Unit 3.1: CV A&P Flashcards
1
Q
A
2
Q
which myocyte property is correct for: Contains actin and myosin myofilaments
A. Similar to neural and skeletal muscle
B. Unique to cardiac muscle
A
A
3
Q
which myocyte property is correct for: propagates action potential
A. Similar to neural and skeletal muscle
B. Unique to cardiac muscle
A
A
4
Q
which myocyte property is correct for: generates a resting potential
A. Similar to neural and skeletal muscle
B. Unique to cardiac muscle
A
A
5
Q
which myocyte property is correct for: has gap junctions
A. Similar to neural and skeletal muscle
B. Unique to cardiac muscle
A
B
6
Q
which myocyte property is correct for: Contains t-tubule system
A. Similar to neural and skeletal muscle
B. Unique to cardiac muscle
A
A
7
Q
which myocyte property is correct for: oxygen consumption at rest of 8-10 mL O2/100 g/min
A. Similar to neural and skeletal muscle
B. Unique to cardiac muscle
A
B
8
Q
the resting membrane potential is established by what 3 mechanisms
A
- chemical force
- electrostatic counterforce
c. sodium/potassium ATPase
9
Q
define resting membrane potential
A
the electrical potential across a cell membrane at rest
10
Q
define threshold potential
A
the voltage change that must be achieved to initiate depolarization
11
Q
Review:
note similarities and differences between neural, skeletal, and cardiac muscle
A
12
Q
what is the name of the equation to predict an ions equillibrium pote4ntial
A
Nernst
Do not need to know how to calculate… just understand concept
13
Q
Describes the force of myocardial contraction during systole
A. Inotropy
B. Chronotropy
C. Dromotropy
D. Lusitropy
A
A
14
Q
describes Heart rate
A. Inotropy
B. Chronotropy
C. Dromotropy
D. Lusitropy
A
B
15
Q
Describes conduction velocity through the heart (Velocity = distance/time)
A. Inotropy
B. Chronotropy
C. Dromotropy
D. Lusitropy
A
C
16
Q
describes the rate of myocardial relaxation during diastole
A
D
17
Q
primary determinant of threshold potential
A
Serum Calcium
18
Q
primary determinant of resting membrane potential
A
serum potassium
19
Q
A
2
20
Q
Review
A
21
Q
sort each myocardial event to its primary phase of the myocyte action potential: ST Segment
A. Phase 0
B. Phase 2
C. Phase 3
D. Phase 4
A
B
22
Q
sort each myocardial event to its primary phase of the myocyte action potential: Q Wave
A. Phase 0
B. Phase 2
C. Phase 3
D. Phase 4
A
A
23
Q
sort each myocardial event to its primary phase of the myocyte action potential: Calcium Influx
A. Phase 0
B. Phase 2
C. Phase 3
D. Phase 4
A
B
24
Q
sort each myocardial event to its primary phase of the myocyte action potential: Sodium influx
A. Phase 0
B. Phase 2
C. Phase 3
D. Phase 4
A
A
25
sort each myocardial event to its primary phase of the myocyte action potential: **isoelectric EKG**
A. Phase 0
B. Phase 2
C. Phase 3
D. Phase 4
D
26
sort each myocardial event to its primary phase of the myocyte action potential: **Plateau**
A. Phase 0
B. Phase 2
C. Phase 3
D. Phase 4
B
27
sort each myocardial event to its primary phase of the myocyte action potential: **Resting phase**
A. Phase 0
B. Phase 2
C. Phase 3
D. Phase 4
D
28
sort each myocardial event to its primary phase of the myocyte action potential: **T Wave**
A. Phase 0
B. Phase 2
C. Phase 3
D. Phase 4
C
29
sort each myocardial event to its primary phase of the myocyte action potential: **Potassium Leak**
A. Phase 0
B. Phase 2
C. Phase 3
D. Phase 4
D
30
sort each myocardial event to its primary phase of the myocyte action potential: **Final Repolarization**
A. Phase 0
B. Phase 2
C. Phase 3
D. Phase 4
C
31
sort each myocardial event to its primary phase of the myocyte action potential: **Potassium Efflux**
A. Phase 0
B. Phase 2
C. Phase 3
D. Phase 4
C
32
sort each myocardial event to its primary phase of the myocyte action potential: **Depolarization**
A. Phase 0
B. Phase 2
C. Phase 3
D. Phase 4
A
33
34
I-f
35
**Review**
- what is the order of stimulus through heart
36
**Review SA node Firing**
37
what determines the heart rate...
