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71 Cards in this Set
- Front
- Back
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7 General Charactaristics of CV System
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Closed system, two circulations, pulsatile pumps, branching organization, unidirectional blood flow
constant pressure-variable flow, flow responsive to organ needs |
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True/False
Ateries are conduit Vessels |
True
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What are the 'resistance' vessels
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arterioles
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what vessels promote "exchange"
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capillaries
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True/False:
Veins require lots of pressure to fill |
False. They are capacitance vessels
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What are the "Capacitance" vessels?
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Veins
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What is the major organ responsible for the excretion of water and salts?
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The Kidney!
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What does the kidney excrete?
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Excretes water ,salt, toxins, nitrogenous wastes.
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What does the kidney regulate?
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Blood volume and the composition of the extracellular body fluid.
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True/False:
The kidney is a critical component of normal CV function (and vise-versa) |
True!
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Papillary muscles serve what function?
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To prevent eversion during systole
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How is eversion of the semilunar valves prevented during ventricular diastole
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Fibrous insertions and thickened edges
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5 subsystems of heart
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1) Electrical conduction system
2)ANS (parasymp & sympathetic innervation) 3)cardiac muscles (myocardium) 4) valves 5)coronary circulation |
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What is "right ventricular assist"?
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When the Left ventricule contracts, it assists the compression of the right.
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S1 represents what?
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AV valves closing
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Whats first, mitral or aortic valve closure?
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Mitral
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When do the semilunar valves open?
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when ventricular pressure exceeds aterial diastolic pressure
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S2 represents what?
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Semilunar valves closing
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S3 is caused by what?
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Tensing of the chordae tendineae and the AV ring
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S3 is normal in ___________
and _________ in adults |
children; pathological
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S4 is caused by what?
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oscillation of cardiac chambers due to atrial contraction (its usually inaudible)
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What is first, aortic or pulmonic closure?
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Aortic first, pulmonic second.
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What is affected more during increased heart rate: Cardiac Cycle, or Filling Time. Which is increased?
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Filling time is most, effected -- they are both DECREASED as a result of increased HR.
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What kind of murmur is present in Mitral Stenosis: Diastolic or Systolic?
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Diastolic: opening of the AV valve because its big and thick
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Which pressure is increased with Mitral Stenosis: Ventricular, Atrial, Aortic, or all? Why?
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Atrial, because the stenotic mitral valve increases resistance to filling the ventricle.
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What kind of murmur is present in Mitral Insufficiency: Diastolic or Systolic?
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Systolic, because of backflow
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Which pressure is increased with Mitral Insufficiency: Ventricular, Atrial, Aortic, or all? Why?
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Atrial, because there is increased backflow during ventricular systole.
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How are the pressure changes different in mitral stenosis and insufficiency?
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Stenosis is represented by a complete upshift if the atrial pressure curve. The atria just requires more pressure to work.
Insufficiency is represented by an upswing in pressure only during ventricular systole, because of its poorly controlled valves. |
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In what valve pathologies do we see a decrease in Cardiac Output?
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Both Mitral Valve Pathologies and Aortic Stenosis
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In which valve pathologies do we see an increase in stroke volume?
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Aortic insufficiency.
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What kind of pressure differences are seen (on a wigger diagram, for example) during aortic stenosis?
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L. Ventricular pressure is highly increased due to increased outflow resistance.
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What kind of murmer is appreciated during aortic stenosis: Systolic or Diastolic?
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Systolic, bitches!
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What kind of murmer is appreciated during aortic insufficiency: Systolic or Diastolic?
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Diastolic, bitches!
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What kind of pressure differences are seen (on a wigger diagram, for example) during aortic insufficiency?
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The aortic pressure curve falls rapidly during ventricular diastole, because blood is regurgitating from the aorta back into the ventricle.
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4 determinants of myocardial performance
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Preload, Afterload, Contractility, Heart rate
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3 effects of changing preload with a constant afterload:
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1)increased shortening velocity
2)increased shortening distance 3)increase in rate of tension development |
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2 effects of changing afterload with a constant preload:
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1)decreases shortening velocity
2)decreases shortening |
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lusitropic effect:
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Faster relaxaion
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True/False:
Increasing Preload will have an effect on Vmax. |
False!!
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3 things increasing contractility does for the heart:
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1)Increases maximal tension development
2)increases maximal shortening velocity 3)increases myosin ATPase activity |
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Which isoform of TITIN is stiff?
Which is compliant? |
N2B = Stiff
N2BA = Compliant |
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How can we increase Vmax in the heart?
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Beta-Adrenergic Agonists
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What is the frank-starling relationship:
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An increase in preload results in an increase in the rate of tension development, shortening velocity, and perhaps in total tension development.
matching the CO to level of venous return. |
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Stroke work calculation:
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Average aortic pressure
x stroke volume |
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Minute Work
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SW x HR
or Average Pressure x CO |
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What is "wasted work"
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Overcoming internal resistance
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4 determinants of Myocardial Oxygen Consumption:
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1) Heart Rate
2) wall tension (determined by afterload) 3)Stroke Volume 4) Contractility |
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What is TTI?
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Tension Time Index
= avg Psys x Ejection Duration x HR |
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Law of laplace
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Wall Tension = (Pressure x Radius)/(2 x wall thickness)
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Most ATP comes from
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Oxidative Phosphorylation
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Preferred energy substrate for ATP
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Fatty Acids
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Which vessels contain the most vascular smooth muscle?
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Arterioles
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Which vessels contain the most collagen?
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Large Veins
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Arteries have more of which?
Elastin or Collagen? |
Elastin
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Veins have more of which?
Elastin or Collagen |
Collagen
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In a cross section of a vessel, what three levels of structure are apparent?
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Tunica externa = Collagen Fibers
Tunica Media = smooth muscle and elastic fibers Tunica intima = endothelium |
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Compliance is represented how, mathematically?
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dV/dP
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At what point are arteries more compliant than veins?
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around 25-55mmHg
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Why do veins resist overfilling?
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Because of robust Tunica Externa: lots of collagen.
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What is transmural Pressure?
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pressure difference across the vessel wall
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Amplitude of the arterial pressure puls is affected by 3 things:
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1) Duration of Ejection
2) arterial compliance 3) stroke volume -- most important |
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MAP =
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Pd + 1/3(Ps-Pd)
or TPR x CO |
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What will an increase in TPR do?
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it will redistribute blood to the arterial side and increase MAP
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What are the two factors contributing to "Heart Suction"
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Diastolic Rebound and Systolic Rebound
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Diastolic Rebound
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relaxation of ventricles rapidly decreases pressure and assists filling
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Systolic Rebound
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ventricular contraction stretches and tends to expand atria, decreasing pressure -- and increasing filling.
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What are the 4 auxiliary forces for venous return?
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1)Heart 'suction'
2)negative thoracic pressure 3)respiratory pump 4)skeletal muscle pump |
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V = IR is analogous to:
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Q = (Pin-Pout)/R
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What does the magnitude of the pressure drop for a certain portion of a system indicate?
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The relative contribution to total resistance.
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True/False:
Skeletal Muscle only provides up to 1/4 of pumping power during exercise |
False!! it can contribute up to 1/3 power during exercise.
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Splitting of S2 is accentuated by
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Inspiration
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