Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Comprehensive Exam > Physiology > Flashcards

Physiology Flashcards

(252 cards)

Start Studying
1
Q

Tissues layers in Heart

A

endocardium - inner lining of chamber

epicardium - outer lining of chambers

pericardiu, - surrounds entire heart (composed of visceral and parietal layer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Papillary muscules

A

attach to AV valves via chordae tendinae

  • do not help close the valves
  • help in prevevnting regurgitation into atria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

mitral valve closes at the beginning of ______

A

isovolumetric contraction

(ventricular systole)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Intracellular [K+]

A

140

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Extracellular [K+]

A

4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Nersnt equilibrium potential of K and Na

A

K+ = -90

Na+ = +70

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Intracellular [Na+]

A

10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Extracellular [Na+]

A

140

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Na+-K+-ATPase pump

A

maintains negative potential

3 Na out for 2 K in

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Na+-H+ exchanger

A

regulates intracellular pH

H+ out and Na+ in

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Cardiac Action Potential

[phase 0]

A

activation of fast Na+ channels (iNa)

  • increases membrane conductance 100x
  • generates inward current
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Cardiac Action Potential

[phase 1]

A

inactivation of iNa and activation of transient outward K current (iTO)

  • decreases membrane potential which favors Ca2+ entry
  • influences plateau length
    • more K efflux = shorter plateau phase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Cardiac Action Potential

[phase 2]

A

opening of L-type Ca2+ channels (iCa-L) and Na-Ca exchanger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Cardiac Action Potential

[phase 3]

A

opening of delayed rectifier K (iKV)

  • increased K+ conductance
  • size of current determines plateau duration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Cardiac Action Potential

[phase 4]

A

“pacemaker potential”

  • small Na+ current (ib) and inward rectifier (Kir)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

inward rectifier K+ channel (iK1)

A

maintains high K+ permeability during phase 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

fast Na+ voltage channel

A

accounts for phase 0

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

L-type Ca2+ channel

A

responsible for phase 2

  • enhanced by sympathetic stimulation and Beta agonists
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Ca-ATPase

A

sequesters calcium back into SR

  • regulated by phospholamban (inhibitor)
  • catecholamines decrease inhibitor effect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

absolute refractory period

[during which phases]

A

0, 1, 2, and 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

chronic heart failure

[ion channels]

A

decreased K+ (iTO) expression

  • delays repolarization, prolongs plateau, and arryhthmogenic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Long QT syndrome

[ion channel]

A

abnormality of delayed rectifier channel (iK)

  • prolongs plateau and results in Ca2+ overload after depolarization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Early After Depolarizations

A

secondary depolarizations that occur before the end of phase 3

  • increased frequency with slow heart rate
  • may lead to Torsades de pointes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Purkinje cells

[beats per minute]