38
other name for the SA node
Kieth flack node
39
**Review**
40
the ______ vagus nerve innervates the SA Node and the ______ vagus nerve innervates the AV Node
Right = SA
Left = AV
41
Cardiac accelerator fibers
T1-T4
42
**REVIEW**
43
44
what 3 variables can be manipulated to change the sinus node rate
1. rate of spontaneous phase 4 depolarization
2. threshold potential
3. Resting membrane potential
45
how does SNS stimulation increase the HR
46
47
1000 ml/min
48
oxygen delivery equation
*what is the normal*
*1,000 mL*
49
**Review**
50
solution coefficient for dissolved oxygen
0.003
51
3 things CO is determined by
1. preload
2. afterload
3. contractility
52
oxygen content equation
*what is the normal*
*20 mL/dL*
53
oxygen extraction ration
54
oxygen consumption normal amount
55
venous oxygen content equation
*what is the normal*
*15 mL/dL*
56
match the "parts of the choo choo train" to the components of the oxygen delivery equation
**Cargo**
A. Hemoglobin
B. SaO2
C. Cardiac Output
B
57
match the "parts of the choo choo train" to the components of the oxygen delivery equation
**Engine**
A. Hemoglobin
B. SaO2
C. Cardiac Output
C
58
match the "parts of the choo choo train" to the components of the oxygen delivery equation
**Boxcar**
A. Hemoglobin
B. SaO2
C. Cardiac Output
A
59
what does CaO2 tell you
how many grams of oxygen are contained in a dL of **ARTERIAL** blood
60
the amount of oxygen dissolved in blood (PaO2) follows what law
henrys law
61
hematocrit
62
equation to calculate MAP
63
poiseuilles Equation
64
altering what part of poiseuilles Equation yields the gretest impact on flow
radius
65
**Review**
66
what factors influence CO
SV
HR
ESV
EDV
Filling pressures
compliance
afterload
contractility
67
how does CO impact the variable that comes after it
directly impacts MAP, tissue blood flow, and oxygen delivery
68
what are the 5 components of Poiseuilles Law
69
how much flow occurs when the radius of a tube is quadrupled
256 times
70
how is viscocity related to temperature
A. Inversely proportional
B. Directly proportional
A
71
Reynolds # for turbulent flow
> 4,000
72
Reynolds # for transitional flow
2,000-4,000
73
Reynolds # for laminar flow
< 2,000
74
75
Normal value for:
**Cardiac Output**
5-6 L/min
76
Normal value for:
**Stroke Volume**
50-100 mL/beat
77
Normal value for:
**Ejection fraction**
60-70%
78
Normal value for:
**Mean arterial BP**
70-105 mmHg
79
Normal value for:
**SVR**
80
Normal value for:
**Pulmonary Vascular Resistance**
81
**Review**
82
**Review**
83
84
**Review**
85
**Review**
*notice that several terms can be used on the x- and y- axes. You should know all of them*
86
atrial kick accounts for ______% of the final LVEVV
20-30%
87
conditions associated with *decreased* myocardial compliance...
- myocardial hypertrophy
- heart failure with preserved EF (diastolic failure)
- fibrosis
- aging
88
On the Starling curve, is this variable on the X- or Y-axes?
**LVEDV**
X
89
On the Starling curve, is this variable on the X- or Y-axes?
**PAOP**
X
90
On the Starling curve, is this variable on the X- or Y-axes?
**CO**
Y
91
On the Starling curve, is this variable on the X- or Y-axes?
**SV**
Y
92
On the Starling curve, is this variable on the X- or Y-axes?
**LVSW**
Y
93
On the Starling curve, is this variable on the X- or Y-axes?
