PTA - section 2 Flashcards
1
Q
SYSTEMIC CIRCUIT
A
- vessels carry blood from the heart to the tissues and back to the heart
2
Q
PULMONARY CIRCUIT
A
- vessels carry blood from the heart to the lungs and back to the heart
3
Q
OXYGEN POOR, CO2 RICH
A
-blue
4
Q
OXYGEN RISH, CO2 POOR
A
- red
5
Q
THE HEART COVER
A
- covered in a sack of pericardium, that has fluid to help with friction during contraction
6
Q
VENTRICLES
A
-occupy the bulk of the heart
7
Q
ARTERIES AND VEINS
A
- are attached to the base of the heart
- visible on the surface of the heart
- enter heart walls to deliver oxygen & nutrients & waste
8
Q
CORONARY SINUS
A
- delivers deoxygenated blood to right atrium
9
Q
VENTRICLE THICKNESS PULMONARY
A
- low pressure, low resistance, less thickness
10
Q
VENTRICLE THICKNESS SYSTEMIC
A
- high pressure, high resistance, thicker wall
11
Q
MYOCARDIC MUSCLES
A
- fibres arranged spirally
- spiral provides ringing effect at contraction which squeezes blood upward from apex
12
Q
DESMOSOMES
A
- strong connection of force from one cardiac cell to another
13
Q
GAP JUNCTIONS
A
- channels allow ions to spread from one cell to another
14
Q
INTERCALATED DISKS
A
- contain desmosomes and gap junctions
15
Q
INLET
A
- right (AV) tricuspid, left (AV) bicuspid
16
Q
OUTLET
A
- pulmonary semi- lunar valve, aortic semi lunar vavle
17
Q
1ST STEP OF BLOOD FLOW
A
- av valves open in left ventricle, atrial pressure is great than venticle pressure
18
Q
SEMILUNAR VALVES WHAT DO THEY DO
A
- prevent the black flow of blood during ventricular filling
19
Q
FLAP CONNECTED TO PAPILLARY MUSCLES
A
- prevent flaps from being push backed into the atrium when the ventricles contract
20
Q
2ND STEP OF BLOOD FLOW
A
- AV valves close, ventricle pressure greater than atrial pressure, aortic semilunar vavles open
21
Q
HEART SOUNDS
A
- Closure of heart valves creates turbulent flow
22
Q
1ST SOUND
A
- inlet AV valves closing lubb
23
Q
2ND SOUND
A
- outlet valves closing dupp
24
Q
CARDIAC VS SKELETAL SIMILAR
A
- striated
- sarcomere structure
25
CARDIAC VS SKELETAL DIFFERENT
- muscles fibres shorter cardiac
- braches
- singular nucleus
26
CARDIAC VS SMOOTH SIMILAR
- electrically linked to one another
- exhibit pacemakers
- under sympathetic and para control as well as hormone
27
CARDIAC VS SMOOTH DIFFERENT
- gap junctions in intercalated disks
28
PACEMAKER
- helps maintain the heartbeat
- used to speed up slow heart beats
- maximize heart circulation
29
BRADYCARDIA
- heart beat too slowly
30
TACHYCARDIA
- fast beating heart
31
PACEMAKER STRUCTURE
- battery
- pulse generator
- electrodes to heart
32
TEMPORARY ENDOCARDIAL (transvenous) PACE
- the pulse generator is the outside heart
- tempory abnormality
- waiting for permanent
- right atrium make connect with endocardium
33
EXTERNAL PACE (transcutaneous)
- emergency
| - generator outside
34
TEMPORARY EPICARDIAL PACE
- surgery
- can cause inflammation
- bradycardia
35
PERMANENT (internal)
- heart block - 3d & 2nd degree
| - symptomatic sinus bradycardia
36
Most of the cardiac muscle of the heart is found in the:
Myocardium
37
The right ventricle pumps _______ blood into the _______ circulation.
deoxygenated; pulmonary
38
The _______ supply oxygenated blood to the heart muscle itself
coronary arteries
39
The wall of the left ventricle is thicker than the wall of the right ventricle because the:
Left ventricle must pump the same amount of blood into the high-resistance, high-pressure systemic system as does the right ventricle into the low-resistance, low-pressure pulmonary system
40
How is blood drained by the tissues of the heart?
Mainly into the coronary sinus, which empties into the right atrium
41
Which chamber of the heart has the thickest musculature?
Left ventricle
42
The function of the pericardial fluid is to:
reduce friction between the heart and the pericardium
43
Chordae tendinae are strands of connective tissue extending from________ to ________?
AV valves : papillary muscle
44
Which of the following is NOT a component of the pulmonary circuit?
