Cardiac A&P 3

Cardiac A&P 3
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1. quantity of bld pumped per minutes by the ____ or _______2. Give following numerical values:a. RAPb. R ventricular pressurec. pulm art pressured. pulm art wedge pressure (PAWP)
1. right or left ventricle2a. 0-4mmHgb. 20-30/ 0-8mmHgc. 20-30/ 8-15mmHgd. 8-12mmHg
1. Frank Starling Law of the HEart= as cardiac muscle fibers are stretched, the fibers will respond how?2. why?3. Is cardiac muscle @ optimal fiber length at normal diastolic volumes?4. Increasing diastolic vol to a point will allow for what?5. If diastolic vol and stretch become excessive, what 2 things decrease? (decompensation)
1. with greater force of contraction (within physiological limits)2. As more bld fills ventricle during diastole, cardiac fibers are stretched so that actin and myosin filaments are brought to a more optimal degree of overlap 3. no4. increased vol of bld to be pumped5. force of contraction decreases and CO falls
1. degree of tension on the muscle when it begins to contract2. often measured as what?3. look at PA catheter waveforms on pg34. 5 factors affecting PL (which of 5 is #1)
1. preload2. end-daistolic vent pressure4. #1- bld volume- position-intrapleural pressure- venous tone/ muscle pump- atrial kick
Frank Starling's Law1. what pressures can be estimated using a plum art catheter2. distal end of catheter is positioned where?3. wedge (PAWP) is an estimate of what?4. normal PAWP values5. optimal stretch of the sarcomeres is achieved at PAWP of what?
1. left ventricular filling pressures2. distal segment (zone 3) of plum artery3. left atrial pressure4. 4-125. 16-20
Central Venous Pressure1. zero transducer to what?2. read CVP at what point during resp cycle?3. it is a direct measurement of what?
1. phlebostatic axis2. end of expiration3. right ventricular end diastolic pressure
1. If swan is pulled back into RV, it is considered what? What does it look like?2. PCWP- number should not be greater than what?3. PCWP is an indirect measurement of what?4. the impediment which the ventricles have to work against to eject blood? - can usually be approx by what value as a reflection of SVR
1. swan emergency- catheter needs to be pulled out immediately - V-tach2. PA diastolic3. left ventricular end diastolic pressure4. afterload - MAP
Atrial Stretch1. stretch of right atrial wall by increased bld vol leads to what? (not nearly as important as Frank-Starling mech to increase CO)2. SVR= reflects what?3. PVR- reflection of what?
1. increased HR (by 10-20%)2. left ventricular after load3. right ventricular afterload
Sympathetic Nervous System1. sympathetic fibers originate where?2. efferent fibers synapse in the ___ ___ of spinal segments ______. 3. Preganglionic fibers arise and synapse where? - post-gang fibers innervate which areas of the heart?4. symp stimulation increase which 2 things?
1. medulla from the cardioaccelerator center2. lateral horns of spinal segments T1-T53. paravertebral ganglia - more specifically, the stellate ganglia - all areas of the heart4. HR and force of contraction
Effect of NorEpi on the Heart1. stimulation of which receptors? a. increased permeability of what 2 things? b. effect?2. increased contractility is reflected by which 2 things?
1. B1 a. Na/ Ca b. heart rate (chronotropy) and contractility (inotropy)2. - SV is increased at any given end-diastolic volume - both rate of contraction and relaxation are increased
Mechanism of increased contractility by NE1. NE binds to ___ receptor on cell membrane2. ___ ___ is activated, converting ___ to ___3. cyclic AMP activates ___ ___ to phosphorylate 3 proteins resulting in WHICH 3 PROCESSES?
1. B12. Adenylate cyclase/ ATP to cyclicAMP3. protein kinase**opening of slow Ca channels and activating SR to release more Ca**stimulating active transport of Ca into SR, promoting quickly rate of relaxation**increasing rate of crossbridge cycling -> resulting in increased velocity and force of contraction
1. Vagus innervates primarily what?2. Vagal stimulation slows ____ of SA node and decreases ____ of AV nodal fibers (slowing transmission to the ventricles)Endocrine System3. Epi/ NorEpi are rls'd by the ______. These hormones bind to B1 receptors on the heart, producing same effects as the ___________.
1.right vagus innervates SA node left vagus innervates the AV node2. automaticity/ excitability3. adrenal gland/ symp nervous system
Extrinsic Regulation = other factors affecting cardiac fct1. cardiac debility = ____ heart2. exercise= _____ heart3. elevated ECF ___ a. decreases _____ _____ for K b. ____ resting cell membrane c. decreases amplitude of ___ ___, resulting in weaker _____4. Changes in ECF ____5. changes in _____
1. hypoeffective2. hypereffective3. K a. concentration gradient b. hypopolarizes c. action potential/ contraction4. Ca5. temperature
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