CVP Unit 1 Lecture Flashcards

1
Q

Principles of cardio vascular function include__________and the balance of it.

A

Supply and demand

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2
Q

The cells demand _______and ______, the CV system must supply with the use of ______to the cells

A

O2 and nutrients Blood flow

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3
Q

Blood flow occurs when the ______exists.

A

change of pressure- 🔼p

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4
Q

Blood flow only occurs when the pressure at one point ________ that of another.

A

Exceeds

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5
Q

If pressure was the same ______ would happen

A

Nothing

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6
Q

The heart pumps and moves blood from ______pressure to _____pressure.

A

Higher pressure to lower pressure

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7
Q

The mean arterial pressure is ______to ______and coming back is close to _____

A

95 to 100 Close to zero

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8
Q

3 things that every cell needs for survival

A
  1. 02 and nutrients 2. Removal of C02 and other metabolic wastes 3. Optimal temperature
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9
Q

02 is needed for ________respiration and nutrients are needed for _______.

A

Aerobic respiration Energy building blocks

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10
Q

If metabolic wastes are not removed the system becomes more ________

A

Acidic

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11
Q

Retention of ______causes _______which leads to confusion, coma, arrythmis, muscle weakness, GI disturbances.

A

Co2 Acidosis

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12
Q

Retention of ______ causes anorexia, lethargy, decreased mental acuity and death.

A

Urea

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13
Q

Optimal temp. Is important because most enzymes work at _______ body temp.

A

98.6

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14
Q

Can demands be met with diffusion?

A

No

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15
Q

Diffusion is too _______over _____distances

A

Too slow Long

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16
Q

The main purpose of the CV system is to provide a sufficiently fast mechanism of ______and _____of gasses, nutrients, wastes by use of ______.

A

Delivery and removal Blood flow

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17
Q

Diffusion is still important at the level of?

A

Capillaries, interstitial fluid and cell membranes

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18
Q

Any organ that changes the composition of the blood for the benefit of the rest of the body

A

Blood conditioning organs

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19
Q

Blood conditioning organs include:

A
  1. Lungs 2. Kidneys 3. GI Tract 4. Skin
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20
Q

The lungs put _____into the blood and take ____out of the blood

A

02 C02

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21
Q

Kidneys filters out ______, balance _______and eliminate hormones.

A

Metabolic waste Balance pH

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22
Q

How does the the GI tract change the composition of the blood?

A

Absorptions of nutrients

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23
Q

How does the skin condition the blood?

A

The skin increases or decreases the temp of the body

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24
Q

All blood conditioning organs have 2 things in common

A
  1. They have blood flow beyond their metabolic need 2. They can tolerate substantial drops in blood flow for short periods of time.
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25
Q

These organs are NOT blood conditioning organs- (3) they are considered ________ only.

A
  1. Brain 2. Muscle 3. Heart Consumers
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26
Q

Two things that NON blood conditioning organs have in common

A
  1. Their blood flow is regulated to be at or just above metabolic need 2. Loss of blood flow to these organs could be detrimental
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27
Q

Circuits help push _____through the system

A

Blood

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28
Q

There are two circuits these two circuits are?

A

Systemic circuit Pulmonary circuit

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29
Q

This circuit starts from the left ventricle goes to the body then to the right atrium

A

Systemic circuit

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30
Q

This circuit starts from the ventricles- to the lungs then to the left atrium.

A

Pulmonary circuit

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31
Q

The systemic circuit and the pulmonary circuit are in_________with eachother

A

Series

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32
Q

The systemic circuit supplies _______ which includes organs, trunk, head, and limbs in ______circulation

A

The body Parallel circulation

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33
Q

Within the systemic circuit there are 3 places where there is ______blood supply. These organs include _______, ________and _________

A

Serial blood supply Liver, kidney and anterior pituitary

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34
Q

What is the basic flow equation and what is it called?

A

Q=🔼P/R Ohms Law

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35
Q

Q=_____ 🔼P= ________ R=________

A

Q= flow 🔼P= change in pressure R= resistance to flow

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36
Q

What is the resistance equation?

A
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37
Q

When Q is up then 🔼p is ? and R is ?

A

🔼p is up R is down When Q is up then change of pressure is up and resistance is down.

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38
Q

When Q is down, 🔼p is ?? and R is ?

A

When Q is down, pressure is down and resistance is up.

