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Human Bio 2 > Cardiovascular System > Flashcards

Cardiovascular System Flashcards

1
Q

Describe the size of the heart in the thorax

A

The size of a fist, mass of 250-350 grams

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2
Q

Describe the structure of the heart?

A

1) inter-atrial septum (separates the atria longitudinally)

2) inter-ventricular septum (separates the ventricles)

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3
Q

Describe the location of the heart in the thorax

A

Enclosed in the mediastinum, from the second rib to the fifth intercostal space, superior to the diaphragm you can feel the apex between the fifth and sixth rib

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4
Q

Describe the orientation of the heart in the thorax

A

2/3 of its mass lies to the left of the mid-sternal line, and 1/3 to the right

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5
Q

What are the covering of the heart?

A

1) Fibrous pericardium (dense connective tissue, protects the heart, anchors it to surrounding structures, prevents overfilling the heart with blood)

2) parietal layer of serous pericardium

3) parietal cavity (contains the serous membrane)

4) visceral layer of serous pericardium/Epicardium

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6
Q

What is the structure of the heart layers?

A

1) Epicardium/visceral layer of serous membrane (often filled with fat)

2) myocardium (cardiac muscles)

3) Endocardium (sheath of endothelium, squamous epithelium)

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7
Q

What are the vessels associated with the right atrium?

A

1) superior vena cava

2) inferior vena cava

3) coronary sinus

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8
Q

What forms most of the anterior surface of the heart?

A

Right ventricle

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9
Q

What are the vessels associated with the left atrium?

A

4Pulmonary vein

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10
Q

What are the vessels associated with the left ventricle?

A

Aorta

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11
Q

What is the structure of the right atrium?

A

1) auricles (wrinkled appendages, which increase the atrial volume)

2) anterior portion made of muscles (pectinate muscle)

3) smooth posterior wall

4) walls separated by C-shaped ridge (crista terminalis)

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12
Q

What is the structure of the ventricles?

A

1) trabeculae carnea (irregular ridges of muscles)

2) papillary muscles (controls the valves)

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13
Q

What is the structure of the left atrium?

A

1) auricles (wrinkled appendages, which increase the atrial volume) with pectinate muscles

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14
Q

What is the structure of the left ventricle?

A

Forms most of the inferoposterior aspect of the heart, forms the apex,

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15
Q

What is the name of the four valves?

A

1) tricuspid valves

2) pulmonary semilunar valves

3) bicuspid (mitral) valves

4) aortic semilunar valves

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16
Q

What is the systematic circulation?

A

The circulation which distributes blood to the whole body except to the lungs, ejected from the left ventricle, via the aorta

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17
Q

What is the pulmonary circulation?

A

The circulation which distributes blood to the lungs via the pulmonary semilunar valves through the pulmonary arteries

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18
Q

What is the function of the papillary muscles?

A

They contract to tighten the cordage tendineae to prevent the valves from opening when the heart contracts

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19
Q

What is the function of the trabeculae carnea?

A

Muscles that marks the internal walls of the ventricles

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20
Q

What is the function of the pectinate muscles?

A

Muscles which forms part of the atria helping it to contract

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21
Q

How does the valves work?

A

1) Blood returning to the heart fills atria, pressing against the AV valves, Increased pressure forces AV valves open

2) As ventricles fill, AV valve flaps hang limply into ventricles

3) Atria contract, forcing additional blood into ventricles

4) Ventricles contract, forcing blood against AV valve cusps.

5) AV valves close

6) Papillary muscles contract and chordae tendineae tighten, preventing valve flaps from everting into atria.

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22
Q

What is valvular stenosis?

A

Narrowing of the valves, as the valves becomes stiff and constricts the opening usually due to calcium deposits or scar tissue deposits, can be replaced with a mechanical valve

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23
Q

How is the coronary arteries distributed?

