Cardiac A&P Flashcards
(heart’s anatomical location) ~⅔ heart’s mass:
Bottom of heart aka:
Top of heart aka:
Great vessels:
Aorta diameter:
= L of midline w/ remainder to right
= apex: just above diaphragm, left of midline 5th rib
= Top of heart/base: ~2nd rib.
= connect to the heart through the base.
= ~2 inch
Heart’s 3 tissue layers:
= Endocardium, myocardium, & pericardium.
Endocardium:
= Innermost layer, Lines heart chambers & is in contact w/ blood.
Myocardium:
= Thick middle layer, Resembles skeletal muscle but has electrical properties like smooth muscle, Conducts electrical impulses for heart contraction.
Diastole:
Systole:
= 1st phase, ventricles fills w/ blood, hold 100mLs & pumps 50-70mLs
= “squeeze” 2nd phase, period of cycle myocardium is contracting
!!Poiseuille’s law:
Example:
= vessel w/ relative radius of 1 would transport 1mL per min at BP difference of 100mmHg. Keep pressure constant
= Less blood = vaso-press
Ejection Fraction (EF):
<45% usually indicates:
<30%:
= Ratio of blood pumped from the ventricle to the amount remaining @ the end of diastole/ %of blood pumped out from ventricle (60-70%)
=<45% usually indicates in or going to CHF
=<30% in CHF & chronic cardiac crip on oxy
Preload:
= pressure (volume) w/in the ventricles at the end of diastole & Also commonly called the end diastolic volume (frank starlings law)
Afterload:
= resistance against which the heart must pump against afterload become increased w/ increased ventricular workload
Systemic vascular resistance:
Nitro dynamics:
= how dilated arteries are
= decreases afterload pressure > decreases workload & O2 demand
Contractility:
= ability of CM. cells to contract, or shorten (Actin Myosin)
Stroke volume:
3 factors that affect stroke volume:
= amount of blood ejected by heart in 1 contraction, varies 60-100mLs w/ average 70mL
= preload, afterload, & contractility
Fastest way to effect preload:
= IV bolus Afterload affect vaso-med
Contractilititly factors electrolyte & receptor:
= Calcium & +Beta1 effects
Cardiac output formula:
= SV x HR
(Electrolytes role on heart) NA:
Ca:
K:
= depolarizing myocardium
= depolarization & majority myocardial contractile
= influences repolarizations
(3 internodal pathways) 1:
2:
3:
= SA node to Bachmann’s bundles left atrium
= AV junction to AV node,
= Junction AV node, Sinus SA node
Heart’s Endocrine hormones’:
ANP:
BNP:
= store & secretes 2 hormones released when somewhere in heart fail
= Atrial Natriuretic Peptide: made, stored, & released by atrial-M cells response to atrial distension & Sympathetic stim (counter RAAS & lessen afterload pressure)
= Brain Natriuretic peptide: secreted by ventricles response to stress to excessive stretching of myocytes & Counter RAAS
Tunica intima:
Tunica media:
Tunica adventitia/externa:
Lumen:
= inside layer/ tissue of heart
= middle layer/muscle of heart
= external layer of heart
= where blood flows throughs
!!Starling’s Law of heart:
= states that the more the myocardium is stretched, up to a certain amount, the more forceful the subsequent contraction will be
Chrontropy:
Inotropy:
Dromotropy:
= HR, + tropic +HR vice versa
= Contraction force
= Speed of impulse transmission, usually goes w/ Inotropy
(only in heart) Intercalated discs:
Discs speed Vs standard cell membrane:
Syncytium:
= Special tissue bands inserted between myocardial cells that increase the rate(400x) in which AP is spread from cell-cell thus Syncytium
= 400x faster than standard cell membrane drom/Inotropy
= Group of cardiac cells physiologically function as a unit, “working together in sync” “top in syncytium to bottom”
Cardiac depolarization:
RP of Ac:
RP of Cc:
Phases 0-4 of Cc:
= reversal charges of cell membrane inside becomes + & outside -,
= -60 slow Na & fast Ca -40
= -90 Na & -85 gap Junctions fast Na influxes
= 0 depolar, 1 early repolar, 2 plateau + for +, 3 K pumps, 4 refractory
Side of heart has most myocardium:
Epicardium makes what & how:
Pericardium holds what, w/ what color & Fn.:
