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DPT 503 > Cardiovascular System > Flashcards

Cardiovascular System Flashcards

1
Q

right side of the heart

A

lungs

receives unoxygenated blood

lungs get rid of the CO2

thinner and flatter

crescent shape

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2
Q

left side of the heart

A

systemic-lungs to body

carries oxygenated blood from the lungs through the system

thicker walls

round

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3
Q

pulmonary arteries

A

pump blood out

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4
Q

pulmonary veins

A

pump blood in

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5
Q

apex of the heart

A

bottom aspect of the heart

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6
Q

Diaphragm is higher on the ___ side

A

right

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7
Q

heart location

A

mediastenum of the chest between the 2nd and 5th intercostal space

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8
Q

heart rate vs pulse

A

rate-listen
pulse-feel

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9
Q

pericardium

A

ceran wrap aorund the heart

3 layers (endocardium, myocardium, and visceral epicardium)

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10
Q

pericarditis

A

inflammation of pericardium

roughens membrane surface and causes pericardial friction rub (creaking) that can be heard with a stethescope (sounds like sandpaper or crackling)

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11
Q

cardiac temponade

A

excess fluid that leaks into pericardial space

can compress the heart’s pumping ability

treatment-fluid drawn out with syringe

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12
Q

epicardium

A

visceral layer of serous pericardium

parietal-outer

visceral-inner

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13
Q

myocardium

A

circular or spiral bundles of contractile and noncontractile cardiac muscle cells

noncontractile tissues are the pacemaker cells that contract by themselves w/o outside help

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14
Q

endocardium

A

innermost layer; continuous with endothelial lining of blood vessels

lines the heart chambers and covers the cardiac skeleton of valves

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15
Q

role of heart valves

A

ensures unidirectional blood flow through the heart with no backflow

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16
Q

what causes the valves to open/close

A

pressure changes

pressure builds-valves close
low pressure-valves open

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17
Q

two major types of valvues

A

semilunar and atrioventricular

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18
Q

SL valves

A

located between the ventricles and major arteries

pulmonary and aortic

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19
Q

AV valves

A

located between the atria and ventricles

tricuspid-right
bicuspid-left

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20
Q

incompetent valve (mitral regurgitation)

A

blood backflows so the heart repumps the same blood over and over again

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21
Q

valvular stenosis (mitral stenosis)

A

stiff flaps that constrict the opening

heart needs to exert more force to pump blood

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22
Q

blood flow through the right side of the heart

A

Superior vena cava (SVC), inferior vena cava (IVC), and coronary sinus →

Right atrium →

Tricuspid valve →

Right ventricle →

Pulmonary semilunar valve →

Pulmonary trunk →

Pulmonary arteries →

Lungs

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23
Q

blood flow through the left side of the heart

A

Four pulmonary veins →

Left atrium →

Mitral valve →

Left ventricle →

Aortic semilunar valve →

Aorta →

Systemic circulation

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24
Q

coronary arteries

A

functional blood supply to the heart itself

shortest circulation in the body

during relaxation, coronary arteries profuse the heart (diastole)

myocardium of the left ventricle receives the most blood

start from the aorta

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25
Q

left coronary artery

A

supplies interventricular septum, anterior ventricular walls, left atrium, and posterior wall of left ventricle

2 branches: anterior interventricular artery and circumflex artery

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26
Q

right coronary artery

A

supplies right atrium and most of right ventricle

two branches: right marginal artery and posterior interventricular artery

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27
Q

anterior interventricular artery (also called left anterior descending artery)

A

oxygenated blood to 70% of the heart

BIG PROBLEM WHEN BLOCKED

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28
Q

circumflex artery

A
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29
Q

posterior interventricular artery

A

heart ryhthms

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30
Q

right marginal artery

A
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31
Q

angina pectoris

A

Thoracic pain caused by fleeting deficiency in blood delivery to myocardium

cells are weakened

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32
Q

myocardial infarction (heart attack)

A

prolonged coronary blockage

areas of cell death are repaired with noncontractile scar tissue

blocked left anterior often leads to immediate death

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33
Q

compare and contrast cardiac and skeletal muscle

A

same:
- both are contractile tissues
- both types of muscle contraction are preceded by depolarization in the form of an action potential (AP)
- both require the sarcoplasmic reticulum (SR) to release Calcium (Ca2+)

different:
- some cardiac cells are self-excitable
- the heart contracts as a unit
- special Ca2 channels
- no tetanic contractions
- must have aerobic respiration (heart cannot function without oxygen)

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34
Q

contractile cells

A

responsible for contraction

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35
Q

pacemaker cells

A

noncontractile cells that spontaneously depolarize and initiate depolarization of the whole heart-automaticity

