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Cardio Flashcards

1
Q

Two circuits of cardio system

A

Pulmonary: right heart -> lungs -> left heart

Systemic: left heart -> body -> right heart

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2
Q

Arteries carry blood AWAY from heart except which one?

Veins carry blood TO heart except which one?

A

Pulmonary artery

Umbilical vein

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3
Q

Artery order going away from heart

A

Elastic arteries
Muscular arteries
Arterioles

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4
Q

What are the function of pericytes

A

Regulate the blood flow of capillaries

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5
Q

3 layers of vasculature

A

Inner: tunica intima

Middle: tunica media

Outer: tunica adventitia

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6
Q

Tunica intima characteristics

A

Inner: sim squamous ET

Middle: subendothelial layer

Outer: internal elastic lamina

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7
Q

Subendothelial layer made of

A

Loose CT

Aka lamina propria

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8
Q

Tunica media made of

A

Smooth muscle in circular layer
Produces ECM
NOOOO fibroblasts
External elastic lamina

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9
Q

Tunica adventitia made of

A

Loose CT made of fibroblasts unlike tunica media

Contains: vasa vasorum, Nervi vasorum, and lymph vessels

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10
Q

Vasa vasorum

A

Blood vessels of the tunica adventitia

Feeds and takes away ox/deox blood from the blood vessel itself

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11
Q

Nervi vasorum

A

Nerve endings in blood vessel to stimulate

Regulates constriction and dilation

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12
Q

Artery vs Vein

A

Arteries have very prominent layers

Veins have thinner layers and valves
Large veins may have muscle in tunica adventitia, usually larger than artery
Only some veins have an internal elastic lamina

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13
Q

Vasculogenesis

What is it, when does it occur

A

De novo, NEW blood vessels formed
Embryogenesis

VEGF is secreted by mesenchymal cells which tells angioblasts to line up and form a tube to make INTIMA

Angiopoeitins recruit smooth muscle to cover intima which makes the MEDIA layer

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14
Q

Angiogenesis

What is it, when does it occur

A

Existing blood vessels sprout new branches
Embryogenesis and adulthood

Basal lamina breaks down and VEGF recruits angioblasts to line up in tube and angiopoeitin recruits smooth muscle to make media

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15
Q

When does angiogenesis begin

A

When heart starts pumping blood

This creates a hydrodynamic force that begins and mediates the development of new blood vessels

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16
Q

Normal vs portal system

A

Normal: artery -> capillary -> vein

Portal 2 types:
Arterial portal: afferent arteiole -> cap -> efferent arteriole -> cap (deox) -> vein , Blood remains oxygenated for second cap

Venous: arteriole -> cap -> vein-> cap -> vein
blood remains deoxygenated for second cap

POINT: allows short, direct transfer of material through the blood between two organs without having to traverse the heart/systemic circuits

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17
Q

Arterial and venous portal locations

A

Arterial: KIDNEY

Venous: Hypothalamus

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18
Q

What is a direct connection between an artery and a vein with NO caps in between
Where is this seen?

A

Arteriovenous anastomosis
SHUNT

Seen in the skin

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19
Q

What maintains the integrity of the blood vessels

A

Blood pressure

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20
Q

What is the systolic measurement?

Diastolic measurement?

A

Vessel pressure during heart pumping HIGHER

Vessel pressure during heart filling LOWER

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21
Q

Blood pressure is highest in the ____ and lowest in the ____

A

Aorta

Vena cava

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22
Q

Largest arteries are the

A

Elastic arteries

Closest to heart

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23
Q

Elastic artery characteristics

A

Thin tunica intima, falls apart during x section bc so small, hard to see

Very muscular with 80 layers of SM in media layer
Produce own ECM and ELASTIN network that stores potential energy and controls BP