Vena cava
45
The source of blood carried to capillaries in the myocardium would be_______
coronary arteries
46
EC COUPLING CARDIAC 1
- action potential enters from adjacent cells
47
EC COUPLING CARDIAC 2
- voltage gated ca2 channels open, ca2 enters cells
48
EC COUPLING CARDIAC 3
- ca2 induces ca2 release through RYR channels
49
EC COUPLING CARDIAC 4
local release ca2 sparks
50
EC COUPLING CARDIAC 5
- summed ca2 sparks create a ca2 signal
51
EC COUPLING CARDIAC 6
- ca2 ions bind to tropinin to initate contraction
52
EC COUPLING CARDIAC 7
- relaxation occurs when ca2 unbinds from troponin
53
EC COUPLING CARDIAC 8
- ca2 is pumped back into sacroplasmic reticulum for storage
54
EC COUPLING CARDIAC 9
- ca2 is exchanged with a by NCX antiporter
55
EC COUPLING CARDIAC 10
- na gradient is maintained by Na k atpase
56
EC COUPLING CARDIAC VS SKELETAL
- initiation of actional potential
- source and role of ca2 in muscle contraction
- muscle relaxation - handling of unbound ca2
57
FRANK STARLING MECHANISM 1
- crowding do to actin overlap
| - no force
58
FRANK STARLING MECHANISM 2
- actin overlap due to polarity
| - force same
59
FRANK STARLING MECHANISM 3
- no problems / no overlapping
| - lots of force
60
FRANK STARLING MECHANISM 4
- really stretched
- actin is out of reach
- no force
61
FRANK STARLING LAW
The law states that the stroke volume of the heart increases in response to an increase in the volume of blood in the ventricles, before contraction (the end diastolic volume), when all other factors remain constant.
62
In excitation-contraction coupling in myocardial contractile cells, Ca2+ induces Ca2+ release from the sarcoplasmic reticulum through:
Ryanodine receptor channels (Ryr)
63
When a cardiac contractile cell is stimulated:
Voltage-gated Ca2+ channels open. Ca2+ enters the cell
64
From the point of Ca2+ diffusing through the cytosol to the contractile elements, what step below is unique to cardiac contractile muscle cells compared with skeletal muscle cells?
Ca2+ is removed from the cell via a Na+- Ca2+ exchanger
65
In excitation-contraction coupling in myocardial contractile cells, the Ca2+ that causes contraction comes from:
The opening of Ca2+ -sensitive channels in the sarcoplasmic reticulum that have picked up calcium from the extracellular fluid
66
AUTHORHYTHMIC CELL ACTION POTENTIAL
- sa node =pacemaker
- funny channel open, then close at -40 ca open
- ca close at threshold, k open, close at -60
67
CONTRACTILE CELL ACTION POTENTIAL
```
- na open
na close
ca opn, fast k close
ca close, slow k open
resting
```
68
REFRACTORY PERIOD OF CARDIAC CELL
- force of contraction can be graded = to how much ca enters
69
If channels are permeable to:
Na+ and K+
70
Myocardial cells can generate action potentials spontaneously because they have
unstable ion channels
71
A typical action potential of a myocardial contractile cell lasts ________ millisecond(s).
at least 200
72
Epinephrine and norepinephrine increase ion flow through ________ channels.
If and Ca2+
73
The action potentials of myocardial autorhythmic cells are due to a combination of increasing Na2+ ________ and decreasing K+ ________.
influx, efflux
74
The flattening of the action potentials of myocardial contractile cells, called the plateau phase, is due to a combination of ________ K+ permeability and ________ Ca2+ permeability.
decreasing, increasing
75
During the plateau phase of the action potentials of myocardial contractile cells, which ion(s) is/are crossing the membrane?
both Ca2+ and K+
76
The rapid depolarization phase of the action potentials of myocardial contractile cells is due to which ion(s)?
