Physio 2.0 Flashcards

1
Q

What is the Cardiac cycle time?

A

0.8 seconds when the heart beats at 75 bpm

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2
Q

What I known as the contraction/emptying phase stage of the cardiac cycle?

A

Systole

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3
Q

What is known as the relaxation/filling phase of the cardiac cycle?

A

Diastole

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4
Q

Fill in th blanks.” Atrial systole is caused by ___________.”

A

Atrial depolarisation

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5
Q

What are the phases involved in Atrial Systole?

A
  • Ventricles are relaxed
  • AV valves ( tricuspid & mitral) are open because pressure in the atria is greater than ventricular pressure.

-Ventricles were filling prior to atrial systole, Atrial systole causes further increase in ventricular volume.

  • Throughout atrial contraction , atrial pressure exceeds ventricular pressure so AV valves remain OPEN.
  • Ends with ventricles maximally filled with blood ( EDV = 120ml)
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6
Q

What heart sound may be produced in Atrial systole?

A

S4 - may produce sound during atrial contraction as it causes the ventricular wall to vibrate if the ventricle is “stiff”

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7
Q

Fill in the blanks. “ Isovolumetric ventricular contraction is initated by ______.”

A

By the QRS complex - Ventricular depolarisation.

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8
Q

In which stage of the Cardiac cycle is the first heart sound produced ( S1) ?

A

Isovolumetric ventricular contraction.

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9
Q

True or False? In Isovolumetric ventricular contraction , there is NO change in ventricular volume as all valves are CLOSED.

A

TRUE!!

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10
Q

In which stage of the Cardiac cycle is the Second Heart sound produced (S2)?

A

Isovolumetric ventricular relaxation

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11
Q

What is the pressure in the Right atrium?

A

0-8 mmHg

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12
Q

What is the pressure in the left atrium?

A

2-10 mmHg

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13
Q

What is the pressure in the right ventricle?

A

25 / 6(2-8) mm Hg

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14
Q

What is the Pressure in the left ventricle ?

A

120 / 8(2-10)

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15
Q

What is the pressure in the aorta?

A

120/80

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16
Q

What is the pressure in the pulmonary artery?

A

25/10 mmHg

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17
Q

In the atrial pressure curve, what does the ‘a’ wave represent?

A

The atrial contraction as a primer pump

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18
Q

In the atrial pressure curve, what does the ‘c’ wave represent?

A

This represents when the ventricles begin to contract

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19
Q

In the atrial pressure curve, what does the ‘v’ wave represent?

A

It represents the end of ventricular contraction

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20
Q

Fill in the blanks.” When the aortic valve closes, blood rebounds against the valve causing a decrease then a rebound of aortic pressure. This causes the appearance of a ________.”

A

Dicrotic notch

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21
Q

What is the normal End diastolic volume?

A

120-130ml

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22
Q

What is the End Diastolic volume?

A

This is the Volume of blood in each ventricle at the end of diastole.

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23
Q

What is the normal End systolic volume?

A

50-60 ml

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24
Q

What is the stroke volume?

A

It is the volume of blood pumped out by each ventricle per beat . It is about 70-80 ml.

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25
Q

How is Stroke volume calculated?

A

EDV-ESV

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26
Q

What is Ejection Fraction?

A

It is the percentage of ventricular end diastolic volume which is ejected with each stroke.

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27
Q

What is the formula for Ejection Fraction?

A

EF= SV (EDV-ESV)/ EDV x 100

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28
Q

What is the norma ejection fraction?

A

60-65%

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29
Q

True or False? Diastole length (time) is shortened much more than systole length.

A

TRUE!!

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30
Q

Fill in the blanks.”The third heart sound can be heard during _________.”

A

Rapid filling of the ventricles( audible in children)

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31
Q

Fill in the blanks.”The fourth heart sound is heard during_________.”

A

Atrial systole ( normally not audible)

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32
Q

Where is the sound of the aortic semilunar valve heard?

A

Second intercostal space at the right sternal margin.

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33
Q

Where is the sound of the pulmonary semilunar valve heard?

