IFS 1 Exam 1 Study Guide PDF

IFS 1 Exam 1 Study Guide Exam will consist of 50 multiple choice questions covering Units 1-2. There will be an equal distribution of questions from each unit. Remember to tie these concepts back to main movement question. What is movement? How do we define it, where does it originate from, what ar...

IFS 1 Exam 1 Study Guide Exam will consist of 50 multiple choice questions covering Units 1-2. There will be an equal distribution of questions from each unit. Remember to tie these concepts back to main movement question. What is movement? How do we define it, where does it originate from, what are the key players in movement and what factors affect it? What influences optimal movement (typical)? Also remember to use the guiding questions in each unit intro presentation to help inform your studying. Possibility for some video-based questions related movement. The following are NEED-to-KNOW topics that are testable material Unit 1: Systems & Thorax Overview of the cardiovascular system 1. Know the anatomy & tissues of major organs and the primary function of the cardiovascular system including the heart & associated chambers, blood vessels, and blood. Heart Anatomy: i. Endocardium: Internal Layer ii. Myocardium: Cardiac Muscle iii. Epicardium: External Layer iv. Pericardium: tough membranous sac that encases the heart Lung Anatomy i. Superior Lobe (L + R) ii. Middle Lobe ( R ) iii. Inferior Lobe (L + R) iv. Oblique Fissure (L + R) v. Horizontal Fissure ( R) 2. How does the function of the cardiovascular system affect movement? Increases in heart rate to accommodate for the amount of oxygen the muscles need - so the heart pumps more blood 3. What type of vessels take blood away from the heart? Arteries 4. What type of vessels bring blood back to the heart? Veins 5. Where is the heart located within the thorax and where is it in relation to other structures in the thorax, i.e. the lungs, sternum, rib cage, trachea, etc. Located int eh ventral aspect of the thorax Apex of heart is located inferior and positioned toward the left Base of the heart is superior and positioned behind the sternum Between both lungs Located anterior to esophagus anterior/inferior to the trachea 6. What pathway does blood travel through the cardiovascular system? Inf/Sup Vena Cava → R Atrium → R Ventricle → pulmonary Trunk → Pulmonary Arteries → Lungs (gets oxygenated) → Pulmonary Veins → L Atrium → L Ventricle → Ascending Aorta → Aortic Arch → Brachiocephalic Trunk + L Common Carotid a. + L Subclavian a. + Descending Aorta a. Which portions carry oxygenated vs deoxygenated blood? Deoxygenated Blood 1. Inferior and Superior Vena Cava 2. R Atrium 3. R Ventricle 4. Pulmonary Trunk 5. Pulmonary Arteries Oxygenated Blood 1. Pulmonary Veins 2. L Atrium 3. L Veentricle 4. Ascending Aorta 5. Aortic Arch 6. Brachiocephalic Trunk 7. L Common Carotid a. 8. L Subclavian a. 9. Descending Aorta b. What valves do blood flow through in the heart along the path and where are they located? R Atrium → Tricuspid Valve → Pulmonary Semilunar Valve L Atrium → Bicuspid (Mitral) Valve → Aortic Semilunar Valve c. What is the purpose of these valves? To prevent backflow of blood into the heart. 7. What type of muscle is the heart composed of? Myocardium a. What are the two main cell types of this muscle and how are they anatomically different? Contractile Cells (99%) ○ Striated Fibers ○ Branched w/ single nucleus ○ Attached by intercalated disks Autorhythmic Cells aka “Pacemaker Cells” (1%) ○ Generate electrical signal for contraction ○ Smaller and fewer contractile fibers ○ Lack of organized sarcomeres b. How does their structure influence their function? 