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Flashcards in Physiology Deck (250):
1

Main different features between cardiac and skeletal muscle? Pg 89

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2

What are the different cells in the heart and the percent of cells they make up? Pg 89

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3

How are cardiac myocytes electrically and physically connected to each other? Pg 90

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4

How much percent does the extracellular space make up in the heart? Pg 91

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5

What mainly makes up the extracellular space? Pg 91

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6

Why is the extracellular space important for cardiac function? Pg 91

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7

Function and structure of Sarcolemma? Pg 90

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8

Function and structure of T-tubules? Pg 90

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9

Structure and function of the Sarcoplasmic Reticulum? Pg 91?

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10

What is the junction called between the T-tubule and the Sarcoplasmic reticulum?

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11

Receptors found on T-tubules? Pg 90

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12

Receptors found on Sarcoplasmic reticulum? Pg 91

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13

What is one thing that can go wrong in diads that cause reduced excitation-contraction coupling? lmao Pg 91

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14

Briefly define the process of of excitation-contraction coupling. Pg 92

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15

First step of EC coupling? Pg 93

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16

Role of DHPR (L-type Ca2+ channels) Pg 92

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17

How do cardiac myocytes buffer the gradient of high Ca2+ which works against SERCA?

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18

What is a Ca2+ spark? (Pg 92)

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19

What about Ca2+ sparks determines the Ca2+ transient amplitude? (Pg 92)

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20

Second step in EC coupling? Pg 93

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21

Third step in EC coupling? Pg 93

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22

Why does cardiac muscle need CICR but skeletal muscle doesn't? Pg 92

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23

Fourth step in EC coupling? (Pg 93)

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24

Four receptors responsible for relaxation? Pg 92

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25

What regulates SERCA? Pg 92

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26

Where are Mitochondrial uniporters located mostly and why? Pg 92

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27

What happens if Ca2+ efflux decreases or Ca2+ influx increases? Pg 93

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28

Why and how is the NXC exchanger electrogenic and ATP independent? Pg 92

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29

How does NXC contribute to the plateau phase when it pumps Ca2+ OUT of the cell usually? Pg 92

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30

What is Ca2+ extrusion via NXC stimulated by? Pg 92

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31

What is the first conventional phase of the cardiac cycle?

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32

What do atrial pressures reflect? Pg 116

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33

What two events does the isovolumetric contraction phase occur between? Pg 117

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34

What events does the onset of isovolumetric contraction coincide with? Pg 117

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35

What does the ejection phase begin with? Pg 117

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36

What are the 3 phases of rapid ejection? Pg 117

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37

LOOK UP REDUCED EJECTION Pg 117

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38

What two events does the isovolumetric relaxation phase occur between? Pg 117

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39

What happens to pressure and volume during isovolumetric relaxation? Pg 117

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40

What causes the incisura (notch) on the aortic P wave?

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41

Is aortic flow ever negative? Pg 117

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42

What happens during the rapid filling phase and why? Pg 118

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43

What is the main cause of diastasis/slow filling? Pg 119

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44

What is the cause of a slow rise in atrial and venous pressure during diastasis? Pg 119

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45

What does an echocardiogram measure and how does it do this? Pg 118

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46

Learn echocardiogram Pg 118

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47

What is the difference between a RV and LV'S pressures and heart valve sequences? Why? Pg119

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48

Does the RV or LV valves close later and open sooner? Pg 119

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49

What do we use to listen to heart sounds? Pg 120

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50

What are we looking for when listening to heart sounds and murmurs? Pg 120

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51

What is the frequency of heart sounds heard at? Pg 120

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52

What causes the first heart sound and when does this occur? Pg 120

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53

What causes the second heart sound and when does this occur? Pg 120

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54

What heart sound has the higher frequency and why? Pg 120

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55

What heart sound has splitting of the sound? Pg 120

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56

What is one way to measure blood pressure other then the conventional way? Pg 120

