Unit 1 Flashcards
(159 cards)
1
Q
What is the #1 cause of death
A
Cardiovascular disease
2
Q
What is the major underlying cause of of cardiovascular disease
A
Ischemia
3
Q
What can ischemia in cardiovascular disease be due to (2)
A
Atherosclerosis:
White thrombus
Red thrombus
Artery spasm
4
Q
What is the strength of the link between high blood cholesterol and atherosclerosis
A
Strong/abundant
5
Q
In atherosclerosis, what does the inflammatory mechanism couple dyslipidemia to
A
Atheroscleroma
6
Q
T/F inflammatory pathways inhibit thrombosis
A
False: promote thrombosis
7
Q
What is the definition of hemostasis
A
Prevention of blood loss
8
Q
What are the 4 mechanisms/events of hemostasis
A
Vascular spasm
Formation of a platelet plug
Blood coagulation
Fibrous tissue growth to seal
9
Q
How do neural reflexes affect vascular constriction
A
SNS induced constriction from pain
10
Q
How does local myogenic spasm affect vascular constriction
A
It is responsible for most of the constriction
11
Q
How do local humoral factors affect vascular constriction
A
Thromboxane A2 from platelets
Especially important in smaller vessels
12
Q
T/F: the degree of spasm is proportional to the severity of the trauma
A
True
13
Q
Can platelets divide
A
No but they function as whole cells
14
Q
What does the platelet cell membrane contain (2)
A
Glycoproteins
Phospholipids containing platelet factor 3
15
Q
Where are the glycoproteins in the platelet cell membrane located
A
Avoid normal endothelium but adhere to damaged area
16
Q
What initiates clotting in the platelet cell membrane
A
Thromboplastin
17
Q
What 4 things happen when platelets contact the damaged area
A
Swell
Irregular form, radiate from surface
Contractile protein - granule release
Secrete 3 substances
18
Q
What 3 substances are released during platelet activation
A
ADP
Thromboxane A2
Serotonin
19
Q
Is thromboxane A2 a vasodilator or vasoconstrictor
A
Vasoconstrictor
20
Q
What is the half life of a platelet
A
8-12 days
21
Q
How are platelets eliminated
A
Primarily by macrophage action
22
Q
What is the role of the endothelium regarding platelet activation
A
Endothelium prevents platelet aggregation
23
Q
What does the endothelium produce
A
PGI2 (prostacyclin)
24
Q
Is PGI2 (prostacyclin) a vasodilator or vasoconstrictor
A
Vasodilator
25
which factor (#) is produced in the endothelium and what is it involved with
```
Factor VIII (8)
Clotting
```
26
What blocks is thromboxane A2 & prostacyclin production (2)
Aspirin & Ibuprofen
27
Why take aspirin to prevent heart attacks
Low dose aspirin targets (inhibits) primary COX1
28
COX inhibitors are one type of ________
NSAIDs
29
How are COX 2 inhibitors different than COX1
COX2 inhibitors provide less GI risk (bleeding ulcers) than COX1 inhibitors
30
What are examples of COX2 inhibitors
Celebrex, Vioxx
31
What prevents clots from forming
Anticoagulants
32
What dissolves clots that have already formed
Lysis of clots
33
T/F plasmin is involved with anticoagulants
False: lysis of clots
34
T/F: chelators, heparin, and dicumarol are types of anticoagulants
True
35
Where are endogenous activators found (3)
Tissues, plasma, urine
36
Is streptokinase an endogenous/exogenous activator of plasminogen
Exogenous
37
Most of the frank tissue damage associated with infarction occurs upon ________
Reperfusion
38
What is reperfusion injury associated with the formation of
Reactive oxygen species with unpaired electrons
| "Free radicals"
39
What is the term for the ability to open up alternative routes of blood flow to compensate for a blocked vessel
Collateralization
40
Is vasoconstriction or vasodilation associated with collateralization
Vasodilation
41
SNS may augment collateralization via the release of ________
Neuropeptide Y (NPY)
42
How is the extrinsic mechanism of blood coagulation initiated
Chemical factors released by damaged tissues
43
What do intrinsic mechanisms of blood coagulation require
Only components in blood & trauma to blood or exposure to collagen
44
What is clotting factor I
Fibrinogen
45
What is clotting factor II
Prothrombin
46
What is clotting factor III
Thromboplastin
47
What is clotting factor IV
Calcium
48
What is clotting factor X
Stuart factor
49
What numbered clotting factors are associated with antihemophilic factors (A, B, C)
7
9
11
50
What clotting factor (#) is hageman factor
XII
51
What 5 clotting factors does the liver synthesize
```
1
2
7
9
10
```
52
What vitamin does coumarin (warfarin/Coumadin) depress?
