Slide set 1 Flashcards
1
Q
Thoracic pressure changes usually associated with
A
Increased RR
2
Q
What type of things can change Total blood volume
A
Bleed, dehydration, blood donations
3
Q
Increased diastolic pressure equals
A
Lower compliance
4
Q
What Does PDA feed
A
Part of septum
5
Q
AV valves is closed during what phase
A
Systole
6
Q
Is Ejection fraction a direct measurement
A
NO
7
Q
What is afterload related to
A
Peripheral vascular resistance
8
Q
SA node PsNS stimulation causes
A
decreased HR
9
Q
Right ventricle transfers deoxy blood to where via what valve
A
Pulmonary system - Pulmonic valve
10
Q
What is ventricle irritability esentially referring to
A
Arrythmia
11
Q
What are ostia
A
Small openings of the L-R coronary arteries
12
Q
Do we have control over Frank starling mechanism of compensation?
A
No
13
Q
What stimulation can cause ventricle irritability
A
Sympathetic innervation
14
Q
Purpose of papillary muscles
A
Keeps orifice closed during systle and keeps them from regurging
15
Q
What connects AV valves to ventricles
A
Paillary muscles and chordae tendinae
16
Q
What is the primary measurement of heart fx
A
Cardiac Output (ejection fraction)
17
Q
A dilated heart can and cants
A
Can accept more volume but cant push out as much
18
Q
Afterload is
A
the force which the LV must pump against
19
Q
Blood supply of heart (4)
A
RCA, LAD, LCX, PDA
20
Q
Arterial baroreceptors causes the heart rate to
A
Decrease
21
Q
How many papillary chordae are in L-Vent
A
2 (sheets of fiber)
22
Q
Ventricular dilation is caused by
A
Chronic high preload or Chronic increase in Left EDV/EDP
23
Q
Atrial kick represents
A
Both atria contracting at the end of diastole
24
Q
L-atrium transfers O2 blood to L-Ventricle via what valve
A
Mitral valve
25
What is normal ejection fraction
55-75%
26
EF equals
SV divided by EDV
27
Lower end diastolic pressure equals
More compliance
28
L-Vent transfers O2 blood out into the body via what valve
Aortic valve
29
What 3 mechanisms contribute to HR reg
ANS Brainbridge reflex to atrial stretch Thoracic pressures with respiration and venous return
30
What increases myocardial contractility (3)
Adrenergic nervous system Catecholamines POS inotropic drugs
31
Chronic stimulation of the SNS results in
Down regulation of adrenergic receptors causing less of an effect
32
Another name for mitral valve is
Bicuspid valve
33
S4 occurs just before what heart sound
S1
34
Ventricular dilation initially does what to CO but then changes
Initally increases CO (per Frank Starling) but then decreases CO eventually
35
What does the RCA feed
Inferior wall of left ventricle Right atrium - ventricle Part of septum SA (Most patients) and AV node PDA (Right dom flow)
36
SympatheticNS originates where
Thoracic 1-5 ganglia
37
Right ventricle ejects deoxy blood into pulmonary system during what phase
Systole
38
What factors determine afterload
Aortic pressure Volume of the ventricular cavity to include wall thickness
39
Right atria accepts deoxygenated blood from
SVC, IVC, and Coronary sinus
40
What does the LAD feed
Part of septum Bundle branches Bulk of left ventricle
41
AV valves is open during what phase
Diastole
42
The volume and thickness of ventricular cavity is follows whatprinciple
The law of laplace
43
A hypertrophy heart can and cants
Can push out better but can't accept as much volume
44
How many cusps do Semilunar valves have
3 cusps
45
Atria PsNS stimulation causes
decreased contractility
46
After all Coronary artery feed zones established what supplies the rest of the heart?
RCA and LCX (generally)
47
What is the big player of CO
Left Ventricle
48
Both atria correlates with what ABNL sound
S4 (atrial gallop)
49
Brainbridge reflex physiology
Atria stretching causes baroreceptors to increase HR so that blood may be redistributed
50
What indirect method can we use for preload measurement
Pulmonary capillary wedge pressure with Right heart cath
51
AV Node PsNS stimulation causes
decreased velocity
52
What can you often hear durinf an MI
Mitral regurgitation
53
The Law of Laplace says
Afterload increases : SV and CO decreases
54
Ejection fraction is not the same thing as what
SV
55
Left atrium accepts O2 blood from where
Pulmonary system via 4 pulmonary veins
56
Semilunar valves are open during what phase
Systole
57
What are the 2 names of semilunar valves
Aortic valve and Pulmonary valve
58
What decreases myocardial contractility (4)
NEG inotropic drugs Some Anti-arrythmics CCBs and B-BLKs
59
Preload is
the load that causes ventricular wall tension prior to contraction at the end of diastole
60
Do we have control over sympathetic stimulation compensatory mechansim?
