Physiology and Anatomy 2B Study Guide
Circulation and Respiration
I.
Heart
A. Structure and Electrical Conduction
1. Review the structure and electrical conducting tissue of the heart.
2. Explain the effects of firing the extrinsic nerves of the heart –i.e. vagus or sympathetic
stimulation by the cardiac center.
3. Explain what is meant by heart block, arrhythmias, tachycardia, bradycardia and
fibrillation.
B. Cardiac Cycle
1. Understand the mechanical events of the cardiac cycle and the relative time for each.
Include blood flow, heart sounds, atrial and ventricular systole and diastole and
opening/closing of valves. Understand the relationship of the EKG,arterial pulse,
venous pulse and systolic and
2. diastolic pressures to these events.
3. Define diastasis, pulse wave and pulse deficit.
C. Clinical Correlations
Explain the following abnormal conditions related to the heart and cardiac cycle:
Endocarditis
heart murmur
mitral stenosis
ischemia
valvular prolapse
angina pectoris
valvular insufficiency
myocardial infarction (MI) or
regurgitation
“heart attack”
II.
BLOOD VESSELS
A. Basic Structure and Function
1. Review the basic structure of arteries, arterioles, capillaries, pre-capillary sphincters,
venules, veins, sinusoids and venous sinuses.
2. Define vasoconstriction and vasodilation and how these responses are regulated by
nerve fibers and how each affects blood flow and blood pressure.
3. Explain the components of the arterial system, including elastic arteries, muscular
arteries and arterioles
4. Understand the factors involved in establishing the hydrostatic and osmotic pressures
of capillaries and tissue fluid, and how these relate to the movement of fluid between
the capillaries and interstitial fluid. Explain how changes in capillary hydrostatic (low
or high BP) or capillary osmotic (e.g. low blood protein from starvation) pressures
could be harmful.
B. Clinical Correlations
Explain what is meant by the following terms:
atherosclerosis
angiogram
plaque
phelebitis
aneuryism
phlebotomy
varicose veins
III.
CIRCULATION PHYSIOLOGY
A. General
1. What is the basic reason blood flows, and what is meant by the “blood pressure
gradient”?
2. Describe the relative pressure changes, relative blood flow and relative total cross
sectional diameter through the arteries, capillaries and veins of the circulatory system.
3.
4.
5.
6.
7.
Explain the mechanisms that aid venous return (and cause lymph to flow)-include
muscles, respirations and valves.
Explain the meaning and significance of, as well as normal values for systolic pressure,
diastolic pressure, pulse pressure and mean arterial pressure (MAP). Where in the vessel
pressure gradient does pulse pressure disappear?
Locate and describe the peripheral chemo- and presso-receptors that are in the aortic arch
and int. carotid artery. What does each of these receptors detect?
Explain the location and function of the rt. atrial presso-receptors (Bainbridge), which
detect rt. atrial pressure /venous return.
Be able to list and explain the major determinants of blood pressure and explain which of
these are important in minute to minute adjustments and which have more long term
effects on BP. Be sure to include:
a) blood volume
b) cardiac output
c) peripheral resistance (arteriole diameter, (adjustable and not) length of blood
vessels, compliance of blood vessels and blood viscosity.
B. Blood Volume
8. Explain the relationship of blood volume to blood pressure, and explain the role of blood
reservoirs, such as the liver and spleen.
9. Explain the effect of some hormones on blood volume—include aldosterone, ADH and
Atrial natriuretic peptide (ANP)
C. Cardiac Output
10. Explain what is meant by cardiac output, and how it relates to blood pressure. Define
stroke volume (SV) and stroke rate --heart rate (HR) and be able to calculate cardiac
output from a given stroke vol. and heart rate. Understand that if SV goes up, that a
lower HR would maintain the same CO and vice versa.
11. What would be the consequence of too rapid a heart rate on cardiac output? Explain.
12. Understand the meaning of end diastolic volume and end systolic volume, and how this
relates to cardiac output. What is an approximate normal ventricular blood volume and
an approximate stroke volume/ventricle?
13. What is pre-load and how is it related to end diastolic volume and venous return?
Explain Starling’s law of the heart, which relates pre-load to strength of contraction and
stroke volume.
14. Explain some factors that affect contractility and thus have positive or negative inotropic
effects. Be sure to include sympathetic stimulation, hormones, Ca++, H+, K+ and Ca++
channel blockers.
15. How does high blood pressure (incr. ESV or afterload) affect stroke volume?
16. List and explain some factors that control heart rate—positive and negative chronotropic
effect—be sure to include peripheral receptors, low BP, low pH, increased venous return
(Bainbridge reflex) and hormones, such as epinephrine and thyroxine.
D.Peripheral resistance
17. Explain the effect of blood pressure changes, as detected by baroreceptors,
and blood pH changes, as detected by chemoreceptors, on blood vessel
diameter and blood pressure.
18. Be able to explain circulatory adjustments to every day changes such as standing and
exercise.
