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Patho > cardiology > Flashcards

cardiology Flashcards

1
Q

Blood flow of the heart

A

blood low in O2, high in CO2 enters the R side of the heart through the superior and inferior vena cava -> R atrium ->Tricuspid valve ->R ventricle-> pulmonic valve->pulmonary artieries->Lungs->pulmonary veins->L atrium->mitral valve->L ventricle->aorta-> body

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2
Q

excitability.

A

The ability of the cells to respond to electrical impulses

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3
Q

automaticity

A

Cardiac cells are able to generate an impulse to contract even with no external nerve stimulus

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4
Q

Cardiac conduction

A

SA node ->AV node->bundle of His->right and left bundle branches (which divide into the left anterior and posterior bundles) ->Purkinje network of fibers

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5
Q

Sinus rhythm

A

60 to 100 beats per minute

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6
Q

where is the AV node

A

in the right atrium adjacent to the septum

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7
Q

What is the intrinsic rate of the AV node and when does it initiate impulses

A

40-60 beats per minute, does not usually initiate impulses unless the SA node begins failing

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8
Q

P

A

atrial depolarization, which triggers atrial contraction

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9
Q

QRS

A

depolarization of AV node and conduction of electrical impulse through ventricles. Ventricular contraction begins at R.

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10
Q

T

A

repolarization of ventricles.

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11
Q

P to R interval

A

time required for impulses to travel from SA node to ventricles

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12
Q

ST segment

A

complete ventricular depolarization

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13
Q

Q to T interval

A

complete electrical systole

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14
Q

Cardiac cells require what to initiate and conduct electrical signals in addition to muscular contraction

A

sodium (Na+), potassium (K+), calcium (Ca+), and chloride (Cl-) ions

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15
Q

The medulla monitors and controls cardiac function through _____, ______ and ______

A

the autonomic nervous system, endocrine system and cardiac tissue

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16
Q

chronotropic effect

A

rate of contraction

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17
Q

dromotropic effect

A

rate of electrical conduction

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18
Q

inotropic effect

A

strength of contraction

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19
Q

what do Chemoreceptors detect

A

detect chemical changes in the blood

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20
Q

baroreceptors detect and are located

A

located in the carotid arteries, detect pressure in the heart and arteries

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21
Q

What happens when homeostasis is interrupted

A

receptors begin to fire, and neurotransmitters or hormones that activate either the sympathetic nervous system (SNS) or the parasympathetic nervous system (PNS) are released

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22
Q

What happens when the sympathetic nervous system is stimulated?

A

norepinephrine along with other catecholamines such as epinephrine is released by nerve endings on the heart ->bloodstream->bind with receptors on the heart

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23
Q

where are beta 1 receptors located

A

on the conduction system and myocardium

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24
Q

where are beta 2 receptors located

A

myocardium and smooth muscles

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25
Q

Beta 1 or 2? heart rate and contractility increase

A

both

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26
Q

Beta 1 or 2? blood vessels will vasodilate

A

Beta 2

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27
Q

what is the predominant receptor on the heart?

A

Beta 1

28
Q

Beta 1 or 2? bronchodilation

A

Beta 2

29
Q

Stimulation of Beta-3?

A

leads to reduced contractility

30
Q

Alpha 1 or 2? vasoconstriction

A

Alpha-1

31
Q

Alpha 1 or 2? centrally mediated vasodilation

A

Alpha-2 (keeps blood pressure in balance)

32
Q

How do beta-adrenergic blocking agents work?

A

block beta-1 and beta-2 receptors thereby decreasing heart rate and contractility

33
Q

Second generation beta blockers are

A

Cardioselective, blocking mainly beta 1 receptors

34
Q

Parasympathetic nervous system stimulation, specifically the vagal nerve, causes

A

release of acetylcholine, which decreases heart rate and reduces contractile strength

35
Q

Vagal nerve stimulation, which may occur with emotional distress from any situation like blood drawing, will cause

A

drop in heart rate and blood pressure referred to as a vagal or vasovagal reaction

36
Q

heart’s blood is supplied by the

A

coronary arteries - Two main arteries arise from the root of the aorta and divide into the right (RCA) and left (LCA) coronary arteries.

