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HUBS192 > Cardio > Flashcards

Cardio Flashcards

1
Q

What does the left atrium receive, and where from

A

Oxygenated blood from 4 pulmonary veins

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2
Q

What does the right atrium receive, and where from

A

Deoxygenated blood from superior and inferior vena cava, and coronary sinus

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3
Q

What does the left coronary artery branch into

A

Circumflex and anterior interventricular arteries

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4
Q

What supplies the coronary sinus

A

Great and small cardiac veins

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5
Q

What is the vagus nerve

A

Brake: parasympathetic nerve (rest and digest) which innervates the SA and AV nodes to decrease heart rate

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6
Q

What are the sympathetic cardiac nerves

A

Accelerator: nerve from sympathetic trunk ganglion, increases heart rate by innervating nodes and increases force of contracting by telling cardiac muscle to release more calcium

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7
Q

What are auricles

A

Folds of atria to create potential space for extra blood

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8
Q

What is pectinate muscle

A

Ridges covering the interior walls of auricle and atrium to confer strength to the atria enabling their expansion

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9
Q

What is the first major artery that branches off the aorta

A

Brachiocephalic artery

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10
Q

What is the second major artery that branches off the aorta

A

Left common carotid artery

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11
Q

What is the third major artery that branches off the aorta

A

Left subclavian artery

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12
Q

What are the first arteries to branch off the aorta

A

Left and right coronary arteries

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13
Q

What structure delineates the change between the thoracic and abdominal aorta?

A

Diaphragm

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14
Q

Where is the SA node located

A

The junction of the superior vena cava and right atrium

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15
Q

What is the function of the SA node

A

Pacemaker: cells spontaneously initiate each cardiac action potential, and hence heartbeat

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16
Q

What is the function of the interatrial bundle

A

Conducts the action potential from the right atrium to the anterior part of the left atrium

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17
Q

What is the function of the internodal bundles

A

Conduct the action potential from the SA node to the AV node

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18
Q

What is the function of the AV node

A

Slows conduction of AP from atria to ventricles, ensures atria complete their contraction before ventricles are depolarised

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19
Q

What is the function of the left and right branches of the AV bundle

A

Conduct the AP from the AV node to the left and right ventricles

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20
Q

What is the function of the Purkinje fibres

A

Conduct AP to all parts of the ventricles

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21
Q

What are serous membranes

A

Membranes which secrete fluid to lubricate internal structures

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22
Q

What is the name of the loose sac covering the heart

A

Pericardium (fibrous and serous: pericardial space filled with pericardial fluid)

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23
Q

What are the three layers of the heart wall

A

Epicardium, myocardium, endocardium

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24
Q

Describe the epicardium

A

Visceral layer of serous pericardium**, as well as adipose, blood vessels and loose irregular fibrous connective tissue

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25
Q

Describe the myocardium

A

Thick, contractile muscular layer

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26
Q

Describe the endocardium

A

Thin inner layer of heart wall made of loose irregular fibrous connective tissue and simple squamous epithelium

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27
Q

What valve separates the right atrium and ventricle

A

Right AV valve: tricuspid

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28
Q

What valve separates the left atrium and ventricle

A

Left AV valve: bicuspid

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29
Q

What valve separates the pulmonary artery and right ventricle

A

Pulmonary semilunar valve (3 cusps)

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30
Q

What artery leaves the right ventricle

A

Pulmonary artery

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31
Q

What artery leaves the left ventricle

A

Aorta

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32
Q

What valve separates the aorta and left ventricle

A

Aortic semilunar valve (3 cusps)

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33
Q

What supplies the right atrium

A

Superior and inferior vena cava

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34
Q

What supplies the left atrium

A

The four pulmonary veins (two left, two right)

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35
Q

What is the function of chordae tendinae

A

Prevent AV valves from inverting when they snap shut due to ventricular pressure

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36
Q

What are papillary muscles

A

Finger like projections of ventricular myocardium attached to chordae tendinae

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37
Q

What is trabeculae carnae

A

Muscular, beam like structures on the inner surface of the myocardium forming ridges or bridges

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38
Q

What does the pulmonary trunk divide into

A

Right and left pulmonary arteries

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39
Q

What are the two types of connective tissue in the cardiovascular system?

