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Physiology- Cardiophysiology
Special Circulation (T Pierce)
37
Medical
Post-Graduate
02/02/2009

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Cards

Term

Major determinants of coronary blood flow

Definition
  • perfusion pressure (most important factor)
  • myocardial extravascular factor
  • local myocardial metabolism
  • neurohormonal control
Term
Why does the heart not receive blood during systole?
Definition
when heart contracts, it generates pressures leading to the occlusion of the coronary vessels
Term
Equation for coronary blood flow
Definition
Q=(aortic pressure during diastole - cornary sinus P)/ coronary resistance
Term
At what pt in the cardiac cycle is coronary blood flow shut off/sign. reduced?
Definition
isovolumetric ventricular contraction
Term
At what pt in the cardiac cycle does coronary blood flow get restored?
Definition
isovolumetric ventricular relaxation
Term
Effect of autoregulation of coronary blood flow. What would happen to flow in coronary system without it?
Definition
It allows blood flow within coronary blood flow to continue at a constant flow between 50-140 mmHg. If they did not, the smooth muscle would contract upon increases in pressure, leading to occlusion of coronary blood flow.
Term
Effect of decrease in oxygen and increase in adenosine on coronary blood flow
Definition
vasodilation in coronary blood vessels, causing increase blood flow
Term
Effect of increase in CO2, H, K, osmolarity on coronary blood vessels
Definition
causes vasodilation, leading to increase coronary blood flow
Term

Effect of metabolism on autoreg. curve of Q and P

Definition
  • in high metabolism states, you operate on the "higher flow" end of the autoregulatory curve
  • in low metabolism states, operate on "lower flow" end of autoregulatory curve

If you hit maximal dilation state, we override this autoregulatory mechanism, so we would get a linear relationship between coronary bp and coronary flow.

Term
define active hyperemia
Definition
increase in blood flow with increase in metabolic needs
Term
Define reactive hyperemia
Definition
increase blood flow in response to prior period of decreased blood flow, usually associated with build up of metabolic waste products and low oxygen conc.
Term
Part of heart more susceptible to reactive hyperemia
Definition
Endocardium (their AP is longer)- they depolarize sooner and repolarize later (see EKG)
Term
How is it that the SA node fires at such a high rate the heart beat is no where near its intrinisic pacemaker rate?
Definition
tonic parasympathetic activity
Term
Role of neurohormonal control in coronary blood flow
Definition
very little direct control, but they can control heart rate, which will indirectly affect myocardial metabolism
Term

Importance of vascular structure of circle of willis

Definition
You have a circle, so if you had a ICA occlusion, it will preserve cerebral perfusion/flow.
Term
Role of cerebral blood flow autoregulation
Definition
maintains constant cerebral blood flow in conditions of increase pressure (50-150 mmHg)
Term
equation for cerebral perfusion pressure
Definition
CPP = MAP- intracranial P (ICP)
Term
Common local vasodilator/increase blood flow signals of cerebral blood flow
Definition
  • increases in CO2
  • increases in H concentration (decrease pH)
Term
Resistance and Pressure in pulmonary circulations
Definition
resistance is lowo so their are small rises in P when pulmonary flow increases (you can increase cardiac output without increasings your pulmonary pressure significantly)
Term
Effect of low oxygen conc. on pulmonary circ.
Definition
unlike the rest of the body, it elicits vasoconstriction, which will decrease flow
Term
Role of gravity in pulm. circ.
Definition
blood flow lowest at apex when standing
Term
What factor controles pulmonary circulation the most?
Definition
oxygen concentrations
Term
Predominant dilating factor of lungs
Definition
nitric oxide
Term
mechansim of action of nitric oxide on lungs
Definition
  1. activates guanylyl cyclase
  2. produce cGMP
  3. relax vascular smooth muscle
Term
Clinical pulmonary conditions to clinically use NO
Definition
  • acute respiratory distress syndrome (ARDS)
  • high altitude pulmonary edema
  • pulmonary hypertension
Term
What makes NO a good treatment of respiratory hypertension?
Definition
  • rapidly inactivated by Hb, so no systemic vasodilation
  • does not impair ventilation/perfusion matching
Term
blood flow in renal system
Definition
  1. afferent arteriole
  2. Bowman's capsule
  3. glomerulus
  4. efferent arteriole
  5. peritubular capillary
Term
Effect of sympathetic activity on renal circulation. Effect of Ang II.
Definition
  • sympathetic activity vasoconstricts afferent arteriole
  • Ang II vasoconstrct efferent arteriole
Term
Why is renal blood flow highly autoregulated?
Definition
flow must remain constant despite changes in renal perfusion pressure
Term

Effect of sympathetic activity on skeletal muscle

Definition
  • tonic sympathetic activity prevent blood from flowing to every single muscle and supply the rest of the body
Term

Mechanism of action of symp. system on skel. muscle

Definition
  1. norepi activate alpha one receptors
  2. cause vasoconstriction in skeletal muscle arterioles
Term
Effect of beta2 adrenergic agonist on pulm. circ.
Definition
decrease pulm vascular resistance
Term
Effect of high activation of symp. system on skel. muscle
Definition
  1. adrenal glands release epi
  2. activate beta 2 receptors
  3. cause vasodilation of skel. muscle
Term

Factors other than symp. system that can influence blood flow during exercise

Definition
  • local metabolites
    • lactic acid
    • adenosine
    • potassium
Term
Innervation of cutaneous circulation
Definition
dense tonic sympathetic activity
Term
Role of symp. sys. on cutaneous circulation. How it responds to exercise?
Definition
  • maintain body temperature
    • exercise- lose symp. activity, so vasodilate, leading to increase blood flow and increase heat loss
Term
Effect of trauma to the skin on cutaneous circulation
Definition
  1. increase vasoactive substances like histamine to vasodilate the response
  2. triple response
    1. focal red line assodciated with trauma
    2. red flare as vasodilation expands spatially
    3. local edema/swelling
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