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Physiology I Test I > part 4 > Flashcards

part 4 Flashcards

1
Q

What will the plateua phase before repolarization do in cardiac muscle?

A

It sets limits on the number of beats per minute.

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2
Q

What is auto-rhythmicity?

A

Spontaneous action potentials (cardiac cells can spontaneously create action potentials)

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3
Q

How will cardiac muscle cells create auto-rhythmicity?

A

They have naturally leaky membranes that allow ions to move intracellularly.

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4
Q

What type of cardiac muscle cells have the fastest cycle of polariztion and repolarization?

A

SA node (sino-atrial node). Even though the action potential isn’t as fast in the depolarization phase.

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5
Q

Cardiac muscle cells are complexly covered with what? And this will lead to what?

A

Receptors. That make cells sensitive to hormones and neurotransmitters.

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6
Q

Name the 2 groups of receptors found on cardiac muscle cells?

A
  1. Adrenergic receptors 2. Cholinergic receptors
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7
Q

What is the primary type of adrenergic receptor found on cardiac muscle cells? What are these receptors sensitive to and where will this come from?

A

Beta1 receptors They are sensitive to norepinephrine released from the axons of the sympathetic fibers.

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8
Q

What wil norepinephrine do to cardiac muscle cells once it comes in contact with the beta1 receptors(from the adrenergic receptor group)?

A

Increase the excitability and strength and rate of contractions by hypo-polarizing the plasma membrane of the cell.

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9
Q

What is the major cholinergic receptor and what is it sensitive to and where will it come from?

A

Ach “muscarinic” receptors sensitive to acetylcholine. Acetylcholine is released from parasympathetic fiber axons.

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10
Q

What will acetylcholine released from parasympathetic fiber axons do to cardiac muscle cells when it contacts cholinergic receptors(from the cholinergic receptors)?

A

Decrease the excitability and strenght and rate of contraction by hyperpolarizing the membranes.

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11
Q

What are the main pumps of the heart?

A

The venticles.

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12
Q

What type of pump are the atria?

A

Priming pumps.

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13
Q

What is the valve of the heart that is between the right atrium and the right ventricle?

A

Right Atrioventricular valve aka Tricuspid.

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14
Q

What is the name of the valve between the left atrium and left ventricle?

A

Left atrioventricular valve aka mitral.

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15
Q

What are the right and left valves that leave the venticles?

A

Right and left semilunar valves Right aka pulmonic left aka aortic

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16
Q

What is the shape of the right ventricle?

A

Crescentic or “c” shaped.

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17
Q

What will the high pressure pump aka the left ventricle look like?

A

Cylindrical.

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18
Q

What are the 2 circulatory systems of blood flow?

A
  1. Systemic circulation= extensive body wide. 2. Pulmonary circulation= small and goes to lungs.
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19
Q

What are the names for the contraction and relaxation periods of the heart?

A

Contraction= systole relaxation= diastole

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20
Q

What is the cardiac cycle?

A

The full action of the heart per beat.

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21
Q

What are the 6 parts to the cardiac cycle?

A
  1. Ventricular pressure 2. Aortic pressure 3. Ventricular volume 4. Electrocardiogram 5. Phonocardiogram 6. Atrial pressure.
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22
Q

How will blood flow into the ventricles at rest?

A

75% comes from normal blood flow through the veins. 25% is done by systolic atrial contractions

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23
Q

Since only 25% of blood in ventricles comes from atrial contractions what is the purpose of the atrium?

A

Maximizes the efficiency of each ventricluar beat.

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24
Q

What is isovolumetric relaxation?

A

A very brief period of no filling of the ventricle during diastole.

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25
Q

What is rapid inflow?

A

It is 1/3 of the time of blood inflowing and filling the ventricles where 75% of the blood is passively brought in.

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26
Q

What is diastasis?

A

1/3 of the time for filling the ventricles where minimal filling happens.

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27
Q

What is the atrial systole phase?

A

1/3 of the time for filling the ventricles where the atria actively fill the last 25% of the ventricals.

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28
Q

What are the valves doing during isovolumetric contraction?

A

The valves are closed.

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29
Q

When will the isovolumetric contraction take place?

A

During the systole phase at the begining.

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30
Q

What happens after isovolumetric contractions of the systole phase?

A

Ejection of blood.

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31
Q

What is the end-diastolic volume measuring and what is the number?

A

Volume of blood in the ventricle at the end of diastolic phase. about 130ml.

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32
Q

What is end-systolic volume measuring and what is the number?

A

It measures the volume of blood in the ventricle at the end of systole about 60ml

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33
Q

What is the stroke volume measuring and what is the normal number.

A

It is the volume of blood that the heart ejected so take the end-diastolic volume and minus the end-systolic volume and we get the stroke volume normal is about 70ml.

