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Pathophysiology I: Exam I > Cardiac Physiology > Flashcards

Cardiac Physiology Flashcards

(105 cards)

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1
Q

Blood pathway

A

toe/finger ►inferior/superior vena cava►RA►tricuspid valve►RV►pulmonary valve►PA►lung

Pulmonary vein►LA►Mitral valve►LV►aortic valve►aorta►coronary arteries►body

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2
Q

S1

A

associated with ventricular contraction

sound when tricuspid and mitral valves close

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3
Q

S2

A

associated with ventricular relaxation (repolarization)

sound of aortic and pulmonic valve closing

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4
Q

Auscultation of the heart (4 areas)

A
  • aortic
  • pulmonic
  • tricuspid
  • mitral
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5
Q

auscultation of the heart

aortic area

A

2nd to 3rd right intercostal space

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6
Q

auscultation of the heart

pulmonic area

A

2nd to 3rd left intercostal space

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7
Q

auscultation of the heart

tricuspid area

A

lower left sternal border

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8
Q

auscultation of the heart

mitral valve

A

apex

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9
Q

A

A

aorta

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10
Q

B

A

right coronary artery

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11
Q

C

A

coronary vein

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12
Q

D

A

left main coronary artery

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13
Q

E

A

left circumflex coronary artery

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14
Q

F

A

left anterior descending coronary artery (LAD)

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15
Q

coronary arteries

A

right coronary artery

left anterior descending coronary artery

circumflex coronary artery

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16
Q

coronary arteries

RCA supplies:

A

right side of heart

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17
Q

coronary arteries

LAD supplies:

A

left anterior

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18
Q

coronary arteries

circumflex supplies:

A

left posterior

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19
Q

A

A

circumflex coronary artery

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20
Q

B

A

coronary sinus

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21
Q

C

A

right coronary artery

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22
Q

cardiac conduction pathway

A
  1. SA node
  2. AV node
  3. Bundle of His
  4. Right and left bundle branches
  5. Purkinje fibers
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23
Q

