Cardiopulm Weak Points Flashcards
Lowest part of the heart that projects anteriorly and left at the 5th intercostal space
apex of the heart
Upper border of the heart below the second rib
base
Endocardium
interior of the heart chambers and valves
Epicardium
serous layer of pericardium
contains epicardial coronary arteries, veins, autonomic nerves and lymphatics.
Myocardium
thick contractile middle layer of muscle cells that form the bulk of the heart wall.
Aorta begins at the
left ventricle
Inferior vena cava returns blood to the
RA
Pulmonary arteries carry what kind of blood to RV
deoxygenated
Pulmonary veins carry what kind of blood to LA
oxygenated
Right side gets blood from
body and pumps to lungs
Left side gets blood from
lungs and pumps to body
Flow of blood through the heart
- deoxygenated blood from body through superior and inferior vena cava
- RA
- tricuspid valve
- RV
- pulm valve
- pulmonary arteries
- lungs
- oxygenated blood via pulmonary veins
- LA
- mitral valve
- LV
- aorta
- body
Sinus node artery supplies
RA
Right marginal artery supplies
RV
Posterior descending artery supplies
inferior walls of both ventricles
inferior portion of interventricular septum
Right coronary artery includes
Sinus node artery
Right marginal artery
Posterior descending artery
and all they supply
Circumflex artery supplies
LA
Posterior and lateral walls of LV
Anterior and inferior walls of LV
LAD supplies
Anterior portion of interventricular septum
Left coronary artery includes
Circumflex and LAD
What veins drain into the coronary sinus which empties into the RA?
great cardiac vein
small and middle cardiac veins
The thebesian veins arise in the myocardium and drain into what?
all the chambers of the heart but primarily into the RA and RV
Each cardiac myocyte has an intrinsic ability to depolarize and propagate electrical impulse from cell to cell….
without nerve stimulation
Normal pacemaker of the heart
SA node
Bachmann bundle appears to conduct
cardiac pulse preferentially from the R to L atrium
Bundle of His comes from which node
AV
Bundle of His passes to the
interventricular septum
Purkinje fibers extend to
both ventricular walls
Heart rate, rhythm, and contractility are influenced by…
autonomic nervous system
Vagus nerve is associated with heart
Sympathetic influence is achieved by release of what hormones?
norepinephrine
epinephrine
Sympathetic nerves stimulate chambers to
beat faster and with greater force
Beating faster from sympathetic stimulation is called
chronotropic effect
Beating with greater force from sympathetic stimulation is called
inotropic effect
Parasympathetic influence is achieved via … release from vagus nerve.
AcH
Parasympathetic nerves do what to HR and primarily through their influence on which node?
slow
SA
Baroreceptors and mechanoreceptors are those that
detect changes in pressure
Baroreflex maintains
BP
Sympathetic activation leads to
increased cardiac contractility
increased HR
venoconstriction
arterial vasoconstriction
Bainbridge reflex
increase in venous return stretches receptors in the wall of the RA which sends vagal afferent signals to CVD. These will inhibit parasympathetic activity which increases HR.
Chemoreceptor reflex
changes in pH and blood oxygen tension.
When arterial partial oxygen less than 50 mmHg (acidosis), stimulate respiratory centers and increase depth and rate of ventilation.
Parasympathetic system reduces HR and contractility.
Valsalva maneuver
increased intrathoracic pressure, increased central venous pressure, decreased venous return.
Resultant decrease in cardiac output and BP is sensed by baroreceptors which reflexively increased HR and contractility through sympathetic stimulation.
Arteriole systole
contraction of R and L atria pushing blood into ventricles
Arteriole diastole
period between atrial contractions when the atria are repolarizing
Ventricular systole
contraction of R and L ventricles pushing blood into pulmonary arteries and aorta
Ventricular diastole
period between ventricular contractions when ventricles are repolarizing
Preload
tension in ventricular wall at the end of diastole.
venous filling pressure that fills the left ventricle during diastole
Afterload
forces that impede the flow of blood out of the heart.
Pressure in peripheral vasculature and compliance of aorta; mass and viscosity of the blood
Stroke Volume
blood ejected by each contraction in LV
Normal ranges 60-80 ml
Cardiac Output
amount of blood pumped from the L or R ventricle per minute.
