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z PP1: Intro Physiology > Cardio Exam 4 > Flashcards

Cardio Exam 4 Flashcards

1
Q

What do these parts do in the cardiovascular system: heart, blood vessels, blood, oxygenated and deoxygenated blood

A

heart: pump blood
blood vessels: plumbing
blood: carrier vehicle
oxygenated blood -> transport O2 and nutrients
deoxygenated blood -> remove CO2 and other waste products

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2
Q

Location of the heart

A

Between two hard surfaces which is good for CPR
Size of your fist

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3
Q

What are the four chambers of the heart

A

Right upper chamber -> right atrium
Left upper chamber -> left atrium
Right lower chamber -> right ventricle
Left lower chamber -> left ventricle

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4
Q

What is the main function of the upper and lower chambers

A

Upper chambers receive blood and pass it to lower chambers
Lower chambers eject blood from heart

Normally no blood flow between two atria or two ventricles

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5
Q

How does the right atrium receive and pass blood

A

Receives deoxygenated blood from superior vena cava, inferior vena cava, and coronary circulation

Passes venous blood to right ventricle

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6
Q

How does the right ventricle send blood

A

Sends deoxygenated blood to the lungs for oxygenation

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7
Q

Blood leaves the right ventricle for the lungs

A

Blood leaves via arteries
These are the only arteries that carry deoxygenated blood (only exception)

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8
Q

Blood leaves the heart using the __________ system

A

arterial

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9
Q

Deoxygenated blood LEAVES right side if heart through what,

A

superior vena cava: upper
inferior vena cava: lower
coronary circulation: blood from heart as organ
right pulmonary arteries: pulmonary arteries and capillaries of lung

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10
Q

Oxygenated blood LEAVES left side of heart

A

Ascending: head and upper limbs
Descending: trunk and lower limbs

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11
Q

Oxygenated blood enters left atrium and then left ventricle: left atrium receive and pass blood

A

Blood from lungs enter atrium via left & right pulmonary veins
Veins carry oxygenated blood (only exception to veins)

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12
Q

Oxygenated blood leaves the left ventricle for organs

A

Leaves via aorta (large artery)
Thicker wall than left side of heart (transport farther so needs to be thicker)

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13
Q

Oxygenated blood flow THROUGH left side of heart

A

Ascending aorta, descending aorta, left pulmonary arteries

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14
Q

Chambers fill with blood during diastole

A

Chambers are relaxed

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15
Q

Chambers pump blood during systole

A

Chambers contract
Eject blood
-right ventricle blood goes to pulmonary artery
-left ventricle blood goes to aorta

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16
Q

Where are the outflow (semilunar) valve and atrioventricular valve located

A

outflow (semilunar): entrance leading to pulmonary or systemic circulation
atrioventricular: entrance to ventricles

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17
Q

Atrioventricular valves: tricuspid and mitral (bicuspid)
How does the valve open and close

A

Right: tricuspid valve -> between right atrium and right ventricle
Left: mitral (bicuspid) valve -> between left atrium and left ventricle

Prevents backflow of blood
Atrium contracts and ventricle relaxes -> valve opens
Increased pressure in ventricle closes the valve

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18
Q

How does the atrioventricular valve open and close

A

Atrium contracts and ventricle relaxes -> valve opens
Increased pressure in ventricle closes the valve

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19
Q

Outflow (semilunar) valve: pulmonary and aortic

A

Pulmonary (right):
-between ventricles and pulmonary artery
-opens pulmonary trunk
-prevents backflow of blood into right ventricle

Aortic (left)
-between left ventricle and aorta
-opens into aortic arch
-prevents backflow of blood into left ventricle

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20
Q

How does the outflow (semilunar) valve open and close

A

left ventricle contracts -> mitral valve closes -> arotic valve opens -> blood flow into aorta

Ventricle relaxes -> blood flow back from artery -> valve closes

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21
Q

What is stenosis

A

Narrowing of the heart valve opening -> restriction of blood flow
cause: genetic, rheumatic fever
treatment: valve repair or valve replacement

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22
Q

What is mitral valve prolapse

A

Backflow of blood from the left ventricle into the left atrium
Cause: genetic, rheumatic fever, infection, age
Treatment: valve repair or replacement