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34
Q

What will the ejection fraction measure and what is the normal number and when will it be a problem?

A

stroke volume divided by end-diastolic volume which is a percentage of blood volume ejected and should normaly be 50% problems if it is less than 40%.

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35
Q

What part of the electrocardiogram is systole slightly preceded by?

A

QRS complex.

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36
Q

What will the QRS complex do?

A

It causes the Ventricles to contract. Then ejection happens.

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37
Q

What is the T wave?

A

The part of the electrocardiogram where the ventricle cells repolarized near the end of ejection.

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38
Q

What is a P wave?

A

A P wave causes atrial systolic filling not just blood gussing into the ventricles.

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39
Q

What happens to ventricular pressure at the onset of systole and why?

A

It skyrockets because of the imediate closure of the mitral valve.

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40
Q

What is the period of isovolumetric contraction?

A

The volume of blood will stay the same because the mitral and aortic valves are both closed and ventricular pressure increases because no blood can get out and the ventricle is contracting.

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41
Q

When will the peroid of ejection begin?

A

As the pressure inside the ventricle exceeds the pressure in the aorta then the aortic valve will open and ejection happens.

42
Q

What happens during the period of ejection?

A

The aortic and ventricular pressure both increase until they reach a peak and then they both start to drop.

43
Q

What happens when the aortic and ventricular pressures fall during the period of ejection?

A

The Ventricular pressure will fall below the aortic and this will cause the aortic valve to close.

44
Q

What happens after the aortic valve closes?

A

Isovolumetric relazation because both mitral and aortic valves are closed this allows aortic pressure to remain almost the same and ventricular pressure to fall off to zero.

45
Q

What is the ventricular pressure like during filling of the ventricle?

A

It remains at essentialy zero and rises briefly during atrial systol filling.

46
Q

What is the normal systolic pressure and what is it?

A

It is about 120 mm Hg and it is the peak aortic pressure derived from systole.

47
Q

What is diastolic pressure and what is the normal pressure?

A

It is the lowest aortic pressure found at the end of diastole and it is normaly about 80 mm Hg

48
Q

What could make the Diastolic pressure lower?

A

Lower heart rates because the aortic pressure would have more time to drop.

49
Q

What is the Dicrotic notch?

A

It is a small increase in aortic pressure due to elastic recoil following the aortic valve closure.

50
Q

What causes heart noise?

A

Valve action most likely valves closing.

51
Q

What causes S1 and S2 and what sounds will they make?

A

S1- Closure of the AV valve and makes the Lub sound S2- Closure of the semilunar valves makes a dub sound

52
Q

What is heart auscultation?

A

Listening to the heart.

53
Q

What 2 things can cause valvular abnormalities in general?

A
  1. Stenosis- difficulty pushing blood through. 2. Insufficiency- valve fails to prevent backflow.
54
Q

What is Aortic Stenosis? What will it cause and it is known as what?

A

Difficulty pushing blood through the aortic valve. This creates a loud murmur heard during left ventricular ejection. Can be heard by standing by someone and is called a Thrill.

55
Q

What is aortic insufficiency?

A

The aortic valve fails to prevent backflow into left ventricle a murmur is heard during diastole.

56
Q

What is mitral stenosis?

A

Difficulty pushing blood through the mitral valve creates a murmur during second half of diastole.

57
Q

What is mitral insufficiency?

A

Mitral valve fails to prevent blood to backflow into the left atrium and creates a murmur heard throughout systole.

58
Q

What is chamber dilation?

A

When the heart has vascular abnormalities it works harder to maintain the net stroke volume and this causes hypertrophy and can overload the heart and this leads to chamber dilation and failure.

59
Q

What is cardiac output?

A

Combine the stroke volume(volume of blood pumped inot aortic arch each beat) and multiply it by the heart rate (beats per min.) This gives us the volume of blood pumped into the aortic arch per minute.

60
Q

What is the normal cardiac output?

A

5000 ml/minute

61
Q

Cardiac input can rise from the normal 5L/min to what?

A

Up to 30L/min

62
Q

What are 2 basic regulations of cardiac output?

A
  1. Intrinsic autoregulation 2. Reflex (extrinsic) control
63
Q

What is the mechanism for intrinsic autoregulation of cardiac output?

A

Frank-starling mechanism or Law of the heart.

64
Q

What is Frank-starling mechanism or law of the heart?

A

When Diastolic filing goes up the chamber is stretched and this will increase the end diastolic volume this will increase the strength of contraction and this decreases the end systolic volume and this will increase the stroke volume.

65
Q

According to intrinsic autoregulation of cardiac output what happens when venous return to the heart is increased?

A

Increase cardiac output in other words put more blood in more comes out.

