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Test 3 Note Cards
Cardiac and Renal System
133
Physiology
Undergraduate 2
03/13/2012

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Cards

Term
function of basophils
Definition
release histamine & other mediators of inflammation
Term
basophils
Definition
-large bilobed, blue purple granules
-10 to 12um
-20 to 50 cells/uL of blood
-develops in 3-7 days
-lifespan? a few hours to few days
Term
lymphocytes
Definition
-nucleus spherical
-agranulocytes
-pale blue cytoplasm
-1500-3000 cells/uL of blood
-diameter 5 -17 um
-develops in days - weeks
-lifespan is hours - years
Term
function of lymphocytes
Definition
mount immune response by direct cell attack (T-cells) or via antibodies (B-cells)
Term
monocytes
Definition
-nucleus is U or kidney shaped
-agranulocytes
-gray/blue cytoplasm
-diameter is 14-24um
-100-700 cells/uL of blood
-develops in 2-3 days
-lifespan is months
Term
function of monocytes
Definition
function in phagocytosis; develop into macrophage tissue
Term
T-cells
Definition
attack foreign cells directly
Term
B-cells
Definition
multiply to become plasma cells and secrete antibodies
Term
thrombocyte role
Definition
blood clotting
Term
thrombocyte function
Definition
-Releasing of serotonin stimulates constriction of blood vessels which reduces blood flow to injured area.
-also secrete growth factors
-autocrine regulators meaning they can vbind to their own receptors and control their own production
Term

 

hematopoeisis

Definition
  • means formation of bloodcells
  • starts in intrauterine life
    • then liver takes over
    • later in life bone marrow takes over as main production site
Term

 

cell lines in blood cell formation

Definition
  • all blood cells originate in bone marrow from blood stem cells
  • lymphoid stem cells -->lymphocytes
  • myeloid stem cells -->all other blood cells
Term

 

Genesis of 

erythrocytes

Definition
  • committed cells are proerythroblasts
  • remain in the reticulocyte stage for 1-2 days in circulation
  • makeup 1-2% of all erythrocytes
Term

 

production of red blood cells and synthesis of hemoglobin depends on

Definition
 
  • iron
  • B12
  • folic acid
Term

 

formation of leukocytes

Definition
  • granulocytes form from myeloblasts
  • monoblasts enlarge and form monocytes
  • platelet forming cells from megakaryoblasts that break apart into platelets
Term

 

polycythemia

Definition
  • abnormal excess of RBC (erythrocytes)
  • abnormality of bone marrow produces excess RBC
  • excess platelets cause RBC to accumulate and could cause stroke
Term

 

polycythemia (excess RBC) can cause what chain of events?

Definition

excess RBC can cause hypertension which stimulates the medulla oblongata and can cause

  1. acromegaly
  2. hepatomegaly
  3. splenomegaly
Term

 

blood throughout life

Definition
  • 1st blood cells develop in early blood vessels
  • mesenchyme cells cluster into blood islands
  • late in 2nd month liver & spleen take over production
  • at 7 months, bone marrow becomes major hematopoeitic site
Term

 

What is sickle cell anemia?

Definition
  • abnormal hemoglobin causes a change in the RBC shape
  • RBC now cannot cross capillary wall and loses elasticity
Term

 

How can sickle cell anemia cause ulcers?

Definition

 

lack of elasticity can cause destruction of wall of blood vessels which causes rupture of capillary and small hemorrhage which can cause an ulcer

Term

 

What is leukemia?

Definition

 

when bone marrow makes abnormal WBC which do NOT function normal, grow faster than normal WBC, and do not stop growing when they should!

Term

 

signs and symptoms of a patient with leukemia?

Definition
  • fever
  • infection
  • weak immune system
Term

 

What is lymphocytic leukemia?

Definition

 

leukemia that affects the WBC and produces large number of mature WBC (lymphocytes)

Term

 

What is myelogenous leukemia?

Definition

 

affects WBC called myelocytes and produces large number of immature and mature WBC (myelocytes)

Term

 

Name the 3 layers of blood vessels

Definition
  1. Tunica intima - simple squamous
  2. Tunica media - sheets of smooth muscle
  3. Tunica externa - composed of connective tissues 
Term

 

lumen

Definition

 

central blood filled space of vessel

Term

 

elastic arteries

Definition
  • largest arteries
  • high elastin
  • diameters 1cm-2.5cm (aorta & other large vessels)
  • also called conducting arteries
Term

 

Name the 4 differences between arterial and venous systems

Definition
  1. Wall of artery is thicker than venous system
  2. Wall of artery has more elastic fiber
  3. Pressure in artery (100mm/Hg) is higher than venous system (4mm/Hg)
  4. The amount of blood which circulates in arterial system is slightly less because of the thickness of wall of the artery.
Term

 

Describe the mechanisms that help blood circulation in the venous system due to the low pressure.

