Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

M1 Block 3 > Week 2 > Flashcards

Week 2 Flashcards

1
Q

Compare the movement of Na+ and K+ excluding the known, Na+ moves in and K+ moves out

A
  • Permeability for K+ is 50-100 times greater
  • Na+ cannot move in as fast as K+ moves out
  • Na+/K+ pump moves Na+ as fast as it leaks in
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What one major difference between cardiac action potentials and muscle action potentials?

A

Cardiac does not have a hyperpolarization state

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

All cardiac cells have __________ resting membrane potential.

A

All cardiac cells have unstable resting membrane potential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What anatomic component of cardiac muscle ensures the muscle beats as a syncytium?

A

Gap junctions: electrical connections between cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which has the longest action potential among the three:
- Skeletal muscle
- Neuron
- Cardiac cell

A

Cardiac cell: 300+ msec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

T/F: The action potential for atrium, ventricles, and nodes are all different

A

False, cardiac muscle (atria & ventricles) have the same action potential while nodal tissue has different action potential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the action potential phases of cardiac muscle

A

Phase 0: Rapid depolarization
Phase 1: Early repolarization
Phase 2: Plateau
Phase 3: Late Repolarization
Phase 4: Resting membrane potential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cardiac Action Potential: what ion is responsible for plateau phase? How does it work?

A
  • Ca+ coming inward via L type calcium channels
  • The incoming Ca+ balances the forming negative charged caused by the efflux of K+
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Cardiac AP: During phase ___: ____________, Ca+ comes into the cell via __-type Calcium channels. Where does the Calcium come from?

A

During phase 2: Plateau, Ca+ comes into the cell via L-type calcium channels.
Calcium is coming from the T tubules since L-type Calcium channels = Dihydropyridine Receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

List 5 drugs that bind to DHPR receptors. What do they block?

A
  1. Nitrendipine
  2. Nimodipine
  3. Nifedipine
  4. Diltiazem
  5. Verapamil
    Blocks calcium from entering cardiac cells via L-type Ca channels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What can be said about the relationship between electrical and mechanical events in the cardiac said

A

Electrical events precede mechanical events or contraction follows action potential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe calcium induced calcium release

A

After action potential reaches T tubule the voltage sensitive Dihydropyridine (DHP) receptors (L-type calcium channels) open for calcium entry
- Calcium influx triggers sarcoplasmic reticulum via Ryanodine Receptors to release Ca+ & increase Ca concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

T/F: The SR in Cardiac muscle can release enough Ca to sustain a contraction

A

False, without the calcium from the T tubules, the strength of cardiac muscle contraction would be reduced considerably because the SR of cardiac muscle is less well developed than skeletal muscle & does not store enough calcium to provide full contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What characteristics of Cardiac muscle allows for large calcium stores?

A
  1. T tubules have diameter 5 times greater than skeletal muscle
  2. Large quantity of mucopolysaccharides that are negatively charged and bind an abundant store of Ca ions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Compare the release of Ca in skeletal muscle vs cardiac muscle

A
  • Skeletal: Ca+ is largely released from the SR RYR channels inside the skeletal muscle fiber
  • Cardiac: Ca+ comes from stores in the T tubule in the extracellular fluid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

The _______________ of contraction of cardiac muscle depends on the concentration of calcium ions in the ECF.

A

Strength of contraction of cardiac muscle depends on [Ca]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Contrast the coupling of cardiac vs skeletal muscle

A
  • Cardiac: electrochemial coupling due too Ca induced release of Ca
  • Skeletal: electromechanical coupling-direct interactions b/t the DHPR in T tubule and RYR in SR
  • In cardiac, the DHPR & RYR do not touch
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Briefly describe the pathway and product for Gq proteins

A

G q > Phospholipase C > PIP2 > either DAG or IP3

DAG > Protein Kinase C > Increase Ca

IP3 > Increase Ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Briefly describe the pathway and products of Gs proteins

A

Gs > Adenylate cyclase > cAMP > Protein Kinase A > Inc. Ca+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Briefly describe Gi pathway and products

A

Gi inhibits overall > Adenylate cycles > cAMP > Protein kinase A > Decreased Ca+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Where do potassium channel blockers exert the greatest effect in cardiac muscle contraction

A
  • In phase 3
  • Prolongs the phase = delays repolarization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Why does hyperkalemia shorten phases 2 & 3 despite the concentration gradient pushing K+ into the cell?