Na+ only
77
The action potential in a cardiac contractile cell causes:
opening of L-type calcium channels
78
In cardiomyocytes, voltage-gated Na+ channels are found in the _______ cells and contribute to the _______ phase of the action potential
contractile; depolarization
79
CONDUCTING HEART SYSTEM
sa node --> intermodial pathways --> av node --> av bundle --> bundle branches --> purkinjie fibers
- sa node depolarizes
- electrical activity goes rapidly to av node via intermodial pathways
- depolar spreads more slowly across atria conductions slows through av node
- depolar moves rapidly through ventricular cconducting system to apex of heart
- depolar wave spreads upward from apex
80
ECG
- the summuened electrical activity of the heart
81
P WAVE
- atrial depolarization
82
P-R SEGEMENT
- conduction through AV node and av bundle
83
Q -T WAVE
- ventricular contraction
84
T WAVE
- ventricular repolarisation
85
HEART EXCITATION NOTE
- QRS = to ventricular depolarisation
| - t = repolarisationn
86
AUTONOMIC CONTROL OF HEART RATE - PARA
- decreases heart rate
| - stimulation of hyperpolarizations
87
AUTONOMIC CONTROL OF HEART RATE - SYM
- increases heart rate
| - stimulation of epinephrine
88
AVERAGE RESTING HR
- 72 beats
89
STROKE VOLUME
- amount of blood pumped by one ventricle during a contraction
90
CARDIAC OUTPUT
- measurement of effectiveness of heart as a pump
| co=hr x sv
91
CARDIAC PERFORMANCE HEART RATE
- postive sympathetic
| - negative para
92
CARDIAC PERFORMANCE STROKE VOLUME
- end of disastolic volume venous return/ preload (P)
- contractile strength of heart muscle (P)
- load on the ventricle as it contracts afterload (N)
93
AUTOHYTHIMIC CELLS PARA HORMONES AND NERVES
- acetylcholine vagus nerves
- slow heart beat
- muscarinic receptors
94
AUTOHYTHIMIC CELLS SYM HORMONES AND NERVES
- thoracic spinal nerves/norepinephrine
- fast heartbeat
- b1 - adrenergic receptors
95
STROKE VOLUME
- 70 ml
96
LONG TENSION RELATIONSHIP SKELETAL
- resting muscle = optimal length for developing maximal tension
- is longer or shorter = contraction is weaker
97
LONG RELATIONSHIP CARDIAC
- resting muscle fibre length is less than optimal length
98
LONG TENSION RELATIONSHIP FILL MORE BLOOD
- increase stroke volume
99
EDV IS DETERMINED BY VENOUS RETURN
- EDV is an indicator of ventricular preload
100
LONG TENSION RELATIONSHIP RELEASE CATECHOLAMINES TO INCREASE VENTRICULAR CONTRACT
- increase stroke volume
101
AFTERLOAD WITH CONTRACTION OCCURS
- reflects the preload and the effort required to push blood out into the circulation = increase in cardiac workload
102
CYTOKINES
- Determine pathway
- regulate blood production
- stem cell factor
103
PLURIPOTENT HEMATOPOIETIC STEM CELL
- ability to become different cells
104
ERYTHROPOIESIS
- erythrocyte production (red blood cells)
- occurs in bone marrow
- don't have nuclei = cant repair
105
KIDNEYS CELLS (negative feed back loop)
- detect decrease delivery (hypoxia)
- kidney secretion erythropoietin increase
- increase red blood cell production in bone marrow
- increase circulating red blood cells
- increase in oxygen delivery in tissues
106
RED BLOOD CELLS NUTRITIONAL REQUIREMENT
- iron for heme groups
- cells division
- folate (dna production)
- vitamin B12
107
DISORDERS OF BLOOD CELLS
- deficiencies in cytokines
| - anticancer treatments
108
SYNTHETIC EPO
- clinical uses (cancer, anemia)
| - potential abuses ( performance enhancing drug)
109
LEUKEMIA
- cancer from abnormal growth and development of leukocytes
110
DESTRUCTION OF RED BLOOD CELLS
- become fragile with age
- cannot repair
- components recycled
111
AGGLUTINATION
- when antibody and same antigen bind together
| - clumping of blood
112
GROUP O
-universal donor
113
GROUP AB
- universal receiver
114
RHESUS FACTOR - NEGATIVE
- no rhesus antigens
| - no antibodies
115
RHESUS FACTOR - POSITIVE
- rhesus d antigen
| - no rhesus antibodies
116
RHESUS NEGATIVE EXPOSED
- no rhesus anitgens
| - anti rhesus antibodies
117
RH FACTOR PROBLEM
- if the mother is negative and baby is positive
- it can kill baby
- injected with antibodies to stop this
118
HEMOSTASIS
- prevention of blood loss
119
HEMOSTASIS PRODUCTION
- vasoconstriction
- platelet plug
- coggulation
120
VASOCONSTRICTION
- immediate
- smooth muscle contraction
- reduces blood flow
121
PLATELET PLUG
- mechanical blockage of hole
- exposed collagen causing binding of platelets
- platelet factors (ADP, TXA)
122
CLOT FORMATION
- formation of fibrin protein mesh that stabilizes platelet
123
CLOT PATHWAY
- extrinsic activated first
- thrombin formed
- 3 pathways in intrinsic
124
THROMBIN
- positive feedback model to promote more clotting
125
LIVER
- impaired blood clotting
126
FIBRINOLYTIC SYSTEM
- dissolved clotting
127
INHIBITION OF PLATELET ADHESION
- limitation of the clot to the damaged area (NO, prostacyclin)
128
INHIBITION OF COAGULATION CASCADE
- anticoagulants block reactions in clotting
- heparin and antithrombin
- protein c
129
Which of the following are the two anticoagulants produced by the body?