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36
Q

desmosomes

A

prevent adjacent cells from separating during contraction

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37
Q

gap junctions

A

allow ions to pass from cell to cell, transmitting current across the entire heart

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38
Q

special Ca2+ channels

A

influx of Ca2+ from extracellular fluid triggers Ca2+ release from SR

secondary calcium release channels triggered by og small influx of calcium

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39
Q

absolute refractory period

A

rest period almost as long as contraction

allows heart to refill again

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40
Q

depolarization

A

reaches threshold of 40 volts and calcium influx

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41
Q

repolarization

A

calcium channel inactive and potassium activated

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42
Q

cardiac action potentials

A

action potential is initiated bc of sodium opening and potassium closing.

sodium makes membrane more positive.

depolarization from sodium making it positive.

at threshold depolarization occurs and calcium comes in.

after this, potassium reopens, and sodium closes, and the membrane becomes more negative.

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43
Q

where are the pacemaker cells found?

A

SA node (sinus atrial node)

If SA isn’t working, it goes to AV node.

If AV node isn’t working, it goes to Bundle of His

If the Bundle of His isn’t working, then to bundle branch and Purkinje fibers.

If AV and Sa aren’t working, depends completely on ventricles.

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44
Q

sequence of excitation

A

Takes .22 seconds.

  1. SA node depolarizes-sodium in, potassium stopped.
    - SA node generates about 75 beats/min.
  2. .1 second pause-ventricles refill
  3. AV bundle
    - The inherent heartbeat of AV node in absence of SA node is 50 beats/min.
  4. Bundle branches
    - Left and right are the 2 pathways down the interventricular septum to Purkinje fibers.
    - Inherent heart rate will be 30 beats/min if AV doesn’t work.
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45
Q

arrythmias

A

irregular heart rythms

uncoordinated artrial and ventricular contractions

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46
Q

fibrillation

A

rapid, irregular contractions

heart becomes useless for pumping blood, causing circulation to cease; may result in brain death

treatment: defibrillation interrupts chaotic twitching, giving the heart “clean slate” to start regular, normal depolarizations

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47
Q

ectopic foci

A

caused by defective SA node

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48
Q

defective AV node

A

heart block

treatment: pacemaker

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49
Q

cardioacceleratory center

A

sympathetic

stimulates SA and AV nodes, heart muscle, and coronary arteries

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50
Q

cardioinhibitory center

A

parasympathetic

inhibits SA and AV nodes via vagus nerves

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51
Q

P wave

A

depolarization of SA node and atria

no pwave=no artial depolarization

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52
Q

QRS complex

A

ventricular depolarization and atrial repolarization

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53
Q

T wave

A

ventricular repolarization

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54
Q

PR interval

A

beginning of atrial excitation to beginning of ventricular excitation

55
Q

ST segment

A

entire ventricular myocardium depolarized

prolonged/shortened=ventricles taking dif amounts of time to repolarize

56
Q

QT interval

A

beginning of ventricular depolarization through ventricular repolarization

57
Q

systole

A

period of heart contraction

58
Q

diastole

A

period of heart relaxation

59
Q

cardiac cycle

A

blood flow through the heart during one complete heartbeat

atrial systole and diastole followed by ventricular systole an diastole

phases: ventricular filling, isovolumetric contraction, ventricular ejection, isovolumetric relaxation

about .8 seconds (atrial systole .1 sec, ventricular systole .3 sec, and quiescent period about .4 sec)

60
Q

ventricular filling stage (mid to late diastole)

A

80% of blood flows passively from artria through open AV valves into the ventricles (SL valves closed)

atrial depolarization triggers atrial systole (p wave) and the atria contracts pushing the remaining 20% of the blood into the ventricles (EDV-blood left in ventricles at end of ventricular diastole)

depolarization spread to ventricles (QRS complex)

atria finishing contracting and returns to diastole while the ventricle begin systole

AV valve opens, SL valves closed

SA node to AV node

61
Q

isovolumetric contraction

A

atria relaxes and ventricles begin to contract

rising ventricular pressure causes closing of AV valves

split-second period when ventricles are completely closed (all valves closed), volume remains constant, ventricles continue to contract

ventricular pressure exceeds pressure in large arteries=SL valves are forced open

pressure in aorta reaches about 120 mm Hg

all blood in ventricles-pressure is greater in ventricles-AV valves close.

pressure isn’t high enough to release SL valves yet.

62
Q

isovolumetric relaxation (early diastole)

A

following ventricular repolarization (T wave), ventricles relax

end systolic volume (ESV): volume of blood remaining in each ventricle after systole (should not be a lot left after, or heart is ineffective)

ventricular pressure drops causing backflow of blood from aorta and pulmonary trunk that triggers closing of SL valves

aorta and pulmonary have higher pressure-SL valves close.

ventricles are completely closed chambers momentarily

63
Q

normal heart rate

A

about 75 beats/min

64
Q

first heart sound (lub)

A

closing AV valves at beginning of ventricular systole.

