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Nursing 2nd Year > Physiology 2058 CVS > Flashcards

Physiology 2058 CVS Flashcards

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1
Q

Organisation of ANS

A

Involuntary, 2 neurone system - preganglionic neurones that synapse on post ganglionic
Neurotrasnmitters are ACh and noradrenaline
Sympathetic and para sympathetic
Regulates cardiac muscle, smooth and glands

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2
Q

SNS

A

thoraco-lumbar division, innervates almost every organ in the body, fight or flight

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3
Q

PNS

A

cranio-sacral division, maintain and restore body energy

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4
Q

Adrenal medulla

A

innervated by pre-ganglionic sympathetic nerves, modified ganglion cells, release adrenaline - 80% adrenaline, 20% noradrenaline, regulates metabolic events

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5
Q

Hypothalamus

A

regulates activity of ANS with brainstem, regulates reproduction, hunger, reaction to stress, control of emotions, sleep/wake cycle, circadian rhythms

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6
Q

Heart

A

Outside to in
pericardium - epicardium - myocardium - endocardium

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7
Q

Blood flow through heart

A

RA - tricuspid valve - RV - plumonary valve - pulmonary trunk and arteries - pulmonary capillaries - pulmonary veins - LA - bicuspid valve - LV - aortic valve - aorta and systemic arteries - systemic capillaries - SVC, IVC and coronary sinus

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8
Q

Heart valves

A

AV - atria and ventricles
Semi lunar - lungs and aorta

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9
Q

Cardiac AP

A

After depolarization - plateau phase due to movement of EC calcium 250-300msec
longer refractory period - relaxation has started by the time refractory period is over
tetany can’t occur

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10
Q

Generation of heart beat

A

conduction system - right atrium , sino-atrial node, generates more AP

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11
Q

Conduction system

A

AP originate in SA node
AP reach AV node - pause
AP conducted through AV bundle
Into ventricles via bundle branches
Through musculature via purkinje fibers

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12
Q

ECG

A

Record of electrical events occurring in heart, electrodes on body
P wave- atrial depolarization
QRS complex- ventricular depolarization
T wave - ventricular repolarization

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13
Q

ANS effect on heart

A

SA node innervated by PNS (vagus nerve) - increased parasympathetic nerve activity decreases HR
Muscle of heart (ventricular myocardium) - innervated by SNS - increased sympathetic nerve activity increases cardiac contractility

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14
Q

Cardiac cycle of a beat

A

Relaxation - diastole
Contractions - systole
Blood flow to heart muscle via coronary arteries and most occurs during diastole

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15
Q

Events of cardiac cycle

A

Ventricular diastole- relax and pressure within falls
AV valves open blood flows from atria into ventricles
As V fills, pressure rises, AV valves snap shut- sound 1
V pressure rises higher than pulmonary or aortic valves the semi lunar valves open silently and blood ejected into 2 arteries - ventricular systole
Semi lunar valves snap shut - sound 2
Cycle typically 0.8 seconds
Sounds caused by closing of valves

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16
Q

Cardiac output

A

HR v SV
Greater volume of blood in heart during diastole (EDV) end diastolic volume , greater next contraction = stroke volume

17
Q

SNS on SV and CO

A

For any EDV, increase in SNS will increase SV- increased contractility
Increased SNS will increase HR
Hormones increase CO

18
Q

Vascular system

A

Closed system of arteries, veins and capillaries into R and L of heart
Blood flow around body - pressure and resistance - Ohm’s law

19
Q

Ohm’s law

A

Q=P/R
Blood flow around body - pressure gradient, high to low
Related to resistance in the circulation - vascular resistance of total peripheral resistance

20
Q

Pressure in circulation

A

Starts at aorta high pressure left side
Ends at vena cavae - empty into lower pressure right side
Greatest pressure in arteries, greatest drop in arterioles - major resistance vessels in circulation

21
Q

What determines VR/ TPR

A

Size of blood vessel- diameter
SNS innervates blood vessels - increased SNS - vasoconstriction - increase resistance
Decreased SNS - vasodilation- decrease resistance
Blood viscosity - cellular components
Length of vessels - constant

22
Q

Capillaries

A

Exchange vessels of circulation, vast SA, one cell thick- endothelial cells, no smooth muscle, exchange driven by force/ pressure gradients between inside capillary and surrounding IF, selectively permeable

23
Q

Osmotic pressure

A

Pressure in blood due to its solute conc, more solute higher osmotic pressure, fluid more concentrated than plasma is hypertonic, reverse is hypotonic, bloods large plasma protein molecules contribute to blood colloid osmotic pressure

24
Q

Forces acting on capillary walls/ exchange

A

Solutes by diffusion, water by osmosis
Capillary blood/ hydrostatic pressure forces fluid out of capillaries into IF at arterial end of capillary - filtration
At venous end fluid is reabsorbed back into capillary
BCOP- pulls fluid into capillaries from IF
Lymphatic vessels mop up excess IF but if IF cuilds up - oedema

25
Q

Short term regulation of BP

A

Barorecptor receptor - arch of aorta and coronary sinus, pressure detecting
BP falls, less stretch on receptors, reflex inhibited -> increase in BP, effects of ANS on heart and circulation
Negative feedback
BP increases- stretch on receptors, increased nerve impulses to CV in medulla, decreased SN activity, decreased CO, decreased peripheral resistance

26
Q

Renin Angiotensin Aldosterone System

A

longer term regulation of BP, involves variety of hormones e.g. RAAS, w kidneys
Kidneys directly affected by BP anf flow to them through juxtaglomerular apparatus
If BP falls, antidiuretic hormone released from posterior pituitary, causes water retention by kidneys, expand blood volume, increase bp
ADH - vasopressin- vasoconstrictor

27
Q

Atrial Natriuretic Peptide

A

salt losing hormone, counteracts affect of aldosterone, if BP is too hgh can be released, in health balance between ANP and aldosterone

28
Q

Regulation of CO/ blood flow

A

Increase in blood flow to muscle during exercise up to 80-85%

29
Q

Organ metabolism

A

important factor in regulation of blood flow, greater metabolism in organ, greater demand for blood supply

30
Q

Regulation blood flow in exercise

A

Muscle metabolism increases, blood temporarily shunted from other regions of body to muscles - by vasodilation of the arterioles that feed muscle and vasoconstriction of arterioles that supply other organs, supply to meet demand

31
Q

Ischemia

A

obstructed blood supply to organ, eg skin- moving patients, induces reactive hyperaemia, prevents skin ulceration
Skin blood flow goes up during exercise to allow heat loss to regulate body temp

32
Q

Autoregulation

A

Ability of tissues to automatically adjust their blood supply to meet demands

33
Q

Foetal circulation

A

Umbilical Vein and ductus venosus, Ductus arteriosus, umbilical arteries

34
Q

Umbilical vein and ductus venosus

A

oxygenated blood returning from the placenta is carried in the umbilical vein, empties into ductus venosus, empties into IVC

35
Q

Ductus arteriosus

A

allows blood to pass from pulmonary trunk directly into aorta, onwards to systemic circulation

36
Q

Umbilical arteries

A

transport foetal deoxygenated blood to placenta, foramen ovale opening between right and left atrium by pass the lings

Nursing 2nd Year (5 decks)

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