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crr cardiovascular > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

overview of conducting system; describe route of AP

A
  1. SA node (atria)
  2. AV node
  3. Bundle of His
  4. Purkinje fibres (wall of ventricles)
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2
Q

where is the AV node?

A

anterior to coronary sinus (R atrium)

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3
Q

where is the SA node?

A

wall of R atrium; inf. to opening of sup vena cava

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4
Q

name of cells which form the pacemaker?

A

autorhythmic cells

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5
Q

which has a higher Na+ concentration; intracellular or extracellular?

A

extracellular

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6
Q

what is a funny current, and what effect on the resting membrane potential?

A
  1. leakage of Na+ into the cell
  2. inhibits K+ from leaving
  3. causes increase in RMP = -40mM
  4. triggers AP
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7
Q

what ion channel is opened in response to an AP?

A

slow L-type Ca2+

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8
Q

3 steps in cardiac myocyte AP

A
  1. depolarisation
  2. plataeu phase
  3. repolarisation
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9
Q

what is a refractory period?

A

time where another AP cannot be fired

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10
Q

2 advantages of the refractory period?

A
  1. non-return valve; prevent AP from backflowing

2. prevents 2nd contraction before 1st contraction has ended (tetanic contraction)

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11
Q

disadvantage to a tetanic contraction

A

produces long, slow muscular contractions - dont allow heart to pump sufficiently.

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12
Q

what is hyperpolarisation?

A

overshoot in repolarisation - more negative than -90mV

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13
Q

P wave:

A

depolarisation of atria

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14
Q

QRS complex

A

depolarisation of ventricles

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15
Q

T wave

A

repolarisation of ventricles

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16
Q

PQ segment

A

conduction time between SA node + ventricular depolarisation

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17
Q

where is the plateau phase

A

ST segment

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18
Q

ECG: ventricular systole

A

QT wave

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19
Q

where on ECG is the ventricular diastole

A

after T wave

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20
Q

why is there a delay at the AV node?

A

allows ventricles to fill

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21
Q

2 points on ECG where ventricular pressure increases?

A
  1. P wave = as atria pump blood into ventricles

2. QRS = as AV valves shut

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22
Q

what occurs during isovolumetric contraction?

A

AV valves shut; pressure in V increases

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23
Q

what occurs during isovolumetric relaxation?

A

AV valves open - due to pressure in aorta exceeding ventricles

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24
Q

when does ventricular volume decrease?

A

during ventricular ejection - ST segment

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25
Q

when does ventricular volume increase?

A

ventricular relaxation - after t wave

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26
Q

what does a lup sound indicate?

A

closing of AV valves

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27
Q

what does a dup sound indicate?

A

closing of semi-lunar valves

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28
Q

2 major contractile filaments in myofibrils?

A

actin + myosin

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29
Q

what makes up I band

A

thin actin

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30
Q

what makes up A band

A

thick myosin

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31
Q

describe the chains in myosin filament

A

2 heavy chains - each of which is attached to a light chain

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32
Q

which 2 proteins are coupled to actin? and how frequently

A

troponin & tropomyosin - every 7th molecule

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33
Q

which troponin complex binds to actin and which binds to tropomyosin?

A 
T= tropomyosin
I = actin
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34
Q

what occurs when Troponin C is added to actin?

A
  1. becomes Ca2+ sensitive
  2. 4 Ca2+ attach
  3. tropomyosin undergoes a conformational change in shape
  4. allows myosin to attach
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35
Q

how does heart muscle produce its own ATP?

A

Creatin kinase moves phosphate from creatin phosphate to ADP.

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36
Q

explain properties of elastic arteries

A

stretchy to propel blood

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37
Q

3 segments of tunica intima

A
  1. endothelium
  2. basement membrane
  3. internal elastic lamina
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38
Q

structure at the end of arterioles to capillary

A

metarterioles

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39
Q

what monitors the blood flow into the capillary?

A

precapillary sphincter

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40
Q

name for distal end of metarteriole?

A

thoroughfare channel

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41
Q

what is vasomotion?

A

contraction of SMC allowing pulsatile flow of blood from metarterioles

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42
Q

which blood vessels have thin walls and large lumens?

A

venules

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43
Q

what are the greatest capacitance vessels?

A

veins

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44
Q

2 factors for filtration

A

blood hydrostatic pressure

interstitial fliud osmotic pressure

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45
Q

2 factors for absorption

A

intersitital hydrostatic pressure

blood colloid pressure

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46
Q

what condition occurs when filtration > reabsorption?

A

oedema

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47
Q

what does the right lymphatic duct drain into?

A

internal jugular vein

48
Q

what does the thoracic duct drain into?

A

subclavian vein

49
Q

6 major vasodialators

A 
NO,
lactic acid, 
histamine,
increased temp,
low pH = low CO2
low O2
50
Q

mechanism of vasodilators

A

relax precapillary sphincters

51
Q

2 vasodialators

A

thromboxanes and endothelins

52
Q

when are thromboxanes released?

A

by platelets at a wound site

53
Q

when are endothelins released?

A

by damaged endothelial cells

54
Q

how do vasoconstrictors work?

A

by contracting precapillary sphincters

55
Q

what is normal BP

A

120/80 mmHg

56
Q

what 3 things does vascular resistance depend on

A

lumen diameter
blood viscosity
vessel length

57
Q

what is the force driving venous return?

A

greater pressure in veins than right atrium

58
Q

where is the cardiovascular centre?

A

medulla oblongata

59
Q

input: from higher brain centres such as?

A

hypothalamus
limbic system
cerebral cortex

60
Q

input; from sensory receptors?

