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1003 > Cardiovascular System > Flashcards

Cardiovascular System Flashcards

1
Q

What is the heart?

A

A hollow muscle the pumps blood

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2
Q

What are blood vessels (vasculature)?

A

They carry blood

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3
Q

How much blood circulates the human body?

A

4-6 litres of blood circulates the human body

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4
Q

What side of the body is the heart apex on?

A

Left

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5
Q

What side of the body is the base of the heart on

A

Centre of body but near the right

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6
Q

Where is the heart located?

A

Within the thoracic cavity

Surrounded by the rib cage

The lungs are positioned on the left and right sides of the heart

The apex of the heart sits just above the diaphragm

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7
Q

Draw a cross section of the chest including the heart, ribs, lungs, trachea and diaphragm

A

See lecture notes

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8
Q

What is the size and orientation of the heart?

A

The heart is a hollow muscular organ and weights between 250 and 300 grams

The apex of the heart sits by the 5th intercostal space, above the diaphragm facing towards the right hip

The base of the heart is roughly 9cm long, facing towards the right shoulder

The majority of the heart is located to the left of the midline

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9
Q

Draw and label a diagram of the heart

A

See lecture notes

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10
Q

Describe the process of blood being pumped around the body

A

See lecture notes

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11
Q

Which part of the heart has a thicker muscular wall?

A

The left ventricle

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12
Q

What is the function of the septum?

A

To separate the two halves of the heart

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13
Q

What is the function of valves in the heart?

A

They ensure a one way flow around the heart

Prevent back flow of blood between chambers

Backflow can cause a stroke, heart failure, blood clots or cardiac arrest

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14
Q

What is the pericardium and what is the function of the pericardium?

A

It is a tough fibrous tissue

It protects the heart from physical damage and over-expansion

It anchors the heart at the right position

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15
Q

What is the endocardium?

A

Smooth squamous vascular endothelium

It minimises friction as the blood flows through the heart

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16
Q

What is the myocardium?

A

Striated muscles

Cardiomyocytes: branch and connect via inter calculated discs

Blood supply to the coronary arteries (the first branches off the aorta)

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17
Q

Draw and label a diagram showing the wall of the heart

A

See lecture notes
Pericardium on outside

Myocardium in middle

Endocardium on inside

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18
Q

What rate cardiac muscle cells called?

A

Myocytes

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19
Q

Describe myocytes

A

Striated appearance

All have a nucleus

Branch

Connect via intercalated disks

Intercalated discs contain two types of cell junctions; gap junctions and desmosomes

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20
Q

What are desmosomes?

A

Strong protein fibres

Composed of complexes of adhesion proteins found on the lateral side of the cells plasma membrane

It holds cardiac muscles together during contraction

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21
Q

Draw and label a diagram of a desmosome

A

See lecture slides

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22
Q

Are cardiac muscle cells excitable or contractile?

A

They can be both

Muscle cells communicate through gap junctions

Local ionic currents flow from one muscle to the next through gap junctions

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23
Q

Draw and label a diagram of the heart and show the direction of blood flow

A

See lecture notes

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24
Q

What is an artery?

A

Any vessel carrying blood away from the heart

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25
Q

What is a vein?

A

Any vessel carrying blood to the heart

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26
Q

When does each atria contact?

A

Both at the same time

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27
Q

When do both of the ventricles contract?

A

At the same time

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28
Q

What does lub mean?

A

Mitral and tricuspid valves shut

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29
Q

What does dub mean?

A

Semilunar valves shut

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30
Q

Draw the systemic circuit and pulmonary circuit showing how blood travels around the body to the heart

A

See lecture slides

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31
Q

Draw the systemic circuit showing how blood travels around the body

A

See lecture notes

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32
Q

Draw the pulmonary circuit to show how blood travels to the lungs

A

See lecture notes

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33
Q

What is the vascular system?

A

Consists of arteries, capillaries and veins

It plays an active role in regulating blood pressure

Plays an active role in distributing blood to various tissues

Smaller arteries are called arterioles

Smaller veins are called venules

Capillaries permeate almost every tissue in the body. At any given time, 5% of circulating blood goes through the capillaries

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34
Q

What are small veins called

A

Venules

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35
Q

What are small arteries called?