Definition
  1. Contraction of surrounding muscles can constrict venous system & increase blood circulation
  2. By having a valve, the position & direction of valve helps blood circulation
  3. Some small veins are connected to bigger veins that are perpendicular to small veins. The circulation of blood in small veins creates pressure to aid in blood circulation
  4. Parallel to the vein (bilateral) are 2 arteries, the pulse from arteries is transferred to the venous system.
Term

 

capillary bed

Definition

 

network of capillaries running through tissues

Term

 

sinusoids

Definition

 

wide, leaky capillaries found in the spleen and liver

Term

 

Name the functions of the circulatory system.

Definition
  • transportation
    • gasses & nutrients
  • regulation
    • hormones & temperature
  • protection
    • like clotting
Term

 

percent of hematocrit in men 

Definition

 

42-52%

Term

 

percent of hematocrit in women

Definition

 

37-47%

Term

 

blood plasma contains...

Definition
  • sodium
  • nutrients
  • hormones
  • enzymes
  • antibodies
  • wastes
  • proteins
Term

 

3 main blood plasma proteins

Definition
 
  1. albumin
  2. globulins
  3. fibrinogen
Term
albumin as a plasma protein
Definition
  • 60-80% of the blood
  • produced by the liver & provide osmitic pressure needed to draw fluid from the surrounding tissue into the capillaries
Term

 

production of RBC

Definition
  • is a hormonal mechanism
  • O2 deficiency initiates and releases erythropoietin
      • -->stimulates RBC production in the bone marrow
Term

 

left ventricle

Definition
  • is the largest chamber of the heart
  • chamber walls are only about a 1/2" thick, but they have enough force to push blood through the aortic valve and into your body.
Term

 

between the left atrium and left ventricle is the ...

Definition

 

atrialventricular valve (AV valve) 

or

mitral valve

 

Term

 

between the right atrium and right ventricle is the...

Definition

 

 

tricuspid valve

Term

 

tricuspid valve

Definition

 

regulates blood flow between the right atrium and right ventricle

Term

 

pulmonary valve 

Definition

 

controls blood flow from the right ventricle into the pulmonary arteries, which carry blood to your lungs to pick up O2 

Term

 

mitral valve

Definition

 

valve lets oxygen-rich blood from your lungs pass from the left atrium into the left ventricle

Term

 

aortic valve

Definition

 

opens the way for oxygen-rich blood to pass from the left ventricle into the aorta, your body's largest artery, where it is delivered to the rest of your body. 

Term
Circulation of blood through heart and lungs
Definition

Superior and inferior vena cava take deoxygenated blood from entire body to the right atrium by contraction of the right atrium, the deoxygenated blood gets into the right ventricle and later on by contraction of the right ventricle the deoxygenated blood is ejected into the pulmonary arteryPulmonary artery takes deoxygenated blood to the lungs and then we have gas exchange. After this, 4 pulmonary veins take the oxygenated blood from the lungs to the left atrium. By contraction of the left atrium the oxygenated blood gets ino the left ventricle and later on by contraction of the left ventricle, fresh oxygenated blood is ejected into the aorta. Aorta takes fresh blood to organs, tissues and cells

Term

 

Systemic Circulation

Definition


the portion of the cardiovascular system which carries oxygenated blood away from the heart, to the body, and returns deoxygenated blood back to the heart. 

Term

 

Pulmonary Circulation

Definition

 

the portion of the cardiovascular system which carries oxygen-depleted blood away from the heart, to the lungs, and returns oxygenated blood back to the heart.

Term

Arteries
Definition
  • deliver oxygenated blood to the tissues.
  • are thick-walled, with extensive elastic tissue and smooth muscle.
  • are under high pressure.The blood volume contained in  the arteries is called the stressed volume.
Term

 

Arterioles

Definition
  • are the smallest branches of the arteries
  • site of highest resistance in the cardiovascular system
  • have a smooth muscle wall that is extensively innervated by autonomic nerve fibers
  • regulated by ANS
Term

 

Alpha1 - Adrenergic receptors are found on the arterioles of the...

Definition

  • skin
  • splanchnic
  • renal circulations.
Term


Beta 2 - Adrenergic receptors are found on arterioles of...

