Cardiovascular Physiology Flashcards
(199 cards)
1
Q
Secreted at cardiac ventricles
Increased BNP - Dix: Left sided heart failure
A
BNP
2
Q
Indomethacin
A
Gout
PDA
3
Q
Arteries
A
Deoxygenated
4
Q
Veins
A
Oxygenated
5
Q
Semilunar Valve
A
Aortic
Pulmonic
6
Q
AV Valve
A
Tricuspid
Mitral
7
Q
Systemic Arterioles
A
Vasodila te
8
Q
Pulmonary Arterioles
A
Only Arterioles that vasoconstric in response to hypoxia
9
Q
Thick-walled, under high pressure (stressed volume)
A
Arteries
10
Q
Control conduits for blood flow
A
Arterioles
11
Q
Vasoconstriction
A
Alpha 1
12
Q
Vasodilation
A
Beta 2
13
Q
Blood flow velocity in the aorta: fastest
A
Arterioles
14
Q
Blood flow velocity in the capillaries slowest
A
Arterioles
15
Q
Site of exchange of nutrients, gases, waste products
A
Capillaries
16
Q
Thin-walled, under low pressure (unstressed volume)
With one way valves
A
Veins
17
Q
Largest percentage of blood in the circulatory system
A
Veins
18
Q
The greatest pressure decrease in the circulation occurs across the Arterioles because
A
They gave the greatest cross-sectional area
19
Q
Systemic Arterioles vasoconstrict
A
TPR/SVR: increases
Blood flow: decreases
20
Q
Systemic Arterioles vasodilate
A
TPR/SVR: decrease
Blood flow: increase
21
Q
Blood pressure when TPR increases
A
Blood pressure: increase
22
Q
Veins vasoconstrict
A
Venous return: increase
23
Q
Which of the following parameters is decreased during moderate exercise?
A
Total peripheral resistance
24
Q
MAP formula
A
2/3 (D) + 1/3 (S)
25
The smaller the radius, the greater the resistance
The greater the radius, the lesser the resistance
Poiseulle's Law
26
Inversely proportional to ELASTANCE
Compliance.Capacitance
27
Streamlined(straight line) flow
| Velocity: highest at the center, lowest at the walls
Laminar Flow
28
Disorderly flow
| Assoc with High Reynold's number
Turbulent Flow
29
Reynold's number for laminar flow
<2000
30
Reynold's number for turbulent flow
>2000
31
A strain in the structure of a substance produced by pressure, when it's layers are laterally shifted in relation to each other
Shear
32
Shear: Highest in
Walls of the blood vessel
33
Shear: lowest
Center of the blood vessel
34
Shear: consequence
Decreased blood viscosity
35
Compliance of Veins (vs Arteries)
24x higher compliance
36
Compliance: effects of aging
24x lower compliance
37
End diastolic volume, immediate before it contracts
Preload
38
Aortic pressure that pump against
After load
39
Highest arterial blood pressure
Systolic pressure
40
Lowest arterial blood pressure
Diastolic pressure
41
= systolic pressure - diastolic pressure
Pulse Pressure
42
= stroke volume / arterial compliance
Pulse Pressure
43
Most important determinant of Pulse Pressure
Stroke volume
44
= 2/3 (Diastole) + 1/3 (systole)
Mean Arterial Pressure
45
Synonym: Right Arterial Pressure
central venous pressure
46
Estimates left atrial pressure
Pulmonary Capillary wedge pressure
47
Pulse Pressure
Determined by stroke volume
48
Considered the most important determinant of pulse pressure
Stroke volume
49
Pulse pressure is increased during aging because of which of the following pwede infant physiologic changes?
Decreased capacitance of the arteries
50
Which of the following factors forms the predominant component of diastolic blood pressure?
TPR
51
What is the predominant contributor of TPR?
Arterioles
52
```
All of the following will lead to an increase in cardiac output except?
A. Increased after load
B. Increased contractility
C.Increased stroke volume
d. Increased heart rate
```
A. Increased after load ( decrease)
53
All of the following will lead to an increase in mean arterial pressure except?