Vitamin K
53
What clotting factors are depressed in the LIVER by Coumarin (warfarin or Coumadin)
2
7
9
10
**can still make #1
54
What chromosome is hemophilia sex linked on
X
55
What gender does hemophilia almost exclusively occur in
Males
56
What clotting factor is defective in 85% of hemophilia cases
7
57
What clotting factor is defective in 15% of hemophilia cases
9
58
What is the key step in clotting
The conversion of fibrinogen to fibrin which requires thrombin
59
What is the name of the syndrome of an autoimmune disorder where body makes antibodies against phospholipids in cell membranes
Antiphospholipid antibody syndrome
60
What is antiphospholipid antibody syndrome
An autoimmune disorder where body makes antibodies against phospholipids in cell membranes
61
What does antiphospholipid antibody syndrome cause
Abnormal clots to form
62
Name a few risk factors in heart disease
```
Increasing age
Male
Tobacco smoke
High blood cholesterol
High blood pressure
Physical inactivity
Obesity/overweight
Diabetes mellitus
High blood homocysteine
```
63
What is homocysteine
Amino acid in the blood that may irritate blood vessels
64
What does homocysteine promote
Atherosclerosis
65
What amino acid that irritates blood vessels and can make blood more likely to clot
Homocysteine
66
How many commonly occurring antigens are found in RBCs
30
67
How many rare antigens have been found on the surface of RBCs
Hundreds
68
What two particular antigen sets are likely to cause blood transfusion reactions if mismatched
ABO
| RH
69
What is an agglutinogen?
A & B antigens on RBCs
Can trigger agglutination
70
What is the most common blood type
OO
71
What is the least common blood type
AB
72
When are agglutination produced
After birth (2-8 months)
73
When do antibody tigers peak
Age 10
74
Is immediate or delayed hemolysis more common
Delayed
75
What is the most lethal effect of a transfusion reaction
Kidney failure
76
How does kidney failure kill you
Circulatory shock from hemolysed RBCs
77
T/F: spontaneous agglutins frequently arise in RH blood types
False: spontaneous agglutinins never arise in RH blood types
78
What are the 6 common RH antigens
C D E c d e
79
Can a person with a C antigen have a c antigen
No
80
What is the most common RH antigen
D
81
What is the condition known as "hemolytic disease of the newborn"
Erythroblastosis fetalis
82
What might jaundice be a sign of in a newborn
Erythroblastosis fetalis
83
are symptoms of Erythroblastosis Fetalis more likely to occur with 1st, 2nd, or 3rd pregnancy
3rd
84
What condition might anemia in a newborn be associated with
Erythroblastosis fetalis
85
What is the term for the condition in which bilirubin is present in the neurons of the brain
Kernicterus
86
What is the treatment for erythroblastosis fetalis
Replace neonate blood with Rh-
87
How many nuclei are located in the heart muscle
1-2
88
What does syncytium mean
Many acting as one
89
What is the natural syncytium of cardiac muscle due to
The presence of intercalated discs
90
What is the duration of action potential in cardiac muscle
.2-.3 seconds
91
Are sodium channels in cardiac muscle fast or slow
Fast
92
Are calcium/sodium channels in cardiac muscle fast or slow
Slow
93
When does the potassium permeability increase in cardiac muscle
During the resting polarized state
94
What blocks fast Na channels selectively
Tetradotoxin
95
If ion channels are open, an ion will seek its _________________ __________________ __________
Nernst equilibrium potential
96
What is Nernst equilibrium potential
Concentration gradient favoring ion movement in one direction is offset by electrical gradient
97
What is the ratio of Na/K in the atpase pump
3:2
98
What part of the cell (inside/outside) remains negative in the ATPase pump
Inside
99
What inhibits the ATPase pump
Digitalis
100
What part of the refractory period is unable to restimulate a cardiac cell (absolute or relative)
Absolute
101
What part of the refractory period requireas a Supra-normal stimulus to re-stimulates (absolute/relative)
Relative refractory period
102
Which node is the normal pacemaker of the heart
SA node
103
T/F: the SA node is self-excitatory
True
104
What is overdrive suppression
Driving a self-excitatory cell at a rate faster than its own inherent rate
This suppresses the cell's own automaticity
105
Does the AV node decrease or increase conduction velocity
Decrease due to smaller diameter fibers
106
What may act as the pacemaker if the natural pacemaker is absent
AV node
107
Is heart rate and cycle length directly proportional or inversely proportional
Inversely
As HR increases, cycle length decreases
108
Systole & Diastole
Which is contraction, which is relaxation
Systole: contraction
