10. Cardiovascular System Flashcards
cardiovascular system
provides transportation of oxygen, water, nutrients, and other substances to every cell in the body
right atrium → tricuspid valve → right ventricle → pulmonary semilunar valve → pulmonary arteries → lungs → pulmonary veins → left atrium → bicuspid valve → left ventricle
systemic circulation
general blood circulation of the body, excluding the lungs
begins with blood being pumped out of the left side of the heart
AKA greater circulation

pulmonary circulation
the flow of blood through the vessels between the lungs and the heart, responsible for oxygenating the blood and removing carbon dioxide
right side of the heart → blood to lungs to absorb O2 and release CO2 → blood picks up O2 from the lungs → vessels deliver now-oxygenated blood back to left side of heart where it is then pumped to the rest of the body

coronary circulation
circulation of blood through the heart itself
aort/o
aorta
arteriol/o
arteriole
arteri/o
artery
capillar/o
capillary
cardi/o, cordi/o, coron/o
heart
pulmon/o
lung
system/o
system
ven/o, phleb/o
vein
venul/o
venule
vascul/o, angi/o, vas/o
vessel
aorta
main trunk of the systemic arterial system
starts at the left ventricle, rises upward, bends over the root of the left lung, and then descends within the thorax, through the diaphragm, and into the abdominal cavity

artery
a large blood vessel that transports blood away from the heart and to other areas of the body
capillaries
microscopic blood vessels that join the arterioles and venules, creating a network in almost all parts of the body
only one blood cell at a time can pass through
vein
a vessel through which blood travels from various parts or organs back to the heart
vena cava
VEE nah KAY vah
venae cavae
VEE nee KAY vee
one of the two large veins transporting blood back to the right atrium of the heart from the peripheral circulation

coronary arteries
arteries that supply the heart muscle
atria
upper chambers of the heart
ventricles
lower chambers of the heart
septum
tissue wall between the chambers of the heart
endocardium
thin tissue that lines each chamber and valve of the heart

myocardium
cardiac muscle surrounding each chamber

pericardium
double-folded layer of connective tissue that surrounds the heart
has two surfaces:
1) inner visceral pericardium (epicardium)
2) outer parietal pericardium not in direct contact with the heart

apic/o
apex
endocardi/o
endocardium
my/o
muscle
myocardi/o
myocardium
pericardi/o
pericardium
sept/o
septum
partition
ventricul/o
ventricle
endo-
within
epi-
above
inter-
between
pre-
before, in front of
peri-
surrounding
tricuspid valves (TV)
valves with three main cusps, located between the right ventricle and right atrium of the heart

semilunar valve
squeezes blood into the pulmonary arteries (PA) from the right ventricle to deliver all deoxygenated blood to the lungs

pulmonary veins (PV)
carries oxygenated blood from lungs to the left side of the heart

mitral valve (MV)
valve through which blood enters the left ventricle (LV) from the left atrium (LA)
AKA bicuspid valve

aortic semilunar valve
valve through which blood is pushed from left ventricle into the aorta for circulation throughout the body

optimum blood pressure
systole under 120
diastole under 80
normal blood pressure
systole 120-139
diastole 80-84
high-normal blood pressure
systole 130-139
diastole 85-89
stroke volume
amount of blood expelled from the left ventricle compared with the total volume of blood filling it
measure of the ejection fraction of cardiac output
sinoatrial (SA) node
clusters of hundreds of cells in the right atrial wall of the heart, near the opening of the superior vena cava, comprising a knot of modified heart muscle that produces impulses that move quickly throughout the muscle fibers (Purkinje fibers) of both atria, causing them to contract
node at which initial electrical signal for the heartbeat begins
contains specialized cells with an intrinsic rhythm independent of any stimulation by nerve impulses from the brain or the spinal cord
called the cardiac pacemaker

atrioventricular (AV) node
in right atrium
receives signal from SA node and passes it along the bundle of His and into the Purkinje fibers which stimulate both ventricles to contract, forcing blood out of hte pulmonary arteries and aorta
Purkinje fibers
myocardial fibers that constitute the terminal ends of the bundle branches