8. How does the blood supply its own tissue? Blood vessels come directly from aorta to feed cardiac muscle Venous blood vessels come directly from the heart into the right atrium via the coronary sinus  a. What are the primary vessels of this coronary supply and why does the heart need to perfuse itself? Artery: 1. Left Coronary Artery a. Circumflex Artery b. Anterior Interventricular Artery 2. Right Coronary Artery a. Posterior Interventricular Artery Vein 1. Great Cardiac Vein 2. Middle Cardiac Vein 3. Small Cardiac Vein 4. Coronary Sinus 9. What are the main branches coming off the aorta arch and what general body regions do they serve? L Common Carotid a. L Subclavian a. Brachiocephalic Trunk R Common Carotid a. R Subclavian a. 10. What general body region does the descending aorta serve and what does it have to travel through as it exits the thorax? Thorax and Abdomen Passes through the Diaphragm (specifically the Aortic Hiatus - T12 level) Cardiac Cycle 1. What role do the 2 types of cardiac muscle cells have in generating an electrical signal of the heart? Contractile: contract based on signal Autorhythmic: Generate action potential spontaneously 2. What is the role of calcium in excitation of each of these cell types? Autorhythmic Cells: i. Require Ca2+ influx/channel opening to generate an action potential to threshold Contractile Cells: i. Ca2+ is responsible for prolonged action potential after the initial influx of Na+ 3. How can the heart generate a spontaneous signal and how do the cell types (autorhythmic vs myocardial contractile cells) communicate? Myocardial via intercalated discs on the cells 4. What is the location of the first point of depolarization in the heart? SA Node (R Atrium) 5. What is the pathway of the electrical signal of the heart? SA node → internodal pathways → AV node in base of atria →AV bundle → bundle branches in interventricular septum to apex of the heart → Purkinje fibers in the walls of the ventricles upward away from the apex. 6. What is the significance of the delay of the signal between the SA node and the AV node? Allows time for the atria to fill with blood before contraction 7. How do we capture this electrical activity on an image for us as PTs to see?  ECG 8. How does the electrical activity relate to the mechanical events of the heart? P Wave: Atrial Depolarization i. Atrial Contraction P-R Segment: Conduction through AV node and AV Bundle i. the atria complete their contraction (atrial systole), and the ventricles continue to fill with blood (end of diastole). QRS Complex: Ventricular depolarization i. initiating ventricular contraction T Wave: Ventricular Repolarization i. the relaxation of the ventricles, which allows them to start filling with blood again during diastole. a. Define systole, diastole, and the cardiac cycle. Systole - time during cardiac muscle Contraction Diastole - time during cardiac muscle Relaxation Cardiac Cycle - the sequence of events that happens in the heart during one heartbeat. b. Which comes first during the cardiac cycle, the electrical signal or the mechanical event? Electrical signal c. What is the significance of the timing of the electrical signal vs mechanical event? Allows the heart to fill with blood d. How do atrial and ventricular depolarization and repolarization relate to contraction/ relaxation? Depolarization causes contraction Repolarization causes relaxation e. What do the first and second heart sounds represent? Heart Sound #1 = AtrioVentricular Valves Close Heart Sound #2 = Semilunar Valves Close 9. How do we define the amount of blood pumped by one ventricle during a single contraction and the percentage of end-diastolic volume ejected in one contraction? Stroke Volume: the amount of blood pumped by one ventricle during a single contraction Ejection Fraction: the percentage of end-diastolic volume ejected in one contraction 10. What is the relationship between the stretch on the cardiac muscle and the force of the contraction and how does that relate to the volume of blood in the heart? Contractility is affected by the stretch of the muscle fiber. As the stretch of the ventricle increases, so does stroke volume. Preload which is the degree of stretch of the myocardium before contraction. This primarily depends on the End Diastolic Volume 11. What is the volume of blood pumped by one ventricle per minute and how does this increase during exercise? 