Cardiology

Question 0

The resting membrane potential for the cardiac muscle cell is about _____mV. The change in membrane potential when an AP occurs is aboout _____ mV

Answer 0

-90

105

Question 1

The plateau in the cardiac action potential is ________secs long which is _____ longer than skeletal muscle

Answer 1

.2

15

Question 2

The 3 main ions responsible for the cardiac AP are _____ (wants to be at 120mV), ______ (wants to be at 67mV), and _____ ( wants to be -90mV)

Answer 2

Ca
Na
K

Question 3

The threshold for an action potential is ______ mV.

Answer 3

-70mv

Question 4

The plateau allows for _________ and ____________ of the heart.

Answer 4

Filling and contraction

Question 5

The increase in________ ions and decrease in ________ ion permeability cause the cardiac AP plateau.

Answer 5

Ca++

K+

Question 6

Preventing outflow of ______ takes cell longer to reach RMP.

Answer 6

K

Question 7

The velocity of excitatory fibers in the atria/ventricles is _____- _____m/sec. It is 1/10th the velocity of skeletal muscles due to the ____ channels being slower. This allows time for _______ to develop.

Answer 7

.3 - .5m/sec
Na
TENSION

Question 8

The ________________ allows for cardiac rest but another AP can come along and cause another depolarization … it will just need a bigger ___________ though.

Answer 8

Relative refractory period

stimulus/ potential

Question 9

The heart will not pump as well with an AP generated during the _______________ period.

Answer 9

Relative Refractory

Question 10

During the ____________ period, no contraction can occur. This correlates to the ___________. The membrane is too ____________.

Answer 10

Absolute refractory
Ca++ plateau
positive +

Question 11

The AP in the heart is generated by the _____ or ______. It then travels into the __________ where depolarization causes extracellular ______ ions to enter the cell.

Answer 11

SA or AV node
T Tubule
Ca++

Question 12

The increase in intracellular Ca++ is detected by Ryanodine receptors in the ____________ which causes ________ to be released. This is called the ______________.

Answer 12

Sarcoplasmic Reticulum
more Ca++
Calcium Spark

Question 13

The T-tubules in the heart are ________ times the size than in skeletal muscle. In cardiac muscle the T Tubules open directly into the ________________ fluid, so their ________ concentration depends highly on extracellular concentration

Answer 13

5
extracellular
Ca++

Question 14

In cardiac cells, there is a slight delay between_________ and _________.

Answer 14

Excitation and contraction

Question 15

The__________ node is the pacemaker of the heart. The ________ delays conduction through the heart which allows for ___________ contraction

Answer 15

SA
AV
atrial

Question 16

In cardiac cells, the wave of depolarization propagates to adjacent cells via ________________ located on ________________.

Answer 16

Gap Junctions

Intercalated Disks

Question 17

The AV valves are only completely shut during ______________.

Answer 17

Ventricular Systole

Question 18

On your CVP, the ______ wave shows you how well the atria are contracting. This correlates to _____ % of your stroke volume

Answer 18

A

20%

Question 19

The most sensitive organ to perfusion is the ______________

Answer 19

Kidney

Question 20

The Four phases of the pressure volume loop are: ____________, ____________, __________, ____________

Answer 20

Filling, Isovolumic contraction, Ejection, Isovolumic Relaxation

Question 21

At End diastolic, the AV valves will _________ and you will start the ____________ contraction

Answer 21

Close

Isovolumic

Question 22

At the end of the isovolumic contraction, the _________ valve will open and you will start the _________ phase. The

Answer 22

atrial

Ejection

Question 23

The pulse pressure can be measured on the P-V loop by subtracting the ________________ from the _________________.

