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Sharlene and MB's PT party > Cardiovascular- Heart (general info) > Flashcards

Cardiovascular- Heart (general info) Flashcards

1
Q

Tissues of the heart

A

Pericardium
Epicardium
myocardium
Endocardium

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2
Q

What is the pericardium?

A

fibrous protective sac enclosing heart

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3
Q

What is epicardium?

A

inner layer of pericardium

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4
Q

What is myocardium?

A

heart muscle, the major portion of the heart

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5
Q

What is endocardium?

A

smooth lining of the inner surface and cavities of the heart

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6
Q

4 chambers of the heart

A

R and L atriums

R and L ventricles

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7
Q

What is the R atrium?

A

receives blood from systemic circulation, from the superior and inferior vena cavae

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8
Q

What is the R ventricle?

A

receives blood from the RA and pumps blood via the pulmonary artery to the lungs for oxygenation; the low pressure pulmonary pump

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9
Q

What is the L atrium?

A

receives oxygenated blood from the lungs and the 4 pulmonary veins

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10
Q

What is the L ventricle?

A

receives blood from the LA and pumps blood via the aorta throughout the entire systemic circulation; the high pressure systemic pump. the walls of the LV are thicker and stronger than the RV and form most of the L side and the apex of the heart.

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11
Q

Name the valves. Why are the important?

A

Provide 1 way flow of blood
Atrioventricular valves: tricuspid valve and bicuspid valve
Semilunar Valves: pulmonary valve and aorta valve

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12
Q

Info about Atrioventricular valves

A

Prevent backflow of blood into the atria during ventricular systole
anchored by the chordae tendineae to papillary muscles
valves close when ventricular walls contract

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13
Q

What is the tricuspid valve?

A

three cusp or leaflets

right heart valve

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14
Q

What is the bicuspid valve?

A

also called the mitral valve
2 cusps or leaflets
left heart valve

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15
Q

Info about semilunar valves

A

Prevents backflow of blood from aorta and pulmonary arteries in ventricles during diastole

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16
Q

Function of pulmonary valve

A

prevents R backflow

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17
Q

Function of aortic valve

A

prevents L back flow

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18
Q

4 components of cardiac cycle

A

1- The rhythmic pumping action of the heart
2- Systole
3- Diastole
4- Atrial contraction

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19
Q

Explain systole

A

The period of ventricular contraction
End systolic volume is the amount of blood in the ventricles after systole
About 50 mL

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20
Q

Explain Diastole

A

The period of ventricular relaxation and filling of blood
End-diastolic volume is the amount of blood in the ventricles after diastole
About 120 mL

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21
Q

Explain atrial contraction (atrial kick)

A

Occurs during the last third of diastole and completes ventricular filling, comprising last 20%-30% of end diastole volume

22
Q

2 points of note: coronary circulation

A

1- Distribution of blood supply is variable from individual to individual
2- Myocardial oxygen supply and myocardial oxygen demand (MVO2) should be in balance in order to maintain a given activity level without ischemia

23
Q

General info about coronary arteries

A

arise directly aorta near aortic valve; blood circulates to myocardium during diastole

24
Q

Info about R coronary artery

A

Supplie R atrium. most of R ventricle, and in most individuals, the inferior wall of L ventricle, AV node and bundle of His
Supplies SA node 60% of the time

25
Q

Info about L coronary artery (LCA)

A

Supplies most of the L ventricle

2 major divisions: L anterior descending (LAD) and Circumflex

26
Q

Info about L anterior descending

A

Supplies the L ventricle and the interventricular septum, and in most individuals, the inferior areas of the apex
It may also give off branches to the R ventricle

27
Q

Info about circumflex (LCx)

A

Supplies blood to the lateral and inferior walls of the L ventricle and portions of the L atrium
Supplies SA node 40% of the time

28
Q

Info about coronary veins

A

Parallel arterial system

The coronary sinus receives venous blood from the heart and empties into the R atrium

29
Q

What is the conduction system of the heart?

