A&P exam 2 Flashcards
(199 cards)
1
Q
Extrinsic regulation is influenced by what two systems?
A
- nervous system
2. endocrine system
2
Q
Bradycardia is an anticipated side effect of which type of medication?
A
beta blocker
3
Q
Patients experiencing AFIB will often be given coumadin in order to prevent ___ in the ___
A
prevent clotting of blood in the atria
4
Q
The QRS complex in an ECG represents
A
ventricular depolarization
5
Q
TPR is regulated by changing the diameter of :
A
arterioles
6
Q
Small changes in radius produce:
A
large changes in resistance
7
Q
increasing release of epinephrine via B2 adrenergic receptors causes:
A
vasodilation
8
Q
increase Ach release from cholinergic postganglionic sympathetic fibers causes vaso___:
A
vasodilation
9
Q
alpha 1 and beta 1 release:
A
both NOREPI and EPI
10
Q
beta2 releases:
A
only epinephrine
11
Q
CO= ___ and is proportional to ____
A
venous return; metabolism
12
Q
norepi and epi via B1 adrenergic receptors do what to HR?
A
increase HR
13
Q
Acetylcholine via muscarinic cholinergic receptors do what to HR?
A
decrease HR
14
Q
Stroke volume can be increased by:
A
increasing preload, increasing contractility and decreasing afterload
15
Q
The heart pumps what it gets; therefore the heart will pump more when it gets more blood. so to increase preload __ venous return
A
increase
16
Q
Afterload=
A
the load the heart has to content with after contraction starts; the load that cardiac muscle fibers must overcome before they can begin to shorten, before the heart can eject blood
17
Q
Major causes of increased afterload:
A
high TPR/high MAP; high local resistance (ex: aortic stenosis)
18
Q
ECG: one second=
A
5 large squares/ 25 small squares
19
Q
ECG: one large square=
A
0.2 sec
20
Q
ECG: one small square=
A
0.04 sec
21
Q
P wave=
A
atrial depolarization
22
Q
QRS wave=
A
ventricular depolarization
23
Q
T wave=
A
ventricular repolarization
24
Q
P wave triggers:
A
atrial systole
25
QRS wave triggers:
ventricular systole
26
T wave occurs:
just before ventricular systole
27
All arrhythmias are thought to be due to abnormal __ or __ of electrical impulses
generation or conduction
28
Abnormal sinus rhythms=
tachycardia and bradycardia
29
two types of ectopic foci=
PACs and PVCs
30
normal sinus rhythm= __ beats/min
75
31
tachycardia can be due to:
sympathetic stimulation, increased body temperature, deficient parasympathetic discharge
32
Bradycardia can be due to:
increased parsaympathetic tone and/or beta blockers
33
Timing between T wave of previous cycle and P wave of next cycle is small (P wave comes early)=
Premature atrial contraction (PAC)
34
In ___, QRS comes before P wave
PVCs
35
__ are among the most common arrhythmias and occur in people with and without heart disease. This is the skipped heart beat we occasionally experience
PVC
36
A dilated heart must work harder b/c when the radius of the ventricular lumen increases it takes greater ___ to produce the same increase in BP. This hemodynamic principle is known as the ___ law
tension; laplace's
37
In a blood vessel with a high degree of compliance, a 200% increase in blood volume will affect pressure in the vessel in what way?
minimally
38
The direct effect of increasing TPR is:
increased afterload
39
The __ vessels provide blood supply to the heart
coronary
40
The __ vessels provide blood supply to the brain
carotid
41
When blood leaves the heart via the aorta what is the path of vessels that it most often takes to supply tissues?
arteries --> arterioles --> capillaries --> venules --> veins --> vena cava
42
__ are responsible for exchange of materials with tissues
capillaries
43
major site of vascular resistance=
systemic arterioles
44
__ have high compliance as compared to arteries
veins
45
The term venous return refers to what?