A

Coronary arteries (arises from the base of the aorta):

1) left coronary arteries (let side of the heart)

-anterior inter-ventricular artery (supplies blood to the inter-ventricular septum & anterior walls of both ventricles)

-circumflex artery (supplies the left atrium and the posterior wall of the left ventricles)

2) Right coronary artery

  • Right marginal artery (supplies the mayocardium of the right side
  • Posterior interventricular artery (supplies to the heart apex & joins with the anterior interventricular artery)
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24
Q

How does the cardiac muscles differ from the skeletal muscles?

A

1) some cardiac muscles are self excitable

2) the heart contracts as a unit

3) The influx of Ca2+from extracellular fluid triggers Ca2+ release from the SR

4) Tetanic contractions cannot occur in cardiac muscles

5) The heart relies almost exclusively on aerobic respiration

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25
Q

What is the structure of cardiac muscles?

A

Straiated, short, branched, one/two nuclei per cell, has gap junctions, contracts as a unit, with few number of T tubules & sarcoplasmic reticulum.

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26
Q

What is the function of cardiac muscles?

A

Contracts to propel blood through the body

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27
Q

Cardiac conduction system

A

1) The sinoatrial (SA) node (pacemaker) generates impulses

2) The impulses pause (0.1 s) at the atrioventricular (AV) node

3) The atrioventricular (AV) bundle connects the atria to the ventricles

4) The bundle branches conduct the impulses
through the interventricular septum

5) The subendocardial conducting network
depolarizes the contractile cells of both ventricles

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28
Q

What are the waves of the heart electrocardiograph?

A

1) P wave (atrial depolarization initiated by the SA node)

  • delay of impulse by the AV node

2) QRS complex (Ventricular depolarization begins at apex, Atrial repolarization occurs)

  • ST segment (ventricular depolarization is complete)

3) T wave (Ventricular repolarization begins at apex)

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29
Q

What does the P wave represent in the ECG?

A

Due to the movement of the depolarization wave from the SA node through the atria (atria contraction)

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30
Q

What does the QRS complex represent in the ECG?

A

ventricular depolarization before the ventricles contracts

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31
Q

What does the T wave represent in the ECG?

A

ventricular repolarization

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32
Q

What does the P-R interval represent in the ECG?

A

The time between the atrial contraction to the beginning of the ventricular excitation

33
Q

What does the S-T segment indicates in the ECG?

A

Represent the beginning of the ventricular depolarization till the ventricular repolarization

34
Q

What is Angia pectoris?

A

It is a deficiency in blood delivery to the myocardium, can be due to stress-induced spasm of the coronary arteries or from increased physical demands on the heart

35
Q

What is myocardial infarction (heart attack)?

A

Due to a prolonged coronary blockage, where cells of the myocardium die.

36
Q

Why is the junctional rhythm abnormal?

A
  • Non-functional SA node
  • P waves are a abscent
  • AV node pages the heart at 40-60 beats per minute
37
Q

What is the shape of the second degree heart block ECG?

A
  • Faliure of the AV node to conduct some SA node impulses
  • More P waves than QRS waves
  • Two P wave for each QRS wave
38
Q

What is ventricular fibrillation?

A
  • Electrical activity is disorganized. Action potentials occur randomly throughout the ventricles
  • Results in chaotic, grossly abnormal ECG deflections
  • Seen in acute heart attack and after an electrical shock
39
Q

What is indicated by the enlarge of the R wave?

A

Enlarged ventricles

40
Q

What does an elevation or depression in the S-T segment indicate?

A

Cardiac ischemia

41
Q

What is cardiac ischemia?

A

Hold back of blood from the heart

42
Q

What does a prolonged Q-T interval indicate?

A

Repolarization abnormalities, can lead to ventricular arrhythmia

43
Q

What are the timing and events of the cardiac cycle?

A

1) ventricular filling:

-passive filling

  • atrial contraction

2) isovolumetric contraction phase

3) ventricular ejection phase

4) isovolumetric relaxation phase

Pressure wise:

1) Atrioventricular (AV) valves close when the ventricular pressure exceeds the atrial pressure

2) Semilunar (SL) valves open when the ventricular pressure exceeds the aortic pressure

3) SL valves close when the ventricular pressure drops below t he aortic pressure

4) AV valves open when the ventricular pressure drops below the atrial pressure

44
Q

What is the normal sound of the heart?

