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HUBS 192 > Cardio x2 > Flashcards

Cardio x2 Flashcards

1
Q
  • What is the heart surrounded by?
  • What secretes serous fluid into the pericardium cavity?
    • What movement does this allow?
  • What are the layers of the serous pericardium?
    • What do they line?
A
  • The heart is surrounded by a loose sac called the pericardium
  • The serous membrane secretes serous fluid into the pericardium cavity
    • Allows for smooth movement of the heart
  • The parietal layer of the serous pericardium lines the inside of the fibrous pericardium
  • The visceral layer of the serous pericardium covers the heart and forms the part of the outermost layer of the heart wall (the epicardium)
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2
Q

What are the 3 layers of the heart wall?

A
  • Epicardium
  • Myocardium (thick muscular)
  • Endocardium (inner)
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3
Q

The heart has 4 chambers

  • What are the upper 2 called?
  • What are the lower 2 called?
A
  • Upper = atria

- Lower = ventricles

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4
Q
  • Where does deoxygenated blood enter the heart?
    • Where does it carry on and pass through?
  • During ventricular contraction where does blood travel via to get to the lungs?
  • What does oxygenated blood enter the heart via?
    • Where does it enter the heart?
  • During ventricular contraction, where is blood pushed?
A
  • Deoxygenated blood enters the heart into the right atrium, and passes through the right ventricle
  • During ventricular contraction, blood passes into the pulmonary trunk, and travels via pulmonary arteries to the lungs
  • Oxygenated blood returns to the heart via pulmonary veins, emptying into the left atrium
  • During ventricular contraction, blood is pushed into the aorta
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5
Q
  • Where are the atrioventricular (AV) valves located?
  • Where is the bicuspid (mitral) valve located?
  • Where is the tricuspid valve located?
  • What is each leaflet (cusps) anchored to?
A
  • The atrioventricular valves are located between the atria and ventricles
  • The bicuspid valve is located on the left side of the heart
  • The tricuspid valve is located on the right side of the heart
  • Each leaflet is anchored to papillary muscles via chords called the chord tendinae
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6
Q
  • What are the 2 semilunar valves?

- Where are the located?

A
  • Pulmonary valve
    • Located at the entrance of the pulmonary trunk
  • Aortic valve
    • Located at the entrance of the aorta
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7
Q
  • What is the first heart sound caused by?

- What is the second heart sound caused by?

A
  • The first heart sound is caused by the AV valves closing at the start of ventricular systole
  • The second heart sound is caused by the semilunar valves closing at the start of ventricular diastole
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8
Q

Cardiac muscle is striated, and consist of many short branched cells

  • What makes up 25% of the cell?
  • What are cells connected via?
A
  • Mitochondria makes up 25% of the cell

- Cells are connected via intercalated disks (ICDs)

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9
Q
  • What makes up the intercalated disks?

- What do these allow or link?

