Test 1: Wk1: 1 Hemodynamics - Puri

Question 1

Systemic circulation

Answer 1

Oxygenated blood flows from the left heart into
the systemic circulation and, after passing through the capillary bed, flows back in
a deoxygenated state to the right atrium of the heart to restart the process.

Question 2

Systemic circulation Flow

Answer 2

Left atrium → mitral valve → left ventricle → aortic valve
→ aorta→ arteries → arterioles → capillary beds → veins → superior vena
cava (SVC) and inferior vena cava (IVC) → right atrium

Question 3

Pulmonary Circulation

Answer 3

Deoxygenated blood in the right heart flows into

the lungs, where it is oxygenated and returned to the left atrium.

Question 4

Pulmonary Circulation Flow

Answer 4

Right atrium → tricuspid valve → right ventricle → pulmonary valve
→ pulmonary trunk → pulmonary arteries → lungs → four pulmonary
veins → left atrium

Question 5

Flow of Blood Through the Heart

Answer 5

Inf and Sup Vena Cava > RA > Tricuspid Valve > RV > Pulmonary Valve > Pulmonary Artery > Lungs Capillary Bed > Pulmonary Veins > LA > Mitral Valve > LV > Aortic Valve > Aorta > Systemic Arteries > Systemic Capillary Beds > Systemic Veins > Vena Cava

Question 6

cyanosis

Answer 6

bluish red discoloration of skin and mucosa
due to
deoxygenated blood circulating in the systemic circulation capillaries (usually seen
when oxygen saturation of hemoglobin drops below 85%)

Question 7

As the pressure in the ventricles starts
to --- during systole, it exceeds the
pressure in the atria, which closes the
---- and the ---- valve. Closure
of the valves causes turbulence that
makes a sound–S1—the first heart
sound is heard—“lub

Answer 7

As the pressure in the ventricles starts
to rise during systole, it exceeds the
pressure in the atria, which closes the
mitral and the tricuspid valve. Closure
of the valves causes turbulence that
makes a sound–S1—the first heart
sound is heard—“lub

Question 8

S2 heart sound

Answer 8

closing of aortic and pulmonary valves

Question 9

Flowing blood is key to homeostasis across organ-systems and to ensure: (4)

Answer 9

1. Nutrient delivery & waste disposal
2. Chemical signaling (think hormones)
3. Thermoregulation (heat exchange in the skin)
4. Defense mechanisms (innate and adaptive immunity travel to the site of injury
   via the circulation)

Question 10

rheumatic heart disease

Answer 10

the mitral valve is stenosed

valve opening is not supposed to make a sound, but
a stenosed valve opens with an audible snap→ the snap is after S2 and before S1

Question 11

In atrial septal defect

Answer 11

blood flows from the left to the right atria during
diastole i.e. some volume of blood “bypasses” the LV and thus, LV output is NOT
equal to RV output.

Question 12

— is the first step in restoring adequacy of circulation in the ER.

Answer 12

fluid infusion

Question 13

distributive shock

Answer 13

all vascular beds dilate at the same time. This drops the

pressure in the system leading to severe under-perfusion of key organs

Question 14

Pressure difference (ΔP)

Answer 14

required to generate flow, which is facilitated by
one-way valves—i.e. pressure upstream MUST be higher than pressure
downstream

Question 15

what is the only purpose of the CV system

Answer 15

generating blood flow

Question 16

where is pressure highest in circualtion

Answer 16

large arteries

Question 17

blood reservoirs

Answer 17

veins

Question 18

veins have — pressure and — volume

Answer 18

low; high

Question 19

stop valves of circulation

Answer 19

arterioles

opening and closing controls flow of blood to capillaries

Question 20

site of gas and nutrient exchange

Answer 20

capillaries
These are single-cell lined
tubes, which are freely permeable to gases and nutrients

Question 21

arterioles are actively controlled by the

Answer 21

SNS

Question 22

arborization

Answer 22

circulatory and respiratory systems are designed like a tree

Question 23

the heart is a generator of

Answer 23

flow

Question 24

Flow

Answer 24

vol/time

Q

Question 25

Energy for flow

Answer 25

Force / Area

P

Question 26

Measure of opposition to fluid movement

Answer 26

R

resistance

Question 27

Flow, pressure and resistance are linked via

this equation

Answer 27

Q = ΔP/R
or
CO = ΔP/R

Question 28

Cardiac output (CO) is defined as

Answer 28

volume pumped by the heart/min.

Question 29

Stroke Volume (SV) is

Answer 29

volume ejected/beat ≈ 69 mL

Question 30

Number of times the heart beats/min

Answer 30

HR = 72/min

Question 31

CO =

Answer 31

CO = HR x SV = Flow (Q)

72 x 69 = 4950ml/min ≈ 5L/min

Question 32

tachycardia is seen in — shock which is characterized by — stroke volume

Answer 32

hypovolemic; reduced

Question 33

how to recover CO if SV is reduced

Answer 33

increase HR

cardiac output
can be regulated by changing either SV or HR or both depending on what the
“desired” outcome is.

Question 34

blood pressure is

Answer 34

directly dependent
on the volume of blood in the major arteries which in turn is controlled by
cardiac output.

Question 35

— refers to pressure in the aorta and its larger branches.

Answer 35

MAP

Question 36

If RAP is 0, MAP = —

Answer 36

If RAP is 0, MAP = Driving pressure

Question 37

MAP= 2/3 — + 1/3 — ≈ 100 mm

Hg

Answer 37

MAP= 2/3 Diastolic + 1/3 Systolic ≈ 100 mm

Hg

Question 38

all organs are arranged in — to each other

Answer 38

parallel

1/TPR = 1/kidney + 1/liver + 1/upper limb + etc..

Question 39

resistance to flow offered by an singular vascular bed is — than TPR

Answer 39

more

Question 40

if an organ is removed what happens to TPR

Answer 40

increased

Question 41

— have highest resistance to blood flow

Answer 41

arterioles

Question 42

Adding resistance in —increases total resistance and adding resistance in — lowers it

Answer 42

Adding resistance in series increases total resistance and adding resistance in parallel lowers it

Question 43

velocity of blood flow is highest

Answer 43

in the aorta

Question 44

to calculate flow
or cardiac output—we
need three things—

Answer 44

1. oxygen consumption/ minute
2. arterial oxygen concentration
3. Venous oxygen concentration