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PD BIO 305 > Heart 2 > Flashcards

Heart 2 Flashcards

2
Q

What is the ‘infarction’ phase? When does it occur?

A

Significant Q wave - much wider than normal

Q may be 1/3 of the height of the QRS

May last for many years after the infarction

Some drugs can cause effects similar to this significant Q

(3rd PHASE)

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3
Q

If someone has an EKG with a ‘Significant Q Wave’ that is much wider than normal. What can be assumed?

A

That the person has had a previous heart attack in their life.

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4
Q

During a myocardial infarction (heart attack), there are 7 things that may occur. What are they?

A
  1. Pain (radiates from neck, jaw, back, shoulder, and left arm)
  2. Nausea and vomiting
  3. Catecholamines are released
  4. Blood sugar usually increases
  5. Cardiac troponins (I and T found in the blood)
  6. Enzymes (Creatine kinase / lactic dehydrogenase)
  7. Troponin/Creatine kinase amounts correlated w/ severity of infarction
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5
Q

What are the two factors that determine the blood flow through a vessel?

A

Pressure / Resistance

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5
Q

What is the normal pressure of the heart? Where is it usually measured?

A
  1. 120/80 mm Hg

2. Arteries

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6
Q

Blood flows from an area of ____ pressure to an area of ____ pressure.

A
  1. High

2. Low

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7
Q

The pressure in the right atrium is nearly what?

A

Zero

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8
Q

Resistance in a blood vessel proportional to two things. What are they?

A

Length of the blood vessel AND viscosity of the blood

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9
Q

What is laminar flow?

A

The velocity flow is greater at the center of the vessel than along the outer edges.

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9
Q

There are 2 types of NERVES that affect vascular diameter.

What are they and how do they affect vascular diameter?

A

Sympathetic:
1. Alpha-adrenergic = (Vasoconstriction)

 2. Beta-adrenergic = (Vasodilation)
 3. Cholinergic = (Vasodilation)

Parasympathetic nerves = (Vasodilation)

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10
Q

There are 3 HORMONES that affect vascular diameter.

What are they and how do they affect vascular diameter?

A
  1. Angiotensin II = (Vasoconstriction)
  2. ADH (Vasopressin) = (Vasoconstriction)
  3. Histamine = (Vasodilation)
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10
Q

Circulation is divided into two parts.

  1. (Not involving lungs)
  2. (Involving lungs)

What are they?

A
  1. Systemic (All parts except lungs)

2. Pulmonary (Lungs)

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10
Q

Systemic circulation is responsible for __% of the blood volume?

A

79% of the blood volume

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10
Q

Pulmonary circulation is responsible for __% of the blood volume?

A

12% of the blood volume

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10
Q

What is the average pressure of the ‘capillaries’ when it enters enters and then when it leaves?

A

30 - 10 mm Hg

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11
Q

What is the average pressure of the ‘arterioles’ when blood enters and when it leaves?

A

85 - 30 mm Hg

*This is the most important in regulation of blood pressure

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11
Q

What is the most important blood vessel in regulation of blood pressure? (Constricting / Dilating)

A

Arterioles

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11
Q

What is the function of precapillary sphincters?

A

Regulate blood flow to capillaries.

Provide intrinsic, loclized regulation of blood flow in capillary beds.

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12
Q

Precapillary sphincters have mechanisms that help regulate blood flow in relation to the local tissues’ need for oxygen.

What is this ability called?

A

Autoregulation

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13
Q

Water flow across the capillary wall is due to two factors. What are the two factors?

A
  1. Capillary Hydrostatic Pressure (CP)

2. Osmotic Force (OF)

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14
Q

The ability for water to diffuse ‘IN’ to the vessel is usually caused by what? This ability is also helped by what protein?

A

Osmotic Force (OF)

Protein = Albumin

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15
Q

The ability for water to diffuse ‘OUT’ to the vessel is caused by what?

