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Pharm 2 > Cardiovascular physiology > Flashcards

Cardiovascular physiology Flashcards

(62 cards)

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1
Q

What is the very general pathway of blood in the heart?

A

-deox blood enters right atrium -> pushed into right ventricle -> pumped up to semilunar valve -> out to lungs to get oxygenated -> ox blood comes back to heart -> enters left atrium -> left ventricle -> up into aorta -> out to three places

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2
Q

What does the thickness of the ventricles have to do with their function?

A

-right ventricle has thin muscle because only has to pump to pulmonary valve
-left ventricle has thick muscle because has to pump to brain and rest of body = more important

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3
Q

The aorta has three branches, where do they go?

A

-upper body
-lower body
-supply for the heart itself

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4
Q

What is the number one priority of the heart?

A

-pump blood to the brain

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5
Q

What is flow velocity?

A

rate/C-S area of vessel

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6
Q

What three things affect resistance of flow?

A

-vessel diameter
-blood viscocity
-tube length

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7
Q

Does flow depend on absolute pressure?

A

-no, depends on pressure difference

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8
Q

Which factor of resistance can be changed through drugs and influence blood flow?

A

-vessel diameter
-viscocity??

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9
Q

What are the two main factors of blood flow?

A

-Pressure gradient
-Resistance

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10
Q

What are the two muscle types in the heart?

A

-skeletal = striated
-cardiac muscle

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11
Q

What are the characteristics of skeletal heart muscle?

A

-striations of fibers are parallel
-stimulated by somatic NS
-can only contract in one direction
-voluntary

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12
Q

What are some characteristics of cardiac muscle?

A

-fibers are branched
-pumps blood to heart
-stimulated by autonomic NS
-involuntary

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13
Q

What are the two types of muscle cells?

A

-myocardial autorhythmic cells
-myocardial contractile cells

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14
Q

What are myocardial autorhythmic cells?

A

-“pacemakers”
-generates electricity
-doesn’t contract
-never rest

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15
Q

What are myocardial contractile cells?

A

-contracts
-only 1% are self-excitable
-gap junctions = faster signals = heart contracts as one unit
-long refractory period = 250ms

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16
Q

What are the general features of cardiac cells?

A

-intercalated discs = branching
-gap junctions = fast signal relay
-many mito
-large T tubes

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17
Q

What is the intrinsic cardiac conduction system?

A

-network of noncontractile cells (autorhythmic) that initiate and distribute impulses to coordinate depolarization and contractions

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18
Q

What does the potential of an autorhythmic cell look like?

A

Pacemaker potential = slowly opening Na+ channels = unstable resting potential -> at threshold -> Ca2+ channels open -> Ca2+ influx = rising phase of AP = depolarization -> Ca2+ channels inactivated and K+ channels open -> repolarization -> charge falls

-never a flat line because it never rests

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19
Q

What is the charge of the cell naturally?

A

-70 mV

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20
Q

What is the threshold for action potential?

A

-40 mV

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21
Q

What is the pathway for the action potential of contractile cells?

A

depolarization opens Na+ channels in sarcolemma -> -90mV to +30mV -> depolarization in T tubules -> SR release Ca2+ -> also opens Ca2+ channels in sarcolemma -> Ca2+ surge = long depolarization = plateau -> repolarization from inactivating Ca2+ channels and opening K+ channels -> back to resting potential

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22
Q

What does the action potential for cardiac contractile muscle look like from a cellular view?

A

action potential enters -> voltage gates Ca2+ channels open -> Ca2+ enters cell -> Ca induced Ca release at ryanodine receptor -> Ca released from SR -> calcium spark -> Ca signal -> Ca binds to troponin -> contraction -> Ca unbinds -> relaxation -> Ca pumped into SR to store -> Ca exchange with Na -> Na gradient mediated by Na-K ATPase

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23
Q

What is Frank-Stirling Law?

A

-increase in end-diastolic ventricular volume produces increase in stroke volume
-force of heart muscle varies with wall fiber tension, which is function of length

-basically = more dilation of the left ventricle = increased ejection
-more SA of actin covering myosin = more contraction

