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Cardiovacular > Cardio Vascular > Flashcards

Cardio Vascular Flashcards

1
Q

What cardio vascular system consist of

A

Heart – the pump
Blood vessels – the distribution/conduction network
Blood – the ‘cargo’; oxygen, nutrients, CO2, waste
Blood remains within the vessels thus, it is called a closed circulatory system; it does not come in direct contact with tissues

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2
Q

Blood vessel

A

Higher blood pressure. faster delivery of oxygen & nutrients

Responsive to change and directing blood to where it is needed by constriction & dilation of vessels

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3
Q

Double circulation

A

blood passes through the heart twice on each circuit / circulation around the body
Pulmonary - oxygenation / carbon dioxide removal
Systemic - distribution; gas exchange, nutrients, waste removal

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4
Q

Heart

A

Blood carried away from heart by arteries
Return by veins via capillaries.
Arterial circulation at higher than venous

Blood pressure decreases further from heart due to friction from blood vessel walls (peripheral resistance)

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5
Q

Arteries

A

Arteries have muscular walls to maintain / regulate blood flow

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6
Q

Capillary vessels

A

Capillary vessels also reduce pressure due to peripheral resistance
and due to loss of ‘tissue fluid’ (exchange of gases, nutrients etc)

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7
Q

Vein

A

carry blood at lowest pressure and have valves to prevent
backflow

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8
Q

Pulmonary circulation

A

Is at a lower pressure them systemic circulation
Ensure effective gas exchange and notdamage pulmonary capillaries

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9
Q

What can be linked to normal health system function

A

The structure of the component that comprise the system

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10
Q

What is the key of understanding card vascular system

A

Understanding the fundamental structure of specific cells
The specialized anatomy
Ability to respond to chemical and physical signal

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11
Q

Pericardium:

A

fibrous and serous layers
Epicardium

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12
Q

Myocardium

A

myocytes (plus other cells)

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13
Q

Endocardium

A

endothelium-like (blood vessel lining)
4 chambers
Atrium x2 (left & right)
Ventricle x2 (left & right); left thicker wall
Valves

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14
Q

Heart parts

A

Atrioventricular (separate atria/ventricles)
Tricuspid and mitral (bicuspid)
Semilunar (ventricles - blood vessels leaving heart)
Aortic and pulmonary
Aorta, pulmonary artery, vena cava, pulmonary vein
Right side: atrium - vena cava; ventricle - pulmonary artery
Left side: atrium - pulmonary vein; ventricle - aorta
Coronary arteries and veins

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15
Q

Heart muscles consist of wrest

A

Cardiomyocytes or myocardial fibers

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16
Q

What fibers made from

A

1 individual cells joined end to end by specialized junctions intercalated discs

These ensure tight interactions and mediate electrical coupling
Fibres often branch to extend the interconnections
Each cell has a single central nucleus and an abundance of mitochondria

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17
Q

Cells show repeating patterns of striation which are ——&——

A

Actin myosin filament plus several other proteins

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18
Q

How filament facilitates concentration

A

By along each other

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19
Q

Concentration depends on what

A

Calcium signaling

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20
Q

Contractions are synchronized via the intercalated discs and junections between them; this ensures that individual cardiomyocytes work together and the cardiac muscle functions as a syncytium

A
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21
Q

Sarcomere

A

is the unit of muscle that contracts; many sarcomeres per cell arranged in series

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22
Q

Filament

A

Thin Composed protein actin
Thick filament composed of protein myosin

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23
Q

Z-lines

A

demark each sarcomere (thin filaments connect to the Z-line)

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24
Q

M-Line

A

defines the middle of each sarcomere and also the middle of the thick filament

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25
Q

I band

A

is a zone around the Z-lines and includes part of two separate sarcomeres. The I band only has thin filaments.

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26
Q

H band

A

is a zone around the M-line.