A

Capillary Hydrostatic Pressure (CP)

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15
Q

True or False:

Osmotic Force (OF) generally changes, but Capillary Pressure (CP) remains the same.

A

FALSE

Osmotic Force (OF) stays the SAME.

Capillary Pressure (CP) is DIFFERENT.

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15
Q

The ‘constant’ pressure of Osmotic Force (OF) is usually ____ mm Hg. (*In the Left A/V Valve)

A

23 mm Hg

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15
Q

What is the equation for determining both the ‘Net Filtration Results’ (OUTPUT) and the ‘Net Absorption Results’ (INPUT)?

A
  1. Net Filtration Results = Capillary Pressure (-) Osmotic Force
  2. Net Absorption Results = Osmotic Force (-) Capillary Pressure
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15
Q

What is ‘Edema’?

A

The presence of excess interstitial fluid in the tissues.

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15
Q

There are 3 main causes of edema. What are they?

A
  1. Increased capillary hydrostatic pressure
  2. Decreased plasma protein (mainly albumin)
  3. Increased interstitial fluid protein
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15
Q

One of the causes of ‘Edema’ is ‘increased capillary hydrostatic pressure’.

What is this caused by (3 things)?

A
  1. Venous Obstruction
  2. Cardiac Failure
  3. Retention of body salt and fluid
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15
Q

One of the causes of ‘Edema’ is ‘decreased plasma proteins (mainly albumin)’.

What causes this to occur (3 things)?

A
  1. Kidney damage resulting in loss of plasma proteins
  2. Liver damage - decreased production of plasma proteins
  3. Malnutrition - not enough protein in the diet
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15
Q

One of the causes of ‘Edema’ is ‘increased interstitial fluid protein’.

What causes this to occur (2 things)?

A
  1. Increased capillary permeability - inflammation

2. Decreased lymphatic flow

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15
Q

Increased interstitial fluid proteins in the body can cause what to happen?

A

Edema

More specifically, ‘Pneumonia’

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15
Q

What are the 3 factors that can change blood pressure (short term)?

A
  1. Cardiac Output
  2. Peripheral Resistance
  3. Total Blood Volume
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16
Q

Long term regulation of blood pressure is controlled by what?

A

Hormones

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17
Q

Alcohol acts as a(n) ___________?

Diuretic/Antidiuretic

A

Diuretic

Alcohol inhibits ADH release
Increases urine production
Increased urine production aids dumping of alcohol from body.

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18
Q

How long does it take the nervous system to regulate blood pressure?

A

Seconds

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18
Q

What organ(s) monitor blood pressure?

A

Kidneys

18
Q

The converting enzyme for Angiotensin is stored in what organ?

A

Lungs

19
Q

The Renin-Angiontensin System regulates blood pressure in 3 ways. What are the 3 ways?

A
  1. Aldosterone Secretion
  2. Increase ADH Release
  3. Vasoconstriction of arterioles
20
Q

What is Primary Aldosteronism (Conn’s Syndrome)?

A

Hypersecretion of aldosterone from the adrenal cortex. Leads to:

Hypertension
Increased extracellular fluid volume
Hypernatremia
Potassium Depletion

21
Q

What is the major etiologic factor in primary aldosteronism (Conn’s Syndrome)? (*Reason why most people have this)

A

Adrenal adenoma (90% of patients)

22
Q

What do ACE inhibitors do?

A

Block the converting enzyme from binding to Angiotensin I so that no Angiotensin II is created.

23
Q

What are the two major control mechanisms in regulating blood pressure (short term) via the nervous system?

A
  1. Baroreceptors

2. Chemoreceptors

24
Q

In the medulla, there are two centers that help regulate blood pressure (short term) via sympathetic/parasympathetic responses. What are the two centers?

