Unit 3.1: CV A&P Flashcards

1
Q
A
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2
Q

which myocyte property is correct for: Contains actin and myosin myofilaments

A. Similar to neural and skeletal muscle
B. Unique to cardiac muscle

A

A

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3
Q

which myocyte property is correct for: propagates action potential

A. Similar to neural and skeletal muscle
B. Unique to cardiac muscle

A

A

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4
Q

which myocyte property is correct for: generates a resting potential

A. Similar to neural and skeletal muscle
B. Unique to cardiac muscle

A

A

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5
Q

which myocyte property is correct for: has gap junctions

A. Similar to neural and skeletal muscle
B. Unique to cardiac muscle

A

B

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6
Q

which myocyte property is correct for: Contains t-tubule system

A. Similar to neural and skeletal muscle
B. Unique to cardiac muscle

A

A

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7
Q

which myocyte property is correct for: oxygen consumption at rest of 8-10 mL O2/100 g/min

A. Similar to neural and skeletal muscle
B. Unique to cardiac muscle

A

B

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8
Q

the resting membrane potential is established by what 3 mechanisms

A
  1. chemical force
  2. electrostatic counterforce
    c. sodium/potassium ATPase
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9
Q

define resting membrane potential

A

the electrical potential across a cell membrane at rest

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10
Q

define threshold potential

A

the voltage change that must be achieved to initiate depolarization

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11
Q

Review:

note similarities and differences between neural, skeletal, and cardiac muscle

A
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12
Q

what is the name of the equation to predict an ions equillibrium pote4ntial

A

Nernst

Do not need to know how to calculate… just understand concept

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13
Q

Describes the force of myocardial contraction during systole

A. Inotropy
B. Chronotropy
C. Dromotropy
D. Lusitropy

A

A

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14
Q

describes Heart rate

A. Inotropy
B. Chronotropy
C. Dromotropy
D. Lusitropy

A

B

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15
Q

Describes conduction velocity through the heart (Velocity = distance/time)

A. Inotropy
B. Chronotropy
C. Dromotropy
D. Lusitropy

A

C

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16
Q

describes the rate of myocardial relaxation during diastole

A

D

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17
Q

primary determinant of threshold potential

A

Serum Calcium

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18
Q

primary determinant of resting membrane potential

A

serum potassium

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19
Q
A

2

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20
Q

Review

A
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21
Q

sort each myocardial event to its primary phase of the myocyte action potential: ST Segment

A. Phase 0
B. Phase 2
C. Phase 3
D. Phase 4

A

B

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22
Q

sort each myocardial event to its primary phase of the myocyte action potential: Q Wave

A. Phase 0
B. Phase 2
C. Phase 3
D. Phase 4

A

A

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23
Q

sort each myocardial event to its primary phase of the myocyte action potential: Calcium Influx

A. Phase 0
B. Phase 2
C. Phase 3
D. Phase 4

A

B

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24
Q

sort each myocardial event to its primary phase of the myocyte action potential: Sodium influx

A. Phase 0
B. Phase 2
C. Phase 3
D. Phase 4

A

A

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25
Q

sort each myocardial event to its primary phase of the myocyte action potential: isoelectric EKG

A. Phase 0
B. Phase 2
C. Phase 3
D. Phase 4

A

D

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26
Q

sort each myocardial event to its primary phase of the myocyte action potential: Plateau

A. Phase 0
B. Phase 2
C. Phase 3
D. Phase 4

A

B

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27
Q

sort each myocardial event to its primary phase of the myocyte action potential: Resting phase

A. Phase 0
B. Phase 2
C. Phase 3
D. Phase 4

A

D

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28
Q

sort each myocardial event to its primary phase of the myocyte action potential: T Wave

A. Phase 0
B. Phase 2
C. Phase 3
D. Phase 4

A

C

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29
Q

sort each myocardial event to its primary phase of the myocyte action potential: Potassium Leak

A. Phase 0
B. Phase 2
C. Phase 3
D. Phase 4

A

D

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30
Q

sort each myocardial event to its primary phase of the myocyte action potential: Final Repolarization

