CVR Physiology
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Questions and Answers

What is the effect of low pH on hemoglobin's affinity for oxygen?

  • Decreases affinity for oxygen (correct)
  • Fluctuates based on temperature
  • No effect on affinity
  • Increases affinity for oxygen

How does a high concentration of carbon dioxide (PCO2) affect hemoglobin's affinity for oxygen?

  • Enhances oxygen binding under high pH
  • Has no impact on affinity
  • Reduces affinity for oxygen (correct)
  • Increases affinity for oxygen

What role does 2,3 BPG play in oxygen delivery in red blood cells?

  • It helps hemoglobin release oxygen more easily (correct)
  • It inhibits hemoglobin from releasing oxygen
  • It binds to hemoglobin only at high oxygen levels
  • It solely regulates carbon dioxide levels

In individuals with chronic anemia, how does the level of 2,3 BPG change?

<p>Increases significantly to aid oxygen delivery (C)</p> Signup and view all the answers

What unique characteristic does fetal hemoglobin have in comparison to adult hemoglobin?

<p>Higher affinity for oxygen (D)</p> Signup and view all the answers

What initiates the pacemaker potential in the SA node?

<p>Opening of gated calcium channels (C)</p> Signup and view all the answers

Which process follows after calcium enters the cardiomyocyte through L-type calcium channels?

<p>Calcium triggers the release of ryanodine receptors (D)</p> Signup and view all the answers

During which phase does rapid depolarization occur?

<p>When the threshold is reached and calcium influxes rapidly (A)</p> Signup and view all the answers

What does the P wave of an ECG represent?

<p>Depolarization of the atrial muscle wall (B)</p> Signup and view all the answers

What role does the SERCA calcium channel play at the end of contraction?

<p>It transports calcium back to the sarcoplasmic reticulum (C)</p> Signup and view all the answers

What is the isoelectric line in an ECG indicative of?

<p>The resting membrane potential (C)</p> Signup and view all the answers

What causes the change in the electrical vector during an action potential?

<p>Movement of sodium and calcium ions into the cell (C)</p> Signup and view all the answers

What role does the Renin-angiotensin-aldosterone mechanism play in blood pressure control?

<p>It helps to control long-term blood pressure by managing resistance. (C)</p> Signup and view all the answers

What happens to arterial pressure when peripheral resistance increases?

<p>Arterial pressure increases. (D)</p> Signup and view all the answers

Which of the following is a common consequence of hypertension?

<p>Stroke and damage to the eyes. (B)</p> Signup and view all the answers

How does age affect arterial health?

<p>Increases stiffness and decreases sensitivity of baroreceptors. (C)</p> Signup and view all the answers

What initiates the process of atherosclerosis?

<p>Injury to the endothelium leading to inflammation. (B)</p> Signup and view all the answers

What occurs during external respiration?

<p>Gas exchange occurs between alveoli and capillaries. (B)</p> Signup and view all the answers

What is 'dead space' in the respiratory system?

<p>The part of the airway that does not participate in gas exchange. (A)</p> Signup and view all the answers

What happens to alveolar dead space during diseases affecting blood flow in the lungs?

<p>It increases as blood flow decreases. (C)</p> Signup and view all the answers

Secondary hypertension can be caused by which of the following?

<p>Kidney disease and vascular changes. (D)</p> Signup and view all the answers

What does VO2max indicate regarding a person's fitness level?

<p>The maximum rate of oxygen utilization during intense exercise (B)</p> Signup and view all the answers

How is a MET defined in the context of physical activity?

<p>It compares the energy used during activities to resting energy expenditure (B)</p> Signup and view all the answers

Which of these factors does NOT control heart rate and ventilation during physical activity?

<p>Involuntary reflexes (A)</p> Signup and view all the answers

During exercise, what change occurs in the body's sympathetic and parasympathetic activities?

