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Body Systems > Cardiopulmonary Anatomy and Physiology > Flashcards

Cardiopulmonary Anatomy and Physiology Flashcards

1
Q

What does the Right Coronary Artery supply

A
  • Right Atrium
  • Right Ventricle
  • Inferior wall of the Left Ventricle
  • AV node, SA node in (60% of people), and bundle of his
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2
Q

What does the Left Coronary Artery branch into

A
  • The Left Anterior Descending
  • The Left Circumflex
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3
Q

What does the Left Anterior Descending supply

A
  • left ventricle
  • intraventricular septum
  • Right ventricle
  • inferior apex
  • Inferior angles of both ventricles
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4
Q

What does the left Circumflex supply

A

-lateral and inferior walls of the left ventricle
- SA node in 40% of the population
- left atrium

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5
Q

what are the tissue layers of the heart from innermost to outermost?

A
  • Endocardium
  • Myocardium
  • Visceral Pericardium
  • Parietal pericardium
  • Fibrous Pericardium
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6
Q

what layers of the pericardium is the pericardial fluid found between

A

in the pericardial cavity between the visceral and parietal layers

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7
Q

What is the myocardium

A

Layer of heart muscle tissue that is striated and is able to contract without conscious voluntary control

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8
Q

What is the Myocardium influenced by?

A
  • Both the sympathetic and parasympathetic (vagus) pathways of the autonomic nervous system
  • Some voluntary control over the heart rate through breathing techniques
  • Vasovagal Scope
  • External factors such as stress
  • Contractile elements of the heart
  • Conductive elements of the heart
  • Middle layer of heart (pericardium, myocardium, endocardium)
  • Heavily O2 demanding through the coronary arteries
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9
Q

What is the structure of the endocardium

A
  • Thin, smooth layer of cells lining the inside of the myocardium, values, and atria
  • Has some connective tissue, some elastic fiber and muscle fibers
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10
Q

What is the function of the endocardium

A
  • Provides a smooth surface to allow blood and platelets to flow freely and not adhere to heart wall
  • Strengthens the valves and supports other heart tissues
  • Supports the subendocardial layer which houses the purkinje fibers
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11
Q

what are the 2 types of heart valves

A

1) Atrioventricular (AV) valve
2) Semilunar valve

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12
Q

what are the two AV valves?

A

1) tricuspid (right atrium and right ventricle)
2) mitral (left atrium and left ventricle)

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13
Q

Pathway of the blood of deoxygenated blood

A

Deoxygenated blood through vena cavea - right atrium - tricuspid valve - right ventricle - pulmonary valve - pulmonary artery - lunges

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14
Q

Pathway of the blood in the oxygenated blood

A

Oxygenated blood through the pulmonary veins - left atrium - mitral valve - left ventricle - aortic valve - aorta - body

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15
Q

what valves are open in diastole

A

tricuspid valve and mitral valve

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16
Q

what valves are open in systole

A

pulmonary valve and aortic valve

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17
Q

what is the equation for Cardiac Output

A

CO=HR x SV

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18
Q

what is Cardiac Output?

A

The amount of blood that is ejected out of the left ventricle into the systemic vasculature/ minute

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19
Q

what is the normal cardiac output at rest

A

4-5 L/minute
normally takes a volume of blood about 1 minute to travel through the pulmonary and systemic circuits

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20
Q

what is stroke volume?

A

the amount of blood that is ejected of the left ventricle/ beat

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21
Q

what is the normal stroke volume values?

A

55-100 ml/beat

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22
Q

what is stroke volume affected by

A

1) preload
2) afterload
3) contractility

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23
Q

Preload

A
  • the amount of stretch experienced by the cardiac sarcomeres pre-contraction
  • the greater the LVEDV the greater the stretch and volume pumped (starling’s law) and the greater the preload
  • affected by venous return and volume of returning blood
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24
Q

Afterload

A
  • Force left ventricle must generate to overcome aortic pressure to open the aortic valve
  • the resistance on the ventricle
  • inversely related to SV
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25
Q

Contractility

A

the squeezing pressure of the left ventricle

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26
Q

what else is the stroke volume affected by

A

The left ventricular end diastolic volume (LVEDV) and end systolic volume (ESV)

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27
Q

what is the ejection fraction

A
  • percentage of blood empties from the ventricle during systole
  • useful in knowing left ventricular function
  • volume of blood ejected (SV) relative to the volume of blood received before contraction (LVEDV)
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28
Q

what is the equation of the ejection fraction (EF)