Answer 23

start of the ejecting phase pressure

peak of the ejecting phase pressure

Question 24

S1 heart sound would be heard at ______________ on the PV loop and S2 would be heard at ________________

Answer 24

``` End Diastolic (mitral valves closing) End Systolic (aortic valve closing) ```

Question 25

The End systolic volume will be around ________ in a healthy heart.

Answer 25

50ml

Question 26

The Stroke volume represents "___________" and can be measured on the PV loop by subtracting start of __________ from the end of ________ phase on the loop.

Answer 26

Net-Work Filling filling

Question 27

The average stroke volume will be around _____ ml. The ejection fraction is the stroke volume divided by ________ and the average will be around _______.

Answer 27

65ml/beat peak volume 60%

Question 28

``` Name the cardiac pressures RA: RV: PA: LA: LV: ```

Answer 28

``` 4 25 25/10 8-10 80-100 ```

Question 29

About _____% of ventricular filling occurs during diastole before contraction of the atria. The remaining is called the ___________.

Answer 29

75 | atrial kick

Question 30

The ____- wave is atrial contraction The ____-wave is ventricular contraction The ____-wave is the in-filling of the atria from venous return.

Answer 30

A C V

Question 31

The fraction of the end-diastolic volume that is ejected is the _____________. It is normally 110-120ml.

Answer 31

ejection fraction

Question 32

What 3 things affect stroke volume?

Answer 32

Preload, afterload, Contractility

Question 33

Excess _______ ions will cause dilation of myocardium. Excess _______ ions will cause spastic contractions.

Answer 33

Potassium | calcium

Question 34

The sympathetic NS effects on the heart will be to _____________ & ________________

Answer 34

Increase HR and Contractility

Question 35

The sympathetic NS ___________ contractility by stimulating _______ receptors

Answer 35

Increases | Beta

Question 36

Most of the sympathetic NS innervates the _____________, while the Parasympathetic goes to the ____________

Answer 36

ventricles | atria(SA& AV nodes)

Question 37

_________ is calculated with End Diastolic Pressure

Answer 37

Preload

Question 38

Preload is affected by _________ and rate of ______________.

Answer 38

Venous BP | Rate of venous return

Question 39

______________ is the pressure the ventricle must generated to EJECT blood.

Answer 39

Afterload

Question 40

Cardiac Output at rest is __________.

Answer 40

4-6L/min

Question 41

_________ are the last small branches of arteries. They are the ____________ and can vastly change blood flow.

Answer 41

arterioles | control conduits

Question 42

___________ is where the exchange of fluids, nutrients, and O2 occurs

Answer 42

Capillaries

Question 43

________ collect blood from capillaries and _______ are the major conduit of transport of blood to the heart

Answer 43

venules | veins

Question 44

___________ are the major reservoir of blood in the body

Answer 44

Veins

Question 45

To increase PRELOAD we want to work on the __________ side

Answer 45

venous

Question 46

cardiac output of the LV is ___________ the CO of the RV

Answer 46

Equal

Question 47

The Systemic circulation is _________ pressure and resistance and the pulmonary circulation is ____________ pressure and resistance.

Answer 47

HIGH | LOW

Question 48

The largest pulse pressure is in the _____________ which is ______mmHg

Answer 48

LV | 120/0

Question 49

As the pressure gradient increases, so does ___________.

Answer 49

Flow

Question 50

Blood flow is determined by ________________ and _______________. This is related to _________ Law which is ....___________

Answer 50

Pressure gradient Vascular Resistance OHMs (P1-P2)/R

Question 51

Blood flow is __________ related to resistance

Answer 51

inversely

Question 52

Flow is talked about in the context of __________.

Answer 52

time

Question 53

___________ flow is parabolic and has uniform flow. Its Reynold's number is _____________. It is proportional to _____________.

Answer 53

Laminar <2000 Pressure

Question 54

_____________ flow has a rapid rate, with resistance and obstruction. Its Reynolds number is ______________.

Answer 54

Turbulent | >2000

Question 55

The equation for Reynolds number is:

Answer 55

DpV/n Diameter x density x velocity // viscosity

Question 56

Flow will continue to be streamline laminar with increased pressure until it hits the ___________

Answer 56

Critical velocity

Question 57

