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98 Cards in this Set
- Front
- Back
What are the three structures located inside the carotid sheath?
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The internal jugular Vein, the common carotid Artery, and the vagus Nerve (remember the Mnemonic VAN)
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What is the spatial relationship among the three structures located inside the carotid sheath?
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The internal jugular vein is lateral, the common carotid artery is medial, and the vagus nerve is posterior
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What is the most posterior part of the heart?
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The left atrium
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What symptoms will be caused by enlargement of the left atrium and compression of nearby stuctures?
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Dysphagia and hoarseness
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Why does enlargement of the left atrium cause dysphagia?
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Because it causes compression of the esophageal nerve
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Compression of the ______ ______ nerve, a branch of the _____ nerve causes hoarseness.
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Recurrent laryngeal; vagus
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In what part of the cardiac cycle do the coronary arteries fill?
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Diastole
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Which coronary artery is most commonly occluded?
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The left anterior descending artery
widow maker |
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What part of the heart is supplied by the left anterior descending artery?
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The anterior interventricular septum
and apex |
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In most cases, the sinoatrial and atrioventricular nodes are supplied by which coronary artery?
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The right coronary artery
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The right coronary artery supplies the posterior septum via which coronary artery?
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The posterior descending artery
(in a right dominant heart- 80%) |
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When the right coronary artery supplies the inferior portion of the left ventricle via the posterior descending artery, what type of dominance is this?
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Right dominance
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A patient has a myocardial infarction that damages the anterior interventricular septum. Which coronary artery was occluded?
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The left anterior descending artery
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The posterior descending artery that supplies the posterior septum arises from the circumflex artery in _____ (20%/50%/80%) of cases.
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20%
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Which coronary artery supplies the posterior left ventricle?
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Circumflex artery
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The right coronary artery supplies the posterior septum via which coronary artery?
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The posterior descending artery
(in a right dominant heart- 80%) |
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When the right coronary artery supplies the inferior portion of the left ventricle via the posterior descending artery, what type of dominance is this?
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Right dominance
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A patient has a myocardial infarction that damages the anterior interventricular septum. Which coronary artery was occluded?
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The left anterior descending artery
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The posterior descending artery that supplies the posterior septum arises from the circumflex artery in _____ (20%/50%/80%) of cases.
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20%
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Which coronary artery supplies the posterior left ventricle?
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Circumflex artery
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Which coronary artery supplies the apex and anterior interventricular septum?
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Left anterior descending artery
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Which coronary artery supplies the posterior septum?
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Posterior descending/interventricular artery
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Which coronary artery supplies the right ventricle?
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Acute marginal artery (from the right coronary artery)
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When the posterior descending artery arises from the circumflex, what type of dominance is this?
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Left dominance
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With regard to auscultation of the heart, in what area is the murmur of aortic stenosis best heard?
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The aortic area (ie, the right sternal border and the second intercostal space)
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In which phase of the cardiac cycle is the murmur of aortic stenosis best heard?
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Systolic
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With regard to auscultation of the heart, in what area is the murmur of pulmonic stenosis best heard?
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The pulmonic area (ie, the left sternal border and the second intercostal space)
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With regard to auscultation of the heart, in what area is the murmur of a ventricular septal defect best heard?
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The tricuspid area (ie, the left sternal border and the fourth intercostal space)
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With regard to auscultation of the heart, in what area is the murmur of tricuspid regurgitation best heard?
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The tricuspid area (ie, the left sternal border and the fourth intercostal space)
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With regard to auscultation of the heart, in what area is the murmur of tricuspid stenosis best heard?
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The tricuspid area (ie, the left sternal border and the fourth intercostal space)
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In which phase of the cardiac cycle is the murmur of tricuspid stenosis best heard?
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diastole
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With regard to auscultation of the heart, in what area is the murmur of an atrial septal defect best heard?
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The tricuspid area (ie, the left sternal border and the fourth intercostal space)
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With regard to auscultation of the heart, in what area is the murmur of mitral stenosis best heard?
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The mitral area (ie, the midclavicular line and the fifth intercostal space)
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In which phase of the cardiac cycle is the murmur of mitral stenosis best heard?
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diastole
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With regard to auscultation of the heart, in what area is the murmur of mitral regurgitation best heard?
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The mitral area (ie, the midclavicular line and the fifth intercostal space)
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In which phase of the cardiac cycle is the murmur of mitral regurgitation best heard?
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Systolic
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With regard to auscultation of the heart, in what area is the murmur of aortic regurgitation best heard?
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The left sternal border (generally)
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In which phase of the cardiac cycle is the murmur of aortic regurgitation best heard?
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diastole
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With regard to the auscultation of the heart, in what area is the murmur of pulmonic regurgitation best heard?
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The left sternal border (generally)
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In which phase of the cardiac cycle is the murmur of pulmonic regurgitation best heard?
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diastole
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With regard to auscultation of the heart, in what area are flow murmurs best heard?
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The second intercostal space and both the left and right sternal borders
-since this is where aortic and pulmonic valves are |
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In which phase of the cardiac cycle are flow murmurs heard?
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systole
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A murmur of hypertrophic cardiomyopathy occurs in the ______ phase of the cardiac cycle.
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systole
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With regard to auscultation of the heart, in what area is the murmur of hypertrophic cardiomyopathy best heard?
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The left sternal border (generally)
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Atrial septal defects can best be auscultated over the _____ (aortic/pulmonic / tricuspid/mitral) area of the heart.
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tricuspid
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Pulmonic flow murmurs and diastolic rumbles are commonly associated with which cardiac defect?