A
  • Hyperkalemia increases potassium channel conductance creating excess repolarization reserve
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What phases comprise cardiac absolute refractory period?

A

Phases 1, 2 & 3 are absolute refractory period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Cardiac muscle: Phases 1, 2, & 3 are considered the ____________ ______________ _______________ since no stimulus can generate another action potential here. Describe what enables this.

A
  • Phases 1, 2, & 3 are absolute refractory period
  • The Na+ channels are closed and unavailable since the inactivation gates are closed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Cardiac muscle: what is the effective refractory period?
What phases of the AP are considered the ERP?

A
  • A conducted AP cnnot be generated as in there is an inward current, but not enough to conduct to the next site
  • Phases 1, 2, 3, & 4
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Cardiac muscle: what is the relative refractory period?

A
  • Can induce a small AP but requires a larger than normal stimulus
  • Na+ channels closed but are available
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the supranormal period?

A
  • State of increased excitability in cardiac muscle
  • Begins -70 mV and continues until -85 mV
  • Na+ channels recovered
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

T/F: Premature contractions of cardiac muscle do not cause wave summation, as occurs in skeletal muscle

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is Rhythmical Excition of the Heart?

A

Conduction of the nodal tissue of the heart, i.e. SA, AV node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the rate of impulse conduction in the SA Node?

A

60-100 BPM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the rate of impulse conduction of AV node?

A

40-60 Beats per minute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the rate of impulse conduction in the bundle of His AKA

A
  • aka R & L bundle branches
  • 20-40 BPM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the rate of impulse conduction in Purkinje fibers?

A

<20 BPM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Describe the action potential at the sinus node

A

Starts at phase 4 > Phase 0 > Phase 3
RMP > Rapid Depolarization > Late repolarization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Describe the action potential of the sinus node

A
  • RMP: -55 to -60 mV as Na+ constantly leaks out
  • -40 mV, slow Calcium channels (T-type) open = AP & subsequently L-type calcium channels open
  • After 100-150 msec, Calcium channels close and K+ channels open to repolarize
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

T/F: Cardiac muscles have L-type calcium channels while nodal tissue has T-type calcium channels

A
  • False, cardiac muscle only has L-type
  • Nodal tissue has both T-type and L-type
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What property of SA & AV nodes makes their tissue slow conducting?

A

Fast voltage-gated Na+ channels are permanently inactivated b/c less negative resting potential in the cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What does the rising slope in phase 4 of the SA node determine?

A

Determines HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What allows for the automaticity of SA & AV Nodes

A

Mixed Na+/K+ inward current by funny current channels cause slow spontaneous diastolic depolarization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are some examples catecholamines?

A

Norepinephrine
Epinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What are the parasympathetic and sympathetic receptors on the nodal tissue in the heart?

A

M2-parasympathetic
β1-sympathetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What mechanism increases heart rate with SNS stimulation?

A

Sympathetic stimulation increases the chance that funny channels are open & inc. HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Which branch of the ANS system changes the force of heart contraction?

A

Sympathetic increases force of contraction of heart as well as increasing HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What phase is changed in nodal tissue AP when there is increased HR?

A

Phase 4 shortens which accelerates self-excitation to increase HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Changes to cAMP levels in the nodal tissue do what?

A

Increase cAMP = increase funny current, Decrease cAMP = decrease funny current

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

How long is the delay at the AV node?

A

0.09 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

How long is the delay at the AV bundle?

A

0.04 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Trace the path impulse flow from the atria to ventricles

A

Start: SA node travels through 3 inter nodal tracts to
AV node-delayed here
Travel to AV bundle - delayed here
Travel to L & R bundle branches

Off the SA node to the L atria is Bachmann’s bundle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Which has a greater delay the AV bundle or AV node?

A

AV node has greater delay 0.09 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

List the nodal tissue in order from fastest to slowest impulse conduction speed

A

Fastest: Purkinje system
Atria
Ventricle
AV node - slowest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is the difference between rate of impulse control and speed of impulse control

A
  • Rate of Impulse Control: Beats per minute
  • Speed of Impulse Control: speed at which depolarized waves spread across myocardial cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What physiological component makes the Purkinje system the fastest speed impulse conduction?

