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Anatomy and Physiology-DNP > Cardiac Structure and Function > Flashcards

Cardiac Structure and Function Flashcards

1
Q

Right heart

A
  • Pumps blood through lungs (pulmonary circulation)
  • Uses unoxygenated blood
  • Seperated from the left by the interatrial septum and interventricular septum
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2
Q

Left heart

A

Pumps blood through the systemic circulation

-Oxygenated blood

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3
Q

Circulatory system

A

-Right atrium-Tricuspid -RV-pulmonic valve-Pulmonary artery-lungs-arteries-arterioles-capillaries-venules-veins-back to 4 pulmonary veins (oxygenated)-LA-mitral valve-LV-aortic valve-Aorta-arteries of each organ-arterioles of each organ-capillaries of each organ-(unoxygenated)-venules of each organ-veins of each organ-vena cava

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4
Q

Heart wall

A
  • 3 Layers (pericardium, myocardium, endocardium)
  • Visceral and parietal layer are seperated by pericardial space that contains 10-30mL of fluid-area of cardiac tamponade
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5
Q

Pericardium

A
  • Double walled membranous sac that encloses the heart
  • Prevents displacement of the heart during gravitational acceleration and deceleration (can live without)
  • Physical barrier that protects the heart against infection and inflammation
  • Contains pain receptors and mechanoreceptors that can elicit reflex changes in BP and HR
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6
Q

Myocardium

A

-composed of cardiac muscle and anchored to the heart fibrous skeleton. Thickness varies from one chamber to the next, related to the amount of resistance it must overcome

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7
Q

Endocardium

A

internal lining of myocardium. It’s continuous w/ the endothelium that lines all of the arteries, veins, and capillaries of the body

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8
Q

RV

A
  • Shaped like cresent triangle

- Overcome pressure of 15 mm Hg (mean PAP)

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9
Q

LV

A
  • Larger than RV

- overcome pressure of 92 mm Hg (MAP)

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10
Q

Atrioventricular valves

A
  • Tricuspid and bicuspid (mitral valves)
  • Flows from low pressure to high
  • Guarded by flaps of tissues called leaflets or cusps that’re attached to the papillary muscles by chordae tendinae
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11
Q

Semiulnar valves

A
  • Pulmonic valve
  • Aortic valve
  • Opens when intraventricular pressure exceeds the aortic and pulmonary pressure
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12
Q

Papillary muscles

A

-extensions of the myocardium that pulls the cusps together and downward at the onset of ventricular contraction preventing them from backflowing into the atria

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13
Q

Phases of the cardiac cycle

A
  • Atrial systole
  • Ventricular systole
  • Ventricular ejection (semiulnar valves open)
  • Ventricular relaxation (closure of aortic valves)
  • Ventricular filling (opening of mitral valves)
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14
Q

Diastole

A

-Myocardium relaxes and the chambers fill with blood

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15
Q

Systole

A

-Myocardium contracts forcing blood out of the ventricles

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16
Q

Cardiac metabolism

A

-Blood w/in the heart chambers doesn’t supply O2 or nutrients to the cells of the heart

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17
Q

Coronary vessels

A
  • Right coronary artery (conus, right marginal branch, posterior descending)
  • Left coronary artery
  • Left main goes into the LAD (Left anterior descending artery, circumflex artery)
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18
Q

Coronary vessels cont

A
  • Collateral arteries: connections between the branches of the same artery between the left and right
  • They are important for ischemia-to provide nutrients if narrowing in one of the major arteries occurs
  • Diabetes also creates smaller arteries-Difficult CABG cases
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19
Q

Conduction system

A

SA (sinoatrial node)-pacemaker of the heart. At the junction of the right atrium and SVC 60-100 bpm

  • Atroventricular node (AV): 40-60bpm
  • Bundle of HIS
  • Right and left bundle branches
  • Purkinje fibers 30-40 bpm
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20
Q

Electrocardiogram

A
  • Pwave: atrial depolarization
  • PR interval: time from the onset of atrial activation to the onset of ventricular activation
  • QRS complex-sum of all ventricular depolarization
  • ST interval: ventricular myocardium depolarized
  • QT interval: Electrical systole of the ventricles
  • Q-depolarization of the intraventricular septum
  • R-depolarization of the main mass of the ventriculars
  • S-depolarization of the purkinje fibers (base of the heart)
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21
Q

Adrenergic receptors

A 
govern automatic (sympathetic) regulation of the HR, contractile force, and dilation or constriction of coronary arteries. 
-These specific receptors in the myocardium and coronary vessels determines the effects of neurotransmitters norepinephrine and epinephrine
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22
Q

B1 + epinephrine

A

-Impact rate and strength (mostly in the heart)

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23
Q

B2 + epinephrine

A
  • Dilation of arterioles.
  • are on the coronary arterioles and cause coronary dilation when stimulated by epinephrine this opposes alpha 1 plus norepinephrne vasoconstriction.
  • B2 are in the lungs
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24
Q

A1 + norepinephrine

A

-Vasoconstriction

25
Q

A2 + norepinephrine

A

-Inhibits norepinephrine, allowing vasodilation

26
Q

Myocardial cells

A
  • Nearly identical to skeletal muscle cells
  • Intercalated disks
  • Actin, myosin, and the troponin-tropomyosin complex (trop T, I, and C)
  • Myocardial metabolism
27
Q

Preload

A
  • CVP or R atrial pressure
  • pressure generated in the ventricles at the end of diastole, depends on the amount of the blood in the ventricle which is directly related to blood in the atria
28
Q

Afterload

A
  • SVR

- Resistance to ejection of the blood from the ventricle. Afterload depends on pressure in the aorta

