Shared Flashcard Set

Details

PBD Exam 3
PBD Exam 3 Dr. Keller-Wood Material
108
Other
Professional
11/20/2010

Additional Other Flashcards

 


 

Cards

Term
What is the arrangement of the Cardiovascular system?
Definition

There is a systemic and pulmonary circuits that is in series. 

In the systemic circuit: The right side of the heart pumps blood to the lungs and the left side of the heart pumps blood to the systemic circulation. 

Term
In the cardiovascular system the circuits of the organ systems are in _______________ which means that flow through these organs are _______________ of each other which ______________ the pressure.
Definition

parallel

are independent (better to have more paths)

decreases

Term
The ____________ has a greater pressure than the ___________.
Definition

Arteries has the highest

Then capillaries

 

Veins have the lowest

Term
In the systemic circuit the arteries have a pressure of ____ while the veins have a pressure of __________.
Definition

120/80

 

2-7

Term
How is tension calculated?
Definition

(The pressure across the wall x radius)/ wall thickness

 

T = (Ptm x R)/ (M)

Term
Tension is greatest in _______ vessels so the ________ will have the greatest tension.
Definition

Big vessels that have a large diameter

Aorta

Term
Tension is least in small vessels with low pressure like in _____________.
Definition
Capillaries
Term
Large vessels need _______ wall thickenss and structure than small vessels.
Definition
Greater
Term
Pressure and volume in the heart are ______________ related so since the arteries have a higher P then you will have a __________ V than the veins.
Definition

inversely

lower

Term
If you have a thicker wall vessel then you tension is ________.
Definition
Lower
Term
The arteries holds about _______ of the blood volume whereas the veins hold ________.
Definition

1/3

2/3

Term
Arterties are made from ___________ and ___________ VSM and elastic fiber.
Definition

Longitudinal

Circular

Term
Elastic arteries are for _______________ whereas muscular arteries are used to ______.
Definition

Stretch and Recoil

Distribute

Term
Arterioles have less elastic fibers and longitudinal VSM than arteries so they have ____________ used for ___________.
Definition

Circular smooth muscle

resistance

Term
Main function for capillaries is for
Definition

exchange

fluid flux

Term
Veins/venules have a high amount of ______________________ so it has _____________.
Definition

Longitudinal VSM

Compliance

Term
Define compliance
Definition

Refers to the total quantity of blood that can be stored in a given portion of the circulation for each mm rise in pressure.

 

C= Volume change/ Pressure change

Term
Which vessel has the largest compliance and why?
Definition
Veins; because an increase in volume change only change the pressure a little bit. This allows them to act as a reservoir for storing large quantities of blood that can be returned to the circulation.
Term
What causes the flow of blood in the heart circuit?
Definition

A pressure gradient

From high pressure to a low pressure

from arteries to veins

Term
What is the physics behind the blood flow in the heart?
Definition

Ohm's Law

Flow = Q

Q = ΔP/R

 

where P = pressure

R= resistance to flow

Term
How do we calculate the resistance to blood flow in the heart?
Definition

R ∞ η/r4

 

So Resistance increases as the viscosity increases.

And if the radius was to increase, this will decrease the resistance by a factor of 10^4.

Term
To increase blood flow we want (narrower/wider) vessels.
Definition

Wider

 

If you increase r then you decrease the resistance.

Term
How do you calculate the change in pressure?
Definition

ΔP = Cardiac output x Total resistance

 

ΔP = P aorta - P Vena cava

 

ΔP  = CO x TPR

 

(where TPR is the total peripheral resistance)

Term
If you want to increase the flow of blood to an organ you want to ____________ or ___________.
Definition

Increase the pressure in the arteries

or

decrease the resistance in the arteriole

Term
How does the heart do "work"?
Definition

By pumping a volume of blood against arterial pressure

 

if you increase either the pressure or volume pumped by the heart you have more work

Term
Arterioles get smaller in size as they branch further into tissues. This leads to ___________ .
Definition

Capillaries

1 single celled endothelial used for exchage/fluid flux

Term
T/F: All capillaries are open at the same time.
Definition
False; they have a precapillary sphincter that controls whether the capillary is open or not. They are not all open at one point in time.
Term
What 2 things control the fluid flux in capillaries?
Definition