Definition

 

skeletal muscle

Term

 

 

Capillaries 

Definition
  • consist of a single layer of endothelial cells surrounded by basal lamina
  • are thin-walled, lack smooth muscle
  • site of exchange of nutrients, gasses & H2O


 

Term

 

Venules

Definition

 

formed from merged capillaries

Term

 

Veins

Definition
  • progressively merge to form larger veins.
  • largest vein (vena cava) returns blood to the heart
  • thin-walled
  • under low pressure
  • contain the highest proportion of the blood in the cardiovascular system
Term

 

the blood volume  contained in the veins is called the

Definition

 

unstressed volume

Term

 

Q stands for 

Definition

 

cardiac output (ml/min)

Term

 

P stands for

Definition

 

Pressure gradient (mm/Hg)

Term

 

R stands for

Definition

 

resistance or total peripheral resistance
(mm Hg/ml/min)

Term

 

What drives blood flow?

Definition

 

P, the pressure gradient

Term

 

blood flow is inversely proportional to...

Definition

 

the resistance of blood vessels

Term

 

Blood flow depends on...

Definition
  1. Pressure
  2. Location
  3. Resistance
    (by decreasing of diameter of capillary and by having of intersectional area in the capillary itself builds up a resistance to the blood flow) 
Term

 

Poiseuille’s equation 

Definition
  • Resistance depends on the viscosity of blood. More concentrated means more viscosity and can add to resistance. Length of the blood vessel – it takes time to flow through.
  • The smaller radius has higher resistance to the blood.
Term

 

Capacitance

 

Definition
  • depends on the elastic fibers (amount) in the arterial system
  • the wall of the artery has more elastic fiber than the venous system and it makes the wall thicker because of the thickness of artery wall, it occupies & reduces the radius of lumen of artery. 
Term

 

mean pressure of the aorta

Definition

 

100mm/Hg

Term

 

mean pressure of the arterioles

Definition

 

50mm/Hg

Term

 

mean pressure of capillaries

Definition

 

20mm/Hg

Term

 

mean pressure of vena cava 

Definition

 

4mm/Hg

Term

 

Systolic pressure
Definition
  • is the highest arterial pressure during a cardiac cycle
  • is measured after the heart contracts (systole) and blood is ejected into the arterial system
Term

 

Diastolic pressure

Definition
  • is the lowest arterial pressure during a cardiac cycle
  • is measured when the heart relaxed (diastole) and blood is returning to the heart via the veins
Term

 

Pulse pressure

Definition

 

difference between the systolic and diastolic pressures

Term

primary hypertension causes

Definition

are unknown 

Term
primary hypertension 
Definition
  • Sympathetic nervous system and renin-angiotensin-aldosterone system have received the most attention for the pathophysiology of hypertension, both can increase cardiac output and total peripheral vascular resistance (CO & TPR)
Term

factors that can influence hypertension

Definition
  • obesity
  • sodium salt
  • endocrine hormone disorder
  • metabolic disorder
  • ix syndrome 
  • stress
Term

cardiac output

Definition

the amount or volume of blood which is ejected into blood vessel by the contraction of ventricle per minute which is about 5L/min 

Term

total peripheral resistance (TPR)

Definition

comes from capillary and by having a small diameter and intersectional area, the pressure is reduced and it builds up resistance to the blood flow

Term

secondary hypertension is cause by

Definition

conditions that affect your kidneys, arteries, heart or endocrine system


Secondary hypertension can also occur during pregnancy 

Term

How does adrenal gland disorders affect secondary hypertension?

Definition
If we have overproduction of aldosterone it causes over reabsorbtion of Cl, Na, and H2O à this increases the blood pressure an the patient becomes hypertensive.
Term

How can an auto-immune disease cause secondary hypertension?

Definition
The patients body produces antibodies against own cells. The antibodies can stimulate the adrenal medulla  and over/under production of norepinephrine/epinephrine & constriction of blood vessels which causes hypertension
Term

Conn’s Disease 

Definition
having a specific adenoma or tumor in the aldosterone producing cells of the adrenal cortex. Also called hyperaldosteronism.
Term

Pheochromocytoma

Definition

the name of the tumor that is in the adrenal medulla of adrenal gland.

This is the cancer of the adrenal medulla. Then we have overproduction of adrenaline and noradrenaline and so then we have constrction of smooth muscle increasing the BP.