Thin adventitia

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24
Q

Two things that control blood pressure

A
  1. Elastic lamina in media layer, stores potential energy when stretched and snaps back to keep blood flowing
  2. Precapillary sphincters in arterioles, small ring of smooth muscle that controls blood flow into organs
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25
Muscular artery characteristics
Medium sized Do most of systemic work Tunica media has 20 layers of SM that produce COLLAGEN, not elastin VERY prominent internal and external elastic lamina VERY thick adventitia
26
Arteriole characteristics | AKA?
Resistance arteries Smallest artery Has precap sphincters Thin tunica media of about 2-3 layers
27
What arteries are Innervated by autonomic nerves and respond to hormones
Arterioles
28
The last artery before capillaries is known as the
MET arteriole
29
What blood vessel is known as the “resistance vessel” and is the primary vessel that regulates BP?
Arteriole Bc they have precap sphincters that are a ring of SM around the arteriole to control blood flow into the capillaries
30
Endothelial cell function in a blood vessel
Keep the blood vessel lined and healthy | Act as a barrier with a junctional complex, so no foreign materials can pass through
31
Endothelial cells in BV functions
1. Convert angio 1 into angio 2 IN LUNG ONLY 2. Inactivate bradykinin and serotonin 3. Lipolysis of lipoproteins 4. Prevent blood coagulation bc they run in the direction of blood flow, keeps blood flow non turbulent 5. Nuclei bulge into lumen 6. Secrete nitric oxide and endothelial 1
32
Smooth muscle Relaxer vs Contractor What are they secreted by?
Vaso relax: Nitric Oxide, dilates BV *NO relaxing Vaso constrict: Endothelin 1 and Angiotensin 2 Secreted by endothelial lining in blood vessels
33
Capillary characteristics
Endothelium and basement mem ONLY Facilitates gas exchange Diameter only allows one RBC at a time Blood moves SLOWLY to allow greater diffusion Have pericytes
34
Pericyte function
Adult cap stem cells that are normally QUIESCENT, but are activated upon damage and function to repair the damage Attach to outside of capillary and LAMINA PODIA act like fingers that wrap around cap
35
3 types of caps
Continuous Fenestrated Discontinuous
36
Continuous caps
TIGHT JUNCTIONS, strict transport Only found in areas where strict transport is necessary BBB of CNS, muscles, BAB (blood air barrier) of lungs Continuous BM Use vesicular transport
37
Vesicular transport
Aka transcytosis Used in continuous capillaries to transport material with vesicles
38
Fenestrated caps
Looser junctions to allow medium transport Found in endocrine glands, GIT, gallbladder Have areas where endothelial cells thin out, these are called “fenestrations” to make material exchange easier Fenestrations may have a diaphragm Continuous BM
39
Fenestration diaphragms
Fenestrations Make material exchange easier in fenestrated caps Diaphragms hold the fenestrations together, some fen caps do not have these
40
Discontinuous caps | Aka
Sinusoidal caps in LIVER, microville on hepatocytes project through these gaps directly into the lumen of the endothelial cell For EASY transport of materials Found in bone marrow, liver, spleen Large gaps “fenestrae” between endothelial cells Can have a discontinuous or ABSENT BM
41
Aortic aneurysm | Where does it occur?
Tunica media Neutrophils invade the tunica media and secrete ELASTASE which causes inflammation, and destroys the tunica media, creates scar tissue Must be surgically fixed
42
Endothelial cells turn ____ into ____ to regulate BP. How is the blood pressure regulation accomplished?
Angio 1 into angio 2 Angio 2 is a vasoconstrictor to increase blood pressure 1. It does this by constricting the JUXTA CELLS in kidney thus lowering the GFR (glomerular filtration rate) to increase the blood in the rest of the vasculature 2. Stim adrenal cortex to release ALDOSTERONE which increases water and Na+ resorption into blood, this increases the blood pressure
43
How to endothelial cells regulate lipolysis?
When cholesterol gets into lumen of of vasculature, macrophages digest the lipid If lipids accumulate, over time the macrophages will lose and lipid will form plaque in the tunica intima, which may eventually break through into the lumen
44
What is it called when endothelial cells prevent blood coagulation in vasculature
Antithrombogenic activity
45
2 types of vascular occlusion
Atherosclerosis | Restenosis
46
Atherosclerosis
Plaque build up in tunica media due to high cholesterol/lipids
47
Restenosis
When the SM in the tunica media crosses the IEL and forms layers in tunica intima which can bust out into the lumen Can occur after stent placement
48
What occurs when vascular occlusion occurs in the heart vasculature
Heart INFARCTION The heart has decreased oxygen causes cardiac myocytes to die fibroblasts proliferate in these areas to make scar tissue FIBROSIS New cardiomyocytes cannot be made in adult hearts! Necrotic/fibrous heart tissue does NOT STAIN in images