37
Q

anastomoses

A

multiple connections within and between the coronary arteries. . The flow through the anastomosis provides critical collateral circulation when it is not sufficient from the RCA or LCA for various reasons such as occlusions.

38
Q

LCA supplies blood flow to where?

A

front of the heart, the left and right ventricles, and the interventricular septum
The second LCA division is the circumflex, which supplies the left atrium and lateral left ventricle wall.

39
Q

RCA supplies blood flow to where?

A

right atrium and right ventricle and posterior part of the heart including the back of the interventricular septum.

40
Q

what artery breaks the rules and carries oxygen depleted blood?

A

pulmonary arteries carry oxygen-depleted blood away from the right side of the heart to the lungs for gas exchange

41
Q

what veins break the rules and carry oxygen saturated blood?

A

pulmonary veins

the oxygen-saturated blood returns to the left side of the heart through the pulmonary veins.

42
Q

inner layer of the blood vessels known as

A

tunica intima

43
Q

middle layer of the blood vessels known as

A

tunica media

44
Q

what is the tunica intima comprised of

A

endothelium

45
Q

what is the tunica media made of and what does it do?

A

smooth muscle that is responsible for the vessel’s ability to change diameter

46
Q

Outer layer of the blood vessels known as

A

tunica adventitia

47
Q

what is the tunica adventitia made of and what does it do?

A

consists of elastic and fibrous connective tissues that provide the necessary elasticity to accommodate the rush of blood with each cardiac contraction

48
Q

what do some arteries also have to help accommodate the high pressures

A

Arteries also have a layer of elastic fiber in the tunica media and adventitia (externa) of some arteries

smooth muscle layer of arteries and arterioles is also much thicker than veins

49
Q

vasa vasorum

A

Large veins and arteries also have blood vessels called vasa vasorum

50
Q

Capillaries only have an _________ _________

A

endothelial layer

51
Q

What is considered an overall average pressure in the arteries.

A

The average pressure in the arteries in one systole–diastole cycle is the mean arterial pressure considered an overall average pressure in the arteries

52
Q

What can be a determinant of adequate perfusion

A

mean arterial pressure as opposed to blood pressure

53
Q

Pulse pressure

A

the difference between the systolic and diastolic pressures and represents the force the heart generates each time it contracts

54
Q

Cardiac output and systemic vascular resistance significantly affect _____ ______ . What is the equation that represents this?

A

Blood Pressure

BP = CO × SVR, where BP is blood pressure, CO is cardiac output, and SVR is systemic vascular resistance

55
Q

Cardiac output

A

the amount of blood the heart pumps in one minute

56
Q

Cardiac output is determined by what? what is the equation?

A

stroke volume and heart rate (CO = SV × HR, where SV is stroke volume, and HR is heart rate)

57
Q

Stroke volume

A

the amount of blood ejected from the heart with each contraction

58
Q

ejection fraction (EF),

A

Not all the blood in the heart is ejected. The amount pumped out with each cycle relative to how much blood volume there is at the end of diastole is called the ejection fraction (EF),

59
Q

How can you measure EF

A

echocardiogram or computed tomography (CT)

60
Q

The stroke volume is influenced by

A

preload, afterload, and contractility

61
Q

preload

A

The pressure created in the left ventricle by the volume of blood at the end of diastole (left ventricular end diastolic pressure)

62
Q

A key determinant of preload is

A

volume (measurements can be used as a gauge for ventricular volume)

63
Q

Afterload

A

the pressure (resistance) the ventricle must overcome to eject blood (aortic pressure for the left ventricle and pulmonary pressure for the right ventricle).

64
Q

The third variable affecting stroke volume and, in turn, cardiac output and ultimately blood pressure, is the

A

contractility of the heart

65
Q

catecholamines that increases contractility

A

Norepinephrine, epinephrine and dopamine

66
Q

catecholamines that depresses contractility

A

Acetylcholine

67
Q

Frank-Starling law

A

explains the myocardial length–tension relationship and preload. The law states that the more the myocardial stretch, the greater the contraction.

Patho (10 decks)

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