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Pathophys quiz 2 > Pathophys quiz 2 CV > Flashcards

Pathophys quiz 2 CV Flashcards

1
Q

Pressure

A

Force exerted; measured in mmHg

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2
Q

Flow

A

Volume moved; measured in mL/min (volume moved in the time)

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3
Q

Resistance

A

how difficult it is for the blood to flow between 2 points at any given pressure difference; the measure of the friction that impedes flow

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4
Q

3 things that contribute to resistance?

A
  • Blood viscosity
  • Total blood vessel length (surface area increases resistance)
  • Blood vessel diameter (This is the biggest contributor to min-to-min control of resistance in the vascular system)
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5
Q

what has the biggest effect on resistance?

A

Radius

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6
Q

Flow =

A

change in pressure/ resistance

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7
Q

In a system with constant pressure if you increase resistance you _____ flow and if you decrease resistance you _______ flow

A

decrease, increase

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8
Q

In a system with constant pressure if you increase pressure it _____ flow

A

increases

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9
Q

In a system with constant pressure if you decrease pressure you ____ flow

A

decrease

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10
Q

In a system with constant pressure F and R are _______ related

A

inversely

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11
Q

Positive chronotropic factors ______ HR

A

increase

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12
Q

negative chronotropic factors ______ HR

A

decrease

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13
Q

3 systems that regulate the heart

A

Endocrine system, nervous system, kidney

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14
Q

How does the endocrine system regulate the heart?

A

Atrial Natriuretic peptide (hearts own endocrine system

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15
Q

Atrial Natriuretic peptide

A
  • secreted by specialized cells in the atria

- Regulates the concentration of Na+ in extracellular fluid

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16
Q

How does the Nervous system regulate the heart?

A

(body talks to the heart through this system)
Sympathetic nervous system (SNS)
Parasympathetic nervous system (PNS)

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17
Q

How does SNS regulate the heart?

A
  • Increases HR / Increases Stroke volume
  • Innervates entire heart muscle and node cells
  • Binds the neuroendocrine hormone epinephrine from the adrenal gland
  • Beta-adrenergic receptors on the SA node and on Pumping cells
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18
Q

SNS releases ______ through thoracic spinal nerves which kicks in first!

A

Norepinephrine (NE)

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19
Q

_______ hormone from the adrenal medulla will kick in second

A

Epinephrine

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20
Q

How does the PNS regulate the heart?

A
  • Slow HR
  • innervates just the SA/AV nodes
  • Muscarinic Cholinergic receptors on the SA node only
    - releases Acetylcholine (hormone) through vagus nerve
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21
Q

How do the Kidneys regulate the heart?

A

Control blood volume by retaining or relating fluid (affects stroke volume (SV)

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22
Q

arteries and veins both contain what 3 structures, but vary in the amounts of each?

A

smooth muscle
endothelial cells
fibroblasts

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23
Q

Structures involved in the vascular system?

A
  • Arteries
    - Elastiuc arteries (conduit), muscular arteries, arterioles
  • Capillaries
  • veins
    - venules
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24
Q

Arteries need to be more elastic, while veins are more _____

A

compliant

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25
Q

Arteries are responsible for transmitting _____ to the vessels beyond them.

A

pressure

they are pressure reservoirs bc of their elastic recoil

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26
Q

Veins: the higher the compliance, the more they can _____ without corresponding increase in pressure

A

stretch out

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27
Q

Compliance =

A

change in volume / change in pressure

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28
Q

Veins have _____ walls and _____ compliance

A

thin, high

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29
Q

Pulmonary pressure is always ____ than arterial pressure

A

lower

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30
Q

Pressure ______ the farther it travels down the systemic circuit

A

decreases

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31
Q

does pressure increase or decrease between the arterioles and capillaries?

A

decreases greatly

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32
Q

what controls min - to - min blood flow into the capillaries?

A

muscular is or arterioles

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33
Q

what do veins have to prevent back flow?

A

valves

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34
Q

Respiratory pump

A

pressure changes in the central cavity due to the negative pressure generated due to breathing. this helps pull blood back to the heart

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35
Q

muscle pump

A

when muscles contract they squeeze the veins, which moves blood forward. valves prevent back flow. the smooth muscle in the veins is under SNS control and contracts when stimulated, similar to arterial smooth muscle.