Antithrombin III and Heparin
130
Which of the following regarding platelets is CORRECT?
They are fragments of large cells.
131
The fibrinolytic system:
refers to the physiological removal of the clot.
132
Which of the following does NOT play a role in blood clot formation?
Plasmin
133
The platelet plug does not continuously expand along the entire length of the blood vessel due, in part, to the action of:
prostacyclin.
134
An agent that promotes the coagulation of blood; also called a clotting factor
procoagulant
135
Plasma protein that forms polymer fibres that stabilize platelet plugs; inactive form is fibrinogen
fibrin
136
Enzyme that breaks down fibrin
plasmin
137
Plasma protein that converts fibrinogen into fibrin
thrombin
138
A genetic blood defect that is characterized by delayed clotting of the blood and consequent difficulty in controlling haemorrhage even after minor injuries
haemophilia
139
A protein-phospholipid mixture released by damaged blood vessel walls
tissue factor
140
Any chemical that inhibits blood coagulation
anticoagulant
141
A blood clot that adheres to the wall of a blood vessel
thrombus
142
A detached blood clot that travels through the bloodstream and lodges so as to obstruct or block a blood vessel
emblous
143
A molecule that promotes dissolution of blood clots
tPA
144
Substance in membrane of intact endothelial cells that precents platelets from adhering
prostacyclin
145
An anticoagulant molecule
heparin
146
BLOOD VESSELS
- network of hollow tubes that carry blood throughout the entire body
147
STRUCTURE AND FUNCTION OF BLOOD VESSELS
- blood flow = cardiac output
- pressure in left ventricle is stored in elastic wall
- 60% of blood is in veins to cap
148
STRUCTURE OF VESSEL WALLS ARTERY
- thicker walls = closer to heart
| - smaller lumen help w blood pressure flow
149
STRUCTURE OF VESSEL WALLS VEINS
- nervi vasom used for exchange (dilation and restriction)
- less resistant
- closer to lumen
150
DIFFERENT ARTERIES
- condult vessels ( elastic artery, muscular)
- resistance vessel ( arterioles)
- decrease in diameter elasticity
151
STRUCTURES CAPILLARIES
- continuous = water and small molecules
- fenestrated = walls leaky kidneys
- sinusoid = large molecules more gaps
152
METARTERIOLES AND PRE CAP SPHINCTERS
- pre sphincter = regulate blood flow, open when oxygen is needed
-
153
HEMODYNAMICS
- describes the physical factors that govern blood flow
- moves from high pressure (heart) to regions of low pressure (tissue)
- fluid is impeded by resistance
154
THE FLOW EQUATION RELATIONSHIP
- garden hose (flow constant) - p/ increase r
- water supply to home (constant pressure)
- flushing toliet during a shower ( constant resistance)
155
RESISTANCE TO BLOOD FLOW
- physical characteristics ( viscosity)
- size of vessels
- organization of network
156
LAMINAR FLOW
- layers flow without mixing
- streamline
- flow is 0 at wall and maximal at centre
157
TURBULENT FLOW
- layers mix
- non streamline
- high speeds
158
POISEUILLES LAW
- the resistance to laminar flow of an incompressible fluid having viscosity through a horizontal tube of uniform radius and length
159
SERIES VS PARALLEL ARRANGEMENT
- arteries = series
| - cap = parrallel
160
SERIES ARRANGEMENT
- total resistance = to sum of the individual
161
PARALLEL ARRANGEMENT
- total resistance is less than individual
162
VISCOSITY OF BLOOD FLOW
- is not related to the proximity of heart but depends on the diameter and the cross section of areas of vessels
163
FLOW RATE
- blood flow rate - pressure resistance
164
AUTOREGULATION
- occurs automatically
- heart, brain, kidney = increase regulation
- skeletal muscle = moderate
- skin = no regulation
165
BELOW 60 mmHg
- no regulation vessels are dilated
166
HIGHER 170 mmHg
- can not constrict any greater
167
MYOGENIC THEORY
- stretchy of smooth muscle vessels q
168
VARIABLE RESISTANCE
- the main factor of mean arterial pressure
169
LOCAL INTRINSIC CONTROL
- regulate coronary, cerebral, skeletal, pulmonary and renal circulation
170
SYSTEMIC EXTRINSIC CONTROL
- regulate and maintain skin circulation
171
HYPEREMIA
- local mediated increase in blood flow
172
ACTIVE HYPEREMIA
- matches blood flow to increase metabolism
173
REACTIVE HYPEREMIA
- follows a period of decreased blood flow
174
HORMONAL CONTROL
- relaxation