Term

P wave

Definition
  • represents the wave of depolarization that spreads from the SA node throughout the atria, and is usually 0.08 to 0.1 seconds (80-100 msin duration
  • represents atrial depolarization.
  • contraction of atrium
Term

PR interval

Definition
  • The period of time from the onset of the P wave to the beginning of the QRS complex
  • which normally ranges from 0.12 to 0.20 seconds in duration.  
  • the time between the onset of atrial depolarization and the onset of ventricular depolarization 
  • depolarization of AV node
Term

ST segment

Definition
  • is the segment from the end of the S wave to the beginning of the T wave
  • represents the period when the ventricles are completely depolarized
  • important in the diagnosis of ventricular ischemia or hypoxia because under those conditions, the ST segment can become either depressed or elevated. 

Term

T wave

Definition
  • represents ventricular repolarization and is longer in duration than depolarization (i.e., conduction of the repolarization wave is slower than the wave of depolarization). 

Term
[image]
Definition
Term

QT interval

Definition
  • the beginning of the Q wave to the end of the T wave
  • Q-T interval represents the time for both ventricular depolarization and repolarization to occur, and therefore roughly estimates the duration of an average ventricular action potential.
  • This interval can range from 0.2 to 0.4 seconds depending upon heart rate
Term

Action potential of ventricles, atrium and Purkinje system

Definition
  • have stable resting membrane potentials of about 90mV
  • This value approaches the K+ equilibrium potential.
  • Action potentials are long duration, especially in Purkinje fibers, where they last 300 msec
  • has 5 phases
Term

Phase 0 of cardiac action potential

Definition
  • is the upstroke of the action potential.
  • Na+ inflow is caused by a transient increase in Na+ conductance. This increase results in an inward Na+ current that depolarizes the membrane.
  • At the peak of the action potential, the membrane potential approaches the Na+ equilibrium potential. (45-65)
Term

Phase 1 of cardiac action potential

Definition
  • is a brief period of initial repolarization
     
  • Opening of a few K channels and K leaves the cell (slowly)
  • Initial repolarization is caused by an outward current, in part because of the movement of K+ ions 
 
Term

Phase 2 of cardiac action potential

Definition
  • is the plateau of action potential
  • right after phase 1 we have opening of Ca channels
  • caused by an increased in Ca conductance and and increase in K+ conductance
  • During phase 2, outward and inward currents are approximately equal, so the membrane potential is stable at the plateau level
Term

Phase 3 of cardiac action potential

Definition
  • repolarization phase
  • opening  of the rest of K channels and K leaves the cell
  • Ca conductance decreases, K conductance increases
  • high K conductance results in hyperpolarization 
Term

Phase 4 of cardiac action potential

Definition
  • is resting membrane potential phase
  • the period during which inward and outward current (Ik1) are equal and the membrane potential approaches the K= equilibrium potential

     

Term

Conduction velocity

Definition
  • reflects the time required for excitation to spread throughout cardiac tissue.
  • depends on the size of the inward current, larger current = higher conduction veolcity
  • fastest in Purkinje system
  • slowest in AV node
Term

excitability

Definition
  • the ability of cardiac cells to initiate action potential in response to inward, depolarizing current
  • reflects the recovery of channels that carry the inward current
  • changes over the course of action potential.
  • these changes in excitability are described by refractory periods.
Term
absolute refractory period (ARP)
Definition
no action potential can be initiated
Term
effective refractory period (ERP)
Definition
stimulus can have an effect but the cell membrane cannot show any reaction
Term
relative refractory period (RRP)
Definition
the cell membrane can accept stimulus and show its physiological reaction to the stimulus in the cell membrane.
Term
Length-tension relationship in the ventricles (1-5)
Definition
  1. Preload
  2. Afterload
  3. sarcomere length
  4. velocity of contration at a fixed muscle length
  5. Frank-Starling relationship
Term

Length-tension relationship in the ventricles

PRELOAD

Definition
  • is equivalent to end-diastolic volume, which is related to right atrial pressure
  • when venous return increases, end diastolic volum increases and stretches or lengthens the ventricular muscle fibers
Term

Length-tension relationship in the ventricles

AFTERLOAD

Definition
  • for the left ventricle the afterload is equivalent to aortic pressure. Increase in aortic pressure cases an increase in afterload on the left ventricle.
  • for the right ventricle is equivalent to pulmonary atrtery pressure. increase in pulmonary artery pressure causes an increase in afterload on the right ventricle
Term

Length-tension relationship in the ventricles

SARCOMERE LENGTH

Definition
  • determines the maximum number of cross-bridges that can form between actin and myosin
  • determines the maximum tension, or force, of contraction
Term

Length-tension relationship in the ventricles

VELOCITY of CONTRACTION

Definition
  • velocity of contraction is maximal when the afterload is 0
  • velocity of contraction is decreased by increase in afterload
Term

Length-tension relationship in the ventricles

FRANK-STARLING RELATIONSHIP

Definition
  • Greater venous return leads to greater end diastolic volume and causes greater cardiac output
  • increases in end diastolic volume canse an increase in ventricular fiber length which increases tensionn
Term

Frank-Starling relationship

increase in contractility causes...