<p>Parasympathetic activity decreases while sympathetic increases (A)</p> Signup and view all the answers

What is the role of tidal volume in respiratory response during physical activity?

<p>It indicates the amount of air breathed in or out per normal breath (C)</p> Signup and view all the answers

What is characterized as sedentary behavior?

<p>Activities performed while sitting or lying down (A)</p> Signup and view all the answers

Which of the following describes heavy exercise intensity?

<p>Activity performed at a vigorous level with significantly increased heart rate (B)</p> Signup and view all the answers

What physiological signal is primarily sent out to increase oxygen supply during exercise?

<p>Increased adrenaline production (C)</p> Signup and view all the answers

Which exercise intensity domain includes the highest level of physical exertion?

<p>Extreme (A)</p> Signup and view all the answers

What is the typical breathing frequency during moderate exercise?

<p>Between 12 to 20 breaths per minute (C)</p> Signup and view all the answers

What is the formula for calculating minute ventilation?

<p>Tidal volume x breathing frequency (C)</p> Signup and view all the answers

What happens to stroke volume during exercise as intensity increases up to 60% of VO2max?

<p>It increases and then levels off (D)</p> Signup and view all the answers

Which parameter is NOT typically monitored during cardiopulmonary exercise testing (CPX)?

<p>Oxygen saturation levels (B)</p> Signup and view all the answers

Why is hemoglobin considered an allosteric protein?

<p>It changes conformation based on oxygen levels (A)</p> Signup and view all the answers

What is the oxygen saturation level of hemoglobin in the veins after oxygen delivery?

<p>77% (C)</p> Signup and view all the answers

What type of chains does hemoglobin consist of?

<p>2 alpha and 2 beta chains (C)</p> Signup and view all the answers

What occurs in the lungs regarding hemoglobin and oxygen levels?

<p>Hemoglobin binds almost all available oxygen due to high pressure (A)</p> Signup and view all the answers

What is the primary function of the cardiopulmonary unit tested in CPX?

<p>To analyze cardiovascular efficiency (C)</p> Signup and view all the answers

During exercise, which blood pressure component remains relatively unchanged?

<p>Diastolic pressure (A)</p> Signup and view all the answers

What characterizes fetal hemoglobin compared to adult hemoglobin?

<p>It has a higher affinity for oxygen (A)</p> Signup and view all the answers

Flashcards

Calcium's role in action potential

Calcium moves in and out of the cytosol during each action potential, influencing the cell's electrical activity.

Pacemaker potential

Gradual depolarization of the cell, leading to an action potential.

Cardiac action potential

Rapid depolarization caused by the influx of calcium into the cell.

Calcium-induced calcium release

Calcium entering the cell triggers more calcium release from the sarcoplasmic reticulum.

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ECG (Electrocardiogram)

A graphical recording of the electrical activity of the heart.

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P wave (ECG)

ECG wave representing atrial muscle depolarization.

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Electrical Vector

Direction of electrical impulse during an action potential.

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VO2max

The maximum rate your body can take in, transport, and use oxygen during intense exercise. It reflects your overall fitness level.

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METs

A unit for measuring how much energy your body uses during an activity compared to resting.

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Exercise Intensity Domains

Categorizations of exercise intensity based on how hard your body is working. They include moderate, heavy, severe, and extreme.

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Carotid/Central Chemoreceptors

Specialized cells in your blood vessels that detect changes in oxygen, carbon dioxide, and pH levels, influencing your heart rate and breathing.

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Proprioreceptors

Sensory receptors in your muscles and joints that sense position, movement, and force, providing feedback to your brain for coordination.

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Central Radiation

A mechanism where the signals from the cardiovascular and respiratory centers in your brain regulate heart rate and breathing.

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Tidal Volume

The amount of air you breathe in or out with each normal breath.

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Breathing Frequency

The number of breaths you take in one minute.

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What are the four exercise intensity domains?