A. Increase in systemic vascular resistance
B. Increase in cardiac output
C. Increase in heart rate
D. Nota
D. Nota
54
Master pacemaker
SA node
55
Latent pacemaker/inactive
AV
Bundle of his
Purine fiber
56
Atrial depolarization
P wave
57
Corresponds to AV Node Conduction
PR Segment
58
Correlates with conduction time/Velocity through the AV Node
PR Segment
59
Correlates with conduction time/velocity through the AV Node
PR Interval
60
Ventricular depolarization
QRS interval
61
Ventricular Repolarization
T wave
62
Period of depolarization + Repolarization of ventricles
QT Interval
63
Correlated with plateau of ventricular action potential
ST segment
64
What happens when Sympathetic NS stimulates the AV node?
Conduction velocity: increases
| PR Interval: decreases
65
What happens when Parasympathetic NS stimulates the AV Node?
Conduction Velocity: decreases
| PR Interval: increases
66
Shorter QT interval
Increase Calcium
67
Prolonged QT Interval
Decrease Calcium
68
High plasma K
Increase T waves
69
Hypokalemia
Flat/ inverted T waves with U waves
70
Hyperkalemia
Low P waves, tall T waves
71
Hypocalcemia
Prolonged QT interval
72
Hypercalcemia
Shortened QT interval
73
STEMI / Q wave MI
ST segment elevation
74
NSTEMI
ST segment depression
75
Full thickness infarct
| Transmutation
STEMI
76
Partial thickness
| Sub endocardium
NSTEMI
77
Na influx
Depolarization / Phase 0
78
K Efflux
Partial Repolarization/ Phase 1
79
Ca Influx
Plateau / Phase 2
80
K Efflux
Complete Repolarization / Phase 3
81
RMP
Phase 4
82
Slow Na influx towards threshold/ stable MP
Phase 4 SA node AP
83
CA influx
Depolarization / pHase 0
84
K Efflux
Repolarization / phase 3
85
Slowest conduction velocity
AV node
86
Fastest conduction velocity
Bundle of His, Purkinje fibers, ventricles
87
The ventricle are completely Depolarizes during when isoelectric portion of the ECG?
ST segment
88
Duration of the AP of the heart is greater than the nerve
Plateau
89
Compatible with life
Afib
90
Not compatible with life
Mcc of sudden cardiac death
Vfib
91
What is the basis for AV Nodal delay
Decrease GAP junctions in the area
92
Which Na channel accounts for SA node automaticity?
If channels (slow "funny" Na channels
93
Which is responsible for setting the heart rate?
Rate of Phase 4 depolarization
94
Inhibition of pacemaking of latent pacemakers by the SA node?
Overdrive suppression
95
AV block that causes fainting in patients due to initially suppressed state of Purkinje fibers?
Strokes-Adams Syndrome
96
Condition when latent pacemaker assume pace making activity?
Ectopic pacemaker
97
Conduction velocity is dependent on which phenomenon?
Size of inward current during upstroke of AP
| Not dependent on duration of AP
98
Long conduction pathway
Dilated cardiomyopathy
99
Decreased conduction velocity
Ischemic heart, hyperkalemia, blocked Purkinje
100
Short refractory period
Epinephrine, electrical stimulation
101
Absolute refractory period (ARP)
All Na inactivation gates close
| AP cannot be generated
102
Effective Refractory Period (ERP)
At the end, some Na inactivation channels start to open
| AP cannot be conducted
103
Relative Refractory Period (RRP)
AP can be conducted & generated but higher than normal stimulus is required
104
SupraNormal Period (SNP)
All Na inactivation gates are open & membrane potential is higher than RMP (nearer to threshold)
Cell is more excitable than normal
105
Produces changes in Contractility
Inotropic effect
106
Produces changes in Rate of Relaxation
Lusitrophic effect
107
Produces changes in Heart Rate
Chronotrophic effect
108
Produces changes in Conduction Velocity
Dromotrophic effect
109
Inotropes affect
stroke volume
110
Chronotropes affect
SA node
111
Dromotropes affect
AV node
112
dromotropes are affected by
Inward calcium current
113
Beta-1 stimulation of the heart would cause
```
STRONGER (positive into rope)
BRIEFER (positive suit rope) &
MORE FREQUENT (positive chronotrope) Contractions
```
114
Adverse effect of Digoxin
Arythmia
Gynecomastia
Yellow vision "STARRY NIGHT"
115
An increase in Pre-load will increase Stroke Volume within certain physiologic limits
Frank Starling Mechanism
116
LV EDV is directly proportional to what?
