cardiovascular anatomy and physiology Flashcards
1
Q
what are the 4 layers of the heart
A
parietal pericardium
visceral pericardium
myocardium
endocardium
2
Q
what is the inner most layer that lines the heart contains smooth muscle
A
endocardium
3
Q
which layer of the heart has cardiac muscle fibers the provide the work in distributing blood
to the heart
A
myocardium
4
Q
what is the visceral pericardium also known as
A
epicardium
5
Q
what layer of the heart has coronary blood vessels
A
epicardium
6
Q
which part of the heart can be compressed due to exc3ss fluid accusation that ends to reduce cardiac output
A
pericardium
7
Q
valve issues can lead to
A
endocarditis
8
Q
peripheral restriction is key to what
A
blood pressure
9
Q
what property of the myocardial cells is able to contract without external stimuli
A
automaticity
10
Q
which property of the myocardial cells can contract in a rhythmic manner
A
rhythmicity
11
Q
which property of the myocardial cellls can nerve impulses can be transmitted from one myocardial cell to another due to intercalated disks that form a syncytium (protoplasm of one cell is continuous with that of another)
A
conductivity
12
Q
what are the 2 junctions that the intercalated disk contain
A
desmosomes and connexins
13
Q
what does desmosomes do
A
attach one cell to another
14
Q
what does connexins do
A
allow electrical impulses to spread
15
Q
what artery supplies the myocardium
A
coronary artery
16
Q
how many beats per minutes does teh SA and AV node allowed
A
60-100
17
Q
what neurotransmitter decreases heart rate and myocardial contractility to 60-90 bpm and what system is it in
A
acetylcholine & PNS
18
Q
which neurotransmitter increased heart rate and myocardial contracility and what system
A
norepinephrine and SNS
19
Q
where does the SA node receive input from
A
autonomic nervous system:
20
Q
the SA node paces the heart to beat how many BPM without any other input
A
> 100
21
Q
what functions as the pacemaker of the heart
A
SA node
22
Q
where does the SA node send its signals to
A
the R atrium to contract first
23
Q
what sends signal for ventricles to contract
A
AV node
24
Q
AV node impulses are transmitted to the ventricular myocardium through
A
bundle of His
25
what Divides into a left and right bundle branch at the intermuscular septum to
innervate each respective ventricle
bundle of his
26
Bundle branches further divide into smaller nerve fibers called ______ to cause the ventricles to contract
Purkinje fibers
27
why is the SA node susceptible to disease
proximity to the epicardium (pericarditis)
coronary artery occlusion ( blockage )
28
why is the AV node susceptible to disease
right coronary artery occlusion
29
what generates the 1st heart beat
the closure of the tricuspid and mitral valve
30
what does teh 1st heart beat signal
onset of ventricular systole
31
what is hypokalemia associated with
arrhythmias and mm cramps esp if taking diuretics
32
what is an effect of hyperkalemia
nausea and vomiting
33
what is an effect of hypercalcemia
erratic cardiac contraction
34
what is a effect of hyocalcemia
decreased myocardial contractilty
35
what is systole
myocardial contraction
36
what is diastole
myocardial/ ventricular relaxation
37
when all heart muscles are relaxed and all valves are closed and there is blood returning to the atria what is that called
atrial diastole
38
what happens in atrial systole
atria in contraction
av valves are open
blood to ventricles
39
what happens during ventricular systole
vent. in contraction
semilunar valves are open
blood passing to arties
40
what happens after ventricular systole
vent diastole
41
how do u measure cardiac output
sv x HR
42
what is the equation for BP
HR x SV x total peripheral resistance
43
what is the total peripheral resistance
the pressure w/in the aterial system during diastolic phase while the heart is filling
44
which part of BP does CO affect
systolic
45
what type of BP does TRP affect
diastolic
46
what is an important measure to assess from patients with hypotension
mean artieral pressure
47
what is the normal MAP
93 mmHg
48
if a patients has a MAP _____ be cautious getting them out of bed
< 60
49
what is normal BP
<120 / <80
50
what is elevated BP
120-129 / <80
51
what is high blood pressure stage 1
130-139 / 80-89
52
what is high blood pressure stage 2
>140 / >90
53
what is mean arterial blood pressure determined by
blood volume
cardiac output
resistance of the system to blood flow
relative distribution of blood between arterial and venous blood vessels
54
what is HR affected by
- Baroreceptors at the carotid sinus and aortic
arch
• Autonomic nervous system
• Endocrine system
• Integrity of the cardiac conduction system
• Temperature
• Emotional state
• Primary determinant for increased CO and BP during exercise
55
stroke volume is affected by
cardiac preload
cardiac after load
myocardial contracility
56
what is cardiac preload (end diastolic volume)
amount of left ventricular blood volume prior to contraction
57
cardiac preload is dependent on
venous return
total blood volume
left atrial contraction
frank starting law
58
what is the frank starling mechanism
strength of ventricular contraction increases as the precontractile myocardial cell length increases
59
what is cardiac afterload
amount of pressure encountered by the left ventricle
60
is cardiac output is to high what happens with SV
it decreases because the pressure to put blood out is increased
61
what is stroke volume
the amount of blood that is pumped with each beat
62
if there is an increase in preload then there will be in ___ in SV
increase
63
if pre load increases what happens to SV and EDV
both increase bc if the amount of blood that is filling the heart increases than the amount of blood pumped out increases also
64
if afterload increases what happens to sv and esv
SV will decrease because the amount of pressure in the LV to pump blood out is increased anf ESV will increase bc it is the same as after load
65
if there is an increase in inotropy than what happens to SV and ESV
