Cardiovascular
System
From right to left: tricuspid valve, pulmonary semilunar valve, aortic semilunar valve, bicuspid valve
Which mechanical event of the heart is the P wave associated with?
Which mechanical event of the heart is the T wave associated with?
T-wave = ventricular diastole
In which of the layers of a centrifuged blood sample would you find small molecules and nutrients?
AND
Blood components are separated in a centrifuge according to what?
Blood plasma;
Density
What is the difference between myocardial ischemia and myocardial infarction?
Myocardial ischemia is the reduced delivery of oxygen and nutrients to the heart, while myocardial infarction is the irreversible cell death of the heart. No cells die in myocardial ischemia, and ischemia is reversible.
During thrombosis, a blood clot or thrombus forms on the walls of the blood vessels. When part of the thrombus breaks off, the part that breaks off is called a what?
Embolus
At which point of the blood vessel system does gas and nutrient exchange occur?
Capillaries
What are the x and y axis of the Hb-O2 curve?
x: partial pressure of oxygen molecule (concentration is -50)
y: % oxygen saturation of hemoglobin
Old red blood cells are moved by ___ in the ___, ___, and ____.
Phagocytic cells;
liver, spleen, bone marrow
What is the difference between Necrosis and Apoptosis?
Necrosis is cell death by autolysis; cells leak intracellular content, which can be toxic to other nearby cells.
Apoptosis is cell death by programmed cell death; cells undergo membrane blebbing and do not leak intracellular content. Occurs during the later stages of a heart attack (myocardial infarction).
In MI, cell death occurs through both necrosis and apoptosis.
Erythryopoietin is made by _____ and exerts its effect in the _____.
Kidneys, bone marrow/myeloid tissue.
Which circuit is responsible for removing CO2 and waste from tissues, transporting hormones/nutrients throughout the body, and distributing O2 to tissues?
AND
Which circuit is responsible for expelling CO2 out of the body and receiving O2 from the atmosphere?
Systemic Circuit; Pulmonary Circuit
2,3-DPG concentrations in the blood are increased by what two things?
Anemia and low O2
At which transition is Erythropoiesis is the nucleus expelled?
AND
At which point and location does EPO exert its effect?
From Normoblast to Reticulocyte;
Myeloid tissue, the conversion from Proerythroblast to Erythroblast
What are the indications for a person experiencing myocardial ischemia?
AND
What are the indications for a person experiencing a heart attack or myocardial infarction?
Stable angina, absent or very low levels of troponin levels, pain relieved by nitroglycerin and rest
Unstable angina, elevated troponin levels, pain NOT relieved by nitroglycerin and rest, pain relieved with morphine and supplemental oxygen
What is the initial activator of platelets during the early stages of a hemorrhage/injury?
Collagen
Which regions of the circulatory system have deoxygenated blood (from which point to which point?)
After the capillaries of systemic tissues up until before the capillaries of the lungs.
There are four factors/variables that influence the Hb-O2 dissociation curve; what are they and in which way do they shift the curve?
pH - increase pH = left shift
2,3-DPG - increase 2,3-DPG = right shift
temperature - increase temperature = right shift
PCO2 - increase PCO2 = right shift
There are two pathways that lead to the activation of fibrin to form the fibrin polymer, which trap red blood cells and platelets to form the clot. These pathways involve clotting factors and there are two kinds: the extrinsic pathway and intrisic pathway.
What activates each pathway? And which clotting factors are involved in each pathway? They converge to the common pathway, which has which two clotting factors?
Extrinsic: Activator is tissue factor from cells not usually exposed to blood, Clotting factor 7.
Intrinsic: Activator is "external" material such as glass and collagen, Clotting factor 12, 11, 9, 8.
Common: 10, 5.
Relating to the non-invasive treatment of myocardial infarction, name three classes (out of the four) of the non-invasive treatments (besides pain management).
Antidysrhythmics (atenolol, metoprolol)
Calcium channel blockers (verapamil, nifedipine)
Na/K pump inhibitors (digoxin)
Anticoagulants (aspirin)
A patient comes to the ER complaining of chest pain that started during their run. She describes the pain as sharp, not dull. BASED ON LECTURE ONLY, what does she likely have? (Bonus: what would you treat them with?)
Pulmonary embolism, anticoagulant
A person has an end-systolic volume of 50 mL/beat and an end-diastolic volume of 120 mL/beat. If they have a heart rate of 80 bpm, what is the cardiac output of the person?
CO = HR * SV
EDV-ESV=SV
CO = HR * (EDV-ESV) = 50 bpm * (120 mL/beat - 50 mL/beat)
CO = 3500 mL or 3.5 L/min
What is the reasoning behind the sigmoidal nature of the Hb-O2 saturation curve?
The binding of oxygen molecules to the heme groups of hemoglobin causes a conformational change in the subunits, increasing their affinity for oxygen. However, the binding of the 3rd oxygen molecule reduces the affinity for the 4th (last) oxygen molecule. (extra: this increased affinity to other ligands due to ligand binding is called "cooperativity")
During normal blood flow, the relevant molecules are: prostacyclin (PGI2), NO, CD39, and AMP. (Acronym: PCMN).
During hemostasis, the relevant molecules are: ADP, thromboxane (TxA2), and serotonin. (Acronym: STD). There is also VWF, that promotes the bond between the collagen and platelets.
Describe the function of each in one phrase.
Prostacyclin, NO: vasodilator and prevention of platelet activation
CD39: Convert ADP to AMP
AMP: Does not promote blood clotting (prevents blood clotting)
ADP: Platelet activation and aggregation
TxA2: Platelet activation and aggregation, vasocontraction
Serotonin: Vasoconstriction
What are the three coronary arteries you need to know for this class? And which portions of the heart do they supply blood to?
Right coronary artery: supplies right atrium and ventricle and SA node.
Left anterior descending artery: supplies interventricular septum, anterior & lateral surfaces of left ventricle
Left circumflex artery: supplies lateral & posterior surfaces of the left ventricle
A patient comes into the ER complaining of chest pain. They state it occurs even when they are trying to take a nap. They tried taking advil at home, but it did nothing. The ordered nitroglycerin did not work. Troponin levels are elevated. A heart sound and ECG test reveal they have an abnormal heart rhythm. What are they experiencing? (Bonus: How would you treat the irregular heart rhythm associated with this ?)
Myocardial infarction, pacemaker.