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Medical Physiology > B3W1 > Flashcards

B3W1 Flashcards

(80 cards)

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1
Q

Pathway of circulation throughout the heart and blood. Starting in the (R) atria

A

(R) atria - tricuspid valve - (R) ventricle - Pulmonary semi lunar valve - Pulmonary arteries - pulmonary circulation - pulmonary veins - (L) atria - mitral valve - (L) ventricle - aortic semilunar valve - aorta - systemic circulation - inferior/superior vena cava

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2
Q

S1 and S2 heart sound (what do they correspond to mechanically?)

A

S1 = closing of AV valves S2 = closing of SL valves

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3
Q

Which artery is responsible for supplying the heart with blood?

A

Coronary artery

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4
Q

Ejection Fraction EQ and what does it mean

A

EF = SV/EDV (shows the percentage of blood which is ejected from each ventricular contraction)

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5
Q

Stroke Volume EQ and what does it mean AND what is the average value

A

SV = EDV - ESV (meaning how much volume is being pumped into circulation from each ventricular contraction)
Average value = 70 mL

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6
Q

Mean Arterial Pressure EQ and what does it mean AND average value

A

MAP = 2/3 DBP + 1/3 SBP (average pressure during one cardiac cycle)
Average value = 95 mm Hg

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7
Q

Compliance EQ and what does it mean

A

Compliance = change in volume / pressure (the ability of a vessel to “comply” or stretch to a volume load

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8
Q

Flow EQ’s / Pousielle’s EQ (what does it mean)

A

Determines flow
pressure = flow * resistance
F=Change in pressure / Resistance
F = Change in pressure * (pi)(r^4)/8(viscosity)(length)

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9
Q

Cardiac output EQ and what does it mean AND average value

A

CO = HR * SV (amount of blood pumped in a minute)
Average = 5 L / min

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10
Q

Cardiac Output EQ (from Ficks Principle)

A

CO = Rate of O2 consumption / O2 in artery - O2 in vein

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11
Q

Resistance EQ and what does it tell you

A

R= 8(viscosity)(length) / (pi)(r^4)
Resistance of a vessel

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12
Q

How to calculate a capillary bed resistance in parallel v series

A

Series = R1+R2+R3….
Parallel = 1/R1 + 1/R2 + 1/R3…..

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13
Q

Average HR v Tachycardia v Bradycardia

A

60 bpm - 100 bpm = average
> 100 = tachycardia
< 60 = bradycardia

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14
Q

Average systolic and diastolic blood pressures

A

SBP = 120 mm Hg
DBP = 80 mm Hg

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15
Q

Reynold’s number EQ and what does it mean AND average values

A

Re = 2rvp / n (helps in determining laminar flow v tubular flow)

< 2000 = laminar
2000-3000 = transitional flow
>3000 = tubular

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16
Q

Draw out a pressure loop and explain it to yourself

A

-do it-

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17
Q

Flow, Resistance and Pressure differences across the cardiovascular system

A

Flow and resistance tend to have high variability
Pressure remains fairly constant

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18
Q

In terms of viscosity… describe the relationship to anemia/polycythemia

A

Anemia = less RBC = lower viscosity = lower hematocrit
Polycythemia = more RBC = higher viscosity = higher hematocrit

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19
Q

Examples of capillary beds in series vs parallel

A

Series = portal systems (renal, hypophyseal, hepatic)
Parallel = regular capillary beds you think of

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20
Q

common sites of tubular flow in the body

A

Aorta, sites of branching

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21
Q

What are the three pressures which are present in circulation

A

Hydrostatic, Transmural, Driving

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22
Q

What is driving pressure

A

The main pressure involved in blood pressure setting , and the main pressure in blood flow

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23
Q

What is transmural pressure

A

Difference in pressure across a capillary wall
transmural pressure has to have a higher pressure inside than outside or a vessel will collapse