A

15

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
AV node [beats per minute]
50 - 60
26
SA node [beats per minute]
70 - 80
27
Pacemaker Action Potential [which phases are not involved?]
pacemaker action potentials do not include phase 1 and 2
28
chronotropy
increase heart rate
29
dromotropy
increase AV node conduction
30
inotropy
increased contractility
31
lusitropy
increased rate of myocyte relaxation
32
Phosphodiesterase Inhibitors [effects]
inotropy and chronotropy
33
Phosphodiesterase Inhibitor [examples]
caffeine, theophylline, milrinone, and amrinone
34
Muscarinc M1 Receptor [location]
cortex and hippocampus
35
Muscarinic M2 Receptors [location]
heart
36
Muscarinic M3 Receptors
exocrine glands and GI tract
37
Muscarinic M4 Receptor [location]
neostriatum
38
Muscarinic M5 Receptor [location]
substantia nigra
39
Hypocalcemia [effects]
prolonged QT interval * possible result is EAD and torsades
40
Hypocalcemia [possible causes]
loop diuretics osteomalacia hypoparathyroid respiratory alkalosis
41
Hypercalcemia [effects]
shortens QT interval
42
Hypercalcemia [causes]
adrenal insufficiency hyperparathyroid kidney failure malignancy
43
Hyperkalemia [effects]
wide QRS and peaked T waves * hyperkalemia decreases equilibrium potential and closes Na+-voltage channels * wide QRS * enhanced K+ channel activity * peaked T-waves
44
Hyperkalemia [causes]
potassium-sparing diuretics ACE inhibitors metabolic acidosis MH blood transfusions
45
Hypokalemia [effects]
wide QRS with U-wave * reduces K+ channel activity * prolongs plateau and repolarization
46
Temperature's effect on HR
Hyperthermia: increase 10 bpm per 1oC Hypothermia: conduction slows and ST segment elevates; J or Osnorne wave
47
Ivabradine
funny channel blocker (if) * decreases rate of pacemaker decay * decreases HR
48
Adenosine
activates A-1 Receptors * slows AV conduction and slows HR
49
Bainbridge Reflex
increased CVP → stretch and increased HR * detected by baroreceptors
50
Spontaneous Ventilation effect on HR
**Inhalation**: decreases intrathoracic pressure and increases venous return (_increases HR_) via bainbridge reflex **Exhalation**: increased pressure activates baroreceptor reflex to _decrease HR_
51
Beta-Blocker [overdose treatment]
glucagon
52
cardiac myocytes resting membrane potential
about -90 mV
53
p-wave [electrical event]
altrial repolarization
54
PR interval [electrical event]
delay of conduction by the AV node
55
T-wave [electrical event]
ventricular repolarization phase 3
56
QT interval [electrical event]
ventricle depolarization and repolarization
57
Bazett's Formula
QTc = QT/sqrt(RR)
58
p-wave [normal time]
0.08 - 0.12
59
PR interval [normal time]
0.12 - 0.20
60
QRS complex [normal time]
0.06 - 0.11
61
Horizontal plane leads
V1 - V6 * view across horizontal plane * each lead is positive
62
Bipolar leads
Lead I - III
63
Unipolar leads
aVr, aVL, aVf * amplify the voltage of waves in Leads I - III
64
V1 [location]
right side of sternum 4th intercostal
65
V2 [location]
left side of sternum 4th intercostal
66
V4 [location]
left midclavicular line 5th intercostal
67
V5 [location]
left anterior axillary 5th intercostal
68
V6 [location]
left mid-axillary line 5th intercostal
69
which leads correspond to the high lateral wall?
Leads I and aVL
70
which leads correspond to the inferior wall?
Leads II, III and aVF
71
which leads correspond to the septal wall?
Leads V1 and V2
72
which leads correspond to the anterior wall?
Leads V3 and V4
73
which leads correspond to the lateral wall?
Leads V5 and V6
74
Junctional Rhythm [heart rate]
40 - 60 bpm
75
Ventricular Escape Rhythm
20 - 40 bpm * esentially regular
76
(3) mechanisms associated with tachy-arrhythmias
enhanced automaticity triggered automaticity re-entry
77
QT interval [normal time]
0.45 in men and 0.46 in women
78
normal heart axis
-30o to +90o
79
[axis of heart] If QRS is positive in Lead I and aVF
normal
80
[axis of heart] If QRS is negative in Lead I, but positive in aVF
right axis deviation
81
[axis of heart] If QRS is positive in Lead I, but negative in aVF
LAD
82
sinus node [location]
lateral edge of right atrium
83
First degree heart block
prolonged PR interval | (greater than 0.2 seconds)
84
Second Degree - Type I
progressive prolongation of the PR interval followed by a droped QRS
85
Second Degree - Type II
dropped QRS **_not_** preceded by PR prolongation
86
Third Degree Heart block
atria and ventricular rhythms are independent * no impulses are transmitted through the AV node
87
Right Bundle Branch Block
due to myocardial infarction of the Purkinje system * rabbit ears on V1
88
Tri-fascicular Block
first degree AV block RBBB and LAFB or LPFB
89
Atrial Fibrillation
loss of synchrony during excitation and resing phases * ventricular irregularly irregular rhythm * greater than 300 bpm