P wave

A
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24
Q

QRS complex

A

activation of the ventricles

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25
T wave
26
3 layers of a blood vessel
1. Tunica intima 2. Tunica media 3. Tunica adventitia
27
blood vessels outer layer
tunica adventitia **contains:** 1. connective tissue 2. vaso vasorum 3. nerve 4. lymph
28
vaso vasorum
blood supply to the blood vessels
29
Tunica media
smooth muscle cells controlled by ACE
30
tunica media ACE
Angiotensin Converting Enzyme controls blood volume, kidneys
31
blood vessels tunica intima
single epithelial layer 1. prevents substance transfer from blood into vessel 2. anti and prothrombotic secretions 3. dilation metabolites 4. constriction metabolites
32
How does the tunica intima prevent substance transfer from blood into the vessel?
acts as a barrier to cholesterol
33
tunica intima dilation metabolites
NO Prostaglandins
34
tunica intima constriction metabolites
endothelin superoxide thromboxane
35
blood vessels valves
only in veins, prevent blood flow back to the extremities
36
blood vessels decreased venous return
causes swelling in the feet due to fluid retention must excrete or increase blood volume
37
A
tunica intima
38
B
elastin
39
C
tunica media
41
D
tunica externa
42
common causes of atrial clots
atrial fibrillation bruits bifurcations
43
A-fib
multiple messages, sporadic contractions in the atria can lead to clotting
44
venous clots cause
* stasis of blood * lack of movement
45
medication to break up a clot
TPA
46
risks associated with DVT
pulmonary embolus flows through the heart into the increasingly smaller airways
47
What medication should someone with a DVT be on?
blood thinners (Coumadin/Warfarin, Heparin) needed to prevent platelet aggregation
48
SV
stroke volume amount (in L) of blood pumped in one beat
49
what is SV a measure of?
**preload** (venous return) **x** **contractility** (how hard the muscle is squeezed)
50
CO
cardiac output ## Footnote **HR x SV**
51
BP
**CO x TPR** * *TPR = total peripheral resistance** - whether vasodilated or vasoconstricted affects
52
What regulates blood pressure? (3)
1. Heart-pumping pressure 2. Blood vessel tone 3. Kidney
53
3 layers of blood vessels
* Tunica adventitia * Tunica media * Tunica intima
54
vaso vasorum
blood supply to the blood supply
55
Tunica adventitia components
* nerve * lymph * connective tissue * vaso vasorum
56
Tunica media
smooth muscle cells angiotensin converting enzyme (ACE) controls
57
Tunica intima actions
* prevents substance transfer from blood into the vessels * antithrombotic and prothrombotic secretions * dilation metabolites * constriction metabolites
58
dilation metabolites
NO prostaglandins
59
dilation constrictors
endothelin superoxide thromboxane
60
tunica intima turbulent blood flow
can damage tunica indica turbulent blood flow at bifurcation points can cause scarring over time
61
valves
only present in the veins prevent backflow into the extremities
62
fluid retention
decreased venous return causes swelling in the extremities
63
how to decrease fluid retention
increase blood volume excrete fluid
64
DVT
deep vein thrombosis blood clot in a vein
65
risk of DVT
pulmonary embolus flows through the heart to increasingly smaller pathways of the lungs
66
Why is there a greater risk of DVT after surgery?
caused by stasis of blood and lack of movement
67
stroke volume =
preload (venous return) x contractility (how hard the muscle is squeezed)
68
Cardiac output =
stroke volume x HR
69
BP =
cardiac output (SV x HR) x TPR TPR = total peripheral resistance
70
blood pressure regulation 3 factors
1. heart pumping pressure 2. blood vessel tone 3. kidney
71
Frank Starling Mechanism
The heart pumps all blood that comes to it within the physiologic limits
72
What controls heart pumping pressure?
sympathetic and parasympathetic control of HR and CO
73
blood vessel tone
systemic resistance to flow
74
What does blood vessel tone rely on?
* compliance of vessels * arteries * veins * capillaries
75
Blood vessel tone What happens when sympathetic stimulation is increased?
see an increase in BP \*atherosclerosis and aging altered vascular compliance, PVD, hypertension, etc.
76
How do kidneys regulate blood pressure?
Blood volume control Local factors * interstitial pressure * hormones * local control
77
Local control of blood pressure by the kidneys
removal of water removal of salt
78
pressure diuresis
removal of water
79
pressure natriuresis
removal of salt
80
ejection fraction in normal adults
60-75% of blood expelled
81
Hypertension 3 stages
1. 140-159 SBP, 90-99 DBP 2. 160-179 SBP, 100-109 DBP 3. greater than 180, greater than 110
82
hypertension two major categories
1. essential hypertension (EH) 2. secondary hypertension
83
essential hypertension
unknown cause in 95% of cases * genetics or stress possibly causes
84
secondary hypertension
result of a known cause i.e. kidney or bladder infection, arterial disease, Cushing's syndrome, etc
85
LVEDV
left ventricular end diastolic volume occurs after atrial kick
86
ejection fraction
amount you spit out divided by total amount of blood in the ventricle SV/EDV 60-75% is normal
87
muscle contraction in the heart delays?
muscles need to contract simultaneously in the heart
88
renin
released by kidney due to decrease in pressure
89
angiotensin I
released systemically due to renin in circulation
90
Angiotensin I is converted to **(1)** in the **(2)** by **(3)**
1. Angiotensin II 2. lungs 3. ACE (Angiotensin Converting Enzyme)
91
Angiotensin II causes
* causes vasoconstriction and decreased excretion of salt and water by the kidneys * due toincreased release of aldosterone
92
aldosterone ## Footnote **(1) Result** **(2) Drug**
produces reabsorption of salt and water **(1) Result:** Elevated BP (hypertension and potential long term CHF) **(2) Drug:** ACE inhibitor
93
Sleep Apnea and Acute Hypertension chemoreflexes
influence cardiac, vascular, and breathing control
94
Sleep Apnea and Acute Hypertension What do chemoreflexes respond to?
hypoxia hypercapnia
95
Sleep Apnea and Acute Hypertension Stimulation of chemoreceptors leads to what response?
sympathetic response of vasoconstriction
96
sleep apnea and acute hypertension peripheral chemoreceptors
carotid bodies of carotid artery respond to hypoxia
97
sleep apnea and hypertensives central chemoreceptors
brain stem and respond to hypercapnia
98
How do hypertensives respond to hypoxia or hypercapnia?
exaggerated response
99
renal artery stenosis
1. Fibromuscular dysplasia (FMD) 2. Atherosclerosis
100
Who does fibromuscular dysplasia (FMD) typically affect?
young women
101
S/S renal artery stenosis atherosclerosis
hypertension renal failure refractory angina recurrent episodes of CHF flash pulmonary edema
102
S/S renal artery stenosis treatment
stent of renal artery angioplasty
103
What is this condition?
FMD fibromuscular dysplasia
104
What is heart failure?
"the inability of the heart to pump blood forward at a sufficient rate to meet the metabolic demands of the body (forward failure), or the ability to do so only if the cardiac filling pressures are abnormally high (backward failure), or both.”
105
preload
amount of blood filling along with stretch
106
afterload
what heart is pumping against 1. hypertension 2. blood volume 3. vascular compliance

Pathophysiology I: Exam I (6 decks)

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