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23
Q

What are the three circulatory processes in the body

A

Pulmonary, Coronary, Systemic Circuit

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24
Q

The right-sided pulmonary circulation

A

Deoxygenated blood is pumped to the lung to be oxygenated -> oxygenated blood returns to the heart

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25
Q

The left-sided systemic circulation

A

Oxygenated blood is pumped from the left side of the heart to tissues and cells in the body

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26
Q

What are the steps of the pulmonary and systemic circulation starting at right atrium

A

Right atrium
Right ventricle
Pulmonary trunk and arteries
Pulmonary capillaries lose CO2 gain O2
Pulmonary veins
Left atrium
Left ventricle
Aorta
Systemic capillaries lose O2 gain CO2
Superior vena cave
Inferior vena cava
Coronary sinus

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27
Q

Coronary Arteries

A

-Deliver oxygenated blood and nutrients to the heart muscle (myocardium)
-Blood flows from aorta to the right and left coronary arteries -> into arterioles and capillaries
—-During ventricular diastole (relaxation)

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28
Q

Coronary Veins

A

-Drain the deoxygenated blood away from the myocardium
-Collect deoxygenated blood into the coronary sinus

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29
Q

Myocardial Ischemia

A

-Heart muscle is not getting enough oxygenated blood
Cause: Narrowed coronary arteries
Risks: age, smoking, high cholesterol levels, hypertension

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30
Q

Which structure in the atria and ventricles does the blood pumping action

A

Muscle

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31
Q

What are the three layers of the heart

A

Epicardium:
Protective layer

Myocardium:
Cardiac Muscle, pumping action, 95% of heart wall

Endocardium:
smooth lining for heart chambers, minimizes the surface friction when blood passes through the heart

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32
Q

Muscle in atria and ventricles

A

Muscle cells known cardiomyocytes (need to be activated before contraction)

Conduction cells aka Pacemaker cells activate cardiomyocytes

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33
Q

What are the two systems working together for the heart to function

A

Conduction system -> pacemaker cells
Contraction system -> cardiomyocytes

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34
Q

What are the four different stages in cardiac conduction and contraction

A

1: Cell #1 from conduction system spread a stimulus across the atrium

2: atrium contracts and cells #2 from the conduction system picks up stimulus, cells #2 send stimulus down to Cell #3 from conduction system

3: Cells #3 from conduction system move the signal down to Cells #4 from conduction system

4: Cells #4 from the conduction system spread stimulus across ventricle, ventricles contract

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35
Q

What cells set the heartbeat, initiate/distribute electrical impulses, activate muscle cells, and do not contract

A

Cells in the conduction system (Sinoatrial node, atrioventricular node, atrioventricular bundle or Bundle of His, Purkinje fibers)

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36
Q

Sinoatrial node (SA)

A

Spontaneously depolarize most frequently
Known as natural pacemaker cells
Do not have stable resting membrane potential

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37
Q

Artioventrucular node (AV)

A

Specialized cells at the junction between atria and ventricles
Signal has a short delay in AV node

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38
Q

Artioventricular bundle (AV) or bundle of His

A

Conducts impulses from the atria to the ventricles
Conducts impulses through the interventricular septum
Right and left branches

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39
Q

Purkinje fibers

A

Distribute impulse through the ventricles

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40
Q

Pacemaker cells generate action potentials at different rates. What is the fastest cell

A

SA node (70-80)

*Like a train fastest needs to be first

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41
Q

What are the three phases of the action potential of pacemaker cells in the conduction system

A

Phase 4 - spontaneous depolarization
Phase 0 - Depolarization
Phase 3 - Reploarization
*they have unstable resting membrane potentials

42
Q

Phase 4 spontaneous depolarization what are the three channels that open

A

Slow Na+ channels open (-60mv) -> Na+ in -> If (funny) -> activated by hyperpolarization (K+ efflux)

T-Type (transient) Ca2+ channels open (-55 to -50) further depolarization

L-type (long lasting) Ca2+ channels open (-40 mv) further depolarization

43
Q

Phase 0 depolarization in pacemaker cells

A

Depolarization -> action potential
Ca2+ in
L-type Ca2+ channels open
phase is activated at threshold