**CVP**
X
94
LVEDP, LAP, and PAOP are all surrogate measures of:
LVEDV
95
- hypoxia
- hypercapnia
- hyperkalemia
96
true or false: contractility is independent of preload and afterload
true
97
What happens to ventricular output when contractility is increased vs decreased
98
Factors that influence contractility
**Remember**
**C** hemicals affect **C** ontractility - particularly **C** alcium
99
**Review**
100
Review how Beta-1 stimulation increases contractility
101
what is the primary substance that determines inotropy
calcium
102
name 5 factors that increase LV contractility
103
list 3 ways that B-1 receptor stimulation modulates calcium in the myocyte
104
Afterload
105
**Review**
106
law of laplace equation
107
normal SVR in adults
107
myocardial wall stress is reduced by what 3 factors
108
- rapid ventricular filling
- diastasis
- atrial systole
109
**REVIEW x 1000**
110
**Review**
**Systole**
111
**Review**
**Diastole**
112
identify the status of the mitral valve ( *open vs closed* ) during each phase of the cardiac cycle
**Ventricular Ejection**
mitral valve = closed
113
identify the status of the mitral valve ( *open vs closed* ) during each phase of the cardiac cycle
**Isometric ventricular relaxation**
mitral valve = closed
114
identify the status of the mitral valve ( *open vs closed* ) during each phase of the cardiac cycle
**Isometric ventricular contraction**
mitral valve = closed
115
identify the status of the mitral valve ( *open vs closed* ) during each phase of the cardiac cycle
**atrial systole**
mitral valve = open
116
identify the status of the mitral valve ( *open vs closed* ) during each phase of the cardiac cycle
**rapid ventricular filling**
mitral valve = open
117
identify the status of the aortic valve ( *open vs closed* ) during each phase of the cardiac cycle
**isometric ventricular contraction**
AV= closed
118
identify the status of the aortic valve ( *open vs closed* ) during each phase of the cardiac cycle
**Ventricular Ejection**
AV = open
119
identify the status of the aortic valve ( *open vs closed* ) during each phase of the cardiac cycle
**rapid ventricular filling**
AV = closed
120
identify the status of the aortic valve ( *open vs closed* ) during each phase of the cardiac cycle
**atrial systole**
AV = closed
121
identify the status of the aortic valve ( *open vs closed* ) during each phase of the cardiac cycle
**isometric ventricular relaxation**
AV = closed
122
stroke volume ___________ between Q wave and end of T wave
A. Does occur
B. Does not occur
A
123
atrial systole ___________ between Q wave and end of T wave
A. Does occur
B. Does not occur
B
124
rapid ventricular ejection ___________ between Q wave and end of T wave
A. Does occur
B. Does not occur
A
125
mitral valve opens ___________ between Q wave and end of T wave
A. Does occur
B. Does not occur
B
126
atrial valve opens___________ between Q wave and end of T wave
A. Does occur
B. Does not occur
A
127
left ventricular systole ___________ between Q wave and end of T wave
A. Does occur
B. Does not occur
A
128
isovolumetric ventricular relaxation ___________ between Q wave and end of T wave
A. Does occur
B. Does not occur
B
129
what cardiac event occurs at the marked area of the image
A. Mitral Valve closes
B. Mitral Valve Opens
C. Aortic Valve closes
D. Aortic Valve Opens
A
130
**Review**
131
**Review**
132
identify each phase of the ventricular cycle as systole or diastole
133
identify each mechanical event of the ventricular cycle
134
calculate the stroke volume (in mL)
70 mL
**equal to the width of the loop**
135
**Review**
136
true or false: the LV volume increases during isovolumetric contraction
False -- LV volume does not change
137
when is DBP measured
where aortic valve opens
138
When is SBP measured
at the peak of the ejection curve
139
**Review**
140
identify the status of the cardiac valves on the LV pressure volume loop
141
**Ejection Fraction:**
- Normal
- mild dysfunction
- moderate dysfunction
- severe dysfunction
- Normal: >/= 50%
- mild dysfunction: 41-49%
- moderate dysfunction: 26-40%
- severe dysfunction:
142
intravenous fluid bolus
143
**Review**
*increased preload*
144
**Review**
*decreased preload*
145
**Review**
*increased contractility*
146
**Review**
*decreased contractility*
147
**Review**
*increased afterload*
148
**Review**
*decreased afterload*
149
*Identify the change that occurs in each LV pressure-volume loop*
increased preload
150
*Identify the change that occurs in each LV pressure-volume loop*
increased contractility
151
*Identify the change that occurs in each LV pressure-volume loop*
increased afterload
152
*Identify the change that occurs in each LV pressure-volume loop*
decreased preload
153
*Identify the change that occurs in each LV pressure-volume loop*
decreased contractility
154
*Identify the change that occurs in each LV pressure-volume loop*
decreased afterload
155
circumflex
156
**Review**
*arterial circulation*
157
**Review**
158
**Review**
159
**Review**
*arterial supply to the conduction system*
160
**Review**
*coronary venous circulation*
161
**Review**
162
on TEE/TTE, what is best view for diagnosing LV ischemia
what is 2nd best...