19. Explain what is meant by hyperemia and give some examples.
20. Explain the effects of adrenal medulla hormones, atrial natriuretic peptide, ADH,
Angiotensin, nitric oxide and inflammatory chemicals on arteriole constriction.
E. Applications
21. Explain what is meant by and list some common pulse points and pressure points.
22. Explain what is meant by heart failure, and understand the different results seen with left
heart failure and right heart failure.
23. Explain what is meant by shock, and understand the three basic causes of shock, based on
the three main determinants of BP. Give examples of each.
Respiratory System and Respiration
1. Know all the respiratory system related anatomical structures presented in lab/lecture and in the
textbook and lab manual. Identify the seven apertures by which the pharynx communicates with
the nose, ears, mouth, larynx and esophagus.
2. Understand the meaning of cell respiration, internal respiration and external respiration, as well as
where each occurs.
3. Explain how the oxygen breathed in and the protons and electrons from nutrients are used by cells
to make metabolic water and ATP. Explain what is meant by asphyxiation and some ways this
may occur. How does CO (carbon monoxide) affect oxygen availability in the blood? Under what
conditions is CO a danger?
4. Clearly distinguish what is meant by the pleura, parietal pleura, visceral or pulmonary pleura,
pleural cavity and mediastinum.
General Principles
5. Explain what is meant by a gas pressure gradient, and explain how this affects gas flow.
6. Explain the relationship between volume and pressure of a gas, and the relationship between gas
pressure and its solubility in a liquid.
7. Explain what is meant by the partial pressure of a gas as well as pCO 2 and pO2. Be able to
calculate these values.
8. State the per cent oxygen and carbon dioxide in inhaled air, expired air and in the alveoli. Why
are they different? How does this relate to CPR?
9. Explain what is meant by surface tension and explain what effect surface tension has on the lungs.
10. Explain how and why gas exchange with blood occurs in the lungs and tissues
Use alveolar, tissue and blood pO2 and pCO2 in this explanation. Understand the effect of
lowering or raising atmospheric O2 (such as altitude changes) and CO2 on gas exchange.
11. Explain the effect of diving on blood gas nitrogen, and the problem with rapid ascent. What is a
hyperbaric chamber and how is it used?
Ventilation
12. Explain the meaning and location of intrapulmonic pressure, intrapleural pressure and
atmospheric pressure.
13. List the muscles involved in increasing the circumference and length of the thorax, and thus the
lungs. Describe the changes in the pressures listed in #12 as the thorax and lungs increase and
decrease in volume. List additional muscles that may be used in forced breathing.
14. Describe the mechanism for inhalation and exhalation. Include nerves, muscles and gas pressures.
15. Describe the Heimlich Maneuver and explain how it works.
16. Explain the forces that tend to cause the lungs to collapse, as well as the factors that tend to
prevent lung collapse. Be sure to include pressure differences, elasticity, surface tension and
surfactant.
17. Explain what is meant by atelectasis, pneumothorax (and some possible causes).
External and Internal Respiration
18. Describe and label a diagram of the respiratory membrane and state some factors that play a role
in gas exchange across this membrane.
19. First, review # 10 above. Explain how oxygen is picked up, carried and released to tissues, and
explain how carbon dioxide is picked up, carried and released to the air. Be sure to include
carbonic anhydrase, erythrocytes and plasma.
20. Define the following respiratory terms and give approximate volume where indicated:
spirometer
tidal volume(TV)and approximate volume
expiratory reserve volume (ERV)
inspiratory reserve volume (IRV)
residual volume
minimal air
vital capacity (VC)and approximate volume
dead space (estimate from body weight )& alveolar ventilation volume(tidal vol – dead space))
Control of Breathing
21. Explain the location and function of various brain areas that affect breathing. (cerebrum, ponspneumotaxic and apneustic areas—medulla—basic inspiratory and expiratory areas) and explain
how the breathing rhythm is established. Describe how the Hering-Breuer receptors influence
respirations.
22. Describe how the following factors influence respirations: pO2. pCO2, pH, blood pressure,
voluntary control, hyperventilation, and miscellaneous factors such as stimuli to pharynx or
larynx, to the nasal cavity, pain, cold, exercise, etc.
Clinical Applications
23. Explain what is meant by the following terms related to the respiratory system: eupnea, apnea,
dyspnea, orthopnea, hypoxia, hypercapnia, cyanosis, drowning, suffocation, Cheyne-Stokes
respiration.
24. Explain what is meant by the following terms related to respiration: cleft palate, deviated nasal
septum, laryngitis, laryngectomy, tracheotomy, tracheostomy, esophageal speech, rhinitis,
pharyngitis, tracheitis, bronchitis, pneumonitis (pneumonia), pleuritis (pleurisy), emphysema,
bronchiectasis, asthma, SIDS (sudden infant death syndrome), COPD (chronic obstructive
pulmonary disease), RDS (respiratory distress syndrome).