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Cardiopulmonary Spring 2021 > Cardiovascular Anatomy and Physiology > Flashcards

Cardiovascular Anatomy and Physiology Flashcards

1
Q

What is the only artery that carries deoxygenated blood?

A

Pulmonary Artery

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2
Q

Where does the left heart extend from?

A

2nd costal cartilage (12-15mm from left sternal cartilage) to 5th intercostal space (9 cm from left sternal boarder)

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3
Q

Where does the right heart extend from?

A

3rd to 6th costal cartilage about 10-15mm from sternum

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4
Q

What is the largest portion of the heart?

A

Apex

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5
Q

Where is the apex of the heart located?

A

Left of the mid sternal line at the 5th intercostal space

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6
Q

What are the 4 heart layers from most external to most internal?

A

Parietal pericardium
Visceral Pericardium
Myocardium
Endocardium

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7
Q

What is the fibrous outer layer of the heart that forms a sac and contains terminal branches of several blood vessels? Coronary blood vessels are in this layer.

A

Partietal Pericardium

Also called: Epicardium

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8
Q

What is the layer of the heart that forms pericardial fluid to moisten the heart to prevent friction and also maintains the heart in position.

A

Visceral Pericardium

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9
Q

What is the name of the cardiac muscle fibers that provide the work in distributing blood to the heart?

A

Myocardium

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10
Q

What is the name of the innermost layer that lines the heart containing smooth muscle?

A

Endocardium

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11
Q

What is pericarditis?

A

Inflammation of the pericardium, causing it to fill with fluid

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12
Q

The myocardium only functions in what type of metabolism?

A

Aerobic

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13
Q

The ____ receives blood from the veins

A

atria

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14
Q

What is the function of the left atria?

A

Receives oxygen rich blood from the pulmonary vein and sends to to the left ventricle through the mitral (bicuspid) valve

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15
Q

What is the function of the right atria?

A

Receives blood from the inferior and superior vena cava and sends it to the right ventricle through the tricuspid valve

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16
Q

The _____ eject blood into the arteries

A

ventricles

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17
Q

What is the function of the left ventricle?

A

ejects blood through the aortic valve into the aorta

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18
Q

What is the function of the right ventricle?

A

ejects oxygen DEFICIENT blood through the pulmonic valve into the pulmonary trunk which becomes the left and right pulmonary artery

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19
Q

What structures carry oxygen right blood to peripheral tissues via pressure exerted by the heart and the elastic properties of these vessels?

A

Arteries

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20
Q

What structures carry oxygen deficient and CO2 rich blood back to the heat via pressure exerted by the skeletal mm and smooth mum (venues)?

A

Veins

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21
Q

Where is the majority of the blood supply at any given time?

A

Veins

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22
Q

Explain the pathway of blood from leaving the heart then back to the heart.

A 
Aorta 
Large Artery 
Small Artery
Arteriole 
Capillary 
Venule
Vein 
Vena Cava
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23
Q

Why are veins more elastic?

A

They hold more blood volume

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24
Q

Which structure is more muscular, arteries or veins?

A

Arteries

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25
Q

Where does gas exchange happen?

A

capillaries

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26
Q

As an action potential happens, Na+ rushes in and K+ rushes out, so the inside of the myocardial cell becomes primed for a ___________

A

contraction

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27
Q

The sliding of ____ and _____ myofilaments is responsible for the mm contraction of the myocardium

A

actin

myosin

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28
Q

What are the three properties of myocardial cells?

A

Automaticity
Rhythmicity
Conductivity

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29
Q

What does automaticity mean?

A

The ability to contract without external stimuli

Remember that skeletal muscles are not like this

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30
Q

What does rhythmicity mean?

A

The ability to contract in a rhythmic manner

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31
Q

What does conductivity mean?

A

The ability to transmit nerve impulses from one myocardial cell to another due to the intercalated disks that form a syncytium

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32
Q

What can prevent or disrupt conductivity in the heart post MI?

A

Scar tissue

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33
Q

Intercalated disks contain two junctions. What are they and what do they do?

A

Desmosomes: attach one cell to another
Connexins: allow electrical impulses to spread from one cell to another

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34
Q

What is released from the myocardium upon injury that can impact the heart beating?

A

Ca++

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35
Q

What coronary artery supplies most of the right ventricle, Av node (in 55% of people), and SA node?

A

RCA

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36
Q

The RCA supplies the part of the heart responsible for what (in general)?

A

Heart Rate

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37
Q

What are the branches of the RCA?

A

Right Posterior Artery

Right Marginal Artery

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38
Q

What does the LCA supply?

A

Left Ventricle
Left Atrium
Ventricular Septum
and SA node (in 45% of people)

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39
Q

What are the branches of the Left Coronary Artery?