A

Arterioles

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36
Q

What are arteries? And describe the three layers:

A

All arteries carry blood away from the heart

All arteries carry oxygenated blood except form the pulmonary attires which carry deoxygenated blood form the heart to the lungs

The three layers:

Innermost layer: Tunica Intima

  • made of simple squamous epithelium called endothelium
  • the only part that is in contact with blood

Middle layer: tunica media:

  • made of smooth muscle and elastic connective tissues
  • involved in the maintenance of normal blood pressure

Outer layer: tunica externa

  • made of strong fibrous connective tissues
  • provides support and protection
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37
Q

What are veins? Describe the layers

A

All veins carry blood to the heart

Veins carry deoxygenated blood from tissues to the heart however, pulmonary veins carry oxygenated blood from the lungs to the heart

3 layers:

The inner layer: Tunica intima
- smooth endothelium

The middle layer: tunica media
- thin layer of smooth muscle

The outer layer: tunica externa
- thin layer of fibrous connective tissue

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38
Q

Discuss the differences between an artery, a vein and a capillary

A 
Artery: 
Thick outer wall 
Small lumen
Thick layer of muscles and elastic fibres 
Thicker due to higher blood pressure

A vein:
Thin layer of muscle and elastic fibres
Large lumen
Fairly thin outer wall

A capillary:
Very small lumen
Wall made of a single layer of cell

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39
Q

What are capillaries?

A

They carry blood from arterioles to venules

Capillaries are exchange sites of materials (nutrients, waste)

Their walls are thin - simple squamous epithelium lining

They have contractile cells called pericytes

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40
Q

Draw and label a cross section of a capillary:

Remembered
Pericyte
Basal membrane
Epithelial cell

A

See lecture notes

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41
Q

Draw and label a diagram showing how blood is supplied to the heart

A

See lecture notes

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42
Q

Draw and label a diagram showing the electrical conduction in a heart

A

See lecture notes

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43
Q

What is the intrinsic conduction system in the heart

A

Internal regulating system responsible for rhythmic contraction of the heart

Consists of auto-rhythmic cells: 
Sinoatrial (SA) node - specialised myocardial tissue 
Internodal tracts 
Atrioventricular (AV) node 
AV bundle (bundle of his) 
Bundle branches 
Purkinje fibres

The SA node depolarises spontaneously, it fires at regular intervals generating the sinus rhythm

SA node is the pacemaker of the heart

44
Q

Name the auto-rhythmic cells

A

sinoatrial (SA) node - specialised myocardial cells

Internodal tracts

Atrioventricular (AV) node

AV bundle (bundle of his)

Bundle branches

Purkinje fibres

45
Q

How is sinus rhythm generated?

A

SA node depolarises spontaneously, it fires at regular intervals which generates the sinus rhythm

46
Q

Which part is the pacemaker of the heart

A

The SA node

47
Q

What is the average beats per minute of the heart?

A

60-70 beats per minute

48
Q

Explain the intrinsic conduction system of the heart

Use a Diagram to help

A

See lecture notes

49
Q

Name the two factors which affect heart rate:

A

The sympathetic nervous system increases heart rate

The parasympathetic nervous system decreases heart rate

50
Q

What neurotransmitters of the sympathetic nervous system increase heart rate?

A

Adrenergics

Norepinephrine

51
Q

What neurotransmitters of the parasympathetic nervous system reduce heart rate?

A

Cholingeric

Acetylcholine

52
Q

Draw and label a diagram showing how the parasympathetic and sympathetic nervous system impact heart rate

A
53
Q

What is the resting membrane potential?

A

Inside cell negative voltage (mV) with reference to the outside

54
Q

What is action potential?

A

Sequence of electrical changes due to movement of ions through channels - includes depolarisation and depolarisation

55
Q

What three ion channels are found in the heart?