A

Many gap junctions at intercalated disks allow the electrical signal to travel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What mechanism ensure adequate blood ejection from the ventricle?

A

Rapid conduction through Purkinje fibers ensures adequate ejection from ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What mechanism ensures adequate ventricular filling?

A

AV delay: slow conduction through AV node ensures adequate ventricular filling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

The _____________ the potential difference between the depolarized and polarized regions (i.e., the __________ the AP amplitude), the ____________ effectively local stimuli can depolarize adjacent parts of the membrane ,and the more ____________ the wave of depolarization is propagated down the fiber.
This applies to:

A

Fast-response fibers: The greater the potential difference between the depolarized and polarized regions (i.e., the greater the AP amplitude), the more effectively local stimuli can depolarize adjacent parts of the membrane, and the more rapidly the wave of depolarization is propagated down the fiber.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Conduction velocity is dependent on:

  • Fast response fibers:
  • Slow response fibers:
A
  • Conduction velocity is dependent on rate of depolarization
  • Fast response: Na+ entry
  • Slow response: Ca+ entry
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What are dromotropic effects?

A

Changes in conduction velocity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

AV Node Tissue: Describe how the SNS changes dromotropic effect and through what mechanism

A

Sympathetic Syst: has positive dromotropic effect in that it increases conduction velocity in AV node
- Increase Ca+ such that the depolarization phase is faster = inc. conduction velocity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

AV Node Tissue: Explain how the parasympathetic NS effects the dromotropic effects and through what mechanism

A
  • PNS: Decreased dromotropic effect = reduce conduction velocity = Reduce HR
  • Decreased Ca+ = decreased depolarization
  • Increased K+ outward current
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What is the basic premise of heart block?

A

If conduction velocity through the AV node is slowed sufficiently, some action potentials may not be conducted at all from atria to ventricles
- Milder forms, conduction of AP from atria to ventricle are slowed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What is Stokes-Adams syndrome?

A

Delay in pickup of the heartbeat with complete AV block in AV node or bundle
- Transient (5-20 sec) of lack of blood to brain due to the delay in heartbeats leads to syncope
- 3rd degree Heart block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What is Ectopic pacemaker?

A

If AP does not surpass SA node, the AV node will pick up transmission, if AV node is blocked, AB bundle can take over, if that fails Purkinje fibers take over but a lower rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

The motions of the vertebrae are described how:

A

The motions of the vertebra are described in relation to the vertebrae immediately inferior to it
- Ex. With L1-L2 vertebral until, the action of L1 is described in terms of its behavior to L2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Which Lumbar vertebrae is wedge shaped?
What is the purpose of this?

A
  • L5 Wedge shaped
  • Allows for transition from vertical vertebrae to near horizontal sacrum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What is the action long restrictor muscles of the lumbar region?
List restrictor muscles

A
  • Create side bending
  • Erector spinae
  • Quadratus lumborum
  • Psoas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

List short restrictors of the lumbar spine

A
  • Intertransversarii
  • Multifidus
  • Rotatores
  • Interspinales
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Define Spondylosis

A

Degenerative change of the vertebral body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Term: ______________
Definition: Degenerative change in vertebral body

A

Spondylosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Define Spondylolysis

A

Fx of the pars interarticularis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Term: ______________
Definition: Fracture of pars interarticularis

A

Spondylolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Define: Spondylolisthesis

A

Forward slip of one vertebrae relative to another

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Term: _________________
Define: forward slip of one vertebrae relative to another

A

Spondylolisthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

In XR, what does it mean if you can see the Scottie’s collar?

A

Indicates Fx of Pars interarticularis = Spondylolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Describe compression fx

A

Loss of vertebral body height
- does not have to occur from a fall
- Localized pinpoint pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

How is scoliosis named?

A

Named for convexity side of curve in the coronal plane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What is the difference between functional or structural scoliotic curve?

A

Functional: Curve will change its appearance with sidebending into the convexity of the curve

Structural: will NOT change in appearance with side bending

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What is functional scoliosis usually caused by?

A

Functional curve is usually secondary to primary Fryette Type I somatic dysfunction locally (which is often caused by a Type II) or adaptation from mechanical dysfunction elsewhere

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What is the Cobb angle used for?