A

Lup-dup

The first sound is caused by the closing of the AV valves, the second sound is caused by the closing of the SL valves. The heart is in systole between the first and second sound

45
Q

How heart murmurs differs from the normal heart sounds?

A

When the blood strikes obstructions, however, its flow becomes turbulent and generates abnormal heart sounds. Heart murmurs are quite common in young children (and some elderly people) with perfectly healthy hearts, probably because their heart walls are relatively thin and vibrate with rushing blood, murmurs indicate valve problems. As there is a swishing sound as blood backflows or
regurgitates through the partially open valve after the valve has (supposedly) closed.
In a stenotic aortic valve, a high-pitched sound or click can be detected when the valve should be wide open during ventricular contraction

46
Q

What are the factors which contributes to the cardiac out-put?

A

It is the amount of blood pumped out by each ventricle in 1 minute

Which is the product of the heart rate (HR) * stroke volume (SV)

47
Q

What is the stroke volume?

A

It is the difference between the end diastolic volume and end systolic volume (EDV - ESV)

can be controlled by:

1) exercise, which will increase the venous return, which will increase the EDV, which will increase the stroke volume

2) decrease in the heart rate, will increase ventricular filling, increases venous return, increases EDV, increases SV

3) blood borne epinephrine/thyroxine/& excess Ca2+, will increases contractility decrease ESV, increase stroke volume

48
Q

What is the end-systolic volume?

A

the volume of blood remaining in a ventricle after it has contracted

49
Q

What is the role of the autonomic nervous system in regulating the cardiac output?

A

Changes in autonomic CNS output (in response to exercise, fright, anxiety, or blood pressure) will decrease the parasympathetic activity & increase the sympathetic activity which will increase the contractility of the heart

50
Q

From where can you hear the aortic valve?

A

2nd intercostal space at the right sternal margin

51
Q

From where can you hear the pulmonary valve?

A

2nd intercostal space at the left sternal margin

52
Q

From where can you hear the mitral valve?

A

In the 5th intercostal space

53
Q

From where can you hear the tricuspid valve?

A

right sternal margin of 5th intercostal space

54
Q

What does the heart murmurs indicate?

A

Valve problems, (stenotic valves)

55
Q

What is the sound heard from a stenotic aortic valve?

A

High-pitched sounds/click (as it should be completely opened during ventricular contraction but its not!)

56
Q

How is the heart rate regulated?

A

1) Autonomic nervous system

2) Chemical regulation

3) age, gender, exercise, body temperature

57
Q

What is hypocalcemia?

A

Reduced blood calcium levels, which can depress the heart

58
Q

What is hypercalcemia?

A

Above than normal calcium levels which increases the heart rate and contractility

59
Q

What can happen due to high calcium levels?

A

Disruption of the heart function, causing life threatening arrhythmias

60
Q

What is hyperkalemia and what can it cause?

A

Increase in the blood k+ levels, it depolarizes the resting membrane potential which might lead to a heat block & cardiac arrest

61
Q

What is hypokalemia?

A

Low blood K+ levels, where the heart beats feebly and arrhythmically

62
Q

What does a marked & persistent heart rate change might indicate?

A

Cardiovascular problems

63
Q

What is tachycardia?

A

Abnormally fast “resting” heart rate which can be due to:

1) elevated body temperatures

2) stress

3) certain drugs

4) heart diseases

It promotes fibrillation

64
Q

What is Bradycardia?

A

Abnormally low resting heart rate (slower than 60/bpm), due to:

1) low body temperatures

2) certain drugs

3) activation of parasympathetic nervous system

In poorly conditioned individuals, it may result in inadequate blood circulation to body tissues, and it might be a sign of brain edema after a trauma

65
Q

What is congestive heart failure?