A 
Cardioinhibitory Center (Parasympathetic)
   B.P. (Decreases)
   H.R. (Decreases)
   C.O. (Decreases)
   Vasodilation (INCREASES)
Vasomotor Center (Sympathetic)
   B.P. (Increases)
   H.R. (Increases)
   C.O. (Increases)
   Vasoconstriction (Increases)
25
Q

Baroreceptors are found in 5 locations near the heart. What are the 5 locations?

A
  1. Aortic Arch
  2. Pulmonary Veins
  3. Right/Left Atria
  4. Superior/Inferior Vena Cava
  5. Carotid Sinus
26
Q

Where are chemoreceptors found (2 locations) and how are they stimulated?

A
  1. Aortic Bodies
  2. Carotid Bodies

Stimulated by DECREASED levels of oxygen and INCREASED levels of CO2 and H+ in blood.

27
Q

When does circulatory shock occur?

A

When there is an inadequate bloodflow and/or oxygen delivered to the tissues.

28
Q

There are 4 types of circulatory shock. What are they?

A
  1. Hypovolemic shock
  2. Anaphylactic shock
  3. Neurogenic shock
  4. Cardiogenic shock
29
Q

What are the characteristics of ‘Hypovolemic shock’?

A

Reduced blood volume
Caused by hemorrhage/dehydration/ or loss of fluid from burns

Symptoms:

Low B.P.
Rapid Pulse
Cold
Clammy Skin
Little Urine Formation
Increased Respiration Rate
Intense Thirst
30
Q

What are the characteristics of ‘Anaphylactic shock’?

A

Rapid drop in B.P.
Result from severe allergic reaction
Histamine causes vasodilation and thus a drop in B.P.

31
Q

What are the characteristics of ‘Neurogenic shock’?

A

Spinal cord damage causes decreased sympathetic activity.

31
Q

What are the characteristics of ‘Cardiogenic shock’?

A

Inadequate circulation of blood in body tissues due to cardiac failure.

31
Q

As a result from circulatory shock. The body tries to compensate the ‘LOW BLOOD PRESSURE’ in 10 different ways. What are they?

A
  1. Vasoconstriction (Minus vessels of brain/heart)
  2. Venoconstriction (Extra blood stored in veins)
  3. Increased Heart Rate
  4. Increased Respiration
  5. Increased Thrist
  6. Secretion of Epi/Norepi
  7. Secretion of ADH
  8. Activation of Renin-Angiotensin System
  9. Contraction of spleen (Extra RBCs stored here)
  10. Increased Hematopoiesis
32
Q

When the body compensates for ‘low blood pressure’ after circulatory shock. How long does it usually take for plasma volume to be restored?

A

Matter of hours

33
Q

When the body compenstates for ‘low blood pressure’ after circulatory shock. How long does it usually take for ‘plasma proteins’ to be restored? Through what synthesis are they restored?

A
  1. Several days

2. Through Hepatic Synthesis

34
Q

When the body compensates for ‘low blood pressure’ after circulatory shock. How long does it usually take to restore RBCs (Red Blood Cells)?

A

3-4 Weeks

35
Q

Hypertension occurs in about __% (1 out of every ___ persons)

A
  1. 20%

2. 1 out of every 5 persons

36
Q

Hypertension causes __% of all deaths.

A

12%

37
Q

How does hypertension cause death?

A

Rupturing vessel in vital organ

Causing Heart/Kidneys to fail

38
Q

What are the two types of hypertension?

A
  1. Primary (Essential)

2. Secondary

39
Q

What is the most common type of hypertension?

A

Primary (Essential)

40
Q

What systolic/diastolic values are considered to be ‘HYPERTENSIVE’?

A

140/90 mm Hg

41
Q

What are some of the characteristics/factors of primary (essential) hypertension? There are 10.

A
  1. No cause
  2. 85-90% of all hypertensive patients
  3. Rare in persons younger than 20
  4. Occurs 25-50 years of age
  5. Females more than males
  6. Hereditary factors involved
  7. High in blacks than whites
  8. High salt intake
  9. Psycho emotional stress
42
Q

What are some reasons for essential (primary) hypertension?