44
Q

Phase 3 repolarization in pacemaker cells

A

Open K+ channels
Inactivate L-type Ca2+ channels
Membrane potential becomes negative
*ion concentrations need to go back to initial concentrations

45
Q

Altered normal automaticity

A

Occur in SA node, AV node, His-Purkinje system
Altered by ANS
-parasympathetic stimulation -> lower heart rate
-sympathetic stimulation -> increases heart rate

46
Q

Regulation of Cardiac Conduction: ANS

A

Phase 4 slope dictates the rate of depolarization and the heart rate

Acetylcholine -> decreases heart rate
NE and E -> increases heart rate

47
Q

Parasympathetic effects in cardiac conduction

A

-Decrease rate of spontaneous depolarization from SA node
-Activate K+ channels by beta-gamma subunits
-Increase in repolarizing K+ current (hyperpolarization, longer to reach threshold)
-Decreases heart rate

48
Q

Sympathetic Stimulation effects in cardiac conduction

A

-Increases phase 4 slope (less time to reach threshold)
-Pacemaker rate increases, K+ current decreases
-Phosphorylation of L-type Ca2+ & slow Na+ channels
-Increase activity of both channels
-Pacemaker cells depolarize faster

49
Q

Steps in how the node initiates action potential in cardiac conduction and contraction

A
  1. SA node activity and atrial activation begin
  2. Stimulus spreads across the atrium and reaches the AV node
  3. Impulse travels through AV bundle to Purkinje fibers & heart apex
  4. Purkinje fibers distribute impulse to ventricular myocardium
    Atrial contraction is completed and ventricular begins - blood pumped out.
50
Q

Action potential in contractile muscle fibers

A

-Action potential initiated by SA node travels along conduction system and excite the atrial and ventricular contractile muscle cells or cardiomyocytes

-Muscle cells get activated producing an action potential -> muscle contraction

51
Q

What are the 5 stages in cardiomyocytes action potential

A

Phase 0: Depolarzation
Phase 1: Transient Repolarization
Phase 2: Plateau
Phase 3: Repolarization
Phase 4: Resting membrane potential

*cardiomyocytes have stable resting membrane potential

52
Q

What do Phase 0, 1, and 2 do for action potential in cardiomyocytes

A

Phase 0: Na+ into cell, producing FAST channels
Phase 1: K+ out by opening some transient K+ channels
Phase 2: Plateau: Ca2+ enters, at same rate K+ leaves

53
Q

What do Phase 3 and 4 do for action potential in cardiomyocytes

A

Phase 3: K+ out (Ca2+ and K+ transient channels close)
Phase 4: Resting membrane channel reestablished

54
Q

Contraction and Refractory period in cardiomyocytes

A

Contraction: Electrical activity (action potential) leads to the mechanical response (contraction) - needs Ca2+ to contract

Refractory Period: second contraction can not occur (lasts longer than contraction itself, only contracts when relaxed)

55
Q

Where are contractile cells found and how are they activated

A

Found in atria and ventricles
Activated by action potential generated by pacemaker cells

56
Q

Coordinating Contractions: Atrial Contraction

A

Atrial muscle contracts as a single unit to force blood down into the ventricles

Action Potential is required to initiate contraction
Contract as a unit

57
Q

Coordinating Contractions: Ventricular Ejection

A

Ventricular muscle starts contracting at the apex, squeezing blood upward to exit the outflow tracts

58
Q

Cardiac Muscle Myocardium: Intercalated disc and function

A

Intercalated Disc: connects ends of cardiac fibers to neighbor fibrin
Function: Electrical connection between cells, contains desmosomes and gap junctions

59
Q

How is cardiac muscle like and unlike skeletal muscle

A

Like: is striated
Unlike: fibers are shorter and the fibers branch

60
Q

Desmosomes in cardiac muscle

A

Hold muscle fibers together
Molecular complexes -> cell-to-cell adhesion, allow the force created in one cell to be transmitted to adjacent cells

61
Q

Gap Junctions in cardiac muscle

A

-Intercellular channels
-Allow direct movement of ions from cell to cell
-Muscle action potential is conducted from one muscle fiber to other
-Allow for atrial or ventricular myocardium to contract as a single unit

