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Cardiovascular Medicine > Understanding the physiology of the cardiovascular system > Flashcards

Understanding the physiology of the cardiovascular system Flashcards

1
Q

what are the components of the cardiovascular system

A
  • cardiopulmonary unit
  • left and right side
  • pulmonary artery and vein
  • arteries, arterioles, capillaries, venules and veins
  • portal systems
  • intra-renal circulation
  • intra-coronary circulation
  • intra-cranial circulation
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2
Q

what are portal systems. give examples

A

an arrangement by which deoxygenated blood collected from are from a set of capillaries passess through a large vessel or vessels to another set of capillaries before it returns to the systemic circulation
e.g., -> hepatic portal system -> hypothalamic + anterior pituitary (hypophyseal)

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3
Q

hypophyseal

A

hypothalmic and anterior pituitary portal system

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4
Q

stroke volume

A

the volume of blood pumper by the left ventricle per beat. denoted by SV

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5
Q

cardiac output

A

the volume of blood pumped by the heart per unit time. measured as L/min and denoted by Q

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6
Q

perfusion

A

the passage of blood through the circulatory system to the body’s tissues. measured as ml of blood/min/g of tissue

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7
Q

preload

A

the degree to which the left ventricle is filled at the end of diastole, just prior to systolic contraction. measured as mL and denoted as EDV

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8
Q

contracticity

A

the innate ability of the myocardium to contract

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9
Q

afterload

A

the resistance against which the L ventricle must eject the SV from the heart. measured as aortic pressure during systole divided by cardiac output

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10
Q

compliance

A

the ability of the blood vessel to expand and contract with changes in pressure. measured as unit of volume change per unit of pressure change. denoted by C

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11
Q

functions of the cardiovascular system

A
  1. rapid connective transport of O2, glucose, amino acids + fatty acids, vitamins, water, waste products of metabolism, i.e., CO2, urea, creatinine.
  2. homeostatic control- hormones and temperature
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12
Q

factors that affect heart rate

A

atrial reflex, autonomic innervation, hormones

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13
Q

atrial reflex

A

The Bainbridge reflex (aka, atrial reflex) occurs when the heart rate increases in response to a rise in atrial pressure. This is a compensatory mechanism since increased right atrial pressures frequently result from elevated left heart pressures from decreased cardiac output.

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14
Q

factors that affect stroke volume

A

venous return, filling time, autonomic innervation, hormones, vasodilation/vasoconstriction

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15
Q

what factors affect preload

A

venous return, filling time

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16
Q

what factors affect contractility

A

autonomic innervation and hormones

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17
Q

what factor affects afterload

A

vasodilation/vasoconstriction

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18
Q

factor that affects end diastolic volume

A

preload

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19
Q

factors that affect end systolic volume

A

preload, contractility and afterload

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20
Q

stroke volume formula

A

EDV-ESV

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21
Q

formula for Q

A

HR x SV

22
Q

define frank-starling mechanism

A

the SV of the heart increase in response to an increase in the vol of blood in the ventricles before contraction when all other factors remain constant

23
Q

what do each of the four corners on the frank-starling graph stand for

A
  1. mitral valve closes
  2. Aortic valve opens
  3. Aortic Valve closes
  4. Mitral Valve closes
24
Q

an increase in preload, afterload or contractility would lead to an ____ in EDV, _____ in ESV and ____ in stroke volume

A
  1. increase
  2. decrease
  3. increase
25
Q

a decrase in preload, afterload or contractility would lead to an ____ in EDV, _____ in ESV and ____ in stroke volume

A
  1. decrease
  2. increase
  3. decrease
26
Q

what are the two main extrinsic controls of circulation

A
  1. autonomic: sympathetic and parasympathetic

2. RAAS System

27
Q

where are the parasympathetic control centres/nerves locate

A

brain stem, cranial nerves, sacral outflow, end organ ganglia, postganglionic (ACh + adrenergic, non-cholinergic (NANC) transmitters)

28
Q

where are the sympathetic control centres/nerves located

A

brain stem, spinal cord, preganglionic fibres (ACh), spinal ganglia, postganglionic fibres (NA), distant ganglial (coeliac + hypogastric ganglia and the adrenal medulla)

29
Q

sympathetic stimulation of the blood vessels would lead to ….