A

Elastin for stretch and fibrocollagen for strength

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40
Q

What is the main difference between the blood and lymph vascular systems

A

Blood: continuous loop, lymph: one way drainage system

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41
Q

What is the pulmonary circuit

A

Heart and lungs

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42
Q

What is the systemic circuit

A

Heart and rest of the body

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43
Q

Where do lymph projections pick up overflow

A

In the interstitium of capillary beds

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44
Q

Where are major arteries situated to avoid damage

A

Deep in the trunk or on flexor aspect of limbs

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45
Q

What are the three types of capillary

A

Continuous, fenestrated, sinusoidal

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46
Q

What are the three pathways for drainage

A

Deep veins, superficial veins and lymphatics

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47
Q

What is the only pathway for supply

A

Arteries

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48
Q

Why can veins exist more superficially than arteries

A

Operate at a much lower pressure so less dangerous

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49
Q

Where is the apex located (point of maximal impulse)

A

Left mid clavicular line, between ribs 5 and 6

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50
Q

Describe the position of the heart in the thorax

A

Rotated to the left, base tilted posteriorly

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51
Q

What separates the two ventricles

A

Interventricular septum

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52
Q

Describe pericardium

A

Outer wall: parietal serosa/pericardium, serous fluid, inner wall: visceral serosa/pericardium

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53
Q

What is diastole

A

Relaxation

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54
Q

What is systole

A

Contraction

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55
Q

Describe the four valves during diastole

A

AV valves open, semilunar valves closed

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56
Q

Describe the four valves during systole

A

AV valves closed, semilunar valves open

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57
Q

How big are capillaries

A

RBCs must be single file (as close as possible to walls for exchange)

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58
Q

Describe cardiac muscle cells

A

Striated, short, branched, 1 (occasionally 2) central, oval shaped nuclei per cell (compared to multinucleated, peripherally located skeletal muscle). Cytoplasmic organelles packed at poles. Interconnected with neighbouring cells via intercalated discs

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59
Q

Describe mitochondria in cardiac muscle cells

A

Make up about 20% of the cell, can never run out of ATP!

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60
Q

What are the three types of intercalated discs

A

Adhesion belts, desmosomes and gap junctions

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61
Q

What do adhesion belts link

A

Actin to actin: vertical portion

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62
Q

What do desmosomes link

A

Cytokeratin to cytokeratin: vertical and horizontal portion

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63
Q

What do gap junctions link

A

For electrochemical communication: horizontal portion

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64
Q

Conduction pathways are not nervous tissue, but are

A

Modified cardiac muscle

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65
Q

Describe cardiac conduction cells

A

Some peripheral myofibrils, central nucleus, mitochondria, glycogen, lots of gap junctions, some desmosomes, few adhesion belts (1% of all cardiac cells). Bloated compared to contractile cells.

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66
Q

List the vessels of the cardiac circulation

A

Aorta, coronary arteries, myocardial capillaries, cardiac veins, coronary sinus, right atrium

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67
Q

What type of nerves can alter the rate of conduction node impulse generation

A

Autonomic nerves

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68
Q

What artery branches into the right subclavian and common carotid arteries

A

Brachiocephalic

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69
Q

Where are the intercostal arteries

A

Along the inferior aspect of the ribs

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70
Q

What artery supplies the spleen, stomach and liver

A

Celiac trunk

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71
Q

What is the branching of the aorta at the pelvis called

A

Aortic bifurcation

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72
Q

What are the two paths of the aortic bifurcation

A

Left and right common iliac

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73
Q

What do the left and right common iliac arteries branch into

A

External and internal iliac

74
Q

Describe a possible pathway for blood to the foot

A

Aorta, common iliac artery, external iliac artery, femoral artery, popliteal artery, posterior tibial artery, plantar arch