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39
Q

Blood flow from the heart is also known as ______

A

Cardiac output

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40
Q

Cardiac output is usually ______liters/ pm

A

5 liters/pm

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41
Q

The source of pressure comes from the _____action of the _____

A

Pumping action of the heart

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42
Q

The heart must keep the arterial pressure ______than the _______ for flow to occur.

A

Greater than the venous pressure

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43
Q

Resistance is due to ______that impede flow

A

Frictions

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44
Q

_________radius is the main determinant of resistance especially at ______.

A

Blood vessel radius Arterioles

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45
Q

Arterioles are responsible for majority of _____

A

Regulation

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46
Q

Initial pressure mean is at ______and final pressure is _____

A

100mmHg 0

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47
Q

Blood flows along the path of ______. Organs with _____resistance receives the most flow.

A

Least resistance Low resistance

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48
Q

More flow means?

A

Low resistance- larger vessel

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49
Q

Less flow means?

A

High resistance Small vessel

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50
Q

Requirements for effective heart function include;

A
  1. Synchronized contraction of heart muscle 2. Valves open fully 3. Valves must not leak when closed 4. Contractions must be strong 5. Ventricles must fill adequetly
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51
Q

Circulation through the left side of the heart.

A

Lungs Pulmonary veins Left atrium Mitral valve ( bicuspid, AV valve) Left ventricle Aortic valve (semi lunar valve) Aorta Body

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52
Q

Other names for the mitral valve are?

A

Bicuspid AV Valve

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53
Q

Another name for the aortic valve

A

Semi lunar valve

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54
Q

Circulation through the right side of the heart.

A

IVC and SVC Right atrium Tricuspid valve (RAV valve) Right ventricle Pulmonary valve (semilunar valve) Pulmonary arteries Lungs

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55
Q

Another name for tricuspid valve

A

RAV valve

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56
Q

Another name for pulmonary valve

A

Semi lunar valve

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57
Q

What are the functions of the left side of the heart?

A
  1. Receives blood from the lungs 2. Pumps blood to the body
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58
Q

What are the functions of the right side of the heart?

A
  1. Receives blood from the body 2. Pumps blood to the lungs
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59
Q

Characteristics of cardiac myocytes.

A
  1. Single centrally located nucleus 2. Branched fibers 3. Striated appearance 4. Intercalated discs and gap junctions connecting adjacent cells
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60
Q

Then branched fibers in myocytes help to distribute ________

A

Force

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61
Q

Myocytes contract similar to ______

A

Skeletal muscle

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62
Q

Gap junctions form ______between cells

A

Electrical synapses

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63
Q

Atrial and ventricular syncytia are separated by a _________.

A

Fibrous septum

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64
Q

The fibrous septum surrounds the openings of the _______. Action potentials are _______propagated through this septum.

A

AV valve NOT

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65
Q

Within typical action potential- resting membrane potential is _______which means the inside of the cell is more _____and the outside of the cell is more _______

A

Polarized negative Positive

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66
Q

Resting potential can range from ______to ______ milivolts

A

50 to 90

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67
Q

Regarding typical AP- ___________phase is opening of Na+ channels making the inside of the cell more ______.

A

Depolarization phase Positive

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68
Q

Regarding typical AP- Repolarization phase opens _______gated ______channels where ____moves out of the cell losing the _____charge.

A

Repolarization phase Voltage gated K+ channels K+ Positive charge

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69
Q

Regarding typical AP- ________phase undershoots and then stabalizes

A

Hyperpolarization

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70
Q

Regarding typical AP- the resting membrane only becomes polarized with the AP reaches its ______

A

Threshold

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71
Q

Cardiac muscles are different because they exhibit _____ and ______ 2 properties.

A

Automaticity Rhythmicity

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72
Q

The cell can spontaneously depolarize without stimulus, its not random, happens in a regular inherent rhythm or firing rate.

A

Automaticity

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73
Q

The cells generate their own action potential without external stimulus from nerves or chemicals.

A

Automaticity

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74
Q

The cells action potential repeat at regular intervals.

A

Rythmicity

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75
Q

This cardiac muscle has the fastest firing rate.

A

Sinoatrial node (SA node)

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76
Q

Called the pacemaker

A

SA node

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77
Q

The SA Node has connections with the rest of the conduction system through _________. It controls the rate of the _______.

