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Physiology Exam 3
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68
Physiology
Professional
01/29/2012

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Term
causes of The first heart sound
Definition
"LUB" is produced by the closing of the AV valves at the onset of systole...occurs as soon as ventricular pressure exceeds atrial pressure
Term
Things that make S1 heart sound more intense
Definition
shortened PR interval, mild mitral stenosis, high cardiac output
Term
Things that make S1 heart sound less intense
Definition
longer PR interval, mitral regurgitation
Term
causes of the second heart sound
Definition
"DUB" is produced by closure of the semilunar (aortic and pulmonic) valves...this occurs when P in the ventricle falls below the pressure in the corresponding great a.
Term
What causes a split S2
Definition
S2 can be heard split because in normal adults the aortic valve closes before the pulmonic
Term
causes of clicks heard early in systole
Definition
aka ejection clicks...indicate the presence of aortic or pulmonic stenosis
Term
causes of clicks heard in mid or late systole
Definition
usually due to the bulging of prolapsed mitral or tricuspid valves into the corresponding atrium
Term
cause of an opening snap during diastole
Definition
opening snap of a mitral or tricuspid valve can be heard after S2 when either of the valves is stenosed
Term
Cause of a 3rd heart sound and when does it occur?
Definition
occurs during diastole, during the rapid filling phase of the ventricles. Is thought to be due to excessive oscillation of blood back and forth between the ventricular walls as blood rushes in from the atria...may be due to vibration of the tissue that anchors the av valve leaflets
Term
fourth heart sound causes and timing
Definition
occurs in late diastole. Results from atrial contraction into a stiffened, (low compliance) ventricle.
Term
3 Causes of systolic murmurs
Definition
1.) Aortic or pulmonic valve stenosis (crescendo/decrescendo)
2.) mitral or tricuspid valve insufficiency
3.) Interventricular septal defects
Term
2 causes of diastolic murmurs
Definition
1.) mitral stenosis
2.) aortic insufficiency

(rarely diastolic murmurs are caused by tricuspid stenosis or pulmonary artery insufficiency because there is less pressure on the right side
Term
continuous murmur and the most common of these
Definition
a continuous murmur occurs throughout all of systole and diastole. probably the most common of these is caused by a patent ductus arteriosus
Term
To and fro murmurs and what causes them
Definition
to and fro murmurs occur during parts of systole AND diastole...to and fro murmurs occur when an outflow valve is both stenosed and insufficient
Term
Ohms Law
Definition
F=change in pressure/R
Term
Hydrostatic pressure equation
Definition
Pressure=density of fluidxgravity constantx height of fluid above point
Term
dynamic/kinetic pressure
Definition
the pressure generated by blood movement
Term
driving pressure
Definition
sum of hydrostatic and dynamic pressures
Term
Total resistance of resistors arranged in series
Definition
R (total)= R1+R2+R3...
Term
total resistance of resistors arranged in parallel
Definition
1/R(total)=1/R1 + 1/R2 + 1/R3....
Term
conductance equation
Definition
1/R

*flow is directly proportional to conductance
Term
Poiseuille's Law equation
Definition
1/R={(pi)(radius^4)}/{8)(viscosity)(length of tube)
Term
viscosity equation
Definition
viscosity= (Force/area)/ (velocity)/(distance)
or shear stress/shear rate, when shear stress=the force that must be applied to a second sheet to make it move faster and shear rate=the velocity gradient between two sheets
Term
Reynold's number equation
Definition
indicates the propensity for turbulent blood flow

Reynold's number= density x tube diameter x velocity/viscosity
Term
equation for total energy
Definition
E= potential E + {fluid density(velocity)^2}/2
Term
Laplace's Law
Definition
Wall tension=transmural pressure x radius/wall thickness
Term
Stroke Volume
Definition
SV=EDV-ESV

(Is the volume ejected per beat)
Term
Cardiac Output
Definition
blood flow per unit time

CO=SV x HR
Term
Cardiac Index
Definition
Cardiac Output/surface area

Compensates for the fact that larger individuals have greater cardiac outputs
Term
Stroke Work
Definition
The amount of work the heart does during a single contraction..specifically

SW=VPPxSV
where VPP is ventricular pulse pressure (the peak pressure minus end-diastolic pressure) and SV is the stroke volume
Term
Law of laPlace
Definition
Tension=Pressure x radius

Describes PRELOAD tension (the resting tension prior to a contraction)
Term
Equation for ventricular compliance
Definition
compliance= change in volume / change in P
Term
Ejection Fraction
Definition
SV/EDV

