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3 Cardiopulmonary > CV Physiology > Flashcards

CV Physiology Flashcards

1
Q

Systemic circulation

A

path of oxygen rich blood from LV through aorta, pumped to all organ systems, back to heart (RA)

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2
Q

Pulmonary circulation

A

path of partially oxygen-depleted blood from RV through lungs and back to the heart (LA)

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3
Q

Semilunar valves

A

origin of pulmonary artery and aorta

one-way valves that open during systole to allow blood to enter pulmonary and systemic circulations

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4
Q

Atrioventricular valves

A

atria and ventricles are separated into 2 functional units by connective tissue and by AV valves

tricuspid and mitral valves
one-way valves that open during diastole to allow blood into ventricles

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5
Q

Valves…

A

prevent backflow of blood
what opens a valve is a difference in pressure

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6
Q

Cardiac Cycle

A

repeating pattern of contraction and relaxation of the heart

includes all mechanical and electrical events of the heart

divided into 5 phases

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7
Q

Systole

A

contraction phase

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8
Q

Diastole

A

relaxation phase

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9
Q

Phases of Cardiac Cycle

A
  1. atrial systole
  2. isovolumetric contraction
  3. ejection
  4. isovolumetric relaxation
  5. rapid inflow and diastasis
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10
Q

Phase 1 Cardiac Cycle

A

Atrial Systole

  1. Mitral valve is already open, ventricle has been filling with blood before atrial contraction
  2. P wave, atrial depolarization
  3. Atrial contraction pushes 10-20% more blood into ventricle
  4. S4 sound, always abnormal, vibration sound
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11
Q

Phase 2 Cardiac Cycle

A

Isovolumetric ventricular contraction

  1. QRS complex, ventricular depolarization
  2. contraction of ventricles causes ventricular pressure to rise
  3. S1 sound: LUB
  4. Ventricular P > atrial P, so AV valves closes
  5. EDV
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12
Q

Isovolumetric

A
  1. ventricles are not filling with blood because AV valves closed
  2. ventricles are not ejecting blood because ventricular pressure is less than aortic pressure, so semilunar valves are still closed

occurs during phase 2

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13
Q

End-diastolic volume

A

volume of blood in ventricle before ejection
about 120 mL

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14
Q

Phase 3 of Cardiac Cycle

A

Ejection

  1. Contraction of ventricles causes ventricular pressure to rise above aortic pressure
  2. Ventricular pressure > atrial pressure, AV valves are closed
  3. Ventricular repolarization (T wave)
  4. Stroke volume is about 80 mL
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15
Q

T wave

A

ventricular reploarization
LV pressure starts to fall

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16
Q

Stroke volume

A

volume of blood ejected during one contraction
resting SV = 80 mL

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17
Q

Phase 4 of Cardiac Cycle

A

Isovolumetric ventricular relaxation

  1. ventricles are fully repolarized and relaxed
  2. ventricular pressure falls below aortic pressure, AV closes
  3. S2 sound–DUB
  4. ESV–volume of blood in ventricles is constant
  5. phase lasts until pressure in ventricles falls to pressure in atria
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18
Q

Phase 5 Cardiac Cycle

A

Rapid inflow and diastasis

  1. ventricular pressure < atrial pressure, which opens AV valves
  2. ventricular pressure is low, chamber is relaxed
  3. Rapid ventricular filling occurs (S3 sounds)
  4. cycle returns to phase 1, with active rapid filling

longest phase of cardiac cycle

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19
Q

Diastasis

A

reduced ventricular filling and longest phase of cardiac cycle

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20
Q

S3 sound…

A

sometimes normal in <40 yrs
abnormal leads to heart failure

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21
Q

Left ventricular pressure volume loop

A

1–> 2 Isovolumetric contraction
2–> 3 ventricular ejection
3–>4 isovolumetric relaxation
4–>1 ventricular filling

22
Q

Isovolumetric contraction…

A

pressure increases
all valves closed
ventricular volume remains constant

23
Q

Ventricular Ejection

A

aortic valve opens
pressure remains high
volume decreases to 70 mL

24
Q

Isovolumetric relaxation

A

Ventricle relaxes
aortic valve closes
volume remains constant at 70 mL

25
Q

Ventricular filling

A

pressure rises
mitral valve opens
volume increases

26
Q

Preload

A

end-diastolic volume (EDV)

27
Q

Ejection fraction

A

portion of blood pumped out of ventricle with each contraction (SV/EDV), often expressed as a percentage

healthy/normal = 55-70%
systolic heart failure <40%

28
Q

Afterload

A

pressure against which the heart has to work to eject blood
strictly speaking = aortic pressure
more broadly = systemic BP

29
Q

Contractility

A

intrinsic ability of myocardial cells to develop force

30
Q

Increased preload

A
31
Q

Increased afterload

A
32
Q

Increased Contractility

A
33
Q

S1 Sounds

A

Closing of AV valves when ventricles contract at systole
LUB sounds
mitral and tricuspid

34
Q

S2 Sounds

A

Closing of semilunar valves when ventricles relax at diastole, sometimes can be split during breathing
DUB sounds
aortic and pulmonic

35
Q

Heart murmurs

A

abnormal heart sounds produced by abnormal patters of blood flow in heart

caused by turbulent blood flow–> defective heart valves and septal defects

36
Q

Defective heart valves

A

causes murmur
stenotic = valves do not open fully
Regurgitant/insufficient/incompetent = valves do not close tightly

37
Q

Causes of incompetent heart valves

A

Congenital
Damage by antibodies (rheumatic endocarditis)
damage to papillary muscles

38
Q

Septal Defects

A

holes in the septum between left and right sides of heart

  1. usually congenital
  2. can occur in either septa, blood goes from left to right
  3. result is increased blood and pressure on right side of heart, leading to pulmonary HTN and edema
39
Q

Cardiac muscles

A

myocardial cells are striated, actin/myosin are arranged in sarcomeres, short, branched, interconnected cells. Have gap junctions

cardiac muscle can produce action potentials spontaneously

40
Q

Gap junctions

A

each cell is joined to adjacent cell by electrical synpase
helps depolarization to spread quickly

41
Q

Functional Synctium

A

adjacent cardiac muscle cells are all connected

results in myocardium behaves like a single, large muscle cell

no graded contractions like those in skeletal muscle, electrical impulses spreads to all cells

42
Q

How can myocardial contractility be increased?

A

increased EDV/frank-starling mechanism
epinephrine/norepinephrine (increases Ca)

43
Q

Types of heart cells

A

Contractile cells
conducting/automatic cells

44
Q

Contractile cells

A

produce the force of contraction
the pump

45
Q

Conducting/automatic cells

A

contribute little to no force generation in heart
include SA node, AV node, bundle of His, purkinje fibers

46
Q

Depolarization

A

occurs when there is a net movement of positive ions into the cell (inward current)

47
Q

Hyperpolarization

A

occurs when there is a net movement of positive ions out of the cell (outward current)

48
Q

Mechanisms that can produce in membrane potential

A

change in driving force for a permeant ion
opening and closing of ion channels

49
Q

Automaticity

A

automatic nature of the heartbeat

50
Q

Sinoatrial node

A

group of myocardial cells in RA
demonstrate spontaneous depolarization
functions as pacemaker, has fastest firing rate
don’t maintain stable resting membrane potential

SA nodes initiate the SINUS rhythm

3 Cardiopulmonary (9 decks)

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