A

Intercalated discs Whole heart

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78
Q

The conduction system is made of specialized cells. They have very little _____ and _____ making them contract weakly.

A

Actin and myosin

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79
Q

The conduction system coordinates the ______of the atrial and ventricular contractions.

A

Timing

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80
Q

Communication between the atria and ventricles is ONLY through the _____

A

Bundle of HIS

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81
Q

The SA node is the start of the electrical system of the heart. From the SA node the ________get the signal towards the _______ which _________the signal down. Next to fire is the ______ to the ________ which is also called the _________.

A

internodal fibers AV node Slow AV node AV bundle Bundle of HIS

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82
Q

The _______or the ___________is the only connective tissue that passes through to the other side.

A

AV bundle or the bundle of HIS

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83
Q

Phase 0

A

Depolarization- opening of the “fast” voltage gated Na+ channels

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84
Q

Phase 1

A

Initial spike, v-gated Na+ channels inactivate

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85
Q

Phase 2

A

Plateau- v-gated Ca+ channels open slowly, these are also called Ca+ Na+ channels Decrease in K+ permeability also occurs

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86
Q

Phase 3

A

Repolarization- voltage gated Ca+ channels close, voltage gated K+ channels open

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87
Q

Phase 4

A

Resting membrane potential- active transport of Na+, K+ and Ca+

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88
Q

In what way does cardiac muscle and skeletal muscle action potential work in similar ways?

A
  1. Action potentials propagate along cell membrane and into T-tubules 2. Action potentials arriving in the T-tubules cause release of Ca+ from the S.R. 3. Ca+ diffuses to troponin, tropomyosin moves to allow actin/myosin cross bridges to form causing contraction.
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89
Q

Cardiac muscle and skeletal muscle work much the same way-

A
  1. Action potential propagates along cell membrane and into T-tubules. 2. Action potential potentials arriving in the T-tubules cause release of Ca+2 from the S.R. 3. Ca+2 diffuses to troponin, tropomyosin moves to allow actin/myosin cross bridges to form causing contraction.
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90
Q

The differences between cardiac muscle and skeletal muscle are?

A
  1. Cardiac S.R. Is not well developed- less capacity to store Ca+2 2. T-tubules are 5 times bigger in diameter as compared to skeletal muscle.
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91
Q

Cardiac cells depend greatly on extracellular ______ for initiation and strength of ______

A

Ca+2 Contraction

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92
Q

Relaxation of the cell requires pumping ____back into the S.R. And out of the cell.

A

Ca+2

93
Q

The duration of cardiac contraction is equal to the duration of the cardiac ______

A

Action potential

94
Q

Why is cardiac action potential long?

A

The heart needs to contract for a length of time in order for blood to get through the system.

95
Q

Define the cardiac cycle

A

All events occurring in the heart from the beginning of one heart beat to the beginning of the next.

96
Q

Systole

A

Periods of contraction

97
Q

Diastole

A

Periods of relaxation

98
Q

What is pressure?

A

The magnitude of force exerted by a fluid on the surface, divided by the surface area. P=F/A

99
Q

Events of the cardiac cycle are:

A
  1. Systole 2. Diastole 3. Pressure changes 4. Changes in blood volume 5. Changes of electrical activity 6. Heart sounds
100
Q

______is the driving force that causes blood to flow. Fluid moves from an area of ______to area of ______

A

Pressure High pressure Low pressure

101
Q

Blood pressure is the measurement of force applied to _______

A

Artery walls

102
Q

The chambers of the heart alternate between _____and _____

A

Systole and diastole

103
Q

Systole is contraction whose purpose is to generate _____to perform the work of moving _____

A

Pressure Blood

104
Q

Diastole- relaxation is the release of _____so that the heart _____can fill with blood.

A

Pressure Chambers

105
Q

The atria function as primer pumps. ____% of the blood in the atria moves to the ventricles ______atrial systole

A

80% Before

106
Q

20% of the blood enters during atrial ______.

A

Systole

107
Q

What happens if the atrial fails to function?

A

Nothing immediately- but pooling blood causes clots

108
Q

When ventricles stop contracting what happens?

A

Death

109
Q

Regarding atrial pressure curves: the a curve represents?

A

Increase in pressure due to contraction or atrial systole

110
Q

Regarding atrial pressure curves: the c curve represents?