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24
Q

pathway for regulation of monocyte action through adrenergic system

A
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25
What signals control contraction?
-norepinephrine -epinephrine
26
What is the relationship between contractions and crossbridges?
-graded contraction is proportional to crossbridges formed -more Ca = crossbridges = more force/speed
27
What nerve connects to the SA and AV node?
-The vagus nerves
28
Where on the heart do the sympathetic nerve chain connect?
-only connects to contractile cells -doesn't connect to AV and SA node
29
What factors affect arterial blood pressure?
-cardiac output -heart rate - contractility -filling pressure - blood volume venous tone -peripheral resistance -arteriolar tone
30
When you stand up from lying down, what is the pathway for maintaining blood pressure?
lying down -> stand up -> decrease in venous return -> decrease in end-diastolic volume -> decrease stroke volume -> decrease cardiac output -> decrease BP (stimuli) -> baroreceptors -> sensory neurons -> medulla obl. -> increase sympathetic and decrease parasympathetic = vasoconstriction, increase HR, increase peripheral resistance -> increase in blood pressure (-ve feedback response)
31
What are the Purkinje fibers?
-branch of cells in the ventricles -allow the heart to have synchronized contractions
32
What is the bundle of His?
-the AV bundle -sends electrical impulses from AV node to Purkinje fibers
33
In what order of structures does the electrical current flow?
-SA node -> pumps atria -> AV node -> AV bundle -> purkinje fibres -> pump ventricles
34
what is the cardiac cycle?
-coordinates sequence of events as blood enters atria, leaves ventricles and starts over -synchronizing via Intrinsic electrical conduction system -rate influenced by symp and parasymp division of ANS
35
What are the 6 stages of the cardiac cycle?
1. Late diastole: full of blood 2. atrial systole: makes sure all blood is in heart; top contraction 3. isometric ventricular contraction (lub): no movement; pressure built; no backflow; atria go to diastole 4. Ventricular ejection: ventricles contract; semilunar valves open 5. isometric ventricular relaxation (dub): last bit of blood leaves ventricles; no more contraction; AV valves still closed 6. diastole: heart fills with blood from atria to ventricles; due to low pressure
36
What is the electrical conduction pathway of the heart?
-SA node initiates -> depol spreads through atria via gap junctions and internodal paths -> to AV node ->fibrous tissue slows formation of APs -> AP travel down Bundle of His -> split to L and R atrioventricular bundles -> into purkinje cells
37
What is systole?
period of contraction
38
What is diastole?
period of relaxation
39
Why does increased pressure in the ventricles cause the AV valves to close?
**
40
What is the sympathetic nervous system activated by?
-emotional or physical stressors -ex. norepinphrine = more rapid pacemaker
41
What is the vagal tone?
-the heart at rest -parasympathetic
42
Which NS system does parasympathetic oppose?
-sympathetic -involves acetylcholine
43
What is the Bainbridge?
-aka atrial reflex -sympathetic reflex initiated by increased venous return -SA node stim by stretch of atrial walls -same law as Frank Sterling but for atria
44
What are the two main chemical regulations of heart rate?
1: hormones -epinephrine = increased HR and contractility -thyroxine = increases HR and effects of epinephrine 2: intra/extracellular ion [ ] maintenance
45
What are other factors of heart rate?
-age -gender -exercise -body temperature
46
What occurs with age that can increase the effects on the heart?
-sclerosis and thickening of valve flaps -decline in cardiac reserve -fibrosis of cardiac muscle -atherosclerosis
47
What are three possible congenital heart defects?
1. ventricular septal defect: no septum separating ventricles = blood mixes; more blood in right 2. coarctation of the aorta: narrow aorta = increases workload of left ventricle 3. tetralogy of Fallot: four defects = narrow pulmonary trunk; hypertrophied R ventricle; ventricular septal defect; aorta opens from both ventricles
48
What is an arrhythmia?
-most common disorder -includes atrial fibrillation and flutter -related to age and or heart disease
49
What are the symptoms of arrhythmias?
-palpitation or fluttering sensation -racing heart -dyspnea -syncope (fainting) -fatigue -chest pain -cardiac arrest
50
What can cause arrhythmias?
-coronary artery disease (ischemia or infarction) -altered impulse conduction -changes in cardiac structure from heart failure -drugs -electrolyte distrubances
51
Why is coronary artery disease a common cause of arrhythmia?
-because it causes ischemia or infarction -if cardiac cells lack O2, they depolarize = altered impulse formation and conduction -this causes changes in automaticity
52
What are Ectopic Foci?
-ectopic foci = abnormal pacemaker sites outside of SA node with automaticity -occur in atria or ventricles -create additional beats -can lead to tachycardia and bradycardia -can occur after reentry too
53
What is Wolfe Parkinson White Syndrome? (on exam)
-cause of supraventricular tachycardia in children -extra conducting tissue = accessory pathway -sometimes can conduct electricity and establish a circuit with AV node
54
What is an AV block?
- conduction block within the AV node or bundle of His -impairs impulse conductions from atria to ventricles
55
What are 5 types of supraventricular arrhythmias?
-Sinus tachycardia -atrial tachycardia -paroxysmal atrial tachycardia -atrial flutter -atrial fibrillation
56
What is sinus tachycardia?
-high sinus rate -100-180 beats/min -during exercise or from conditions that lead to increased SA nodal firing rate
57
What is atrial tachycardia?
-series of 3+ consecutive atrial premature beats at over 100/min
58
What is paroxysmal atrial tachycardia?
-tachycardia begins and ends in acute manner
59
What is atrial flutter?
sinus rate of 250-350 bpm
60
What is atrial fibrillation?
-uncoordinated atrial depolarizations
61
What are 4 ventricular arrhythmias?
-ventricular premature beats: from ectopic ventricular foci -ventricular tachycardia: from abnormality or reentry; 100-200 bpm; life threatenening -ventricular flutter: over 200 depol/min -ventricular fibrillation: uncoordinated depol
62
When do the two heart sounds occur?
isometric ventricular contraction = lub isometric ventricular relaxation = dub

Pharm 2 (11 decks)

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