= L side of heart (muscle)
= folds over self to make pericardium
= holds 25-50mLs straw color fluid to reduce friction, 150mL = heart can squeeze,
Pectinate ”comb” muscles L. & Fn:
Chordae Tendineae L. & Fn:
= @ Atriums’ to contract for Mitral & Tricuspid valves
= heart tendons connect to Papillary-M.s, down to open atria valves
Foramen Ovale:
Pulmonary stenosis:
= hole in the atrial septum that is part of the fetal blood circulation
= pulmonic valve/arteries rigid
(Heart’s Physiology) Diastole) R-side:
L-side:
= Atrium’s tricuspid valve opens filling ventricle & Pulmonic-V closed
= L atrium’s Bicuspid valve opens filling & streching ventricle & Aortic-V closed
1st & 2nd most common heart defect:
ASD Atrial Septum Defect:
VSD Ventricle Septum Defect:
= ASD atrial septum defect then VSD ventricle septum defect
= hole in atriums’ septum; when breaths & closes, CAUSES L-R SHUNT, overloads right side decreases BP
= hole in ventricle’s septum L→R shunt, R-side balloons > hypertrophic
Isolated Dextrocardia:
Abdominal situs Inversus:
Situs Inversus Totalis:
= Heart on right side/flipped “Right = Left” so mirror leads, AEDs
= Spleen & Liver flipped but H normal
= “EVERYTHING WRONG” H right side
Fossa Ovalis:
Patent Foramen Ovale (PFO):
Forman Ovale A&P:
= depression in R-Atrium remnant of Foramen Ovale
= ASD; hole in atriums septum that didnt close after out of uterus in fetus
= b/c fetus fluid in lung/heart & closes w/ 1st breath b/c lungs neg/ pressure
Chordae Tendineae:
Heart regurgitation:
= connect valves’ leaflets to papillary-M.s to prevent valves from prolapsing into atria & allowing backflow during ventricle contraction
= papillary not working &/or valve doesn’t correctly opens so prolapse
Semilunar valves:
Semilunar valves FN:
Left Semilunar valve:
Right Semilunar valve:
= Aortic & Pulmonic
= reg/ blood flow between ventricles & arteries into which empty. They permit 1-way m-nt of blood & prevent backflow
= Aortic valve connects L-ventricle to aorta.
= Pulmonic valve connects R-ventricle to pulmonary artery
BP form/s:
BP is related to:
= (SV x HR) x SVR or CO x SVR
= CO & peripheral resistance
(Blood Flow L-L) 1:
2:
3:
4:
5:
6:
7:
only vein carrying oxy/ blood:
only artery carrying deoxy: blood:
Intracardiac pressures Left>Right b/c:
= 1.Vena Cavas: recieves deoxy blood from body; SVC receives from head & upper extremities & IVC receives from areas below heart.
= 2. R-Atrium: receives deoxy blood from body via venae cavaes
= 3. R-Atrium: pumps blood through Tricuspid valve & into R-ventricle.
= 4. R-ventricle: pumps through Pulmonic valve to P/artery & on to lungs
= 5. Lungs: oxygenates blood & returns to L-atrium via pulmonary veins.
= 6. L-Atrium: sends oxygenated blood by mitral valve & into L-ventricle
= 7. L-Ventricle: pumps blood through Aortic valve>Aorta feeding oxygenated blood to the rest of the body.
= Pulmonic veins
= Pulmonary artery
= Lungs offer less resistance to blood flow than systemic circulation thus’ left myocardium is thicker than right)
(Heart’s Physiology) Systole) R-side:
L-side:
= Atrium’s tricuspid valve closed & filled ventricle contracts to overcome Pulmonic-V opening it & sending de/oxy blood to lungs to oxygenate (weak & vol/ dependent (Frank Starlings)
= Atrium’s Bicuspid valve closed & filled ventricle contracts to overcome Aortic-V opening it & sending oxygenated blood to body (Strong w/ more muscle to contract)
(Einthoven’s triangle(Bipolar/limb leads) leads 1 views:
Lead 1 Negative:
Lead 1 Positive:
= Left Lateral wall
= Right Arm
= Left Arm
(Einthoven’s triangle(Bipolar/limb leads) leads 2 views:
Lead 2 Negative:
Lead 2 Positive:
= Inferior wall diagonally towards left foot
= Right Arm
= Left Leg
What? Manufactured, stored, & released by Atrial M. cells in response to such things as atrial distention and sympathetic stimulation.
Atrial Natriuretic Peptide (ANP)
What? secreted by the ventricles of the heart in response to excessive stretching of the ventricle myocytes.