A

Used to quantify the magnitude of spinal deformities
I.e. scoliosis, kyphosis, lordosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

A lateral lumbar disc buldge typically affects:

A

Lateral lumbar disc bulge affects the nerve root below
- L4 post. Lateral protrusion would affect L5 nerve root

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Define: Dextroscoliosis

A

Scoliosis is named for convexity side of the curve
- Spine bent to the right

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Define: Levoscoliosis

A
  • Scoliosis is named from the convexity side for the curve
  • Scoliosis where spine is sidebent left
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

What innervates the pericardium?

A

Phrenic nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

The distribution of blood circulating to the different regions of the body is determined by:

A
  • Output of the L ventricle
  • Contractile state of the resistance vessels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What is purpose of Mean Arteriole Pressure?

A

Pressure required for blood to move forward

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Which of the vessels in the body has the greatest resistance?

A

Arterioles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Compare the larger arteries and aorta to the arterioles

A
  • Aorta & Large Arteries: have more elastic tissue gives them better elastic recoil
  • Arterioles: have more smooth muscle than elastic tissue which makes them better resistance vessels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

The resistance to blood flow and pressure drop in the arterial system are greatest at the:

A

Resistance to blood flow and pressure drop in the arterial system are greatest at the level of small arteries and arterioles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

What are the receptors found in arterioles?

A
  • α1 adrenergic receptors of vascular smooth muscle
  • β2 adrenergic receptors found in arterioles of skeletal muscle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Which receptor(s) does Norepinephrine not act on?

A

Norepi does not act on β2 receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What receptors are found in the heart? What are their actions?

A
  • SNS: β1 to increase HR & force of contraction
  • PNS: M2 to decrease HR via nodal tissue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Describe the parameters of a Type 1 dysfunction

A
  • In a neutral dysfunction, sidebending and rotation occur in opposite directions to one another
92
Q

Describe a Type 2 Dysfunction

A

In a flexed or extended dysfunction, sidebending and rotation occur in the same direction as one another

93
Q

Consider the rule of threes: when palpating T_-T___, the tip of the spinous process is located one level below the transverse process of the same vertebrae

A

T7-T9

94
Q

Rule of 3s: when palpating T___-T__ & T___ the spinous process is located 1/2 step below the transverse process of the same vertebrae

A

T4-T6 & T11

95
Q

Rule of 3s: which of the thoracic vertebrae are the spinous process located at the same level as the transverse process

A

T1-T3 & T12 spinous process are located at the same level as their respective transverse processes

96
Q

Describe the superior cervical facet orientation

A
  • Backward
  • Upward
  • Medial
97
Q

Describe the orientation of the superior thoracic facets

A
  • Backward
  • Upward
  • Medial
98
Q

Describe the orientation of superior facets of the Lumbar vertebrae

A

Backward and Medial

99
Q

About how much of the blood is located in the veins?

A

60%

100
Q

What portion of the cardiovascular system operates in series?
What portion of the CV system operates in parallel?

A
  • L & R Heart operate in SERIES
  • Circulatory system operate in PARALLEL
101
Q

What is cardiac output?

A

Rate at which blood is pumped from either ventricle

102
Q

What factors determine cardiac output?

A

Heart Rate
Myocardial contractility
Preload (End diastolic P)
Afterload

103
Q

What is preload?

A
  • Volume of blood in the ventricles before the heart begins contraction
  • Volume at end of diastole
  • Volume of blood at end of ventricular filling
104
Q

What is afterload?

A

Force heart must pump against for blood to move in the forward direction through the aorta

105
Q

What is the overall flow in circulation of an adult?
What can this be equated to?

A

5 L/min = cardiac output

106
Q

What are the determinants of blood flow?

A

Q = ΔP/R
- Q = flow
- P = pressure (P1 @ arterial end - P2 @ venous end)
- R = resistance of vessel

107
Q

When the flow of blood is silent, what type of flow is existing in the vessel?

A

Laminar flow is silent

108
Q

What is the difference in a murmur and bruit?

A

Mumur: turbulent blood flow heard in the heart

Bruit: turbulent blood flow heard in the peripheral vasculature

109
Q

What is a thrill?