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36
Q

What are the components of the cardiac cycle? (slide 38)

A

Isovolumetric contraction, ventricular ejection, isovolumetric relaxation, ventricular filling

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37
Q

Isovolumetric contraction

A

the ventricle starts contracting, but no valves are open at first because the pressure hasn’t gotten high enough to open them

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38
Q

ventricular ejection

A

ventricular pressure gets high enough to causesemilunar valves to open. when the LV pressure is higher than aortic pressure, the valve opens and the aorta fills

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39
Q

Isovolumetric relaxation

A

the ventricle relaxes, causing the semilunar valves to fall shut. the aortic pressures do high theres a backwards slosh of aortic blood against the aortic valve, creating the dicrotic notch (the blood that sloshes back exits through the coronary Ostia to oxygenate the blood

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40
Q

Ventricular filling

A

the atria are contracting, the ventricles are relaxed. AV valves are open bc atrial pressure is at least equal to ventricular pressure

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41
Q

Heart sounds

A

systole, diastole

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42
Q

Systole sounds:

A

closing of the mitral and tricuspid valves (LUB)

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43
Q

diastole sounds:

A

Closing of the pulmonary and aortic valves (DUB)

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44
Q

Why is diastole longer than systole?

A

bc ventricles which are bigger are filling

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45
Q

valve problems

A 
stenotic (narrow valve) - turbulent flow
insufficient valve (leaky valve) - turbulent backflow
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46
Q

What causes a murmur

A

turbulent flow or back flow

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47
Q

systolic pressure =

A

maximum pressure at systole

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48
Q

diastolic pressure =

A

minimum pressure at diastole

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49
Q

pulse pressure=

A

systolic- diastolic

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50
Q

Mean arterial pressure (MAP) =

A

diastolic + 1/3 of the pulse pressure

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51
Q

What is cardiac output?

A

amount of blood pumped out of each ventricle in one minute

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52
Q

Cardiac Output =

A

HR x SV

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53
Q

Stroke Volume (SV) =

A

EDV - ESV
(fairly constant in a healthy system)
the amount of blood that was pumped out of the heart after contraction

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54
Q

End diastolic volume (EDV)

A

total amount of blood in the ventricle that has the potential to be pumped out

55
Q

End systolic volume (ESV)

A

the amount of blood left over in the ventricle after the contraction of the heart

56
Q

amount how much blood does the heart pump out during each beat?

A

60%

57
Q

When SV decrease, the body will increase what to compensate in an unhealthy system?

A

HR

58
Q

Inotropy

A

positive or negative things that affect contractility

59
Q

SV can be increased by what?

A

emptying the ventricles better (increasing ventricular contraction)
-SNS stimulation increases SV

60
Q

What is the most common way of changing CO?

A

HR

61
Q

Chronotropy

A

positive (increases HR) or negative (decreases Hr) that affect HR
(HR can also be controlled by the nervous system)

62
Q

Frank-starling Law

A
  • the critical factor controlling stroke volume is preload
  • Length/tension relationship (overextension leads to inefficient pumping and under extension limits force)
  • Afterload
63
Q

Preload

A

the degree to which the cardiac muscle cells are stretched (amount of blood in the ventricles) before the contract

64
Q

Amount of blood in the ventricles is controlled by what 2 factors?

A

venous return and the amount of time between ventricular contractions

65
Q

Anything that increases venous return or slows HR _______ the EDV

A

increases

ex. increased SV = Increased EDV

66
Q

Afterload

A

pressure that the ventricles must overcome to force open the aortic and pulmonary valves
-anything that increases systemic or pulmonary arterial pressure can increase afterload (hypertension)

67
Q

it is easiest for the heart to work with a ____ preload and ____ afterload

A

high

low

68
Q

Ejection fraction =

A

SV / EDV (measures contractility)

  • expressed as a percentage (normally between 50-70)
  • increased contractility = increased ejection fraction
69
Q

What does the SNS innervate?

A

SA/AV node and individual cardiac cells by releasing Norepinephrine (NE). It also binds the neuroendocrine hormone epinephrine from the adrenal gland

70
Q

PNS innervates what?

A

only the SA/AV node and releases Acetylcholine

71
Q

What is BP role in homeostasis of oxygen delivery?