arrhythmia
any deviation from the normal rhythm of the heartbeat
AKA dysrhythmia
electrocardiograph (ECG)
a device used to record the electronic impulses of the heart as wave deflections of a needle
bundle of His
AKA atrioventricular bundle
normal sinus rhythm (NSR)
regular heart rhythm
beats per minute (bpm)
heart rate measured in pulsations per minute
diaphoresis
profuse sweating
pallor
paleness of skin or mucous membranes
on darker pigmented skin, it may be noted on the inner surfaces of the lower eyelids or the nail beds
syncope
fainting or loss of consciousness
atypical pain
a type of cardiac pain
stabbing or burning pain unrelated to exertion
ischemic pain
a type of cardiac pain
pressing, squeezing, or weightlike pain caused by decreased blood supply
bruit
broo ee
abnormal sound heard when auscultating an artery (not the heart)
usually a blowing or swishing sound, higher pitched than a murmur
bradycardia
brad dee car dee uh
slow heartbeat, with ventricular contractions less than 60 bpm
cardiomegaly
enlargement of the heart
cyanosis
lack of oxygen in blood, seen as a bluish or grayish discoloration of skin, nail beds, and/or lips
dyspnea
DISP nee uh
difficult and/or painful breathing
emesis
expelling the contents of the stomach through the esophagus and mouth; vomiting
murmur
abnormal heart sound heard during systole, diastole, or both, which may be described as a gentle blowing, fluttering, or humming sound
palpitations
pounding or racing of the heart, such that the patient is aware of his/her heartbeat
pulmonary congestion
excessive amount of blood in the pulmonary vessels
usually associated with heart failure
tachycardia
rapid heartbeat, more than 100 bpm
thrill
fine vibration felt by the examiner on palpation
venous distension
enlarged or swollen veins
coarctation
narrowing
coarctation of the aorta
congenital cardiac anomaly characterized by a localized narrowing of the aorta
patent ductus arteriosus (PDA)
congenitally abnormal opening between the pulmonary artery and the aorta caused by failure of the fetal ductus arteriosus to close after birth, most often in premature infants
Fig. B

septal defect
any congenital abnormality of the walls between the heart chambers
Fig. A

atrial septal defect (ASD)
a congenital hole in the wall between the upper chambers of the heart
ventricular septal defect (VSD)
a congenital hole in the wall between the lower two chambers of the heart
tetralogy of Fallot
congenital cardiac anomaly that consists of four defects:
- pulmonic stenosis
- ventricular septal defect
- malposition of the aorta, so that it arises from the septal defect or the right ventricle
- right ventricular hypertrophy
Fig B

stenosis
narrowing
aortic stenosis (AS)
narrowing of the aortic valve, which may be acquired or congenital

mitral regurgitation (MR)
backflow of blood from the left ventricle into the left atrium in systole across a diseased valve. It may be the result of congenital valve abnormalities, rheumatic fever, or mitral valve prolapse (MVP)
mitral stenosis (MS)
narrowing of the valve between the left atrium and left ventricle caused by adhesions on the leaflets of the valve, usually the result of recurrent episodes of rheumatic endocarditis
left atrial hypertrophy develops and may be followed by right-sided heart failure and pulmonary edema (cor pulmonale)
mitral valve prolapse (MVP)
protrusion of one or both cusps of the mitral valve back into the left atrium during ventricular systole

