Term
|
Definition
delivery of O2 and removal of CO2
transport nutrients and remove wastes
protect help fight disease
transport hormones
regulate body temperature |
|
|
Term
| exceptions to 1 capillary bed |
|
Definition
|
|
Term
brain
(normal flow and O2 consumption) |
|
Definition
flow: 50mL/min/100g
O2: 3.3mL/min/100g |
|
|
Term
heart
(normal flow and O2 consumption) |
|
Definition
flow: 70ml/min/100g
O2: 8.4ml/min/100g |
|
|
Term
skeletal muscle
(normal flow and O2 consumption) |
|
Definition
flow: 2ml/min/100g
O2: 0.2ml/min/100g |
|
|
Term
skin
(normal flow and O2 consumption) |
|
Definition
flow: 10ml/min/100g
O2: 0.1ml/min/100g |
|
|
Term
kidney
(normal flow and O2 consumption) |
|
Definition
flow: 400ml/min/100g
O2: 5.5ml/min/100g |
|
|
Term
abdominal organs
(normal flow and O2 consumption) |
|
Definition
flow: 50ml/min/100g
O2: 2.1ml/min/100g |
|
|
Term
other
(normal flow and O2 consumption) |
|
Definition
flow: 3ml/min/100g
O2: 0.1ml/min/100g |
|
|
Term
total body
(normal flow and O2 consumption) |
|
Definition
7ml/min/100g = 5L/min
3.2ml/min/100g = 250ml/min |
|
|
Term
| distribution of blood (at rest) |
|
Definition
60% in veins and venules
15% in arteries/arterioles |
|
|
Term
|
Definition
difference between maximum and resting cardiac output
normally a 4-5 fold increase possible |
|
|
Term
|
Definition
| amount of substance that enters an organ over time minus the amount that leaves, equals the tissue utilization of that substance |
|
|
Term
| cardiac output influences |
|
Definition
pressure - direct proportion
resistance - inverse proportion
blood viscosity - inverse proportion
total vessel L - inverse proportion
vessel radius - direct by 4th power |
|
|
Term
|
Definition
| high velocity, large diameter, high density, low viscosity |
|
|
Term
|
Definition
CO=HR*SV
CO=(Tissue Consumption)/([arterial]-[venous])
CO = (aterial-central venous P)/(systemic resistance)
CO = (deltaP*r^4)/(viscosity*L) |
|
|
Term
|
Definition
| MAP = diastolic BP +(PP)/3 |
|
|
Term
|
Definition
| the ease with which an object can be deformed |
|
|
Term
|
Definition
= change in volume/change in pressure
veins are more compliant than arteries
compliance in vessels decreases as pressure increases |
|
|
Term
|
Definition
| blood flow can go up/against a pressure gradient if it is travelling down the total energy gradient |
|
|
Term
| normal EDV, ESV, SV, HR, EF and cycle time |
|
Definition
EDV = 130mL
ESV = 60mL
SV = 70mL
HR = 75b/min
EF = 54%
cycle time = 0.8sec |
|
|
Term
|
Definition
phase of heart cycle
volume in ventricles remains constant
all valves closed
occurs after systole
atria are filling |
|
|
Term
|
Definition
phase of heart cycle
flow rapid from atria to ventricles
AV valves open (atrial P > ventricular P) |
|
|
Term
|
Definition
blood flow from atria in smaller volume
initial passive filling of the heart's ventricles has slowed down, but before the atria contract to complete the active filling
occurs during ventricular filling phase |
|
|
Term
|
Definition
occurs during ventricular filling
pushes final 20-25mL of blood into ventricle |
|
|
Term
| isovolumetric contraction |
|
Definition
phase of heart cycle
after pressure of contraction closes AV valves, but before SL valves open
pressure increases |
|
|
Term
|
Definition
phase of heart cycle
ventricules eject blood
SL valves open when ventricle P > pulmonary/aorta |
|
|
Term
|
Definition
|
|
Term
|
Definition
| bulge of AV valve during ventricular contraction |
|
|
Term
|
Definition
| rise in atrial pressure before AV valve opens |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
right atrial systole precedes left
right ventricular systole starts after left, but RV starts to eject bevore LV (due to lower pressures) |
|
|
Term
| respiration effect on cycle |
|
Definition
expiration - pulmonic and aortic valves close at same time
inspiration = aortic valve closes before pulmonary |
|
|
Term
|
Definition
| rapid ventricular filling |
|
|
Term
|
Definition
|
|
Term
|
Definition
pulmonary or aortic stenosis
AV (mitral) insufficiency |
|
|
Term
|
Definition
AV (mitral) stenosis
pulmonary or aortic insufficiency |
|
|
Term
|
Definition
huge difference between LV and aortic pressures
LV hypertrophy (decreased diastolic function)
increased ventricular diastolic pressure
contractility can increase
