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S1 Pharmacology > Cardiac Structure > Flashcards

Cardiac Structure Flashcards

1
Q

What is the innermost layer of the heart ?

A
  • endocardium
  • lines heart chambers + is coninuous with blood vessels
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2
Q

What is the middle layer of the heart ?

A
  • myocardium
  • thick + muscular layer = responsible for pumping blood
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3
Q

What is another name for the epicardium + where is it located ?

A
  • epicardium is also called visceral pericardium
  • outermost layer of the heart + part of serous membrane
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4
Q

What is the pericardial cavity ?

A
  • space between the visceral + parietal pericardium
  • fluid-filled to reduce friction
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5
Q

What are the 2 layers of the serous pericardium + what are there roles ?

A
  • visceral pericardium (epicardium) = lines surface of the heart
  • parietal pericardium = lines internal surface of fibrous pericardium
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6
Q

What does it mean that the heart tissue is “continuous with blood vessels”?

A
  • endocardium (inner heart lining) is directly connected to the lining of the blood vessels
  • ensuring smooth blood flow
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7
Q

Why is the myocardium of the left ventricle much thicker than the right ?

A
  • left pumps blood to rest of the body
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8
Q

What supplies blood to the heart ?

A
  • the coronary artery supplies oxygenated blood to the heart
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9
Q

Where do the coronary arteries branch off from ?

A
  • coronary arteries branch off from aorta
  • they branch into smaller vessels
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10
Q

How does coronary artery disease arise ?

A
  • when coronary artery cannot deliver blood adequately often due to plaque in arterial walls
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11
Q

What is myocardial infarction ?

A
  • blood supply to heart is completely blocked off so muscle dies
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12
Q

What are the functions of the pericardium ?

A
  • protects and anchors the heart
  • prevents overfilling of blood in heart
  • allows for heart to work in friction-free environment
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13
Q

What is the pericardium + what 2 things is it composed of ?

A
  • pericardium is double-walled sac around heart
    Made of :
  • superficial fibrous pericardium
  • deep two-layer serous pericardium (visceral + parietal )
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14
Q

What are the 2 circuits of the heart + what are there functions ?

A
  • pulmonary circuit - blood to and from lungs
  • systemic circuit - blood to and from rest of the body
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15
Q

Why are arteries considered as pressure vessels ?

A
  • maintain high pressure to carry blood away from heart
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16
Q

Why are veins considered capacitance vessels ?

A
  • can distend (expand) to match various blood volumes
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17
Q

What is the cardiac cycle ?

A
  • electrical, pressure and volume changes that occur in functional heart between two heart beats
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18
Q

What is the diastolic phase ?

A
  • myocardium is relaxing
  • allows chambers to fill with blood
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19
Q

What is the systolic phase ?

A
  • myocardium contracting
  • pumps blood out the chambers
  • systole = sounds like squeezing
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20
Q

What happens during atrial diastole ?

A
  • atria are relaxed
    • Blood flows passively from veins into the atria and into the ventricles (80% of blood flow).
    • AV valves are open.
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21
Q

What happens during atrial systole ?

A

• Atria contract, increasing pressure.
• 20% of blood is pumped into ventricles.
• AV valves remain open.

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22
Q

What occurs during ventricular filling ?

A

• 80% of blood flows passively into ventricles.
• Atrial systole pumps the remaining 20% into the ventricles.
• AV valves remain open.

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23
Q

What occurs during ventricular systole ?

A
  • AV valves close due to increased ventricular pressure, producing the “lubb” sound.
  • Isovolumetric contraction phase = volume stays the same (see separate flashcard)
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24
Q

What is the isovolumetric contraction phase ?

A
  • Ventricles contract, no blood leaving (pressure too low to open semilunar valves)
    – Ventricular ejection phase opens semilunar valves
    • Ventricular pressure&raquo_space; pressure in arteries
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25
Q

What occurs during ventricular diastole ?

A
  • Ventricles relax; blood backflow, closes semilunar valves (“dubb”)
  • Blood once again flowing into relaxed atria and passively into ventricles
26
Q

What causes the ‘lub’ sound + where is it loudest ?

A
  • closure of AV valves
  • loudest at the cardiac apex
27
Q

What causes the ‘dub’ sound + where is it the loudest ?

A
  • closing of the SLV
  • Loudest at the base of the heart
28
Q

Where is the tricuspid valve located ?

A
  • between right atrium + right ventricle
  • has 3 cusps
29
Q

Where is the bicuspid valve located ?

A
  • between left atrium + left ventricles
  • has 2 cusps
30
Q

blood flow through the heart

A

deoxygenated blood:
- superior + inferior vena cava
- right atrium through
- tricuspid valve
- right ventricles
- pulmonary SLV
- pulmonary artery
- lungs
Oxygenated blood:
- pulmonary vein
- left atrium
- bicuspid valve
- left ventricle
- aortic SLV
- aorta
- body

31
Q

Where is the aortic SLV located ?

A
  • between left ventricle and aorta
32
Q

Where is the pulmonary SLV located ?