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24
Q

What is hydrostatic pressure

A

pressure due to gravity

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25
Blood Flow : velocity and area relationship of vessel
As area increases, velocity decreases to balance flow Ex. aorta has a high velocity because of small area Ex. capillaries have a high area, and a low velocity
26
Bernoulli's Effect
-Fluid flows from a area of high to low pressure to conserve total energy -when there is a stenosis of a vessel there is a localized increase in velocity and a decrease in pressure which then makes the whole net movement from low pressure to high pressure -connects both kinetic and potential energy -velocity = kinetic energy -pressure = potential energy
27
Organization of the vascular system and describe the elastance/compliance of each
-Arteries = high pressure, high elastic (distribution system) -Capillaries = diffusion and filtration systems -Veins = high compliance, low pressure (holding system)
28
Aggregate vs individual chart
-REVIEW it-
29
Aggregate ____ remains constant throughout the body
Flow
30
Composition of arteries v capillaries v veins
Arteries: endothelial cells, elastic fibers, smooth muscle, collagen fibers Capillaries: endothelial cells (NO VSMC) Veins: endothelial cells, elastic fibers, smooth muscle, collagen fibers
31
EQ for how to determine pressure in capillary
Pressure in capillary = R post / R pre
32
Increasing capillary pressure leads to _____ (systemic problem)
edema
33
Compliance v Elastance
Compliance is the ability of a vein to stretch and "comply" for contents, elastance is the rubber band ability of a vessel (how it can stretch and come back)
34
A high youngs modulus vs a low youngs modulus
High young modulus = there is more elastance and the vessel is stiffer low young modulus = there is more compliance there fore leading to a more elastic vessel
35
Capacitance vs resistance vessels
Capacitance vessels = veins resistance vessels = arteries
36
Changes that lead to high physiological pressure changes will rupture what kind of vessel
veins
37
Why is the aorta being compliant important?
Think the windkessel effect. By allowing for a compliant tissue there will be oscillating periods of high and low pressure which causes there to be no STOP GO STOP GO STOP GO movement. it is continuous
38
Arteriosclerotic changes
as we age, vessels become stiffer and increase in rigidity leading to an increase in pressure and decrease in compliance
39
What is blood pressure measuring (general)
measuring the pressure exerted by the blood against the walls of the vessels
40
What is BP measuring (systolic v diastolic)
SBP: measuring pressure exerted in the arteries by blood leaving the heart DBP: measuring pressure exerted in the arteries during ventricular filling
41
what do you use to measure BP
sphygmomanometer
42
Auscultation method of taking BP
using stethescope listen for systolic v diastolic systolic - Korotkoff sounds - you are hearing turbulent blood as it moves past the cuff diastolic - you are hearing an absence of the tubular flow and restoration of laminar flow in vessels
43
Papatory method of taking BP
assess the radial pulse (on the wrist) while inflating the cuff
44
Why would MAP be important to calculate in a clinical setting
MAP = average blood pumped through 1 cardiac cycle can be used to assess tissue perfusion (low MAP could be showing signs of ischemia)
45
Pulse Pressure EQ and what does it mean
EQ: Systolic BP - Diastolic BP (equals the force generated at each contraction)
46
High pulse pressure v low pulse pressure
High = high PP equals high SV = increased risk of turbulent flow small = slow PP equals small SV = decrease in blood being pumped from heart
47
cardiac tamponade (pathology and diagnosis)
blood fills the pericardial sac and decreases the ability to expand, which decreases SV diagnosed using Becks Triad (hypotension due to small PP, JVD, diminished heart sounds)
48
Aortic valve stenosis
narrowing of the aortic valve leading to a decrease in radius, less SV and decreased PP
49
Wider pulse pressures lead to a ______in aortic compliance, ________ in aortic radius and a _________ of arteries.
decrease, decrease, stiffening
50
Ficks Law of Solute Movement
movement of solutes into blood or interstitial space is based off the equation of: Jx= Lp [(Pc - P if) - sigma ((pi)c - (pi) if)]
51
Positive Jx means
net filtration - water is leaving the capillary
52
Negative Jx means
net absorption - water is entering the capillary
53
Factors that increase filtration
(+) Pc (-) Pif (-) (pi) c (+) (pi) if
54
Factors that increase absorption
(-) Pc (+) P if (+) (pi) c (-) (pi) if
55
Physiological changes that cause Pc to rise (increasing hydrostatic pressure)
standing up increases hydrostatic pressure, pulmonary edema leads to excess filtration without absorption, increases in venous pressure which leads to (R) heart failure