A

EF=SV/LVEDV

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29
Q

what is the average percentage of ejection fraction

A

greater then 55% (60-70%)

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30
Q

what is a low EF an indicator of

A

Cardiomyopathy or heart failure; impairment of the left ventricle

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31
Q

what is the myocardial O2 demand

A
  • HRxSBP produces rate pressure product
  • Increases with activity and HR and/or BP
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32
Q

what is preload impacted by

A
  • end-systolic volume
  • venous return
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33
Q

what impacts afterload

A
  • aortic pressure
  • aortic valvular function
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34
Q

what impacts contractility

A
  • end diastolic volume
  • sympathetic stimulation
  • myocardial O2 supply
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35
Q

what impacts heart rate

A
  • CNS
  • Autonomic nervous system
  • Neural reflexed
  • Atrial receptors
  • Hormones
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36
Q

what are the neurohumeral influences on sympathetic stimulation (adrenergic)

A
  • control of the medulla via T1-T4
  • SA node, AV, conduction pathways, impacted by adrenergic system
  • increases HR and force of myocardial contraction = increase in myocardial oxygen demand
  • coronary artery vasodilation
  • sympathomimetics; antihypertensives and sympathetic blockers
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37
Q

what are the neurohumeral parasympathetic stimulation (cholinergic)

A
  • control in the medulla via the vagus nerve, cardiac plexus
  • innervates the SA and AV nodes
  • slows rate and force of myocardial contraction = decrease in myocardial contraction
  • coronary artery vasoconstriction
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38
Q

baroreceptors

A

pressure receptors that are found in the walls of aortic arch and carotid sinus

39
Q

what is the circulatory reflex

A

respond to blood pressure changes
increased BP - parasympathetic stimulation: decrease HR, force of contraction, and peripheral resistance
decreased BP - sympathetic stimulation, increased HR and BP, vasoconstriction

40
Q

Chemoreceptiors

A
  • located in the carotid body
  • sensitive to changes in O2, CO2 and lactic acid pH and will affect HR and RR
41
Q

what does an increase in CO2 or decrease in O2 or pH lead to

A

increased HR and RR

42
Q

what does an increase in O2 lead to

A

decreased HR

43
Q

Hyperkalemia

A

increased concentration of K+ ions leads to a decrease in HR, decrease in contractile forces, arrhythmias, and EKG changes

44
Q

what would you see on an EKG of a pt with hyperkalemia

A

widened PR interval and QRS, tall T waves

45
Q

Hypokalemia

A

decreased concentration of K+ ions, EKG changes

46
Q

what would you see in an EKG of a pt with hyperkalemia?

A

flattened t waves, prolonged PR intervals

47
Q

Hypercalcemia

A

increased calcium concentration leading to an increase in HR and + inotrophic effect (contractibility). Often kidneys affected, confusion, and coma

48
Q

Hypocalcemia

A

a decrease in calcium concentration that may lead to arrhythmias

49
Q

Hypermagnesmia

A

increased magnesium concentration it is a calcium blockers that can lead to arrhythmias, cardiac arrest, hypotension, confusion and lethargy

50
Q

Hypomagnesmia

A

decreased magnesium concentration leading to ventricular arrythmias and coronary artery vasospasm

51
Q

what is the cardiac cycle

A
  • the period from one heartbeat to the beginning of the next heartbeat
  • Action potential starts at the SA node, depolarized the atria, spreads to the AV node
52
Q

Systole

A

the period of contraction that the heart undergoes while it pumps blood into circulation

53
Q

Diastole

A

the period of relaxation that occurs as the chambers fill with blood

54
Q

Cardiac Cycle Phase I - the filling period

A
  • blood flows into the left and right atrium with both tricuspid and mitral valves open allowing blood to flow into the ventricles
  • SA node depolarizes allowing for a atrial contraction for ventricular filling
  • AV node depolarizes and sends signals to the bundle of his
  • pressure of the ventricles starts to rise causing the closing of the tricuspid and mitral valves
55
Q

Cardiac Cycle Phase 2- Isovolumic contraction

A
  • continued polorization of the bundle branches and perkinjie fibers create a stronger ventricular contraction
56
Q

Cardiac Cycle phase 3 - Ejaction

A
  • Pressure in ventricle > then pressure in pulmonary trunk and aorta pushing the semilunar valves open
  • ventricular relaxation or diastole follows repolarization of the ventricles
57
Q