The amount of blood that returns to the heart following systemic circulation
46
What are some factors that promote venous return?
increased venous tone, increased blood volume, skeletal muscle pumping and venoconstriction
47
What adjective describes enlarged, overstretched superficial veins with compromised valves?
varicose
48
The ___ nervous system has chronotropic effects on the heart
parasympathetic
49
The __ nervous system displays chronotropic and inotropic effects on the heart
sympathetic
50
Autoregulation refers to the ability of a tissue to regulate its own ___
blood flow
51
A drop in pH will typically cause which response in a blood vessel?
vasodilation
52
The baroreceptors involved in the baroreceptor reflex are located where?
aortic arch and carotid sinus
53
ACE inhibitors are frequently used clinically for treatment of HTN. Which process is caused by ACE?
Angiotensin I to angiotensin II
54
Intrinsic cardiovascular control mechanisms=
1. starlings law
| 2. autoregulation
55
The vasomotor center is located in the ___. It is responsible for coordinating ____ ___ information in the CV system and sending out an appropriate response by the autonomic nervous system
medulla oblongata; visceral sensory
56
HTN can result in cardiac hypertrophy and dilation. This occurs b/c the heart must work harder to overcome the increased ___ associated with high blood pressure.
afterload
57
In chronic HTN, the myocardium enlarges until it is overstretched and inefficient, resulting in decreased ___ of the heart
contractility
58
When blood backs up into the veins, the resulting condition is called venous ___
congestion
59
In HTN, which cardiovascular parameters are likely increased?
CO, TPR or both
60
Which of the following are used to treat HTN? B blockers; ACE inhibitors; sympathetic nervous system stimulants; thiazides; vasodilators
B-blockers; ACEi; thiazides; vasodilators
61
The leading cause of death in the US for men and women is ___
corondary artery disease
62
The pain associated with angina pectoralis is a symptom that the myocardium is what?
ischemic (oxygen deprivation)
63
Heart failure occurs when the heart doesn't pump what it gets (low stroke volume- starlings law isn't working). As a consequence, CO is decreased. The kidneys often try to compensate: the volume loading that occurs in chronic heart failure is an indication that renal control mechanisms are doing what?
working to increase blood pressure and cardiac output up to normal
64
Myocardial infarction is often the result of which of the following?
atherosclerosis; coronary artery disease; embolism in coronary vessel; stroke; hypotension
atherosclerosis; coronary artery disease; embolism in coronary vessel
65
ECGs are used to:
monitor the electrical events in cardiac conduction
66
The P wave on an ECG represents:
atrial depolarization
67
Tachycardia can result from activation of which receptor?
B1 adrenergic
68
calcium channel blockers are sometimes used to treat sinus tachycardia b/c CCBs:
slow the action potentials of pacemaker cells
69
In atrial flutter, the atria contract so quickly that:
ventricular filling is compromised
70
In a blood vessel with a high degree of compliance, a 200% increase in blood volume will affect pressure in which way?
minimally
71
If a vessel constricts so that its radius is half the original width, the rate of blood flow will change by how much?
blood flow will decrease by 16-fold
72
Relatively thin muscular walls and large diameter lumen refers to:
systemic vein
73
Arteries carry bloow __ the heart and __ the tissues
away; toward
74
Veins carry blood __ the heart and __ the tissues
towards; away from
75
An increase in sympathetic tone at systemic arterioles results in:
increased total peripheral resistance (TPR)
76
The sympathetic nervous system aids in venous return by:
constriction of veins
77
The kidneys promote venous return by:
increasing blood volume
78
When blood pools in vessels for significant lengths of time, one is at risk for:
inappropriate clotting
79
When you stand up, what force causes pooling of blood in the legs?
gravity
80
Vampires drink blood from which blood vessel located in the neck?
jugular vein
81
The femoral vein carries blood from the __ to the __ (drains into ___)
thigh; heart; common iliac veins
82
The iliac vein carries blood from ___ to the ___
pelvis and lower limbs to the inferior vena cava
83
In response to an increase in perfusion pressure, an organ will do what to keep its local blood flow constant?
