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Block C: Circulation > Physiology > Flashcards

Physiology Flashcards

1
Q

When does the mitral valve closes?

A

When the intraventricular pressure rises above that of the atrium

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2
Q

What is the period between the closure of the mitral valve and the opening of the aortic valve?

A

Isovolumetric contraction phase

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3
Q

What is the Windkessel Effect?

A

During diastole, arterial pressure is maintained by elastic recoil on the walls of the aorta

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4
Q

What is the isovolumetric relaxation phase?

A

Interval between aortic valve closure and mitral valve opening

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5
Q

What represents the first (small bump) on the Wiggers Diagram?

A

Atrial contraction to fill the ventricle

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6
Q

On the Wiggers Diagram, why is there a plateau between the systolic and diastolic phase? What is the name of this plateau?

A

Incisura/diacrotic notch

It represents the aortic blood flow going backwards to fill the aortic leaflets (cusps)

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7
Q

What is the ejection fraction?

A

Stroke volume
_____________
End-distolic volume

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8
Q

What is an normal ejection fraction?

A

55-70%

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9
Q

What is systolic blood pressure?

A

Highest arterial pressure at peak ventricular contraction

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10
Q

What is diastolic blood pressure?

A

Lowest recorded blood pressure at the end of diastole

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11
Q

Systolic BP - Diastolic BP =

A

Pulse pressure

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12
Q

Mean arterial pressure =

A

Diastolic BP + 1/3 Pulse pressure

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13
Q

On the pressure-volume loop, the curve [aortic valve closing]-[mitral valve opening]-[mitral valve closing] is what?

A

Diastole

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14
Q

On the pressure-volume loop, the curve [mitral valve closing]-[aortic valve opening]-[aortic valve closing] is what?

A

Systole

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15
Q

What is EDPVR?

A

End-diastolic pressure-volume relation (pressure-volume relation during cardiac filling)

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16
Q

What is ESPVR?

A

End-systolic pressure-volume relation (pressure-volume relation at aortic valve closure)

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17
Q

If left ventricle is less compliant, EDPVR curve will…

A

Shift upward

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18
Q

End diastolic volume (EDV) - End systolic volume (ESV) =

A

Stroke volume

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19
Q

What are the three determinants of stroke volume?

A

Ventricular prepload
Ventricular afterload
Ventricular contractility

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20
Q

What is Frank-Starling’s Law?

A

Ceteris Paribus, stroke volume increases as cardiac filling increases

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21
Q

Increase in preload leads to what?

A

Higher end-diastolic volume

Higher stroke volume

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22
Q

Decrease in preload leads to what?

A

Less end-diastolic volume

Less stroke volume

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23
Q

Afterload (wall stress) is proportional to what?

A

Mean arterial pressure

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24
Q

Pressure in ventricle x Radius
________________ =
2x wall thickness

A

Afterload

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25
Q

Hypertension and aortic valve stenosis is associated with

A

High afterload

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26
Q

Increase in afterload leads to what?

A

Decrease stroke volume

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27
Q

Decrease in afterload leads to what?

A

Increased stroke volume

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28
Q

What is contractility?

A

Strength of heart’s contraction during systole

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29
Q

With respect to contractibility, norepinephrine will…

A

Increase contractibility

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30
Q

Increased contractibility will lead to what?

A

Decreased end-systolic volume

Higher stroke volume

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31
Q

Decreased contractibility will lead to what?

A

Higher end-systolic volume

Decreased stroke volume

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32
Q

Positive chronotropic effect leads to what?

A

Higher heart rate

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33
Q

Positive inotropic effect leads to what?

A

Higher contractibility

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34
Q

What is Fick’s formula?

A

Cardiac output = VO2/(ConcO2a-ConcO2v)

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35
Q

Usinf the thermodilution method, the cooler the blood…

A

The smaller the cardiac output

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36
Q

Diffusion coefficient x Concentration gradient =

A

Flux (flow per unit area)

37
Q

Diffusion coefficient x ((ConcOut - ConcIn)/thickness) =

A

Flux

38
Q

What is 1 unit of blood?

A

450ml

39
Q

What is the usual cardiac ouput?

A

5L/min

40
Q

Hydrostatic pressure =

A

Density (p) x Height x Gravity

41
Q

Perfusion pressure/Resistance =

A

Flow

42
Q

Within a vessel, where is the blood the fastest?

A

At the center

43
Q

Mean arterial pressure/Cardiac output =

A

Total periphery resistance

44
Q

According to Poisseule’s Law, with respect to resistance, the higher the radius…

A

The lower the resistance

45
Q

Who recorded the first heart’s current?