Cardiac Cycle phase 4 - Isovolumentric ventricular relaxation phase

A
  • ventricles continue to relax and pressure of in the ventricles drops
  • tricuspid and mitral valves begin to reopen
58
Q

what are the 2 pleurae of the lung

A
  • the visceral innermost layer
  • parietal outermost layer
59
Q

what is the space between the visceral and the parietal pleura called

A

the pleural cavity/pericardial cavity

60
Q

what is the purpose of the pleural fluid

A
  • creates surface tension to keep the lungs in the thorax
  • allows the lungs to expand when the thorax expands
  • cushions and lubricates the lung during expansion and retraction
61
Q

what is the parietal pleura of the lungs innervated by

A

the phrenic and intercostal nerves (can sense pain, temperature and touch)

62
Q

Accessory muscles of inspiration

A
  • SCM
  • Scalene
63
Q

Principal muscles of inspiration

A
  • External intercostals
  • Diaphragm
64
Q

Muscles of experation

A
  • Internal intercostals
  • External obliques
  • Rectus Abdominis
  • Transversus Abdominis
  • Internal obliques
65
Q

what are the 3 different types of pressure that contribute to breathing

A

1) atmospheric
2) intra-alveolar
3) intrapleural

66
Q

what are the competing forces of pressure that keep the lungs inflated

A

1) inward pull: elasticity of the lungs and the surface tension of the alveoli
2) outward pull: surface tension within the pleural cavity

67
Q

what pull is slightly higher to keep the lungs inflated

A

the outward pull from the pleural cavity

68
Q

What happens to size of the thorax during inspiration

A
  • diaphragm contracts expanding the thorax inferiorly
  • External intercostals pull the ribs up and out expanding the thorax anteriorly
69
Q

what happens to the size of the thorax during expiration

A
  • diaphragm and external intercostals relax causing the volume of the thorax to decrease expelling air out.
70
Q

what are the physical properties of the lungs that facilitate breathing

A

1) lung compliance (distensibility of tissue)
2) Tendency of the lungs to recoil
3) elastic recoil or elasticity
4) surface tension at the air-liquid interface on the alveolar surface
5) Resistance to airflow at the level of the airways

71
Q

what part of the brain controlled breathing?

A

medulla and the pons

72
Q

what drives the RR in the medulla and pons

A

changes in CO2 and pH levels in the blood

73
Q

what happens as CO2 concentration increases in the blood

A

pH decreases in blood, stimulates respiratory centers in medulla to contract diaphragm and external intercostals, increases rate and depth of respiration

74
Q

what happens as CO2 concentration decreases in the blood

A

pH increases, causes respiratory centers to lower the rate and depth of respiration

75
Q

what is hypercapnia

A

increasing ventilation in response to increasing levels of CO2 in blood

76
Q

what is hypoxia

A

increasing ventilation in response to decreasing levels of O2 in the blood

77
Q

where does gas exchange occur

A

in the respiratory zone toward the bottom of the lungs where there are more abundant alveoli

78
Q

what is the V/Q match

A

when ventilation (V) is the same as perfusion (Q)

79
Q

what do areas of the lungs with greater perfusion act as

A

shunts

80
Q

what do areas of the lungs with greater ventilation act as

A

dead spaces

81
Q

what makes up hemoglobin

A

4 iron molecules and 4 protein molecules

82
Q

what is oxyhemoglobin

A

Hgb carrying O2

83
Q

what is deoxyhemoglobin

A

Hgb that has released O2 to the peripheral tissues

84
Q

Carbicyhemoglobin

A

Hgb bound to CO instead of CO2

85
Q

what is the normal O2 carrying capacity in men and women?

A

13-16 in men
12-16 in women

86
Q

what is the oxyhemoglobin dissociation curve

A

describes the relationship between SaO2 and the partial pressure of arterial O2

87
Q

what are implications of a left shifted oxyhemoglobin curve

A
  • increased O2 affinity
  • reduced O2 delivery to tissues
88
Q

what is a left shifted oxyhemoglobin curve caused by

A
  • high pH (alkalosis)
  • low temperature
  • high O2 affinity
89
Q

what are the implications of a right shifted oxyhemoglobin curve

A
  • reduced O2 affinity
  • increased O2 delivery to the tissues
90
Q

what can a right shifted oxyhemoglobin curve be caused by

A
  • low pH (acidic)
  • increased O2
  • High temperature
91
Q

Areas of the Lungs: R. Anterior

A

1,3,4,5,8

92
Q

areas of the lungs: L anterior

A

1,3,4,5,8

93
Q

areas of the lungs: L posterior

A

1,2,6,9,10

94
Q

areas of the lungs R posterior

A

1,2,6,8,9,10

Body Systems (4 decks)

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