Brain Natriuretic Peptide (BNP)
Match the labels
A= Superior Vena Cava
B= Pulmonary Valve
C= Right Pulmonary Veins
D= Right Atrium
E= Tricuspid Valve
F= Chordae Tendineae
G= Right Ventricle
H= Inferior Vena Cava
Match the Labels
H= Aorta
I= Pulmonary Artery
J= Left Pulmonary Veins
K= Left Atrium
L= Bicuspid Valve
M= Aortic Valve
N= Left Ventricle
O= Papillary Muscle
Match the Labels
A= SA Node
B= AV Node
C= Interventricular Septum
D= Right Bundle Branch
E= Purkinje System
F= Purkinje Fibers
G= Left Bundle Branch
H= Bundle of His
I= AV Junction
J= Internodal Pathways
K= Bachmann’s Bundle
Which coronary artery feeds the inferior wall of the heart?
Right Coronary Artery (RCA)
Which coronary artery feeds the left lateral wall of the heart?
Left Circumflex (LCX)
A blockage of which of the following would result in the entire left ventricle not receiving blood supply?
Left Main Coronary Artery (LMCA)
OMI:
Occlusion Myocardial infarction (V2)
STEMI:
ST Elevated Myocardial Infarction (50% don’t show)
Atrial appendages:
(abnormal heart birth defect) pockets that form clots on either atrium from uterine dev/,
What is the most prevalent extracellular ion?
What is the most prevalent intracellular ion? Potassium
= Sodium
= Potassium
Communication or the connecting of two or more vessels is known as:
= Anastomosis
Which ion has the greatest influence on muscular contraction:
= Calcium
Blood cell travels from the right atrium, through what & into where?
= Tricuspid valve & into Right ventricle
Blood cell travels from the right ventricle, through what & into where?
= Pulmonic valve & into Pulmonic arteries
Blood cell travels from the left atrium, through what & into where?
= Mitral/Bicuspid valve & into Left Ventricle
What is the intrinsic firing rate of SA,AV node, & Purkinje System:
= SA: 60-100BPM, AV: 40-60BPM, Purkinje System: 15-40BPM
When in diastole, which of the valves are open?
Mitral & tricuspid
in Systole & pumping blood from ventricles, which valves are open:
Pulmonic & Aortic
Norm/ ventricle ejects ~2/3s blood it contains @ after systole, known as
Ejection Fraction
(CAD):
(CVD):
= Coronary Artery disease: disease affecting coronary vessels
= Cardiovascular disease: affecting heart, peripheral blood vessels, or both
Atrioventricular valves aka & leaflets# & aka:
Atrioventricular valves Fn:
= R-Tricuspid valve beeu w/ 3 cusps & L-Bicuspid/Mitral valve w/ 2 cusps
= control blood flow between atria & ventricles via connection to specialized papillary muscles in ventricles.
Semilunar valves:
Semilunar valves Fn:
= L-Aortic valve: connects L-Ventricle to Aorta to body & R-Pulmonic valve: R-Ventricle to pulmonic artery to lungs
= reg/ blood flow between ventricles & arteries into which empty. They permit 1-way m-nt of blood & prevent backflow
Major vessels of the body:
3 main Major Vessels) 1:
2:
3:
= all branch off of the aorta
= Ascending: comes directly from the heart.
= Thoracic: curves inferiorly & goes through the chest (or thorax).
= Abdominal: goes through diaphragm & enters the ABDMN
(Coronary) left coronary artery supplies:
Left coronary artery 2 major branches are:
= L-ventricle, Intraventricular septum, part of R-ventricle & lower conductive system
= anterior descending artery and the circumflex artery
(Coronary) Right coronary artery supplies:
Right Coronary arteries’ 2 major branches:
= portion of R-atrium & ventricle, upper portion of conduction system
= posterior descending artery & marginal artery
The coronary vessels A&P
coronary vessels receive blood during diastole when the heart relaxes b/c aortic valve leaflets cover the coronary artery openings (ostia) during systole.
Blood drains from Left Coronary system via:
the 2 veins empty into:
right coronary vein empties directly into:
= anterior great cardiac vein & lateral marginal veins
= coronary sinus
= the right atrium via smaller cardiac veins.
Coronary arteries L&Fn:
Coronary veins & Vena Cavas pick up & drop off to:
Cornary sinus:
= Aorta, feed oxygenated blood to heart/myocardium during diastole b/c semilunar valve closed during aortic kick/
= deoxygenated blood sent to Right atrium
= vein deoxy blood back to R atrium above AA
Which coronary artery feeds the anterior wall of the left ventricle?
Left Anterior Descending (LAD)
(Einthoven’s triangle(Bipolar/limb leads) leads 3 views:
Lead 3 Negative:
Lead 3 Positive:
= inferior (down & rightward) 50% MI has R ventricle Infarction
= Left Arm
= Left Leg
Pericardium:
Visceral pericardium (epicardium):
Parietal pericardium:
= Protective sac around the heart w/ 2 layers:
= Inner layer, in contact w/ heart muscle
= Outer, fibrous layer