orthopnea
or THOP nee uh
condition in which a person must sit or stand to breathe comfortably
tricuspid stenosis (TS)
relatively uncommon narrowing of the tricuspid valve associated with lesions of other valves caused by rheumatic fever
symptoms include jugular vein distention and pulmonary congestion
valvulitis
inflammatory condition of a valve, especially a cardiac valve, caused most commonly by rheumatic fever and less frequently by bacterial endocarditis or syphilis
results are stenoses and obstructed blood flow
rheumatic fever
an inflammatory disease that may follow an inadequately treated group A beta-hemolytic streptococcal infection of the upper respiratory tract
usually occurs in school-age children and may affect the heart, brain, joints, or skin
atrial flutter
rapid, regular atrial rhythm
atrioventricular (AV) block
partial or complete heart block that is the result of lack of electrical communication between the atria and the ventricles
AKA heart block
bundle branch block (BBB)
incomplete electrical conduction in the bundle branches, either left or right to the ventricles
ectopic beats
heartbeats that occur outside of a normal rhythm
atrial ectopic beats (AEB)
`irregular contractions of the atria
AKA premature atrial contractions (PAC)
ventricular ectopic beats (VEB)
irregular contractions of the ventricles
AKA premature ventricular contractions (PVC)
fibrillation
disturbance of the heart’s rhythm in which there are rapid, disorganized, and ineffectual contractions (300-600/min) of the atria or ventricles
can occur with or without an underlying cardiovascular disorder, such as coronary artery disease
can occur in either the atrium or the ventricles
ventricular tachycardia
ventricular contraction >100 bpm

sick sinus syndrome (SSS)
any abnormality of the sinus node
atrial fibrillation (AF)
most common type of cardiac arrhythmia; a series of extremely rapid and irregular atrial contractions (300-600 per minute) occurring with or without an underlying cardiovascular disorder, such as coronary artery disease or hypertension

paroxysmal atrial fibrillation
PEAR ock sis mul
atrial fibrillation occurring as a marked episode
ventricular fibrillation (VF)
rapid contraction of the ventricles reflects a complete lack of organized electrical activity
often the terminal event in sudden cardiac death
angina pectoris
an JYE nuh
paroxysmal chest pain that is often accompanied by shortness of breath and a sensation of impending doom
treatable with sublingual or dermal nitroglycerin (NTG)

coronary artery disease (CAD)
accumulation and hardening of plaque in the coronary arteries that eventually can deprive the heart muscle of oxygen, leading to angina
myocardial infarction (MI)
cardiac tissue death that occurs when the coronary arteries are occluded (blocked) by an atheroma, a mass of fat or lipids on the wall of an artery, or a blood clot caused by an atheroma, and are thus unable to carry enough oxygenated blood to the heart muscle
atherosclerosis
form of arteriosclerosis in which medium and large arteries have atheromas, which can reduce or obstruct blood flow
patients with peripheral atherosclerosis complain of intermittent claudication

cardiomyopathy
progressive disorder of the ventricles of the heart
cardiac tamponade
tam puhn ahd
compression of the heart caused by fluid in the pericardial sac
Fig A