PP is diminished
systolic murmur |
|
|
Term
|
Definition
aortic pressure fall rapidly and further during diastole
PP increases
LV pressure and EDV increase
diastolic murmur
dilated and hypertrophied ventricle
HUGE SV increase
P-V loop is huge, lots of stroke work
no isovolumetric periods |
|
|
Term
|
Definition
higher atrial pressure
decrease in EDV
decreased SV
decreased systolic pressure
hypertrophy of atrium
diastolic murmur |
|
|
Term
|
Definition
increased systolic atrial pressure (high v wave)
LV has increased EDV
enlarged atrium and LV
huge SV increase
huge P-V loop, lots of cardiac work
no isovolumetric periods
systolic murmur |
|
|
Term
beta-adrenergic stimulation
(effects on SV) |
|
Definition
increases myocardial metabolism
increases myocardial contractility
increases myocardial relaxation
increases heart rate |
|
|
Term
|
Definition
Vmax = contractility
Fmax = preload |
|
|
Term
|
Definition
force-frequency relationship
stimulation of heart at higher rate increases the tension development
due to increase of Ca2+ influx through PM channels |
|
|
Term
| post-extrasytolic potentiation |
|
Definition
premature contractions
cardiac contractions that follow premature systolic depolarization
increases in Ca2+ influx which increases SR stores for next normal contraction |
|
|
Term
|
Definition
| increase in contractility follows an increase in afterload to compensate for the decrease in SV |
|
|
Term
| homeometric autoregulation |
|
Definition
minor role in Anrep effect???
intrinsic mechanism that controls strength of ventricular contraction independent of preload |
|
|
Term
|
Definition
energy that propels blood from ventricles into artery
aka StrokeWork = P*SV
increased by: inc. EDV |
|
|
Term
|
Definition
energy generated with contraction that is not converted to external work
ex: energy to stretch and lengthen viscous elements in ventricles
increased by: inc. afterload |
|
|
Term
|
Definition
| external work * heart rate |
|
|
Term
|
Definition
external work per unit energy consume
low efficiency due to energy expened during isovolumetric contraction |
|
|
Term
|
Definition
= pressure*radius/wall thickness
hypertrophy compensates for increases in pressure or radius |
|
|
Term
| measures of contractility |
|
Definition
slope of pressure generated vs. time (contraction force, preload or contractility can effect)
increase in ESV -> impaired contractility |
|
|
Term
|
Definition
major player in controlling blood flow
CVS adjusts to efficiently distribute CO to tissues according to their needs
regulated by several factors, 1*ly metabolism |
|
|
Term
|
Definition
one factor effecting vascular tone
alteration of vascular tone in response to change in pressure
aka Bayliss effect
stretch is s stimulus for cell to constrict
Mechanism: stretch --> more Ca2+ influx across PM and from SR |
|
|
Term
|
Definition
| intrinsic vascular tone at a constant level or pressure |
|
|
Term
| alpha-receptors (vascular tone) |
|
Definition
SMC constriction
vasoconstriction |
|
|
Term
| beta-receptors (vascular tone) |
|
Definition
SMC relaxation
vasodilation |
|
|
Term
| endothelial factors (vascular tone) |
|
Definition
NO - major relaxor
PGI2 - relaxor
Hyperpolarizing factors - relaxors
Thromboxane A2 - constrictor
Endothelin-1 - potent constrictor |
|
|
Term
|
Definition
endothelial factor, major relaxor
stimulated production by serotonin, shear stress on cells, etc. |
|
|
Term
|
Definition
endothelial factor, relaxor
produced by COX, promotes flow |
|
|
Term
|
Definition
endothelial factors, relaxors
stimulate K+ channels in SMC and cause relaxation |
|
|
Term
|
Definition
endothelial factor, constrictor
COX derived metabolite |
|
|
Term
|
Definition
endothelial factor, potent constrictor
very long acting, very hard to reverse |
|
|
Term
|
Definition
potent dilator that is dumped out of ischemic tissue
listed as "the metabolite" for local metabolic factors that affect vascular tone |
|
|
Term
|
Definition
| movement of fluid and solutes from plasma to interstitial fluid |
|
|
Term
|
Definition
movement of fluid and solutes from interstitial fluid to plasma
~85% of what is filtrated usually |
|
|
Term
| capillary hydrostatic pressure |
|
Definition
water pressure
fluid pushing out of capillary
filtration promoter |
|
|
Term
| interstitial hydrostatic pressure |