A

Palpable murmur

110
Q

The mitral area is the best place to hear:

A

Mitral area is best place to hear S1 sound

111
Q

___ sound is best heart at the left upper sternal border

A

S2 sound best heard at left upper sternal border

112
Q

T/F: S3 & S4 sounds are all abnormal

A

False, in children and pregnant adults S3 sound can be considered normal

113
Q

_____ sound is best heart at apex of heart with patient in the left lateral decubitus position

A

S3 sound

114
Q

What is S3 sound?

A

Rapid ventricular filling in early diastole

115
Q

What is S4 sound?

A

Turbulent flow due to stiff L ventricle/ventricular non-compliance. Atrium refuses to relax

116
Q

____ sound is best heard at apex of heart with patient in left lateral decubitus position

A

S4

117
Q

What factors determine resistance?

A
  • Blood flow
118
Q

T/F: There are two ways to determine resistance of blood vessels

A

True,

Resistance = P1-P2/Q
- Q is flow

Resistance = 8nL / 3.14 * r 4
- L is length of vessel
- r is radius
- n is viscosity

119
Q

How might polycythemia impact vascular resistance?

A
  • Polycythemia = too many RBC = increased Hct = increased viscosity
  • Resistance = 8nL / 3.14 * r 4
  • Increasing n will increase numerator and increase resistance of blood vessels
120
Q

What is vascular conductance?
How is it calculated?

A
  • A measure of the blood flow through a vessel for a given pressure difference
  • Conductance = 1/resistance
121
Q

What parameter change is vessel conductance the most sensitive to?
What is the equation to determine conductance?

A
  1. Conductance is very sensitive to change in diameter of vessel
  2. Conductance = 1/ Resistance
122
Q

What controls flow of blood back to the heart?

A

Veins

123
Q

What is diastolic blood pressure?

A
  • 80 mm Hg
  • Pressure of the blood in the vessels during diastole
124
Q

What is systolic blood pressure?

A
  • 120 mm Hg
  • Pressure generated during systole
125
Q

Define: incisura

A

Backflow of blood to close aortic valve

126
Q

What is mean arterial pressure?
Where is its greatest influence in the body?

A
  • Average pressure during a complete cycle
  • MAP is the driving force for blood flow to organs and capillaries
127
Q

What is the equation(s) for MAP?

A
  • Diastolic P + 1/3 Pulse pressure = MAP
  • 1/2 Systolic BP + 2/3 Diastolic BP
128
Q

What is pulse pressure?

A

Difference between systolic and diastolic pressures

129
Q

What is pulse pressure?

A

Difference between systolic and diastolic pressures

130
Q

What is vascular distensibility?

A
  • Fractional increase in volume for each mmHg rise in pressure
  • Vascular distensibility = inc in volume / inc. in pressure * original volume
131
Q

What is vascular compliance?
What vascular capacitance?

A

They are the same both meaning the total quantity of blood that can be stored in a given portion of the circulation for each mm Hg

132
Q

Compare the capacitance of veins vs arteries.
Compare the vascular distensibility of veins vs. arteries

A
  • Capacitance of veins is 24 times larger than arteries
  • Distensibility is 8 times more in veins compared to arteries
133
Q

Compare vascular conductance vs Vascular compliance

A
  • Conductance: reflection of vascular tone in situations where changes in tone lead to primarily to changes in flow
  • Compliance: ability of vessel to respond to an increase in pressure by distend, hold an amount of blood with pressure changes
134
Q

What causes arterial pressure increase in older adults?

A

The arterial walls become stiffer, less distensible = less compliant

135
Q

What happens in veins are constricted?

A

When veins are constricted large quantities of blood are transferred to the heart to increase end diastolic volume/increase preload thereby increasing cardiac output

136
Q

Compliance measures the ____________ change elicited by a ____________ change.

Elastance measures the _____________ change elicted by a _____________ change.

A

Compliance measures the volume change elicited by a pressure change

Elastance measures the pressure change elicited by a volume change

137
Q

The degree of damping is proportional to:

A

The degree of damping is proportional to the resistance of small vessels and arterioles and the compliance of larger vessels

138
Q

Term:
Definition: the change in arterial pressure that occurs when a stroke volume is ejected from the left ventricle into the aorta

A

Pulse pressure

139
Q

What physiologic conditions can alter pulse pressure?