75
Q

Describe a pathway for the return of blood from the foot

A

Plantar venous arch, posterior tibial vein, popliteal vein, great saphenous vein or femoral vein, external iliac vein, common iliac vein, inferior vena cava

76
Q

What is the great saphenous vein

A

A superficial vein from in lower limbs

77
Q

What are the three layers of blood vessels

A

Tunica intima, tunica media and tunica adventitia

78
Q

Describe the tunica intima

A

A simple squamous epithelium which lines the lumen of all vessels, a sparse pad of loose FCT cushioning the endothelium, an internal elastic lamina: condensed sheet of elastic tissue (more developed in arteries)

79
Q

Describe the tunica media

A

Smooth muscle, variable content of connective tissue fibres, thickness proportional to vessel diameter and blood pressure. Much thicker in arteries than veins

80
Q

Describe the tunica adventitia

A

Loose FCT (high collagen, variable elastin), contains vasa vasorum (vessels of the vessel) in larger vessels. Lymphatics and autonomic nerves also found in this region. Thicker in veins (limit extent of capacitance)

81
Q

What does IEL stand for

A

Internal elastic lamina

82
Q

What wall of the blood vessel is the IEL a part of

A

Tunica intima

83
Q

How is pulsatile flow dampened into vessels

A

Elastic walls

84
Q

What is an approximate healthy blood pressure

A

120/80 mmHg

85
Q

What are the arteriole’s function

A

Resistance vessels of the circulation: determine blood pressure

86
Q

What is the function of the capillaries

A

Exchange between blood and tissues

87
Q

What is the function of the venules

A

Start of the drainage system

88
Q

What are the main features of veins

A

Low pressure, large volume, unidirectional flow, capacitance vessels

89
Q

What is a vascular bundle

A

Group of veins, arteries and nerves (run along similar pathways)

90
Q

How do veins ensure unidirectional flow

A

Valves, tone of surrounding tissue (vein “flanked” by skeletal muscle)

91
Q

What are the main features of capillary beds

A

Very thin walls, large CSA, slow and smooth blood flow, made of endothelial cells welded to themselves to form tube

92
Q

What are precapillary sphincters

A

Rings of smooth muscle that constrict to stop blood running into side branches of capillary beds

93
Q

What is shunting

A

The contraction of precapillary sphincters to move blood directly from arterioles to venules

94
Q

What are continuous capillaries

A

Tightly welded endothelial cells, continuous basement membrane

95
Q

What are fenestrated capillaries

A

Endothelial cells with fenestrations, continuous basement membrane

96
Q

What are sinusoidal capillaries

A

Much wider (not primarily focussed on passive exchange) capillaries with large fenestrations and incomplete basement membrane.

97
Q

How do continuous capillaries exchange

A

Diffusion through membrane (lipid soluble substances), movement through intercellular clefts (water soluble substances), transport via vesicles (large substances)

98
Q

How do fenestrated and sinusoidal capillaries exchange

A

Diffusion through membrane (lipid soluble substances), movement through intercellular clefts (water soluble substances), transport via vesicles (large substances), movement through fenestrations (water soluble substances)

99
Q

What are the functions of the lymph vascular system

A

An open entry drainage system: drains excess tissue fluid and plasma proteins, filters foreign material, screens lymph for foreign antigens, and absorbs fat from intestine

100
Q

Describe the structure of the lymphatic system

A

Lymphatic vessels: large, blind ending capillaries

101
Q

What do lacteals (special group of lymphatic vessels from small intestine) do

A

Drain fat laden lymph into collecting vessel called cisterna chyli (milk jug) (swelling of thoracic duct)

102
Q

How does exchange occur across lymph vessels

A

Between endothelial cells, no tight connections

103
Q

Features of lymph vessels

A

Thinnest walls, no RBCs, valves

104
Q

Lymph node structure

A

Many afferent lymphatics, one efferent. Bathe immune cells for immune surveillance