A

There are specialized conduction tissues that allow rapid transmission of electrical impulses throughout the myocardium (normal sinus rhythm, NSR)

30
Q

Structures of the conduction system

A

SA node
AV node
Bundle of His
Purkinje tissue

31
Q

Explain the Sinoatrial node

A

1- Located at junction of superior vena cava and R atrium
2- Main pace maker of the heart, initiates the impulse at rate of 60-100 beats per minute
3- Has sympathetic and parasympathetic innervation affecting both heart rate and strength of conduction.

32
Q

Explain Atrioventricular node

A

1-Located at the junction of the R atrium and the R ventricle
2- Has sympathetic and parasympathetic innervation
3- Merges with bundle of His
4- Intrinsic firing rate of 40-60 beats per minute.

33
Q

Explain Purkinje tissue

A

1- R and L bundle branches of the AV node are located on either side of intraventricular septum
2- Terminate in purkinje fibers, specialized conducting tissue spread throughout the ventricles.

34
Q

2 Points about the conduction system of a normal heart beat

A

1- Origin is in the SA node; impulse spreads throughout both atria, which contract together
2- Impulse stimulates AV node, is transmitted down the bundle of His to the purkinje fibers; impulse spreads throughout the ventricles, which contract together (atrial kick)

35
Q

3 points about myocardial fibers

A

1- Muscle tissue: striated muscle fibers with more numerous mitochondria; exhibits rhythmicity of contraction; fibers contract as a functional unit (sliding filament theory of contraction)
2- Myocardial metabolism is essentially aerobic, sustained by continuous O2 delivery from coronary arteries
3- Smooth muscle tissue is found in the walls of blood vessels.

36
Q

What is stroke volume (SV)?

A

The amount of blood ejected with each myocardial contraction
Normal range is 55-100mL/beat
It is influenced by L ventricular end diastolic volume, contractility, and afterload

37
Q

What is L ventricular end diastolic volume (LVEDV)?

A

the amount of blood left in the ventricle at the end of diastole,also known as preload. The greater the diastolic filling (preload), the greater the quantity of blood pumped (Frank-Starling Law)

38
Q

What is Frank-Starling Law?

A

The greater the diastolic filling (preload), the greater the quantity of blood pumped.

39
Q

Define contractility in the context of hemodynamics?

A

The ability of the ventricle to contract

40
Q

What is afterload?

A

The force the LV must generate during systole to overcome aortic pressure to open the aortic valve.

41
Q

What is Cardiac Output (CO)?

A

The amount of blood discharged from the R to the L ventricle per min.
Average adult at rest - normal range is 4-5L per min
Determined by HR x SV = CO

42
Q

How is cardiac index determined?

A

Cardiac output divided by body surface area

Normal range is 2.5- 3.5 L/min

43
Q

What is L ventricular end diastolic pressure (LVEDP)?

A

pressure in the L ventricle during diastole

Normal range is 5-12 mm Hg

44
Q

What is ejection fraction?

A

percentage of blood emptied from ventricle during systole; a clinically useful measure of LV function

45
Q

How is EF calculated?

A

SV/LVEDV

46
Q

Norms for EF

A

Normal EF averages >55%

The lower the EF , the more impaired the LV

47
Q

What is atrial filling pressure?

A

the differences between atrial and venous pressures

48
Q

Factors that affect atrial filling pressure

A

1- R atrial filling pressure is decreased during strong ventricular contraction, and atrial filling is enhanced
2- R atrial filling pressure is affected by changes in intrathoracic pressure; decreases during inspiration and increases during coughing or forced expiration
3- venous return increases when blood volume expands and decreases during hypovolemic shock

49
Q

Diastolic filling time ______ with increased heart rate and with heart disease.

A

decreases

50
Q

What does myocardial oxygen demand (MVO2) represent?

A

The energy cost to the myocardium

* MVO2 increases with activity and with HR and/or BP

51
Q

How is MVO2 measured?

A

Clinically measured by the product of heart rate and systolic BP, known as the rate pressure produce

Sharlene and MB's PT party (35 decks)

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