A
  • Gap junctions
    • Allow electrochemical communication
  • Desmosomes
    • link cytokeratin to cytokeratin
  • Adhesion belts
    • link actin to actin
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10
Q
  • What carries blood away from the heart?
  • What carries blood towards the heart?
  • What are the layers of blood vessel walls?
A
  • Arteries carry blood away from the heart
  • Veins carry blood toward the heart
  • Tunica adventitia (outermost)
  • Tunica media
  • Tunica intima (innermost)
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11
Q
  • What is the tunica adventitia made up of?
    • Which is this thickest in?
  • What do larger vessels often have in this layer?
  • What is the tunica media made up of?
  • What is the tunica intima made up of?
    • What is this layer more developed in?
A
  • Tunica adventitia is made up of loose FCT
    • Thicker in veins
  • Vaso vasorum
  • Tunica media is made up of smooth muscles as well as connective tissue containing collagen & elastin
  • Tunica intima is made up simple squamous endothelium, some FCT and an internal elastic lamina IEL
    • This layer is more developed in arteries
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12
Q
  • Why do arteries need to be elastic?
  • Do veins return blood at a high or low pressure to the heart?
  • Because they can take up extra blood volume, what are they known as?
  • To ensure blood flow is unidirectional, what do veins contain?
    • What are they extensions of?
A
  • To allow the vessels to stretch (eg the aorta)
  • Veins return blood at low pressure to the heart
  • They are known as capacitance vessels
  • Veins contain valves
    • Which are extensions of the endothelium
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13
Q
  • What are the smallest blood vessels called?
  • What do these allow?
  • What are the 3 main types?
A
  • The smallest blood vessels are called capillaries
  • These allow exchange of nutrients b/w the blood & surrounding tissues
  • Continuous - Fenestrated - Sinusoidal
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14
Q
  • What does continuous capillaries allow?
    • Leaky?
    • What are the endothelial cells joined by?
  • What does the fenestrated capillaries contain?
    • Leaky?
    • Where would you find these capillaries?
  • What does the sinusoidal capillaries have?
    • What do they allow?
    • leaky?
    • Where would you find these capillaries?
A
  • Only allow limited passage of fluids & small solutes
    • These are the least leaky of the capillaries
    • Endothelial cells joined by tight junctions
  • Contain pores in the endothelium
    • leaky
    • you would find this type in the kidney
  • These have pores and few tight junctions
    • These allow large molecules or even blood cells to pass through
    • Most leaky
    • you would find this type in the liver
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15
Q
  • What blood vessel controls blood flow through capillaries?
    • What do they join?
    • What do they contain that form the precapillary sphincter
    • What does the precapillary regulate when it contracts?
A
  • Metarterioles
    • Join arterioles to capillary beds, and contain smooth muscle fibres that form precapillary sphincter that can contract to regulate blood flow
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16
Q
  • What is the first blood vessel that branches off the aorta?
  • What do they supply?
  • What branches from these arteries?
A
  • The first blood vessels which branch off the aorta are the left & right coronary arteries
    • Which supply the heart tissue
  • Branching from these arteries are the anterior & posterior inter ventricular arteries & the circumflex artery
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17
Q
  • What drains the right side of the heart?
  • What drains the left side of the heart?
  • What do both these vessels empty into?
    • where does this open?
A
  • The small cardiac vein drains the right side of the heart
  • The great cardiac vein drains the left side
  • Both vessels drain into the coronary sinus
    • Which opens into the right atrium of the heart
18
Q
  • What type of system is the lymphatic system?
  • What is this involved in the balance with?

Within the lymphatic system it contains lymph nodes
- What is the function of lymph nodes?

  • What does fluid enter the system via?
    • Permeability?
    • Why valves?
  • Where does lymph fluid drain?
A
  • This system is an open entry drainage system
  • Involved in the balance of interstitial fluid
  • Lymph nodes filter & screen lymph fluid
  • Fluid enters the system via lymphatic vessels which are highly permeable and are blind ended, with valves to ensure a oneway flow of lymph from the tissues
  • Lymph fluid drains from the right lymphatic duct into the right subclavian vein
  • And from the thoracic duct into the left subclavian vein
19
Q
  • What is the electrical excitation of the heart driven by?
    • Where is this located?

-electrical “wiring” of the heart:
6 parts of the conduction pathway

A
  • Largely driven by the activity of the Sino-atrial (SA) node
    • Located towards the top right of the right atrium

(1) Sinoatrial (SA) node (pacemaker) → interatrial bundle & fibres → (2) Left atrium & (3) Right atrium
Internodal bundle & fibres→ (4) Atrioventricular (AV) node
→ Subendocardial branches (purkinje fibres) → (5) Lateral wall & septum of right ventricle & (6) Lateral wall and septum of Left ventricle

20
Q
  • What is the normal range for resting heart rate?
  • Which part of the autonomic nervous system is dominant during rest?
  • Which part of the autonomic nervous system is dominant during exercise?
A
  • 40-100 bpm
  • Parasympathetic
  • Sympathetic
21
Q

ECG & cardiac cycle

A 
P wave
- Atrial depolarisation
- Atrial contraction
QRS complex
- Ventricular depolarisation
- Ventricular contraction
- Rise in ventricular pressure
- Ejection of blood
- Fall in ventricular volume
- Rise in aortic pressure
T wave
- Ventricular repolarisation
- Ventricular relaxation
.... fall in ventricular pressure 
.... atrioventricular valves open
... filling of the ventricles occur
22
Q

Cellular mechanism of cardiac contraction

A

(1) Increase in cytosolic Ca2+ levels
- Ca2+ induced Ca2+ release from sarcoplasmic reticulum (SR)
(2) Actin binding site revealed
- Myosin binds forming the X-bridge
(3) A/M filaments slide relative to each other
- Sarcomere shortens
- Force generated
(4) Every myocyte activated each heart beat