SV x HR
normal for male at rest is 4.5-5.0L/min
Can increase to 25 L/min with exercise
Venous return
amount of blood that returns to the RA each minute
similar to volume of CO
Because the CVD is a closed loop, the venous return must equal…
CO when averaged over time
Deep vein accompany the
arteries
More valves in which veins
deep
Normal blood volume of an adult is
4.5-5.0 L
Hypovolemia
decreased blood volume, specifically plasma
Causes of hypovolemia
bleeding
dehydration-vomiting, diarrhea, sweating, severe burns, diuretic medications used to treat HTN.
Signs and symptoms of hypovolemia
orthostatic hypotension
tachycardia
elevated body temp
Hypervolemia
fluid overload
increased blood plasma
Causes of hypervolemia
excess intake of fluids and sodium or fluid retention
Signs and symptoms of hypervolemia
swelling in legs
ascites
fluid in lung
Plasma is
the liquid component
Plasma consists of
water
electrolytes
proteins
Plasma consists of
more than half the total blood volume
Plasma is important for
regulating BP and temp
RBC account for
40% of blood volume
Polycythemia
too many RBC
blood is too thick and this increases the risk for stroke or heart attack
Thrombocytes are aka
blood platelets
Thrombocytopenia
low number of platelets
increases risk of bruising and abnormal bleeding
Thrombocythemia
high number of platelets
increases the risk of thrombosis which increases risk of stroke or heart attack
Leukocytes
White blood cells
Leukopenia
low # of white blood cells
Leukocytosis
abnormally high number of white blood cells
5 main types of white blood cells
neutrophils
lymphocytes
monocytes
eosinophils
basophils
Neutrophils
protect against bacteria and debris
Lymphocytes
T, natural killer (viral infections and can protect against some cancer) and B (antibodies).
Monocytes
ingest dead or damaged cells
Eosinophils
kill parasites, destroy cancer cells
allergies
Basophils
allergic responses
What provides attachment sites for accessory muscles of inspiration?
clavicles and scapulae
Manubrium articulates with
right and left clavicles
body of sternum
second rib
Sternal angle of manubrium and body is called
angle of louis
Ribs ____-____attach to sternum.
Ribs ___-___ attach to cartilage of rib above and not to sternum. They are aka…
Ribs ___-___ have no skeletal attachment and are aka…
1-7
8-10
11 and 12
What are the principal muscles of inspiration?
diaphragm
external intercostals
Upper movement of the upper ribs increases the ….. diameter of the chest.
anterior-posterior
Elevation of the lower ribs increase the ….diameter.
transverse
Accessory muscles of inspiration…
SCM
scalenes
pec major
pec minor
serratus
Forceful exhalation muscles
rectus
external and internal oblique
TA
Upper respiratory tract
nasal cavity
pharynx
larynx
Lower respiratory tract
larynx to alveoli
Which lung has three lobes?
right
Lingula is to which lobe?
right
Oxygen diffuses across …. into RBC in lung capillaries where it combines with hemoglobin to be transported back to heart. CO2 diffuses opposite.
alveolar capillary septum
abnormal instances where pleural space may contain air….
pneumothorax
hemothorax
pus or serous fluid
Innervation of lungs
vagus
Breathing control is where
central respiratory center in brainstem and peripheral receptors in lungs, airways, chest wall and blood vessels
Central chemoreceptors in …. respond to increases in partial pressure of CO2 and hydrogen ion.
medulla
Expiratory reserve volume
max volume exhaled after normal tidal
15 % of total volume
Forced expiratory volume
max volume exhaled in specific period of time
Forced vital capacity
volume expired during forced maximal expiration after forced maximal inspiration
Functional residual capacity
volume in lungs after normal exhalation
40% of volume
Inspiratory capacity
max volume inspired after normal tidal exhalation
60% of volume
Inspiratory reserve volume
max volume air inspired after normal tidal volume inspiration
50% of total volume
Peak expiratory flow
max flow of air during beginning of a forced expiratory maneuver
Residual volume
volume in of gas remaining in lungs at the end of max expiration
25% of total volume
Tidal volume
total volume inspired and expired during each breath of quiet breathing
10% of total
Total lung capacity
volume of air in lungs after max inspiration and the sume of all lungs volumes
vital capacity
volume change that occurs between max inspiration and max expiration
75% of all volume