midpapillary muscle level in short axis
...2nd best = apical segment in short axis
163
Identify each coronary artery
164
identify the coronary artery responsible for perfusing each segment of the heart
165
Which part of the myocardium does Lead II monitor
A. Lateral
B. Inferior
C. Anterior
D. Septal
B
166
Which part of the myocardium does Lead V5 monitor
A. Lateral
B. Inferior
C. Anterior
D. Septal
A
167
Which part of the myocardium does Lead I monitor
A. Lateral
B. Inferior
C. Anterior
D. Septal
A
168
Which part of the myocardium does Lead aVF monitor
A. Lateral
B. Inferior
C. Anterior
D. Septal
B
169
Which part of the myocardium does Lead V1 monitor
A. Lateral
B. Inferior
C. Anterior
D. Septal
D
170
Which part of the myocardium does Lead V3 monitor
A. Lateral
B. Inferior
C. Anterior
D. Septal
C
171
Which part of the myocardium does Lead V2 monitor
A. Lateral
B. Inferior
C. Anterior
D. Septal
D
172
Which part of the myocardium does Lead V6 monitor
A. Lateral
B. Inferior
C. Anterior
D. Septal
A
173
Which part of the myocardium does Lead III monitor
A. Lateral
B. Inferior
C. Anterior
D. Septal
B
174
Which part of the myocardium does Lead aVL monitor
A. Lateral
B. Inferior
C. Anterior
D. Septal
A
175
Which part of the myocardium does Lead V4 monitor
A. Lateral
B. Inferior
C. Anterior
D. Septal
C
176
MEdiators of coronary vasodilation include (select 2):
A. adenosine
B. Beta 2 stimulation
C. Alpha-1 stimulation
D. hypocapnia
A & B
177
**Review**
*coronary blood flow and perfusion*
178
coronary blood flow auto regulates between a MAP of
60-140 mmHg
179
adenosine is a byproduct of ______ metabolism and is a potent coronary vessel___________
ATP
vasodilator
180
the __________ response refers to a vessels innate ability to maintain a constant vessel diameter
myogenic
181
**Review**
*causes of coronary artery constriction and dilation*
182
what 2 pressures determine coronary perfusion pressure
CPP = aortic DBP = LVEDP
183
what 3 responses are responsible for autoregulation of coronary blood flow
184
**Histamine-1** causes:
A. Coronary vasoconstriction
B. Coronary vasodilation
A
185
**Beta-2** causes:
A. Coronary vasoconstriction
B. Coronary vasodilation
B
186
**Hitamine-2** causes:
A. Coronary vasoconstriction
B. Coronary vasodilation
B
187
**muscarinic** causes:
A. Coronary vasoconstriction
B. Coronary vasodilation
B
188
**alpha** causes:
A. Coronary vasoconstriction
B. Coronary vasodilation
A
189
blood flow thru which cardiac region corresponds to the waveform in the image
A. RV subendocardium
B. LV subendocardium
C. LV epicardium
D. Aorta
B
190
describe each waveform
191
which region of the heart does this pressure waveform represent
Lt coronary artery flow during the cardiac cycle
192
which myocardial arterial bed is most susceptible to ischemia
endocardial blood vessels of the myocardium
193
decreased diastolic filling time
194
**Review**
*what increases and decreases oxygen demand*
195
name 3 circumstances that affect both sides of the myocardial supply-demand equation
1. changes in HR
2. aortic diastolic pressure changes
3. changes to preload
196
what does tachycardia do to myocardial oxygen supply and demand
197
what does increased aortic diastolic presure do to myocardial oxygen supply and demand
198
what does increased preload do to myocardial oxygen supply and demand
199
mortality rate of a perioperative MI
20%
200
**Review**
201
3 pathways that affect intracellular calcium concentration
202
PKA affects excitation-contraction coupling by:
203
**Review**
*Nitric Oxide cGMP pathway*
204
activators of PLC pathway (4)
- phenylephrine
- norepinephrine
- angiotensin 2
- endothelin-1
205
the nitric oxide cGMP pathway causes:
A. vasodilation
B. Vasoconstriction
A
206
the Phospholipase C pathway causes:
A. vasodilation
B. Vasoconstriction
B
207
the G-protein cAMP pathway causes:
A. vasodilation
B. Vasoconstriction
A
208
What 4 ways does protein kinase A affect excitation-contraction
209
phenylephrine stimulates what effector to ultimately cause vasoconstriction
phospholipase C
210
A. I
B. aVL
C. II
D. V6
E. V1
F. V3
A, B, D
211
trendelenburg
212
766 mL O2/min
213
214
215
216
217
218
219
220
where on the loop does aortic valve open
221
222
increasing potassium conductance
223
224
adenosine
225
hyperkalemia increases resting membrane potential
226
which letter corresponds with diastole (select 2)
B & C
227
rapid ventricular filling
diastasis
atrial systole
228
SA Node automaticity
229
5%
230
231
232
80
233
neither preload or afterload
234