Yes - some (meds)
61
Example Positive inotropic drugs
Digoxin Isoproterenol Dopamine Dobutamine Caffeine
62
Chronic overload of the hear results in
Dilation
63
Disadvantages of ventricular hypertophy
Increased stiffness and increased myocardial O2 demand
64
Mitral valve has how many leaflets
2 (Anteromedial and Posterolateral)
65
MUGA stands for
Multi-gated acquisition
66
What are the 2 names of Semilunar valves
Aortic valve and Pulmonic valve
67
When does the coronary arteries fill
During Diastole (Low pressure backwash)
68
Thoracic pressure physiology
Rib cage expands (Diaphragm moves down) Lowers Thoacic P and Rises ABD P Increased ABD P increases venous return
69
AV correspond to what heart sound
S1 (Lub)
70
Semilunar valves are close during what phase
Diastole
71
Disadvantages of ventricular dilation
Increased wall stress (per LaPlace) Increased myocardial O2 demand
72
Compliance reflects
Diastolic ventricular pressure
73
Some anti-arrythmic drugs
Quinidine Procainamide Disopyramide
74
What valves are in time with carotid pulses
AV valves
75
Right atria transfers deoxy blood to Right ventricle via what valve
Tricuspid
76
L-Vent SV is inversely related to what
Afterload
77
Chronic compensatory mechanisms (2)
Ventricular hypertrophy Ventricular Dilation
78
What type of receptors are innervated through SNS stimulation
?eta-1 receptors
79
A tear or ischemia of the papillary muscle can cause
Regurgitation
80
Standing position causes what to venous return
Decreases it
81
Aortic pressure is influenced by
Blood volume and peripheral vascular resistance
82
What is normal thickness of L-Vent muscle
8-15mm (3x the size of RV)
83
What is the function of the heart
Deliver O2 blood to tissues
84
Cardiac Output is measured as
Total blood volume per minute
85
SV equals
EDV - ESV
86
Frank Starling mechansims suggests
More stretch of myocytes the more capable force to a limit
87
CO equals
SV x HR
88
Methods EF is determined (3)
Nuclear ventriculography (MUGA) Echocardiography MRI
89
Ventricular hypertrophy is caused by
Chronic contraction against high afterload
90
SV is
Volume of blood ejected with each contraction
91
What allows for beat to beat compensation of the heart?
Frank Starling compensatory mechanism
92
What are the 2 names of AV valves
Tricuspid and Mitral
93
What method can use use for direct measurement of preload
Left heart catherization
94
Semilunar valves correspond to what heart sound
S2 (Dub)
95
Where does the cardiac plexus meet
Near Aortic arch
96
ANS regulates what
Rate, Conductivity speed, Force
97
What does LCX feed
SA node & PDA (Left dom flow) (Not predom) Lateral and part of posterior wall of LV
98
Ejection fraction physiologically represents
Fraction of EDV ejected from ventricle each systolic contraction
99
What are the names of Aortic valve cusps
Right cornary cusp, Left cornary cusp, and Noncoronary cusp
100
Increase preload you increase what?
Stroke volume (per Frank Starling mech)
101
Major compnents of preload (4)
Total blood volume Distribution of blood volume Atrial contraction Heart compliance
102
Increased preload leads to
V-con or increased volume Increased contractility increasing SV
103
Preload is measured with what values
Ventricular end diastolic volume (VEDV) Ventricular end diastolic pressure (VEDP)
104
CO and HR are inversely or directly proporational
Directly proportional
105
SA node SNS stimulation causes
Increased HR
106
Ventricle SNS stimulation causes
Increased contractility and conduction speed
107
Acute compensatory mechanisms (2)
Frank Starling mechanism Sympathetic Stimulation
108
Aortic pressure is also known as
The resistance against which the Ventricles must contract or mean blood pressure
109
Tricuspid valve corresponds to what chambers
RA and RV
110
Atria SNS stimulation causes
Increased contractility and conduction speed
111
Gold standard of determinging EF is
Cardiac cath (invasive)
112
CO is affected by (4)
Preload, afterload, Myocardial contractility and HR
113
AV Node SNS stimulation causes
increased conduction speed
114
Mitral valve corresponds to what chambers
LA and LV
115
What nerve is used for parasympathetic innervation
Vagus nerve
116
Acute compensatory SNS innervation results in
Increased HR or contractility
117
How do semilunar valves close
After ventricles eject into great vessels backward pressure catches the cusps and closes them
118
Is there ventricle PsNS innervation
NO