Is the % of blood ejected in a single beat
Term
Treppe/Staircase Phenomenon/Bowditch effect
Definition
states that an increase in heart rate will directly produce an increase in contractility, which will cause an increase in the stroke volume
Term
Equation for left ventricular stroke work
Definition
LVSW=LVPP x SV OR [h x (a+b)]/2

where
LVSW= left ventricular stroke work
LVPP= left ventricular pulse pressure (peak pressure-end diastolic pressure)
h=width of pressure-volume loop
a=pulse pressure generated during isovolumetric contraction phase
b=the pressure at the point of aortic valve closure
Term
Equation for minute work
Definition
LVSW x HR
Term
External work
Definition
The work done to generate pressure and eject blood...is the area of the pressure=volume loop
Term
Internal work
Definition
the work done by the heart prior to the development of pressure....the work done against the non-contractile elements of the heart
Term
comparison between volume work and pressure work
Definition
for equal amounts of external work performed by volume loading (increased preload) or pressure loading (increased after load)...the volume-loaded heart will have LES oxygen consumption and generally be more efficient
Term
Cardiac efficiency equation
Definition
cardiac efficiency=work performed/oxygen uptake
Term
The Fick Principle
Definition
Flow=Quantity Consumed/ arterial content-Venous Content
OR
Cardiac output=whole body oxygen consumption/ (arterial blood oxygen content-pulmonary artery blood)
Term
Resistance vessel examples
Definition
arterioles and precapillary sphincters
Term
Exchange vessel examples
Definition
capillaries
Term
capacitance vessel example
Definition
veins
Term
relationship between velocity of blood flow and cross sectional area of vessels
Definition
as increase cross sectional area of vessel, decrease velocity of blood
Term
equation for blood flow using velocity and cross sectional area
Definition
Blood Flow=velocity x cross sectional area
Term
pulse pressure equation
Definition
systolic pressure-diastolic pressure
Term
physical factors which influence arterial blood pressure
Definition
arterial blood volume and arterial compliance
Term
physiological factors which influence arterial blood pressure
Definition
cardiac output (HR x SV) and peripheral resistance
Term
Peripheral runoff
Definition
the transfer of blood from the arterial circulation into the capillaries and vv during diastole
Term
mean arterial pressure and how to calculate it
Definition
the average pressure of the blood perfusing the capillaries during a cardiac cycle

MAP can be determined from the area under the pulse curve divided by a period of time

OR

MAP can be approximated by adding diastolic pressure to 1/3 of the pulse pressure
OR
MAP=Cardiac output x total peripheral resistance
Term
equation for change in arterial pressure over time
Definition
change in arterial pressure/time= CO- Peripheral runoff if cardiac output>>peripheral runoff, then you increase the arterial pressure if cardiac output<<peripheral runoff, then you decrease the arterial pressure ***Under steady state conditions, cardiac output always equals peripheral runoff
Term
equation for pulse pressure which involves stroke volume
Definition
pulse pressure= stroke volume/ aortic compliance
Term
effect of a decrease of compliance on pulse pressure for a given TPR
Definition
For a given TPR, as compliance decreases the arterial pulse pressure widens
Term
effect of increase in TPR on systolic and diastolic pressures for a given compliance
Definition
For a given compliance, as TPR increases, both systolic and diastolic pressures increase (although diastolic is affected more)
Term
effect of decrease/increase in SV on systolic pressure and pulse pressure
Definition
If SV is reduced, systolic pressure is reduced as well as pulse pressure...if SV is increased, systolic pressure and pulse pressure increase
Term
Effect of a decrease in arterial compliance on pulse pressure
Definition
A decrease in arterial compliance causes and increase in pulse pressure
Term
The 2 main determinants of diastolic pressure
Definition
Diastolic pressure is mainly influenced by heart rate and total peripheral resistance

HR determines the interval for peripheral runoff and peripheral resistance determines the rate of peripheral runoff...both HR and TPR affect the volume of blood remaining in the arterial system at the end of diastole
Term
Venous Return
Definition
Venous Blood Flow from the peripheral vv to the right atrium...@ steady state this must equal the cardiac output
Term
central venous pressure
Definition
is right atrial pressure
Term
peripheral venous pressure
Definition
pressure generated by flow of blood from the capillaries into the peripheral vv
Term
0 reference point for hydrostatic pressure in the body
Definition
the base of the tricuspid valve
Term
What happens to venous/arterial pressure when a muscle in the calf contracts?
Definition
venous pressure falls while arterial pressure remains constant...this improves perfusion of muscle capillary beds
Term
What happens in veins during inspiration
Definition
During forced inspiration, intrathoracic pressure becomes more negative...this causes an increase in venous transmural pressure, causing the central veins to dilate, and the central venous pressure to decrease...simultaneously the pressure in intraabdominal vv increases, these all combine to increase venous return and ultimately SV
Term
Effect of an increase in CO on central venous pressure at a constant TPR
Definition
At a constant TPR, an increase in cardiac output will decrease central venous pressure...this occurs because of the transfer of blood from the venous circulation to the arterial circulation...at the highest theoretical CO, CVP would fall below ambient pressure, collapsing the vv...this phenomenon limits the maximal values that CO can have
Term
The effect of a sudden increase of TPR on arterial blood volume, venous blood volume, venous blood pressure and MCP
Definition
A sudden increase in TPR will cause a greater volume of blood to be retained in the arterial system, accompanied by an equivalent decrease in venous blood volume...thus at any cardiac output, an increase in TPR will cause a decrease in venous pressure, but with no change in MCP
Term
Vascular function curve
Definition
Cardiac output on y axis, central venous pressure on x axis
Term
cardiac function curve
Definition
cardiac output on y axis, central venous pressure on x axis
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