29
Q

Ejection fraction

A

SV/EDV

EDV-ESV=Stroke volume (blood moved with each beat)

30
Q

Baroreceptors (neural reflexes)

A

facilitates both pressure and HR (if BP decreases, HR increases)

31
Q

Norepinephrine

A

increases HR and enhances myocardial contraction and constricts blood vessels

32
Q

Epi

A

Increases myocardial contractility

33
Q

hormones

A
  • Thyroid hormones can increase cardiac output
  • Some adenocortical hormones like hydrocortisone can potentiate the effects of catecholomines (thus stress dose steroids used in vasopressor refractory hypotension)
34
Q

Bainbridge (neural reflexes)

A

-causes changes in HR w/ response to volume receptors in the atria that are innervated by the vagus nerves

35
Q

Cardiac output

A

-Volume of blood flowing through either the systemic or pulmonary circuit in liters per minute

36
Q

Myocardial contractility

A
  • Stroke volume
  • Inotropic agents
  • O2 and carbon dioxide levels
37
Q

Structure of blood vessels

A

-Lumen, tunica intima, tunica media, tunica externa (adventitia)

38
Q

Tunica media

A

of arteries close to the heart contains a greater proportion of elastic fibers

39
Q

Blood flow through veins

A

assisted by the contraction of skeletal muscles (muscle pump) and backflow in the lower body is prevented by one way valves particularly in the deep veins of the legs-DVT prophylaxis is important

40
Q

Factors affecting blood flow

A

Arterial chemoreceptors-specialized areas w/in the medulla oblongata, aorta and carotid arteries that are sensitive to concentrations of O2, carbon dioxide, and hydrogen ions within the blood

  • For example decrease arterial oxygen concentration or pH causes a reflexive increase in BP
  • Increased CO2 causes decreased BP
41
Q

Hormones affecting blood flow

A

-Epinephrine, norepinephrine, antidiuretic hormone, renin-angiotensin-aldosterone system, natriuetic peptides, adrenomedullin, insulin, and others

42
Q

Lymphatic system

A

special vascular system that picks up excess fluid and returns it to the blood stream
-Tonsils, cervical lymph nodes, right lymphatic duct, red bone marrow, inguinal lymph nodes, spleen, thoracic duct, axillary lymph nodes, thymus gland, peyers patches in intestinal wall

43
Q

Vasoconstrictor hormones

A

Epinephrine, norepinephrine, angiotensin 2, vasopressin

44
Q

Vasodilator hormones

A

Natriuretic peptides

45
Q

Norepinephrine

A

Released by adrenal medulla. Acts mainly as neurotransmitter. Increases HR, enhances contractility, and constricts blood vessels

46
Q

Epinephrine

A

Dilated blood vessels of the liver, skeletal muscles, and increase in HR and contractility, and vasoconstriction

47
Q

Thyroid hormone and growth hormones

A

Decrease in these can result in bradycardia, reduced CO and low BP. Thyroid hormone triiodothyronine cause increases in HR, contractility, and increased CO and decreased SVR

48
Q

Vasopressin and aldosterone

A

Effect BP by increasing fluid reabsorption and blood volume

49
Q

Lymphatic nodes, lymphatic pump, and lymphatic circulation

A
  • plasma, interstitial fluid, and lymph are intimately connected
  • when blood leaves the capillary it becomes interstitial fluid (or vice versa)
  • Interstitial fluid also enter the lymphatic capillary and becomes lymph
  • How body filters out waste and protects against pathogens
50
Q

Lymph nodes

A
  • lymph nodes are located along lymphatic vessels
  • filter lymph traveling through vessels
  • filtered several times
  • several lymphatic vessels enter each lymph node (afferent lymphatic vessels)
  • fewer lymphatic vessels exit the lymph node (efferent)
  • filters more slowly through the lymph nodes b/c more afferent vessels-more filtered
51
Q

Lymph

A
  • Flow of lymph only goes in one direction, from vessels towards blood
  • main lymphatic trunks (right lymphatic duct, thoracic duct)
  • Right lymphatic duct drains from upper right quadrant of body
  • Thoracic duct drains lymph from rest of the body
  • as soon as it enter the blood-now plasma
52
Q

Lymphatic pump

A
  • skeletal muscle contraction help lymph flow-lymphatic pump

- lymphatic vessels have valves to prevent backflow

53
Q

Lymphocytes

A
  • Some mature in bone marrow and become B lymphocytes
  • Some mature in thymus gland becoming T lymphocytes
  • Other sites are spleen, appendix, tonsils, peyer patches in small intestine
54
Q

Capillaries

A

site of oxygen, CO2, nutrient and waste exchange

55
Q

arterioles

A

-smallest arteries connecting to capillaries

-

56
Q

venules

A

tiny veins that connect capillaries to veins

57
Q

Coronary arteries

A
  • oxygenated blood enters the coronary arteries through openings w/in the semiulnar valves at the entrance to the aorta (diastole)
  • deoxyganted blood from the coronary veins enters the right atrium through coronary sinus
58
Q

Contraction process and cross bridges

A
  • cross bridges between actin and myosin enable contraction to occur
  • Ca and its interaction w/ the troponin complex facilitate the contraction process.
  • W/ troponin release of Ca, myocardial relaxation begins
59
Q

Layers of the vessels

A
  • tunica media of arteries close to the heart contains a greater portion of elastic fibers b/c these arteries must distend and recoil during cardiac cycle
  • distributing arteries farther from the heart contain more smooth muscle fibers b/c they must be able to constrict and dilate to control BP and volume

Anatomy and Physiology-DNP (18 decks)

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