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FS Exam 4 > Cardiovascular Overview And Myocardial Function > Flashcards

Cardiovascular Overview And Myocardial Function Flashcards

1
Q

Heart wall and covering

A

Fibrous Pericardium

Serous Pericardium

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2
Q

Function of pericardium

A

Protective function

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3
Q

Serous Pericardium

A

Parietal Pericardium

Visceral Pericardium

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4
Q

Heart Wall

A

Epicardium
Myocardium
Endocardium

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5
Q

Epicardium

A

Visceral Pericardium
Coronary vessels are housed
Provides the heart with blood
Function: lubricative outer covering

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6
Q

Myocardium

A

Muscles, reactive hyperemia

Function: provides muscular contractions that eject blood from heart chambers

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7
Q

Endocardium

A

In contact with blood inside the chambers, is continuous with endothelium
Function: Serves as protective inner lining of chambers and valves

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8
Q

4 Chambers

A

2 Atria

2 Ventricles

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9
Q

4 Valves

A 
2 AV (bicuspid and tricuspid)
2 Semilunar (aortic and pulm)
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10
Q

Trace a drop of blood through CV System

A

do it :)

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11
Q

What is the importance of heart valves

A

When papillary muscles are contracted, valves close

Prevent backflow

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12
Q

The CV system is a ____ system

A

Closed loop

  1. Systemic - blood to tissues
  2. Pulmonary - blood to lungs
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13
Q

Pressure arterial vs. venous side

A

High pressure on arterial side

Low pressure on venous side

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14
Q

Which ventricle is normally thicker

A

Left ventricle

Has more pressure than the right, so thicker walls

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15
Q

Cardiac Output

A 
ALL of it goes to the lungs
20% kidneys
24% liver and GI
21% skeletal muscle
4% coronary circulation 
18% skin and other organs
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16
Q

Systemic organs are arranged in ___ Why?

A

Parallel
With parallel arrangement the total resistance is lower than each of the individual resistances
It is a method for keeping low resistance

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17
Q

Arrangement of Vascular Beds

A

Greater flow achieved with small changes in pressure

Greater ability to control flow to individual organs

18
Q

Movement of blood flow depends on….

A

A pressure gradient
Gradient is established by contracting of AV valves
Our heart is generating contractile force that creates pressure

19
Q

Myocardium similarities to skeletal muscle

A
  1. Striations
  2. Contracts according to sliding filament theory
  3. Alters force by cross bridge overlap
20
Q

Myocardium differences from skeletal muscle

A
  1. No fiber types - all are ST like (high endurance, lot of mitochondria)
  2. Underdeveloped SR - relies heavily on extracellular calcium
  3. Gradates force by increasing Ca
    - Intercalated Disks (allows functional syncytium - contract as one unit and allows free passage of ions through gap junctions)
    - Single nuclei serving a single cell
    - No satellite cells (no regeneration capacity)
21
Q

Calcium Induced Calcium Release (CICR)

A

Small inc in Ca near the SR leads to a much larger Ca release from the SR
Required for contraction

22
Q

What happens with the Ca

A
  1. Depolarization wave at the sarcolemma activates the VGCCs (DHPR)
  2. Ca influx activates Ca release channels on the SR (RYR)
  3. Increase in intracellular Ca
  4. Ca binds to troponin to activate the contractile element
23
Q

Influx

A

VGCC (L type Ca channels)

NCX

24
Q

Efflux

A

SERCA (80%) - Ca sequestered back into SR

NCX (20%)

25
Q

NCX

A

Sodium calcium exchange
3 Na in for 1 Ca out
OR 1 Ca in for 3 Na out

26
Q

Digoxin

A

Blocks the Na/K Atpase
Increases contractility of the heart to have normal atrial rhythm
More Na builds up inside - leaves via NCX and gets more Ca inside - more contracility

27
Q

Ca Sparks =

A

Single episode of calcium induced calcium release

  • Basis for modulating intracellular Ca
  • Explains graded force of contraction
28
Q

Ca Sparks represent

A

Ca passing through the RYRs
Small, local Ca release events
Occur spontaneously
Can be evoked by depolarization too

29
Q

More Ca in the cell does what to affinity

A

Increases it

Higher affinity for troponin at higher force

30
Q

Mechanisms that inc intracellular Ca….

A

Also increase affinity btw Ca and troponin and cross bridge formation and therefore an increased developed force in left ventricle - more force of contraction in the heart - leads to increase in pressure and cardiac output

31
Q

Bowditch Effect

A

Rate induced regulation
Increase force as Inc. heart rate - inc in heart rate –> shorter time to fill heart, so more Ca in heart cells and causes heart to contract harder
Greater Ca influx but less time for efflux
Net inc in SR Ca load

32
Q

Greater contractility with increased heart rate

A

Ca influx but not enough time to get full relaxation so as result with each beat you are adding intracellular Ca contraction

33
Q

Ionotropy - what impacts it?

A

Contractility

  1. Sympathetic nerve (extrinsic)
  2. Bowditch Effect (intrinsic)
  3. Cardiac glycosides
  4. Ca channel blockers inhibit VGCCs
  5. Altering Na gradient
  6. pH and temperature
34
Q

Lusitropy - what does it occur by

A

Relaxation

  1. Extrusion of Ca into ECF (getting it out of the cell)
  2. Reuptake of Ca into SR
  3. Dissociation of Ca from TnC
35
Q

Chronotropy

A

Rate

Autonomic NS

36
Q

Sympathetic influence on myocardium

A

Beta 1 adrenergic stimulation increases both cardiac ionotropy and lusitropy (need to relax the heart before can contract again)
Increases heart rate too

37
Q

Ionotropic Mechanisms

A

Activates VGCCs
Activates ryanodine receptors
Gets more Ca into heart cell

38
Q

Lusitropic Mechanisms

A

Activates troponin I (inc offrate of Ca from troponin)

Relieves inhibition of Ca atpas by phosphorylating phospholamban - allow more Ca to be taken up into SR

39
Q

Phosphoralamban

A

Inhibits SERCA in the unphosphorylated state - acts as a break on Ca Atpase pump

40
Q

More Ca in the cell =

A

More contraction

FS Exam 4 (6 decks)

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