Exercise intensity domains are categorized as moderate, heavy, severe, and extreme. These categories reflect the level of effort your body exerts during exercise.

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How does the body increase oxygen delivery during exercise?

When exercise begins, the parasympathetic nervous system reduces activity while the sympathetic system increases. This signals the need for more oxygen in the muscles. Signals are sent to increase heart rate and ventilation, delivering more oxygen to working muscles.

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Renin-angiotensin-aldosterone system

A hormonal mechanism that helps regulate blood pressure. It involves the production and release of renin (from kidneys), which triggers a cascade of events leading to the formation of angiotensin II (a powerful vasoconstrictor) and aldosterone (a hormone that promotes sodium retention).

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Arterioles

Small blood vessels that regulate blood flow to different tissues. They are essential for controlling blood pressure and distribution of blood.

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How do arterioles affect blood flow?

When arterioles constrict (narrow), they increase resistance to blood flow, leading to decreased blood flow. When they dilate (widen), they decrease resistance, allowing for increased blood flow.

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Arterial pressure: What's the equation?

Arterial pressure is determined by the product of cardiac output (amount of blood pumped by the heart per minute) and peripheral resistance (阻力) (resistance to blood flow in the blood vessels).

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Age-related changes and blood pressure

Blood pressure tends to increase with age due to several factors including: increased arterial stiffness, decreased baroreceptor sensitivity, increased responsiveness to the sympathetic nervous system (SNS), and alterations in the renin-angiotensin-aldosterone (RAA) system.

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Secondary hypertension

High blood pressure caused by an underlying medical condition, rather than genetic or lifestyle factors. Examples include kidney disease, anatomical issues like coarction of the aorta (narrowing of the aorta), or chronic changes in blood vessel structure.

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What are some effects of hypertension?

High blood pressure can lead to several health issues, including stroke, damage to eye capillaries, edema (swelling), renal (kidney) failure, injury to artery walls, and heart failure.

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What is atherosclerosis?

A condition where fatty deposits (plaque) build up inside the arteries, narrowing them and restricting blood flow. It's a major contributor to heart disease.

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What are the steps involved in atherosclerosis?

Atherosclerosis starts with injury to the artery epithelium. In response, leukocytes (white blood cells) create an inflammatory response, leading to retention and oxidation of lipoproteins. Monocytes (type of white blood cell) turn into macrophages that engulf low-density lipoproteins (LDL), contributing to plaque buildup.

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Bohr Effect

The phenomenon where a decrease in blood pH (increased acidity) reduces hemoglobin's affinity for oxygen, leading to increased oxygen release to tissues.

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CO2 and Hemoglobin Affinity

High CO2 levels in the blood decrease hemoglobin's affinity for oxygen, promoting oxygen release. Low CO2 levels increase affinity, favoring oxygen uptake.

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Temperature and Hemoglobin Affinity

Elevated temperatures lower hemoglobin's affinity for oxygen, meaning more oxygen is released to tissues. Lower temperatures increase affinity.

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2,3 BPG and Oxygen Release

2,3 Bisphosphoglycerate (2,3 BPG) is a molecule within red blood cells that binds to hemoglobin, reducing its affinity for oxygen and promoting oxygen delivery to tissues.

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CO2 Transport in Blood

CO2 is transported in the blood mainly as bicarbonate ions (HCO3-) formed by the reaction of CO2 with water inside red blood cells. This process also generates hydrogen ions (H+), contributing to the Bohr effect.

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Minute Ventilation

The total volume of air inhaled and exhaled per minute. Calculated by multiplying tidal volume (air inhaled per breath) by breathing frequency (breaths per minute).

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Stroke Volume During Exercise

The amount of blood pumped out of the heart with each beat. It increases during exercise, plateauing at around 40-60% of VO2max (maximum oxygen uptake).

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Blood Pressure Changes During Exercise

Systolic blood pressure increases during exercise, while diastolic blood pressure remains relatively unchanged.