A

Left Anterior Descending Artery
Left Circumflex Artery
Left Marginal Artery

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40
Q

When someone refers to the “pacemaker” of the heart, they are talking about the ___ _______

A

SA Node

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41
Q

Why is the LCA called “the widow maker?”

A

It supplies so much of the left side of the heart, which is so muscular

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42
Q

What is a common anomaly that causes sudden cardiac death in athletes?

A

LCA comes off of the RCA

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43
Q

What contracts first, atria or ventricles?

A

Atria

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44
Q

Without any other input, how fast does the SA node pace the heart to beat?

A

> 100 BPM

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45
Q

What part of the autonomic nervous system slows the HR and myocardial contractility? Through what neurotransmitter? How slow does the HR become?

A

Parasympathetic

NT: acetylcholine 60-90BPM

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46
Q

What part of the autonomic nervous system increases the HR and myocardial contractility? Through what neurotransmitter?

A

Sympathetic

Norepinephrine

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47
Q

The AV node can spontaneously discharge without external stimuli at a rate of ___ to ____ BPM

A

40-60

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48
Q

SA node transmits impulses to the ______

A

atria

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49
Q

What is the formula for ejection fraction?

A

EF= SV/EDV

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50
Q

How are the AV node impulses transmitted to the ventricular myocardium?

A

Bundle of His

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51
Q

The bundle of His divides into L and R _______ _______ that innervate each respective ventricle, and then into smaller ________ _______ to cause the ventricles to contract.

A

bundle branches

Purkinje fibers

52
Q

Proximity to the epicardium (pericarditis), age, and coronary artery occlusion makes what node susceptible to disease?

A

SA node

53
Q

The AV node is susceptible to disease due to:

A

RCA occlusion

54
Q

What are normal potassium levels?

A

3.5-5

55
Q

What are some symptoms of hypokalemia?

A 
arrhythmias 
mm cramping (especially if taking a diuretic)
56
Q

What are some symptoms of hyperkalemia?

A

nausea

vomiting

57
Q

What are normal calcium levels?

A

9-11

58
Q

What are some symptoms of hypercalcemia?

A

erratic cardiac contraction

59
Q

What are some symptoms of hypocalcemia?

A

decreased myocardial contractility

60
Q

Describe the systole phase of ventricular activity

A

myocardial contraction
Isovolumetric contraction- same volume
Rapid ejection- volume decreases
slow ejection- volume begins to increase

61
Q

Describe the diastole phase of ventricular activity

A

Myocardial relaxation
passive rapid filling
slower filling
active rapid filling

62
Q

What takes longer, systole or diastole?

A

diastole

63
Q

As the HR increases, the amount of blood ejected _________

A

decreases

64
Q

Cardiac output equals ____ X ______

A

HR

Stroke Volume

65
Q

What is cardiac output?

A

The amount of blood being pumped by both ventricles per unit time

66
Q

What is the stroke volume?

A

volume of blood pumped from the ventricle per beat

67
Q

What is a typical resting CO?

A

5-6L

68
Q

Blood pressure = ___X_____X______

A

HR
SV
TPR

69
Q

What is total peripheral resistance?

A

the amount of force affecting resistance to blood flow throughout the circulatory system.

70
Q

CO particularly affects __________ BP

A

systolic

71
Q

TPR particularly affects _________ BP

A

diastolic

72
Q

MAP = ____ + 1/3 (______ - ______)

A

DBP

SBP-DBP

73
Q

What is a normal MAP?

A

93 mmHg assuming a BP of 120/80

74
Q

In general, patients that have a MAP < ____ need to stay in bed!

A

60

75
Q

MAP is determined by what 4 factors?

A

Blood volume
Cardiac Output
Resistance of the system to blood flow (TPR)
Relative distribution of the blood between arterial and venous blood vessels

76
Q

Fluid loss may be _______ or regulated at the _______

A

passive

kidneys

77
Q

When perfusion is decreased, the _____ system is activated.

A

RAAS

78
Q

If the diameter of the arterioles is increased, the blood pressure _________

A

decreases

79
Q

If the diameter of the arterioles is decreased, the blood pressure _________

A

increases

80
Q

BP is an indirect measure of pressure in the _____.

A

Aorta

81
Q

Pulse pressure is the difference in _______ vs _______

A

Systolic BP

Diastolic BP

82
Q

There is a linear relationship between workload and what two other factors?

A

CO and HR

83
Q

What is the primary determinant for increased CO and BP during exercise?

A

HR

84
Q

What is cardiac preload?

A

The volume of blood left in the ventricles at the end of diastole, prior to contraction

85
Q

What is cardiac afterload?

A

Resistance the left ventricle must overcome to circulate blood

86
Q

If after load increases, what happens to end systolic volume and systolic volume?