A

When the heart is an inefficient pump that blood circulation is inadequate to meet tissue needs, which reflects weakening of the myocardium by various conditions that damage it in different ways:

1) coronary atherosclerosis

2) persistent high blood pressure

3) multiple myocardial infarctions

4) dilated cardiomyopathy (DCM)

66
Q

What is coronary atherosclerosis?

A

fatty buildup that clogs the coronary arteries, impairing blood and oxygen delivery to cardiac cells, making the heart hypoxic and to contract ineffectively

67
Q

What can happen due to high blood pressure?

A

Normally, pressure in the aorta during diastole is 80 mm Hg, and the left ventricle exerts only slightly over that amount of force to eject blood from its chamber. When aortic diastolic blood pressure rises to 90 mm Hg or more, the myocardium must exert more force to open the aortic valve and pump out the same amount
of blood. If afterload is chronically elevated, ESV rises and the myocardium hypertrophies. Eventually, the stress takes its toll and the myocardium becomes progressively weaker.

68
Q

What is meant by multiple myocardial infarctions?

A

A succession of MIs (heart attacks) depresses pumping efficiency because noncontractile fibrous (scar) tissue replaces the dead heart cells

69
Q

What is Dilated cadiacmyopathy (DCM)?

A

When the ventricles stretch and become flabby and the myocardium deteriorates, for unknown reasons. Drug toxicity or chronic inflammation may be involved.

70
Q

What is pulmonary congestion?

A

When the left side of the heart fails to pump the blood into the systemic circulation adequately, while the right pump continues to pump the blood into the pulmonary circulation, causing the blood vessels to become engorged with blood, increasing the pressure in them which causes the fluids to be leaked into the lungs causing pulmonary edema, and consequently the person suffocates

71
Q

What is peripheral congestion?

A

When the right side of the heart fails to pump the blood into the pulmonary circulation adequately, causing the blood to stagnate into the body organs, which impairs the ability of the body cells to obtain adequate nutrients and oxygen and to rid themselves from their wastes, causing an edema in the extremities, (feet, ankle, & fingers)

Treatment is directed primarily toward:

1) removing the excess leaked fluid with diuretics (drugs that increase the kidneys’ excretion of Na• and water)

2) reducing afterload with drugs that drive down blood pressure

3) increasing contractility with digitalis derivatives

72
Q

What is congenital heart defect?

A

Heart defects during pregnancy, which is most probably due to certain drugs being taken in the second month when most of the heart formation occur which can cause:

1) lead to mixing of oxygen-poor blood with oxygenated blood (so that inadequately oxygenated blood reaches the body tissues) “septal defects”

2) involve narrowed valves or vessels that greatly increase the workload on the heart “coarctation of the aorta”

These two effects can cause tetralogy of fallot where the baby become cyanotic within minutes after birth these abnormalities are usually treated via surgery

73
Q

What is pericarditis?

A

Inflammation of the pericardium, characterized via pain deep into the chest, which can lead to the adhesion of the visceral and parietal pericardia

74
Q

What is cardiac temponade?

A

When large amounts of fluid accumulate in the pericardial cavity, treated by inserting a syringe and draining of the excess fluid

75
Q

What are the blood supply of the heart myocardium?

A

1) coronary sulcus

2) anterior interventricular sulcus

3) posterior interventricular sulcus

76
Q

How many veins enters the left atria

A

4 (pulmonary veins)

77
Q

What are the coronary veins?

A

1) great cardiac vein (anterior interventricular sulcus)

2) middle cardiac vein (posterior interventricular sulcus)

3) small cardiac vein (right inferior margin)

All of them empty their contents in the coronary sinus, which in turn empties its contents into the right atrium

78
Q

Terminologies

A

Systole: cardiac contraction

Diastole: cardiac relaxation

Isovolumetric phase: it is the phase where all four valves are closed, isovolumetric contraction where ventricles contracts, During the isovolumetric relaxation phase, the ventricles are relaxing and pressures fall

Quiescent period: period of total heart relaxation

Human Bio 2 (7 decks)

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