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57

What are some abnormalities heard by heart sounds/murmurs? Pg 120

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58

What are two ways to measure Cardiac output? Pg 122

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59

What principle is Fick's method of measuring CO based on? Pg 122

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60

How is O2 in arterial blood measured in the Fick method? Pg 122

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61

How is O2 in mixed venous blood measured in the Fick method? Pg 122

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62

What is the problem with using the Fick method to measure CO? Pg 122

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63

What are the perquisites for using the Fick method? Pg 122

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64

What is the most popular technique in measuring Cardiac Output? Pg 123

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65

What kind of technique does thermodilution use? Pg 123

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66

What is the indicator in thermodilution? Pg 123

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67

What is the purpose of atrial systole and when does it start? Pg 117

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68

What is the contribution of atrial systole to filling dependant on? Pg 117

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69

What are the three different venous pulses and what are they caused by? Pg 116

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70

Is systole or diastole the faster process and why? Pg 116

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71

How does thermodilution work and what does a large temperature change indicate? Pg 123

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72

What are the three advantages of using the thermodilution technique? Pg 123

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73

What is the equation to measure specific resistances across vascular beds? Pg 124

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74

How do you measure Total Peripheral Vascular Resistance? Pg 124

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75

What is an example of decreased resistance? Pg 124

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76

What response does the sympathetic and parasympathetic nervous systems mediate respectively? Pg 137

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77

What is vasovagal syncope? Pg 137

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78

Triggers of vasovagal syncope Pg 137

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79

Word to describe activity of the autonomic nervous system? Pg 138

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80

What is the trend in of sympathetic activity to muscle in relation to seriousness of disease? Pg 138

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81

Where do parasympathetic nerves originate from? Pg 138

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82

Where do sympathetic nerves arise from? Pg 138

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83

Do sympathetic or parasympathetic nerves have long pre ganglionic and short post ganglionic fibres? Pg 138

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84

Norepinephrine/epinephrine is both a ? and a ? Pg 139

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85

Why are nicotinic receptors called nicotinic receptors? Pg 139

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86

What is the difference between N1 receptors and N2 receptors? Pg 139

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87

What are examples of parasympathetic target organs? Pg 139

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88

What are the receptors on parasympathetic target organs called, and why? Pg 139

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89

Neurotransmitter in parasympathetic pre-ganglionic and post-ganglionic nerves? Pg 139

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90

What does Nm and Nn mean? Pg 140

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91

What is an example of a neuromuscular blocker, and what do they do? Pg 140

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92

What are two types of nicotinic receptor antagonists? Pg 140

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93

What are ganglion blockers, and why aren't they used anymore? Pg 140

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94

What is an example of a muscarinic receptor antagonist and where is it derived from? Pg 140

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95

What is the clinical use of muscarinic antagonists? Pg 140

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96

What are receptors found on target organs involved in sympathetic activity? Pg 139

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97

What are the two main classes of adrenergic receptors and what does each receptor respond mostly to? Pg 141

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98

What are the main subtypes of adrenergic receptors, where are they found and what are they mainly responsible for? Pg 141

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99

What is the main neurotransmitter released by post-ganglionic sympathetic nerves? Pg 141

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100

What are two exceptions to sympathetic post-ganglionic nerves releasing noradrenaline? Pg 141

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101

What is an example of a α1 agonists, and what is it used for? Pg 141

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102

What is an example of an β2 agonist and what is it used for? Pg 141

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103

What is the equation for blood pressure? Pg 142

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104

What controls CO and what controls TPR? Pg 142

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105

What does the parasympathetic nervous system innervate/control in the CVS? Pg 142

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106

What does the sympathetic nervous system innervate/control in the CVS? Pg 142

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107

Does parasympathetic or sympathetic activity have a stronger/faster effect on heart rate? What does this show? Pg 143

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108

What is the resting heart rate for an uninnervated heart? Pg 143

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109

Why is the resting hear rate for an innervated heart lower than an un-innervated heart? Pg 143

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110

How does sympathetic activity increase stroke volume? Pg 143

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111

How does vagal stimulation decrease HR? Pg 143

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112

How does sympathetic stimulation increase HR? Pg 143

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113

What does stroke volume depend on? Pg 144

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114

How does increasing the heart rate increase stroke volume? Pg 144

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115

What are beta blockers mainly used for? Pg 143

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116

What do beta blockers do? Pg 143

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117

How does sympathetic stimulation cause vasoconstriction? Pg 144

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118

What is the main α1 receptor antagonist, and why is it only used for extreme hypertension? Pg 145

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119

What does the baroreceptor reflex do and what level of pressure changes does it maintain? Pg 145