constrict its precapillary sphincters (vasoconstriction)
84
Baroreceptors transmit signals via ___ ___ pathways
visceral sensory
85
Increased venous return causes an increase in cardiac output b/c it increases
end diastolic volume (preload)
86
Sympathetic stimulation of arterioles through alpha1 adrenergic receptors causes __ and __ blood flow
vasoconstriction; decreased
87
Adrenal epinephrine acting through alpha2 adrenergic receptors causes __ and __ blood flow
vasodilation; increased
88
when BP falls, then renin is released by the ___
kidney
89
Angiotensin II raises BP by:
stimulating vasoconstriction, increasing blood volume, increasing CO, and stimulating hypothalamic thirst centers
90
Angiotensin converting enzyme (ACE) converts __ to ___
antiotensin I to angiotensin II
91
When blood pressure drops, baroreceptors signal the brainstem to increase sympathetic output resulting in all of the following except: vasoconstriction; increased contractility of the heart; venoconstriction; decrease in heart rate
decrease in heart rate
92
One frequent consequence of "right sided" heart failure is :
systemic edema
93
One frequent consequence of "left sided" heart failure is:
pulmonary edema
94
A blood pressure of 129/80 is categorized as:
pre-hypertensive
95
The pain in the left arm and shoulder that develops during myocardial ischemia is an example of:
referred pain
96
The volume loading by the kidneys that occurs in heart failure is an attempt to:
restore CO to normal
97
Left ventricular hypertrophy is one result of:
hypertension
98
Which of the following is associated with circulatory shock? a sudden drop in blood pressure; hemorrhaging; massive vasodilation; loss of autonomic nervous system tone
all of the above
99
What type of vessels supply blood to the myocardium?
coronary arteries
100
What type of vessels supply blood to the brain?
carotid arteries
101
___ inhibit myocardial contractility and heart rate
beta blockers
102
Angina pectoralis=
crushing pain of the chest
103
___ inhibit the activity of an enzyme located in the lungs
ACE inhibitors
104
___ is a consequence of sudden hypotension
shock
105
___ decrease blood volume and ultimately CO and MAP
diuretics
106
The ___ transmits parasympathetic signals to the heart
vagus nerve
107
___ decrease TPR by causing arteries to dilate
calcium channel blockers
108
The main secretion of the adrenal medulla is ___
epinephrine
109
The amount of blood returned to the heart from systemic circulation=
venous return
110
___ dilates veins to decrease venous return, preload and stroke volume
nitroglycerin
111
Stroke volume is regulated by all of the following except: heart rate; contractility of the heart; afterload; preload/EDV
heart rate
112
A heart with an expanded ventricular radius (a dilated heart) must work harder than a heart with a normal ventricular radius (law of laplace). A dilated heart must develop higher __ to accomodate a given ___
tension; pressure
113
Compared with a normal heart, a dilated heart has:
a higher oxygen demand
114
As we age, our blood vessels lose some of their elasticity. As a consequence they lose the ability to fill with blood without experiencing a significant elevation of pressure in the vessel. This principle is known as:
compliance
115
Most systemic vascular resistance and regulation of this resistance occurs at __
arterioles
116
One of the main effects of calcium channel blockers is to:
dilate arteries
117
In general blood FLOW is slowest in:
capillaries
118
Blood pressure is read from:
the brachial artery
119
The superior and inferior mesenteric arteries deliver oxygenated blood to:
the intestines
120
The __ runs from the foot to the groin, where it empties into the femoral vein
Great saphenous vein
121
CO=
MAP/TPR
122
Increased venous return causes an increased CO because it increases __
end diastolic volume
123
What is the effect of epinephrine at beta 2 adrenergic receptors?
decreased smooth muscle tone
124
Hardening of the arteries due to the development of cholesterol laden plaques is called:
atherosclerosis
125
When standing, what allows blood to flow "uphill" from the legs to the heart?