|
Definition
water pressure
fluid pushing into capillary
absorption promoter |
|
|
Term
|
Definition
due to plasma protein concentration
pulling fluid into capillary
absorption promoter |
|
|
Term
| interstitial osmotic force |
|
Definition
due to interstitial fluid protein concentration
pulling fluid out of capillary
filtration promotor |
|
|
Term
|
Definition
results when filtration greatly exceed reabsorption
causes: increase in CapHydroP, increase in capillary permeability, decrease in plasma protein levels, blocked lymphatics |
|
|
Term
| organs with autoregulation of flow |
|
Definition
|
|
Term
| cardiac circulation characteristics |
|
Definition
phasic pattern
~75% O2 extraction
auto-regulates 60-140mmHg
very strong neuronal-metabolic mechanisms
flow primarily during diastole (LV, systole for RV) |
|
|
Term
| cerebral circulation characteristics |
|
Definition
internal carotids, vertebral, and basilar arteries; Circle of Willis
incompressible contents, small range of okay flow levels
autoregulates 60-160mmHg
regional functional hyperemia
weak sympathetic, parasympathetic causes vasodilation
least tolerant to ischemia (5sec->LOC, minutes->irreversible damage) |
|
|
Term
| skeletal muscle circulation characteristics |
|
Definition
at rest 75% of capillaries = closed
at rest, neural and myogenic mechanisms are primary controlling
exercise, sympathetic constriction, local metabolic dilation, and skeletal muscle pump controlling
flow can increase more than 20fold |
|
|
Term
| skin circulation characteristics |
|
Definition
dissipate heat
ateriovenous anatomoses, controlled by sympathetic |
|
|
Term
| renal circulation characteristics |
|
Definition
20% of CO resting
2 capillary beds in series (glomerular and peritubular)
strong sympathetic constriction
strong autoregulation |
|
|
Term
| intestinal circulation characteristics |
|
Definition
poor Autoregulation
local metabolic control is main factor
strong autonomic influences as well
GI hormones with direct dilator effect
countercurrent flow in villi |
|
|
Term
| hepatic circulation characteristics |
|
Definition
20-30% hepatic a., 70-80% portal vein
hepatic arterial buffer response (to prevent explosion)
strong sympathetic constriction
blood reservoir, sympathetic stimulation causes dumping |
|
|
Term
|
Definition
via vagus nerve
terminates on SA and AV nodes and atrial mycrdium
releases ACh
decrease HR (decrease If, increase IK) |
|
|
Term
|
Definition
via thoracic region
increase HR (increase If, decrease IK)
increase heart contractility (increase SV and CO) |
|
|
Term
| epinephrine effects on CV |
|
Definition
activates Beta1 = inc. contractility, HR, CO and systolic pressure
activate Beta2 = vasodilation to muscle and liver, decreased diastolic pressure
MAP ~constant
PP widens |
|
|
Term
| norepinephrine effects on CV |
|
Definition
activates Beta1 = inc CO, contractility, HR and systolic pressure
alpha = systemic vasocontraction, increased diastolic pressure
MAP increase
PP ~constant
HR reflex decrease due to activation of baroreceptors |
|
|
Term
|
Definition
in carotid sinus and aortic arch
inc P, increase stretch, increase firing rate to CV center in medulla oblongata
minimizes fluctuations in short-term |
|
|
Term
|
Definition
| regulate autonomic activity in response to mechanical pressure/distortuion |
|
|
Term
|
Definition
| arterial and central receptors alter breathing and autonomic activity in response to changes in PO2, PCO2 and/or pH |
|
|
Term
|
Definition
| influence central activity in response to increases in local metabolic products |
|
|
Term
|
Definition
increase in intracranial P
elicits increase in arterial pressure
helps prevent collapse of vessels and preserve flow
HALLMARK: increased pressure despite reflexive brachycardia |
|
|
Term
|
Definition
| increased sympathetic activity to localized cutaneous vessels |
|
|
Term
|
Definition
loss of sympathetic tone, decrease in HR and blood pressure
results in fainting in response to severe stress |
|
|
Term
|
Definition
concept that cerebral cortex drives CV and respiratory response to voluntary exercise
getting pumped! |
|
|
Term
|
Definition
cutaneous - increases BP
visceral (deep) - causes vasovagal syncope |
|
|
Term
| renin-angiotensin-aldosterone system (RAAS) |
|
Definition
signal: decrease in BP or flow to kidney