A

propoiceptors
chemoreceptors
baroreceptors

61
Q

sympathetic nerves out to the heart from CV centre

A

cardiac accelerator nerves

62
Q

parasympathetic nerves out to heart from CV centre

A

vagus nerve

63
Q

how does the CV centre increase of decrease HR?

A

increase/decrease depolarisation of AV & SA nodes

64
Q

where are the baroreceptors which detect BP directly?

A

aortic & carotid bodies

65
Q

which hormones increase BP?

A

epinephrine + norepinephrine

66
Q

which system controls BP long term?

A

RAAS

67
Q

what in the RAAS increases blood volume and how?

A

Aldosterone - increases renal reabsorption of Na+, therefore water follows

68
Q

what in the RAAS causes vasoconstriction?

A

angiotensin II

69
Q

how do parasympathetic neurones slow down heart rate?

A
  1. parasymp neurones secrete ACh
  2. causes K+ channels to open
  3. K+ influx
  4. Inhibits depolarisation
  5. Less action potentials
70
Q

what does the atrial reflex respond to

A

increase in venous return

71
Q

3 homeostatic mechanisms to regulate cardiovascular system

A
  1. autoregulation
  2. neural
  3. endocrine
72
Q

what is autoregulation control?

A

vasodilation & vasoconstriction with chemicals

73
Q

what innervation is used by neural regulatory mechanism?

A

sympathetic

74
Q

which centre controls neural regulatory mechanism?

A

vasomotive centre

75
Q

in the neural mechanism, describe the process of vasoconstriction

A
  1. nerves are adrenergic - secrete noradrenaline

2. stimulates alpha1- adrenoreceptors; causes contraction of SMC in precapillary sphincters

76
Q

in the neural mechanism, describe the process of vasodilation

A
  1. nerves are cholinergic - secrete ACh - triggers NO releases
  2. nerves are nitroxidergic - release NO
  3. NO is a vasodialtor; causes relaxation of SMC in precapillary sphincter
77
Q

when there is an increase in BP, what centres are inhibited & which are stimulated?

A 
stim = cardio-inhibitory 
inhib = cardio-accel & vasomotive
78
Q

when there is an decrease in BP, what centres are inhibited & which are stimulated?

A 
stim = cardio-accel & vasomotive 
inhib= cardio- inhib
79
Q

what does stimulation of the vasomotive centre cause?

A

vasoconstriction

80
Q

which hormones work to increase BP?

A

ADH, angiotensin II, erythropoiten

81
Q

which hormones work to decrease BP?

A

Anti-natriuteric peptide

82
Q

where is ADH released from?

A

posterior lobe of pituitary gland

83
Q

what stimulates production of ANP?

A

stretching of atrial wall

84
Q

what cells produce ANP?

A

atrial myocytes

85
Q

during exercise, where is more blood distributed to?

A

skeletal muscles, skin, heart

86
Q

during exercise, where is less blood distributed to?

A

GI tract, kidneys

87
Q

what is the anticipatory response

A

before exercise, the sympathetic NS increases HR, increasing CO, vasoconstriction of splanchnic arterioles

88
Q

3 changes during light exercise

A
  • increased vasodilation
  • increased CO
  • increased venous return
89
Q

5 changes during heavy exercise

A
  • Max CO
  • peripheral blood changes
  • vasomotive centre; direct blood to essential organs
  • cardio-accelertory centre activated
  • increased skin perfusion - due to increased body temp
90
Q

during haemorrhaging, what are the short term responses? what do all of them do?

A

cause vasoconstriction

  1. sympathetic response detected by low BP
  2. neural - noradrenaline
  3. endocrine - ADH
91
Q

during haemorrhaging, what are the long term responses?

A
  1. RAAS
  2. ADH
  3. EPO
92
Q

what level of blood loss defines ischaemia?

A

<30%

93
Q

what do lipoproteins consists of?

A

lipids + proteins

94
Q

why are the different lipoproteins transported in differemt ways?

A

due to different apoproteins on their surface

95
Q

function of lipoprotein lipase

A

converts triglycerides into fatty acds + monoacylglycerol

96
Q

what is a characteristic of true congestive heart failure?

A

pulmonary oedema

97
Q

what is arteioscleorisis?

A

thickening of arterole wall - causing reduction in elasticity

98
Q

what is atheroscleosis?

A

plaque building up

99
Q

narrowing of a blood vessel

A

stenosis

100
Q

what is more anterior-pulm trunk or aorta?

A

pulm trunk/artery

101
Q

what is afterload

A

pressure of heart to eject after atrial systole

102
Q

what is preload

A

end-diastolic vol that stretches V to greastest dimension

103
Q

pO2- hypoxia to hyperoxia

A

10-13

104
Q

PCO2 - hypocapnia to hypercapnia

A

4.5-6

105
Q

HCO3- high and low

A

22-26

106
Q

what is type 1 respiratory failure characterised by, and what causes it?

A

hypoxia - ventilation exceeds perfusion

107
Q

whatis type 2 respiratory failure characterised by, and what causes it?

A

hypoxia + hypercapnia; reduced lung SA

108
Q

in embryology - what do the cardiogenic cords develop into?

A

endocardial tubes

109
Q

what does the fusing of the endocardial tubes form?

A

primitive heart tube

110
Q

what fuses to form the atrial septum?

A

sinoatrial orifice

111
Q

what is the hole called which the septum primum close, and in what chamber?

A

ostium primum- atria

112
Q

what prevents the complete closure of atria

A

ostrium secundum

113
Q

what forms the foramen ovalis?

A

septum primum

114
Q

remnant name for foramen ovals

A

fossa ovalis

115
Q

what forms the AV valves?

A

mesenchymal extensions

crr cardiovascular (2 decks)

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