A

Sodium channel

Potassium channel

Calcium channel

56
Q

Describe action potentials of cardiac auto-rhythmic cells

A

Unlike non-pacemaker action potentials in the heart, and most other cells that elicit action potentials (e.g. nerve cells and muscle cells) the depolarising current is carried into the cell primarily by relativity slow Ca++ currents instead of the fast Na+ currents

Slower action potentials mean an unstable resting potential

57
Q

What is the depolarisation phase?

A

Once the pacemaker potentials reaches threshold, Ca++ channels open

A rapid influx of Ca++ occurs, leading to a self-induced action potential

58
Q

What is the depolarisation phase?

A

Falling phase of the action potential because rapid release of K+ due to the activation of the K+ channels

59
Q

How does the myocardium communicate through gap junctions?

A

Allows cytoplasmic connections between two cells

Facilitate the spread of action potentials from one cell to another

Ensures all cells contract as a single co-ordinated unit

60
Q

Draw and label a diagram showing the impulse conduction through the heart

A

See lecture notes

61
Q

What does ECG mean and what does it do?

A

Electrocardiogram

Measure the electrical activity of the heart

62
Q

Draw and label a normal ECG

A
63
Q

What is the P wave on an ecg?

A

Is the first positive deflection on the ECG

Lasts about 0.08 seconds

Results from movement of the depolarisation wave from the SA node

Represents atrial depolarisation

64
Q

What is the PR segment in a normal ECG?

A

Is the flat, usually isoelectric segment between the end of the P wave and the start of the QRS complex

Atrial depolarisation complete and the impulse is delayed at the AV node

65
Q

What is the QRS complex?

A

Results from ventricular depolarisation (begins at the apex) and precedes ventricular contraction

Atrial depolarisation occurs

Average duration is 0.08s

66
Q

What is the ST segment?

A

Is the flat, isoelectric section between the end of the QRS complex and the beginning of the T wave

It represents the interval between ventricular depolarisation and depolarisation

67
Q

What is a T wave in an ECG?

A

The T wave is the positive deflection after each QRS complex

It presents ventricular re-polarisation

Ventricular re-polarisation begins at the apex

68
Q

What is the TP interval?

A

Time during which the ventricles are relaxing and filling

69
Q

Draw and label a diagram showing what happens to ventricles and atrial during systole and diastole conditions

A

See lecture notes

70
Q

What does systole and diastole mean?

And where do these events take place?

A

In the ventricles

Systole: period of ventricular contraction and blood ejection

Diastole: ventricular relaxation and blood filling

71
Q

How long is systole and how long is diastole?

How long does the cardiac cycle last in a patient with a typical heart rate?

A

Systole: 0.3 seconds

Diastole: 0.5 seconds

For a typical heart rate of 72 bpm, the cardiac cycle lasts 0.8 seconds

72
Q

What are the four basic principles of the cardiac cycle?

A

1: blood flows from higher to lower blood pressure
2: contraction increases the pressure
3: relaxation decreases the pressure
4: valves open/close according to pressure gradients

73
Q

When do the AV valves open and close?

A

The AV valves open when pressure is higher in the atria and close when the pressure gradient is reversed

74
Q

When do the semilunar valves open?

A

The semilunar valves open when ventricular pressures are higher than aortic and pulmonary pressures

75
Q

What is cardiac output?

A

The volume of blood each ventricle pumps expressed in litres/minute

76
Q

What does heart rate mean?

A

Number of heart beats per minute

77
Q

What does stroke volume mean?

A

Volume of blood ejected from each ventricle during systole (litres/beat)

78
Q

What is the equation to find out cardiac output?

A

CO = HR x SV

Co: cardiac output
Hr: Heart rate
SV: stroke volume

79
Q

How do you calculate the factors that affect stroke volume?

A

Sv: volume of blood pumped out of each ventricle during each heart beat (litre/beat)

Sv represents the difference between end diastolic volume (EDV) and end systolic volume (ESV)

SV= EDV - ESV

EDV= volume of blood in each ventricle at the end of ventricular diastole

ESV= volume of blood in each ventricle at the end of the ventricular systole

The relationship between SV and EDV is known as frank-starling mechanism

80
Q

How does preload affect stroke volume?