A

ESV increases

SV decreases

87
Q

If preload increases, what happens to end systolic volume and systolic volume?

A

EDV decreases

SV increases

88
Q

What is the formula used to calculate SV?

A

SV= EDV-ESV

89
Q

If EDV increases, what happens to SV?

A

Increases

90
Q

Where is the S2 sound heard

A

Base of the heart

After the carotid pulse

91
Q

bility of the heart to change its force of contraction and therefore stroke volume in response to changes in venous return is called the:

A

Frank Starling Mechanism

92
Q

The Frank-Starling Law states that the ______ ______ of the left ventricle will increase as the left ventricular volume increases due to the myocyte stretch causing a more forceful systolic contraction.

A

stroke volume

93
Q

What is the production of RBCs called?

A

Hematopoiesis

94
Q

What is the formula for ejection fraction?

A

EF= SV/EDV

95
Q

The ___ heart sound lasts longer than the ___ sound.

A

s1

s2

96
Q

Where is the S1 sound heard? Where is the sound located in relation to the carotid pulse?

A

Apex of the heart, mitral valve

Before the carotid pulse

97
Q

Where is the S2 sound heard

A

Base of the heart

After the carotid pulse

98
Q

What are the 4 main components of blood?

A

Plasma
RBCs
WBCs
Platelets

99
Q

Upon beginning exercise the body creates more ______ as an adaptation to help with blood volume.

A

plasma

100
Q

Describe the steps of the oxygen transport system from Ventilation to Muscle ATP Turnover

A 
Ventilation 
Pulmonary O2 diffusion 
Circulatory O2 delivery 
Muscle O2 diffusion 
Muscles O2 Utilization 
Muscle ATP Turnover
101
Q

RBC production is regulated by what hormone produces where?

A

Erythropoietin

Kidneys

102
Q

Hematocrit measures what?

A

Concentration of RBCs in blood

103
Q

People with low levels of Hct may also have:

A

anemia, vitamin/nutrion deficiencies

104
Q

People with high levels of Hct may also have:

A

dehydration, polycythemia vera, lung/heart disease

105
Q

The amount of oxygen in the blood that is bound to HgB is called:

A

O2 Saturation (SaO2)

106
Q

_____ reflects only free oxygen molecules dissolved in plasma and not those bound to hemoglobin

A

PaO2

107
Q

what is the formula for the FICK equation to determine VO2?

A

VO2= HR x SV x (a-VO2 diff)

108
Q

What is the net fluid exchange (and in what direction) from the capillaries?

A

2 mmHg outwards from capillary

109
Q

In regard to peripheral gas exchange, decreased activity of the sympathetic nervous system causes ____________.

A

vasodilation

110
Q

What type of pressure tends to move blood across the capillary membrane into the interstitium?

A

Capillary Hydrostatic Pressure

111
Q

What type of pressure results in the flow of interstitial fluid into the capillary circulation?

A

Capillary oncotic pressure

112
Q

What type of pressure draws fluid out of the microcirculation into the interstitium?

A

Interstitial oncotic pressure

113
Q

This is the difference in the oxygen content of the blood between the arterial blood and the venous blood and Is a good way to see how much oxygen is delivered and used by the muscle

A

a-VO2 difference

114
Q

If ventilation volume is too small for relative blood flow, what happens are the arterioles?

A

vasoconstriction to reduce blood flow through the capillaries

115
Q

What is the net fluid exchange (and in what direction) from the capillaries?

A

2 mmHg outwards from capillary

116
Q

Do patients with systolic HF typically have a high or low ejection fraction?

A

LOW

117
Q

Do patients with diastolic HF typically have a high or low ejection fraction?

A

Normal or slightly elevated?

118
Q

O2 moves across alveoli membrane to the pulmonary _______ circulation and is returned to the heart via pulmonary ____

A

arterial

Vein

119
Q

CO2 moves across alveoli membrane to the pulmonary ______ circulation and is sent to the lungs via the pulmonary ______

A

venous

Artery

120
Q

If V/Q is reduced, blood _______ occurs

A

shunting

121
Q

If V/Q is increased, what happens?

A

No gas exchange occurs, physiological dead space

122
Q

What do the arterioles do if the ventilation volume is too large for relative blood flow?

A

vasodilation to the arterioles occurs to allow for increased blood flow

123
Q

If ventilation volume is too small for relative blood flow, what happens are the arterioles?

A

vasoconstriction to reduce blood flow through the capillaries

124
Q

Vasodilations are induced by reductions of O2 at local tissues or increased production of: (3)

A

H+
CO2
Metabolites

125
Q

Vasoconstriction and vasodilation are both controlled by _________ controls: endocrine system and autonomic nervous system

A

extrinsic

Cardiopulmonary Spring 2021 (1 decks)

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