Fill in the blanks for the following:
Intense exercise increases decreases( increases, decreases ) SNS outflow, causing large vein constriction dilation( constriction, dilation ), and increase decrease( increase, decrease ) in heart rate and an increase decrease( increase, decrease ) in contractility.

Beriberi disease leads to a manifestation of insufficient dietary vitamin B1 (thiamine). The results of auto-regulatory compensation increases decreases maintains( increases, decreases, maintains ) cardiac output.

A shift to the right left( right, left ) reflects the increase RA pressure that will be required to fill the cardiac chambers to offset the increase decrease( increase, decrease ) in external pressure.

The normal venous return curve demonstrates that if the pumping ability of the heart decreases, the RA pressure will rise fall stay the same( rise, fall, stay the same ), and the backward force of this rising pressure on the systemic vasculature will decrease increase( decrease, increase ) VR.

When both arterial and venous pressure flow in the systemic circulation ceases increases decreases( ceases, increases, decreases ).

Place in order the electrical pathways of the heart.

1 2 3 4( 1, 2, 3, 4 ) AV node

1 2 3 4( 1, 2, 3, 4 ) SA node

1 2 3 4( 1, 2, 3, 4 ) Internodal pathway

1 2 3 4( 1, 2, 3, 4 ) Left and right bundles of Purkinje fibers

The Purkinje fibers transmit impulses faster slower( faster, slower ) than other fibers.

The Purkinje fibers are larger smaller( larger, smaller ) than ventricular muscle fibers.

The Purkinje fibers have high low( high, low ) levels of permeability of the gap junctions between successive cells in the conducting pathways.

SA node discharges both the AV node & Purkinje fibers after during before( after, during, before ) either of these can undergo self-excitation.

Parasympathetic fibers in the heart are nicotinic muscarinic( nicotinic, muscarinic ).

Vagal Adrenergic Sympathetic( Vagal, Adrenergic, Sympathetic ) stimulation releases acetylcholine. This goes to muscarinic receptors that decrease cAMP. This causes increased K permeability, which decreases transmission of impulses. Ventricular escape occurs.

Sympathetic nerves release norepinephrine aCH cAMP( norepinephrine, aCH, cAMP ).

Sympathetic Parasympathetic( Sympathetic, Parasympathetic ) activation increases conduction velocity in the AV node • Rate of depolarization increased
• i.e. slope of Phase 0 3 4( 0, 3, 4 ) increase
• Leads to more rapiddepolarization of adjacent cellsàmore rapid conduction of action
potentials
• Positive Negative( Positive, Negative ) dromotropy

Normal delay of conduction thru AV node reducedàtime between
atrial and ventricular contraction reduced
• Increase in AV conduction velocity manifests as decrease increase( decrease, increase ) in P-R interval on EKG

Parasympathetic Nerves
• Releases acetylcholine norepinephrine( acetylcholine, norepinephrine )
• Binds to muscarinic nicotinic( muscarinic, nicotinic )
• Decreases Increases( Decreases, Increases ) conductivity of K and decreases increases( decreases, increases ) conductivity of Ca2+
• Decreases Increases( Decreases, Increases ) heart rate of rhythm and excitability of AV junctional fibers and AV node
• Excitatory signals are no longer transmitted into the ventricles.

SympatheticNerves
• Releases acetylcholine norepinephrine( acetylcholine, norepinephrine ) at
sympathetic endings.
• Binds to β1 β2( β1, β2 ) receptors
• Decreases Increases( Decreases, Increases ) the rate of sinus nodal discharge.
• Decreases Increases( Decreases, Increases ) the overall heart activity.
• Decreases Increases( Decreases, Increases ) the permeability of Na+ and Ca2+ ions.

Conduction velocity is altered by:
Sympathetic stimulation (decreases increases( decreases, increases ))
Vagal stimulation (decreases increases( decreases, increases ))
Ischemia/Hypoxia: decreases increases( decreases, increases )
Drugs (adrenergic and cholinergic): increase or decrease

Key Difference in Pacemaker Cell AP

•The higher the slope of Phase 0 3 4( 0, 3, 4 ), the higher the rate
•Vagal stimulation slows speeds( slows, speeds ) phase 4 depolarization
•Rate slows •Catecholamines speed it up

Extracellular fluid volume increases, then arterial pressure decreases increases( decreases, increases )
• increase in arterial pressure, then the kidneys to lose retain( lose, retain ) Na+ and water then returns arterial BP to return to normal

If arterial BP decreases increases( decreases, increases ) then the loss of H2O and Na+ will be greater than the intake → a decrease increase( decrease, increase ) in fluid volume and BP will decrease increase( decrease, increase ) until the arterial pressure falls exactly back to the equilibrium point

If arterial BP falls below the equilibrium point, intake of Na+ and H2O will be greater less( greater, less ) than the output → an decrease increase( decrease, increase ) in fluid volume and BP until the arterial pressure returns exactly back to the equilibrium point

