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96 Cards in this Set

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The work done by the heart to move blood down a pressure gradient is equal to _____ x _____.
Pressure x change in volume
Net work of the heart is equal to the work done by the heart minus ____, or the area inside the _____.
the work done by the blood on the heart, pressure-volume loop
The mechanica efficiency of the heart is equal to the _____/ _____.
Work (P x change in V), chemical energy used
The mechanical efficiency of the heart is typically less than ___%.
10
Most of the energy used by the heart is used to ______, after the blood has been brought to arterial pressure.
maintain tension
Once the ventricle has raised the pressure of the blood it contains, ATP continues to be consumed to maintain continued ______, producing _____ heat.
cross-bridge cycling, tension
The efficiency of the heart depends largely on the ____ of the myocardial fibers, which is dependent on the end _____ volume.
length
Low tension at short myocardial fiber length may be due to low affinity of ____, reduced ____ in T-tubules, and/or reduced calcium sensitivity to_____.
troponin for Ca2+,
calcium levels, ryanodine receptors.
Starling's law states work done by the heart on blood increases with increasing _____ volume.
end diastolic volume
_____ is a term that refers to the force acting on the cardiomyocytes prior to the onset of contraction, which is dependent on total force and thickness of the ventricular wall.
Preload
The force acting on an individual muscle fiber depends both on the total force and the _____ of the ventricular wall.
thickness
The heart contracts _____ forcefully during systole when it is filled to a greater degree during diastole, resulting in an _____ stroke volume and ejection fraction.
more, increased
______ refers to the force the ventricle must overcome to eject blood into the arteries, which is the ____ pressure of the aorta.
after load, systolic
Increased afterload with a fixed contractility results in a _____ stroke volume and ejection fraction.
decreased
Decreased ability of the cardiac muscles to shorten against a _____ afterload will cause a decrease in _____.
increased, stroke volume
Increased contractility due the increased ability of the cardiac muscles to _____ causes an _____ in stroke volume resulting from a _____ end systolic volume.
shorten, increase, decreased
Increased cardiac output from the right ventrical causes ____ in pulomary vein presure and left ventricle filling.
increase
Increased preload causes an _____ in contractility causing a ____ in LV cardiac output.
increase, increase
Positive ____ agents cause increased myocardial contraction by increasing ____ in the sarcoplasmic reticulum.
ionotropic, calcium ions
Increased Ca2+ occurs by opening ____ channels, inhibiting _____, or inhibiting the ___ pump.
Ca2+, Na-Ca exchange, Ca2+
The most important physiologic positive inotropic agents are _____ agonists and ____, which inhibit Na/K pumps in the heart.
adrenergic(norepinephrine and epinephrine), cardiac glycosides
Negative inotropic agents decrease mycardial contractility by lowering extracellular ___ or increasing ___ concentration.
calcium ion, sodium ion
Rate of Pressure Development = ___/___, and is a measure of ______.
ΔP/Δt, contractility
The slope of the length tension diagram is equal to ______.
contractility
As preload is increased, the pump performance _____.
increases
Sympathetic stimulation greatly ______ pump performance.
increases
A cardiac performance curve shifts _____during heart failure, meaning stroke work ____, and left atrial pressure ____.
down and to the right, decreased, increased
A cardiac performace curve is shifted _____ by positive inotropic agents and excercise.
Up and to the left
Cardiac performance curves are plots of stroke work (____ x____) versus atrial pressure.
systolic pressure, stroke volume
Arterial pressure waves become ____ and ____ with increased distance from the heart.
steeper and narrower
The heart preferentially adjusts output by changes in ____ rather than stroke volume.
rate
Preload is synonymous with the ______ volume.
EDV
Increasing the preload with a fixed contractility results in an increased ____ in a healthy heart.
stroke volume
A measure of contractility is independent of the ____, ____, and other factors.
preload, afterload
Four ways to measure contractility are the _____ fraction, the ______ development obtained by a cardiac catherization, the slope of the ______ diagram, and the ______ curves.
ejection, rate of pressure development (change in P/change in t), length-tension, cardiac performace curves (systolic pressure x stroke volume versus atrial pressure)
A suitable approximation of the length- tension diagram is the slope of the ____ versus the maximum pressure diagram.
end diastolic volume
The pulse felt in the peripheral arteries is a pressure wave that moves through the blood ____ than the velocity of blood in the arteries.
