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Which side of the heart pumps blood into the lungs? into circulation?
- Lungs: right
- Circulation: left
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Atrioventricular valves
Prevent back flow from the ventricles into the atria during ventricular systole
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Semilunar valves
Prevent backflow of blood from the elastic arteries (pulmonary trunk on the right and aortic arch on the left) into the ventricles during ventricular diastole
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First heart sound
When ventricular systole begins and the atrioventricular valves slam shut
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Second heart sound
When ventricular diastole begins and the semilunar valves slam shut
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Isovolumic relaxation
- Period which the pressure within the atria rise and the pressure when the ventricles are declining
- All valves remain closed
- Once the pressure is high enough, the AV valves open and filling begins
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Isovolumic contraction
- When the pressure increases within the ventricles, while all valves remain closed
- Once the pressure is sufficient to push the semilunar valves open, ejection of blood from the heart begins
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Electrocardiogram (ECG or EKG)
Measures voltage changes across the body that result from the action potential activity of the heart
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P wave
Depolarization of the Atria
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QRS complex
Product of ventricular depolarization
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T wave
Result of ventricular repolarization
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PR interval
- Time between the beginning of the P wave to the beginning of the QRS complex
- Normal: 0.12-0.2 seconds
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Extended PR interval
- Sign of an abnormally long delay of the action potential at the AV node
- Known as a first degree AV nodal block
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ST segment
- Between the S wave and the T wave
- Elevated ST suggests ischemia; accompanied by inverted T
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Ischemia
Lack of adequate oxygen supply
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Infarction
- Previous, permanent damage to heart muscle cells
- Suggested by abnormally deep Q wave
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QT interval
- The time from the beginning of the Q wave through the end of the T wave
- Short interval= hypercalcemia
- Long interval= hypocalcemia
Normal: 0.3-0.4 seconds
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Veins delivering blood to the atrium in the right and left heart
Right: inferior and superior vena cava
Left: pulmonary veins
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Valve between the atrium and the ventricle in right and left heart?
Right: tricuspid (AV)
Left: bicuspid (mitral)
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Valve between the ventricle and the elastic artery in the right and left heart
Right: pulmonic semilunar
Left: aortic semilunar
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Elastic artery in the right and left heart
Right: pulmonary trunk
Left: aortic arch
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Blood enters atria from veins throughout
Atrial diastole
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Blood is pumped past the AV valves during
Atrial systole
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When does the first heart sound occur and which valves are involved
Early ventricular systole or onset of isovolumetric contraction
AV
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Isovolumic contraction ends when which valves open
Semilunar valves
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Blood is pumped past the semilunar valves during
Late ventricular ejection phase
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Which heart wave is considered inconsequential if it occured alone
Inverted T wave
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Pressure difference between isovolumic contraction and relaxation
- Contraction: high pressure
- Relaxation: low pressure
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Dynamic exercise
- Involves muscles that are freely moving with no or only modest resistance
- Involves primarly aerobic metabolism (aerobics, running)
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Static exercise
- Involves isometric contractions close to the maximum capacity of the muscles involved
- Generally involves almost exclusively anaerobic metabolism (weight lifting)
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Cold Pressor Test
- Involves placing a hand in ice water for a period of minutes
- Mild pain increases sympathetic nervous system activity which increases CO and constricting blood vessels
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What is BP dependent on
- Cardiac Output (CO)
- Resistance (TPR)
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Cardiac Output
- Rate at which blood is flowing from the heart each minut
- Determined by the HR and the stroke volume (volume of blood pumped with each beat)
Directly proportional to BP; if it increases so does BP
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Resistance (TPR)
- Resistance to blood flow within the cardiovascular system
- Primarily a function of blood vessel diameter; vasodilation means less resistance
If resistance increases so does BP
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What happens during dynamic exercise to blood vessels?
- SNS increases CO and constricts peripheral blood vessels which increase BP
- However, local vasodilation tends to reduce resistance which decreases BP
- Changes resistance in central vessels as well as periphery
Overall, only a slight elevation in BP
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What happens during static exercise to BP
- SNS increases CO and constricting peripheral blood vessels
- However, vessels in contracting muscles are pinched shut by the force of contraction.
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Explain how a beta receptor antagonist causes a decrease in BP
- They block beta receptors on the heart so epinephrine cannot bind
- This decreases CO (HR) which decreases BP
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Explain how alpha receptor antagonist causes a decrease in BP
- They block alpha receptors in the vasculature which prevents epinephrine from binding causing vasodilation
- This decreases resistance as well as decrease BP
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What are the pattern changes in vital signs during dynamic exercise, immediately after and during recovery?
- During: increase HR, increase systolic pressure, no change diastolic
- Immediately after: decrease HR, decrease systolic, no change diastolic
- Recovery: decrease HR, decrease systolic, no change diastolic
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How does immersing hand in ice water affect vital signs?
Cold imitates static exercise so it constricts local vessels which increases BP and HR
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How to the patterns observed with dynamic exercise contract with similar observations during static exercise and the cold pressor test?
- Static and cold: vasoconstriction and increase in diastolic
- Dynamic: no change in diastolic
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How do changes in CO and blood flow that occur during dynamic and static exercise relate to the blood pressure changes observed during the exercise?
- Dynamic: increase CO which increases systolic BP
- Static: increase CO as well as systolic and diastolic BP
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Homeostatic mechanism for BP
- Involves baroreceptors (structures that monitor BP) which are located on the aortic arch and in the carotid sinuses
- When they detect a change in BP, they send signals to the hypothalamus and vasomotor center of medulla oblongata
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Cause and effect sequence to increased CO
Increase CO = Increase BP = Decrease TPR
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Cause and effect sequence to decreased CO
Decrease CO = Decrease BP = increase TPR
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Cause and effect sequence to increased resistance
Increase TPR = Increase BP = Decrease CO
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Describe the body's normal homeostatic response to a sudden increase in BP
Try to decrease CO and TPR to counteract the increase in BP
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Describe the body's normal homeostatic response to a sudden decrease to BP
Increse in CO and TPR
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How would a decrease in CO affect BP
Decrease BP
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How would an increase in peripheral resistance affect BP
Increase BP
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How is the fact that an artificial heart is being used important?
Allows the manipulation of CO only
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WHat changes would be expected in peripheral resistance, blood pressure, and cardiac output if vasodilatory drug that has no direct effect on the heart were infused?
Vasodilation would result in decrease TPR which would result in decrease in BP so CO must increase to bring to normal
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If a magical drug that increases HR without directly effecting any other cardiovascular parameters was injected, what changes in CO, BP, and resistance would be expected?
Increase HR, increase CO, increase BP, decrease TPR
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Antigens
Foreign molecules that have a potential to elicit immune responses
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Antibodies
- Proteins produced by the immune system to protect the body by recognizing antigens
- Can bind to the antigen that induced its production and neutralizing the threat presented
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ABO system
Assesses RBC for the presence of absence of two antigens: A and B antigen
If have A antigen then type A blood
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Rh system
Based on the presence or absence of Rh antigen or antigen D
If an individuals RBC possesses this then the blood type is Rh positive
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Successful blood transfusions
- Immune responses must be avoided
- If the antigens don't match then the body's immune system would respond to the donated RBC as invading bacteria
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Blood type antigens and antibodies
- A: A antigen with Anti-B antibodies
- B: B antigen with Anti-A antibodies
- AB: A and B antigens with no antibodies
- O: neither antigen with Anti-A and B antibodies
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Universal donor and recipient
- Type O negative
- Type AB positive
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Flaw in universal donor
- It is possible that antibodies in the donated blood to attack recipient's blood
- Ex: type O blood may contain anti-B antibody which would then attack the type B blood cells
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What antigens are present on type B blood
B
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What blood type can a B- person safely receive?
B- and O-
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An individual's blood agglutinates when mixed with antiserum to the A antigen, but not when mixed with antiserum to the B or Rh antigens. What is the blood type?
A-
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Remembering that the immune system does not (normally) produce antibodies to molecules that are a normal part of the host, what kinds of antibodies might be found in the serum of a person with type A blood?
Anti-B antibodies
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What kind of antibodies might be found in the serum of a person with type O blood?
Anti A and Anti B
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What kinds of antibodies might be found in the serum of a person with type B blood
Anti A antibodies
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Which of the following does not exist and why? Anti-A, anti-B, and anti-O
Anti-O because O means an individual doesn't have any antigens present to develop antibodies against
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Ventilation
- The product of the autonomic and somatic nervous systems regulating the activities of the diaphragm, intercostal muscles, and abdominal muscles
- At rest, this is a product of autonomically induced rhythmic contractions of the diaphragm which moves moves relatively little air
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Tidal volume
- Volume of air moved in and out of the respiratory system during resting ventilation
- 500 ml for the average individual
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Inspiratory reserve volume
- Additional volume of air that can be inhaled beyond a resting inspiration by further contraction of diaphragm and elevation of ribs by intercostals
- 3000 ml
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Expiratory reserve volume
- Contraction of the anterior abdominal muscles and depression of the rib cage allows extra air to be forced out after normal expiration
- 1500ml
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Vital capacity
- Greatest volume of air that can be moved in a single breath
- 5000 ml
- Sum of expiratory reserve volume, tidal volume, and inspiratory reserve volume
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Residual volume
- Volume of air that remains in the respiratory system even after complete expiration
- 1000 ml
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Total lung volume
- Maximum volume that can be in the respiratory system
- 6000 ml
- Equal to vital capacity and residual volume
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Inspiratory capacity
- Volume of air that can be inhaled after a normal resting expiration
- Equal to the sum of the tidal volume and the inspiratory reserve volume
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Functional reserve capacity
- Total volume left in the respiratory system after normal expiration
- Sum of the expiratory reserve volume (can be exhaled, but not exhaled at rest) and residual volume (cannot be exhaled)
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Dead space
- 150ml
- Sum of all volume within the respiratory system where gas exchange does not occur
- Dangerous increases in this can occur when alveoli are damaged by illness or injury which requires more respiratory effort
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Based on their definitions, which is larger vital capacity or total lung volume? why?
Total lung volume because it includes the vital capacity in the calculation along with the addition of residual volume
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History has demonstrated that the techniques employed in the lab often overestimate an individual's actual resting tidal volume. Why is it?
Altering respirations from thinking about breathing or miscallibration of the mechanism being used to measured
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If experimental error overestimates an individual's resting tidal volume, how would this impact the measurement of inspiratory reserve, expiratory reserve, and vital capacity?
- In inspiratory and expiratory reserve they would decrease
- No change in vital capacity
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Breathing through a mouthpiece, a "spit filter", and a flow transducer adds several milliliters of additional air passages between the alveoli and fresh air, for example as what occurs when a patient is put on a ventilator. This additional volume of "plumbing" would be considered new dead space. How would this additional dead space influence tidal volume and vital capacity?
- Vital capacity would not be affected
- Tidal volume would increase (adding 100 ml)
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How would you expect vital capacity to change with age and why?
Decrease because lung elasticity decreases as well as muscles weaken
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How does vital capacity change as one goes form standing to lying on ones back and why?
Decrease VC bc you can't fully expand lungs to full capacity which would increase the compression.
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