A. Phase 0
B. Phase 2
C. Phase 3
D. Phase 4

A

C

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31
Q

sort each myocardial event to its primary phase of the myocyte action potential: Potassium Efflux

A. Phase 0
B. Phase 2
C. Phase 3
D. Phase 4

A

C

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32
Q

sort each myocardial event to its primary phase of the myocyte action potential: Depolarization

A. Phase 0
B. Phase 2
C. Phase 3
D. Phase 4

A

A

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33
Q
A
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34
Q
A

I-f

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35
Q

Review

  • what is the order of stimulus through heart
A
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36
Q

Review SA node Firing

A
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37
Q

what determines the heart rate…

A
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38
Q

other name for the SA node

A

Kieth flack node

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39
Q

Review

A
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40
Q

the ______ vagus nerve innervates the SA Node and the ______ vagus nerve innervates the AV Node

A

Right = SA

Left = AV

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41
Q

Cardiac accelerator fibers

A

T1-T4

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42
Q

REVIEW

A
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43
Q
A
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44
Q

what 3 variables can be manipulated to change the sinus node rate

A
  1. rate of spontaneous phase 4 depolarization
  2. threshold potential
  3. Resting membrane potential
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45
Q

how does SNS stimulation increase the HR

A
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46
Q
A
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47
Q
A

1000 ml/min

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48
Q

oxygen delivery equation

what is the normal

A

1,000 mL

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49
Q

Review

A
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50
Q

solution coefficient for dissolved oxygen

A

0.003

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51
Q

3 things CO is determined by

A
  1. preload
  2. afterload
  3. contractility
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52
Q

oxygen content equation

what is the normal

A

20 mL/dL

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53
Q

oxygen extraction ration

A
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54
Q

oxygen consumption normal amount

A
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55
Q

venous oxygen content equation

what is the normal

A

15 mL/dL

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56
Q

match the “parts of the choo choo train” to the components of the oxygen delivery equation

Cargo

A. Hemoglobin
B. SaO2
C. Cardiac Output

A

B

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57
Q

match the “parts of the choo choo train” to the components of the oxygen delivery equation

Engine

A. Hemoglobin
B. SaO2
C. Cardiac Output

A

C

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58
Q

match the “parts of the choo choo train” to the components of the oxygen delivery equation

Boxcar

A. Hemoglobin
B. SaO2
C. Cardiac Output

A

A

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59
Q

what does CaO2 tell you

A

how many grams of oxygen are contained in a dL of ARTERIAL blood

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60
Q

the amount of oxygen dissolved in blood (PaO2) follows what law

A

henrys law

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61
Q
A

hematocrit

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62
Q

equation to calculate MAP

A
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63
Q

poiseuilles Equation

A
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64
Q

altering what part of poiseuilles Equation yields the gretest impact on flow

A

radius

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65
Q

Review

A
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66
Q

what factors influence CO

A

SV
HR
ESV
EDV
Filling pressures
compliance
afterload
contractility

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67
Q

how does CO impact the variable that comes after it

A

directly impacts MAP, tissue blood flow, and oxygen delivery

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68
Q

what are the 5 components of Poiseuilles Law

A
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69
Q

how much flow occurs when the radius of a tube is quadrupled

A

256 times

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70
Q

how is viscocity related to temperature

A. Inversely proportional
B. Directly proportional

A

A

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71
Q

Reynolds # for turbulent flow

A

> 4,000

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72
Q

Reynolds # for transitional flow

A

2,000-4,000

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73
Q

Reynolds # for laminar flow

A

< 2,000

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74
Q
A
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75
Q

Normal value for:

Cardiac Output

A

5-6 L/min

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76
Q

Normal value for:

Stroke Volume

A

50-100 mL/beat

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77
Q

Normal value for:

Ejection fraction

A

60-70%

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78
Q

Normal value for:

Mean arterial BP

A

70-105 mmHg

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79
Q

Normal value for:

SVR

A
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80
Q

Normal value for:

Pulmonary Vascular Resistance

A
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81
Q

Review

A
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82
Q

Review

A
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83
Q
A
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84
Q

Review

A
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85
Q

Review

A

notice that several terms can be used on the x- and y- axes. You should know all of them

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86
Q

atrial kick accounts for ______% of the final LVEVV

A

20-30%

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87
Q

conditions associated with decreased myocardial compliance…

A
  • myocardial hypertrophy
  • heart failure with preserved EF (diastolic failure)
  • fibrosis
  • aging
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88
Q

On the Starling curve, is this variable on the X- or Y-axes?