A

A fluctuation in pressure due to AV valve closure

111
Q

Regarding atrial pressure curves: v curve represents?

A

Increase in pressure as atrium fills

112
Q

Regarding ventricular pressure/volume curves: what are the elements of diastole?

A
  1. Isovolumic relaxation 2. Early diastole 3. Middle diastole 4. Late diastole
113
Q

Regarding diastole: what is isovolumic relaxation?

A

Valves shut and no volume change

114
Q

Regarding diastole: what is early diastole?

A

Rapid inflow

115
Q

Regarding diastole: what is middle diastole?

A

Diastasis, reduced inflow

116
Q

Regarding diastole: what is late diastole?

A

Atriole systole

117
Q

The A curve represents increase in pressure due to contractions or atrial systole. Find the a curve on the graph.

A

Add photo with A curve

118
Q

The C curve represents a fluctuation in pressure due to AV valve closure. Find the C curve on the graph Photo of graph

A

Photo of graph with c curve

119
Q

The V curve represents increase in pressure as atrium fills. Find the V curve on the graph Add photo of graph

A

Add photo of graph with v curve

120
Q

Find diastole on the graph

A

Add photo of graph

121
Q

Find systole on the graph

A
122
Q

The volume of blood in the end of systole is called?

A

End diastolic volume

123
Q

The volume of blood in the end of systole is called?

A

End- systolic volume

124
Q

The amount of blood ejected with one ventricular beat is called?

A

Stroke volume EDV-ESV

125
Q

The percentage of end diastolic volume ejection- usually 60%

A

Ejection fraction SV/EDVx100

126
Q

The amount of blood with one beat, liters per minute

A

Cardiac output CO=SVxHR (usually up to 180)

127
Q

The atrioventricular valves include?

A

Bicuspid or Mitral or left AV valve AND Tricuspid or right AV valve

128
Q

The atrioventricular valves close when _________pressure is ________than _______pressure

A

Ventricular pressure is greater than atrial pressure

129
Q

The atrioventricular valves open when _______pressure is _______than _______pressure.

A

Atrial pressure greater than ventricular pressure

130
Q

_______ and ________prevents prolapse into the _____

A

Chordae tendineae and papillary muscles Atria

131
Q

Semilunar valves include?

A

Aortic and pulmonic

132
Q

The semilunar valves open when the _______pressure is _______in the ________pressure.

A

Ventricular pressure Greater Aortic/ pulmonic

133
Q

The semilunar valves close when _______pressure is ______then the ________pressure

A

Aortic/pulmonic Greater Ventricular pressure

134
Q

The semilunar valves act like ______. They have NO ______

A

A cusp No chordae tendinea

135
Q

The aortic pressure curve includes?

A

Systole Incisura Diastole

136
Q

Where is the aortic pressure curve on the graph? Add photo

A

Add photo

137
Q

Regarding the aortic pressure curve- the curve ______during systole with _______contraction.

A

Rises Ventricular (120mmHg)

138
Q

Regarding aortic pressure curve incisura is also the ________ caused from pressure _______due to the _____of the ______valve.

A

Dicrotic notch Fluctuation Closing Aortic

139
Q

Regarding aortic pressure curve, falls to _____only are due to _______of the aorta

A

80mmHg Elastic recoil

140
Q

Heart sounds can be hear using a?

A

Stethoscope

141
Q

Heart sounds are recorded using a?

A

Phonocardiogram

142
Q

The heart sound, closure of the AV valves is sound ____.

A

Sound 1

143
Q

Heart sound, closure of the semilunar valves.

A

Sound 2

144
Q

Heart sound, due to filling of ventricles in mid diastole- can be heard in young person, is the sound of ventricles at most full state- high pitch

A

Sound 3

145
Q

Heart sound can only be heard by phonocardiogram and is due to atrial systole- its is very quite.

A

Sound 4

146
Q

Find the electrocardiogram on the graph.

A
147
Q

This wave initiated by the SA node and represents atrial depolarization

A

P wave

148
Q

This wave just precedes atrial systole

A

P wave

149
Q

This represents ventricular depolarization and precedes ventricular systole Add photo

A

QRS complex

150
Q

This represents ventricular repolarization and precedes ventricular diastole. Add photo

A

T wave Add photo

151
Q

This is the amount of energy that the heart converts to work during each heart beat.