90
Atrial Flutter
re-entry circuit in the right atrium * 240-340 bpm
91
Wolf Parkinson White
accessory pathway (bundle of Kent) * contains delta wave and short PR interval
92
Bowditch Effect
increased HR causes increased contractility * due to increase SR calcium store
93
Extracellular [composition]
3L of plasma and 12L interstitial fluid
94
"conduit vessels"
arteries
95
"resistance vessels"
arterioles
96
"exchange vessels"
capillaries
97
"capacitance vessels"
veins
98
which electrolytes are higher interstitially?
Na+ and Ca2+
99
which electrolyte is higher intracellularly?
K+
100
Heart sounds [S1]
begining of systole due to AV valve closure * best heart at apex * during isovolumetric contraction
101
Heart Sounds {S2]
closing of semilunar valves beginning at diastole * isovolumetric relaxation after T-wave * inspiration will "split" sound
102
Heart Sounds [S3]
ventricular gallop * occurs after S2 * rush of blood into ventricles during diastole
103
Heart Sounds [S4]
atrial gallop * atrial contraction and rapid filling * often indicates ventricular diastole stiffness
104
dicrotic notch
closure of aortic valve
105
Fick's Equation [in relation to Cardiac Output]
Q = (total O2 consumption rate) / ([arterial O2] - [venous O2])
106
Ejection Fraction [equation]
stroke volume / EDV
107
Right coronary artery [branches into _____ and \_\_\_\_\_)
posterior descending and right marginal
108
left coronary artery [branches into _____ and \_\_\_\_\_)
left anterior descending and circumflex
109
Thebesian vein
empties venous blood into the oxygenated blood of the left atrium
110
(3) veins that empty directly into chambers
arteriosinusoidal, anterioluminal, and thebesian
111
Diastolic pressure [definition/event]
pressure once the semilunar valves are closed and the ventricle is filling
112
Contractile elements of the myocye
actin = thin filaments myosin = thick calcium binds to sites on actin, revealing a binding site that allows myosin head to attach
113
Tunica adventitia
connective tissue of blood vessel * contains vaso vasorum
114
tunica media
smooth muscle fibers and elastic lamina
115
tunica interna
single layer of squamous epithelium
116
Vaso Vasorum
network of small blood vessels that supply the walls of large blood vessels (aorta and vena cava)
117
how much blood volume is contained within the venous system?
65%
118
119
aorta [cross sectional area]
2.5 cm2
120
largest external vein
great saphenous
121
what vessel is responsible for draining the majority of blood from the brain?
internal jugular
122
TCVC
Tunneled Central Venous Catheter
123
Tunneled Central Venous Catheter
Hickman or Broviac * used for drawing blood, chemotherapy, IV fluids, blood transfusions, or IV nutrition
124
Port-a-Cath
plastic or metal port under the skin which is connected to a central line * used for chemotherapy or IV treatments
125
Permacath
hemodialysis catheter
126
Greenfield Filter
placed in femoral vein and floated into inferior vena cava which prevents emboli from entering the heart
127
(3) plasma proteins produced by the liver
albumin, globulin, and fibrinogen
128
Diffusion coefficient for O2
0.0031
129
diffusion coefficient for CO2
0.0642
130
red blood cell [life span]
120 days
131
(6) types of anemia
* hemorrhagic * pernicous * folate-deficiency * iron-deficiency * hemolytic * aplastic
132
Osmotic Pressure [definition]
across _cell_ membranes due to _ion concentrations_
133
Oncotic Pressure [definition]
across _capillary_ membranes due to _large protein molecules_
134
Granulocytes [types]
neutrophils, eosinophils, and basophils
135
Basophils
essentially mast cells | (histamine)
136
which leukocyte participates in fibrin degredation?
neutrophils
137
Prothrombin Time [test]
time to clot after adding thromboplastin and Ca2+
138
blood product to reverse warfarin therapy
fresh frozen plasma
139
Cholinergic Receptors [Types]
nicotinic and muscarinic
140
which type of choinergic receptor involves a G-protein cascade?
muscarinic
141
parasympathetic effect on the conduction system
causes hyperpolarization and therefore longer to reach threshold
142
murmur type [systolic ejection]
aortic stenosis
143
murmur type [pan-systolic]
mitral regurgitation
144
murmur type [late systolic with click]
mitral prolapse
145
murmur type [early diastolic decrescendo]
aortic regurgitation
146
murmur type [mid diastolic decresendo-crescendo]
mitral stenosis
147
murmur type [continuous]
patent ductus arteriosus
148
what two factors affect the **size** of a pressure-volume loop?
volume and resistance to ejection
149
what (2) factors affect the **shape** of the pressure-volume loop
contractility and compliance
150
mean circulatory filling pressure [definition]