heart failure
inability of the heart muscle to pump blood efficiently, so that it becomes overloaded
the heart enlarges with unpumped blood, and the lungs fill with fluid
previously referred to as congestive heart failure (CHF)
pericarditis
inflammation of the sac surrounding the heart, with the possibility of pericardial effusion
endocarditis
inflammation of the endocardium and heart valves, characterized by lesions and caused by a number of different microbes
aneurysm
localized dilation of an artery caused by a congenital or acquired weakness in the wall of the vessel
acquired causes may be arteriosclerosis, trauma, infection, and/or inflammation
arteriosclerosis
disease in which the arterial walls become thickened and lose their elasticity, without the presence of atheromas
claudication
cramplike pains in the calves caused by poor circulation in the leg muscles
esophageal varices
varicose veins that appear at the lower end of the esophagus as a result of portal hypertension; they are superficial and may cause ulceration and bleeding
hemorrhoid
varicose condition of the external or internal rectal veins that causes painful swellings at the anus
hypertension
condition of high or elevated blood pressure that occurs in two forms:
- primary (essential) hypertension which has no identifiable cause
- secondary hypertension, which occurs in response to another disorder
AKA arterial hypertension
peripheral arterial occlusion
blockage of blood flow to the extremities
acute or chronic conditions may be present, but patients with both types of conditions are likely to have underlying atherosclerosis
Raynaud disease
RAY noh
idiopathic disease of the peripheral vascular system that causes intermittent cyanosis/erythema due to spasming of the vessel walls of the distal ends of the fingers and toes
varicose veins
elongated, dilated superficial veins with incompetent valves that permit reverse blood flow
most often appear in lower extremities
thrombophlebitis
throm boh fluh BYE tis
inflammation of either deep veins (deep vein thrombosis, DVT) or superficial veins
atrial myxoma
mick SOH mah
bnign growth usually occurring on the interatrial septum
hemangioma
noncancerous tumor of the blood vessels
ay be congenital (“stork bite”) or develop later in life
cardiac myxosarcoma
rare cancer of the heart usually originating in the left atrium
hemangiosarcoma
hee man jee oh sar KOH mah
rare cancer of the cells that line the blood vessels
myx/o
mucus
varic/o
dilated vein
ather/o
fat, plaque
lipid profile
blood test to measure the lipids (cholesterol and triglycerides) in the circulating blood
cardiac enzymes test
blood test that measures the amount of cardiac enzymes characteristically released during a myocardial infarction
determines the amount of lactate dehydrogenase (LDH) and creatine phosphokinase (CPK) in the blood
echocardiography
use of ultrasonic waves directed through the heart to study the structure and motion of the heart
transesophageal echocardiography (TEE)
images the heart through a transducer introduced into the esophagus
exercise stress test (EST)
imaging of the heart during exercise on a treadmill, with the use of radioactive thallium or technetium (Tc99m) sestamibi
Holter monitor
portable electrocardiograph that is worn to record the reaction of the heart to daily activities
magenetic resonance imaging (MRI)
computerized imaging that uses radiofrequency pulses in a magnetic field to detect areas of myocardial infarction, stenoses, and areas of blood flow
myocardial perfusion imaging
use of radionuclide to diagnose CAD, valvular or congenital heart disease, and cardiomyopathy
positron emission tomography (PET)
computerized nuclear medicine procedure that uses inhaled or injected radioactive substances to help identify how much a patient will benefit from revascularization procedures
radiography
posteroanterior and lateral chest x-rays may be used to evaluate the size and shape of the heart
angiocardiography
injection of a radiopaque substance during cardiac catheterization for the purpose of imaging the heart and related structures
cardiac catheterization
threading of a catheter (thin tube) into the heart to collect diagnostic information about structures in the heart, coronary arteries, and great vessels and potentially insert stent implants
also used to aid in treatment of CAD, congenital abnormalities, and heart failure
digital subtraction angiography (DSA)
digital imaging process used for nonmoving arteries wherein contrast images are used to “subtract” the noncontrast image of surrounding structures, leaving only a clear image of blood vessels
Swan-Ganz catheter
long, thin cardiac catheter with a tiny balloon at the tip that is fed into the femoral artery near the groin and extended up to the left ventricle
this instrument is then used to determine left ventricular function by measuring pulmonary capillary wedge pressure
atherectomy
removal of plaque from the coronary artery (or other arteries) through a catheter with a rotating shaver or a laser
if a laser is used, procedure is called laser angioplasty
laser angioplasty
procedure in which plaque is vaporized by pulsating beams of light through a catheter introduced into the coronary artery at the site of the blockage
may be used alone or with balloon angioplasty
cardiac defibrillator
either external or implantable device that provide an electronic shock to the heart to restore a normal rhythm
cardiac pacemaker
small, battery-operated device that helps the heart beat in a regular rhythm
can be either internal (permanent) or external (temporary)
cardiopulmonary resuscitation (CPR)
manual external cardiac massage and artificial respiration used to restart the heartbeat and breathing of a patient
commissurotomy
KAHM ih shur aht uh mee
surgical division of a fibrous band or ring connecting corresponding parts of a body structure
commonly performed to separate the thickened, adherent leaves of a stenosed mitral valve
coronary artery bypass graft (CABG)
open-heart surgery in which a piece of a blood vessel from another location is grafted onto one of the coronary arteries to reroute blood around a blockage