increasing inotropy means increase in contraction so SV will increase and ESV will decrease
66
when is afterload increased
hypertension
vascocontriction
67
when is preload increased
hypervolemia
regurgitation of cardiac valves
HF
68
what is the Amount of ventricular blood volume pumped per heart beat
ejection fraction
69
how to calculate EF
SV / EDV
70
normal values of EF at the LV
55-70 %
71
if you have a poor SV what happens to EF
decreases
72
T/F EF is a ration of the volume of ejected blood relative to what was received before systole or contraction
T
73
systolic HF results in a ____ Ef
low
74
diastolic HF results in a _____ EF
normal
75
what is a positive chronograph agent
anything that makes the HR increase
76
what does contractilty increase and decrease with
positive and negative inotropic agents
77
if there is a decrease venous pressure what happens to venous return and preload and SV and CO
decrease everything
78
what does ESD directly affect
afterload
79
how many leaflets does the mitral and tricuspid valves have
2 and 3
80
how many leaflets does the aortic and pulmonic valves have
3
81
what is making the sound of the S2
closure of aortic and pulmonic valves
82
where is S1 the loudest
apex
83
where is teh aortic valve located on human body
2nd - 3rd right interspace
84
what is the pulmonic vlave loavted on the human body
2nd -3 rd left interspace
85
where is the tricuspid valve located on the human body
left sternal boarder
86
where is the mitral valve located on the human body
5th intercostal space
87
what makes up 55% of the blood
plasma
88
what are the 4 main components in the blood
plasma ‘
RBC
WBC
platelets
89
what is not a blood cell and is invovled in the production of platelets to promote the clotting process
thrombocytes
90
where does hematopoiesis take place
in cancellous spongy bone
91
what is RBC production regulated by
hormone called erythropoietin produced in the kidney
92
what does hematocrit measure
the o2 on RBC in the blood
93
if you have low hematocrit what effects do u have
anemia , vitamin /nutrition deficiencies
94
if you have high levels of hematocrit what effects do u have
dehydration , polycythemia vera, lung/heart disease
95
what is the Specialized protein in RBCs that binds to O2 for delivery to all bodily tissues
hemoglobin
96
what is O2 saturation
amount of O2 that is bound to hemoglobin
97
there is more increased in SaO2 if PaO2 is
> 50 mmHh
98
if there is a shift to the right for the SaO2 curve what does that meant
increase relseae of O2
99
if there is a shift to he left tin the SaO2 curve what does that mean
decreased release of O2
100
what does the autonomic nervous system receive input from
barorecptors , carotid sinus and aortic arch on changes in BP
101
increased activation of the autonomic nervous system causes what
vascocontriction
102
decreased activation of the autonomic nervous system causes what
vasodiliation
103
what is capillary hydrostatic pressure
move blood across the capillary membrane into the tissue
104
what is capillary oncotic pressure
albumin (plasma protein) pulls on fluid back into the capillary
105
what is interstitial hydrostatic pressure
move fluid back into the blood vessels
106
what is interstitial oncotic pressure
draws fluid out of the capillaries into the tissues
107
what is the net fluid exchange
2 mmHg outwards from capillary
108
what is the oxygen extraction ratio
the body increases the ability to take more O2 from the blood as metabolism increase
109
oxygen delivery (DO2) increase as tissue metabolism ___
increases
110
oxygen consumption increases as tissue metabolism ___
increases
111
at rest how much O2 is extracted from peripheral circulation
23%
112
what is hypoxia
decrease O2 in the tissues
113
what is hypoxemia
decreased O2 in the blood
114
if o2 delivery decreases what happens to o2 consumption
stays teh same bc the tissues will utilize the same relative amount of O2 that is present in the blood
115
if oxygen consumption falls below critical level what happens to anaerobic metabolism , serum lactate levels , the organs
anaerobic metabolism will ensue , lactate will increase and multi organ failure
116
how many alveoli are present in the normal lung
300 mil
117
where does gas exchange in the lungs happen
alveoli
118
the pulmonary oxygen exchange allows for duffsiuon of O2 across ____ membrane to the __________ when then move to the _____ system then ____ and retuned to the heart via the ______ ____
alveoli , pulmonary arterial circulation , capillary , venues , pulmonary vein
119
what is cool about the pulmonary vein
only oxygenated vein we have
120
pulmonary oxygen exchange aloos for diffusion of CO2 across ___ membrane to the e_______ and them move to the capillary system to the ___ and sent o the lungs via ______
alveoli , pulmonary venous circulation , arterioles , pulmonary artery
121
what is rich in the pulmonary arterioles
CO2
122
Diffusion of O2 and CO2 across the alveoli to the pulmonary arterial circulation dependent on four factors
area of capillary membrane
diffusion capacity of alveolar capillary membrane e
pulmonary capillary volume
ventilation to perfusion ration
123
what is the number 1 reason for hypoxemia
ventilation perfusion mismatch
124
pulmonary capillary volume will increase with
exercise
125
what is the normal ventilation perfuction ration
.8
126
if V/Q is reduced then
blood is shunted to other parts of the lung and there is more perfusion then ventilation
127
if V/Q is increased then there is
no gas exchange occurs , refered to as a dead space
128
where in the lung is perfusion higher then ventilation
base
129
when someone’s in a upright position the top of the lung has more
ventilation then perfusion
130
what is perfusion
the amount of blood surrounding the alveoli’s
131
what extrinsic controls is vasoconstriction and vasodiliation controlled by
endocrine systems
autonomic nervous system
132
what controls the endocrine system
hypothalamus
133
epinephrine released but the adrenal medulla causes
vascocontriction alpha receptors and vasodilation for beta receptors