49
Large vein characteristics
Larger lumen than arteries Very irregular lumen shape Thin tunica media that produces COLLAGEN, not elastin like a large artery Minimal or ABSENT elastic lamina SM found in the ADVENTITIA, longitudinally arranged unlike artery
50
Medium veins characteristics
Similar to large veins | Thinner tunica intima than large veins
51
What is the KEY feature of veins
VALVES
52
What are valves made of and how do they function
Core: elastic CT Outer layer: endothelial cells Contraction of surrounding skeletal muscle constricts veins pushing the blood up past the valves The valves immediately close to prevent back flow
53
Varicose veins
Damage to vein valves Caused by sedentary lifestyle Blood pools in veins bc valves no longer work to prevent back flow Commonly seen in legs where there is increased blood flow
54
Thrombosis | Hemorrhoids
Diseases involving veins Thrombosis: When a blood clot becomes dislodged and travels to the lungs Hemorrhoids: When blood vessels dilate in the anal canal, can cause bleeding during defecation
55
Lymphatic system vasculature
System of blind ending caps that permeate through CT of the body Carry lymph to the large vessels that drain into veins Absorb excess interstitial fluid around caps
56
How is an edema formed
When excess interstitial fluid does not drain into the lymph system Fluid accumulates and causes swelling
57
Why does fluid leak out of arteries and where does it go?
There is a higher hydrostatic pressure in arteries than veins bc of their distance from the heart, arteries have higher BP There is a high osmotic pressure in veins than in arteries bc of ALBUMIN So there is a tendency for fluid to leak out into surrounding CT which is then absorbed by lymph caps
58
Lymph capillary characteristics
Have valves Contains leukocytes in lumen that ARE NUCLEATED (seen in images compared to RBC in caps w no nucleus) Sim squamous ET and BM Evident in SMALL INTESTINE MV
59
Lacteal location and function
Blind ending lymph cap that projects into a microvilli in small intestine Lined by sim squamous ET Absorbs LIPIDS
60
Where are carbs and proteins absorbed? Where are lipids absorbed?
Blood capillaries Lacteal *Lipids and Lacteal
61
Layers of the heart wall
Inside- Endocardium Myocardium Outside- Epicardium
62
Endocardium
Heart inner layer 1. Endothelial lining 2. SM and CT 3. Autonomic nerves 4. Purkinje fibers
63
Purkinje fibers. AKA Location Characteristics
Located in the sub endocardium Conduction of lower part of ventricles Aka Specialized cardiac myofibers Large uni or binucleated cells Structure: similar to skeletal muscle, DIAD, intercalated discs, nuclei centrally located
64
Myocardium
Heart middle layer Bulk of the heart 1. Cardiac myocytes 2. Firbroblasts Myoendocrine cells
65
What is atrial natriuretic factor and what is it produced by
Acts on the kidney and causes excretion of Na+ and H2O, pee becomes less concentrated Produced by the myoendocrine cells in the myocardium
66
Epicardium
Outer layer of the heart Made of parietal and visceral layers Epicardium= parietal pericardium= fibrous CT outside of heart for protection Pericardial space between layers filled with fluid Holds the vasa vasorum which supplies blood to the heart itself Holds nerves and adipose tissue and apex to cushion
67
Parietal vs Visceral pericardium
``` Parietal= epicardium and is made of fibrous CT, outermost layer of heart Visceral= mesothelial lining closest to myocardium ```
68
Conduction of the heart
1. SA node in RA 2. AV node in RA 3. Bundle branches 4. Purkinje fibers in Lower ventricles (located in the sub endocardium layer)
69
All conduction tissue is ____
Specialized cardio myocytes
70
3 junctions of intercalated discs
Fascia adherens- along z line anchors w ACTIN Gap junctions- 6 connexins make 1 connexon, perpendicular to z line Ionic coupling Macula adherens- spot desmosome, present throughout
71
All myocytes are _____
Electrochemically coupled
72
Orientation of myocytes in the myocardium
Muscle cells in the myocardium Fibers TWIST for better TORQUE and contraction to support blood expulsion Closer to Epi- fibers superior to inferior Middle- fibers run anterior to posterior Closer to endo- fibers run superior to inferior
73
Adult cardiac myocytes do NOT undergo
Hyperplasia (Proliferate! ) They are unable to create more cells ONLY done by smooth muscle They do however undergo hypertrophy in response to overload
74
Hypertrophy definition | And describe what occurs in hypertrophy of cardiac muscle
Increase in tissue size due to enlargement of cells Can be done by all muscles When the heart is being overworked due to a clogged BV, heart pumps harder to make up for it Which can lead to increased genes, protein synth, and changes to ECM This interferes with intercalated discs PATHOLOGIC

Histology (8 decks)

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