23
Q

Ways to increase cardiac contraction

A

(1) Every cardiomyocyte is activated during each heart beat
(2) Extent of x-bridges formed not maximized at rest…
- ↑ cytosolic Ca2+ level
- ↑ number of x-bridges formed
- ↑ force of contraction

24
Q

Cellular mechanism of cardiac relaxaition

A

(1) ATP binds to myosin
(2) Decrease in cytosolic Ca2+ levels
- Ca2+ into SR
(3) X- bridges release
- A/M separate
(4) Reduction in force
(5) All cardiac myocytes relax each beat

25
Q

Blood pressures throughout the systemic circulation

A
  • Blood pressure high in major arteries - Oscillatory
  • Blood pressure falls steeply across the “microcirculation”
    • Oscillatory nature is reduced
  • Blood pressure is very low in veins
  • Large difference in pressure (ΔP) between the arterials and venous sides
    • Creates a driving force for blood flow
26
Q

Blood pressure throughout the systemic system

- Highest to lowest

A

Left ventricle → large arteries → resistance vessels → capillaries & pulmonary artery → venules → veins

27
Q

Cardiac cycle and it’s main phases

A

Atrial systole → isovolumetric ventricular contraction → ejection → Isovolumetric ventricular relaxation → passive ventricular filling

28
Q

Features (4) of Pulsatile blood flow in arteries

A
  • Intermittent injection of blood into aorta from the left ventricle
  • Elastic arteries - stretches then recoils - storing and releasing energy
  • cycles of increase (systolic) and decrease (diastolic) pressure
  • Pulse wave is a pressure wave - travels along the arteries - ahead of the blood
29
Q

Features (2) of Electrical cells of the heart

A
  • 1%

- ‘Pale’ striated appearance - low actin and myosin

30
Q

Features (3) of contractile cells of the heart

A
  • Striated appearance
  • High actin and myosin
  • ‘working myocardial cell’
31
Q
  • What is the MABP equation?

- What happens to MABP during exercise?

A

MABP = CO x TPR

During exercise, the net effect of the regional vasoconstriction & vasodilation is a decrease in TPR. This is usually enough of a decrease to offset the increase in CO and MABP only rises very slightly

32
Q

Cardiac output is determined by?

A

Cardiac Output (L/min) = Stroke Volume (L/beat - pulse strength) x Heart Rate (beats/min - Pulse speed)

33
Q

Compliance definition & equation

A
  • The extent to which a vessel allows deformation in response to an applied force
  • ΔV/ΔP
34
Q

Compliance of Vein vs Artery

A
  • Vein = thin wall → compliant
  • Vein - Large volume = small pressure = high compliance
  • Artery = think wall → rigid
  • Artery - Small volume = large pressure = low compliance
35
Q

Features of blood transfusion from venous to arterial system

A
  • Arterial puncture
  • Loss of arterial blood
  • Life threatening fall in arterial pressure
  • Leads to vasoconstriction (under neural control)
  • Blood transfusion from venous to arterial system
36
Q

Features (4) of High vascular compliance (pooling in veins)

A
  • Venous volume (blue) is larger than arterial volume (red)
  • While supine (laying down), venous volume is uniform from head to toe
  • In the upright position, venous volume below the heart increases; whereas venous volume above the heart decreases
  • Extreme venous pooling in the legs and feet
37
Q

Features (2) of venous valve counteracting venous pooling

A
  • No valves → continuous column: heavy at bottom

- Valves → discontinuous column: more even distribution of weight

38
Q

Features (4) of ‘tone’ of surrounding tissue counteracting venous pooling

A
  • Particularly the case for skeletal muscle, because it can alter it’s tensile state
  • resting muscle tone varies between individuals
  • Muscle tone acts to stiffen the veins - makes them less compliant and prone to pooling
  • Some people prone to fainting have low muscle tone and excessive venous pooling
39
Q

How does the skeletal muscle pump affect ‘venous return’ to the heart?

A
  • Muscle relaxed = low pressure
  • Muscle contracted = high pressure
  • Muscle contraction increase venous blood flow
  • Increased venous return means increase stroke volume
40
Q

Features (3) of Starlings law of the heart

A
  • The more stretched muscle fibres are before a contraction, the stronger the contraction will be
  • ↑ in stroke volume (mL) = ↑ ventricular volume (mL) at end of diastole - increasing venous return
  • ↑ venous return means ↑ stroke volume

HUBS 192 (9 decks)

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