62
Q

What is an electrocardiogram

A

A recording of electrical events in the heart, obtained by electrodes in body locations (looks at action potentials)

63
Q

ECG Waves and Traces

A

Pattern has three distinct waves in each heartbeat
First half is related to the atria and the second half is ventricles

64
Q

What is the P wave, QRS complex, and T wave

A

P wave: atrial depolarization (small wave because mass is smaller than ventricle)
QRS: Ventricular depolarization
T wave: ventricular repolarization

No waves for SA (small) depolarization and atrial repolarization (masked by QRS)

65
Q

What is the PR interval, PR segment, ST segment, and QT interval

A

PR interval: Time between onset of atrial depolarization and ventricular depolarization
PR segment: AV nodal delay to allow filling of ventricles
ST segment: Ventricles are depolarized (ventricle contract)
QT Interval: Time from the beginning of ventricular depolarization to the end of ventricular repolarization

PR and QT intervals shorten with increased heart rate

66
Q

What are the steps of correlation of ECG with Cardiac Cycle

A

1: Depolarization of atrial contractile fibers produces P wave
2: Atrial systole (contraction)
3: Depolarization of ventricular contractile fibers produces QRS complex
4: Ventricular Systole (contraction)
5: Repolarization of ventricular contractile fibers produces T wave
6: Ventricular diastole (relaxation)

67
Q

What is EDV and ESV

A

End-diastolic Volume: amount of blood in a ventricle at the end of ventricular diastole
End-systolic Volume: amount of blood that remains in the ventricle at the end of systole

68
Q

What is SV

A

Stroke volume: Volume ejected from left and right ventricle every beat

Mostly associated with left side of heart
Blood ejected by the left ventricle in one contraction

69
Q

Cardiac Output (CO)

A

Volume ejected from left ventricle into the aorta or from the right ventricle into the pulmonary trunk each minute

CO = Stroke Volume * Heart Rate

70
Q

What are the two factors that can change the cardiac output

A

Stroke Volume: preload, afterload, contractility
Heart Rate: ANS, hormones from adrenal medulla

71
Q

Preload

A

Degree of ventricular stretching during ventricular diastole
Proportional to ventricular filling before contraction -> EDV

72
Q

What are the two factors in EDV

A

Filling Time: duration of ventricular diastole
Venous Return: flow of blood returned to the heart from systemic circulation

73
Q

Frank-Starling Law

A

Describes the relationship between EDV and stroke volume -> heart can change its force of contraction and stroke volume in response to changes in EDV

74
Q

Contractility

A

Myocardial contractility (inotropy) is the strength of contraction at any given preload

Increased Contractility -> increased ejection fraction -> increased stroke volume (more blood pumped out)

Decrease ESV or volume left in the ventricle after contraction

75
Q

What are the factors regulating contractility

A

Circulating hormones: E, NE, thyroid
Increasing heart rate
Sympathetic Activation: NE
Parasympathetic Inhibition: inhibit Ach
Pharmacy Drugs: Positive ionotropic drugs, stimulate B receptors

Increasing contractility is important during exercise

76
Q

Afterload: Left and Right ventricles

A

Pressure that must be overcome before a semilunar valve can open

Right Ventricle: pulmonary arterial pressure must be overcome
Left Ventricle: Aortic Arterial Pressure must be overcome (greater afterload than right)

77
Q

What happens if you increase afterload

A

Increased afterload -> increased work by the heart
Causes hypertension
Stroke volume decreases (more blood remains in the ventricles)

78
Q

Vasculature

A

Vessels taking blood from the heart (arterial system) and vessels taking blood back to the heart (venous system)

capillaries in the middle of two systems

79
Q

Tunica Interna (blood vessels)

A

Direct contact with blood, diffusion of materials

80
Q

Tunica Media (blood vessels)

A

Regulates lumen diameter by sympathetic innervation (regulate blood pressure and flow)
Elastic fibers that causes stretching
Smooth muscle

81
Q

Tunica Externa (blood vessels)

A

Anchor vessels to tissues, supply wall with nerves and tiny blood vessels

82
Q

Types of Arteries: Elastic Artery

A

AKA: conducting arteries
Large vessels
Tunica media elastic fibers, few muscle cells
propel blood while ventricles relax

