

when your heart beats faster it needs

A

more blood

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40
Q

blood flow through the heart is

A

phasic

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41
Q

during systole, blood flow in heart

A

decreases

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42
Q

during diastole, blood flow in heart

A

increases

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43
Q

when heart is contracting,why does blood flow decrease

A

it is contracting so pressure is high

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44
Q

right side of heart will not see the kind of phasic change on left side of heart, why

A

because left side of heart is under mich higher pressure

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45
Q

what is major driving force of blood flow through heart

A

pressure during diastole

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46
Q

anything that decreases diastolic blood pressure will do what to coronary blood flow

A

decrease coronary blood flow

47
Q

what condition might decrease coronary blood flow

A

aortic regurgitation

anything that decreases diastole

48
Q

there is still some coronary blood flow through systole, but if you have aortic stenosis, what happens to coronary blood flow

A

might go to zero b/c the pressure would be higher ( i think?)

49
Q

when heart contracts it contracts from ____ to ___

A

inside out

50
Q

endocardial areas in heart have to have

A

extra vessels to bring blood back to heart

51
Q

control of coronary blood flow is almost the same as

A

skeletal muscle

52
Q

what is driving force for coronary blood flow

A

local metabolism

53
Q

adenosine at level of heart is

A

most important vasodilator - increases blood flow to heart

54
Q

does nervous control to heart affect blood vessels themselves

A

no

55
Q

why does nervous system change bloodf low to heart

A

b/c they increase metabolism - they have indirect effect

56
Q

what kind of effect does nervous system have on blood flow to heart

A

indirect

57
Q

most common cause of death in western culture

A

ischemic heart disease

58
Q

ischemia means

A

decrease in blood flow

59
Q

acute coronary occlusion can lead to

A

MI

60
Q

if areas of heart are ischemic or hypoxic, the resting membrane potential of cells or way AP

A

it changes

61
Q

anythign that changes electircal activity of local area of heart can lead to things like

A

V fib

62
Q

heart that is hypertrophying, and pt has ischemic heart disease, what is happening

A

making muscle bigger and decreasing blood flow to it which weakens heart

63
Q

number one cause of ixchemic heart disease is

A

Atherosclerosis

64
Q

Atherosclerosis what is it

A

lots of cholesterol deposit, get foam cells b/c of macrophages, causes fibrous plaque that gets calcified, ad it can grow and either protrude into vessel lumen and block blood flow or

65
Q

in Atherosclerosis what is ultimate thign that happens

A

vesel narrows

66
Q

when pt has Atherosclerosis what happens if body wants to vasodilate

A

not going to happen, it is rigid

67
Q

Atherosclerosis plaque can cause local blood clot called

A

thrombus

68
Q

thrombus does what

A

occludes artery

69
Q

if thrombus breaks off it can cause

A

coronary embolus

70
Q

in individuals with blockage or coronary artery thrombus or embolus, the degree of what will determine damage

A

extent of collateral circulation

71
Q

the more collateral circulation you have, then what happens with MI

A

there will be less damage the more collateral circulation you have

72
Q

Myocardial infarction is:

A

area of muscle that has zero or so little flow it cannot sustain function

73
Q

where do MI usually happen

A

subendocardial region

74
Q

what happens in subendocardial infarction

A

High oxygen consumption

Decrease blood flow due to muscle compression

75
Q

you can decrease blood flow to areas of heart and the cells will remain alive, why?

A

pg 19

76
Q

what are 4 causes of death after acute coronary occlusion

A
  1. Decreased cardiac output
  2. Damming of blood in the pulmonary blood vessels and then death resulting from pulmonary edema
  3. Fibrillation of the heart
  4. Rupture of the heart
77
Q

what is systolic stretch

A

if ventricular area of heart is dmaged, it can’t contract, so when left ventricle contracts, it is pushed out int he systolic stretch area, b/c that area can’t contract

78
Q

what does systolic stretch do to blood ejection

A

decreases, b/c it is going to the systolic stretch area

79
Q

cardiac shock, what is it

A

Cardiogenic shock is a condition in which your heart suddenly can’t pump enough blood to meet your body’s needs. The condition is most often caused by a severe heart attack.

80
Q

when does cardiac shock usually occur

A

> 40% LV infarction

81
Q

strong sympathetic stimulation can cause

A

fribrillation

82
Q

rupture of infarcted area

A

over time heart gets replaced with fribrous tissue and can rupture

83
Q

dead heart cells are not

A

replaced by new heart cells

84
Q

heart cells do not

A

proliferate

85
Q

stages of recovery from acute myocardial infarction

A

replacement of dead muscle by scar tissue

hypertrophy of undamaged areas

86
Q

why is rest important after MI

A

don’t want to increase workload on heart
even though you may have good collateral circulationin heart, most times the collateral circulation can’t dilate

don’t want coronary steal syndrome

87
Q

if you increase workload on heart, what happens

A

blood gets diverted away from collaterol circulation and you get coronary steal syndrome

88
Q

what is coronary steal syndrome

A

blood is stolen from one area of heart to another

89
Q

over time what happens after MI

A

reduced cardiac reserve

90
Q

what does reduced cardiac reserve mean

A

the cardiac output curve is decreased, because of the damaged tissue

91
Q

a person after MI, what happens to cardiac output at rest and exercise

A

at rest their CO might be fine, but say ,in exercise, their CO can’t be increased enough

92
Q

cardiac shock is likely to cause

A

death

93
Q

function of heart after MI, it depends on

A

how much damage was caused

94
Q

what will you see on ventricular function curve after MI

A

rightward shifts

95
Q

compared to normal heart, what happens to CO in a heart after MI

A

there will always be decrease

96
Q

what is angina pectoris

A

cardiac pain

97
Q

when coronary blood flow can’t keep up with heart activity you can feel

A

pain

98
Q

heart pain is caled

A

angina

99
Q

heart pain is due to release of

A

acidic substances - lactic acid, histamin, kinins (like bradykinin)

100
Q

why do you feel heart pain due to acidic substances

A

the acidic substances build up and go to pain receptors and cause pain

101
Q

treatment for angina

A

vasodilator drugs

102
Q

nitroglycerin and other nitrate drugs release

A

NO

103
Q

NO stands for

A

nitric oxide

104
Q

nitroglycerin is a

A

vasodilator

105
Q

ACE inihbitors are

A

vasodilators

106
Q

AII receptor blockers are

A

vasodilators

107
Q

calcium channel blockers are

A

vasodilators

108
Q

beta blockers are

A

vasodilators

109
Q

ranolazine, how does it work

A

Inhibits inward sodium current in heart muscle
Decreases wall tension and oxygen requirements
Inhibits IKr and causes slight QT prolongation

110
Q

do the vasodilator drugs for angina cure the pain?

A

no - they are just symptomatic

111
Q

how do you fix coronary occlusion? what are the 2surgical treatments for coronary artery disease

A

CABG

angioplasty

112
Q

what does CABG stand for

A

coronary artery bypass graft

113
Q

how does sCABG work

A

take vein and make it into artery

114
Q

how does angioplasty work

A

string in catheter with balloon and stent and inflate the balloon into open up the artery and put stent into artery to keep it open and then remove the balloon and leave the stent in

Physiology I Block 4 (13 decks)

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