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120

What reflexes maintain higher drops or increases in blood pressure? Pg 145

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121

Draw a flow diagram of the baroreflex? Pg 145

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122

What does the dive reflex respond to? Pg 144-145

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123

What are the reflex effect of the dive reflex? Pg 145

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124

What is the purpose of the dive reflex? Pg 145

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125

What is blood pressure measuring? Pg 147

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126

Why is treating blood pressure so important? Pg 147

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127

What is the equation to measure MAP? Pg 147

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128

Why is MAP 100mmHg? Pg 147

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129

What is the trend with blood pressure and age? Is it always the case? Pg 147

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130

Why can't MAP be calculated by taking the mean of systolic and diastolic pressure? Pg 147

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131

What are the main determinants of mean arterial pressure? Pg 148

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132

What are the short term determinants of MAP? Pg 148

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133

What are the long term determinants of MAP? Pg 148

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134

What is pulse pressure? Pg 148

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135

Factors that affect systole? Pg 149

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136

How does stroke volume affect systole? Pg 149

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137

How does aortic compliance affect systole and diastole? Pg 149

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138

How does aortic compliance affect pulse pressure? Pg 149

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139

How does diastolic run-off effect diastole, and therefore pulse pressure, and therefore MAP? What factors can change diastolic run off? Pg 149

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140

How does heart rate affect diastolic heart rate? Pg 149

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141

Why are there larger pulses in the lower limbs? Pg 149

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142

Why does flow continue during diastole? Pg 149

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143

Who made the first blood pressure measurement and when? Pg 149

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144

Who made the first non-invasive blood pressure measuring device (sphygmomanometer) and when? Pg 149

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145

Explain how the palpitation method works for non-invasively measuring blood pressure? What is it's main disadvantage? Pg 149

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146

How does the auscultatory method work? What does it measure? Pg 149

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147

What are the sounds called heard in the auscultatory method called? Pg 150

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148

What other consideration do you have to make when measuring blood pressure? WhyPg 150

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149

What is the effect on gravity in blood vessels? Pg 152

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150

What is the equation for Blood pressure? What remains constant? Pg 201

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151

What are the different blood vessels? What do they each contain mostly? Pg 201

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152

In which vessels does the greatest pressure drop occur? Pg 202

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153

What is cross-sectional area inversely proportional to? Pg 202

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154

Where is minimal flow rate? Why? Pg 202

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155

What does CO = in terms of Ohm's law? How is this derived? Pg 203

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156

Where does the biggest resistance occur? Pg 203

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157

Ideal Cardiac output and MAP? Pg 203

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158

How do you find resistance of vessels in series? Pg 204

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159

Doubling the resistance in which bed would have the most impact on flow? Pg 204

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160

Why do vessels in parallel have the least resistance? Pg 204

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161

What has the biggest effect on resistance and therefore in Poiseuille's equation and why? 204

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162

What is resistance of a vessel dependant on? Pg 204

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163

What type of drugs have biggest impact on blood flow and why? Pg 205

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164

What is viscosity dependant on? Pg 205

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165

What is haematocrit and what is the resting haematocrit ratio? Pg 205

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166

How does vessel diameter determine blood viscosity? Pg 206

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167

What does Poiseuille's law assume? Pg 206

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168

Why do blood vessels not follow Poiseuille's assumptions? Pg 206

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169

What is the critical closing pressure? Is it higher or lower in sympathetic stimulation? Pg 206

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170

What is shear stress? How does it change? What does it cause blood vessels to do, and how? Pg 207

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171

How does flow rate and resistance change in terms of Pressure in distensible tubes? Pg 207

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172

What are two main factors that cause turbulent flow? Pg 208

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173

What is blood flow proportional to in turbulent flow? Pg 208

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174

When does laminar flow transition to turbulent flow? Pg 208

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175

How is turbulent flow clinically significant? Pg 208

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176

What is the Bernoulli Principle and what are the three components of it? Pg 208

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177

How does the Bernoulli principle apply to a situation where blood flows horizontally from a large to a small vessel? Pg 153

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178

What is a physiological implication of Bernoulli's principle? Pg 153

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179

What is transmural pressure? Pg 209

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180

What is wall tension dependant on? Pg 209

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181

What is the importance of the Laplace equation? Pg 209

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182

What is compliance? Pg 210

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183

What is the difference between compliance and capacitance? Pg 210

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184

Do veins or arteries have higher compliance? Pg 211

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185

What decreases and increases compliance of vessels? Pg 211

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186

What does the functional organisation of the microcirculation consist of? Pg 214

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187

What are pre-capillary sphincters? What do they do and determine? Pg 214

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188

What are pre-capillary sphincters controlled by? Pg 214

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189

Where does blood flow if pre-capillary sphincters are contracted? Pg 214

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190

What factors promote dilation of pre capillary sphincters? Pg 214

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191

Properties of arterioles and meta-arterioles. Pg 214

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192

What is reactive hyperaemia? Pg 214

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193

What is auto-regulation? Pg 214

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194

Where is auto-regulation the most important and why? Pg 214

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195

What are three types of movement in trans-capillary exchange? Pg 216-218

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196

What is the driving force in diffusion and give an example of where this changes in response to something? Pg 216

