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CP/SL Exam Flashcards

1
Q

Equation for O2 consumption (VO2)

A

VO2 = COx(arterial O2 - venous O2)

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2
Q

Cardiac Output/Flow

A

CO = HRSV or change in P (MAP - CVP)/TPR or vA or (change in P * pi * r^4)/(8Lviscosity)

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3
Q

Normal range of CO

A

5-6L/min

25L/min with exercise

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4
Q

Sides that pump to systemic vs pulmonary

A 
Left = systemic
Right = pulmonary
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5
Q

Normal Blood Volume

A

5L

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6
Q

Which circulation system is in parallel vs series?

A 
Systemic = parallel (except liver has both)
Pulmonary = series
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7
Q

Liver blood sources

A

Hepatic artery & portal vein from GI system

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8
Q

MAP

A

about 95mmHg
mean arterial pressure = mean aortic pressure
MAP = DBP + PP/3

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9
Q

CVP

A

about 2mmHg

central venous pressure = vena cava pressure

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10
Q

Normal systemic BP & pulmonary BP

A

Systemic 130/80

Pulmonary 25/10

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11
Q

Mechanisms to help pressure drop

A
  1. Reduce outflow - increase resistance in organs that do no have high demand for nutrients
  2. Increase inflow (CO) - increase HR or contractility (SV)
  3. Increase Volume - short term, veins; long term, kidneys
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12
Q

How much blood does the venous system hold?

A

about 70%

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13
Q

P of right atrium

A

2mmHg

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14
Q

P of left atrium

A

8mmHg

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15
Q

P of right ventricle

A

25/5mmHg

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16
Q

P of left ventricle

A

130/10mmHg

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17
Q

P of pulmonary artery

A

25/10mmHg

Mean = 15mmHg

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18
Q

P of aorta

A

130/80mmHg

Mean = 95mmHg

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19
Q

P of pulmonary capillaries

A

8mmHg

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20
Q

P of systemic capillaries

A

25mmHg

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21
Q

Route of electrical impulse through heart

A

SA -> AM -> AV -> His/P -> VM

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22
Q

What has fast APs? slow APs?

A

Fast - His/P, AM, VM

Slow - SA, AV

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23
Q

Fast AP

A

Phase 0: rapid depolarization, inward Na current
Phase 1: repolarization from inactivation of Na channel, activation of outward K+
Phase 2: plateau - slowly activating inward Ca2+ currents
Phase 3: repolarization from inactivation of Ca2+ currents and activation of IKr & IKs (K channels)
Phase 4: resting potential from inward-rectifying K channels (IK1)

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24
Q

Slow AP

A

Phase 0: slow depolarization from slow activating Ca2+ channels (NOT NA)
Phase 3: repolarization from Ca2+ inactivation and activation of K channels
Phase 4: slow depolarization