Venous Return
| Right Atrial Pressure
117
What happens when Pre-load increase?
Stroke volume & Cardiac Output: increase
118
What happens when afterload increases
Stroke volume & cardiac output: decrease
| Velocity of Sarcomere Shortening: decrease
119
What happens when TPR increases
Cardiac output and Venous return: decreases
120
What happens when blood volume increases or venous compliance decreases
Cardiac output and venous return: increases
121
Stroke volume
EDV - ESD
122
Ejection Fraction
SV / EDV
123
Cardiac Output
HR X SV
124
Stroke Work
SV X Aortic Pressure
125
Cardiac Minute Work
CO X Aortic Pressure
126
Considered as the main source of fuel for the heart?
Glucose
127
An ECG on a person shows ventricular extrasystoles, which of the following terms pertain to this condition?
Premature ventricular complexes
128
An ECG on a person showed ventricular extrasystoles, the extrasystolic beat would produce
Decrease pulse pressure because stroke volume is decreased
129
What is the rationale behind the answer in the previous question above?
Decreased stroke volume due to decreased ventricular filling time
130
After an extrasystoles, the next normal heart beat or ventricular contraction produces?
Increased pulse pressure because of increased ventricular contractility
131
What is the rationale behind the answer in the previous question above?
Accumulation of intracellular Ca from previous contraction increases contractility
132
Isovolumetric contraction
1-2
All heart valves close
Mitral valve closes ( S1 hear)
2: aortic valve opens, VP > Aortic pressure
133
Ventricular Ejection
2 - 3
Width: stroke volume
3: volume is ESV
134
Isovolumetric Relaxation
3 -4
All valve close
Aortic valve closes (S2)
4: mitral valve opens; Atrial pressure > ventricular pressure
135
Ventricular filling
4 - 1
4: volume is EDV
136
7 Phases of cardiac cycle
```
Atrial contraction / systole
Isovolumic contraction
Rapid ventricular ejection
Slow/reduced ventricular ejection
Isovolumic relaxation
Rapid ventricular filling
Slow/reduced ventricular filling
```
137
A wave
Atrial contraction
138
C wave
Contraction of ventricles
139
V wave
Venous blood going to atrium
140
4th heart sound heard
Atrial contraction
141
S1
Isovolumic contraction
142
Atrial filling begins
Rapid ventricular ejection
143
T wave occurs
Reduced ventricular ejection
144
Incisura of aortic pressure is seen
V wave
Isovolumic relaxation
145
S2 heard
Isovolumic relaxation
146
S3
Rapid ventricular filling
147
Longest phase of the cardiac cycle
Reduced ventricular filling (Diastasis)
148
S1
Closure of AV valves
| Isovolumic contraction
149
S2
Closure of semilunar valves
| Isovolumic Relaxation
150
S3
Rapid ventricular filling
| Rapid ventricular filling
151
S4
Stiff ventricles
| Atrial contraction/ systole
152
Portion of the cardiac cycle where ventricular volume is lowest?
Isovolumetric relaxation
153
The aortic valve closure marks the beginning of which phase of the cardiac cycle?
Isovolumetric relaxation
154
The 1st heart sound is heard in which part of the cardiac cycle?
Isovolumetric contraction
155
The 3rd heart sound if present is most likely heard during which phase of the cardiac cycle?
Rapid filling
156
Aortic
2nd ICS R parasternal border
157
Pulmonic
2nd ICS L parasternal border
158
Tricuspid
4th ICS L parasternal border
159
Mitral
5th ICS L MCL
160
Physiologic murmurs occur only during systole or diastole?
Systole
161
Inspiration splits the second heart sound because?
