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Cardio > pathophysio > Flashcards

pathophysio Flashcards

1
Q

Muscle fibers surrounding the heart are oriented ____ which allows ____.

A
  • circular, longitudinal, oblique

- blood to be squeezed from apex to base

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2
Q

cardiac output =

A

HR x SV

volume per min

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3
Q

flow

A

Q =∆P/R

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4
Q

mean arterial pressure

A

DP + [(SP-DP)/3]

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5
Q

myocardial cell types

A
  • pacemaker: automatically depolarize

- non-pacemaker (majority): depolarize when stimulated

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6
Q

pacemaker cell potentials consist of:

A
  • phase 4 depolarization: slow rise to threshold
  • action potential
  • repolarization
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7
Q

phase 4 depolarization involves:

A
  • decreased outward flow of K
  • **funny current influx of Na
  • gradual influx of Ca as threshold approached
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8
Q

myocyte depolarization involves:

A
  • vg Ca channel opening and influx of Ca
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9
Q

myocyte repolarization involves:

A
  • Ca channels close

- K channels open

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10
Q

PNS ____ HR by ____.

A
  • slows

- slowing hyperpolarization and slowing phase 4 (decreased If ICa)

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11
Q

SNS ____ HR by ____.

A
  • increases (also force)

- increases phase 4 rate (increased If and ICa) and decreasing threshold

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12
Q

+ ionotropic effect

A
  • increase HR and force of contraction due to increased intracellular Ca
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13
Q

non-pacemaker cell action potential

A
  • phase 0: rapid influx of Na
  • phase 1: inactivation of Na channel and open K channel
  • phase 2: plateau (Ca K balanced); Ca influx, slow K out
  • phase 3: Ca close, K predominates
  • phase 4: resting phase
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14
Q

the slowest conduction velocity

A

travels through the AV node

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15
Q

P wave

A
  • atrial depolarization following SA node firing
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16
Q

QRS complex

A
  • ventricular depolarization

- atrial repolarization

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17
Q

T wave

A
  • ventricular repolarization
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18
Q

PR segment

A
  • time to pass through AV node
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19
Q

QT interval

A
  • duration of ventricular AP
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20
Q

normal axis:
left axis deviation:
right axis deviation:

A

-30 to +90
< -30
> +90

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21
Q

pulmonary wedge pressure estimates

A
  • left atrial pressure
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22
Q

ventricular systole begins with ____ and ends with ____.

A
  • mitral valve closure

- aortic valve closure

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23
Q

atrial pressure waves

A
  • a: atrial systole
  • c: mitral valve closure
  • v: atrial filling and emptying
24
Q

stroke volume =

A

EDV-ESV

25
Q

end diastolic volume

A
  • volume in ventricle just before contraction
26
Q

end systolic volume

A
  • volume in ventricle right after contraction
27
Q

S1

A
  • closure of mitral and tricuspid valves

- c wave

28
Q

S2

A
  • closure of aortic and pulmonic valves
29
Q

S3

A
  • diastolic; kentucky

- during rapid filling, v wave

30
Q

S3

A
  • diastolic; tennessee

- vibration of ventricular walls in atrial contraction, a wave

31
Q

systolic murmurs

A
  • aortic/pulmonary stenosis, mitral/tricuspid regurgitation, VSD
32
Q

diastolic murmurs

A
  • aortic/pulmonary regurgitation, mitral/tricuspid stenosis
33
Q

continuous murmurs

A
  • patent ductus arteriosis
34
Q

L heart pressures are ____ than R heart pressures.

A

greater

35
Q

pressure volume loop: axes

A
  • x: left ventricular volume

- y: left ventricular pressure

36
Q

pressure volume loops: phases

A
  • moves counter clockwise
  • a: ventricular filling (mitral valve open/close)
  • b: isovolumetric contraction
  • c: ejection of sv (aortic valve open/close)
  • d: isovolumetric relaxation
37
Q

pressure volume loop: width and area

A
  • width = SV = EDV-ESV

- area = stroke work = SV * MAP

38
Q

ejection fraction

A

SV/EDV

39
Q

SV is affected by

A
  • preload (increases EDV and Sv)
  • afterload (increase ESV, decreases SV)
  • contractility (inotropy) (decreases ESV, increases SV)
40
Q

preload

A
  • stretch of cardiac myocyte prior to contraction

- maximized at EDV

41
Q

heterometric regulation

A
  • regulation of cardiac function via changing sarcomere length (i.e. preload)
42
Q

afterload

A
  • load against which heart muscle contracts to eject blood (aortic or pulmonary pressure and ventricular wall stress)
43
Q

homeometric regulation

A
  • regulation of cardiac function independent of sarcomere length (i.e. afterload)
44
Q

positive inotropic effects result from:

A
  • increased rate of delivery of Ca to myofibrils
  • increased binding of Ca to troponin c
  • increased rate of cross-bridge cycling
  • increased HR (increased Ca)
45
Q

loss of arterial compliance means that systolic pressure ____ and capillary flow ____.

A
  • rises

- becomes pulsatile

46
Q

largest pressure drop is associated with ____. 3 functions are:

A
  • arterioles
  • reduce blood pressure at capillary entrance
  • distribution of blood flow between/within tissues
  • dampens pressure pulses
47
Q

autoregulation allows:

A
  • local/regional control of blood flow without ANS involvement
  • so tissue blood flow remains constant in spite of arterial pressure changes
48
Q

distribution of blood flow between tissues is aided by:

A
  • muscular walls of arterioles
  • metarterioles
  • precapillary sphincters (direct blood flow)
49
Q

causes of edema

A
  • increased venous pressure (hydrostatic)
  • decreased blood osmotic pressure
  • increased interstitial osmotic pressure
50
Q

factors that increase O2 demand of heart

A
  • increased afterload
  • increased SV
  • increased HR
51
Q

How is O2 delivery to heart increased?

A
  • increasing coronary circulation

- autoregulation with adenosine

52
Q

coronary blood flow in left ventricle occurs primarily during ____.

A
  • diastole
53
Q

velocity varies ___ with total cross sectional area. slowest velocity is in ____.

A
  • inversely

- capillaries

54
Q

ERP

A
  • plateau phase
  • limits frequency of AP and avoids tetany
  • allows for ventricular filling
55
Q

Frank-Starling curve

A
  • x-axis: preload, EDV, EDP, sarcomere length, venous return

- y-axis: contractile force, SV

56
Q

baroreceptor signaling functions between MAP of:

A
  • 75-150 mmHg
57
Q

response to increased O2 demand

A
  • increased afterload
  • increased SV
  • increased hr

Cardio (4 decks)

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