LVEDV

A

X

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89
Q

On the Starling curve, is this variable on the X- or Y-axes?

PAOP

A

X

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90
Q

On the Starling curve, is this variable on the X- or Y-axes?

CO

A

Y

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91
Q

On the Starling curve, is this variable on the X- or Y-axes?

SV

A

Y

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92
Q

On the Starling curve, is this variable on the X- or Y-axes?

LVSW

A

Y

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93
Q

On the Starling curve, is this variable on the X- or Y-axes?

CVP

A

X

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94
Q

LVEDP, LAP, and PAOP are all surrogate measures of:

A

LVEDV

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95
Q
A
  • hypoxia
  • hypercapnia
  • hyperkalemia
96
Q

true or false: contractility is independent of preload and afterload

A

true

97
Q

What happens to ventricular output when contractility is increased vs decreased

A
98
Q

Factors that influence contractility

A

Remember

C hemicals affect C ontractility - particularly C alcium

99
Q

Review

A
100
Q

Review how Beta-1 stimulation increases contractility

A
101
Q

what is the primary substance that determines inotropy

A

calcium

102
Q

name 5 factors that increase LV contractility

A
103
Q

list 3 ways that B-1 receptor stimulation modulates calcium in the myocyte

A
104
Q
A

Afterload

105
Q

Review

A
106
Q

law of laplace equation

A
107
Q

normal SVR in adults

A
107
Q

myocardial wall stress is reduced by what 3 factors

A
108
Q
A
  • rapid ventricular filling
  • diastasis
  • atrial systole
109
Q

REVIEW x 1000

A
110
Q

Review

A

Systole

111
Q

Review

A

Diastole

112
Q

identify the status of the mitral valve ( open vs closed ) during each phase of the cardiac cycle

Ventricular Ejection

A

mitral valve = closed

113
Q

identify the status of the mitral valve ( open vs closed ) during each phase of the cardiac cycle

Isometric ventricular relaxation

A

mitral valve = closed

114
Q

identify the status of the mitral valve ( open vs closed ) during each phase of the cardiac cycle

Isometric ventricular contraction

A

mitral valve = closed

115
Q

identify the status of the mitral valve ( open vs closed ) during each phase of the cardiac cycle

atrial systole

A

mitral valve = open

116
Q

identify the status of the mitral valve ( open vs closed ) during each phase of the cardiac cycle

rapid ventricular filling

A

mitral valve = open

117
Q

identify the status of the aortic valve ( open vs closed ) during each phase of the cardiac cycle

isometric ventricular contraction

A

AV= closed

118
Q

identify the status of the aortic valve ( open vs closed ) during each phase of the cardiac cycle

Ventricular Ejection

A

AV = open

119
Q

identify the status of the aortic valve ( open vs closed ) during each phase of the cardiac cycle

rapid ventricular filling

A

AV = closed

120
Q

identify the status of the aortic valve ( open vs closed ) during each phase of the cardiac cycle

atrial systole

A

AV = closed

121
Q

identify the status of the aortic valve ( open vs closed ) during each phase of the cardiac cycle

isometric ventricular relaxation

A

AV = closed

122
Q

stroke volume ___________ between Q wave and end of T wave

A. Does occur
B. Does not occur

A

A

123
Q

atrial systole ___________ between Q wave and end of T wave

A. Does occur
B. Does not occur

A

B

124
Q

rapid ventricular ejection ___________ between Q wave and end of T wave

A. Does occur
B. Does not occur

A

A

125
Q

mitral valve opens ___________ between Q wave and end of T wave

A. Does occur
B. Does not occur

A

B

126
Q

atrial valve opens___________ between Q wave and end of T wave

A. Does occur
B. Does not occur

A

A

127
Q

left ventricular systole ___________ between Q wave and end of T wave

A. Does occur
B. Does not occur

A

A

128
Q

isovolumetric ventricular relaxation ___________ between Q wave and end of T wave