A

By using sympathetic and parasympathetic stimulation to innervate and suppress the vessels in order to vasodilator and constrict depending on the body need for CO2

72
Q

What is pH role in homeostasis of oxygen delivery?

A

by using ion channels to facilitate the movement of CO2 and O2 to alter pH within a cell. increased acidity (aka increased CO2) increases oxygen drop off

73
Q

What is Oxygens role in homeostasis of oxygen delivery?

A

Hypoxic state= increased HR

74
Q

What is ions role in homeostasis of oxygen delivery?

A

some atria cells secrete atrial natriuretic peptide which regulates Na+

75
Q

what two things keep valves from flying open?

A

Chordae tendinae and Papillary muscles

76
Q

what valves are open during diastole?

A

M/T

77
Q

What valves are open during systole?

A

P/A

78
Q

Hydrostatic pressure:

A

pressure needed for water to be forced out of the capillaries (filtration)
-over comes osmotic pressure at the beginning of the capillaries

79
Q

Osmotic (oncotic) pressure

A

pressure causes O2 to flow into the capillary

  • it opposes hydrostatic pressure, keeping fluid in the cells.
  • Over comes hydrostatic pressure at the end of capillaries
80
Q

arrhythmia

A

uncoordinated atrial and ventricular contractions caused by a defect in the conduction system

81
Q

defibrillation

A

application of an electrical stimulation to shock the heart back into normal SA rhythm

82
Q

Heart block

A

damage to AV node

83
Q

Total heart block

A

ventricles beat at their intrinsic rate (purkinje fiber rate) = too slow to maintain circulation

84
Q

partial heart block

A

AV node impulse is slowed but it does get through (pacemaker treats this)

85
Q

Pacemaker

A

substitues SA and/or AV nodes. for chronic issues. can be single or double lead

86
Q

extrasystoles

A 
premature contractions (atrial or ventricular)
-Ventricular (PVC) most problematic
87
Q

Extopic focus

A

abnormal pacemaker that takes over the conducting system

-can go faster than SA node when it takes over for the damaged SA node

88
Q

Fibrillation

A

rapid and irregular (usually out of phase) contraction where the SA node is no longer controlling HR

89
Q

Atrial Fibrillation can cause what 2 things?

A

clotting and inefficient filling of the ventricles

90
Q

Ventricular Fibrillation

A
  • life threatening

- ventricles pump inefficiently and without filling

91
Q

What does the pulmonary system do?

A

carries oxygen poop blood to the lungs and then back to the heart

92
Q

why is pressure in the pulmonary pump less?

A

blood is going to 1 organ at a shorter distance and the capillaries in the lungs are fragile and damage easily

93
Q

What does the systemic system do?

A

carries blood from the heart to the rest of the body

94
Q

why is pressure in the systemic system higher?

A

bloody has to be sent out a further distance to the entire body

95
Q

4 advantages to having a closed system with 2 parallel loops

A
  • more bang for you buck (stronger contractions)
  • easy to create force when pushing against each other (shared wall, atrioventricular septum)
  • Lungs are close by
  • More efficient, blood is being oxygenated and delivered to the rest of the body simultaneously
96
Q

Disadvantages to having a closed system with 2 parallel loops

A

A small imbalance in one side affects the other side

  • if the right side doesn’t deliver/fill properly, the left side has nothing to pump out (atrial dysfunction)
    - if the left side doesn’t pump fast enough, it backs up into the right (systolic dysfunction)
97
Q

Describe portal systems

A
  • 2 systems that have 2 sets of capillaries that exchange with their surroundings, found chained together in one-two fashion
  • ensure all parts of the organ receive what they need
  • 2 drop-off points
98
Q

Hepatic portal system

A

vein-capillary-vein
-directs blood from parts of the GI tract to the liver. substances absorbed in the small intestine travel first to the liver for processing before continuing to the heart

99
Q

Hypothalamic portal system

A

vein-capillary-vein

  • picks up hormones at the hypothalamus and drops them off in high concentration at the pituitary
  • not a lot of releasing hormone is needed because it is not being diluted by the entire blood stream
100
Q

Nephron portal system

A

artery-capillary-artery

-water is filtered out at one capillary bed, reabsorbed at another

101
Q

order of blood through the body

A

arteries-arterioles-capillaries-venules-veins-heart

102
Q

arteries =

A

away (normally oxygenated)

103
Q

arterioles =

A

smallest arteries. their fx in controlled by neural, hormonal, and local chemicals (see study guide for more info)

104
Q

autoregulation

A

dynamic process of constant changing diameter in the arterioles

105
Q

paracrine signaling:

A

endothelial cells secrete paracrine agents (affect smooth muscle) and induce a relaxation or contraction

106
Q

NO is one of the most important paracrine signals because…

A

its causes vasodilation for proper vessel tone.