force exerted on blood by elastic blood vessels * when MCRP = right atrial pressure, venous return stops
151
elderly patients generally have an _____ systolic pressure
over-estimated
152
Central venous pressure [normal value]
1 - 7 mmHg
153
(2) organs where consumption is greater than distribution of cardiac output
heart and brain
154
(2) organs where distribution of CO is greater than consumption
skin and kidneys
155
myogenic response
stretch induces depolarization and opens smooth muscle Ca2+ channels leads to vasoconstriction
156
Endothelin [effects]
vasoconstriction * released by shearing forces and Angtiotensin II
157
(4) main influences on vensou return
sympathetic stimulation posture skeletal muscle pump ventilation
158
lymphatic system [pathway]
lymph capillaries collecting lymphatics afferent lymphatics lymph nodes cysterna chyli Thoracic duct SCV
159
How does the heart compensate for an increase in oxygen demand?
increasing blood flow
160
the hepatic portal vein produces \_\_\_\_% of the liver's blood
70%
161
chemoreceptor location
carotid **body** and aortic arch
162
baroreceptor location
carotid **sinus** and aorti arch
163
Baroreceptor Reflex
baroreceptors sense an increased MAP afferent signals to medulla medulla inhibits SNS and promotes PNS
164
which two hormones are activated by changes in blood pressure by the SNS?
vasopressin and aldosterone
165
Cushing Reflex
increased contractility, bradycardia, irregular breathing, and MAP from activating SVS _due to cerebral ischemia caused by increased ICP_
166
aortic and carotid body chemoreceptors [sense]
hypoxia, hypercarbia, and acidosis
167
effets of aortic and carotid body chemoreceptors
increase in ventilation vasoconstriction of splanchnic and skeletal muscle tachycardia
168
Brachiocephalic artery [a.k.a.]
innominate
169
which layer of a blood vessel secretes vasoactive agents?
intima
170
systemic resistance [mmHg/mL/min]
0.02
171
pulmonary resistance [mmJg/mL/min]
0.003
172
CVP waveform [a wave]
atrial systole
173
CVP waveform [c wave]
bulging of tricuspid valve
174
CVP waveform [v wave]
passive filling of the atria
175
CVP waveform [x descent]
atrial relaxation
176
CVP waveform [y descent]
AV valve opens
177
What is the effect of hyperkalemia on the resting membrane potential
will decrease concentration gradient closer to threshold
178
KATP channels
open during ischemia shortens plateau phase causing less contraciton to decrease the work of the heart and decrease O2 consumption
179
Digitalis [negative effects]
inhibits Na-K pump causing a buildup of Na intracellularly * causes Ca to accumulate inside the cell * higher resting membrane potential * slower rise of phase 0 * shorter refractory period
180
where in the conduction pathway is the fastest transmission?
purkinje fibers
181
what is more tonically active in the heart, SNS or PNS?
PNS
182
describe the cascade following activation of PNS M2 receptor
Gi activated which inihibits adenylene cyclase hyperpolarizes cell membrane by opening KAch
183
which electrolyte imbalance will cause peaked T-waves
hyperkalemia
184
which electrolyte abnormality will cause U-waves to appear
hypokalemia
185
how much time does each square represent on an EKG?
0.2 seconds for each large square | (0.5 mV on y-axis)
186
what may cause a left axis deviation?
laying down, deep exhalation, and diaphragm displacement
187
(6) factors that increase Preload
* ventricular failure * _decreased_ heart rate * increased afterload * _decreased_ inflow resistance * increaed CVP * increased ventricular compliance * increased atrial contractility
188
Glycocalyx
thin layer of negatively charged albumin molecules that determine overall permeability
189
What are the endothelium channels responsible for the increase in intracellular Ca2+
receptor operated channels (ROC) store operated channels (SOC) KCa channels
190
KCa channels
potassium channels activated by Ca2+ to hyperpolarize the membrane and allowing more calcium to enter
191
how does nitric oxide cause vasodilation
activates cGMP through guanylyl cyclase high [NO] directly activates BKCa channels of vascular myocyte causing hyperpolarization
192
main difference between capillary and cell membranes
cell membrane is not permeable to electrolytes
193
normal body osmolarity
280
194
D5W osmolarity
252
195
LR osmolarity
273 | (closes to normal body osmolarity)
196
hetastarch osmolarity
310
197
normal saline osmolarity
308
198
albumin osmolarity
330
199
hyperosmolar will draw fluid _____ intracellular space
out
200
Albumin [risks]
anaphylactoid reaction HIV and hepatitis Creutzfeldt-Jakob
201
cardiac cell refractory period is determined by the reactivation of which ion channel
Sodium
202
Calcium conductance is highest during which phase of the cardiac action potential in ventricular muscle?