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atrial septal defects
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Atrial septal defects progress to louder diastolic murmurs due to pulmonic regurgitation from dilatation of which artery?
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pulmonary artery
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Cardiac output = stroke volume x _____ _____.
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Heart rate
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What does Fick's principle measure?
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Cardiac output
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What is the equation of Fick's principle?
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Cardiac output = rate of oxygen consumption / (arterial oxygen content - venous oxygen content)
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Stroke volume × heart rate = _____ _____.
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Cardiac output
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Mean arterial pressure = _____ _____ × total peripheral resistance.
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Cardiac output
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Cardiac output = rate of oxygen consumption / (arterial oxygen content - _____ _____ _____).
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Venous oxygen content (the Fick principle)
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Mean arterial pressure = cardiac output × _____ _____ _____.
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Total peripheral resistance
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Cardiac output = _____ _____ _____ _____ / (arterial oxygen content - venous oxygen content).
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Rate of oxygen consumption
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_____ _____ _____ = cardiac output × total peripheral resistance.
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mean arterial pressure
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_____ _____ _____ = (1/3) systolic pressure + (2/3) diastolic pressure.
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mean arterial pressure
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_____ _____ = systolic pressure - diastolic pressure.
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pulse pressure (increased with aortic regurgitation)
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What is pulse pressure proportional to?
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stroke volume
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Stroke volume = end-diastolic volume - _____ _____.
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End-systolic volume
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During exercise, cardiac output increases initially as a result of a(n) ______ (increase/decrease) in stroke volume.
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increase-- note that SV increases before HR does during exercise!!!
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After prolonged exercise, cardiac output increases as a result of an increase in _____ ____.
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heart rate
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If the heart rate is too high, _____ filling is incomplete, and cardiac output decreases.
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diastolic
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What are the three variables that affect stroke volume?
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Contractility, Afterload, and Preload (remember the mnemonic SV CAP)
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What happens to stroke volume when there is an increase in contractility?
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Stroke volume increases
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How does digitalis affect contractility (and thus stroke volume)?
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Digitalis increases contractility (by trapping Ca2+ inside cells)
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By what mechanism does digitalis cause an increase in contractility (and thus stroke volume) ?
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Digitalis increases intracellular sodium, which results in an increase in intracellular calcium, strengthening contraction (no gradient for Na+/Ca2+ exchanger)--blocks Na/K ATPase pump
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What happens to stroke volume when there is a decrease in afterload?
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Stroke volume increases
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How does acidosis affect contractility?
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Acidosis decreases contractility
-don't want to drive up metabolic demand when youre already acidotic. |
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How does β1 blockade affect contractility and stroke volume?
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β1 blockade decreases contractility and stroke volume
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What cardiac output variable is increased when there is an increase in preload?
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stroke volume
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How does hypoxia/hypercapnia affect contractility and stroke volume?
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Hypoxia and hypercapnia decrease contractility and stroke volume-- dont have the materials needed to sustain high output
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Does anxiety increase or decrease stroke volume?
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Increase
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How do catecholamines affect contractility (and thus stroke volume)?
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Catecholamines increase contractility
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By what mechanism do catecholamines cause an increase in contractility?
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By increasing the activity of the calcium pump in the sarcoplasmic reticulum
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How do calcium channel blockers affect contractility and stroke volume?
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Calcium channel blockers decrease contractility and stroke volume
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How does heart failure affect contractility and stroke volume?
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Heart failure decreases contractility and stroke volume
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How does decreasing extracellular sodium affect contractility (and thus stroke volume)?
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A decrease in extracellular sodium increases contractility (less gradient to pump Ca2= out through the Na/Ca2+ exchanger)
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By what mechanism does decreasing extracellular sodium cause an increase in contractility (and thus stroke volume)?
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By decreasing the activity of the sodium/calcium ion exchanger
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Does pregnancy increase or decrease stroke volume?
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increase
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By what mechanism does increasing heart size increase myocardial oxygen demand?
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By causing an increase in wall tension
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Does exercise increase or decrease stroke volume?
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increase
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Does increasing contractility increase or decrease myocardial oxygen demand?
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increase
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Contractility and stroke volume _____ (increase/decrease) with non-dihydropyridine calcium channel blockers such as verapamil.
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decrease
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Does increasing afterload increase or decrease myocardial oxygen demand?
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Increase
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Ventricular end-diastolic volume = _____.
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preload
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_____ = Mean arterial pressure.
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Afterload
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Do venous dilators decrease preload or afterload?
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preload
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Do vasodilators decrease preload or afterload?
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afterload
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Does exercise increase or decrease preload?
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increase
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Does sympathetic stimulation increase or decrease preload?
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increase
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Afterload is proportional to _____ _____.
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peripheral resistance
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The Starling curve shows that the force of contraction is proportional to what?
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The preload or the initial length of the cardiac muscle fiber
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On the Starling curve, the x-axis is represented by two variables: ______ (preload/afterload) and _____ _____-_____ _____ (ventricular end-diastiolic volume/ventricular end-systolic volume).
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Preload; ventricular end-diastolic volume
(which are the same thing) |
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On the Starling curve, the y-axis is represented by two variables: _____ _____ and _____ _____.
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Cardiac output; stroke volume
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True or false: Congestive heart failure causes a decrease in slope of the Starling curve.
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true
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True or false: Exercise causes the Starling curve to move to the right and decrease in slope.
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False; exercise causes the Starling curve to move to the left and increase in slope
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Does digitalis increase or decrease contractile strength?
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Increase
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