-sns / pos make arterioles more sensitive to NO

107
Q

Continuous capillaries are…

A

most common and allow passage of fluids and small solutes (skin and muscle)

108
Q

fenestrated capillaries

A

more permeable to fluids and solutes than continuous capillaries- allowing for more rapid transfer of substances into/out of the capillary (kidneys, intestines, endocrine (hormone) tissue)

109
Q

Sinusoidal capillaries

A

leaky capillaries that allow large molecules to pass between blood and surrounding tissues (liver, bone marrow, lymphatics)

110
Q

Filtration

A

flow of fluid leaving the plasma to the interstitial fluid through the capillaries

111
Q

absorption

A

flow of fluid from the interstitial fluid to the plasma through the capillaries

112
Q

Colloid osmotic (oncotic) pressure remains _______through the entire capillary

A

constant

113
Q

Hydrostatic pressure is _____ at the arteriole end of the capillary and _____ at the venous end of the capillary

A

Higher, lower

114
Q

3 layers of the veins:

A

Tunics: interna-media-externa (less smooth muscle and elastin than arteries

115
Q

varicose veins are caused by what

A

leaky valves

116
Q

4 determinants of venous pressure

A
  • Nervous sytem (sympathetic increases BP by increasing central blood volume)\
  • Skeletal muscle “pump” of the legs
  • Inspiratory effort (creates negative pressure in the thorax)
  • blood volume (more volume = higher pressure)
117
Q

Pulmonary artery

A

carries deoxygenated blood to the lungs

118
Q

pulmonary vein

A

carries oxygenated blood to the heart

119
Q

umbilical artery

A

carries deoxygenated blood away from the fetus to the mom

120
Q

how much blood is in our veins at any given time?

A

60%

121
Q

how many more veins do we have than arteries?

A

3x as many

122
Q

Why are arteries stiffer?

A

accommodate larger volumes of blood and pressure

123
Q

what percent of your capillaries are open at any given time?

A

5-10%

124
Q

What would happen if all of your capillaries were open at the same time?

A

BP drops, not enough blood goes back to your heart, and SHOCK

125
Q

Hematocrit

A

Percentage of blood made up by RBC

  • 45% men
  • 38-42% women
  • measured by separating components of blood via centrifuge
126
Q

3 layers of the heart

A

Epicardium, myocardium, endocardium

127
Q

epicardium

A

superficial outer layer of the heart

128
Q

Myocardium

A
  • bulk
  • cardiac muscle
  • middle layer
129
Q

endocardium

A

inner layer

  • made of endothelium resting on a thin layer of connective tissue
  • continuous with lining of blood vessels (this is important bc it reduces “roadblocks”, less resistance)
130
Q

Progression of blood through circulatory system

A
  1. Superior and inferior venacava
  2. Right atrium
  3. Tricuspid valve (right atrioventricular)
  4. Right ventricle
  5. Pulmonary valve(semilunar)
  6. pulmonary artery
  7. lungs
  8. pulmonary vein
  9. Left atria
  10. Bicuspid (mitral) (left atrioventricular) valve
  11. Left ventricle
  12. Aortic valve (semilunar)
  13. Aorta
  14. Systemic
131
Q

Where does the pause occur during conduction of the heart and why does it occur?

A
  • Occurs at the bundle of His

- allows for atria emptying and ventricle filling

132
Q

What are the 2 reasons why the refractory period is needed?

A
  • allows for ventricular emptying
  • prevents cardiac tetani
  • T wave= ventricular reporlarization
133
Q

how does the percentage of blood change in the brain, heart, skeletal muscle, skin, kidneys, abdominal organs, and other from resting to exercise?

A 
Brain: less
Heart: same
Skeletal muscle: more
Skin: more
Kidneys: less
abdominal organs: less
Other: less

Pathophys quiz 2 (4 decks)

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