A

Arteriosclerosis & Aortic stenosis

140
Q

Pulse pressure is directly proportional to:

A

Pulse pressure is directly proportional to stroke volume and arterial compliance

141
Q

Why does arteriosclerosis have different effects on pulse pressure curve compared to aortic stenosis?

A
  • Arterioles: the ejection of a stroke vol. from the L ventricle causes a much greater change in arterial pressure
  • Aortic stenosis: lumen of aorta reduced due to stenosis of the valve. Stroke volume is reduced so less blood is ejected = lowered systolic BP, Pulse pressure, and mean pressure
142
Q

What is aortic stenosis?

A

Condition associated with diameter of aortic valve opening is reduced and flow of blood through aortic valve is low. Decreased stroke volume

143
Q

Describe the pressure pulse curve in patent ductus arteriosus?

A

Blood shunts from the pulmonary artery to the aorta, this causes low diastolic pressure and high systolic pressure = high pulse pressure since PP is directly proportional to stroke volume

144
Q

How does Aortic Regurgitation change pulse pressure contours?

A
  • In aortic regurgitation, there is back flow of blood through the aortic valve.
  • Results in low diastolic and high systolic pressure leading to high pulse pressure
145
Q

What is right atrial pressure?

A
  • R atrial pressure = Central venous pressure
  • Normally, 0 mmHg
146
Q

Describe the relationship that establishes central venous pressure

A
  • Right atrial pressure is regulated by a balance between the ability of the heart to pump blood out of the atrium and the rate of blood flowing into the atrium from the peripheral veins
147
Q

Weight of blood in the vessels causes venous pressure to be as high as 90 mmHg. What lowers venous pressure?

A

Venous pump maintains low venous pressure in legs

148
Q

Why is atrial repolarizing not seen on an EKG?

A

Atrial repolarization is hidden by the QRS complex meaning, it is hidden by ventricular depolarization

149
Q

What happens to the P wave if cell conduction decreases?

A

If conduction decreases in the atria, the P wave will become more spread out

150
Q

What does the PR segment represent?

A
  • Time of conduction through the AV node
  • Time from first depolarization of the atria to first depolarization of the ventricles
151
Q

Why is the QRS complex total duration similar to the duration of the P wave?

A
  • The conduction velocity of the Purkinje system is much faster than atrial conducting system
152
Q

What does the ST segment represent?
Changes to this segment may indicate:

A
  1. ST segment is early part of ventricular repolarization
  2. Myocardial ischemia or injury
153
Q

What is a normal PR interval?

A

0.12-0.20 seconds

154
Q

What is a normal QRS interval?

A

0.06-0.11 seconds

155
Q

What is a normal QT interval?

A

0.36 to 0.44 seconds

156
Q

What are three things a EKG needs to be considered normal?

A
  • P wave must come before the QRS complex
  • Rate is 60-100 BPM
  • RR internal must be regular
157
Q

What is the time duration for a large box on EKG paper?
On what axis?

A

Time for large box is 0.20 seconds
Tims is on the X axis

158
Q

What is the voltage of one large box on EKG paper?
On what axis?

A
  • Voltage is 0.5 mV
  • Read on Y axis
159
Q

T/F: No potential is recorded when the ventricular muscle is either completely depolarized or repolarized?

A

True

160
Q

Where is the ____________ lead aVR located?

A

Augmented lead aVR is on right arm

161
Q

Where is __________ lead aVL located?

A

Augmented lead aVL is located on Left arm

162
Q

Where is ____________ lead aVF located?

A

Augmented lead aVF is located on Left foot

163
Q

These leads measure vectors towards or away from the apex of the heart:

A

Inferior leads- II, III, aVF

164
Q

What do the inferior leads II, III, aVF measure?

A

Measure vectors towards or away from the apex

165
Q

What do the lateral leads I, aVL, V5, and V6 measure ?

A

Vectors towards or away from the L ventricular free wall

166
Q

The following leads measure vectors towards or way from the left ventricular free wall

A

Lateral leads I, aVL, V5, V6

167
Q

What do Right sided leads aVR, V1 measure?

A

Measure vectors towards or away from the right side

168
Q

The following leads measure vectors towards or away from the right side

A

Right sided lead aVR, V1

169
Q

What do anterior V2, V3, V4 leads measure?