5-6 L/min During Exercise - this can increase by up to 5x 12. How does the autonomic nervous system regulate heart rate? What is the difference between the effects of the parasympathetic vs sympathetic system? The Autonomic Nervous System controls the heart rate by controlling the rate of depolarization causing an increase/decrease in heart rate Parasympathetic Control: Reduced HR  Sympathetic Control: Increase HR Blood Flow, Regulation of the CV system, & Blood 1. How does blood flow throughout the cardiovascular system? Inf/Sup Vena Cava → R Atrium → R Ventricle → pulmonary Trunk → Pulmonary Arteries → Lungs (gets oxygenated) → Pulmonary Veins → L Atrium → L Ventricle → Ascending Aorta → Aortic Arch → Brachiocephalic Trunk / L Common Carotid a. / L Subclavian a. / Descending Aorta a. Which vessels typically have higher pressures, and which have lower pressures? Arteries have higher pressures Veins have lower pressure b. What part of the heart provides this driving force for pressure changes? The Left Ventricle c. What is the numeric value for the typical systolic and diastolic pressures and how can we as PT’s assess this pressure? 120/80 mmHg using a sphygmomanometer (blood pressure cuff) and a stethoscope 2. What three factors can affect resistance to blood flow? Blood Vessel Diameter (Radius) Blood Viscosity Blood Vessel Length a. What is the name of the law that describes the relationship between these three factors? Poiseulle’s Law b. Which factor has the most significant impact? Blood Vessel Diameter (Radius) 3. What is the difference between vasoconstriction and vasodilation and how does this impact blood flow? Vasoconstriction- The narrowing of blood vessels. Vasodilation - The widening of blood vessels. a. What factors can influence vasodilation/ vasoconstriction? i.e. which hormones and neurotransmitters? Vasoconstrictors 1. Serotonin (Paracrine, Neurotransmitter) 2. Endothelin (Paracrine) 3. Vasopressin (Neurohormones) 4. Angiotensin II (Neurohormones) 5. Norepinephrine (Neurotransmitter) Vasodilators 1. Nitric Oxide (Paracrine) 2. Bradykinin (Paracrine) 3. Adenosine (Paracrine) 4. ↓O2,↑CO2, ↑H+, ↑K+ (Paracrine) 5. Histamine (Paracrine) 6. Epinephrine (Neurohormones) 7. Peptides (Neurohormones) 4. Which vessels allow for exchange of materials based on their composition? Capillaries 5. Which vessels have one-way valves to prevent back flow? How can the musculoskeletal and respiratory systems also assist with one way flow in these vessels? Veins Muscle Pump (Skeletal Muscle Pump) During inhalation, the diaphragm moves downward, increasing pressure in the abdomen and decreasing pressure in the chest. This pressure gradient helps to push blood upward from the abdomen and lower extremities toward the heart. Exhalation helps restore pressure, promoting continued blood flow in the veins toward the heart. 6. Which organs are dependent on a steady supply of blood and why? Brain Heart Kidneys Lungs Liver Intestines 7. What are the four factors that affect mean arterial blood pressure? Blood Volume - fluid intake vs loss Effectiveness of the heart as a pump (cardiac output) Resistance of the System to Blood Flow (measured via arteries) Relative Distribution of Blood between Arterial and Venous Blood Vessels (measured via veins) 8. How does the central nervous system exert an influence on the cardiovascular system? a. What is the primary structure of the cardiovascular control center that communicates with the peripheral system? Medulla Oblongata b. What is the baroreceptor reflex and how does this influence blood pressure? Detect changes in stretch on vessel walls > send signal to medulla > deploy appropriate response via autonomic nervous system 9. What is blood composed of? Plasma 1. 92% water 2. 7% proteins 3. 1% other elements Cellular elements 1. Red Blood Cells 2. White blood cells 3. Platelets 10. What is the process for the synthesis of blood cells and where does this occur? Hematopoiesis Occurs in the bone marrow 11. Which blood cells carry oxygen and what is the ratio of these cells to plasma?  Red Blood Cells 42% Red Blood Cells