83
Q

Types of Arteries: Muscular Artery

A

AKA distribution arteries
Medium sized vessels
Tunica Media Muscle cells, thick walls
Vasoconstriction and vasodilation

84
Q

Types of Arteries: Arteriole

A

Smallest
Little/no tunica externa
deliver blood to capillaries
regulate blood flow to capillaries
sympathetic nerves

85
Q

Arterioles: sympathetic control, endocrine control, pharmacological control

A

Sympathetic control: innervated by sympathetic nervous system only -> vasoconstriction

Endocrine control: E secreted by adrenal medulla causes vasoconstriction

Pharmacological control: Drugs target muscular contraction causing relaxation

*Can change size to regulate blood flow

86
Q

Capillaries

A

Smallest and most numerous of blood vessels
Connect vessels that carry and return blood
*Exchange nutrients and waste between blood and tissue cells
NOT innervated by ANS

87
Q

Venous System

A

Return blood to heart
Veins and venules have thinner and less rigid walls
Less smooth muscle and connective tissue
*Larger than arteries
*Operate at lower blood pressure
Have valves

88
Q

Function of valves in venous system

A

Folds of tunica intima forming flap cusps
Valves keep blood flowing only one direction
Prevent blood from flowing backward

89
Q

BP in Arteries and Veins

A

Pressure higher in arteries than veins
Larger arteries and veins have more BP

90
Q

What does the blood pressure numbers mean

A

Higher pressure during left ventricular contraction when aortic valve is open (120) - systolic

Lower pressure during left ventricular relaxation when aortic valve is closed (80) - diastolic

91
Q

Hypertension

A

An elevated systolic blood pressure, an elevated diastolic blood pressure, or both

92
Q

Hypotension leading to hypo-perfusion

A

Low blood pressure

Hypo-perfusion results in shock

93
Q

Factors affecting blood pressure (increasing)

A

Increase blood volume
Increase cardiac output
Increase blood viscosity
Increase Peripheral Resistance (friction between blood and wall of vessels, length and diameter)

94
Q

Regulation of blood pressure: short term and long term

A

Short Term: Reflex control, ANS, Endocrine system
Long Term: Endocrine system

95
Q

Long-Term Regulation of Blood Pressure

A

Endocrine System:
Renin-angiotenisin-aldosterone
Vasopressin (ADH) - antidiuretic hormone
Atrial natriuretic peptides
Erythropoietin (EPO)

Effects blood volume which affects pressure

96
Q

Renin-Angiotension-Aldosterone System and Vasopressin Mechanism

A

Aldosterone: Angiotension II -> Adrenal Cortex -> Increase aldosterone -> Increased Na+ and water reabosrbtion -> BP Increase

Vasopressin: ADH released from posterior pituitary -> kidney water uptake, sweat gland decrease, arterioles constrict -> Increase BP

97
Q

Natriuretic Peptide Mechanism

A

ANP (atrial natriuretic) in atria and BNP (brain type) in ventricles -> opposite system of Aldosterone system

Increase rate of kidney and decrease renin release -> decrease BP

98
Q

Erythropoietin affecting BP

A

Produced by kidney -> form RBC -> increase blood viscosity
Vasoconstriction -> increase BP

99
Q

Blood Pressure short term regulation: reflex control and endocrine system

A

Reflex Control:
Baroreceptor Reflexes - respond to stretch of blood vessels
Chemoreceptor - respond to decreased O2, high CO2, or low pH

Endocrine system:
Sympathetic Stimulation - release of E and NE from adrenal medulla

100
Q

Baroreceptor Reflexes: Results of BP change and the CV center

A

Changes in BP result in changes in vasoconstriction, heart rate, and stroke volume

CV center: decreased parasympathetic stimulation, increased sympathetic stimulation

Reflexes regulated through a negative feedback loop

101
Q

Chemoreceptor Reflex Control of BP

A

1) aortic bodies monitor O2, CO2, and pH
2) medulla oblongata monitor CO2 and pH

3) decreased blood O2 and pH, increased CO2, decrease parasympathetic system: increases heart rate, force of
contraction, and vasoconstriction

z PP1: Intro Physiology (10 decks)

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