A

Measure vectors towards or away from the right side

170
Q

What do anterior leads V2, V3, V4 measure?

A

Measures vectors in front and back of the heart

171
Q

The following leads measure vectors in front and back of the heart

A

Anterior-V2, V3, V4

172
Q

What is the direction of charge for all bipolar limb leads?
Give examples of a bipolar limb lead

A

Always from Negative to Positive
- Lead I
- Lead II
- Lead II

173
Q

What does the bulbus cordis give rise to?

A

Smooth portion of L & R ventricle

174
Q

Truncus arteriosus becomes:

A

Aortic arch & pulmonary trunk

175
Q

What is Truncus arteriosis?

A

Aorta and pulmonary artery do not separate and allows mixing of blood

176
Q

What causes Transposition of the Great Vessels? What is it?

A
  • Caused by lack of spiraling of truncus arteriosus
  • Right ventricle attached to aorta & L ventricle attached to pulmonary A
  • consistently getting deoxygenated blood
177
Q

Persistent Truncus Arteriosis is associated with what condition?

A
  • DiGeorge Syndrome
178
Q

Describe the formation of the atria

A
  1. Septum primum forms
  2. Septum secundum forms proximal to the endocardial cushion
  3. Hole in both primum & septum = foramen ovale
179
Q

What is the difference between patent foramen ovale and Atrial septal defect?

A
  • Patent ovale is incomplete joining of septum primum & septum secundum forms that can be asymptomatic if there is not enough pressure to open the foramen
  • Atrial septal defect is persistent shunt b/t R & L atrium
180
Q

What is the most common atrial septal defect?

A

Defect in septum secundum

181
Q

Where does the aortic arch come from?

A
  • From mesoderm & neural crest cells
182
Q

What germ layer gives rise to the primordial heart

A

Splanchnic mesoderm in 3rd week of gastrulation

183
Q

List the 5 heart tube dilations from venous to arterial end

A
  1. Sinus venosus
  2. Primitive atrium
  3. Primitive ventricle
  4. Bulbus cordis
  5. Truncus arteriosus
184
Q

If a question asks about septum primum and septum secundum, what structure are they asking about?

A

Formation of the atria

185
Q

Which fetal vascular structure shunts blood from the pulmonary artery to the aorta bypassing the lungs

A

Ductus arteriosus

186
Q

Which fetal vascular structure shunts blood away from the liver?

A

Ductus venosus

187
Q

What does the umbilical vein become postnatally?

A

Ligamentum teres hepatis
AKA Round ligament of the liver

188
Q

_____________ _____________ from the lateral plate __________ in the cephalic area forms the primordium of the heart.

A

Splanchnic mesoderm from the lateral plate mesoderm in the cephalic area forms the primordium of the heart.

189
Q

What structures form the two heart tubes?

A
  • Endothelial strands (angioblastic cords) in cardiogenic mesoderm are the earliest sign of the heart
  • These tubes will canalize to form two heart tubes
190
Q

What folding moves the heart to the thoracic region rather than being the most cranial structrure?

A

Caudal cranial foling

191
Q

List the three sets of veins that dump into the sinus venosus

A

Vitelline
Umbilical vein
Common cardinal

192
Q

What do vitelline veins do?

A

Return poorly oxygenated blood from yolk sac/umbilical vesicle

193
Q

What do umbilical veins do?
What is a special component of these veins?

A
  • Carry oxygenated blood to embryo from placenta
  • Includes the ductus venosus: bypassing the liver in circulation straight to IVC
194
Q

What do the common cardinal veins do?

A
  • Return poorly oxygenated blood to placenta
195
Q

Which arteries from the pharyngeal arch degenerate?

A

1, 2, 5

196
Q

Splanchnic layer is synonymous with _____________ ____________. Which came from the _____________. The Splanchnic layer gives rise to what layers of the heart?

A
  • Splanchnic layer = visceral layer
  • Came from mesoderm
  • Splanchnic layer gives rise to myocardium and endocardium of the heart
197
Q

Embryology: The mesoderm gives rise to splanchnic layer which gives rise to the myocardium and endocardium. Where does the epicardium come from?

A

Migrating tissue from the mesoderm gives rise to the epicardium

198
Q

During what time period does the heart tube divide into 4 chambers?

A

4th - 8th week

199
Q

What components form the AV canal?