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25
effective refractory period
only single AP can be elicited, not propagated AP
26
IK,Ach or IGIRK | If
IK,Ach or IGIRK - outward current, hyperpolarizes cell/SA node - PNS If - inward current, nonselective ion channel (HCN), depolarizes - SNS
27
Pace of SA node, AV node and His/Purkinje fibers
SA node - 100bpm AV node - 40-60bpm His/Purkinje - 30-40bpm
28
Dromotropic effects
Conduction velocity Positive - increases (SNS) Negative - decreases (PNS)
29
P-wave
atrial depolarization
30
PR segment
conduction through AV node
31
QRS complex
ventrical depolarization | Q wave often too small to detect
32
bundle branch block
QRS widens
33
ST segment
all ventricular tissue depolarized, plateau phase, beginning of repolarization
34
T wave
repolarization of ventricles
35
Lead I
Right arm to left arm
36
Lead II
right arm to left leg
37
Lead III
left arm to groin
38
AVL, AVF, AVR
``` A = abdomen L = left arm F = femoral artery R = right arm ```
39
shifts in MEA with hypertrophy
RVH - clockwise | LVH - counterclockwise
40
First degree, second degree, third degree AV block
First - PR interval increases Second - P wave not always followed by QRS Third - pacemaker is His/P
41
What happens to ST interval with MI or ischemia?
ischemia, early stages of MI - ST depression | late stages MI - ST elevation
42
S4
atrial gallop - stiffened ventricle
43
S3
ventricular gallop - more flexible ventricle normal in children/young adults dilated cardiomyopathy in adults
44
S2
aortic valve closes
45
S1
mitral valve closes
46
Normal SV
about 60-100mL
47
Normal EF
55-70%
48
Increased preload
Increases EDV, EF, SV, CO
49
Increased afterload
Increases ESV | Decreases EF, SV, CO
50
Increased inotropy
Decreases ESV | Increases EF, SV, CO
51
Largest SA
capillaries
52
Largest pressure drop
arterioles | due to increase in TPR
53
Poiseulle's law
Q or CO = (change in P * pi * r^4)/(8*L*viscosity)
54
factors increasing viscosity
increased hematocrit loss of plasma sickle cell anemia
55
PP
SBP - DBP
56
Which type of shock do you not want to give a vasodilator?
Vasodilatory/septic
57
Deviations from poiseulle's law
1. turbulence 2. viscosity changes with velocity 3. compliance of blood vessels
58
Reynold's number
``` NR = (v*d*density)/viscosity >2000 = turbulent (aortic stenosis) ```
59
compliance
change in V/change in P | decreases with increasing wall thickness
60
Starlings law of the capillary
Q = k*[(Pc + Oi) - (Pi + Oc)]
61
Local control of blood flow through capillaries
A. metabolic wastes vasodilate | B. myogenic - smooth muscle contracts/relaxes
62
Central control of blood flow through capillaries
A. Humoral ANP, AngII, Epi, NO, ET-1 B. Neural norepi
63
Atrial Natriuretic Peptide (ANP)
vasodilator released by atrial myocytes excretion of Na+ and water
64
Angiotensin II
potent vasoconstrictor (increases TPR) retention of Na (increases BV) stimulates thirst & ADH release stimulates aldosterone synthesis
65
Epi
vasodilator in liver, heart and skeletal muscle (B2) vasoconstriction (a1) increases HR
66
NO
EDRF formed from arginine vasodilator produced by endothelium
67
Endothelin (ET-1)
potent vasoconstrictor | released by endothelial cells
68
Rate-pressure product (RPP)
``` RPP = HR * SBP increase = increased O2 demand ```
69
Apical skin
hand, feet, ears, nose, & some face | has lots of AV anastomoses
70
Cerebral Perfusion Pressure
MAP - ICP (intercranial pressure)
71
Glomerular vs Peritubular capillaries
Glomerular - high P, filter stuff out | Peritubular - low P, reabsorb
72
Changes in filtration due to changes in AA & EA resistance
AA with low R - increases filtration/flow AA with high R - decreases filtration/flow EA with low R - increases flow EA with high R - decreases flow
73
Nicotinic receptors
all postganglionic neurons, adrenal medula and skeletal muscle
74
Muscarinic receptors
effector tissues for PNS & sweat glands (SNS)
75
PNS vs SNS ganglionic neurons
``` PNS pre - long post - short SNS pre - short post - long ```
76
Alpha1 adrenergic receptors
stimulated by NE and E radial muscles of eye->dilation contraction of blood vessels->inc. P
77
Alpha2 adrenergic receptors
presynaptic stimulated by NE and E autoregulatory - inhibits release of NE
78
Beta1 adrenergic receptors
heart stimulated by NE and E increases HR and inotropy
79
Beta2 adrenergic receptors
stimulated by only E relaxes bronchi vasodilates increases glycogenolysis in liver/skeletal muscle far vision through dilation of pupil (ciliary muscle relaxes)
80
Bronchioles
SNS B2 - increase airway radius PNS M3 - opposite
81
Heart
SNS B1 - increase HR, contractility, and nodal conductance PNS M2 - opposite
82
Blood vessels
SNS a1 - vasoconstrict in viscera B2 - vasodilate in skeletal muscle
83
Liver
SNS | B2 - increase glycogenolysis/gluconeogenesis
84
Pupil
SNS a1 - dilate/increase pupil radius PNS M3 - opposite (sphincter muscle)
85
Ciliary muscle
SNS B2 - relaxation for far vision PNS M3 - contraction for near vision
86
High Pressure (arterial) Baroreceptors
exposed nerve endings Carotid sinus - glossopharyngeal nerve (IX) - cerebral blood flow Aortic arch - vagus nerve (X) - systemic blood flow
87
Low Pressure (cardiopulmonary) Baroreceptors
cardiac atria and pulmonary artery A receptors - report on HR (sense atrial wall tension during contraction) B receptors - report on atrial volume (sense atrial stretch during filling)
88
Chemoreceptors
CO2 levels | located in carotid fork and aortic arch
89
Where do the baroreceptors signal?
nucleus tractus solitarius (NTS) in the CV center (in medulla oblongata)
90
Increase in baroreceptor firing rate
negative signal to Vasomotor Center (lowers SNS - controls HR and SV) positive signal to Cardioinhibitory Center (increases PNS - controls HR only)
91
Vasoactive vs nonvasoactive substances
Vasoactive - affect vascular smooth muscle cell contraction and relaxation Nonvasoactive - affects blood volume
92
serotonin
vasoconstrictor
93
histamine
vasodilator
94
vasopressin
vasoconstrictor at high conc. | increased water reabsorption
95
Increased renin
due to decreased BP | cleaves angiotensinogen to AngI
96
ACE
angiotensin converting enzyme | AngI -> AngII
97
aldosterone
increases retention of Na and water | stimulated by AngII
98
Does a change in TPR change the mean circulatory pressure?
no
99
Static exercise
Increase HR, TPR, BP, PP | Decrease SV, CO
100
Dynamic exercise
Increase HR, SV, CO, BP, PP | Decrease TPR

Physiology (6 decks)

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