A
  • between right ventricle and pulmonary artery
33
Q

What is the pulse ?

A
  • surge of pressure in artery
34
Q

What is tachycardia ?

A
  • resting heart rate more than 100 bpm
  • caused by stress, drugs, heart disease
35
Q

What is bradycardia ?

A
  • heart rate less than 60 bpm
  • in sleep and endurance trained athelets
36
Q

What are premature atrial contractions ?

A
  • Occasional shortened intervals between one contraction and next (frequently occurs in healthy people)
37
Q

What is the stroke volume ?

A
  • volume of blood pumped by a ventricle per beat
38
Q

What is the equation for calculating stroke volume ?

A

SV= end diastolic volume (EDV) - end systolic volume (ESV)

39
Q

What is end diastolic volume (EDV) ?

A
  • amount of blood in a ventricle at end of diastole
40
Q

What is end systolic volume (ESV) ?

A
  • amount of blood remaining in a ventricle after contraction
41
Q

What is ejection fraction ?

A

% of EDV pumped by the ventricle

42
Q

What is cardiac output + equation ?

A
  • amount of blood pumped by each ventricle in one minute
    CO = HR x SV
    (ml/min) = (beats/min) x (ml/beat)
43
Q

What factors affect heart rate ?

A
  • autonomic innervation - ANS
  • hormones eg. Adrenaline
44
Q

What factors stroke volume ?

A
  • EDV + ESV
45
Q

What is blood pressure ?

A
  • force exerted by blood against blood vessel walls
46
Q

What role do baroreceptors play in blood pressure regulation?

A
  • Baroreceptors detect changes in blood pressure
  • increased pressure stretches the receptors - activating the vagus nerve
  • triggers the parasympathetic system to lower blood pressure.
47
Q

When is blood pressure highest and lowest during the cardiac cycle?

A
  • Highest during ventricular systole (when the ventricles contract).
    • Lowest during ventricular diastole (when the ventricles relax).
48
Q

What factors increase blood pressure ?

A
  • increased blood volume
  • increased heart rate
  • increased stroke volume
  • increased blood viscosity
  • increased peripheral resistance
49
Q

What is preload ?

A
  • tension applied before the muscle performs any work
  • equal to EDV
  • increasing in filling pressure (more blood entering the heart) = increased preload
50
Q

What is afterload ?

A
  • load that preloaded muscle has to work against
  • resistance ventricles must overcome to circulate blood into arteries/aorta
  • associated with ventricular wall stress after systolic ejection
  • estimated using VWS = Pressure x radius / 2 (wall thickness)
51
Q

How does preload affect cardiac output ?

A
  • increased preload (more blood in ventricles) = increased cardiac output
52
Q

What is the Frank-Starling mechanism ?

A
  • increased venous return (blood returning to heart) increases EDV which increases preload
  • preload is initial stretching of cardiac myocytes prior to contraction
  • as myocytes stretch they generate more force so increased stroke volume (pump out more blood)
53
Q

How does afterload affect cardiac output ?

A
  • increased afterload = decreased cardiac output
  • increased afterload (e.g., higher blood pressure or narrowed arteries) makes it harder for the heart to pump blood.
54
Q

How does contractility affect cardiac output ?

A
  • increased contractility = increased cardiac output
55
Q

What is hypertension ?

A
  • arterial pressure too high
  • heart has to work harder
  • left ventricle enlarges
56
Q

What is the treatment for hypertension ?

A
  • Change lifestyle factors
    • Drug therapy to reduce heart rate
    • Ca2+ channel blockers; reduce calcium flow into heart muscle and thus heart rate
    • Beta blockers (reduce stimulation by sympathetic nervous system)
    • Diuretics reduce blood volume
    • ACE inhibitors interfere with renin- angiotensin pathway
  • vasodilators
57
Q

What is renin and when is it secreted ?

A
  • secreted by the kidney in response to reduced blood pressure or blood volume
58
Q

What is angiotensin and how is it formed ?

A
  • Renin converts Angiotensinogen —> Angiotensin I
59
Q

What is role of Angiotensin Converting-Enzyme (ACE) ?

A
  • converts Angiotensin I —> Angiotensin II
60
Q

What are the actions of angiotensin II in regulating blood pressure ?

A
  • Intense vasoconstriction —> increases blood pressure
    • release of Aldosterone from adrenal cortex -> promotes Na+ and H2O reabsorption in kidney —> cause increased blood volume
    • Regulatory negative feedback on the release of Renin.
    • CNS: Stimulate thirst in hypothalamus, stimulate sympathetic outflow
  • increases ADH secretion from pituitary gland more H20 absorption
61
Q

What do ACE inhibitors do to RAAS pathway ?

A
  • inhibit formation of angiotensin II
  • decrease release of aldosterone
  • so less Na+ + H20 reabsorbed
  • so decreased blood volume = decreased blood pressure
62
Q

What do ACE receptor blockers do ?

A
  • Block angiotensin receptors on blood vessels and adrenal cortex
    • Produce vasodilation and decrease the activity of aldosterone

S1 Pharmacology (24 decks)

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