A

Increased sensitivity to epi/norepi

Left ventricular hypertrophy causing enlarged heart and oxygen requirement increases. Heart may outgrow its blood supply.

43
Q

What is the definition of secondary hypertension?

A

Results from clearly DEFINABLE causes. (Structural/Phsyiological)

44
Q

What percentage of the high blood pressure population has secondary hypertension?

A

10-15%

45
Q

What mechanisms of secondary hypertension are involved in ‘Renal Artery Disease’? What system is involved?

A

Kidneys

Decreased urine formation
Secretion of vasoactive chemicals

46
Q

What examples of secondary hypertension are involved with the endocrine system?

A
  1. Conn’s Syndrome

2. Adrenal Medulla Tumor

47
Q

What are the results of having a tumor on the adrenal medulla and blood pressure?

A

Increased Blood Pressure

Excess Catecholamines created

Increased cardiac output and total peripheral resistance

48
Q

What are some of the symptoms of essential hypertension? (There are 8 of them)

A
  1. Headache (most common)
  2. Dizziness
  3. Fatigue
  4. Blurring of vision
  5. Polyuria (Increased urine output)
  6. Polydipsia (Increased fluid intake)
  7. Muscle Weakness
  8. Hypokalemia (Low K+ in blood)
49
Q

What are some dangers of hypertension? (There are 4 of them)

A
  1. Future congestive heart failure
  2. Cerebral blood vessel damage
  3. Stroke
  4. Development of atherosclerosis (chronic inflammation of arteries)
49
Q

There are 6 general treatment methods for hypertension. What are they?

A
  1. Regular physical exercise
  2. Weight loss
  3. Low refined carbohydrate diet
  4. Cessation of smoking
  5. Restriction of salt intake
  6. Reduce psycho-emotional stress
49
Q

What causes the first heart sound, “lub”?

A

The two AV (tricuspid and meitral) valves closing in ventricular systole

49
Q

What is the diastolic pressure in the pulmonary artery?

A

10 mm Hg

49
Q

What is the diastolic pressure in the aorta?

A

80 mm Hg

49
Q

After Ventricular Systole, and under normal resting conditions, the pressure reaches ___ mm Hg on the right side and ____ mm Hg on the left side.

A
  1. 24 mm Hg

2. 120 mm Hg

49
Q

How much blood remains in either ventricle at the end of ventricular systole?

A

50 ml- the end systolic volume

49
Q

True or false: The valves make the “lub” “dub” heart sounds.

A

FALSE! The turbulence of the moving blood makes the noise, not the valves.

49
Q

When does the second heart sound “dub” take place and what makes the noise?

A

During early diastole, when the semilunar (pulmonary and aortic) valves close.

49
Q

What is the correct order of cardiac impulse conduction?

A

SA node, Atrium AV node, bundle of HIS, purkinje fibers, ventricle

49
Q

What percent of ventricle filling takes place during MID-DIASTOLE?

A

65-80%

49
Q

What causes the ‘lub’ heart sound?

A

Closure of the TWO AV valves

49
Q

What pressure is reached int he right ventricle under normal conditions?

A

24 mm Hg

49
Q

Chronotropic refers to what?

A

RATE of heart contraction

49
Q

Cardiac output is measured by what TWO factors?

A

Stroke Volume x Heart Rate

50
Q

True or False

A shift of the pacemaker function from the SA node to another part of the heart is called an ‘ECTOPIC’ pacemaker.

A

TRUE

Ectopic = ABNORMAL
Any pacemaker not started from the SA node is ‘ectopic’

51
Q

Histamine causes what to occur?

A

VASODILATION

52
Q

Precapillary sphincters regulate blood flow in relation to what?

A

Local tissues need for oxygen

53
Q

Stimulation of the ‘VASOMOTOR CENTER’ results in what?

A

DECREASED heart rate

PD BIO 305 (19 decks)

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