extracorporeal circulation (ECC)
use of a cardiopulmonary machine to do the work of the heart during open-heart procedures
heart transplantation
removal of a diseased heart and transplantation of a donor heart when cardiace disease can no longer be treated by any other means
left ventricular assist device (LVAD)
mechanical pump device that assists a patient’s weakened heart by pulling blood from the left ventricle into the pump and then ejecting it out into the aorta
LVADs may be used on those patients awaiting a transplant
minimally invasive direct coronary artery bypass (MIDCAB)
surgical procedure in which the heart is still beating while a minimal incision is made over the blocked coronary artery, and an artery from the chest wall is used as the bypass
percutaneous transluminal coronary angioplasty (PTCA)
surgical procedure in which a catheter is threaded into the coronary artery affected by atherosclerotic heart disease
the balloon at the tip of the catheter is inflated and deflated to compress the plaque against the wall of the artery and increase blood flow
stents are placed in the arteries and used to prop them open after the angioplasty
pericardiocentesis
aspiration of fluid from the pericardium to treat cardiac tamponade
Fig B

port-access coronary artery bypass (PACAB)
procedure in which the heart is stopped and surgery is accomplished through small incisions in the chest
radiofrequency catheter ablation
destruction of abnormal cardiac electrical pathways causing arrhythmias
transmyocardial revascularization (TMR)
procedure used to relieve severe angina in a patient who cannot tolerate a CABG or PTCA
with a laser, a series of holes is made in the heart tissue in the hope of increasing blood flow by stimulating new blood vessels to grow (angiogenesis)
valvuloplasty
VAL vyoo loh plas tee
repair of a stenosed heart valve with the use of a balloon-tipped catheter
balloon angioplasty
involves threading a catheter into the affected coronary artery and inflating and deflating a balloon at its tip to compress plaque against the wall of the artery to increase blood flow

hemorrhoidectomy
excision of hemorrhoids
ligation and stripping
tying (ligating) of varicose veins and their removal in severe cases
sclerotherapy
injection of chemical solution into varicosities to cause inflammation, resulting in an obliteration of the lining of the vein
blood flow is then rerouted through adjoining vessels
commisuro/o
connection
AV
atrioventricular
LA
left atrium
LV
left ventricle
MV
mitral valve
PA
pulmonary artery
PV
pulmonary vein
RA
right atrium
RV
right ventricle
SA
sinoatrial
TV
tricuspid valves
AEB
atrial ectopic beat
AF
atrial fibrillation
AS
aortic stenosis
ASD
atrial septal defect
BBB
bundle branch block
CAD
coronary artery disease
CHF
congestive heart failure
DOE
dyspnea on exertion
DVT
deep vein thrombosis
MI
myocardial infarction
MR
mitral regurgitation
MS
mitral stenosis
MVP
mitral valve prolapse
PAC
premature atrial contraction
PDA
patent ductus arteriosus
PVC
premature ventricular contraction
SOB
shortness of breath
SSS
sick sinus syndrome
TS
tricuspid stenosis
VEB
ventricular ectopic beat
VF
ventricular fibrillation
VSD
ventricular septal defect
VT
ventricular tachycardia
BP
blood pressure
bpm
beats per minute
CPK
creatinine phosphokinase
DSA
digital subtraction angiography
ECG, EKG
electrocardiography
EST
exercise stress test
LDH
lactate dehydrogenase
TEE
transesophageal echocardiogram
CABG
coronary artery bypass graft
CPR
cardiopulmonary resuscitation
ECC
extracorporeal circulation
ICD
implantable cardiac defibrillator
MIDCAB
minimally invasive direct coronary artery bypass
PACAB
port-access coronary artery bypass
PTCA
percutaneous transluminal coronary angioplasty
TMR
transmyocardial revascularization
LVAD
left ventricular assist device
atheroma
a mass of fat or lipids on the wall of an artery