faster
The pulse pressure is ____ in the femoral artery than in the aorta, and the average pressure is ____ than in the aorta.
greater, slightly less
Venous pressure waves are caused by the _____ action of the heartbeat during the cardiac cycle, the _____ cycle, and contraction of the _____.
retrograde, respiratory, skeletal muscles
The 2 normal heart sounds are S1, the closing of the ____ and ___ valves, and S2 the closing of the ____ valves.
mitral, tricuspid, semilunar
Pathological splitting of S1 may result from pathology in the ______ system that accentuates asynchrony in the contraction of the left and right ventricles.
electrical conductance
In S1 the ____ valve closes before the ____ valeve, and in S2 the ___ valve closes before the _____ valve.
mitral, tricuspid, aortic, pulmonary
Physiological spltting of S_ is accentuated by inspiration, which decreases the pressure in the ____ more than in the aorta.
2, pulmonary artery
Pathological splitting of S2 is caused by _____ anomalies, and are _____ accentuated by inspiration.
conductance, not
A physiological S3 is heard in _____ and occasionally and is produced early in diastole by _____.
children, thin adults, the recoil of the ventricular walls following rapid initial ventricular filling
A pathological S3 sound may be heard when the end ______ is large, as in ______.
systolic volume, aortic stenosis
A protodiastolic gallop rhythm is a pathological S_ sound, caused by an _____ in end systolic volume, a decrease in ______, and therefore a stronger recoil in response to ______.
3, increase, conductance, rapid initial ventricular filling
A pathogical S4 sound coincides with ____ contraction is found in conditions that produce low ____ compliance.
atrial, ventricular
A pathological S4 sound is foun in conditions that produce low compliance, caused by conditions that produce ____ or _____.
high end diastolic volume, thickening of the ventricular walls
The opening of the ____ valve may cause an "opening snap" during ____ stenosis.
mitral, mitral
Murmurs are produced by ____ flow of blood, when it flows down large pressure gradients and through narrow openings.
turbulent
Aortic stenosis produces a ____ murmur.
systolic
Mitral stenosis produces a _____ murmer.
diastolic
Mitral incompetence produces a ____ murmer.
systolic
Murmers can also be caused by narrowing of blood vessels, as in coarctation of the ____ and other pathologies such as ______ or ____ septal defects.
aorta, patent ductus arteriosus, ventricular
High pressure baroreceptors reside in the ____ and ____, the arterial side of the circulatory system.
aortic arch, carotid sinuses
The aortic depressor nerve is a branch of the ____ nerve, and the carotid sinus nerves are branches of the ____ nerves.
vagus (X), glossopharyngeal (IX)
Increased stretch causes an ____ in level of afferent nerve activity from the baroreceptors.
increased
The high pressure baroreceptors are strategically located so that the _____ and _____ measure pressures that drive the ____ and ____ blood flow, respectively.
aortic arch, carotid sinus, coronary, cerebral
If arterial pressure is chronically elevated, as in systemic arterial _______, the ______ of the walls of the aortic arch and carotid sinus decrease, as well as their sensitivity to ______.
hypertension, compliance, stretch
Because of their adaptive response, high-pressure baroreceptors are not effective in ______ pressure control.
long-term
Low pressure baroreceptors are also called _____ receptors and are located on the ____ side of system circulation.
volume, venous
Low pressure or volume receptors are located in areas such as the ____, _____, and _____.
atria, vena cava, pulmonary artery
Stimulated high pressure baroreceptors attempt to lower ______ by decreasing cardiac output by decreasing ____ and ____ or decreasing ______.
pressure, stroke volume, heart rate, TPR
High pressure baroreceptors are sensitive to _____ and rate of ______ change.
MAP, pressure
The firing rate of individual fibers from the carotid sinus is highest during the _____ of blood pressure.
upstroke
Stimulation of low-pressure baroreceptors attempts to lower _____ by increasing renal blood flow via renal ______ and ______ or increasing ______ through the ______ reflex.
volume, vasodilation, urine formation, HR, Bainbridge
Blood monitors PO2, PCO2 and pH through vasucalture sensors, called _____ and brain sensors, called _____.
peripheral chemoreceptors, central chemoreceptors
______ chemoreceptors located in the aortic arch and carotid bodies, are stimulated by a decrease in P___ and p___ or an increase in P____.