A

vasoconstriction

30
Q

ionotropy

A

contractility

31
Q

chronotropy

A

heart rate

32
Q

dromotropy

A

velocity of the AV node

33
Q

agonism of a1 , a2 and b1 receptors would ______ iontropy, chronotopy and dromotropy and cause _______

A

increase, vasoconstriction

34
Q

agonism of b2 receptors would _______ ionotropy, chornotropy and dromotropy and cause ________

A

decrease, vasodilation

35
Q

when is RAAS system triggered

A

drop in blood pressure or blood volume

36
Q

RAAS mechanism

A
  1. angiotensin is released by the liver
  2. renin produced by the kidney acts on the angiotensin and forms angiotensin I
  3. ACE is released by the lungs+ kidneys that converts angiotensin I to angiotensin II
  4. Angiotensin II acts on the adrenal gland to release aldosterone
  5. Aldosterone acts on the kidneys to stimulate reabsorption of NaCl and H2O.
  6. Angiotensin II also acts on the blood vessels and stimulates vasoconstriction
37
Q

what cells produce renin

A

juxtaglomerular cells in the afferent arteriole of the renal glomerulus.

38
Q

what stimulates the production of renin by the kidneys

A
  1. sympathetic nerve activation (acting via the b1 receptor)
  2. renal artery hypotension (caused by systemic hypotension or renal artery stenosis)
  3. decreased sodium delivery to the distal tubules of the kidney sensed by the cells in the Macula Densa
39
Q

what cells produce ACE and what is it’s purpose

A

vascular endothelium, especially in the lungs contain ACE and that cleaves Ang-I to Ang-II

40
Q

what are the two receptors that Ang-II acts on

A

T1 receptors- vasoconstriction, cell proflieration, inflammatory responses, blood coagulation, extracellular matrix remodelling
T2 receptors counteract these effects

41
Q

actions of Ang-II on the CVS

A
  1. constricts resistance vessels thereby increase SVR and arterial pressure
  2. stimulates sodium transport (reabsorption) at several renal tubular sites, thereby increasing sodium and water retention
  3. acts on the adrenal cortex to release aldosterone
  4. stimulates thirst
  5. facilitates noradrenaline release from sympathetic nerve endings and inhibits it reuptake
  6. stimulates cardiac hypertrophy and vascular hypertrophy
42
Q

actions of aldosterone on the CVS

A
  1. affects the final part of electrolyte and water absorption within the nephron before acretion in the urine
  2. increases the amt of sodium reabsorbed from the distal tubule and collecting duct of the kidney
43
Q

actions of adrenaline on the CVS

A

stimulates all major receptors- a1, a2, b1, b2. at low concentrations in b2 selective, it causes vasodilation and at higher concentrations, it stimulates the other adrenergic receptors causing vasoconstriction and this increases heart rate and contractility. also causes renal arterioles vasoconstriction, reducing blood flow to the glomeruli and nephrons

44
Q

when is Antidiuretic hormone or Arginine vasopressin released

A

during hypovolaemic shock

45
Q

where is Antidiuretic hormone or Arginine vasopressin synthesised

A

hypothalamus and released from the posterior pituitary gland

46
Q

what is Antidiuretic hormone or Arginine vasopressin released in response to

A

reduction in plasma volume, and an increase in plasma osmolarity

47
Q

ADH affect on CVS

A

acts via V1 receptors to cause arteriolar constriction

48
Q

ADH affect on kidney

A

acts via V2 receptors to cause increase in the amt of water reabsoprtion by renal tubules

49
Q

natriuretic peptide

A

produced, stored and released by atrial myocytes due to atrial distention. acts in response to high renal Na+ excretion and in response to increased stretching of the atrial blood volume.`

50
Q

two kinds of natriuretic peptides produced by the heart

A

BNP, ANP

Cardiovascular Medicine (6 decks)

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