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27
Q

A band

A

is a zone that demarks the length of thick filaments

28
Q

There are several different regions/structures within the heart comprised of cells that are similar to cardiomyocytes

A

Sinoatrial and atrioventricular nodes
The bundle of His and Purkinje fibres

29
Q

Intrinsic waves of excitation (depolarization) spread from the SA node to the AV node and then to myocytes via other parts of the conduction system; the bundle of His and Purkinje fibres

A

While capable of functioning independently, the SA is innervated (as are most parts of the heart and circulatory system) by autonomic nerves and SA activity can be controlled by autonomic nervous system signals

30
Q

Nervous system

A

comprises the central and peripheral nervous systems (CNS and PNS)

31
Q

PNS divided into

A

PNS divided into somatic and autonomic nervous systems
Somatic system controls conscious/subconscious actions
Autonomic system controls actions not normally under voluntary or conscious control (i.e. heart)

32
Q

The autonomic system is anatomically and functionally divided into

A

sympathetic and parasympathetic components

33
Q

Sympathetic system

A

stimulates the heart rate

Stress, exercise, excitement
Norepinephrine (adrenoceptors)

34
Q

Parasympathetic system

A

relaxes/slows the heart
PNS dominates autonomic stimulation of heart
Acetylcholine (muscarinic receptors)

35
Q

Hormones

A

local chemical mediators also contribute to control of myocyte activity

36
Q

Cardiac cycle

A

refers to all events associated with blood flow through the heart

37
Q

Systole –

A

contraction of heart muscle

38
Q

Diastole

A

relaxation of heart muscle

39
Q

Ventricular filling

A

mid-to-late diastole

Heart blood pressure is low as blood enters atria (passively) and flows into ventricles - atrioventricular valves are open, then atrial systole occurs

40
Q

Ventricular systole (contraction)

A

Atria relax and rising ventricular pressure results in closing of atrioventricular valves
Ventricular contraction and ejection phase opens the semilunar valves

41
Q

Heart sounds (‘lub-dup’)

A

Heart sounds (‘lub-dup’) closing of heart valves
First sound occurs as atrioventricular valves close and signifies beginning of systole (contraction)
Second sound occurs when semilunar valves close at the beginning of ventricular diastole (relaxation)

42
Q

The action potentials generated by myocytes contracting can be detected and monitored by what

A

electrocardiogram (ECG)

43
Q

Action potentials are the result of

A

movement of ions (Na+, K+, Ca2+) back and forth cross the myocyte cell membrane (sarcolemma)

44
Q

Excitation-contraction coupling represents what

A

the process by which an electrical action potential leads to contraction of cardiac muscle cells. This is achieved by converting a chemical signal into mechanical energy via the action of contractile proteins

45
Q

ECG trace can provide what

A

details on the function of the heart and thus evidence of heart damage/disease

P wave corresponds to depolarization of SA node
QRS complex corresponds to ventricular depolarization
T wave corresponds to ventricular repolarization

46
Q

Stroke volume

A

is defined as the volume of blood discharged from the ventricle with each contraction. An average adult’s stroke volume is relatively constant, at about ~70 mL.

47
Q

The cardiac output

A

is defined as the volume discharged from the ventricle per minute. It is calculated by multiplying the stroke volume by the heart rate, in beats per minute.

48
Q

‘Preload’ and ‘afterload’ are also key determinants

A
49
Q

The structure/histology of the arterial, capillary and venous systems reflects their ——-

A

specialized functions
Dependent on their diameter and histology of their walls

50
Q

The structure/histology of the arterial, capillary and venous systems reflects their ——-

A

specialized functions
Dependent on their diameter and histology of their walls

51
Q

Similarity and differences between veins and arteries Capillaries

A

1 All have an inner lumen lined with a single layer of endothelial cells
2 Arteries and veins have the same structural 3 layers, but vary in amount and organization, relating to function
3 Capillaries comprise of a single layer of endothelial cells; lack smooth muscle layer, but have pericytes located at intervals along the outer circumference

52
Q

Endothelial cells

A

Regulates interactions with blood and movement of molecules into and out of the circulation

53
Q

3 layer veins and arteries

A

Tunica intima (endothelium)
Tunica media (smooth muscle, plus elastin)
Tunica adventitia (connective tissue, small blood vessels, nerve fibres)
Internal (intima-media) and external (media- adventitia) elastic lamina

54
Q

Arteries

A

Large arteries like the aorta have a thick tunica media comprised of numerous fenestrated layers of elastin interspersed with smooth muscle cells