As the intake of water/salt
decreases increases( decreases, increases ), the equilibrium point shifts to the right (160 mm Hg)
• If there were a decrease increase( decrease, increase ) in water/salt intake, the equilibrium point and the arterial BP would also decrease

Effect of Total Peripheral Resistance TPR

Acutely, if TPR decreases increases( decreases, increases ), arterial BP decreases increases( decreases, increases )
• Arterial pressure = CO x TPR

If renal vascular resistance (RVR) is NOT affected (i.e., increased when TPR is increased), then the equilibrium point for BP will will not( will, will not ) change

Changes in TPR do not typically affect the long-term short-term( long-term, short-term ) arterial pressure level

autoregulation— blood volume has decreased increased( decreased, increased ) then tissue blood flow decreases increases( decreases, increases ) throughout body; constricts vasodilates( constricts, vasodilates ) blood vessels everywhere

As Na+ intake increases, two things happen:
• ECF osmolality decreases increases( decreases, increases ) → stimulation of the thirst center to drink more water to return the ECF salt concentration to normal
• This excess water intake → ↑ ECFV
• The increased osmolality also stimulates the release of ADH Angiotensin Aldosterone( ADH, Angiotensin, Aldosterone ) → kidney reabsorption of H2O → ↑ ECFV

Use the dropdown to choose the appropriate stage in the cardiac cycle:
Diastole Systole( Diastole, Systole ): Muscle re-establishing Na/K/Ca gradient

Diastole Systole( Diastole, Systole ): Contraction of muscle & ejection of blood from chambers

Diastole Systole( Diastole, Systole ): Muscle stimulated by action potential

Diastole Systole( Diastole, Systole ): Relaxation of muscle & filling chambers with blood

Choose if the following descriptions match the atria or the ventricles:

Atria Ventricles( Atria, Ventricles ): Contraction enhances ventricular filling.

Atria Ventricles( Atria, Ventricles ): Blood flows from the RV and LV into the pulmonary artery and aorta

Atria Ventricles( Atria, Ventricles ): Blood flows from the IVC and SVC

The atrium is the stronger weaker( stronger, weaker ) pump of the heart.

The left right( left, right ) ventricle sends blood to the pulmonary circulation.

The left right( left, right ) ventricle sends blood to the peripheral circulation.

Contraction of cardiac muscle is initiated by the SA node AV node Bundle of His Purkinje fibers( SA node, AV node, Bundle of His, Purkinje fibers ).

In cardiac muscle, after the outflow of K+ ions during an action potential (AP), the permeability to K+ ions decreases increases( decreases, increases ) tremendously.

This prevents the early return of the AP voltage to its resting level.

Action potentials of the cardiac cell is much longer shorter( longer, shorter ) than the AP of the nerve cell.

SA node action potential has fewer more the same amount( fewer, more, the same amount ) phases than other cardiac muscle types.

Cardiac T-tubules are five times larger smaller( larger, smaller ) than skeletal muscle T-tubules.

Diastole

-Isovolumic relaxation
-A-V valves close open( close, open )
-Rapid inflow of blood
-Diastasis
-Slow flow into ventricle
-Atrial systole
-Extra blood in following P wave.
-Accounts for 20-25 % of filling

Systole
1. Isovolumic contraction
2. A-V valves close open( close, open )
ventricular press>atrial press
3. Aortic valve opens
4. Ejection phase
5. Aortic valve closes

Aortic Pressure Curve

1. Aortic pressure starts to decrease increase( decrease, increase ) during systole after the aortic valve opens

2. Aortic pressure decreases increases( decreases, increases ) toward the end of the ejection phase.
3. Aftertheaorticvalvecloses,an incisura occurs because of sudden cessation of back-flow toward left ventricle.
4. Aortic pressure decreases increases( decreases, increases ) slowly during diastole because of the elasticity of the aorta.

Mean Pressure Gradient (mmHg)
1. Aortic <5 3 2( 5, 3, 2 )
2. Mitral <5 3 2( 5, 3, 2 )

Because of smaller opening, velocity through aortic & pulmonary valves exceed are less than( exceed, are less than ) that through the A-V valves.

Increased contractility decreases increases( decreases, increases ) stroke volume.

Increased preload decreases increases( decreases, increases ) stroke volume.

Increased afterload decreases increases( decreases, increases ) stroke volume.

Frank-Starling Law

Intrinsic ability of the heart to adapt to increasing volumes of inflowing blood

Greater the heart muscle is stretched during filling, the greater lesser( greater, lesser ) force of contraction, the greater amt of blood pumped to aorta

The Frank-Starling Relationship says that

Decreased Increased( Decreased, Increased ) ventricular filling

Decreased Increased( Decreased, Increased ) Preload

Decreased Increased( Decreased, Increased ) LVEDP

Decreased Increased( Decreased, Increased ) Stroke Volume

What are the ways to increase cardiac output?

Decrease Increase( Decrease, Increase ) contractility

Decrease Increase( Decrease, Increase ) preload

Decrease Increase( Decrease, Increase ) after load

Change the rate