Cardiovascular Physiology

Question 1

heart and the blood vessels are collectively called the

Answer 1

cardiovascular system

Question 2

responsible for pumping blood through the vessels so that the cells of the body are supplied with the oxygen (O2) and nutrients that they need

Answer 2

heart

Question 3

the waste products of cell metabolism are removed to be excreted through the

Answer 3

lungs (in the form of carbon dioxide, CO2) or kidneys or liver and biliary system

Question 4

most prevalent cause of death

Answer 4

heart disease

Question 5

Problems in circulation may affect

Answer 5

blood flowing from the heart in arteries or returning to the heart in veins

Question 6

the lub sound is from what part of the heart

Answer 6

mitral and tricuspid

atrioventricular

Question 7

the dub sound is from what part of the heart

Answer 7

aortic and pulmonic

semilunar

Question 8

Blood enters the atrial chambers of the heart at a ____________ and leaves the ventricles at a _____________.

Answer 8

low pressure

higher pressure

Question 9

The __________ arterial pressure provides the energy to force blood through the circulatory system.

Answer 9

high

Question 10

Basically, blood returning from the body arrives at the _________ side of the heart

Answer 10

right

Question 11

This oxygenated blood then arrives at the left side of the heart, from where it is pumped around the rest of the body in the ____________

Answer 11

systemic circulation

Question 12

blood is returning to both sides of the heart

Answer 12

ventricular diastole (relaxation)

Question 13

ventricular diastole (relaxation) process

Answer 13

Deoxygenated blood from the periphery enters the right atrium and flows into the right ventricle through its open AV valve (tricuspid). At the same time oxygenated blood from the lungs enters the left atrium and flows into the left ventricle through its open AV

Question 14

In the resting state, atrial systole accounts only for some _________ of ventricular filling

Answer 14

20%

Question 15

It is important to note that, when the ventricles contract (systole), and the pressure in the ventricles exceeds the atrial pressure, both the AV valves of the heart slam shut at the same time making the first heart sound

Answer 15

lub

Question 16

As the pressure builds in the ventricles, it exceeds the diastolic blood pressure in the arteries forcing open the semilunar valves. The pressure in the ventricles continues to rise peaking at systolic blood pressure. At the end of systole, when diastole begins, the pressure in the ventricles drops below the pressure in the aorta and pulmonary artery and the semilunar valves are pushed shut creating the second heart sound

Answer 16

dub

Question 17

is the time between the lub and dub, and

Answer 17

Systole

Question 18

is the time between the dub and the next lub.

Answer 18

diastole

Question 19

arterial system

Answer 19

functions as a pressure reservoir

Question 20

Diseased or damaged heart valves may be stiff or leaky or both, blood flowing through a diseased valve may make a “__________“ noise that is referred to as a murmur.

Answer 20

swooshing

Question 21

Blood ________ the arterial system continuously through the capillaries, but enters only intermittently from the heart

Answer 21

leaves

Question 22

ventricles contract during ____________; the semilunar valves open and blood flows into the arterial system

Answer 22

systole

Question 23

the arteries are stretched and the blood pressure increases

Answer 23

systole

Question 24

The aorta and other major arteries bulge (like a balloon being blown up) during

Answer 24

systole

Question 25

At the start of _____________, the pressure in the left ventricle drops below that in the aorta and the greater pressure in the aorta now closes the aortic valve, preventing blood from flowing back into the ventricles from the aorta. So the blood is forced to flow in one direction along the arteries

Answer 25

diastole

Question 26

During ___________, the arterial walls (balloon) recoil pushing the blood forwards through the arteries.

Answer 26

diastole

Question 27

'_____________' is defined as the peak pressure reached during the cardiac cycle

Answer 27

Systolic pressure

Question 28

The period during the relaxation of the ventricles is called

Answer 28

diastole

Question 29

During _____________, while the ventricles fill with blood returning from the veins in preparation for the next systole, blood continues to flow out of the arterial system into the capillaries.