skeletal muscle pumping and venous valves
126
blood pressure is lowest in:
veins
127
increased sympathetic tone results in all of the following except: dilation of systemic blood vessels; dilation of vessels supplying skeletal muscle; constriction of systemic blood vessels; increased venous return
dilation of systemic blood vessels
128
Local vasodilation of capillaries may occur in response to which stimulus? low blood glucose; lactic acid accumulation; elevated temperature; low blood oxygen
all of the above
129
The term "autoregulation" of blood flow refers to the ability of a:
tissue to regulate its own blood flow
130
ACE inhibitors block:
conversion of Angiotensin I to Angiotensin II
131
In the baroreceptor reflex, what does the cardiovascular center do in response to a decrease in blood pressure?
increases sympathetic tone, decreases parasympathetic tone
132
One mechanism by which angiotensin II promotes salt and water retention by the kidneys is to stimulate the secretion of:
aldosterone
133
An increase in blood volume results in release of:
atrial natriuretic peptide
134
The stretch receptors of the aortic arch and carotid sinus are called:
baroreceptors
135
The cardiovascular regulatory center is located in the:
medulla oblongata
136
Cold (weather) exposure in humans results in activation of the sympathetic nervous system and vasoconstriction of peripheral vessels. The result is:
increased MAP
137
The dividing line between normal BP and pre-HTN is:
120/80
138
One of the main hemodynamic consequences of HTN is:
increased afterload
139
The coronary arteries emerge from the:
aorta
140
In most patients, first line therapy for HTN is:
diuretics
141
The pain associated with angina pecotralis is a symptom that the myocardium is ischemic. The goal of treatment is to reduce:
oxygen demand by the heart
142
Pulmonary edema is primarily the result of:
left sided heart failure
143
Myocardial infarction is most often the consequence of:
coronary artery blockage
144
In heart failure, the heart doesn't pump what it gets. Thus a ___ EDV does not result in a greater ___
greater; stroke volume & cardiac output
145
Severe diarrhea can lead to:
hypovolemic shock
146
Neurogenic shock occurs when:
loss of sympathetic tone causse massive vasodilation
147
In compensated heart failure, to restore cardiac output to normal the kidneys:
increase blood volume
148
The kidneys receive _% of cardiac output
20
149
Class I antiarrythmic drugs=
Na+ channel blockade
150
Na+ channel blockers block the __ which depresses the phase __
fast sodium channel; phase 0 depolarization
151
Class II antiarrythmic drugs=
B-adrenergic receptor blockage
152
Beta blockers __ HR; work by ___ the hearts electricalsi gnal as it passes through the ___ on its way from the __ to the ___
decreases; slowing; AV node; atria; ventricles
153
Class III antiarrythmic drugs=
Potassium blockers
154
Potassium blockers prolong ___; prolongs ___ by __ potassium efflux; delay in __ and prolonged ____ period
repolarization; action potential; delaying; refractory
155
Class IV antiarrythmic drugs=
Ca2+ channel blockade
156
Calcium channel blockers work by ___ the hearts electrical signal
slowing
157
flow= driving force/
resistance
158
Q= ___/ R
change in pressure
159
Flow= ___/ resistance
pressure gradient
160
Q (rate of blood flow) is determined by what 3 things?