66
Q

since the heart pumps all the blood that comes to it, it will be described as what type of pump?

A

A permissive pump.

67
Q

What is most important in regulating cardiac output?

A

The peripheral factors that affect returining blood flow.

68
Q

What is preload?

A

An incoming force that creats a tensile load on the chamber muscle prior to contraction

69
Q

What are the limits to increasing cardiac output with just the intrinsic autoregulation? What happens after the top?

A

it tops out at about 15 L/min. Performance will decline.

70
Q

What else will happen when the right atrium stretches besides frank-starling mechanism?

A

The SA node is stretched and this will increase rate of discharge (heart rate increaes).

71
Q

What is afterload?

A

The tensile load the heart or a muscle must exert itself.

72
Q

Will blood pressure affect cardiac output?

A

not normally only when aterial pressure becomes so high that it is too dificult to pump against.

73
Q

How is reflex (extrinsic) control of cardiac output done? How much can it increase the cardiac output?

A

Mostly by nerves of the autonomic nervous system. Can increae up to 30 L/Min.

74
Q

What part of the heart will sympathetic and the parasympathetic innervations mainly go to?

A

Sympathetic- The Ventricles. Parasympathetic- The Nodal tissues.

75
Q

what nerve supplies parasympathetic innervation for the heart?

A

Vagus or X cranial nerve.

76
Q

What will the sympathetic nervous system activate the body to do?

A

Cope with stress or situations of heightened response.

77
Q

What will the parasympathetic nervous system do for the body?

A

attends to digestive, elimination and glandular functions.

78
Q

What will sympathetic and parasympathetic neurons secrete?

A

Sympathetic- norepinephrine parasympathetic- acetylcholine.

79
Q

What will the autonomic nervous system mostly do to the cardiovascular system?

A

Readiness regulator. Or sympathetic

80
Q

In what 3 ways will nerves effect cardiac muscle?

A
  1. Dromotropic effect- conduction speed 2. Chronotropic effect- rate of contraction 3. Inotropic effect- strength of contraction
81
Q

What receptors will work with norepinephrine and where are they found at?

A

Beta 1 adrenergic receptors and they are found on cardiac myocytes.

82
Q

What happens to cardiac muscle cells when their beta1 adrenergic receptors bind with norepinephrine?

A

This will increase dromotropism, chronotropism, and inotropism This increases the heart rate to about 200 beats/min. And this increases stroke volume to 100%

83
Q

What else will norepinephrine do to cardiac muscle cells?

A

Renders them receptive to circulating epinephrine that comes from adrenal glands.

84
Q

When we exercise how will sypmathetic nervs effect stroke volume and heart rate?

A

They both increase, but stroke volume is increased early and heart rate steadily increases with work.

85
Q

What is the maximum efficiency of the heart?

A

140-160 beats per minute.

86
Q

What is tachycardia?

A

a heart rate greater than or equal to 100 beats/min.

87
Q

Is Tachycardia normal?

A

If not at rest then it can be, but at rest this would be a problem.

88
Q

If sympathetic nervous system stops what effect will this have on the heart? Will this ever happen if so when?

A

It can reduce the cardiac output by 25%. It should never happen because there is a background level of sympathetic activity from the brain.

89
Q

What will Beta2 receptors found on cardiac vasculature do when sympathetically stimulated?

A

cause vasodilation.

90
Q

What is beta blockade?

A

Drugs called beta blockers limit the cardiac output like a governor on a car by blocking the beta 1 adrenergic recpetors from receiving their signals from the sympathetics.

91
Q

When cardiac muscles have the acetylcholine receptors they will respond to what?

A

Acetylcholine from the parasympathetic system.

92
Q

Where will most acetylcholine receptors be found at?

A

On the SA and AV nodal cells.

93
Q

What will happen to the cardiac cells stimulated by acetylcholine through acetylcholine receptors?

A

A negative dromotropism, chronotropism, and inotropism Leading to a decreased heart rate at about 30-40 beats/min. And a decreaed stroke volume of 25%.

94
Q

What happens to the parasympathetics of the heart when the heart receives sympathetic innervation?

A

It is attenuated, and vice versa.

95
Q

What is bradycardia?

A

a heart rate at or below 60 beats per minute.

96
Q

Is bradycardia normal?

A

In healthy people it can be and abnormal in other conditions.

97
Q

Reflex control of the heart generally enhances what?

A

Natural performance.

98
Q

What type of control is rapid and even anticipatory?

A

Reflex control.

99
Q

What happens when preload of the heart becomes too great?

A

The heart enters a state of decompensation and decreased ejection and increases venous return. This leads to congestive heart failure.

100
Q

What is congestive heart failure?

A

An inability of the heart to produce an adequate cardiac output.

Physiology I Test I (8 decks)

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