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197

What law describes diffusion? What does this law state diffusion is dependant on? Pg 217

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198

What does filtration driven by? Pg 217

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199

What is Starling's law of Ultrafiltration? Pg 218

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200

What is fluid movement dependant on? Pg 217-218

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201

What provides the main filtration force? What provides the main absorption force in capillaries? Pg 217-218

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202

Why is absorption important? Pg 218

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203

What factors determine capillary hydrostatic pressure? Pg 219

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204

How does vasoconstriction, vasodilation/hypertension, RHS heart failure, dehydration and hypoproteinemia affect filtration/absorption? Draw examples on blood pressure/capillary distance diagram. Pg 220

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205

How does Heart failure cause increased net filtration? Pg 220

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206

Function of lymphatic system? Pg 221

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207

Organisation of terminal lymphatic vessels Pg 220

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208

What occurs in elephantiasis? Pg 221

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209

Is lymph vessels unidirectional? Why/why not? Pg 220

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210

How are ventricular pressures measured? Pg 125

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211

Draw a P-V loop for diastole and systole. Pg 126

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212

What is preload? Pg 127

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213

What do we use for preload? Pg 127

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214

How does increasing pre-load effect the pressure volume loop relationship? Pg 127

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215

What are the 4 phases/steps of the P-V loop and where does the P-V loop fall in the P-V diastolic and systolic relationship graph? Pg 126

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216

What is afterload and what does it equal? Pg 127

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217

What is the effect of afterload on the PV loop? Pg 127

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218

What is an example of increased afterload? Pg 127

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219

What is the relationship between afterload and rate/extent of shortening myocardial shortening? Pg 128

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220

What type of drug increases inotropy, give an example of one, and how does it work? Pg 128

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221

What does increasing inotropy do to the P-V graph? Pg 128

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222

What is another name for increased/decreased Heart rate? Pg 129

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223

Three factors Heart rate affects? Pg 129

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224

What part of an ECG changes when changing heart rate? Pg 129

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225

Does diastole change or systole change with heart rate mainly? Pg 129

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226

The cardiovascular system is a closed system, how does increase in afterload cause an increase in preload? Pg 129

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227

Give an example that shows the R and L sides of a heart balancing. Pg 129

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228

What is the response of afterload on the P-V loop? Pg 130

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229

Factors that affect the four determinants of ventricular function. Pg 131

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230

Four ways of measuring ventricular performance? Pg 131-133

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231

Ejection fraction equation? Pg 132

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232

What is peak change in pressure used for? Can it be negative? Pg 132

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233

What is the ventricular function curve plot? Pg 133

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234

Why isn't stroke volume plotted in a ventricular function curve? Pg 133

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235

Why is EDP used instead of EDV? Pg 133

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236

Equation for stroke work? How is this derived? Pg 134

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237

Why does afterload have no affect on stroke work? Pg 134

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238

What is the effect on inotropic stimulation on ventricular function curves? Pg 134

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239

Why are Ventricular function curves a good way of summarising heart function? Pg 135

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240

What is venous return dependant on? Pg 237

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241

Draw and plot a graph of Venous return vs Mean right atrial pressure? Pg 237

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242

What determines mean systemic filling pressure? Pg 237

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243

Why doesn't pressures equilibrate to 50-50 when the heart isn't pumping? Pg 236

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244

Why is there a plateau in the venous return vs MRAP graph? Pg 237

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245

What increases and what decreases MSFP? Pg 237

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246

How does vascular resistance effect venous return? Pg 238

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247

What can a cardiac function curve show? Pg 239

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248

What is Guyton analysis? What does it show? Pg 240

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249

How do transfusions, sympathetic stimulation, supine to erect, exercise and heart failure effect Guyton analysis? Pg 240-244

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250

In heart failure why do we give drugs to reduce CO? Pg 244

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