Answer 29

diastole

Question 30

The value when the arterial blood pressure is at its lowest - immediately before the contracting ventricle pushes blood into the arteries again - is called the '

Answer 30

'diastolic pressure

Question 31

(a small plateau or dip in the pressure wave) is caused by the closure of the aortic valve

Answer 31

dicrotic notch

Question 32

Although the variation in arterial blood pressure during the cardiac cycle is smoothed out by the inherent elasticity of the major arteries, blood still exhibits____________ through the arteries and arterioles

Answer 32

pulsatile flow

Question 32

A young healthy person may have good elasticity in their arteries with a smoother, less obvious pulse.

Answer 32

true

Question 32

It is these vessels that receive sympathetic nervous innervation that adjusts the contraction of the smooth muscle in their walls.

Answer 32

arterioles

Question 33

Precapillary ____________ and arterioles control the amount of blood that flows into the vast network of capillaries.

Answer 33

sphincters

Question 33

The pulses felt in the _________ are the waves of elastic recoil and skilled observers can detect various qualities of the pulse.

Answer 33

arteries

Question 34

arterioles contribute about __________ of the total peripheral resistance

Answer 34

40%

Question 34

Increased ________________ causes smooth muscle contraction and results in narrowing of the arteriolar lumen, thereby raising peripheral resistance and decreasing arteriolar blood flow

Answer 34

sympathetic activity

Question 34

whereas the diastolic blood pressure in the left ventricle drops back virtually to zero, the diastolic pressure in the arteries is sustained by the elastic nature of the vessels and the fact that the aortic valve is shut, thus trapping blood under pressure in the arteries.

Answer 34

true

Question 35

The walls of capillaries are, however, somewhat leaky and some plasma protein does leak across to the interstitial fluid. The role of the ____________ is to return this lost protein to the blood circulation.

Answer 35

lymphatic system

Question 35

Flow through this network is sufficiently slow that exchanges of gases and nutrients between the blood and the adjacent cells takes place efficiently by diffusion.

Answer 35

capillaries

Question 36

_________ sympathetic activity causes smooth muscle relaxation and thereby lowers peripheral resistance and results in increased arteriolar blood flow

Answer 36

decreased

Question 37

resistance, low pressure pathway for blood to return from the tissues to the heart.

Answer 37

veins

Question 38

This return flow is assisted by the presence of __________ in the veins that are oriented so that they open when the venous pressure is driving blood flow towards the heart, but close when pressure drops, thereby preventing any backflow.

Answer 38

valves

Question 39

There are ________ heart sounds, but only the first two can be heard without use of special amplification.

Answer 39

four major

Question 39

The combination of ____, _________, and __________ squeezes the blood in the veins, thereby raising its pressure, allows us to return blood from the lower limb to the heart, even when we are standing upright and the venous system is subjected to an increased hydrostatic pressure

Answer 39

veins with valves, and skeletal muscle contraction

Question 39

The vibrations producing the sounds can be visually displayed through the use of a heart sound microphone and physiological recorder to produce a

Answer 39

phonocardiogram

Question 40

Airplane passengers are advised to walk about and__________ leg muscles in order to increase the pressure on the leg veins and assist the blood flow back to the heart thereby preventing slow moving blood in the veins from clotting and creating deep vein thromboses

Answer 40

contract their

Question 40

was the first to recognize that the valves in the veins assisted in the blood flowing back towards the heart.

Answer 40

William Harvey

Question 41

means to listen to and study the various sounds arising from the heart as it pumps blood. These sounds are the result of vibrations produced when the heart valves close and blood rebounds against the ventricular walls or blood vessels.

Answer 41

Auscultation

Question 41

The heart sounds may be heard by placing the ear against the chest or by using a

Answer 41

stethoscope

Question 42

occurs during the end of systole and is produced by the closure of the SL valves, the opening of the AV vales, and the resulting vibrations in the arteries and ventricles. Owing to the higher blood pressures in the arteries, the sound produced is higher pitched than the first heart sound. It is commonly referred to as the “dub” sound.