phase 2
203
Stimulation of the adrenergic receptors on the pacemaker cells of the heart increases in the membrane conductance to:
calcium
204
Conduction velocity is the slowest in the heart through the \_\_\_\_\_
AV node
205
stimulation of the vagus nerve causes \_\_\_\_\_
an increased resting potential | (hyperpolarizes)
206
the precordial leads are \_\_\_\_\_
leads V1 - V6
207
T-wave on an EKG represents
ventricular repolarization
208
Effects of hypokalemia on EKG
U-wave reduces K permeability flattening of T-wave
209
how is the QRS affected in a bundle branch block
prolonged
210
A decrease in contractility will shift the Starling's curve to the \_\_\_\_\_
right
211
Y-axis variables on the Starling curve
contractile force ventricular systolic pressure stroke volume stroke work
212
\_\_\_\_\_ begins when the mitral valve opens
rapid ventricular filling
213
\_\_\_\_ ends with the highest left atrial pressure [cardiac cycle event]
isovolumetric relaxation
214
the R wave of the ECG coincides with the beginning of \_\_\_\_\_
isovolumetric contraction
215
the period with the greatest rise in left ventricular pressure
isovolumetric contraction
216
the fourth heart sound occurs in this period
atrial systole
217
arterial compliance _____ with age
decreases
218
In an individual with constant CO and total peripheral resistance, an increase in arterial compliance will _____ pulse pressure
decrease
219
A B2 adrenoceptor antagonist would block which of the following events mediated by norepinephrine?
bronchiole relaxation
220
end organs innervated by post-ganglionic parasympathetic fibers have _____ receptors
M
221
resistance vessels have more _____ than similar sized capacitance vessels
smooth muscle
222
In fast response cardiac action potentials, iK1 turns off during _____ and is reactivated during \_\_\_\_
phase 0 reactivated during phase 3
223
post-repolarization refractoriness is due to slow recovery of \_\_\_\_\_
calcium channels causes a protective effect in a-fib
224
a drug which decreases heart rate could do so by decreasing \_\_\_\_\_
iF
225
cardiac contractility is increased by inhibiting the \_\_\_\_\_
Na-K pump
226
In which phase of the cardiac cycle is both the mitral valve open and ventricular pressure falling
rapid ventricular filling
227
Aortic Stenosis [triad of symptoms]
syncope, angina, and dyspnea
228
aortic stenosis [physical findings]
pulsus parvus et tardus systolic ejection murmur paradoxically split S2
229
Split S2 [causes]
severe aortic stenosis LBBB hypertrophic cardiomyopathy
230
TAVR
Transcatheter Aortic Valve Replacement
231
Dihydropyridines
vascular smooth muscle selective decrease SVR by vasodilation amlodipine, nicardipine, nifedipine
232
Phenylalkylamines
selective for myocardium decrease oxygen demand and HR Verapamil
233
Hierarchy of Vascular Control
1st: (lowest) myogenic response 2nd: intrinsic regulatory chemicals 3rd: extrinsic regulation
234
all nitrates provide venous dilation, which one also provides arterial dilation?
sodium nitroprusside
235
what blocks your endothelin Eta receptor, preventing vasoconstriction?
bosentan
236
Traube-Hering Waves
changes in MAP due to oscillations in sympathetic drive BP decreases on inhalation
237
Mayer Waves
driven by resonance in baroreceptor reflex BP oscillates at 6 per minute
238
Triple response of Lewis
cutaneous reaction red - flare - wheal
239
what recieves afferent information from sensory receptors?
nucleus tractus saltarious
240
Metabolic Syndrome
risk factors that together increase risk for IHD or stroke * abdominal obesity * TG \> 150 * HDL \< 40 * fasting glucose \> 100 * hypertension \> 130
241
gold standard for diagnosing CAD
cardiac catheter
242
what adenosine receptor causes coronary vasodilaton?
A2A
243
What are some drugs used in a pharmacological stress test?
Adenosine Dobutamine Dipyrdamole Regadenosine
244
Enzymes for diagnosing MI
CK-MB \> 5% peaks within 24 hours Troponin persists for 7 days
245
when doing a PCI, what should your door to balloon time be?
90 minutes
246
Takotosubo "broken heart syndrome"
apical ballooning cardiomyopathy due to stress
247
Phase I of valsalva maneuver
increased intrathoracic pressure increased aortic pressure baroreflex mediated and _decrease HR_
248
Phase II of valsalva maneuver
increased intrathoracic pressure decreases venous return and preload decreased CO and MAP baroreflex _increased HR and SVR_
249
Phase III of valsalva maneuver
valsalva ends, normal breathing decreased intrathoracic pressure baroreflex _increase HR_
250
Phase IV of valsalva maneuver
results in increased MAP and decreased HR
251
3 drugs to avoid in aortic stenosis
nitrates over diuresis vasodilators
252

Comprehensive Exam (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions