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Cardiovascular
Physiology
160
Physiology
Graduate
01/17/2014

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Term
fick principle
Definition
rate of O2 consumption / (arterial O2 - venous O2)
Term
equation for CO
Definition
SV X HR
Term
equation for MAP
Definition
- Q X TPR - 2/3 diastolic + 1/3 systolic
Term
equation for pulse pressure
Definition
systolic - diastolic
Term
what happens to CO if HR is too high?
Definition
diastolic filling is incomplete and CO dec
Term
what maintains Co in early stages of exercise
Definition
SV
Term
what maintains CO in late stages of exercise
Definition
HR
Term
what inc SV/contractility?
Definition
catecholamines, inc intracell Ca, dec extracell Na, digitalis
Term
what factors dec contractility/SV?
Definition
B1 block, heart failure, acidosis, hypoxia/hypercapnea, non-dihydro CCB
Term
myocardial O2 demand is inc by:
Definition
inc afterload, inc contracility, inc HR, inc heart size
Term
what conditions can inc SV?
Definition
anxiety, exercise and pregnancy
Term
preload
Definition
venticular EDV
Term
afterload
Definition
MAP
Term
what drug can dec preload?
Definition
venodilators, i.e. nitroglycerin
Term
what drug drug dec after load?
Definition
vasodilators, i.e. hydralazine
Term
what things can inc preload?
Definition
exercise, inc blood volume and excitement (symp)
Term
what is the starling curve?
Definition
force of contraction is proportional to end diastolic length of cardiac mm fiber
Term
EF
- equation
- what is it?
- normal value
Definition
- SV/EDV
- index of ventricular contractility
- >55%
Term
EF
- equation
- what is it?
- normal value
Definition
- SV/EDV
- index of ventricular contractility
- >55%
Term
resistance equation
Definition
- deltaP / Q
- 8nl/(pi)r^4
Term
total resistance of vessels in series
Definition
R1 + R2 + R3
Term
1/total resistance in parallel
Definition
1/R1 + 1/R2 + 1/R3
Term
what can inc viscocity
Definition
polycythemia, hyperproteinemic states, hereditary spherocytosis
Term
what vessels account for most of total peripheral resistance?
Definition
arterioles
Term
inc in MAP on cardiac/vascular fxn curve
Definition
inc in blood volume or dec in venous compliance
Term
dec in MAP in carciac/vascular fxn curve
Definition
dec in blood volume, inc in venous compliance
Term
what does a clockwise rotation of venous return curve indicate?
Definition
dec in TPR
Term
what does a counterclockwise rotation of venous return curve indicate?
Definition
inc TPR
Term
what is the intersect of Co and venous return indicate?
Definition
R atrial pressure
Term
normal pressure in: R atrium
Definition
<5
Term
normal pressure in: R vent
Definition
25/5
Term
normal pressure in: pulmonary artery
Definition
< 25/10
Term
normal pressure in: L atrium
Definition
<12
Term
normal pressure in: L vent
Definition
130/10
Term
normal pressure in: aorta
Definition
130/90
Term
what condition is PCWP > LV
Definition
mitral stenosis
Term
what forces push out of capillary?
Definition
capillary pressure and interstitial osmotic pressure
Term
what forces push in on a capillary?
Definition
capillary osmotic pressure, insterstitial fluid pressure
Term
effect of CHF on capillary fluid exchange
Definition
inc Pc
Term
effect of nephrotic syndrome on capillary fluid exchange
Definition
dec (pi)c
Term
effect of liver failure on capillary fluid exchange
Definition
dec (pi)c
Term
effect of toxins on capillary fluid exchange
Definition
inc Kf
Term
effect of infections on capillary fluid exchangeinfections
Definition
inc Kf
Term
effect of burns on capillary fluid exchange
Definition
inc Kf
Term
effect of lymphatic blockage on capillary fluid exchange
Definition
inc (pi)i
Term
effect of renal failure on capillary fluid exchange
Definition
dec (pi)c
Term
effect of IV infusion of albumin/clotting factors on capillary fluid exchange
Definition
inc (pi)c
Term
effect of venous insufficiency on capillary fluid exchange
Definition
inc Pc
Term
isovolumetric contraction
Definition
between mitral valve closure and aortic valve opening
Term
isovolumetric relaxation
Definition
period between aortic valve closing and mitral valve opening
Term
effect of inc contractility on pressure-volume curve
Definition
inc SV, EF
dec ESV
Term
effect of inc after load on pressure-volume curve
Definition
inc aortic pressure, ESV
dec SV
Term
effect of inc preload on pressure-volume curve
Definition
inc SV
Term
S1 heart sound
Definition
mitral and tricuspic valve closure
Term
S2 heart sound
Definition
Aortic and pulmonic closure
Term
S3 heart sound
Definition
rapid filling; with mitral regurge and dilated CHF
Term
S4 heart sound
Definition
atrial kick; with MI, hypertrophic cardiomyopathy, HTN, aortic stenosis
Term
a wave on JVP
Definition
atrial contraction
Term
C wave on JVP
Definition
RV contraction
Term
x descent on JVP
Definition
atrial relaxation/filling
Term
V wave on JVP
Definition
atrial filling against closed tricuspid
Term
y descent on JVP
Definition
flow from RA to RV
Term
dicrotic notch
Definition
due to elasticity of aorta; effected by marfana dn syphilis; allows coronary a filling
Term
normal split S2
Definition
inspiration -> drop in intrathoracic -> in capacity of plum circa so aortic closes earlier because dec return to L heart
Term
wide split S2
Definition
conditions that delay RV emptying = pulmonic stenosis, R BBB -> delayed pulmonic sound
Term
fixed split S2
Definition
in ASD -> L-R shunt and inc flow through pulmonic valve so pulmonic closure is greatly delayed
Term
paradoxical splitting
Definition
conditions that delay LV emptying = aortic stnosis, L BBB
Term
what can be heard in the aortic area
Definition
aortic stenosis, flow murmur, aortic valve sclerosis
Term
what can be heard in the left sternal border
Definition
diastolic= aortic regurg, plmonic regurg
systolic = hypertrophic cardiomyopathy
Term
what can be heard in the pulmonic area
Definition
pulmonic stenosis, flow murmur
Term
what can be heard in the tricuspid area
Definition
systolic = tricuspid regurg, VSD
diastolic = tricuspid stenosis, ASD
Term
what can be heard in the mitral area
Definition
systolic = mitral regurg
diastoic= mitral stenosis
Term
effect of inspiration on heart sounds
Definition
inc intensity of R heart sounds (tricuspid)
Term
effect of expiration on heart sounds
Definition
inc intensity of L heart sounds (mitral)
Term
effect of hand grip on heart sound
Definition
inc migral regurg and VSD systolic murmurs
Term
effect of valsalva on heart sounds
Definition
most murmus dec; inc MVP and hypertrophic cardiomyopathy
Term
effect of rapid squatting on heart sounds
Definition
dec MVP, hypertrophic cerdiomyopathy
Term
holosystolic, high-pitched blowing murmur
Definition
mitral/tricuspid regurg
Term
cause of mitral regurg
Definition
ischemic heart disease, mitral valve prolapse, or LV dilation, endocarditis, rheumatic fever
Term
fcauses of tricuspid regurg
Definition
RV dilation or endocarditis (IV drug users), rheumatic fever
Term
features of tricuspid regurg?
Definition
loudest at tricuspid area and radiates to L sternal border
Term
features of mitral regurg
Definition
loudest at apex and radiates toward axilla
Term
crescendo-decrescendo systolic mumur with EC
Definition
aortic stnosis
Term
radiates to carotids/apex
Definition
aortic stenosis
Term
ass w/ pulsus parvus et tardus = weak compared to heart sounds
Definition
aortic stenosis
Term
murmur that can lead to syncope
Definition
aortic stenosis
Term
causes of aortic stenosis
Definition
bicuspid aortic valve, age related calcification, chronic rheumatic valve, unicuspid, syphillis
Term
holosystolic, harsh sounding murmur, child
Definition
VSD
Term
holosystolic, harsh sounding murmur, child
Definition
VSD
Term
late systolic crescendo murmur with mid systolic click
Definition
mitral prolapse
Term
most frequent valvular lesion
Definition
mitral prolapse
Term
can predispose to endocarditis
Definition
mitral prolapse
Term
causes of mitral prolapse
Definition
myxomatous degeneration, rheumatic fever, or chordae ruptur
Term
immediate high pitched blowing diastolic murmur
Definition
aortic regurg
Term
murmur with high pulse pressure
Definition
aortic regurg
Term
murmur with bounding pulses and head bobbing
Definition
aortic regurg
Term
cause of aortic regurg
Definition
aortic rot dilation, bicuspid aortic valve or rheumatic fever
Term
delayed rumbling diastolic murmur with OS
Definition
mitral stenosis
Term
continuous machine-like murmur
Definition
PDA
Term
causes of PDA
Definition
congenital rubella or prematurity
Term
compare cardiac to skeletal mm
Definition
- AP has plateau
- nodal cells spent depolarize in diastole
- coupled to each other by gap junctions
Term
phase 0 of ventricular AP
Definition
VG Na channels open
Term
phase 1 of ventricular AP
Definition
inactivation of Na and VG K open
Term
phase 2 of ventricular AP
Definition
VG Ca open to balance K efflux
Term
phase 3 of ventricular AP
Definition
rapid repol= K efflux and closure of Ca
Term
phase 4 of ventricular AP
Definition
high K permeability
Term
where does the pacemaker AP occur?
Definition
SA and AV node
Term
phase 0 of pacemaker AP
Definition
VG Ca channels= upstroke
Term
phase 3 of pacemaker AP
Definition
inactivation of Ca and activation of K
Term
phase 4 of pacemaker AP
Definition
spontaneously depolarizes as Na conductance inc
Term
phase effected by
- Na block
- K block
- CCB
- Beta block
Definition
- phase 0 in ventricular
- phase 3 in ventricular
- phase 0 in pacemaker
- phase 4 in pacemaker
Term
P wave on EKG
Definition
atrial depolarization
Term
PR interval
Definition
delay through AV node; <120 msec
Term
QRS complex
Definition
ventricular depolarization; <120 msec
Term
QT interval
Definition
contraction of the ventricles; < 350 msec
Term
T wave
Definition
ventricular depolarization
Term
T wave inversion
Definition
recent MI
Term
ST segment
Definition
isoelectric, ventricles depolarized
Term
U wave on EKG
Definition
caused by hypokalemia and bradycardia
Term
speed of conduction
Definition
purkinje > atria > ventricles > AV node
Term
pacemaker determinations
Definition
SA > AV > bundle of His/purkinje/ventricles
Term
conduction pathway
Definition
SA node, atria, AV node, common bundle, LAF, bundle branches, purkinje fibers, ventricles
Term
torsades de pointes on EKG
Definition
shifting sinusoidal waveforms
Term
Jervell and lange-Nielson sndrome
Definition
QT prolongation with congenital sensorineural deafness
Term
causes of tosades
Definition
anything that prolongs QT
Term
wolff parkinson white
Definition
accessory conduction pathway from atria to ventricle, partially depolarize earlier -> delta wave
Term
complication of WPW
Definition
SVT
Term
Tx of SVT in WPW
Definition
procainamide, amiodarone
Term
lead I +, lead III -
Definition
left axis deviation
Term
lead I - and lead III +
Definition
right axis deviation
Term
a fib on EKG
Definition
irregularly irregular, no P waves
Term
tx of afib
Definition
beta blocker, CCB, digoxin; coumadin
Term
EKG for atrial flutter
Definition
sawtooth appearance
Term
tx of atrial flutter
Definition
convert to sinus rhythm with antiarrhythmics (I or III)
Term
1st degree AV block
Definition
PR prolonged >120
Term
mobitz type I vs type II
Definition
I = progressive lengthening of PR until beat is dropped
II = topped beat not preceded by change in length of PR interval
Term
3rd degree AV block
Definition
P waves no relation to QRS
Term
cause of 3rd degree block
Definition
lyme disease
Term
Vfib on EKG
Definition
erratic rhythm, no identifiable waves
Term
Vfib tx
Definition
CPR and defibrillation
Term
3rd degree AV block tx
Definition
pacemaker
Term
when is ANP released?
Definition
released from atria with inc blood volume and atrial pressure
Term
effects of ANP
Definition
constricts efferent renal arterioles and dilates afferent artioles, promoting diuresis
Term
baroreceptors in carotid vs aortic
Definition
carotid = sense inc and dec; via IX
aortic = sense inc only; via X
Term
baroreceptor reflex pathway
Definition
hypotention -> dec pressure -> dec stretch -> dec afferent firing -> inc efferent symp and dec efferent parasymp -> vasoconstrict, inc HR, inc contractility, inc BP
Term
carotid massage pathway
Definition
inc pressure on carotid -> inc stretch -> inc afferent firing -> dec HR
Term
peripheral chemoreceptors
Definition
carotid and oartic respond to dec PO2 and inc PCO2 and dec pH
Term
central chemoreceptors
Definition
changes in pH and PCO2 of brain interstitial fluid
Term
cushing reaction
Definition
inc ICP constricts arterioles -> cerebral ischemia -> HTN -> reflex bradycardia
Term
cushing triad
Definition
HTN, bradycardia, reap depression
Term
largest share of systemic CO
Definition
liver
Term
highest blood flow per gram tissue
Definition
kidney
Term
largest arteriovenous O2 diff
Definition
heart, bc O2 extraction is always ~100%
Term
how is inc O2 demand met by the heart
Definition
inc coronary blood flow
Term
factors effecting autoreg of: heart
Definition
O2, adenosine, NO
Term
factors effecting autoreg of: brain
Definition
CO2 (pH)
Term
factors effecting autoreg of: kidneys
Definition
myogenic and tuberoglomerular feedback
Term
factors effecting autoreg of: skeletal mm
Definition
lactate, adenosine, K
Term
factors effecting autoreg of: lungs
Definition
hypoxia causes vasocontriction
Term
factors effecting autoreg of: skin
Definition
sympathetic stimulation imp mechanism, temp control
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