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What is Cardiopulmonary Exercise Testing?

A test that assesses the function of the cardiopulmonary system, including the heart, lungs, and muscles responsible for breathing, by measuring gas exchange, breathing rate, blood pressure, heart rate, and ECG.

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Hemoglobin's Allosteric Nature

Hemoglobin is an allosteric protein, meaning its shape changes in response to the presence of oxygen. This allows it to bind oxygen efficiently.

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Hemoglobin Components

Hemoglobin consists of two alpha and two beta chains, each containing a heme-iron complex. This iron complex binds to oxygen.

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Fetal Hemoglobin vs. Adult Hemoglobin

Fetal hemoglobin is different from adult hemoglobin, allowing it to bind oxygen more effectively in the womb's low oxygen environment.

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Oxygen Binding to Hemoglobin

Hemoglobin's ability to bind oxygen depends on the partial pressure of oxygen. In the lungs, high oxygen levels make hemoglobin almost fully saturated. In veins, lower oxygen levels cause hemoglobin to release some oxygen.

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Oxyhemoglobin vs Deoxyhemoglobin

Oxyhemoglobin is the form of hemoglobin bound to oxygen. Deoxyhemoglobin is the form without oxygen. Both have different structures.

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Hemoglobin's Role in Oxygen Delivery

Hemoglobin acts like a transport vehicle for oxygen. It picks up oxygen in the lungs and delivers it to the body's cells where oxygen levels are low.

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Study Notes

Cardiac Physiology

  • Heart pumps blood from low-pressure veins to high-pressure arteries
  • Pulmonary circuit pressure is approximately 28/8 mmHg
  • Systemic circuit pressure is approximately 120/80 mmHg
  • Heart failure in adults is commonly caused by the left ventricle's inability to function properly (e.g., filling or ejecting blood efficiently).
  • Cardiac cycle is one heartbeat to the next

Cardiac Conduction System

  • Intercalated discs link muscle cells, including desmosomes and gap junctions
  • Gap junctions allow rapid action potential transmission
  • Myocardial cells can depolarize spontaneously
  • Random depolarization potential creates pacemaker potential
  • Fibrous tissue separates atria and ventricles to allow electrical isolation

Cardiac Pacemakers

  • Sinoatrial (SA) node depolarizes over time, causing gradual reduction in resting membrane potential (pacemaker potential).
  • Action potential triggered when membrane potential exceeds threshold (every 0.8 seconds).
  • Atrioventricular (AV) node cells depolarize slower, triggering action potential before spontaneous depolarization.

Cardiac Action Potential

  • Pacemaker potential involves sodium inflow, calcium inflow, followed by calcium channel opening for rapid depolarization.
  • Plateau maintained by calcium influx and potassium efflux
  • Repolarization involves calcium channel closure and potassium outflow.

Excitation-Contraction Coupling

  • Action potential leads to contraction of cardiac muscle cells
  • Chemical signal converts to mechanical energy with aid of contractile proteins (crucial role of calcium)
  • Calcium enters cytosol during action potential to trigger muscle contraction and sarcoplasmic reticulum release.

Cardiovascular Regulation

  • Baroreceptors in carotid arteries and aorta sense pressure
  • Increased BP leads to decreased heart rate and lower BP (baroreceptor reflex)
  • Hormones (e.g., Renin-angiotensin-aldosterone) regulate BP over longer periods
  • Arterioles constrict to increase resistance and reduce blood flow, while dilation decreases resistance and increases flow.

Risk Factors

  • Hypertension (essential and secondary)
  • Age
  • Other modifiable and unmodifiable factors

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Description

This quiz explores the intricate relationships between hemoglobin's affinity for oxygen and factors like pH, carbon dioxide concentration, and 2,3 BPG levels. Additionally, it delves into cardiac physiology including the SA node's pacemaker potential and the electrical aspects of an ECG. Test your understanding of these vital physiological processes!

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