A

Second intercostal space at the left sternal margin.

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34
Q

The sounds of which valve is heard is heard over the heart apex, in the 5th intercostal space, in one with the middle of the clavicle.

A

Mitral valve

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35
Q

Where is the tricuspid valve heard?

A

The sounds of the tricuspid valve is typically heard in the right sternal margin of the fifth 5th intercostal space . Variations include over sternum or over left sternal margin in 5th intercostal space.

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36
Q

If the third heart sound is heard , what pathological diseases could be suspected?

A

Congestive Heart Failure or Vascular disease

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37
Q

The fourth heart sound can be a sign of ?

A

Stiff , fibrotic ventricle

  • Can also be a sign of Aortic stenosis, hypertrophic cardiomyopathy, hypertension.
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38
Q

What are the factors that determine systolic blood pressure?

A
  • The characteristics of the stroke volume being ejected from the heart
  • The ability of the aorta to stretch and accommodate the stroke volume.
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39
Q

What are the factors that determine the Diastolic pressure?

A
  • The energy stored in the aorta as its elastic fibres are stretched during systole.
  • The resistance to the runoff of blood from the peripheral blood vessels.
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40
Q

What is the formula to calculate blood pressure?

A

Blood pressure = Cardiac output x Peripheral resistance

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41
Q

What are the physiological factors that affect blood pressure?

A

Cardiac Output - (SV xHR)
Peripheral resistance
Blood volume

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42
Q

How is the Pulse Pressure Calculated?

A

Systolic BP- Diastolic BP

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43
Q

How is the mean arterial pressure calculated?

A

Diastolic BP + 1/3 Pulse pressure

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44
Q

What is Central venous pressure?

A

Central venous pressure is considered a direct measurement of the blood pressure in the right atrium and vena cava.

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45
Q

How else can the Mean arterial pressure be calculated?

A

MAP = (CO x SVR) + CVP (Central Venous Pressure)

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46
Q

Fill in the blanks. “ Atrial stretch receptors are activated by _________ and act to _________.”

A

They are activated by Increased venous return and act to reduce Blood Pressure.

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47
Q

What are the functions of Atrial Stretch receptors?

A
  • They stimulate reflex tachycardia (increased HR)
  • Inhibit ADH release
  • Promote secretion of Atrial Natriuretic peptide.
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48
Q

What are the factors that determine Mean arterial pressure?

A
  • Blood Volume
  • Effectiveness of the heart as a pump.
  • Resistance of the system to blood flow.
  • Relative distribution of blood between arterial and venous blood vessels.
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49
Q

What are three important sources of resistance?

A

Blood viscosity
Total blood vessel length
Blood vessel diameter

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50
Q

What are the major determinants of peripheral resistance?

A

Small-diameter arterioles.

51
Q

What are the factors that remain constant in Peripheral resistance?

A
  • Blood viscosity ( the stickiness of the blood due to formed elements and plasma proteins)
  • Blood vessel length - “ The longer the vessel, the greater resistance encountered”
52
Q

Where is systemic pressure highest?

A

In the aorta

53
Q

What is the systemic pressure in the right atrium?

A

0 mmHg

54
Q

Where does the steepest drop in systemic pressure occur?

A

In the arterioles

55
Q

Fill in the blanks. “ Blood pressure near the heart is ______.”

A

Pulsatile

56
Q

How does Neuronal control of peripheral resistance work?

A
  • It maintains the mean arterial pressure by altering blood vessel diameter.
  • Alters blood distribution in response to specific demands.
57
Q

Fill in the blanks.” Neuronal controls operate via ________ that involve _______,_________ &_________.”

A

Neuronal Control operate via REFLEX ARC that involves -

*Baroreceptors and chemoreceptors
* Vasomotor centres and vasomotor fibres
* Vascular smooth muscle

58
Q

Where are chemoreceptors located?

A

In the carotid sinus
Aortic arch
Large arteries of the neck

59
Q

Fill in the blanks. “ Chemoreceptors respond to ______,_______ & _______.”