Answer 42

second heart sound

Question 42

is produced at the beginning of systole when the atrioventricular (AV) valves close and the semilunar (SL) valves open. This sound has a low pitched tone commonly termed the “lub” sound of the heartbeat.

Answer 42

first heart sound

Question 43

occurs at the time of atrial contraction and is probably due to the accelerated rush of blood into the ventricles.

Answer 43

fourth heart sound

Question 43

occurs during the rapid filling of the ventricles after the AV valves open and is probably produced by vibrations of the ventricular walls.

Answer 43

third heart sound

Question 44

Aortic area

Answer 44

2nd ICS right parasternal border (RPSB)

Question 45

Pulmonic area

Answer 45

2nd ICS left parasternal border (LPSB)

Question 46

Mitral area

Answer 46

5th ICS left midclavicular line (LMCL)

Question 47

Tricuspid area

Answer 47

4th ICS left parasternal border (LPSB)

Question 48

2nd intercostal space is below the angle of ______________ This is the junction between the manubrium and body of the sternum, which marks that articulation of the second costal cartilage with the sternum, marked by a protruberance.

Answer 48

Louis or sternal angle.

Question 49

The first intercostal space if below the

Answer 49

clavicle

Question 49

is the highest pressure in the artery, produced in the heart’s contraction (systolic) phase. The normal value for a 20-year-old man is 120 mmHg

Answer 49

Systolic blood pressure

Question 50

lowest pressure in the artery, produced in the heart’s relaxation (diastolic) phase. The normal value for a 20-year-old man is 80 mmHg.

Answer 50

Diastolic blood pressure

Question 51

is diastolic pressure plus one third of the pulse pressure. This is the average effective pressure forcing blood through the circulatory system. The normal value is 96 to 100 mmHg.

Answer 51

Mean blood pressure

Question 51

mean blood pressure is a function of two factors

Answer 51

cardiac output (CO) and total peripheral resistance (TPR).

Question 51

depends on the caliber (diameter) of the blood vessels and the viscosity of the blood.

Answer 51

Peripheral resistance

Question 52

cardiac output

Answer 52

c𝑎𝑟𝑑𝑖𝑎𝑐 𝑜𝑢𝑝𝑢𝑡 (𝑚𝐿/𝑚𝑖𝑛) = ℎ𝑒𝑎𝑟𝑡 𝑟𝑎𝑡𝑒 (𝑚𝑖𝑛) ×𝑠𝑡𝑟𝑜𝑘𝑒 𝑣𝑜𝑙𝑢𝑚𝑒 (𝑚𝐿)

Question 52

mean bp

Answer 52

m𝑒𝑎𝑛 𝐵𝑃 =𝑐𝑎𝑟𝑑𝑖𝑎𝑐 𝑜𝑢𝑡𝑝𝑢𝑡 (𝑚𝐿/𝑠𝑒𝑐)×𝑡𝑜𝑡𝑎𝑙 𝑝𝑒𝑟𝑖𝑝ℎ𝑒𝑟𝑎𝑙 𝑟𝑒𝑠𝑖𝑠𝑡𝑎𝑛𝑐𝑒 (𝑇𝑃𝑅 𝑢𝑛𝑖𝑡𝑠)

Question 53

pressure indicates the force of contraction of the heart,

Answer 53

systolic blood

Question 53

indicates the condition of the systemic blood vessels

Answer 53

diastolic blood pressure

Question 54

The highest pressure occurs when the ventricle contracts to force blood into the artery

Answer 54

systolic

Question 54

the lowest pressure occurs when the heart is in its relaxation phase and no blood is flowing through the semilunar valves

Answer 54

diastolic

Question 55

results when the aortic semilunar valves close, causing the blood in the aorta to rebound against the arterial walls to produce a slight elevation in pressure.

