Term
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Definition
| represeants the volume work of the heart. it happens before the contraction! |
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Term
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Definition
| its the amount of blood that must be pumped every time and is determined by venous return |
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Term
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Definition
| force of contraction that increases in ventricular end of diastole volume |
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Term
| the force of contraction of the heart is dependent upon... |
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Definition
| the degree the muscle fibers are stretched before the ventricles begin to contract |
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Term
| the frank starling mechanism allows for the heart to? |
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Definition
| adjust its pumping ability to accompany varying and changing venous returns |
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Term
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Definition
| the pressure or tension work of the heart. pressure heart must pump to move blood to aorta |
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Term
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Definition
| it is the work that the heart has after contractionhas commenced. |
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Term
| what is an example of the primary source of afterload work on the left side? |
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Definition
| systemic arterial blood pressure |
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Term
| what is the main source of afterload work on the right side of the heart? |
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Definition
| pulmonary arterial pressure |
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Term
| afterload work of the left ventricle increases with...? |
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Definition
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Term
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Definition
| the ability of the heart to change it's force of contraction without changing it's resting length |
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Term
| the contractile state is determined by...? |
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Definition
| the number of calcium ions |
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Term
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Definition
| one that modifies the contractile state of the myocardium independent of the frank starling mechanism |
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Term
| sympathetic stimulation causes a ...? |
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Definition
| positive inotropic effect by increasing the calcium available for contraction |
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Term
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Definition
| a negative inotropic effect by interfeering with formation of ATP for contraction |
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Term
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Definition
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Term
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Definition
| powerful vasoconstrictor. |
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Term
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Definition
| controls bleeding, causes vasoconstriction |
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Term
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Definition
| volume of blood streching the heart muscle at the end of diastole |
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Term
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Definition
| the maximum vlume of blood present at the end of diastole |
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Term
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Definition
| the stroke volume increases |
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Term
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Definition
| the force that contracting heart must pump to eject blood from the heart into the body |
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Term
| excessive afterload may cause... |
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Definition
| impaired ventricular rejection and increased wall tension |
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Term
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Definition
| myocardial contractibility. the contractile performance of the heart |
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Term
| myocardial contractibility represeants the...? |
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Definition
| ability of actin and myoson filaments to interact and shorten against a load |
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Term
| if actin and pyosin are to contract, what do we require? |
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Definition
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Term
| besides needing ATP for the heart to contract, what else do we need? |
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Definition
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Term
| in the heart electrical impulse travel from...? |
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Definition
| the t tubules, which releases ca+ from the sarcoplasmic reticulum. |
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Term
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Definition
| the calcium diffuse into myofibrils and promote sliding of actin and myosin |
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Term
| what is another mechanism that can modulate inotropy? |
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Definition
| the sodium/calcium pump and the ATPase pump. |
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Term
| a rise in intracellular ca+ can...? |
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Definition
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Term
| how does the frank starling mechanism operate? |
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Definition
| it operate through an increase in preload |
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Term
| in a normally functioning heart, the frank starling mechanism...? |
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Definition
| matches the outputs of the two ventricles |
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Term
| an increase in inotropy will cause |
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Definition
| the curve to move up and to the left |
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Term
| a decrease in inotropy will cause the curve to mvoe down and to the...? |
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Definition
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Term
| in heart failure, a decrease in cardiac output and renal blood flow causes? |
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Definition
| an increase in sodium and water retention |
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Term
| an increase in muscle stretch causes? |
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Definition
| an increase in ventricular wall tension |
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Term
| we get increased myocardial oxygen consumption with? |
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Definition
| an increase in myocardial muscle stretching |
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Term
| increased wall tension can cause...? |
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Definition
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Term
| what is elevated during late stage heart failure? |
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Definition
| catecholemines such as epinephrine and norepinephrine |
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Term
| an increase in sympathetic nervous stimulation can lead to? |
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Definition
| tachycardia, vasoconstriction, and cardiac arrythemias |
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Term
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Definition
| increased workload, increased oxygen demand, cardiac ischemia, decreased contractability |
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Term
| catecholamines may contribute to...? |
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Definition
| a high rate of sudden deaths in heart failure |
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Term
| increased sympathetic stimulation can cause? |
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Definition
| decreased renal perfussion and decreased blood flow to skin, muscles, and organs |
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Term
| a reduction in blood flow to the kidneys and a decrease in glomerular filtration rate is...? |
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Definition
| sodium and water retention |
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Term
| decreased renal blood flow causes? |
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Definition
| an increase in renin and angiotensin III secretions by the kidneys |
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Term
| angiontensin release causes? |
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Definition
| vasoconstriction and the release and uptake of norepinephrine, |
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Term
| angiotensin II can also cause? |
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Definition
| a stimulus to increase the production of aldosterone by the adrenal cortex. |
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Term
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Definition
| increases tubular reabsorption of sodium with an increase in water retention |
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Term
| aldosterone is metabolized.... |
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Definition
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Term
| angiotensin II causes the release of? |
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Definition
| ADh, antidiuretic hormone (vasoconstrictor and inhibites water excretion!) |
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Term
| in heart failure, the progressive accumilation of fluids leads to...? |
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Definition
| ventricular dilation and increased wall tension |
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Term
| angiotensin II and aldosterone cause..? |
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Definition
| regulation of the inflammatory response and stimulate inflammatory cytokines |
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Term
| angiotensin II and aldosterone continued... |
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Definition
| attract inflammatory responses, activate macrophages, stimulate fibroblast an collagen deposits |
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Term
| fibroblast and collagen deposits can cause? |
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Definition
| ventricular hypertrophy and myocardial wall fibrosis which decreases compliance |
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Term
| what are 2 natriuretic peptides? |
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Definition
| atrial and brain natriuretic peptides. |
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Term
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Definition
| release from atria in response to stretch, pressure, or fluid overload. |
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Term
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Definition
| found in brain, secreted by ventricles in response to ventricular pressure/fluid overload |
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Term
| in response to chamber streching...? |
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Definition
| anp and bnp will cause diuresis via an increase in GFR and water reabsorption |
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Term
| inhibition of angiotensin II and vasopresin via NP's causes? |
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Definition
| a reduction in renal fluid retention |
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Term
| NP's directly affect the...? |
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Definition
| cns and brain inhibiting the secretion of vasopressin and function of hunger/thirst center |
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Term
| T or f: high levels of ANP and BNP are found in those with heart failure? |
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Definition
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Term
| the myocardium is composedof..? |
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Definition
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Term
| what 2 cells are found in the myocardium? |
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Definition
| myocytes and non myocytes |
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Term
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Definition
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Term
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Definition
| don't contract--macrophages,fibroblasts, smooth muscle, and endothelial cells |
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Term
| wht cell can increase in size? |
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Definition
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Term
| what cell can increase in number? |
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Definition
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Term
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Definition
| electrical abnomralities that cause the heart to pump in an uncoordinated manner |
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Term
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Definition
| athletes. increase in length and width that is proportionate |
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Term
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Definition
| an increase in wall thickness commonly from hypertension |
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Term
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Definition
| disproportunate increase in muscle length |
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Term
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Definition
| primary stumulus for hypertrophy. an increase in wall stress |
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Term
| an increase in wall stress will cause? |
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Definition
| replication of myofibrils, thickening of moncytes, and concentric hypertrophy |
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