A

Einthoven

46
Q

Normally, what is the polarity of a cell?

A

The inside of a cell is negative, and the outside is positive

47
Q

The T-wave refers to what?

A

Repolarization

48
Q

If the recording is negative, what does that mean?

A

The flow of polarization went from negative to positive

49
Q

Lead aVR goes from where to where?

A

From the center of body to right arm

50
Q

Lead aVL goes from where to where?

A

From the center of the body to left leg

51
Q

Lead aLA goes from where to where?

A

From the center of the body to left arm

52
Q

Lead I goes from where to where?

A

From right arm to left arm

53
Q

Lead II goes from where to where?

A

From right arm to left leg

54
Q

Lead III goes from where to where?

A

From left arm to left leg

55
Q

What is the name of the first downward deflection, after the P wave?

A

Q-wave

56
Q

What is the name of the first upward deflection, after the P wave?

A

R-wave

57
Q

What is the name of the downward deflection after the Q or R wave?

A

S-wave

58
Q

ST segment is normally isoelectric (it’s a the baseline level). If it moves up or downwards, what does it mean?

A

The heart is lacking oxygen

59
Q

A sinus rhythm of less than 60beats/min is a sign of what?

A

Sinus bradycardia

60
Q

A sinus rhythm of more than 100beats/min is a sign of what?

A

Sinus tachycardia

61
Q

From a birds view, what is the angle of the lead V1?

A

100

62
Q

From a birds view, what is the angle of the lead V2?

A

80

63
Q

From a birds view, what is the angle of the lead V3?

A

75

64
Q

From a birds view, what is the angle of the lead V4?

A

60

65
Q

From a birds view, what is the angle of the lead V5?

A

30

66
Q

From a birds view, what is the angle of the lead V6?

A

0

67
Q

Mean systemic filling pressure =

A

Peripheral venous pressure

68
Q

What are the characteristics of central venous compartments?

A

Small system compared to peripheral venous compartments
Intrathoracic
Includes venae cava and right atrium

69
Q

Which has the bigger volume, peripheral or central venous compartments?

A

Peripheral venous compartments

70
Q

Which is most compliant, peripheral or central venous compartments?

A

Peripheral venous compartments

71
Q

What is the name of the actual pressure that would exist throughout the system in the absence of flow?

A

Mean systemic filling pressure

72
Q

What is the name of the rate at which blood gets to central venous compartment?

A 
Venous return
(normally equal to cardiac output)
73
Q

Rising the central venous pressure will temporarely do what?

A

Increase cardiac output

Decrease venous return

74
Q

Peripheral venous press - central venous press
_____
Venous resistance

A

Flow

75
Q

What happens if central venous pressure falls below the intrathoracic pressure?

A

Thin-walled veins in the thorax will collapse

76
Q

What happens to the venous function curve when peripheral venous pressure increases?

A

Shifts upwards and to the right

77
Q

What happens to the venous function curve when peripheral venous pressure decreases?

A

Shifts downward and to the left

78
Q

What is the instrument that allows the assessment of the left atrial pressure?

A

Swan-Ganz catheter (aka pulmonary artery catheter)

79
Q

Variation of volume
____
Variation of pressure

A

Compliance

80
Q

When someone stands up, the arterial pressure drops momentarily. What does it do with respect to cardiac output, contractility and stroke volume?

A

Decrease cardiac output
Decrease stroke volume
Increase contractility

81
Q

When someone stands up, the arterial pressure drops momentarily. What does it do with respect to central blood volume, heart rate and total peripheral resistance?

A

Decrease central blood volume
Increase heart rate
Increase peripheral resistance

82
Q

Is there a venodilatation when someone stands up?

A

No. There’s venoconstriction

83
Q

Cardiac ouput x total periphery resistance =

A

Mean arterial pressure

84
Q

What happens to plasma volume when you stand up?

A

You lose plasma volume (which explains why you lose central blood volume)

85
Q

During exercise, after correction, what happens to heart rate, cardiac output and mean arterial pressure?

A

All three increase

86
Q

During exercise, after correction, what happens to stroke volume?

A

Stroke volume increase slightly, but will decrease at high heart rate

87
Q

During exercise, after correction, what happens to total periphery resistance and arteriovenous oxygen difference?

A

Decreased total periphery resistance

Increase arteriovenous oxygen difference

88
Q

Will endurance training increase the maximum heart rate?

A

No

89
Q

Exercise will increase blood flow to which systems?

A

Skin
Skeletal muscle
Heart

Block C: Circulation (10 decks)

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