response: release renin from kidney
result: systemic vasoconstriction, H2O and Na+ absorption in kidney, increase blood volume and pressure |
|
|
Term
| atrial natriuretic peptide |
|
Definition
signal: increase volume/stretch of atria/brain
response: brain/atria release peptides
result: decreae blood volume |
|
|
Term
| women vs. men differences |
|
Definition
Women have
decreased LV mass to body weight ratio
decreased afterload
decreased BP
increased endothelial-dependent dilation
thought to be due to estrogen |
|
|
Term
|
Definition
decrease max HR and cardiac indices
increase contraction and relaxation time
decrease myocardial diastolic stiffness
decrease arterial compliance and capillary density (inc. TPR)
decrease sympathetic innervation and responsiveness (impairs reflex control) |
|
|
Term
|
Definition
increase flow to heart, skin, and muscle
decrease flow to kidney and abdo organs
increase sympathetic (inc. SR, SV and contractility)
increase EDV, external work, and systolic pressure |
|
|
Term
|
Definition
increase circulating blood volume
decrease resting HR
increase SV and cardiac reserve
decrease BP
decrease incidence and mortality of CAD |
|
|
Term
|
Definition
| due to acute sudden hemorrhage or fluid loss |
|
|
Term
|
Definition
| when heart fails to pump blood adequately (i.e. myocardial infarction) |
|
|
Term
|
Definition
severe allergic response
see large decrease in BP
can see increase in CO |
|
|
Term
|
Definition
trauma to head, damage to CV center, drastic reduction in sympathetic activity
see large decrease in BP
can see increase in CO |
|
|
Term
|
Definition
vasodilator release by bacteria (endotoxin)
see large decrease in BP
can see increase in CO |
|
|
Term
|
Definition
portion of circulation is blocked
i.e. by pulmonary embolism |
|
|
Term
|
Definition
systolic P <90mmHg
tachycardia
weak pulse
cool, pale, clammy skin
altered mental state
decrease urine output
thirsty
low blood pH
nausea |
|
|
Term
| decompensatory phase of shock |
|
Definition
tissue hypoxia
leaky capillaries, decrease BV, increase blood viscosity
vascular muscle relax, decrease TPR, lower BP, organ failure
myocardial ischemia, derease contractility, dec. BP, organ failure
platelet activation, microvascular damage and intravascular clotting |
|
|
Term
|
Definition
block in flow
non-linear resistor in series with downstream arteries
worse with increasing diameter, legnt, stiffness, platelet aggregation |
|
|
Term
| max blockage that can be compensated |
|
Definition
85% blocked at rest
45-60% blocked at maximal demand |
|
|
Term
|
Definition
irreversible necrosis of heart muscle resulting from prolonged ischemia
results after 15-40 minutes of complete coronary occlusion
85% due to atherosclerotic plaque |
|
|
Term
|
Definition
| necrosis of heart tissue progresses from subendocardium to epicardium |
|
|
Term
|
Definition
fluid accumulates in pericardium
increase RA and vena cava Ps
reduces venous return |
|
|
Term
|
Definition
myoglobin - increases early
creatine-kinase
troponin-I
LDH - increases later |
|
|
Term
|
Definition
| ischemia of sunendocardial tissue |
|
|
Term
|
Definition
|
|
Term
|
Definition
marker for ventricular necrosis
unlikely to disappear
alteration of vector dipole during ventricular depolarization |
|
|
Term
| EKG effect temporal to transmural infarction |
|
Definition
Acute - ST elevation
Hours - ST elevation, dec. R amp, Q wave visible
Day 1-2 - T inversion, Q wave deeper, ST elevation
Days - ST normalizes, T inversion
Weeks - Q wave persists |
|
|
Term
|
Definition
impaired ejection of blood from heart
***atrial pressure = 20-30mmHg
pulmonary edema (LV) systemic edema (RV)
aka forward heart failure
increased internal work for heart |
|
|
Term
|
Definition
impaired filling of ventricles
aka backward heart failure
increased atrial pressures
more internal work for heart |
|
|
Term
|
Definition
| diuretic, inotropic, vasodilator, or combined therpies |
|
|
Term
|
Definition
reduces volume and pressure by increased urine output
little change to SV |
|
|
Term
|
Definition
| augments SV by increased contractility, but raises heart work load |
|
|
Term
|
Definition
| improves SV via reductions in afterload |
|
|
Term
|
Definition
vasodilator + inotropic
improves SV via reduction in afterload and increase in contractility |
|
|