Diastole: relaxation
109
What is the term for the stretch on the wall prior to contraction
Preload
110
What is the term for the changing resistance that the heart has to pump against as blood is ejected
Afterload
111
What is the A wave associated with
Atrial contraction
112
What is the C wave associated with
Ventricular contraction
113
What is the V wave associated with
Atrial filling
114
What is the volume in the ventricles at the end of filling
End diastolic volume
115
What is the volume in ventricles at the end of ejection
End systolic volume
116
What is the volume ejected by ventricles
Stroke volume
117
How is stroke volume calculated
End diastolic volume - end s ystolic volume
118
How is ejection calculated
Stroke volume / end diastolic volume *100%
119
What is normal ejection fraction
50-60%
120
T/F: when LV pressure > aortic pressure...aortic valve is open
True
121
T/F: when aortic pressure > LV pressure...aortic valve is closed
True
122
Which valves are stronger
AV or
Semilunar
Semilunar
123
Which valves are thin, filmy, and attach to chorda tendineae
AV or
Semilunar valves
AV valves
124
What is the term for dysfunctional valves that do not open fully
Stenotic valves
125
What is the law of Laplace
Wall tension = (pressure)(radius)/2
126
What does chronotropic mean
Anything that affects heart rate (increases or decreases)
127
What does dromotropic mean
Anything that affects conduction velocity
128
What does inotropic mean
Anything that affects strength of contraction
129
Which term would caffeine apply to
Chronotropic
Dromotropic
Inotropic
Chronotropic (+)
130
What is the frank-starling law of the heart
Within physiological limits, the heart will pump all the blood that returns to it without allowing excessive damage of the veins
131
What is the mechanism of the frank-starling law of the heart
Increased venous return ---> increased stretch of cardiac muscle fibers
--> increases force of contraction and heart rate
132
What is the term for
"Within limits, as cardiac fibers are stretched, the force of contraction is increased"
Heterometric autoregulation
133
What 3 inductions increase strength of contraction with homeometric autoregulation
Flow induced
Pressure induced
Rate induced
134
What does direct stretch on SA node do to HR
Increases heart rate
135
What are 4 extrinsic influences on heart rate
ANS (autonomic nervous system)
Hormonal influences
Ionic influences
Temperature influences
136
How does sympathetic innervation affect:
HR
Strength of contraction
Conduction velocity
+
+
+
137
How does Parasympathetic innervation affect:
HR
Strength of contraction
Conduction velocity
-
-
-
138
What dominates the inhibitory influence on heart rate at rest
Parasympathetic nervous system
139
What exerts a dominant stimulatory influence on strength of contraction at rest
Sympathetic nervous system
140
Does stimulation of the left Stellate ganglion increase/decrease ventricular fibrillation threshold
Decrease
141
Does stimulation of the right stellate ganglion increase or decrease ventricular fibrillation threshold
Increase
142
Left cardiac sympathetic denervation increases ___________ activity
Caval
143
What is the cardioaccelerator reflex
Stretch on right atrial wall increases SNS outflow to heart
144
What is another term for the cardioaccelerator reflex
Bainbridge reflex
145
What 2 results present with the benzold-Jalisch reflex
Hypotension
Bradycardia
146
What stimulates the benzold-Jalisch reflex
Occlusion of circumflex artery
147
How do thyroid hormones affect heart rate and strength of contraction
Increase chronotropic
Increase inotropic
148
What results from elevated Ca++ in the heart
Spastic contraction
149
HR increases about __ bpm for every degree elevation in body temperature
10
150
What is the preferred energy substrate for cardiac cells
Fatty acids
151
What 5 things are analyzed for in an EKG
```
Rate
Rhythm & Intervals
Axis
Hypertrophy
Infarction
```
152
Sinus arrhythmia is when the longest and shortest RR vary by > ____ seconds
0.16
153
A prolonged QRS complex is > ____ seconds
0.12 seconds
154
Define MEA
Mean electrical axis: the average direction of ventricular depolarization
155
What is an acronym for how the ventricles of the heart depolarize
ADIO
| Above, down, inside, out
156
Hypertrophy of one ventricle relative to the other can be associated with anything that creates an ____________ ____ _____ ____ on that chamber
Abnormally high work load
157
The myocardium is supplied by the __________ ________ and their branches
Coronary arteries
158
Ischemia prolongs ____________ & therefore delays ___________
Depolarization
Repolarization
159
Cardiac troponins _ and _ are the preferred markers for myocardial injury
T & I (i, not L)