Hydrostatic pressure

Oncotic pressure

Term
State Starlings Law
Definition

1. Flux occurs down a hydrostatic pressure gradient

2. Flux occurs into the area with High oncotic P

3. Flux depends on permeability

 

Term
Net flux is proportional to ________________.
Definition
net filtration pressure
Term
How do we calculate the net filtration pressure?
Definition

NFP = (Pc-Pif) - (∏p-∏if)

Pc = pressure in capillary

Pif = pressure in intersitial fluid

 

where P is the change in hydrostatic pressure

And ∏ is the change in oncotic pressure

 

 

Term
What happens at the arterial end of the capillary?
Definition
The NFP is + so there is a net outward flux.  A small amount of fluie leaves along with some soluble substances that cross the capillary.
Term
What happens at the venous end of the capillary?
Definition
The NFP is - so it tends to have a net inward flux back into the capillary.  The returned fluid brings with it some soluble products of metabolism like CO2.
Term
The net flux overall in the body tends to be _______________.
Definition

out

+ NFP

Term
Which system picks up the excess fluids and proteins and returns them to the blood.
Definition
Lymphatic system
Term
When does the lymphatic flow increase?
Definition

When there is an increase in interstitial fluid pressure.

 

 

Term
How does the interstitial fluid pressure increase to increase the Lymphatic flow?
Definition

If more fluid flows out of the capillaries

and if there is an elevated capillary pressure

Term
How does the lymphatic vessels act as a pump?
Definition

They contract surrounding muscles (this increases the pressure)

Pulsate adjacent arteries

And compress the tissues

 

 

Term
The ____________ determines flux of fluids thus the solutes in the fluid which all affects the capillary ________.
Definition

Filtration coefficient (Fc)

permeability

Term
T/F: Capillary permeability varies with the type of solute and with the type of capillary and the size of pores, etc.
Definition
True
Term
Capillary permeability is greatest in the _______ and the least in the ______.
Definition

Liver

Brain

Term
How can we change the flux in our bodies?
Definition

You can constrict arterioles which lowers Pc

This makes more fluid enter the capillaries from the Interstitium.

 

If you lower the # of protein then you decrease your ∏p which makes more fluid leave the capillaries and create Edema.

Term
The heart pumps blood by first contracting the ___________followed by the ________.  This causes changes in ____________.
Definition

Atria

ventricles

pressure (will increase if the chamber size decreases)

Term
Right atrium receives blood returning to the heart from the
Definition
systemic circulation
Term
Left atrium receives oxygenated blood from the
Definition
lungs
Term
Right ventricle pumps blood to
Definition
the lungs
Term
Left ventricle pumps blood to
Definition
the systemic circulation
Term
______ open and close to allow blood to flow in or out of chambers.
Definition
Valves
Term
Atrioventricular valves control the flow
Definition
of blood from Atrial to the ventricles
Term
Pulmonic valves control the flow of blood from
Definition
the right side of the heart to the lungs
Term
Aortic valves control the flow of blood from the
Definition
left side of the heart to the systemic circulation
Term
The ventricles have thicker walls than the atriums because
Definition

they have to pump blood out of the heart.

They do additional work

Term
The bicuspid valve is aka ____________ and is located on the ___________ of the heart.
Definition

Mitral valve

left side

Term
The tricuspid valve is aka ______________ and is located on the ____________ side of the heart.
Definition

atrial

right

Term
The cardiac cycle is divided into 2 parts. What are they?
Definition

Systole

Diastole

Term
During systole the
Definition
ventricles are contracting
Term
During diastole the ventricles are
Definition
relaxed and filling up with blood
Term
What causes the first heart sound?
Definition
The closure of the mitral valves
Term
 T/F: Ventricular systole is divided into isovolumetric contraction period and isovolumetric relaxation period.
Definition
True
Term
What happens during isovolumetric contraction period of ventricular systole?
Definition

1. The mitral valve closes (makes first heart sound)

sn. the other valves are also closed for a short period of time

2. Ventricular pressure rises abruptly because all the valves are closed

3. Ventricles continue to contract until the left ventricular pressure is slightly higher than aortic pressure and right ventricular pressure is higher than pulmonary artery pressure.