Aortic valve closes before the pulmonic valve
162
The following processes explain the physiology of the normal splitting of the second heart sound on inspiration
Inspiration decreases intrathoracic pressure or creates negative pressure
More venous blood is returned back to the heart
More blood is present on the right side of the heart
Higher pressure on the systemic circulation closes the aortic valve first
Reduction in blood coming to the left ventricle due to negative pressure from the lungs causes the left side of the heart to empty earlier
More blood on the right ventricle causes delay in closure of the pulmonic valve
163
Which of the following processes can lead to fixed splitting of the second heart sound
ASD
164
All of the following processes can lead to a paradoxical splitting of the second heart sound except?
A. Severe aortic stenosis
B. hypertrophic obstructive cardiomyopathy
C. LBBB
D. ASD
ASD
165
Patient has a murmur described as early diastolic low intensity high pitched blowing in character decrescendo murmur hear best over the right 2nd ICS or over the left stern all border what is the most likely valvular pathology
Aortic regurgitation
166
The patient above also has an incidental soft rumbling low pitched late diastolic murmur heard best at the apex due to back flow of blood from the aorta presses on the mitral valve leaflet of blood from the aorta presses on the mitral valve leaflet slightly occluding flow from the aorta
Austin flint murmur
167
Sat, buffers minute to minute changes in BP
Baroreceptors
168
Patient with chronic pains in both hands and chronic long standing repeated episodes of Raynaud's phenomenon underwent sympathectomy, after an uneventful surgery and upon discharge, patient started complaining of episodes of dizziness and sensations of blacking out whenever he stands or gets up from bed, which of the following is the physiological explanation for these symptoms?
Under stimulation (suppressed response) of the barorecetors
169
Sudden decrease in blood pressure is sensed by the
Carotid sinus
170
Rank sterling Mechanism
Increased VR -> Increased SV - > inc CO
171
Brain bridge Reflex
Increased VR -> Inc HR -> Inc CO
172
Cushing Reaction or Cushing Reflex Triad
HPN
Bradycardia
Irregular respiration so
173
Which of the following substances passes through water clefts/pores in the membranes?
Glucose
174
Describes fluid movement into (absorption) or out of (filtration) the capillary
Starling Forces
175
Favors filtration; determined by pressure & resistance in arteries & veins
Capillary Hydrostatic Pressure
176
Opposes filtration (favors absorption); increased by increases in plasma protein concentration
Capillary Oncotic Pressure
177
Opposes filtration (favors absorption); slightly negative due to lymphatic pump
Interstitial Hydrostatic Pressure
178
Favors filtration; determined by interstitial protein concentration
Interstitial Oncotic pressure
179
Hydraulic conductance of capillary wall
Filtration Coefficient
180
Examples of increased capillary hydrostatic pressure
Arteriolar dilated ion, venous constriction, inc venous pressure, heart failure, ECF volume expansion, standing
181
Examples of decreased capillary Oncotic pressure
Decreased plasma protein concentration, severe liver disease, protein malnutrition, nephrotic syndrome
182
Examples of filtration coefficient
Burns, inflammation, (due to release of histamine, cytokines)
183
When vascular smooth muscle are stretched, there's a reflex contraction and vice versa
Myogenic Theory
184
May explain autoregulation, but not active or reactive hyperemia
Myogenic Theory
185
Vasodilator metabolites are produced as a result of metabolic activity
Metabolic Theory
186
Substances increase blood flow during deoxygenation
Vasodilator Theory
vasodilator - adenosine
187
O2 is needed for vascular muscle contraction
Oxygen lack theory/ Nutrient lack theory
188
Increase in blood flow in response to brief period of decrease blood flow
Reactive hypermedia
189
Blood flow increases to meet increased metabolic demand
Active Hyperemia
190
Most potent vasoconstrictor
Vasopressin
191
Release as a result of blood vessel damage, cause arteriolar vasoconstriction, implicated in migraine
Serotonin
192
Release by damaged endothelium
Endothelin
193
Vasoconstrictors
PGF & TXA2
194
Counteracts TXA2
Prostacyclin / PGI2
195
Vasodilator upstream blood vessels
Nitric Oxide (EDRF)
196
Vasodilators
PGE
197
Found in muscles
Lactate, Adenosine
198
Causes arteriolar dilation & venous constriction leading to increased filtration (local edema)
Bradykinin, Histamine
199
During exercise, total peripheral resistance decreases because of the effect of
Local metabolites on skeletal muscle Arterioles
