Cardiovascular physio

The exercise was created 2019-12-15 by karlssonsophie. Question count: 168.

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  • % of blood in veins, venules and venous sinusoids 64%
  • % of blood in arteries 13%
  • % of blood in arterioles and capillaries 7%
  • % of blood in heart 3%
  • To increase pressure nervous system will: increase contractility, contract reservoirs, vasoconstrict arterioles
  • Flow is calculated by: Ohms law F=(P1-P2)/R
  • Cardiac output in adult 5000 ml/min
  • Laminar flow has a Parabolic profile
  • Spins in turbulent flow is called eddy currents
  • Re is 200-400 means? turbulent flow at some branches which will die. Normal in large arteries
  • Re is over 2000? Turbulence in straight smooth vessel. Normal close to ventricles during ejection.
  • Factors of Re? velocity of blood, vessel diameter, density, viscosity
  • Normal blood pressure? (110-130)/(70-90)
  • Normal rate of blood flow? 100 ml/s
  • Definition of conductance blood flow in a vessel for a given pressure difference
  • Equation of conductance? Conductance=1/resistance
  • Poiseuilles law? Rate of blood flow
  • factors of poiseuilles law? pressure difference in a vessel, length of a vessel, radius of vessel in the power of four, viscosity of blood
  • Autoregulation definition lowers the effect of arterial pressure on tissue blood flow
  • autoregulation can be explained through myogenic and metabolic mechanism
  • Metabolic mechanism can be explained by active and reactive hyperemia
  • Distensibility allows the vessel to average out and accommodate pulsations
  • Compliance How much blood can be stored in a given portion
  • How much blood can be lost without larger effect on cardiovascular system? Up to 25%
  • Happens when vessel is exposed to increased volume Delayed compliance
  • Pulse pressure systolic-diastolic
  • 2 things that affect the pulse pressure stroke volume and compliance
  • Mean arterial pressure calculated? diastolic pressure + 1/3 PP
  • Central venous pressure is a balance between: ability of heart to pump and tendency of blood to flow into right atrium
  • Normal pressure in abdominal cavity 6mmHg
  • Rise of pressure in abdominal cavity can happen because of: pregnancy, tumors, abdominal obesity, fluid in abdominal cavity
  • Venous pressure in; sagittal sinus -10mmHg
  • Venous pressure in; neck 0mmHg
  • Venous pressure in; shoulder 6mmHg
  • Venous pressure in; hand 36mmHg
  • Venous pressure in; knee 40mmHg
  • Venous pressure in; foot 90mmHg
  • specific blood reservoirs spleen, liver, abdominal veins, venous plexus under skin, heart, lungs
  • Sympathetic stimulation increases: heart rate, strength, volume
  • epinephrine causes .... in muscle vasodilation
  • carotid sinus is stimulated between 50/60-180mmHg
  • aortic baroreceptors are stimulated between: 80/90-180mmHg
  • pressure buffer system nerves from baroreceptors
  • Chemoreceptors are triggered by O2, CO2, H+
  • Atrial and pulmonary reflexes have: stretch receptors
  • Stretch of atria --> signals to hypothalamus --> decrease ADH --> increase filtration in tubules + decreased reabsorption --> normal blood volume
  • bainbridge reflex = atrial stretch reflex
  • factors that affect blood pressure cardiac output, blood volume, viscosity, resistance, elasticity of arteries
  • % of blood in brain 14%
  • % of blood in skeletal muscle 15%
  • % of blood in bone 5%
  • % of blood in GI tract + spleen 21%
  • % of blood in liver 6%
  • % of blood in kidney 22%
  • % of blood in skin 6%
  • % of blood in other 8%
  • factors that increase cardiac output increased heart rate, increased stroke volume, sympathetic stimulation, catecholamines, norepinephrine, thyroid hormones, increased Ca2+
  • factors that decrease cardiac output decreased heart rate, decreased stroke volume, parasympathetic stimulation, changed K+ levels, decreased Ca2+ levels, anoxia, acidosis
  • Mean arterial pressure is determined by cardiac output, systemic vascular resistance, central venous pressure
  • Hypovolemia may be caused by bleeding, dehydration, vomiting, severe burns, medications treating hypertension
  • Hypervolemia can be caused by retention of water and Na, liver cirrhosis, some kidney diseases, hyperaldosteronism, some glucocorticoid steroid treatments
  • Pressure in L atrium 7mmHg
  • Pressure in L ventricle 120/0mmHg
  • Pressure in large arteries 120/80mmHg
  • Pressure in arterioles 80-40mmHg
  • Pressure in capillaries 40-30mmHg
  • Pressure in vena cava 4mmHg
  • Pressure in R atrium 0-2mmHg
  • Pressure in R ventricle 30/0mmHg
  • mean arterial pressure is determined by blood volume, cardiac output, resistance, distribution of blood between arterial and venous vessels
  • Venous return depends on pressure difference from venules to right atrium, tricuspid valve + buildup of blood on the venous side, skeletal muscle pump, respiratory pump
  • Lipid soluble, example + how does exchange happen? O2 + CO2. Diffuse through cell membrane
  • Water soluble, example + how does exchange happen? ions + glucose + amino acids. Between cells
  • What is Jv fluid movement
  • what is Kf hydraulic conductance, water permeability of the capillary wall
  • What is Pc capillary hydrostatic pressure, + filtration, higher at arteriolar end than venous
  • what is Pi interstitial hydrostatic pressure, opposing filtration
  • What is PhiC capillary oncotic pressure, opposing filtration
  • what is PhiI interstitial oncotic pressure, + filtration
  • Net pressure is + --> filtration
  • net pressure is - --> absorption
  • Net pressure calculation (Pc-Pi)-PhiC+PhiI
  • Lymph flow back to the thoracic duct happens by contraction of smooth muscle in the lymph vessels + skeletal muscle pump
  • increased Pc can happen because arteriolar dilation, venous constriction, increased venous pressure, heart failure, extracellular fluid volume expansion
  • Decreased PhiC can be because decreased plasma protein concentration, liver failure, protein malnutrition, nephrotic syndrome
  • Increased Kf can be because burn, inflammation
  • Impaired lymphatic drainage can be because standing, removal of lymph nodes, infection of lymph nodes
  • Mechanisms that regulate blood flow: local (intrinsic control) and neural or hormonal (extrinsic) control
  • Active hyperremia Blood flow is proportional to its metabolic activity
  • Reactive hyperemia Increase in blood flow in response to decreased blood flow
  • Vasodilator metabolites produced by the tissues CO2, H+, K+, lactate, adenosine
  • A1 receptors --> vasoconstriction
  • B2 receptors --> vasodilation
  • Increase in PCO2 in cerebral circulation --> vasodilation
  • Hypoxia in pulmonary circulation --> vasoconstriction
  • Renal circulation is... autoregulated NOT dependent on sympathetic innervation
  • Increase heat production by: stimulation of thyroid hormone production, activation of sympathetic nerves, shivering
  • major actions of thyroid hormones stimulation of NaK-ATPase, increased O2 consumption, increased metabolic rate, increased heat production
  • Brown fat, which NS? sympathetic
  • Shivering? activation in posterior hypothalamus --> activation of A and Y in skeletal muscle --> contraction
  • Getting rid of heat mechanisms are from: anterior hypothalamus
  • Sweat glands are innervated by ... --> increased sweating sympathetic cholinergic fibers
  • Fever is caused by pyrogens --> IL-1, anterior hypothalamus sends signals to posterior hypothalamus to raise temperature to new set point
  • mechanisms for heat generation is from... posterior hypothalamus
  • things transported in gel water, electrolytes, small molecular weight nutrients, cellular excreta, O2, CO2
  • Speed of diffusion through gel is... than through free fluid faster
  • Amount of lymph into blood? 2-3 liters/day = 120 ml/h
  • Ions that vasoconstrict: Ca2
  • ions that vasodilate: K+, Mg, H+, anions, CO2
  • factors that determine the rate of heat production: basal rate of metabolism, rate of metabolism by muscle activity, metabolism by thyroid hormones, metabolism by sympathetic stimulation on cells, metabolism from increased chemical activity, thermogenic effect of food
  • Most heat is produced in liver, brain, heart, skeletal muscle
  • mechanisms of heat loss radiation, conduction, convection, evaporation
  • vasodilators histamine, adrenaline, ANP, relaxin, prostacyclin, NO, bradykinin
  • vasoconstrictors angiotensin 2, ADH, epinephrine, norepinephrine, glucocorticoid, thromboxane, endothelins
  • duration of atria 150 ms
  • duration of ventricles 250 ms
  • duration of purkinje fibers 300 ms
  • Upstroke in atria, ventricle and purkinje system happens because: Na2+ into the cell
  • Phase 1 in atria, ventricle and purkinje system happens because K+ goes out of the cell
  • plateau in atria, ventricle and purkinje system happens because ca2+ into K+ out
  • phase 3 in atria, ventricle and purkinje system happens because k+ out
  • phase 4 in atria, ventricle and purkinje system happens because Na+ and Ca+ into K+ out
  • Phase 0 in SA happens because Ca2+ going in
  • Phase 3 in SA node K+ out
  • phase 4 na+ into the cell
  • spreading through atria, av node, his takes? 220 ms
  • Absolute refractory period is until membrane potential of -50mV
  • Membrane potential of supranormal period -70 to -80 mV
  • chronotropic effect heart rate
  • dromotropic effect conduction velocity
  • inotropic effect contractility
  • 3 features of inotropic effect peak tension, rate of tension development, rate of relaxation
  • how long is normal refractory period in ventricles 0,25-0,30 s
  • how long is normal refractory period in atria +,15 s
  • too much Ca2+ on heart function-> constriction of heart + increased heart rate
  • too musch K+ around heart dilation of heart + slows heart rate
  • contraction happens between which phases: 0-2
  • relaxation happens during phase 2-3
  • Noradrenaline attach to B1 and B2
  • adrenaline attach to B2
  • Sympathetic innervation receptors in atria 70% B1 30% B2
  • Sympathetic innervation of ventricles 80% B1 and 20% B2
  • Lusitropic rate of relaxation and contractility of myocardial cells
  • Bathmotropic frequency of generating action potentials
  • Right sympathetic trunk innervates SA +AV + atrial muscles
  • Left sympathetic trunk innervates ventricular muscles + coronary arteries
  • Left vagus nerve innervates AV node + left atrial muscle
  • right vagus innervates SA node + right atrial muscle
  • 1 big box in voltage 0,5 mV
  • 1 big box in time 0,2s
  • Lead 1 in ° 0°
  • Lead 2 in° 60°
  • Lead 3 in ° 120°
  • Lead aVR in ° 210°
  • lead aVF in ° 90°
  • lead aVL in ° -30°
  • leads for inferior II, III, aVF
  • leads for lateral I, aVL, V5, V6
  • leads for anterior V1, V2
  • leads for septal V3, V4
  • Duration of P wave 0,08-0,11 s
  • duration of QRS complex 0,06-0,11 s
  • duration of PQ interval 0,120-0,20 s
  • duration of QT interval 0,4-0,45 s
  • Prolonged ST can be because of hypokalemia
  • ST elevation can be because pericarditis, infarction, aneurysm
  • ST depression can be because of ischemia, digitalis toxicity
  • duration of ST segment 0,005-0,150 s

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