A

Atria & Ventricle septum attachment is formed by endocardial cushions, cardiac jelly, and neural crest cells

200
Q

What does the primordial pulmonary vein form?

A

Primordial pulmonary vein forms the L atrium smooth portion of the muscle wall

201
Q

What is the name of the positional disorder of the heart wherein the apex is turned to the R side of the body?
T/F: It is always fatal

A

Dextrocardia
- False, if all the body organs are also swapped = OK
- If Isolated Dextrocardia w/sinus solitus = bad

202
Q

What is the most common type of ventricular heart defect?

A
  • Problem with membranous portion
203
Q

This condition causes cyanosis at brith due to abnormal fusion of arteries and veins to atria

A

Transposition

204
Q

What does the Truncus arteriosus give rise to?

A

Pulmonary trunk & ascending aorta

205
Q

What happens to the ductus arteriosus after birth?

A
  • Closes
  • Becomes Ligamentum Arteriosum
206
Q

What does the primitive ventricle give rise to?

A

Trabeculated part of L & R ventricle

207
Q

What does the primitive atrium give rise to?

A

Trabeculated part of the R & L atrium

208
Q

What does the sinus venosus give rise to?

A

Smooth part of R atrium
Coronary sinus
Oblique vein of L atrium

209
Q

Define patent:

A

Open or unobstructed aperture

210
Q

Lift 5 key elements of a normal mid-trimester four chamber view

A
  1. Heart area no more than 1/3 of chest area
  2. R & L sided structures are approximately equal
  3. Patent foramen ovale
  4. Intact cardiac ‘crux’ with normal AV valves and ventricular septum
  5. R Ventricle identified by presence of moderator band
211
Q

What is dextrocardia with siuts inversus

A
  • Heart apex is positioned R and the rest of the organs are also switched
212
Q

What is the most common type of congenital heart disease?

A

Ventricular septal defects

213
Q

What is muscular VSD

A
  • Less common form of Ventricular septal defect
  • Hole in ventricle in any portion or part of the ventricle
214
Q

What is Tetralogy of Fallot?

A
  • Congenital heart defect
    1. Pulmonary stenosis
    2. R ventricular hypertorphy
    3. Overriding aorta
    4. Ventricular septal defect
215
Q

What do the third pair of pharyngeal arches give rise to?

A
  • Proximal part forms common carotid
  • Internal carotid
216
Q

What do the third pair of pharyngeal arches give rise to?

A
  • Proximal part forms common carotid
  • Internal carotid
217
Q

What do the fourth pair of pharyngeal arches give rise to?

A
  • Portion of Aortic arch
  • Right subclavian A
218
Q

What do the 6th pair of pharyngeal arches give rise to?

A
  • L pulmonary A
  • R pulmonary A
  • Distal portion of the Right pharyngeal arch disappears
219
Q

What is coarctation of the aorta?

A
  • It is a narrowing in the aorta either before or after the ductus arteriosus
  • Forces the heart to work harder
  • Weak femoral pulse
  • Differential blood pressure b/t upper and lower extremities
220
Q

What forms the fossa ovalis floor? What forms the border of the fossa ovalis?

A

Floor formed by septum primum
Edge: Septum secundum

221
Q

What is the time period of ductus arteriosus functional and anatomic closure?

A

Functional closure: first few days after birth
Anatomic: by 12th week

222
Q

_____natally you want a patent foramen ovalis.
_________ you do not want a patent ductus arteriosus.

A
  • Prenatally you want a patent foramen ovalis.
  • Postnatally you do not want a patent ductus arteriosus.
223
Q

Describe the motor weakness, screening examination, & reflexes for lumbar disc herniation of L4

A
  • Motor: Extension of quadriceps
  • Screening examination: Squat and rise
  • Reflexes: Knee jerk diminished
224
Q

Name the motor weakness, screening examination, and reflexes associated with lumbar disc herniation of L5

A
  • Motor: dorsiflexion of great toe and foot
  • Screening examination: Heel walking
  • Reflex: None reliable
225
Q

List the motor weakness, screening examination and reflexes associated with S1 lumbar disc herniation

A
  • Motor weakness: Plantar flexion of great toe and foot
  • Screening examination: Walking on toes
  • Reflexes: Ankle jerk diminished

M1 Block 3 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions