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CV 3

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Question
Answer
when in the cardiac cycle is O2 consumption highest?   isovolumetric contraction  
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this is the period between mitral valve closing and aortic valve opening   isovolumetric contraction  
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this is the period between aortic valve opening and closing   systolic ejection  
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this is the period between aortic valve closing and mitral vale opening   isovolumetric relaxation  
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when does rapid filling occur?   just after mitral valve opens  
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when does slow filling occur?   just before mitral valve closes  
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when is JVD seen?   right heart failure  
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what is cardiac muscle contraction dependent on?   extracellular calcium, which enters the cells during plateau of action potential and stimulates calcium release from the sarcoplasmic reticulum (calcium-induced calcium release)  
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what is the plateau in the cardiac muscle action potential due to?   calcium influx  
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where does the pacemaker action potential occur?   SA and AV nodes  
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what accounts for the automaticity of the SA and AV nodes?   slow diastolic depolarization - membrane potential spontaneously depolarizes as Na+ conductance increases (funny channel)  
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what determines heart rate?   slope of phase 4 in the SA node  
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what are the peripheral chemoreceptors? what do they respond to?   carotid and aortic bodies - they respond to decreased (less than 60 mmHg)/increased PCO2, decreased pH of blood  
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what do central chemoreceptors respond to?   changes in pH and PCO2 of brain interstitial fluid, which in turn are influenced by arterial CO2  
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what does the aortic arch respond to? how does it transmit and to where?   responds to increased BP; transmits via vagus to medulla  
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how and to where does the carotid sinus transmit information?   via glossopharyngeal to the medulla  
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how do the central chemoreceptors respond to increased intracranial pressure?   hypertension (sympathetic response) and bradycardia (parasympathetic response)  
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what organ receives the larges share of systemic cardiac output?   liver  
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what organ receivest eh highest blood flow per gramof tissue?   kidney  
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how does the heart meet increased O2 demand?   incrased coronary blood flow, not by increased extraction of O2  
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hypoxia in the pulmonary vasculature causes what?   vasoconstriction (unique because in other organs hypoxia causes vasodilation)  
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what are the local factors in the heart that determine autoregulaton?   O2, adenosine, NO  
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what are the local factors in the brain that determine autoregulation?   CO2 (pH)  
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how do the kidneys determine autoregulation?   myogenic and tuboglomerular feedback  
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what local factors determine autoregulation in skeletal muscle?   lactate, adenosine, K+  
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what is the most important mechanism for determining autoregulation in the skin?   sympathetic stimulation - temperature control  
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what is the effect of carotid massage?   incrases pressure on carotid artery - increasing stretch and leading to decreased HR  
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what is the ultimate consequence of baroreceptors sensing hypotension?   vasoconstriction, incrased HR, contractility, and BP - important in the response to severe hemorrhage  
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sound of mitral and tricuspid valve closure   S1  
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sound of aortic and pulmonary valve closure   S2  
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sound at end of rapid ventricular filling   S3  
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sound from high atrial pressure/stiff ventricle   S4  
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what is S3 associated with?   dilated CHF, mitral/tricuspid regurgitation  
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what is S4 (atrial kick) associated with?   hypertrophic ventricle  
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what is paradoxical splitting associated with?   aortic stenosis, LBBB  
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what is fixed splitting associated with?   ASD  
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holosystolic high pitched 'blowing murmur' loudest at apex   mitral regurg (tricuspid regurg)  
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cresecendo-decrescendo systolic ejection murmur following ejection click   aortic (pulmonic) stenosis  
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pulsus parvus et tardus   pulses weak compared to heart sounds; seen in aortic stenosis  
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holosystolic murmur   VSD  
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late systolic murmur with midsystolic click   mitral prolapse  
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immediate high-pitched blowing diastolic murmur; wide pulse pressure   aortic regurgitation  
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delayed rubbing late diastolic murmur that follows opening snap   mitral stenosis  
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how does the murmur in tricuspid stenosis differ from that of mitral stenosis?   tricuspid stenosis differs because it gets louder with inspiration  
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continuous machine-like murmur   PDA  
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when is the murmur associated with a PDA loudest?   S2  
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