A

Preload: the degree to which the myocardium is stretched before contraction

Determined by venous return and EDV

The bigger the EDV, the higher the preload, the higher the SV

The greater the end diastolic volume, the greater the stretch and the more forceful the contraction will be

81
Q

How does after-load affect stroke volume?

A

After load: the peripheral resistance that the contracting ventricular muscle has to work against when it is ejecting blood

Back pressure exerted but arterial blood in aorta and pulmonary artery

In healthy individuals, after load is relativity constant

The higher the afterload, the higher the ESV, the lower the SV

82
Q

What factors affect cardiac output:

A

1: autonomic nervous system
Sympathetic: increases heart rate
Parasympathetic: decreases heart rate

2: chemicals
Noradrenaline
Acetylcholine

83
Q
A

Pressure that the blood exerts on the walls of the vessels that contain the blood (mmHg)

Blood pressure is the measurement of force applied to artery walls

84
Q

What does systole mean?

A

Period of ventricular contraction and blood ejection

85
Q

What does diastole mean?

A

Ventricular relaxation and blood filling

86
Q

What is systolic pressure?

A

The pressure that blood exerts on the arterial wall when the ventricles of the heart contract to pump blood out

87
Q

What is diastolic pressure?

A

The pressure blood exerts on the arterial wall when ventricles of the heart are relaxed

88
Q

What is the systemic blood pressure?

A

120/80mmHg

89
Q

What is pulmonary blood pressure?

A

25/8mmHg

90
Q

What is venous blood pressure?

A

E.g. the top of the arm

Approximately 6-8 mmHg

91
Q

What is the blood pressure in capillaries?

A

Arterial end of the capillary
Roughly 32 mmHg

Venous end of the capillary:
12mmHg

92
Q

How is blood pressure calculated?

A

Blood pressure (BP) = cardiac output (CO) x peripheral vascular resistance (PVR)

BP = CO x PVR

93
Q

What is the equation for cardiac output?

A

Cardiac output (CO) = Heart rate (HR) x stroke volume (SR)

94
Q

How is stroke volume calculated?

A

Stroke volume (SR) =end diastolic volume (EDV) - end systolic volume (ESV)

95
Q

What is the definition of hypertension?

A

High or raised blood pressure, is a condition in which the blood vessels have persistently raised pressure

96
Q

What are the risk factors of hypertension?

A

Male

Genetic

Family history

Excessive salt intake

Excessive alcohol intake

Unhealthy diet

Sedentary lifestyle

Obesity

Stress

97
Q

What does the NICE guidelines recommend if a patients blood pressure is over 140/90mmHg

A

Offer ambulatory blood pressure monitoring (ABPM) to confirm the diagnosis of high blood pressure

98
Q

What is ABPM?

A

Ensure that at least two measurements per hour are taken during the persons usual waking hours

Or 24 hour monitoring at home (HBPM)

99
Q

Persistent high blood pressure can increase the risk of a number of serious and potentially life threatening health conditions, such as?

A 
Heart disease
Stroke 
Heart attack 
Herbert failure 
Aortic aneurysms 
Kidney disease 
Vascular dementia
100
Q

What are some anti-hypertensive drugs?

A

Calcium channel blockers e.g. nifedipine

Beta adrenergic receptor blockers e.g bisoprolol

Angiotensin converting enzyme inhibitors (ACE) e.g. ramipril

Angiotensin II (Ang-II) receptor antagonists e.g. loser tan

Diuretics e.g. indapamide

101
Q

If a blood pressure is less that 120 systole and less than 80 diastole,

What blood pressure rating does the patient have?

A

Normal

102
Q

A patients systole blood pressure is 120-139 and diastole 80-89.

Do they have high blood pressure?

A

They have prehypertension

103
Q

A patients systole blood pressure is 140-159 and diastole 90-99

Do they have high blood pressure?

A

They have high blood pressure (hypertension) stage 1

104
Q

A patients systole blood pressure is 160 or higher and diastole 100 or higher

Do they have high blood pressure?

A

They have high blood pressure (hypertension) stage 2

105
Q

A patients systolic blood pressure is over 180 and diastolic is over 110

Do they have high blood pressure?

A

The patient is in hypertensive crisis

Emergency care is needed

1003 (7 decks)

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