A

Rise in CO2
Decrease in pH
Decrease in Oxygen

60
Q

True or False? Chemoreceptors are more important in the regulation of respiratory rate.

A

TRUE!!

61
Q

True or False? Chremoreceptors in the medulla oblongata monitor O2 ,CO2 and pH.

A

FALSE !! Chemoreceptors in the medulla oblongata monitor CO2 and pH ONLY!!

62
Q

What substances are monitored by chemoreceptors in the carotid and aortic bodies?

A

O2
CO2
pH

63
Q

Where are Baroreceptors located?

A
  • Carotid sinuses
  • Aortic arch
  • Walls of large arteries of the neck and thorax
64
Q

Where are reflexes that regulate Blood pressure integrated?

A

In the medulla

65
Q

What is the Vasomotor centre?

A

It is a cluster of sympathetic neurons in the medulla that oversee changes in the blood vessel diameter.

66
Q

True or False? Angiotensin II ,generated by Kidney release of renin, causes vasoconstriction.

A

TRUE!!

67
Q

True or False? Atrial natriuretic peptide causes blood volume and blood pressure to increase , causes generalised vasoconstriction .

A

FALSE!! Atrial natriuretic peptide causes blood volume and blood pressure to DECREASE , causes generalised VASODILATION.

68
Q

True or False? ADH (Vasopressin) causes intense vasoconstriction in cases of extremely low Blood Pressure.

A

TRUE!!!

69
Q

What are devices used for measuring blood pressure?

A

Aneroid sphygmometer
Mercury sphygmometer
Electronic/digital sphygmometer

70
Q

Fill in the blanks. “ Phase 1 of the Korotkoff sounds gives you ___________ while ____________ gives you Diastolic pressure.”

A

Phase I gives you Systolic Pressure
Phase V gives you Diastolic pressure

71
Q

How is Cardiac Output calculated?

A

CO = SV x HR

72
Q

How is blood flow to an organ regulated?

A

By altering arteriolar tissue

73
Q

Which organs exhibit auto- regulation?

A

Heart
Brain
Kidneys

74
Q

What is Active hyperaemia?

A

The blood flow of an organ is proportional to its metabolic activity . ex, when you exercise, more blood flow is needed for skeletal muscles.

75
Q

What is Reactive Hyperaemia?

A

An increase in blood flow to an organ after a period of occlusion of flow. ex when taking blood pressure using a cuff.

76
Q

Which organ has the greatest sympathetic innervation?

A

Skin

77
Q

Which hormones causes arteriolar dilation and venous constriction?

A

Histamine and Bradykinin

78
Q

Fill in the blanks. “ In regards to prostaglandins , __________ are vasodilators and __________ are vasoconstrictors.

A

E- series are vasodilators
F- series are vasoconstrictors

79
Q

True or False? Thromboxane A2 is a vasodilator.

A

FALSE!! It is a Vasoconstrictor

80
Q

What percentage of Resting cardiac output goes to Pulmonary circulation?

A

100 %

81
Q

What is the most important local vasodilator for cerebral circulation?

A

Carbon dioxide, CO2

82
Q

True or False? The brain exhibits both active and reactive hyperaemia.

A

TRUE!!

83
Q

True or False? Coronary and cerebral circulation is controlled by local metabolic factors.

A

TRUE!!

84
Q

What are the most important local metabolic factors for coronary circulation?

A

Hypoxia and Adenosine

85
Q

True or False? The resistance and pressure in pulmonary circulation is LOW!!

A

TRUE!!

86
Q

In supine position , how is the blood pulmonary flow distributed?

A

The bloodflow is nearly uniform throughout the lung

87
Q

When standing, how Is the pulmonary blood flow distributed ?

A

It is unevenly distributed because of the effect of gravity .

88
Q

What is the principal function of the cutaneous sympathetic nerves ?

A

Temperature regulation

89
Q

True or False? Increased ambient temperature leads to cutaneous vasodilation, allowing dissipation of excess body heat.

A

TRUE!!

