Physiology (circulatory & gastro) - Irene Gold Booklet :)

Where is blood flowing in isovolumetric contraction

Into the atria (no movement in or out of ventricles)

The last 1/3 of ventricle filling occurs via

Atrial systole (contraction = active filling)

What structure tells the atria to contract

SA node

The period where the ventricles are full of blood, all valves are closed and pressure is building within the ventricles is called

Isovolumetric contraction

What structure carries deoxygenated blood from the heart to the lungs

Pulmonary arteries

What structure carries oxygenated blood from the lungs back to the heart

Pulmonary veins

The pulmonary artery is the ______ artery in fetal circulation

Umbilical

How does blood become oxygenated in the lungs

Bohr effect

Average End diastolic volume

120mL

Average End systolic volume

50mL

In order to open the aortic semilunar valve the pressure in the ventricle must be higher than _______

Pressure in the aorta

How much of ventricular filling is done passively

80% (2/3)

The volume of blood in the ventricles BEFORE contraction is called

End-diastolic volume (EDV)

Blood remaining in the ventricles AFTER ejection is called

End-systolic volume (ESV)

EDV-ESV equals?

stroke volume

Stroke volume x heart rate equals?

Cardiac ouput

What makes the 1st heart sound

The AV valves closing

What makes the 2nd heart sound

The semilunar valves closing

T/F a 3rd heart sound is always pathological

False - normal under 40

T/F a 4th heart sound is always pathological

TRUE

What is the anatomical pacemaker of the heart

SA node

What is the significance of the plateau phase in a cardiac action potential

A second AP cannot occur - prevents tetany

What causes the plateau phase in a cardiac action potential

Slow flow of calcium into the cell

What allows the heart to have autorhythmicity

Leaky sodium channels

What occurs at the P wave on the electrocardiogram

Atrial depolarization (atrial systole)

What is the Winkebock phenomenom

Secondary heart block - elongation of PR interval until 2 P waves appear (ECG)

Primary heart block can be seen on ECG when there is elongation of_____

PR interval

When does ventricular contraction occur on the ECG

QRS complex

When does atrial repolarization occur on an ECG

during the QRS complex (hidden by ventricular depolarization)

The ST segment of an ECG shows what phase of the cardiac cycle

Isovolumetric contraction

When does ventricular Repolarization occur on ECG

T wave

An alterred ST segment (ECG) is indicative of

Myocardial infarction

What is happening during the U wave of ECG

Repolarization of papillary muscle

What conditions cause diastolic murmurs

ARMS & PRTS

Aortic Regurgitation, Mitral Stenosis, Pulmonic Regurgitation, Tricuspid Stenosis

T/F aortic stenosis will cause a systolic murmur

True

T/F mitral stenosis will cause a systolic murmur

False - diastolic (ARMS and PRTS)

Mitral regurgitation will cause _____ murmurs

Systolic

Stenosis of the bicuspid valve will cause ______ murmurs

Diastolic (bicuspid=mitral)

A distended vessel that becomes weak describes an

Aneurysm

Where does a Berry aneurysm occur

Circle of Willis

berry aneurysms will cause

Subarachnoid hemorrhage

What condition is highly associated with dissecting aneurysms

Marfans syndrome

Longitudinal tearing of the aorta is classified as

Dissecting aneurysm

Ur pt is a smoker, they suddenly have extreme low back pain, a thready pulse and is in hypovolemic shock - what condition is likely>?

Abdominal aortic aneurysm

What is the most common benign heart tumor

Myxoma

What is Tetralogy of Fallot?

DRIP

Dextroposition of aorta, Right ventricle hypertrophy, interventricular septal defect, pulmonic stenosis

Rheumatic fever commonly attacks what part of the heart

Mitral valve

Treponema pallidum (syphillis) often targets what part of the heart

Aortic valve

What is vaso vasorum

Blood vessels that irrigates other blood vessels

What vessels have the largest total cross sectional and surface area

Capillaries

Normal blood pH

7.35-7.45

Most common cause of congestive heart failure

Essential hypertension (blood backs up into left ventricle causing left side heart failure)

What is the common early sign of congestive heart failure

Exertional dyspnea (due to fluid backing up into lungs)

What is orthopnea

Cannot breath while lying down

Where does fluid collect in congestive heart failure

Costodiaphragmatic recess (lowest gravity)

Typically congestive heart failure will effect what side of the heart first

Left

What is a sign of right sided heart failure?

jugular vein distention/pulsation

Blood backing up into the IVC will go into

Legs and liver

What is ascites

Fluid collects in abdomen

What is the most common cause of liver failure

Alcoholism

Mallory bodies are a sign of

Alcohol-induced hepatitis

What is Mallory-Weiss syndrome?

Upper GI tearing from forceful vomiting (associated with alcoholism)

What is Wernicke-Korsakoff syndrome?

Memory disorder from Vit B1 deficiency (associated with alcoholism)

Alcohol impairs the body from getting what vitamin

B1 Thiamine

What is Bell Magende Laws of Physiology?

anterior spinal roots are motor, posterior are sensory

reflex triggered to prevent over-inflation of the lungs. stretch receptors present in the smooth muscle of the airways respond to excessive stretching of the lung during large inspirations.

Hering Breuer

The Hering Breuer reflex limits respiratory excursion via what nerve

Vagus

What law states that the tension in arteries will be proportional to the radius of the vessel

Lapalce's Law for arteries

What is Laplace's law for the heart

Ventricular pressure depends on muscle tension, size, and shape of heart

What is Starling's law of the heart?

Cardiac output is equal to venous return

What is the Haldane Effect

The lungs release CO2 from carboxyhemoglobin, and bind oxygen to hemoglobin (occurs in lungs)

What is the Bohr effect

Metabolizing tissues release oxygen from oxyhemoglobin, and uptake carbon dioxide to form carboxyhemoglobin (occurs in tissues)

What are the two properties of hemoglobin

Bohr effect (right shift) and Haldane effect (left shift)

The haldene effect occirs in the lungs when the pH is _____- (higher or lower?)

Higher (more basic)

The Bohr effect occurs in the tissues when the pH is _____- (higher or lower?)

Lower (more acidic)

An increase in temperature and a decrease in pH will have what effect on the oxyhemoglobin curve

Right shift (Bohr effect) - release more oxygen into tissues

IF the temperature is decreasing and the pH is becoming more basic, what is the effect on the oxyhemoglobin curve

Left shift (Haldene effect) - More oxygen will bind to hemoglobin in the lungs

what starts the breakdown of starch?

ptyalin (salivary amylase)

What starts the breakdown of fats in the mouth

Sublingual lipase

What cells produce gastrin

G cells in pyloric gland

Functions of gastrin

Increases gastric secretions, motility and mucous

What cell type produces pepsinogen

Chief cells

What types of cells are found in the gastric glands

Parietal (oxyntic) cells and chief (peptic) cells

What do parietal cells produce

HCl and intrinsic factor

What is intrinsic factor used for

B12 resorption in terminal ileum

What are the mucous producing cells in the small intestine

Goblet cells

Function of Brunner's glands

Secretes alkaline fluid to protect mucosa from stomachs acidic contents

Where is cholecystokinin (CCK) secreted?

Duodenum

What causes the production of pancreatic amylase and lipase

Release of cholecystokinin

Function of lactase

Breakdown lactose into glucose and galactose

What is the function of maltase

Breakdown maltose into glucose and glucose

Cholecystokinin will close the _________ sphincter in response to liquids

Pyloric

Function of trypsinogen

Breakdown protein

What causes the production of trypsinogen

Cholecystokinin

Cholecystokinin inhibits what in the stomach

Gastrin

Function of micelles

Carry digested fat to the lymphatics via chylomircron

Describe where digestion occurs for long vs medium vs small chain fatty acids

Long- lymphatics, medium - portal system OR lymphatics, short - portal system into liver

What is the function of enterogastrone

Helps close pyloric sphincter in response to lipids

What converts trypsinogen to trypsin?

enterokinase

What 3 things are activated by trypsin

Chymotrypsinogen, proteolastsase, and carboxypolypeptide