Elastin helps these vessels to distend / recoil to deal with the high pressure as blood leaves the heart and dampen the pressure wave

Muscular arteries have several layers of smooth muscle arranged spirally, with some elastin within the tunica media

Arterioles have just a one or two layers of smooth muscle and smaller ones have a discontinuous smooth muscle cells

The smaller muscular arteries and arterioles are described as resistance vessels (have highest wall/lumen ratio) and contribute to vascular resistance or tone i.e. control of flow of blood to particular areas / tissues (degree of constriction of smooth muscle within the wall of the vessel)

55
Q

Vein

A

Large veins have a thick intima, relatively thin media and a thick adventitia containing elastic fibres and some smooth muscle

Small-medium sized veins have a well-developed adventitia and thin media with 2-3 layers of muscle. Also have valves, particularly in the limbs to prevent backflow of blood due to lower blood pressure in these vessels

Venules have a thin wall with associated pericytes and smooth muscle cells in larger venules

The unidirectional flow in veins is assisted by the presence of valves, but also by being compressed by neighbouring tissues i.e. positioning of the veins adjacent to an artery or within /between skeletal muscle tissues

Veins are flexible and contain most of the total blood volume in the body and have some vascular tone i.e. can constrict – capacitance vessels

56
Q

Capillaries

A

Found at the terminal end of arterioles connecting with venules to form a capillary bed that extends through tissues
Small arterioles and their smooth muscle can serve as sphincters to regulate flow into the capillary bed

Tubes of endothelium (single layer of endothelial cells) and often have pericytes (contractile muscle-like cells) distributed around them

Three different histological features relating to the interactions between the endothelial cells and particular tissues
Continuous – cells joined together by tight junctions/interactions (most common type)
Fenestrated – small gaps or pores interrupting the tight interactions between cells (glomerulus, parts of gut, endocrine
Sinusoidal – larger gaps between cells or discontinuities in the vessel (liver, spleen, bone marrow)

These histological features, together with slower blood flow and a large overall surface area helps facilitate movement and exchange of diffusible substances/molecules between the blood and the surrounding tissue environment

57
Q

Permeability of the capillary wall is selective with respect of what

A

size and properties of the molecules to be exchanged

58
Q

What can move across endothelial cell membrane

A

Gases and small molecules

59
Q

How larger molecules and water transported

A

selectively transported via tight junctions, fenestrations or membrane vesicles

60
Q

What can facilitate movement exchange

A

Differentials in hydrostatic and colloidal osmotic or oncotic pressures across the capillary bed

Net movement from blood to tissue near the arteriole end
Net movement from tissue to blood at the venule end

61
Q

Lymphatic vessels/system also help return tissue fluid to the circulation

A
62
Q

Arrhythmias

A

abnormalities in heart rate or rhythm, such as fibrillation of atria or ventricles
Often various causes, but linked to abnormal control of excitation/depolarization
Often linked to cardiac arrest i.e. the heart stops beating

63
Q

Hypertension

A

consistently elevated resting blood pressure
Stresses the CVS and can damage blood vessels contributing to other conditions

64
Q

Myocardial ischaemia/infarction

A

reduced flow of blood in coronary arteries
Blocking of arteries due to atherosclerosis
Angina and heart attacks – heart damage and potentially cardiac arrest

65
Q

Heart failure

A

heart unable to produce/maintain an adequate output to perfuse the organs/tissues
Several mechanisms, which might include some of those mentioned above

66
Q

Hypertension

A

Treatments

Lifestyle e.g. diet, smoking etc

Diuretics – thiazides
Reduce blood volume, increase sodium and decrease potassium excretion

Sympathetic nervous regulators – b1 antagonists, a-1 antagonists
Reduce heart rate, stroke volume
Reduce vasoconstriction

Calcium channel blockers
Reduce heart rate, stroke volume
Reduce vasoconstriction, stimulate vasodilation

Vasoactive factors – block vasoconstrictor activity or directly stimulate vasodilation
ACE inhibitors block conversion of angiotensin I to angiotensin II
Angiotenin II receptor antagonists
NO-releasing vasodilators

67
Q

Treatments for angina and IHD

A

Cardiovacular (11 decks)

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