If you increase your diameter of a vessel from 1 to 2 then your Flow rate will be _________ ml/min

Answer 57

2^4 .....16

Question 58

The most important factor when looking at blood flow is ___________.

Answer 58

Radius! It's to the 4th power!

Question 59

Resistors help flow be more _________. Organ are perfused in a _________ fashion that will have __________ resistance

Answer 59

efficient parallel less

Question 60

The total resistance in a parallel series is _________ than in any single vessel. This means _________ blood will flow through them.

Answer 60

far less | far more

Question 61

Resistance in parallel makes for greater local perfusion to the _________. The equation is

Answer 61

organs | 1/R = 1/R1 + 1/R2 + 1/R3

Question 62

Capillaries are ruled by _____________ Law when referring to pressure, radius, and tension. It states : ___________

Answer 62

LaPlaces Law | T= Pr

Question 63

when wall tension is so great to pull apart the capillaries slits...this deals with _____________________ force

Answer 63

hydrostatic pressure

Question 64

With altitude sicknesss, the lungs will _____________ in response to low O2.

Answer 64

vasoconstrict

Question 65

Acute control in local blood flow is mostly related to changes in ____________. This will cause release of __________, __________, ___________, ________, ________ which cause vasodilation. This is considered the ____________ theory.

Answer 65

Oxygen histamine, adenosine, CO2, H+, K+ Metabollic

Question 66

The ____________ theory of local tissue blood flow regulation states that a sudden stretch causes __________ of vascular muscles

Answer 66

Myogenic | Contraction

Question 67

___________ is a potent vasodilator that is all over our bodies and will be released in response to CHEMICAL and PHYSICAL stimuli

Answer 67

Nitric Oxide

Question 68

_____________ are proteins that upon release cause vasoconstriction to help regulate vascular homeostasis

Answer 68

Endothelin

Question 69

The first thing that will happen in response to a decrease O2 delivery to tissue is ___________ release which causes direct _________.

Answer 69

Adenosine | vasodilation

Question 70

________ & _________ work as second messengers following a decrease in O2 delivery to tissues to cause _____________

Answer 70

ADP an ATP | vasodilation

Question 71

_____ works especially in the brain to cause vasodilation

Answer 71

CO2

Question 72

The brain, heart, and skeletal muscles all use more _____________ means to maintain adequate oxygenation to the tissues

Answer 72

Metabolic

Question 73

Angiogenesis uses ___________, ___________, & _____________ for its long term regulation.

Answer 73

VEGF Fibroblast Growth factor Angiogenin

Question 74

Need BP within ______% of baseline to have autoregulation

Answer 74

20

Question 75

If you have Hypertension, your autoregulation curve will shift to the __________.

Answer 75

Right

Question 76

Autoregulation works by using __________& ___________ responses to maintain adequate BP.

Answer 76

Myogenic and Metabolic

Question 77

The vasoconstrictor control of the brain is located in the ________________. The vasodilator area is in the _________________.

Answer 77

Upper medulla | Lower Medulla

Question 78

The sensory center of the brain for neurogenic control of BP is in the __________ _________ in the posterolateral ____________ & ______________

Answer 78

Tractus Solitarius Medulla Lower Pons

Question 79

The sensory area for neurogenic control receives signals from the __________ & _____________ nerves and sends signals to vasoconstrict or dilate. This is a ____________ control and an example is the ________________

Answer 79

Vagus Glossopharyngeal Reflex Baroreceptor

Question 80

The vagus nerve stimulation will cause ______ in HR and _______ in Contracitility. This is via the __________ receptors

Answer 80

Decrease decrease Muscarinic

Question 81

The sympathetic NS works on _______ receptors to give autonomic control to _________ HR and contractility

Answer 81

Beta1 | Increase

Question 82

The baroreceptor reflex is a ____________ reflex that says as BP/ blood volume ____________, HR ____________. These receptors are located in the _________, ___________, and the __________ nerve

Answer 82

``` neurogenic increases decreases carotid body aorta glossopharyngeal ```

Question 83

The Bainbridge reflex will __________ the heart rate as the pressure increases. It detects _____________ and sends two signals... one to the ___________ nerve to the medulla and the other to the ______________.