Definition
an increase in cardiac output for any level of right atrial pressure or end diastolic volume
Term

Frank-Starling relationship

decrease in contractility causes...

Definition
a decrease in cardiac output for any level of right atrial pressure or end diastolic volume
Term
[image]
Definition

Steps 1-2  isovolumetric contraction 

Steps 2-3 ventricular ejection

Steps 3-4 isovolumetric relaxation

Steps 4-1 ventricular filling

 

Term
cardiac cycle steps 1-2 isovolumetric contraction
Definition
  • in point 1 the pressure is very close to 0
  • closure of aortic, pulmonary, tricuspid and bicuspid valves
  • end diastolic volume
Term
cardiac cycle steps 2-3 ventricular ejection 
Definition
  • intraventricular pressure increases
  • high pressure pushes up the aortic and pulmonary valve, then the ventricle has a strong contraction and ejects 70ml stroke volume of blood into aorita or pulmonary trunk of artery
  • the pressure in ventricle increases & we have ejection of stroke volume
Term
cardiac cycle steps 3-4 isovolumetric relaxation
Definition
  • intraventricular pressure drops to 0
  • amount of blood in ventricle is 70ml end systolic volume
  • ventricle is relaxed 
  • atrial pressure is higher than ventricular pressure
  • meanwhile the atrium receives large amount of blood from venous system such as superior/inferior VC on the right side and pulmonary veins on the left side.
Term
cardiac cycle steps 4-1 ventricular filling
Definition
  • the pressure in ventricle is lower than atrial pressure
  • atrial pressure is increased by receiving large amounts of blood from venous system
  • b/c of intra-atrial pressure, the AV valves (mitral and tricuspid) are pushed down and by contraction of atrium, large amount of blood (70mL) is released intro ventricles and we have ventricular filling
  • it contains 140ml again which is end diastolic volume
  • point 4 is exactly 70ml, the atrium released 70ml of blood into ventricle and it goes back to 140ml 
Term
Cardiac O2 consumption 
Definition
  • is directly related to the amount of tension developed by the ventricles
  • is increased by
    • increased afterload (^ aortic pressure)
    • increased size of heart
    • increased contractility
    • increased HR
Term
ECG standard lead 1
Definition
located between the right arm and left arm electrodes, the left arm being positive
Term
ECG standard lead 2
Definition
located between the right arm and left arm electrodes, the left arm being positive
Term
ECG standard lead 3
Definition
is located between the left arm and left leg electrodes, the left leg being positive
Term
What is a myocardial infarction?
Definition
The blood sypply to certain areas of the myocardium is obstructed. The muscle tissue at the center of the infarct dies off.
Term
Causes of myocardial infarction
Definition
  • atherosclerosis (plaque builds up)
  • stress
  • male
  • diabetes
  • history of coronary artery disease
  • high blood pressure
  • smoking 
  • unhealthy cholesterol levels (high LDL and low HDL)
  • chronic kidney disease
Term
symptoms of myocardial infarction
Definition
  • chest pain #1
    • can be severe or minor but usually lasts longer than 20 minutes
  • sweating
  • anxiety
  • cough
  • fainting
  • dizziness
  • nausea/vomiting
  • palpitations
  • dyspnea
Term
What is endocarditis?
Definition
  • inflammation of the inside lining of the heart chambers and heart valves (endocardium)
  • is usually the result of a blood infection like bacteria
    • artificial heart valves
    • congenital heart disease
    • heart valve problems
    • history of rheumatic heart disease

 

Term
globulins in blood plasma
Definition
  • alpha & beta are produced by the liver & function in transporting lipids and fat soluble vitamins
  • function in immunity
Term
fibrinogen in blood plasma
Definition
  • important clotting factor
  • produced by liver
  • fluid from clotted blood is called serum
Term
How are old RBCs removed from the blood?
Definition
in the sinuses of the spleen and there they are degraded
Term
[image]
Definition

Blood comes from superior/inferior

VC --> right atrium --> tricuspid valve -->

right ventricle -->pulmonary valve--> pulmonary arteries--> lungs!! --> pulmonary capillaries --> 

left atrium --> mitral valve -->

left ventricle --> aortic valve --> aorta!

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