A. Does occur
B. Does not occur

A

B

129
Q

what cardiac event occurs at the marked area of the image

A. Mitral Valve closes
B. Mitral Valve Opens
C. Aortic Valve closes
D. Aortic Valve Opens

A

A

130
Q

Review

A
131
Q

Review

A
132
Q

identify each phase of the ventricular cycle as systole or diastole

A
133
Q

identify each mechanical event of the ventricular cycle

A
134
Q

calculate the stroke volume (in mL)

A

70 mL

equal to the width of the loop

135
Q

Review

A
136
Q

true or false: the LV volume increases during isovolumetric contraction

A

False – LV volume does not change

137
Q

when is DBP measured

A

where aortic valve opens

138
Q

When is SBP measured

A

at the peak of the ejection curve

139
Q

Review

A
140
Q

identify the status of the cardiac valves on the LV pressure volume loop

A
141
Q

Ejection Fraction:

  • Normal
  • mild dysfunction
  • moderate dysfunction
  • severe dysfunction
A
  • Normal: >/= 50%
  • mild dysfunction: 41-49%
  • moderate dysfunction: 26-40%
  • severe dysfunction: </= 25%
142
Q
A

intravenous fluid bolus

143
Q

Review

increased preload

A
144
Q

Review

decreased preload

A
145
Q

Review

increased contractility

A
146
Q

Review

decreased contractility

A
147
Q

Review

increased afterload

A
148
Q

Review

decreased afterload

A
149
Q

Identify the change that occurs in each LV pressure-volume loop

A

increased preload

150
Q

Identify the change that occurs in each LV pressure-volume loop

A

increased contractility

151
Q

Identify the change that occurs in each LV pressure-volume loop

A

increased afterload

152
Q

Identify the change that occurs in each LV pressure-volume loop

A

decreased preload

153
Q

Identify the change that occurs in each LV pressure-volume loop

A

decreased contractility

154
Q

Identify the change that occurs in each LV pressure-volume loop

A

decreased afterload

155
Q
A

circumflex

156
Q

Review

arterial circulation

A
157
Q

Review

A
158
Q

Review

A
159
Q

Review

arterial supply to the conduction system

A
160
Q

Review

coronary venous circulation

A
161
Q

Review

A
162
Q

on TEE/TTE, what is best view for diagnosing LV ischemia

what is 2nd best…

A

midpapillary muscle level in short axis

…2nd best = apical segment in short axis

163
Q

Identify each coronary artery

A
164
Q

identify the coronary artery responsible for perfusing each segment of the heart

A
165
Q

Which part of the myocardium does Lead II monitor

A. Lateral
B. Inferior
C. Anterior
D. Septal

A

B

166
Q

Which part of the myocardium does Lead V5 monitor

A. Lateral
B. Inferior
C. Anterior
D. Septal

A

A

167
Q

Which part of the myocardium does Lead I monitor

A. Lateral
B. Inferior
C. Anterior
D. Septal

A

A

168
Q

Which part of the myocardium does Lead aVF monitor

A. Lateral
B. Inferior
C. Anterior
D. Septal

A

B

169
Q

Which part of the myocardium does Lead V1 monitor

A. Lateral
B. Inferior
C. Anterior
D. Septal

A

D

170
Q

Which part of the myocardium does Lead V3 monitor

A. Lateral
B. Inferior
C. Anterior
D. Septal

A

C

171
Q

Which part of the myocardium does Lead V2 monitor

A. Lateral
B. Inferior
C. Anterior
D. Septal

A

D

172
Q

Which part of the myocardium does Lead V6 monitor

A. Lateral
B. Inferior
C. Anterior
D. Septal

A

A

173
Q

Which part of the myocardium does Lead III monitor

A. Lateral
B. Inferior
C. Anterior
D. Septal

A

B

174
Q

Which part of the myocardium does Lead aVL monitor

A. Lateral
B. Inferior
C. Anterior
D. Septal

A

A

175
Q

Which part of the myocardium does Lead V4 monitor

A. Lateral
B. Inferior
C. Anterior
D. Septal

A

C

176
Q

MEdiators of coronary vasodilation include (select 2):