A

Work output

152
Q

The heart moves blood from veins to arteries- this is most of the work done.

A

External work or EW

153
Q

The heart accelerates blood into the great arteries- this is minor fraction of work heart does.

A

Kinetic energy of blood flow

154
Q

What are the 4 factors that influence the strength of contraction?

A
  1. Preload 2. Afterload 3. Contractility 4. Heart rate
155
Q

________ is the end diastolic pressure in the ventricle, or length muscle is stretched before contraction.

A

Preload

156
Q

_______forces against which cardiac muscle must overcome and includes arterial pressure, resistance to flow

A

Afterload

157
Q

____is considered a ______ state, modification of strength independent of loading changes. This occurs at the ______ level and includes effects of ________ and hormones.

A

Contractility Ionotropic state Cellular level ANS

158
Q

________indirectly increases the contractility of the heart due to the accumulation of ______

A

Heart rate Ca+

159
Q

The greater the heart muscle is stretch during filling due to greater preload, the greater the force of contraction and the greater the quantity of blood pumped into the aorta.

A

Frank starlings mechanism

160
Q

Cardiac muscle sarcomere are naturally short and resist stretch more than skeletal muscle. Increase the length increases number of functional cross bridges between actin and myosin, therefore greater force of contraction. This concept is?

A

Length tension relationship

161
Q

Increase of heart rate by 10-20%

A

Right atrial stretch

162
Q

This regulation of the heart comes from the outside the heart

A

Extrinsic regulation

163
Q

Innervation of the heart by the autonomic nervous system is considered?

A

Extrinsic regulation

164
Q

Increases the heart rate, increases the force of contraction- this is done by the_______ it also derives from the ______chain

A

Sympathetic- fight or flight Sympathetic chain

165
Q

Decreases the heart rate, weakly decreases force of contraction. This is done by_____. It also derives from the ________nerve.

A

Parasympathetic- rest and digest Vagus nerve

166
Q

Other influences on heart function include ______ _______and _______/

A

Hyperkalemia Hypercalcemia Fever

167
Q

Too much potassium ions cause ______ which cause _____ contractions, ______heart rate and ______rhythms and potentially death

A

Hyperkalemia Weak Slow Abnormal

168
Q

Too much calcium ions causes ________ which causes _________

A

Hypercalcemia Spastic contractions

169
Q

The ______is the natural pacemaker.

A

SA node- Sinus node

170
Q

The sinus node is located in the _______ of the right _____.

A

Superior posterolateral RA

171
Q

The SA node supercedes and over rides all other muscles in the heart. It has a self-excitation and an _________ making it the _________rate of all cardiac tissue.

A

Inherent rhythmicity Fastest rate

172
Q

The SA node fast rate is attributed to a sodium _____ which produces a higher ______.

A

Sodium lead Higher resting membrane potential

173
Q

The SA node is connected to the ______muscle and the _________fibers

A

Atrial muscle and internodal fibers

174
Q

Steps of the conduction system are:

A
  1. SA node has AP 2. AP signal sent to internodal fibers 3. AV node receives AP signal- 4. AV node slows signal down and sends to the Bundle of HIS os the AV bundle 5. These fibers penetrate the fibrous septum to come out the other side. 6. Signal sent to purkinje fibers- to the rest of the heart
175
Q

Fibers from the AV node through the AV bundle (bundle of HIS) through the left and right bundle branches- then throughout the ventricular muscles describes the____________

A

The purkinje system

176
Q

This fibers have very fast conduction velocities.

A

Purkinje system

177
Q

This signal is moderately fast within the conductive velocities.

A

SA node to AV node

178
Q

The conduction velocity from _____node to _______is slow.

A

AV node to bundle of HIS

179
Q

The conduction velocity from bundle to ventricular muscle is _______

A

Very fast

180
Q

_______is not the same thing as firing rate

A

Conduction velocity

181
Q

The fastest to slowest inherent firing rates are?

A
  1. SA node 2. AV node 3. Purkinje system
182
Q

In order for electrodes to record voltage change you need how many electrodes?

A

You need two One is reference (-) And one is recording (+)

183
Q

These recordings only show amplitude of voltage changes as recorded at a point in a cell. Only one parameter- up and down.

A

Monophasic- action potential recordings

184
Q

This records both amplitude and direction of waves of voltage changes through heart muscle. In other works it is a vector quantity.