viscosity, vessel length and radius of vessel
161
Blood flow is most importantly determined/effected by :
radius of vessel
162
In blood vessels, tension is due to __ of smooth muscle ("active") and the presence of structural elements such as __ and ___ ("passive")
contraction; elastic and collagen fibers
163
A larger blood vessel radius requires larger amount of ___ to contain a given pressure
tension (T)
164
A dilated heart has a larger ___ which requires more __ from contraction necessary to generate a normal pressure increase during systole ; (the heart has to work much harder)
radius; tension
165
Compliance is a measure of ___ and the formula is compliance= __/___
flexibility; change in volume/ change in pressure
166
Small arteries/arterioles have relatively rigid walls so a small change in volume produces a large change in ___
pressure
167
Primary function of small arteries/arterioles=
transmission of blood at high pressure to the tissues
168
Veins are usually partially ___; a large change in __ causes:
collapsed; volume; a small change in pressure
169
primary function of veins=
storage of blood
170
Increased sympathetic tone in the arteries causes increased __ and decreased ___
increased resistance; decreased compliance
171
Increased sympathetic tone in veins causes decreased __ and increased ___
decreased storage; increased venous return to the heart
172
There is NO parasympathetic innervation of ___
blood vessels
173
The walls of arteries and veins are arranged in:
3 layers/tunics
174
Large arteries can be described as having thicker __ than veins (thickness of the __), abundant ___ which are spread throughout the media; high __; and recoiling of __ during __
walls; tunica media; elastic fibers; compliance; fibers during diastole
175
Small arteries/arterioles have __ walls and __ lumens which means they ___ during systole; Low ___; Site of most of the ___ in the vascular system
muscular; narrow; don't stretch much during systole; compliance; resistance
176
Veins/venules are characterized by ___ walls and __ lumens; often partially __ which accounts for much of the high ___; Low ___
thin; large; collapsed; compliance; low pressure (0-10 mmHg)
177
Capillaries are ___ thick and consist of __ only. They have low ___ due to large cross sectional area
1 cell layer; endothelium; velocity
178
Age effects arteries by __ collagen and ___ elastin which ___ compliance
increasing; decreasing; decreasing
179
If venous pressure=0 how does blood get back to the heart?
passive filling and overcoming gravity; venous valves ensure one way flow
180
Venous valves ensure:
one way flow
181
Factors that will increase venous return include (in order of significance):
1. increase mean systemic filling pressure
2. skeletal muscle pump/ venous valves
3. inspiratory pump
4. gravity
182
What must be done to blood volume and blood storage in order to increase mean systemic filling pressure to increase venous return?
increase blood volume and decrease blood storage
183
___ veins are a sign of severe heart failure and are __ in location to the heart
bulging jugular; superior
184
Varicose veins are __ in location to the heart
inferior
185
increased metabolism has what effect on flow?
increases flow
186
increased sympathetic tone causes __ of blood vessels supplying skeletal muscle
vasodilation
187
Increased sympathetic tone causes vasodilation of blood vessels supplying skeletal muscle by ___ fibers and ___ at B2 receptors
cholinergic post ganglionic sympathetic fibers; epinephrine
188
Baroreceptors are also called __ or __ receptors
pressure/stretch
189
Baroreceptor reflex: __ pressure --> ___ --> ___
increase P; increase stretch; increase discharge
190
Impulses from baroreceptors pass through __ nerves (aortic arch) and ___ nerves (from carotid) to vasomotor/CV center in ___
vagus; glossopharyngeal; medulla oblongata
191
To decrease arterial pressure increase __ tone and decrease __ tone
parasympathetic; sympathetic
192
Chemoreceptors are located in __ and __ bodies; major function=
carotid and aortic bodies; respiration
193
Chemoreceptors: decreased Q= __ O2= __ CO2= __ pH= __ discharge= stimulate __ tone and inhibit __ tone
decreased; increased; decreased; increased; sympathetic; parasympathetic
194
The direct effects of angiotensin II = vaso __ especially in __ to increase __
vasoconstriction; arterioles; TPR
195
Angiotensin II causes indirect effects by stimulating __ secretion by the adrenals; it increases blood volume by increasing salt and water retention by the kidneys
aldosterone
196
What type of drugs increase excretion of salt and water to decrease venous return?
diurectirs and natriuretics
197
What drug inhibits effectsof baroreceptor reflexes/ decreases heart rate and contractility?
beta-blockers
198
What type of drugs decreases TPR and venous return?
vasodilators
199
A dilated heart or a heart with high afterload has a __ metabolic requirement
increased
