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NPLEX I > Physiology- Cardio > Flashcards

Physiology- Cardio Flashcards

1
Q

What are the 3 main plasma proteins?

A

Albumin
Globulins
Fibrinogen

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2
Q

What is the major blood electrolyte?

A

sodium

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3
Q

Where does erythropoiesis occur?

A

bone marrow

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4
Q

Cessation of bleeding is known as what?

A

hemostasis

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5
Q

What is the role of platelets in hemostasis?

A

they stick to the injured site causing a platelet plug

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6
Q

What do you call a clot that includes RBCs?

A

a thrombus

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7
Q

What makes up a clot?

A

platelet plug plus fibrin

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8
Q

Vitamin K is important for which clotting factors?

A

II, VII, IX, X

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9
Q

What initiates the intrinsic pathway of the blood coagulation cascade?

A

blood coming into contact with exposed collagen of the damaged tissues.

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10
Q

What mineral is needed for proper clotting?

A

calcium

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11
Q

What is the insoluble substance that precipitates out at an injury site?

A

fibrin

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12
Q

Hemophilia is a genetic absence of what clotting factors?

A

Hemophilia A: Factor VIII

Hemophilia B: Factor IX

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13
Q

What substance dissolves clots?

A

Plasmin

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14
Q

What substance cleaves fibrinogen into fibrin?

A

Thrombin

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15
Q

Myocardial cells have more of this organelle due to its high oxidative capacity:

A

mitochondria

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16
Q

What cellular feature allows the heart to contract as a syncytium?

A

gap junctions between the muscle cells

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17
Q

How do T tubules differ between cardia and skeletal muscle?

A

Cardiac: T tubules contain extracellular fluid high in calcium
Skeletal: T- tubules contain extracellular fluid that is low in calcium

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18
Q

What structure brings depolarization inside the cardiac muscle and helps regulate cytoplasmic calcium?

A

t tubules

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19
Q

What prevents tetanic contraction in cardiac muscle?

A

the long cardiac action potential

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20
Q

What aspect of the action potential prevents a second action potential from taking place?

A

long refractory period of plateau period

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21
Q

What is the originator of the cardiac action potential?

A

the SA node

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22
Q

What property allows the SA node to function as a primary pacemaker?

A

small cell size allows it to spontaneously depolarize

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23
Q

What acts as a delay station for the action potential?

A

The AV node

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24
Q

Why does the AV node delay the action potential?

A

to allow atrial muscle to depolarize before ventricular muscle, to allow for filling

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25
Q

What can act as a secondary pacemaker in pathological conditions?

A

the AV node

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26
Q

What allows for rapid conduction of the action potential?

A

Bundle of His
Bundle Branch fibers
Purkinjie fibers
Specialized tracts

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27
Q

What is the sequence of electrical impulse in the heart?

A

SA node–> specialized tracts–> AV node and atrial muscle–> Bundle of HIS–> bundle branches–> Purkinjie fibers–> ventricular muscle

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28
Q

What serves to depress the heart rate at rest by slowing down the SA node?

A

parasympathetic nervous system

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29
Q

How does the sympathetic nervous system affect conduction through the electrical system?

A

it speeds up conduction of the action potential and therefore increases heart rate

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30
Q

What nerve has the greatest influence on the heart?

A

the vagus nerve

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31
Q

What is the affect of vagal stimulation on the heart?

A

It serves to slow the conduction of action potentials through the AV node due to the parasympathetic nerve fibers

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32
Q

How does norepi affect heart contractility?

A

it increases heart contractility

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33
Q

In which phase do the ventricle fill?

A

late diastole

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34
Q

In which phase do we get isovolumetric contraction?

A

early systole

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35
Q

What phase of the cardiac cycle uses up the most energy?

A

the isovolumetric contraction of early systole

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36
Q

What is the purpose of isovolumetric contraction?

A

to build up the pressure so as to overcome the high aortic pressure

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37
Q

In which phase is ejection?

A

late systole

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38
Q

When is the relaxation phase?

A

early diastole

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39
Q

What causes heart sound 1?

A

closing of atrioventricular valves (mitral and tricuspid)

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40
Q

What causes heart sound 2?

A

closing of pulmonic and aortic valves

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41
Q

When in the cycle is S1?

A

late diastole/early systole

42
Q

When in the cycle is S2?

A

end systole/ early diastole

43
Q

What records electrical activity of the heart?

A

EKG

44
Q

What information do we get from an EKG?

A

heart rate, rhythm, axis of the heart

45
Q

What on an EKG marks atrial depolarization?

A

P wave

46
Q

What on an EKG marks ventricular depolarization?

A

QRS complex

47
Q

What on an EKG marks ventricular depolarization?

A

T wave

48
Q

What 2 things influence cardiac output?

A

heart rate and stroke volume

49
Q

How does the heart adapt to hypertension?

A

increases wall thickness–> cardiac hypertrophy

cardiac dilation

50
Q

What are the 3 major substrates for cardiac metabolism?

A

fatty acids, glucose, glycogen breakdown

51
Q

What are 3 minor substrates for cardiac metabolism?

A

Lactic acid, ketones, intramuscular triglycerides

52
Q

What is the major limitation of energy metabolism by myocardium?

A

coronary blood flow delivering oxygen

53
Q

What 2 factors determine oxygen consumption by the myocardium?

A
  1. wall tension in the heart that must be overcome e.g. during isovolumetric contraction
  2. Isotonic contraction to eject the blood
54
Q

What property of blood vessels helps push blood through the arteriole system?