90
Q

Fill in the blanks. “ Skin vessels is under __________.”

A

Emotional control

91
Q

What is the primary regulator of blood flow to the skeletal muscle?

A

Sympathetic innervation

92
Q

What are the local vasodilators of skeletal muscles?

A

Lactate, adenosine and K+

93
Q

Fill in the blanks. “ Preload = ____________ while Afterload = ________

A

Preload = End diastolic volume
Afterload = End systolic pressure

94
Q

What is Afterload?

A

Afterload is the pressure against which the ventricles contract . ( wall tension during systole)

95
Q

Fill in the blanks. “ Afterload is is determined by ________.”

A

Peripheral resistance

96
Q

What are the factors that affect afterload?

A

Pleural pressure
Vascular compliance
Vascular resistance

97
Q

In what conditions are Pre-loads increased?

A
  • Hypervolemia
  • Regurgitation of cardiac valves
  • Heart Failure
98
Q

In what conditions is after load increased in?

A
  • Hypertension
  • Vasoconstriction
99
Q

What are the factors affecting stroke volume?

A

Heart size
Fitness level
Gender
Contractility
Duration of contraction
Preload ( EDV)
Afterload( resistance)

100
Q

What are the factors affecting heart rate?

A

Autonomic innervation
Hormones
Fitness levels
Age

101
Q

True or False? Autonomic influence on the Cardiac output ( sympathetic stimulation) increases contractility of the heart therefore DECREASES End diastolic volume.

A

TRUE!!!

102
Q

True or False? Excess calcium increases stroke volume by enhancing contractility.

A

TRUE!!

103
Q

What is Venous return ?

A

It is the rate of flow blood back to the heart from the tissues.

104
Q

What is the normal atrial pressure?

A

0 mm Hg

105
Q

True or False? Venous return decreases with atrial pressure.

A

TRUE!!

106
Q

What are the 5 mechanism that enable blood flow back to the heart?

A

Venous valves
Muscle pump
Respiratory pump
Venous smooth muscle
Gravity

107
Q

Which layer of veins & arteries is responsible for vasoconstriction and vasodilation?

A

Tunica media

108
Q

Which layer of arteries & veins is endothelium?

A

Tunica intima

109
Q

What is the function of Tunica adventitia ?

A

It merges with connective tissues surrounding blood vessels

110
Q

What are the different types of capillaries?

A
  • Continuous ( Do not have fenestrae)
  • Fenestrated (have pores)
  • Sinusoidal (large diameter with large fenestrae)
111
Q

Where are fenestrated capillaries located?

A

In kidneys, small intestine , glands , choroid plexuses.

112
Q

Fill in the blanks. “ The physiology of systemic circulation is determined by ________, _______ & _______.

A

Anatomy of circulatory system
Dynamics of blood floe
Re

113
Q

True or False? The flow rate is inversely proportional to resistance.

A

TRUE!!

114
Q

True or False? Meta-arterioles have NO sphincters thus allowing for a continuous blood flow and controls the amount of blood going into neighbouring vessels.

A

TRUE!!

115
Q

What are important peptides that increase vascularity in blood vessels?

A

Vascular Endothelial Growth factor(VGEF)
Fibroblast growth factor
Angiogenin

116
Q

What is the Critical closing pressure?

A

This is the pressure at which a blood vessel collapse and blood flow stops.

117
Q

What is Laplace’s law?

A

This is when the force acting on blood vessel is proportional to diameter of the vessel times blood pressure.

118
Q

What is vascular compliance?

A

This is the tendency for blood vessel volume to increase as blood pressure increases.

The more easily the vessel wall stretches, the greater its compliance.

119
Q

Where is Endothelin A released from?

A

Damaged blood vessels

120
Q

Which ions causes Vasodilation ?

A

K+
Mg 2+
H+ (increase)
Acetate
Citrate
CO2

121
Q

Which ions causes Vasoconstriction?

A

Ca 2+
H+ ( decrease)

122
Q

What happens to the blood flow when oxygen decreases?

A

The blood flow Increases!!

123
Q
A