4. Mitral valve open and signals the ejection period.

Term
What happens at the end of systole in the ventricles?
Definition

1. The ventricles relax

2. This causes a steep fall in intraventricular pressure

3. The blood from the large arteries wants to flow back towards the ventricles but this causes the Aortic and Pulmonic valves to snap shut.

4. Aortic closure of valves causes the 2nd heart sound

5. The ventricular volume remains the same but the pressure drops as the valves stay closed.

Term
What happens during ventricular diastole?
Definition

1. Ventricular filling occurs

2. When ventricular presure is less than atrial pressure, the AV vlaves open

2. Blood flows from the atria into ventricles

3. Most blood is fileld during the first thrid of diastole which is aka rapid filling period.

4. Middle third of diastole the inflow is at a standstill.

5. the last third of diastole is marked bny atrial contraction which gives an additional thrust to ventricular filling.

Term
When do you hear a 3rd heart sound?
Definition
During the rapid filling period of diastole as blood flows into a distended or noncompliant ventricle during atrial contraction.
Term
A fourth heart sound occurs during
Definition
the last third diastole as the atria contract.
Term
During diastole the ventricles increase their volume to 120mL this is called the ___________ and at the end of systole it is ___________.
Definition

End diastolic Volume

50 mL (end systolic volume)

Term
How do you calculate the stroke volume?
Definition

Stroke volume = EDV - ESV

End diasolic volume - the end systolic volume

120-50 = 70 ml

 

Term
What is the ejection fraction and how do you calculate it?
Definition

ejection fraction is the fraction of diastolic volume that is ejected from the heart during systole.

 

Ejection fraction  = SV/EDV

Stroke volume/ End diastolic volume

 

it determines the pump efficiency

Term
Stenosis occurs when there is
Definition
incomplete opening of valves
Term
An insufficeincy occurs when
Definition
there is an incomplete closure of valves
Term
Stenosis occurs when the valve is not completely open this _______ the flow through the valve.
Definition
reduces
Term
Insufficiency of a valve is when it doesnt completely close this causes _____________
Definition
backflow or regurgitation
Term
A mitral insufficiency can lead to either _____________ or ___________.
Definition

Mitral valve prolapse

Mitral Valve Regurgitation

Term
T/F: Mitral Valve Prolapse (MVP) is seen more in men.
Definition
False; it is more common in women
Term
MVP is caused by
Definition
enlarged leaflets or too long of chordae tendinae
Term
What are some symptoms of MVP?
Definition

1. It can be Asymptomatic-- meaning no symptoms. Dont know they have it until they get a check up.

2. Could have midsystolic clicks

3. Could have late systolic murmurs

4. Can have chest pains (arrhythmias)

Term
List some complications of MVP
Definition

Can lead to regurgitation by rupture of the chordae.

Lead to infective endocarditis

Can form an emboli

lead to atrial/ventricular arrhythmias

Term
What are some causes for Mitral Valve regurgitation?
Definition

1. rupture of chordae tendina

2. Rheumatic heart disease

3.Hypertrophic myopathy

4. Left ventricle enlargement

5. Infective endocarditis

6. Abnormality in valves/papillary muscles

7. Ischemic heart disease (CAD)

 

Term
What changes occur during Mitral Regurgitation?
Definition
As the disorder progresses the aortic stroke volume decreases because the left ventricular fucntion is impaired.  The left atrial pressure thus increases.  THe increase in atrial pressure is more pronounced if acute and severe.
Term
What type of murmur occurs during Mitral Regurgitation?
Definition
Systolic murmur occurs throughout systole.
Term
What are some complications of Mitral Regurgitation.
Definition

The volume overload of the left ventricle and atrium can lead to:

1. atrial arrhymthmias

2. pulmonary edema

3. left side heart failure

4. enlargement of LV which leads to S3

Term
What causes Mitral Stenosis?
Definition

1. Thickening and calcification of the valves

2. Shortening/thickening of the chordae tendinae caused by Rheumatic fever and Strep

Term
T/F: During Mitral Stenosis the left atrium becomes dilated and thus increases the pressure. This increased in left atrial pressure is tranmitted to the pulmonary venous system and causes pulmonary congestion.
Definition
True
Term
During mitral valve stenosis there is an impaired filling of the ________ which causes an incraese in pressure in the ________.
Definition

left ventricle

left atrium

Term
The murmur of mitral stenosis is heard during ______________ .
Definition

diastole

 

(sn: a opening snap may preced the murmur as a result of the incrase in LA pressure)

Term
What are some complications of Mitral Stenosis?
Definition

there is a pressure overload int he atrium that can lead to

1. LA enlargement

2. Atrial arrhythmias

3. Right heart failure due to pulmonary edema

4. thrombus formation

Term
T/F: Aortic Vavle Stenosis is chracterized by an increased resistance to ejection of blood from the LV to the Aorta.
Definition
True
Term
In Aortic Stenosis there is a __________  amount of blood ejected intot he systemic ciruclation because the there is ___________ resistance.
Definition

Decreased

increased

Term
Common causes for Aortic Stenosis is?
Definition

Rheumatic fever

Congenetial valve malformations

Senile calcification

Term
With Aortic Stenosis there is a _______________ that caues a ____________.
Definition

Late Systolic ejection murmur

4th sound

Term
Aortic Stenosis causes a decrease in ____________ and an increase in ________________ because of the reduced outflow.
Definition

aortic pressure

left ventricle pressure

Term
What are some complications for Aortic Stenosis?
Definition

It is a pressure overload in the ventricles that can lead to:

1. chest pain

2. angina, syncope (Fainting)

3. Left side heart failure

4. dizzy when exercise

5. Dyspnea

6. Cyanosis

Term
T/F: Aortic regurgitation is the result of an incompetent aortic vlave that allows blood to flow back to the LV during diastole. 
Definition
true
Term
What are some causes for Aortic Regurgitation?
Definition

Floppy valve leaflets or deformed aortic roots that are caused by:

1. Rheumatic disease

2. congential valve defect

3. aortic root dilation

4. hypertension

5. endocarditis

Term
Aortic Regurgitation produces a murmur during
Definition
early diastole
Term
During Aortic Regurgitation there is an increase in volume in the ________.
Definition
left ventricle
Term
Aortic Regurgitation is due to a __________ overload of the LV and LA.
Definition
Volume
Term
Some complications of Aortic Regurgitation include
Definition

1. LV dilation ventricular arrhythmias

2. fatigue, exercise intolerance

3. Angina

4. Pulmonary edema

5. Dyspnea

Term
What is known as the pacemaker of the heart?
Definition

SA node

Sinoatrial node

Term
The SA ndoe has the fastes intrinsic rate of firing around ________.
Definition
60-100 beats per min
Term
What are the electric pathways in the heart?
Definition

1. SA node

2. Internodal = from SA to AV

3. Bachmann bundle = SA to LA

4. AV node = 2nd pacemaker

5. Bundle of His

6. Purkinje fibers = impulse to ventricles

Term
How are cells in the heart electrically coupled?
Definition
Via gap junctions
Term
What are the 5 phases of the cardiac action potential?
Definition

Phase 0 = rapid D.P

Phase 1 = Early R.P.

Phase 2 = Plateau

Phase 3 = final Rapid R.P.

Phase 4 = Diastolic D.P.

Term
What happens in each phase in the ventricular muscle?
Definition

Phase 0 = Na+ gates open and causes a D.P

Phase 1 = Na+ channels become inactive due to efflux of  K or influx of Cl.

Phase 2 = Plateau occurs cuz K+ permeability is low so cell stays D.P. And Ca influx into cell via L-type Ca channels.

Phase 3= Final rapid R.P. Channels close and Ca and Na influx stop. K moves out

phase 4 = membrane resting potential

Term
What is special about the SA cardiac action potential?
Definition

It has a spontaneous phase 4 depolarization

aka

automaticity

Term
T/F: The SA node has a leak that continues until the threshold is firing reached.
Definition
True
Term
When is the absolute refractory period reached?
Definition
When no stimuli can generate another A.P. During phases 0, 1, 2 and part of 3
Supporting users have an ad free experience!