A. adenosine
B. Beta 2 stimulation
C. Alpha-1 stimulation
D. hypocapnia

A

A & B

177
Q

Review

coronary blood flow and perfusion

A
178
Q

coronary blood flow auto regulates between a MAP of

A

60-140 mmHg

179
Q

adenosine is a byproduct of ______ metabolism and is a potent coronary vessel___________

A

ATP

vasodilator

180
Q

the __________ response refers to a vessels innate ability to maintain a constant vessel diameter

A

myogenic

181
Q

Review

causes of coronary artery constriction and dilation

A
182
Q

what 2 pressures determine coronary perfusion pressure

A

CPP = aortic DBP = LVEDP

183
Q

what 3 responses are responsible for autoregulation of coronary blood flow

A
184
Q

Histamine-1 causes:

A. Coronary vasoconstriction
B. Coronary vasodilation

A

A

185
Q

Beta-2 causes:

A. Coronary vasoconstriction
B. Coronary vasodilation

A

B

186
Q

Hitamine-2 causes:

A. Coronary vasoconstriction
B. Coronary vasodilation

A

B

187
Q

muscarinic causes:

A. Coronary vasoconstriction
B. Coronary vasodilation

A

B

188
Q

alpha causes:

A. Coronary vasoconstriction
B. Coronary vasodilation

A

A

189
Q

blood flow thru which cardiac region corresponds to the waveform in the image

A. RV subendocardium
B. LV subendocardium
C. LV epicardium
D. Aorta

A

B

190
Q

describe each waveform

A
191
Q

which region of the heart does this pressure waveform represent

A

Lt coronary artery flow during the cardiac cycle

192
Q

which myocardial arterial bed is most susceptible to ischemia

A

endocardial blood vessels of the myocardium

193
Q
A

decreased diastolic filling time

194
Q

Review

what increases and decreases oxygen demand

A
195
Q

name 3 circumstances that affect both sides of the myocardial supply-demand equation

A
  1. changes in HR
  2. aortic diastolic pressure changes
  3. changes to preload
196
Q

what does tachycardia do to myocardial oxygen supply and demand

A
197
Q

what does increased aortic diastolic presure do to myocardial oxygen supply and demand

A
198
Q

what does increased preload do to myocardial oxygen supply and demand

A
199
Q

mortality rate of a perioperative MI

A

20%

200
Q

Review

A
201
Q

3 pathways that affect intracellular calcium concentration

A
202
Q

PKA affects excitation-contraction coupling by:

A
203
Q

Review

Nitric Oxide cGMP pathway

A
204
Q

activators of PLC pathway (4)

A
  • phenylephrine
  • norepinephrine
  • angiotensin 2
  • endothelin-1
205
Q

the nitric oxide cGMP pathway causes:

A. vasodilation
B. Vasoconstriction

A

A

206
Q

the Phospholipase C pathway causes:

A. vasodilation
B. Vasoconstriction

A

B

207
Q

the G-protein cAMP pathway causes:

A. vasodilation
B. Vasoconstriction

A

A

208
Q

What 4 ways does protein kinase A affect excitation-contraction

A
209
Q

phenylephrine stimulates what effector to ultimately cause vasoconstriction

A

phospholipase C

210
Q

A. I
B. aVL
C. II
D. V6
E. V1
F. V3

A

A, B, D

211
Q
A

trendelenburg

212
Q
A

766 mL O2/min

213
Q
A
214
Q
A
215
Q
A
216
Q
A
217
Q
A
218
Q
A
219
Q
A
220
Q

where on the loop does aortic valve open

A
221
Q
A
222
Q
A

increasing potassium conductance

223
Q
A
224
Q
A

adenosine

225
Q
A

hyperkalemia increases resting membrane potential

226
Q

which letter corresponds with diastole (select 2)

A

B & C

227
Q
A

rapid ventricular filling
diastasis
atrial systole

228
Q
A

SA Node automaticity

229
Q
A

5%

230
Q
A
231
Q
A
232
Q
A

80

233
Q
A

neither preload or afterload

234
Q
A