56
Physiological changes that cause (pi)c to fall
nephrotic syndrome, pregnancy, malnutrition
57
If there is an increase in lymphatic drainage impairment......
there is a decrease in Jv lymphatics drain interstitial fluid, therefore if there is a block then there will be an increase in pressure on the if side leading to net absorption of capillaries
58
Fick Law v Ficks Principle
Ficks Law = Jv (think J and L are close) Ficks Principle = (think P and O are close) oxygen
59
Factors that can lead to increase in O2 uptake
increasing the HR, increasing SV, increasing O2 extraction
60
Factors that inhibit O2 extraction
decreasing cardiac output, increasing afterload, increasing blood flow
61
Wiggers Diagram
-read it- learn it - love it -
62
4 phases of heart contraction (according to Wiggers)
1. diastasis and atrial contraction (diastole) 2. isovolumetric contraction 3. ejection (sytole) 4. isovolumetric relaxation
63
Vascular Smooth Muscle Contraction Mechanism
Calmodulin is activated by an increase in Ca. Ca binds to calmodulin which then binds and activates MLCK. Phosphorylation of MLC by MLCK leads to activation
64
Increasing cAMP in vascular smooth muscle leads to..... by ......
leads to muscle relaxation by increasing the activity of PKA which phosphorylates MLCK, which can no longer phosphorylate MLC leading to muscle relaxation
65
increasing cGMP in vascular smooth muscle leads to ..... by.....
leads to muscle relaxation by increasing the activity of PKG which phosphorylates MLCK, decreasing MLC phosphorylation leading to relaxation
66
What are the 4 general ways to modify vascular tone?
1. vasomotion 2. nervous system control 3. humoral control 4. local control
67
What is vasomotion
Vasomotion = spontaneous contractions caused by rhythmic oscillations in Ca and Vm which leads to vasulcar tone
68
Mechanism of vascular tone
-intermittent Ca release from the SR and intermittent release of NO from endothelial cells lead to the activation of cGMP -cGMP leads to SERCA uptake of Ca -cGMP and Ca activated chloride channels then depolarize cells -depolarization leads to ca voltage channel activation which will increase intracellular Ca -gap junctions will cause group depolarization influx of Ca from the SR causes Ca release and depolarization
69
How does the nervous system cause vascular tone regulation
ATP, neuropeptide Y, and Epi/NE
70
Humoral Control of Vascular Tone regulation
Endocrine and paracrine mechanisms that consist of use of Angiotensin II (increases BP), serotonin (increases), Neuropeptide Y (increases), ADH (increases CO and BP)
71
Another word for local control is.....
autoregulation
72
Autoregulation/local control of Vascular Tone (what are the general mechanisms)
myogenic response, metabolic control, endothelial control
73
What are three important areas in which autoregulation is important
coronary circulation, cerebral circulation, renal circulation
74
What is the myogenic response and mechanism
Myogenic = autoregulation regulation of vascular tone Mechanism = -stretching of VSMC leads to the activation of stretch sensitive non selective Ca channels which depolarize cells -depolarization leads to increase in Ca leading to increase in contraction and constriction -after contraction, stretch sensitive non selective cation channels close and there is muscle relaxation
75
Metabolic control - what is it and what is the mechanism in regards to vascular tone
Metabolic control = autoregulatory pathway of vascular tone Mechanism = increase metabolism leads to vasodilation (decrease in O2, increase in CO2, decrease in pH, accumulation of K and lactate, decrease of ATP, increase of ADP and adenosine) , decrease metabolism leads to vasoconstriction (all the opposite of above)
76
What is endothelial control in regards to vascular tone
Endothelial control = autoregulation of vascular tone (controlling NO and endothelin)
77
Mechanism of NO sheer stress in vasodilation
-stress on cell or NO dependent vasodilator binds to an endothelial cell -leads to an increase in Ca in endothelial cell -leads to the activation of cNOS which converts L-arg to NO (cNOS = calcium dependent NOS) - NO diffuses across endothelial cell to smooth muscle cell and binds to GC -GC hydrolyzes GTP to cGMP -rises in cGMP leads to phosphorylation of the SERCA pump leading to Ca reuptake and MLCK deactivation leading to vasodilation
78
Mechanism of endothelin in vascular tone regulation
uses Gq pathway to raise intracellular Ca to cause vasoconstriction
79
Factors that maximize and inhibit O2 extraction (ficks principle)
Maximize: increasing SV, HR (to increase metabolism) Inhibit: increasing afterload, decreasing cardiac output, increasing flow
80
What do the heart sounds mean
S1 = mitral valve closing S2 = aortic valve closing S3 = ventricular rapid filling ending S4 = atrial contraction

Medical Physiology (6 decks)

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