105
Q

Metastasis meaning

A

Movement of primary tumour to form secondary tumour

106
Q

Where are lymph vessels

A

Wherever there are capillary beds there will be lymphatics

107
Q

What are some examples of lymph nodes (locations)

A

Cervical (neck), axillary (armpits), inguinal (inner hip)

108
Q

What are arteries

A

Blood vessels with blood flowing away from the heart

109
Q

What are veins

A

Blood vessels with blood flowing toward the heart

110
Q

What are the thick and thin filaments in a myofibril

A

Myosin: thick, actin: thin

111
Q

How can the force of contraction be increased?

A

Stimulate cells to release more calcium = more cross bridges

112
Q

How does cardiac contraction end

A

Ca2+ pumped back into sarcoplasmic reticulum by SERCA

113
Q

What are the phases of the cardiac cycle

A

Atrial systole, atrial diastole, ventricular systole (isovolumetric contraction, ventricular ejection), ventricular diastole (isovolumetric relaxation, late ventricular diastole)

114
Q

Atrial and ventricular systole can be described as

A

Mutually exclusive

115
Q

The heart spends the most time in

A

Diastole

116
Q

What is the lubb sound

A

AV valves snapping shut to prevent backward movement of blood from ventricles to atria (semilunar valves closed)

117
Q

What is the dupp sound

A

Semilunar valves snapping shut after ventricular ejection

118
Q

What is the longest phase of the cardiac cycle

A

Passive filling of atria and ventricles

119
Q

How does the systemic circuit blood pressure compare to the pulmonary circuit

A

Much higher

120
Q

What is systolic blood pressure

A

Highest point on a trace (~120mmHg)

121
Q

What is diastolic blood pressure

A

Lowest point on a trace (~80mmHg)

122
Q

What is pulse pressure

A

The difference between the highest and lowest points on a blood pressure trace

123
Q

What is mean pressure

A

The average blood pressure across the full cycle (below mid point as heart spends more time in diastole)

124
Q

What is hypertension

A

High blood pressure, can be life threatening over time

125
Q

What is hypotension

A

Low blood pressure, life threatening immediately

126
Q

Why do conduction cells have actin and myosin pushed to the periphery

A

To make room for glycogen and mitochondria

127
Q

Where does the SA node transmit signals to

A

RA, LA and AV node

128
Q

What is the interatrial bundle

A

Bundle of conduction cells from SA node, along RA to LA

129
Q

What is quiescence

A

Passive refilling of heart with blood

130
Q

What is the order of de and repolarisation of parts of the heart

A

Atria depolarise, atria repolarise, ventricles depolarise (interventricular septum, then walls), ventricles repolarise

131
Q

What does an ECG measure

A

Changes in voltage (directionality of trace irrelevant)

132
Q

What is the P wave

A

Atrial depolarisation

133
Q

What is the QRS complex

A

Ventricular depolarisation and atrial repolarisation (tall, skinny peak as happens fast)

134
Q

What is the T wave

A

Ventricular repolarisation

135
Q

How do depolarisation and repolarisation relate to contraction and relaxation

A

Electrical event (first!!) causes mechanical event

136
Q

How does MAP relate to cardiac output and resistance

A

MAP = CO * TPR

137
Q

How is CO determined

A

CO = SV * HR (strength * speed)

138
Q

How is blood pressure coordinated

A

Within the brainstem: afferent input from CNS and periphery

139
Q

Where are baroreceptors located

A

Aortic arch, carotid artery, embedded within walls

140
Q

How do baroreceptors work

A

Change frequency of their signal to provide information on blood pressure

141
Q

What are baroreceptors

A

Stretch receptors

142
Q

What is the body’s reaction to the tilt test

A

Stroke volume falls (work against gravity) hence CO falls, HR increases to combat this. TPR increases to help combat fall in blood pressure

143
Q

How is flow related to pressure and resistance

A

Q = ΔP / R
You don’t have control of flow unless you have a high pressure

144
Q

How does cardiac output directed to the heart change during exercise?
(Divergent flow depending on metabolic needs)