Periperhal, O2, pH, CO2
_____ chemoreceptors are stimulated only by an increase in PCO2.
Central
_____ chemoreceptors generally have little impact on the cardiovascular system.
Peripheral
Peripheral chemoreceptors illicit a cardiovascular system response when _____ function is impaired or when a person is in _____.
pulmonary, high altitude
Impairment of pulmonary funciton or high altitude will cause ______ inducing a response from the ______ chemoreceptors.
hypoxia, peripheral
With severe hypoxia peripheral chemoreceptors leads to _____ and ______.
bradycardia, vasodilation

(NOT END RESULT OF HYPOXIA)
The increased depth and rate of breathing produced by hypoxia results in the fall of ____ and activation of ______.
PCO2, central chemoreceptors
The fall in PCO2 is sensed by ______ chemoreceptors causing _____ and _____.
central, tachycardia, vasoconstriction
The end result of hypoxia is _____ and ____.
tachycardia, vasoconstriction
In addition to baroreceptors, blood pressure can be influenced by afferent input resulting from somatic and visceral _____, stimulation of _______ receptors and _____ inflation.
pain, trigeminal cold, lung
The ______ alters cardiovascualr control secondary to thermoregulation and defense reactions, and the _____ can have direct effects due to emotional stress.
hypothalamus, cerebral cortex
Peripheral baroreceptors and chemoreceptors inputs enter the brainstem and synapse within the area known as the _____ in the _____.
nucleus tractus solitarius, caudal medulla.
Inhibitory neurons from the NTS project onto the ______ area located in the ventrolateral portion of the medulla.
vasomotor
The vasomotor area is divided into 2 areas, the C1 and the A1, which contains neurons that are ____ and unless inhibited by the _____ cause _____.
tonic, NTS, vasoconstriction
In the dorsal portion of the medulla is a _______ area which is tonically active, and unless it is attenuated by the ____ both ____ and _____ will increase.
cardioaccelatory, NTS, heart rate, cardiac contractility
The vasomotor area causes ______, and the cardioaccelatory causes ______ and _____. Both are _____ active unless inhibited by the ______.
vasoconstriction, increased HR, increased contractility, tonically, NTS
Excitatory neurons from the NTS project onto the ______ area.
cardioinhibitory area
The cardioinhibitory area consists of the _____ and the
____ of the vagus.
nucleus ambiguous, dorsal motor nucleus
Stimulation of the cardioinhibitory area by the NTS causes ____.
decrease in HR
The NTS inhibits the _____ and ____ area and stimulates the ______ area.
vasomotor, cardioacceleratory, cardioinhibitory
The NTS is continuously stimulated by ____ so it is tonically sending output to reduce the _____ and ____ and stimulate the _____.
baroreceptors, vasomotor area, cardioacceleratory area, cardioinhibitory area
If arterial blood pressure increases, ____-pressure baroreceptors increase stimulation to the _____ which inhibits the _____ and ____ and stimulates the ______.
high, NTS, vasomotor area, cardioacceleratory area, cardioinhibitory area
Increased arterial blood pressure increases baroreceptor firing to the NTS which inhibts the vasomotor area leading to _____, and inhibits the cardioaccelertory area leading to ______, and stimulates the _______ leading to _______.
decreased peripheral resistance, decreased heart rate and stroke volume, cardioinhibitory area, decreased heart rate (negative chonotropic agents)
The ____ area and the _____ area are part of the sympathetic system, while the cardioinhibitory area is part of the parasympathetic system.
vasomotor, cardioacceleratory
A decrease in blood pressure _____ afferent output from the baroreceptors, _____ stimultion to the NTS, ____ inhibition to the vasomotor area and _____ stimuation to the cardioinhibitory area.
decreases, decreasing, decreasing, decreasing
Decreased stimulation to the NTS, decreases inhibition to the vasomotor area and cardioacceleratory area leading to ____, and decreases stimulation to the ______.
vasoconstriction, increased stroke volume and heart rate, cardioinhibitory area.
The mechanisms responsible for local control of blood flow are the _____, arising from the metabolic activity of surrounding cells, and the _____, related to the vessels themselves.
metabolites or paracrine agents, endothelial and myogenic control
High cellular metabolic activity causes ______ levels of adenosine, phosphate, PCO2, lacatate, K+, and H+, and a _____ level of O2 causing ____ of the arteriole.
increased, decreased, vasodilation