A

Biphasic- ECG recordings

185
Q

Vector is defined as _________and _______ and amount of _______change.

A

Amplitude and direction and amount of voltage change

186
Q

P wave is________. Show on graph. Add photo

A

Add photo Atrial depolarization

187
Q

QRS was is _________. Find on graph. Add photo

A

Add photo Ventricular depoarization

188
Q

T wave is ________. Find on graph Add photo

A

Add photo and definition of t wave

189
Q

P-R interval is _________sec. This is the amount of time that passes from the begining of the _____wave to the next _____wave Find on the graph

A

0.16 sec P wave P wave add photo

190
Q

RR interval is the time elapses from the _____was to the next ______wave.

A

QRS wave QRS wave

191
Q

Q-T interval is the ____to the _____wave- this is all the electrical activity by the _______

A

QRS T wave Ventricles

192
Q

This line represents zero

A

Isoelectric line

193
Q

ST segment should be on the _______ line. If it is not it could indicate _____or ______

A

Isoelectric line Eschemia Heartattack

194
Q

Regarding vector rule for depolarization: A wave of depolarization moving towards a positive electrode records a _________ deflection.

A

Positive

195
Q

Regarding vector rules for depolarization: A wave of depolarization moving away from a positive electrode records a ______deflection.

A

Negative

196
Q

Regarding vector rules for depolarization: A wave of repolarization moving towards a positive electrode records a ________ deflection

A

Negative

197
Q

Regarding vector rules for repolarization: A wave of repolarization moving away from a positive electrode records a _____ deflection.

A

Positive

198
Q

What would happen if a wave of depolarization or repolarization was moving at a right angle to both electrodes?

A

Nothing it would not be seen- no deflection

199
Q

What would happen if a wave of depolarization was moving at an oblique angle to the electrodes?

A

The deflection would be very very small

200
Q

Electrodes are placed on the surface of the body to detect waves of depolarization and repolarization throughout the heart tissue.

A

Electrocardiogram

201
Q

How many electrodes and leads are needed?

A

10 electrodes 12 leads

202
Q

From machine to skin wire

A

Electrode

203
Q

Electrodes make a tracing

A

Lead

204
Q

Standard leads are ?

A

Lead I

Lead 2

Lead 3

205
Q

Unipolar leads are?

A

AVR, AVL and AVF

206
Q

+ end on Left wrist

  • end on right wrist
A

Lead I

207
Q

+ end on Left ankle

  • end on Right wrist
A

lead II

208
Q

+ end on Left ankle

  • end on Left wrist
A
209
Q
A

Einhovens triangle

all leads go towards positive deflection

210
Q

II= I+III

in regards to the amplitude of the R wave

A

Einthovens law

211
Q

What does AV stand for in the augmented uinpolar limb leads?

A

Augmented voltage

212
Q

The last letter after the AV tell you which end of the lead is_______

A

Positive

213
Q

+ rt wrist

  • left ankle/ left wrist
A

AVR

214
Q

+ Left wrist

  • left ankle/ right wrist
A

AVL

215
Q

+ left ankle

  • left wrist/ right wrist
A

AVF

216
Q

The left ankle and left wrist is always the ______electrode in augmented unipolar limb leads.

A

Reference

217
Q

Regarding precordial chest leads- V1 is placed where?

A

4th ICS to the right of the sternum

218
Q

V2 is placed ?

A

4th ICS to the left of the sternum

219
Q

V3 is placed?

A

Between V2 and V4

220
Q

V4 is placed?

A

5th ICS- left midclavicular line

221
Q

V5 is placed?

A

5th ICS, left anterior axillary line

222
Q

V6 is placed?

A

5th ICS- left mid-axillary line

223
Q

ECG interpretation- Mean vector pertains to action potential which spreads out like a fan and a mean average is calculated called the ________ wave

A

P wave

224
Q

The direction and pattern of depolarization of the atria and ventricles

A

P-wave

225
Q

Atrial repolarization is not seen on a normal ECG is is obscured by QRS complex. It is called?

A

Atrial T

226
Q

Septal activation is the ______ wave

A

Q wave

227
Q

Apical activation is called ______peak and is the most ________ peak

A

R peak

significant

228
Q

Left ventricle activation is the ________

A

R wave return

229
Q

Late left ventricular activation is called _______

A