A

elastic tissue

55
Q

What property of blood vessels does smooth muscle provide?

A

its ability to contract and dilate allows blood to be shunted from one area to another

56
Q

What protects blood vessels against distension?

A

the fibrous nature of the tissue

57
Q

What type of circulation has few controls, and is a low pressure/low resistance system?

A

pulmonary circulation

58
Q

What serves as a conduit for blood?

A

arteries

59
Q

What types of blood vessels are resistance vessels due to their smooth muscle?

A

arteries and arterioles

60
Q

What blood vessel in involved in nutrient and waste exchange?

A

capillaries

61
Q

What type of capillary excludes proteins and cells from passing through?

A

Continuous capillaries

62
Q

What type of capillary excludes cells? Where are they found?

A

fenestrated capillaries, found in the kidney

63
Q

What type of capillary allows cells and protein to pass through? Where are they found?

A

sinusoidal/ discontinuous

found in liver, bone marrow, spleen

64
Q

What blood vessels act as capacitance vessels?

A

veins and venules

65
Q

What increases venous return?

A

vasoconstriction

66
Q

Which blood vessels have valves?

A

veins and venules

67
Q

What are the 4 pressures that affect capillary exchange?

A
  1. plasma oncotic pressure
  2. plasma hydrostatic pressure
  3. interstitial oncotic pressure
  4. interstitial hydrostatic pressure
68
Q

Which of the 4 capillary pressures favors filtration?

A
  1. plasma hydrostatic pressure

2. Interstitial hydrostatic and oncotic pressure

69
Q

Which of the 4 capillary pressures is actually a negative pressure or “suction”?

A

interstitial hydrostatic pressure

70
Q

What are 3 mechanisms for edema?

A
  1. increased plasma interstitial pressure
  2. decreased plasma oncotic pressure
  3. increased interstitial oncotic pressure
71
Q

How will decreased blood protein synthesis cause edema?

A

by decreasing plasma oncotic pressure

72
Q

What will influence lymph flow?

A

smooth muscle tone

skeletal muscle contraction

73
Q

Pressure in the right atrium or the vena cava at the level of the heart is known as what?

A

central venous pressure

74
Q

What will increase venous blood flow and decreased venous pressure?

A

skeletal muscle contraction

75
Q

Where are baroreceptors located?

A

aortic arch and carotids

76
Q

What do baroreceptors sense?

A

blood pressure

77
Q

What kind of neurotransmitters are released when baroreceptors are stimulated by high blood pressure?

A

inhibitory neurotransmitters

78
Q

What do inhibitory neurotransmitters accomplish with relation to blood pressure?

A

decrease in sympathetic firing that innervate smooth muscle, causing vasodilation

79
Q

What is accomplished by stimulation of baroreceptors?

A

decrease in blood pressure due to the vasodilation

80
Q

Where are chemoreceptors located?

A

aortic arch and carotids

81
Q

What are chemoreceptors sensitive to?

A

low blood oxygen levels as a result of decreased blood flow due to low blood pressure

82
Q

What kind of neurotransmitter is released when chemoreceptors are stimulated by low blood pressure?

A

excitatory neurotransmitters

83
Q

What to excitatory neurotransmitters do with relation to blood pressure?

A

increase sympathetic firing down neurons that innervate smooth muscle of blood vessels –> vasoconstriction

84
Q

What is accomplished by the stimulation of chemoreceptors?

A

an increase in blood pressure by vasoconstriction

85
Q

How does increased vagal output cause a decreased blood pressure?

A

via its parasympathetic effects that cause decreased heart rate –> decreased CO–> decreased BP

86
Q

How does the kidney affect blood pressure?

A

via the renin angiotensin system: dec BP –> dec GFR–> renin released–> aldosterone release –> kidneys reabsorb Na and water–> increase in blood volume –> increased BP

87
Q

How doe ADH affect blood pressure?

A

low BP –> ADH release–> kidney holds onto water–> increased blood volume –> inc BP

88
Q

In metabolic control of blood flow, decreased oxygen causes release of metabolite (CO2, lactate etc.) which causes what?

A

vasodilation of blood vessels, metabolic acidosis

89
Q

what is the name of the control that protects against high blood pressure damage?

A

autoregulation

90
Q

What tissue is best at auto regulation?

A

the brain

91
Q

What is the net result of blood vessels on auto regulation?

A

vasoconstriction

92
Q

What is the long term control of blood flow called (ie. compensation for some type of tissue ischemia)

A

angiogenesis

93
Q

What is the primary catecholamine for alpha adrenergic receptors?

A

norepinephrine

94
Q

Which vascular beds have primarily alpha receptors?

A

skin, renal, splanchnic vasculature

95
Q

What affect does Norepi have on smooth muscle cells in the vascular beds?

A

vasoconstriction

96
Q

What is the primary catecholamine for beta 2 receptors?

A

epinephrine

97
Q

Which vascular beds have primarily beta 2 receptors?

A

coronary and skeletal muscle vessels

98
Q

What affect does epic have on smooth muscle in the vascular beds?

A

vasodilation

99
Q

Which of the ANS branches has the most control over circulation?

A

sympathetics via norepi/epi

100
Q

Which vascular beds are over perfused at rest?

A

skin, splanchnic and renal

101
Q

Brain ischemia caused by and increase in CSF pressure is known as what?

A

Cushings reflex

102
Q

When, during the cardiac cycle, are the coronary arteries perfused?

A

during diastole

NPLEX I (22 decks)

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