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CardioAP
ch 9, 15, 19, 20
| Question | Answer |
|---|---|
| what are the respiratory components of the medulla oblongata | dorsal and ventral respiratory groups |
| what are the pontine resp. centers? | apneustic and pneumotoxic center |
| the drgs consist of mostly | inspiratory neurons |
| the DRGS recieve inspiratory impulses from what monitoring systems | central chemoreceptors, peripheral chemoreceptors, stretch receptors, peripheral proprioceptors and higher brain centers |
| what can cause a temp. cessation of breathing | sudden pain and sudden cold |
| what will readily diffuse across the blood-brain barrier | CO2 molecules |
| when the blood pressure increases the aortic bodies and carotid bodies initiate reflexes that cause what? | heart rate and resp rate to decrease to balance out the delivery of oxygen to the tissues |
| when are the peripheral chemoreceptors significantly activated? | low PaO2 (60 mmhg) SaO2 90% |
| peripheral chemoreceptors are sensitive to | low PO2,decreased pH,increased PCO2 and increase temperature |
| stimulation of the peripheral chemoreceptors cause? | peripherial vasoconstrictin, increased pulmonary vascular resistance, systemic arterial hypertension, tachycardia, and left ventricular performance |
| when are the peripheral chemoreceptors suppresed? | when the PaO2 falls below 30 mmhg |
| where are the peripheral chemoreceptors located? | outside the CNS usually in the wall of the blood vessel. |
| what are the reflexes that influence ventilation? | Hering-Breuer Reflex, Deflation Reflex, Irritant, Juxtapulmonary capillary, peripheral proprioceptor, hypothalamic controls, corical controls, reflexes from the aortic and carotid sinus barorecptors |
| periferal proprioceptor reflexes | maintain and initiate increased resp rate. i.e increases resp rate during excercise |
| where are the periferal properioceptors located | muscle,tendon,joints, pain receptors in the muscle and skin, |
| cortical controls | voluntary control; conscious control to change the rate and depth of breathing |
| what is the role of cerebral cortex in regulation of ventilation | conscious control of ventilation |
| which nerves are used to transmit signals to the resp components in the medulla | glossopharyngeal nerve (9 cranial nerve) & the vagus nerve (10 cranial nerve) |
| which nerve innervates the aortic bodies | vagus nerve |
| which nerve innervates the carotid peripheral chemorecptors | glossopharyngeal nerve |
| what is the most powerful stimulus known to influence the resp components of the medulla | an increased H+ hydrogen ion in the cerebrospinal fluid |
| hering-breuer reflex | called the inflation reflex; via the vagus nerve, a reflex triggered to prevent over-inflation of the lungs; causes inspiration to cease. |
| where is the hering-breuer reflex located | in the visceral pleura and in the walls of the bronchi and bronchioles |
| juxtapulmonary-capillary receptors | trggers a rapid shallow breathing pattern |
| what stimulations the j receptors | alveolar inflammation, pulmonary capillary congestion and edems, pulmonary emboli |
| when the systemic blood pressue increases the aortic and carotid sinus barorecptors initiate reflexes that cause | decreased vent and heart rate |
| hypothalamic controls | excitement causes increase resp rate and increase body temp causes a decrease resp rate |
| what factors cause an increase pulmonary vascular resistance | decreased pH (acidemia) Epinephrine, dopamine, norepeinephrine, histamine, mech vent, serotonin |
| what factors cause a decrease pvr | OXYGEN, calcium-channel blocking agents, acetylcholine, bradykinin |
| what factors increase systemic vascular resistance? | dopamine, epinepherin, norepinepherin, hypovolemia, decreased PC02 |
| what factors decrease svr | nitroglyverin, morphine, septic shock (early stages), increased PCO2 |
| pathological factors that increase pvr | pulmonary emboli, tumor mass, emphysema, pneumothorax |
| what determines stroke volume | preload, afterload, and myocardial contractility |
| stroke volume | volume of blood ejected by the ventricles with each contraction |
| stroke volume formula | sv= CO/HR= beats/min |
| which hemodynamic values are measured? | cardiac output, pulmonary capillary wedge pressure, central venous pressue, right atrial pressure, mean pulmonary artery pressure |
| which hemodynamic values are calculated? | strok volume, stroke volume index, cardiac index, systemic vascular resistance, pulmonary vascular restistance, right ventricle stroke work index, left ventricle stroke work index |
| what is the normal range for central venous pressure? | 0-8 mmhg |
| what is the normal range for right atrial pressure | 0-8 mmhg |
| what is the normal range for cardiac output | 4-8 l/min |
| normal range for mean pulmonary artery pressure | 9-18 mmhg |
| normal range for pcwp | 4-12 mmhg |
| normal range for stroke volume | 60-130 ml |
| normal range for SVI | 30-65 mL/beat/m^2 |
| normal range for cardiac index | 2.5-4.2 L/min/m^2 |
| normal range for RVSWI | 7-12 g m/m^2 |
| normal range for LVSWI | 40-60g m/m^2 |
| normal range for PVR | 20-120 dynes x sec. cm ^-5 |
| normal range for svr | 800-1500 dynes.sec.cm^ -5 |
| normal range for BSA | 1.5-2 m^2 |
| stroke volume index equation | SVI= SV/BSA |
| what is the calc measurement that reflects the afterload on the right ventricle | PVR |
| what is the calc measure the afterload of the left ventricle | SVR |
| hemodynamics | study of forces that influence the circulation of blood |
| SVI reflects | contractility of the heart, overall blood volume status, and the amount of venous return |
| what is the cardiac index | heart performance to the size of the individual |
| cardiac index equation | CI= CO/BSA |
| what factors will increase SV,CO,RVSWI,LVSWI? | Epinepherine, norepinepherine, hyperthermia,dopamine,hypervolemia,decreased vascular resistance |
| what factors will DECREASE SV,CO, RVSWI, LVSWI? | drugs ending in "lol" hypovolemia, mech vent, pulmonary emboli, increased vascular resistance |
| equation for PVR | PVR= (PA-PCWP/CO)x 80 |
| SVR | SVR= (MAP-CVP/CO) x80 |
| RVSWI | RVSWI= SVI*(PA-CVP)*0.0136 |
| LVSWI | LVSWI=SVI*(MAP-PCWP)*0.0136 |
| at what altitude is the barometric pressure approx half of the sea level value | 18000-19000 ft |
| is the O2 diffusion capacity of high altitude natives higher or lower than low landers? by how much? | higher by 20-25% |
| what are the symptoms of acute mountain sickness | palpitation, dizziness, insomnia, nasuea, fatigue, |
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