A

Increases

145
Q

How does cardiac output directed to the brain change during exercise?
(Divergent flow depending on metabolic needs)

A

No change

146
Q

How does cardiac output directed to the kidneys change during exercise?
(Divergent flow depending on metabolic needs)

A

Decreases

147
Q

How does cardiac output directed to the abdominal viscera change during exercise?
(Divergent flow depending on metabolic needs)

A

Decreases

148
Q

How does cardiac output directed to the skin change during exercise?
(Divergent flow depending on metabolic needs)

A

Increases

149
Q

How does cardiac output directed to other tissues change during exercise?
(Divergent flow depending on metabolic needs)

A

Decreases

150
Q

How does cardiac output directed to skeletal muscle change during exercise?
(Divergent flow depending on metabolic needs)

A

Increases

151
Q

How is peripheral resistance changed

A

Precapillary sphincters

152
Q

How are resistance and radius of blood vessel related

A

R = 1/r^4 : Small change in radius = huge change in resistance (*16)

153
Q

Where do we store extra blood in our body (can lose some blood and be fine)

A

Veins: capacitance vessels

154
Q

What is compliance

A

The extent to which a vessel allows deformation in response to an applied force

155
Q

What is the formula for compliance

A

ΔV / ΔP = compliance

156
Q

What is venous pooling

A

Movement of blood down body to accumulate near feet due to gravity and low pressure of veins

157
Q

What counteracts venous pooling

A

Valves and tone of surrounding tissue (especially skeletal muscle as it can alter its tensile state)

158
Q

What is starling’s law of the heart
(Increased venous return means increased stroke volume)

A

The more stretched muscle fibres are before a contraction, the stronger the contraction will be: i.e the heart will contract more strongly if there’s more blood in the heart

159
Q

Which blood vessel has the thickest tunica media

A

Artery

160
Q

Which blood vessel has the thickest tunica adventitia and why

A

Vein, to limit capacitance capability

161
Q

What is the R-R interval

A

Time between two R wave peaks (used to determine heart rate)

162
Q

What is the Q-T interval

A

Time between the start of Q wave to end of T wave

163
Q

What is the P-R interval

A

Time from start of P wave to start of Q wave

164
Q

What are the three general functions of blood

A

Transport, immune response and coagulation

165
Q

What does blood transport

A

Good stuff out, bad stuff in. Oxygen, water, nutrients, carbon dioxide, waste products, ions, heat, hormones, immune cells, coagulation factors

166
Q

How does coagulation happen

A

Via platelets and coagulation factors in plasma

167
Q

What is blood composed of

A

55% plasma, 45% formed elements

168
Q

What is plasma composed of

A

Plasma proteins, other solutes, water

169
Q

What are formed elements composed of

A

Platelets, white blood cells, red blood cells

170
Q

What is hematopoiesis

A

Formation of blood cells

171
Q

Where does hematopoiesis occur

A

In red bone marrow, which contains hemocytoblasts

172
Q

Why are red blood cells biconcave

A

Large SA:V ratio, allow efficient diffusion of gases, flexibility for movement through narrow capillaries

173
Q

What are the functions of RBCs

A

Contain large ammounts of hemoglobin for transporting oxygen (need iron to bind oxygen)

174
Q

What is hematocrit (or packed cell volume, PCV)

A

The fraction of blood occupied by red cells

175
Q

What is anemia

A

Low levels of hematocrit, often associated with iron deficiency

176
Q

What is polycythemia

A

High levels of hematocrit resulting in very viscous blood, heart has to work very hard, vessels put under a lot of strain

177
Q

What is erythropoiesis

A

Generation of red blood cells

178
Q

What is erythropoietin (EPO)

A

Something which stimulates erythropoiesis

179
Q

What hormone augments erythropoiesis

A

Testosterone

180
Q

Which layer of the heart wall is vascular

A

Epicardium

HUBS192 (6 decks)

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