Answer 83

increase RA and LA stretch Vagus SNS

Question 84

The ________________ reflex prevents the pooling of blood in the veins, atria, and pulm. circulation with increase blood volume.

Answer 84

Bainbridge

Question 85

Definition of CO

Answer 85

The amount of blood pumped each minute into circulation

Question 86

The ____________ is the sum of flow to all tissues of the body

Answer 86

Cardiac Output

Question 87

The cardiac output mostly relies on _____________

Answer 87

venous return

Question 88

The average CO is _________. Males are ________ and females are _______

Answer 88

5 L/min 5. 6 4. 9

Question 89

The 4 main patient factors that have an effect on CO are:

Answer 89

age body size ( cardiac index) metabolic rate --- o2 consumption rate exercise

Question 90

The average cardiac index is _________

Answer 90

3L/min/m^2

Question 91

So under resting conditions, CO is controlled almost entirely by ___________ mechanisms. The 2 main are :

Answer 91

peripheral SVR Blood flow to the RA (venous return)

Question 92

The 2 CO equations are:

Answer 92

CO = arterial pressure/ SVR CO = HR x SV

Question 93

Contributors to CO include : ________ system control, _______, _______, HR, ___________.

Answer 93

nervous preload afterload contractility

Question 94

We normally breath under ___________ pressure. With intubation we need to __________ pressure to get same CO. This would be shown with a shift to the ___________ on the curve.

Answer 94

Negative Increase Right

Question 95

Surgically opening the thoracic cage would make the internal pleural pressure on the heart ________mmHg and would shift the curve to the ______.

Answer 95

0 | Right

Question 96

Cardiac tamponade shifts the CO/ RA pressure curve to the _________.

Answer 96

Right.

Question 97

Normal Intrapleural pressure is _____mmHg.

Answer 97

-4

Question 98

Normal filling pressure is ______mmHg

Answer 98

7

Question 99

The pressure that pushes venous blood from system to heart is the ______________ pressure

Answer 99

mean systemic filling pressure.

Question 100

If you completely inhibit the SNS you shift the venous return/RA pressure curve to the __________. You will have increased __________.

Answer 100

RIght | Volumes

Question 101

If you have strong SNS stimulation you shift the Venous Return/RA pressure graph to the ___________. You will have __________ volumes.

Answer 101

Left | Lower

Question 102

Venous Return is basically the same as your ____________ unless you are bleeding

Answer 102

Cardiac Output

Question 103

Venous Return is about _____ L/min Mean systemic filling pressure is about ______mmHg RA pressure is _______mmHg Resistance to Venous Return is ________mmHg

Answer 103

5 7 0 1.4

Question 104

______________ is directly related to the Mean Systemic Filling Pressure

Answer 104

Venous Return

Question 105

If you increase RA pressure, you will _________ venous return

Answer 105

decrease

Question 106

___________ pressure is the pressure pushing venous blood from the periphery to the heart it is about ____mmHg

Answer 106

Filling | 7

Question 107

Most of the resistance to venous return comes from the _________ (about 2/3rds).

Answer 107

veins

Question 108

The heart gets _____% of the total CO (______ml/min)

Answer 108

5 | 225

Question 109

The LCA supplies the _________ and ________ LV. The RCA supplies the _______ and posterior part of the __________.

Answer 109

anterior and lateral RV LV

Question 110

The Coronary Sinus returns _______% of venous blood from the _____to the RA after supplying the cardiac muscle

Answer 110

75 | LV

Question 111

The __________ venous network is considered an alternative pathway of venous drainage of the myocardium that empties blood directed into the chambers of the heart

Answer 111

Thebesian veins

Question 112

The _________ vessels supply the cardiac muscle with blood during diastole and the ______________ vessels compensate and supply during systole.

Answer 112

Epicardial vessels | Subendocardial vessels