Answer 55

dicroticnotch

Question 55

A recording of these pressure changes in an artery during one cycle of the heart is called an

Answer 55

arterial pulse wave

Question 56

The difference between the systolic and diastolic pressures is called the

Answer 56

pulse pressure

Question 56

The magnitude and contour of the arterial pulse wave are directly related to the

Answer 56

stroke volume

Question 57

The arterial pulse wave moves over the large arteries at a rate of

Answer 57

3 to 5 m/sec

Question 57

The magnitude and contour of the arterial pulse wave are inversely related

Answer 57

compliance (elasticity) of the arterial vessels

Question 57

As the vessels lose their compliance (as with age or in arteriosclerosis), the stroke volume increases and the height of the pulse wave increases (pulse pressure increases).

Answer 57

true

Question 57

The arterial pulse wave moves over the small arteries at a rate of

Answer 57

14 to 15 m/sec

Question 57

the less compliance a vessel has, the faster the pulse wave will move over

Answer 57

true

Question 57

sounds are the sounds of blood flow through the artery as a blood pressure cuff is deflated.

Answer 57

Korotkoff sounds

Question 58

EFFECT OF POSTURE on bp

Answer 58

a. After the subject has reclined for 5 minutes Systolic BP: Normal or slightly lower than upright positions. Diastolic BP: Usually stable or slightly higher compared to standing. b. Immediately after the subject stands up Systolic BP: There may be a brief drop of 10-15 mmHg. Diastolic BP: This may rise slightly or stay the same. c. After the subject has stood for 5 minutes Systolic BP: Should stabilize or slightly increase from the initial drop. Diastolic BP: Often stays stable or may rise slightly.

Question 59

EFFECT OF VALSALVA MANEUVER

Answer 59

Systolic BP increases: This happens because the increased pressure in the chest compresses the large veins (venous return is decreased), leading to a temporary increase in arterial pressure. Heart rate decreases slightly due to increased vagal (parasympathetic) tone.

Question 60

EFFECT OF COLD PRESSOR TEST

Answer 60

A normal response includes an increase in systolic pressure of 15 mmHg or more within 1 minute.

Question 60

EFFECT OF EXERCISE

Answer 60

Systolic BP: Increases significantly during exercise. Diastolic BP: May stay the same or slightly increase. Post-Exercise Hypotension (also known as "Exercise-Induced Hypotension"): After exercise, especially moderate-to-intense aerobic exercise, BP may temporarily drop below pre-exercise levels.

Question 61

FACTORS AFFECTING THE PULSE RATE

Answer 61

a. While sitting. normal resting heart rate range of 60–100 beats per minute (bpm) b. After standing for 5 minutes. Increases slightly, typically by 10–20 bpm from the sitting/resting rate. c. After a vigorous exercise (e.g. running for at least 5 minutes). Increases significantly during exercise, with pulse rates often reaching 120–160 bpm or higher, depending on the intensity of the exercise and the individual's fitness level.

Question 61

CARDIAC INHIBITION AND STIMULATION Oculocardiac reflex

Answer 61

Mild to Moderate Bradycardia

Question 61

is a physiological phenomenon where pressure applied to the eyeball (or stimulation of the eye) leads to a reflex decrease in heart rate (bradycardia).

Answer 61

Oculocardiac Reflex

Question 62

CARDIAC INHIBITION AND STIMULATION a. Subject drinks a glass of water.

Answer 62

Drinking a glass of water can lead to both cardiac inhibition (slowing of heart rate) and stimulation (increase in blood pressure). This effect is primarily due to the body's physiological response to hydration, involving the activation of the vagal nerve and the sympathetic nervous system.

Question 62

CARDIAC INHIBITION AND STIMULATION b. Application of pressure on the carotid sinus (just below the angle of the jaw).

Answer 62

Applying pressure to the carotid sinus, located just below the angle of the jaw, can stimulate the carotid sinus nerve, which can lead to a decrease in heart rate (bradycardia) and/or a drop in blood pressure

Question 63

CARDIAC INHIBITION AND STIMULATION c. Subject inspires slowly and deeply.

Answer 63

Slow, deep breathing influences heart rate through a phenomenon called respiratory sinus arrhythmia (RSA). During inspiration, vagal outflow to the heart is inhibited, leading to an increase in heart rate.