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Anesthesiology > Cardiac phys > Flashcards

Cardiac phys Flashcards

(55 cards)

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1
Q

When is the left ventricle perfused?

A

During diastole

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2
Q

When is the right ventricle perfused?

A

During systole and diastole

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3
Q

What percentage of oxygen does the heart extract?

A

60-70%

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4
Q

What are the endogenous regulators of coronary blood flow?

A

Adenosine
Nitric oxide
Adrenergic stimulation

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5
Q

When does CBF become exhaused?

A

when 90% of flow is blocked by stenosis of the coronary artery

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6
Q

What is resistance directly proportional to?

A

The viscosity of blood and length of the vessel

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7
Q

What is resistance inversely proportional to?

A

R4

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8
Q

Where is the site of greatest resistances?

A

arterioles

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9
Q

Where is the largest pressure drop in the systemic circulation?

A

In the arterioles because they are the area of high resistance

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10
Q

When is systolic BP measured?

A

After the heart contracts

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11
Q

When is diastolic BP measured?

A

when the heart is relaxed and blood is returning to the heart

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12
Q

What is pulse pressure?

A

The difference between systolic and diastolic pressure

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13
Q

What is atrial pressure measured with?

A

Swan ganz catheter. = PCWP

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14
Q

What is phase 1 of the cardiac cycle?

A

Atrial systole seen as the P wave and a wave

Contributes 25% of ventricular filling

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15
Q

What is phase 2 of the cardiac cycle?

A

Isovolumetric ventricular contraction:

begins after the onset of the QRS wave

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16
Q

When do the AV valves close?

A

When pressure in the ventricle exceeds that in the atria

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17
Q

What is phase 3 of the cardiac cycle?

A

Rapid ventricular ejection

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18
Q

When does the aortic valve open?

A

Phase 3 when ventricular pressure exceeds aortic

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19
Q

What is happening with the S1 heart sound?

A

The mitral and tricuspid valve close

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20
Q

What is happening with the S2 sounds?

A

The aortic and pulmonic valve close

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21
Q

What wave on the EKG marks the end of phase 3?

A

T wave

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22
Q

What is phase 4 of the cardiac cycle?

A

Reduced ventricular ejection: pressure in the ventricles and aorta decrease as blood flows into the arterioles

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23
Q

What is phase 5 of the cardiac cycle?

Study These Flashcards
A

Isovolumetric ventricular relaxation: end of the T wave
Aortic and pulmonic valves close (S2)
Dicrotic notch is seen after closure of the aortic valve
Ventricular pressure decreases
ALL VALVES ARE CLOSED

24
Q

How is action potential created in cardiac muscle?

Study These Flashcards
A

Due to the option of fast sodium channels and calcium channels

25
When does the mitral valve open?
When ventricular pressure becomes less than atrial pressure
26
What is phase 6 of the cardiac cycle?
Rapid ventricular filling (S3)
27
What is phase 7 of the cardiac cycle?
Reduced ventricular filling: dependent on HR longest phase of the cardiac cycle
28
What is a dromotropic effect?
Effects on AV conduction
29
What is a ionotropic effect?
Effects on contractility
30
What is a lusitropic effect?
effects on diastole
31
What is the main NT of the SNS?
NE - is chronotropic, inotropic and lusitropic
32
What is the main NT of the PNS?
Ach
33
What governs the main resting tone of the heart?
PNS
34
What do the baroreceptors in the aortic arch respond to?
An increase in BP, but not a decrease
35
What happens in the carotid sinus when there is decreased BP?
Decreased stretch, decreased firing of CN IX so decrease PNS by vasomotor center in brain and increase SNS ---> Inc. HR, contractility
36
What happens when there is a decrease in renal perfusion?
JG cells of afferent arteriole release renin
37
What does renin do?
Converts angiotensiogen to angiotensin
38
What converts angiotensin 1 to angiotensin 2?
ACE
39
What does angiotensin 2 do?
Increase thirst Vasoconstriction (inc. MAP and TPR Stimulates aldosterone synthesis and release in adrenal cortex
40
What causes the release of ADH in volume depletion?
Atrial receptors sense the decreased volume and cause release of ADH from posterior pituitary
41
What does ADH do?
vasoconstriction | water reabsorption in distal tubules and collecting ducts
42
What does ANP do?
Causes arteriole dilation Natriuresis Inhibits renin secretion
43
What is the carotid sinus reflex?
Massage carotid senses stretch --> increased firing of CN IX so sends signal to vasomotor center which decreases SNS and increases PNS tone to slow HR/contractility. Used for SVT
44
What is the Bainbridge reflex?
Atrial stretch causes an increase in HR, leading to increased CO
45
What is the abdominal reflex?
Decreased HR with stretch of abdominal viscera
46
What is the Cushing reflex?
Increased ICP causes cerebral ischemia and an increase in MAP through SNS (due to peripheral constriction to try to preserve blood flow to the brain) with a decrease in HR
47
What is the oculocardiac reflex?
A decrease in HR with IOP or stretching of ocular muscles
48
Which inhalation anesthetic increases PVR?
Nitric oxide
49
Which inhalation anesthetics have the greatest effect on HR?
Isoflurane/Des
50
Which induction agent preserves CO and contractility?
etomidate and midazolam
51
What induction agent causes an increase in HR, MAP and CO?
Ketamine
52
What is the MOA of Ketamine?
Stimulates SNS | Inhibits uptake of NE
53
What happens in cor pulmonale?
RV dilation | Decreases stroke volume due to ventricular interdependence (ballooning of right heart into the left heart)
54
What is the equation for MAP?
MAP = SVR X CO/80 + CVP
55
What is the equation for coronary perfusion pressure?
MAP- LVEDP

Anesthesiology (19 decks)

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