65
Q

second heart sound (dup)

A

closing of SL valves at beginning of ventricular diastole

66
Q

pause between lub-dups

A

heart relaxation

67
Q

aortic heartbeat

A

heard at 2nd intercostal space

68
Q

mitral heart beat

A

heard at apex

69
Q

tricuspid heart beat

A

heard at sternal margin of the 5th intercostal space

70
Q

heart murmurs

A

abnormal heart sounds when blood hits obstructions

usually valve issues

71
Q

cardiac output

A

amount of blood pumped out by each ventricle in 1 minute

heart rate x stroke volume

72
Q

stroke volume

A

volume of blood pumped out by 1 ventricle with each beat (correlated to force of contraction)

SV=EDV-ESV (normal SV=120 ml-50ml=70 ml/beat

regulated by ANS, hormones, and ions

remain relatively constant

73
Q

cardiac index

A

cardiac output x body surface area

3L/min/m2

74
Q

what factors increase cardiac output?

A

increased stroke volume

faster heart beat

75
Q

cardiac reserve

A

difference between resting and maximal CO

76
Q

what are the main factors that affect stroke volume?

A

preload, contractility, and afterload

77
Q

preload

A

degree of stretch of heart muscles just before they contract

most important factor is venous return

78
Q

contractility

A

positive ionotropic: increase in contractility
- epinephrine and norepinephrine
- promotes calcium influx
- lowers ESV
negative ionotropic: decrease in contractility
- reduced sympathetic stimulation=reduced contractility
- acidosis, increased potassium, blocked calcium channels

79
Q

afterload

A

back pressure exerted by arterial blood; the pressure the ventricles must overcome to eject blood

aortic pressure~80 mmHg
pulmonary trunk pressure~10 mmHg

increased by hypertension

increase=increased ESV=decreased SV

80
Q

Frank Starling Mechanism

A

relationship between preload and SV

changes in preload cause changes in SV

81
Q

chronotropic effect

A

any mechanism that alters cardiac rate

82
Q

positive chronotropic effect

A

increases HR

83
Q

negative chronotropic effect

A

decreases HR

84
Q

HR can be regulated by…

A

ANS, chemicals (ions and hormones), age, gender, exercise, and body temp

85
Q

ejection friction

A

best indicator of cardiac function

% of blood ejected from ventricles relative to the volume in the ventricles b4 contraction

normal=60%-70%

86
Q

tachycardia

A

fast HR (over 100 beats/min)

87
Q

bradycardia

A

slow HR (under 60 beats/min)

88
Q

congestive heart failure (CHF)

A

inadequate circulation

weakened myocardium

persistent high BP is most common cause of heart failure

left-sided failure: pulmonary congestion (blood backs up in the lungs)
- SOB and wet cough

right-sided failure: peripheral congestion
- blood pools in body organs causing edema

failure of one side weakens the other

89
Q

elastic arteries

A

thick-walled with large, low-resistance lumen

act as pressure reservoirs that expand and recoil as blood is ejected from the heart

aorta and its major branches

90
Q

muscular arteries

A

deliver blood to body organs

active in vasoconstriction

91
Q

arterioles

A

smallest arteries

control flow into capillary beds via vasodilation and vasoconstriction of smooth muscle

lead to capillary beds

92
Q

capillaries

A

microscopic vessels; diameters so small only a single RBC can pass through at a time

supply almost every cell except for cartilage, epithelia, cornea, and lens of the eye

functions: exchange of gases, nutrients, wastes, hormones between blood and interstitial fluid

93
Q

continuous capillaries

A

abundant in skin, muscles, lungs, and CNS

94
Q

fenestrated capillaries

A

occurs in areas of active filtration (kidneys) or absorption (small intestine) and areas of endocrine hormone secretion

allow for increased permeability

95
Q

sinusoidal capillaries

A

fewer tight junctions; usually fenestrated with larger intercellular clefts; incomplete basement membranes

occur in liver, bone marrow, spleen, and adrenal medulla

allow large molecules and even cells to pass across their walls

96
Q

terminal arteriole

A

exchange of gases, nutrients, and wastes from surrounding tissue takes place in capillaries

97
Q

capillary bed

A

an interwoven network of capillaries between the arterioles and venule

98
Q

vascular shunt

A

channel that directly connects arteriole with venule (bypasses true capillaries)

99
Q

precapillary sphincter

A

acts as valve regulating blood flow into the capillary bed

100
Q

blood flow control

A

arteriole and terminal arteriole dilated when blood needed; constricted to shunt blood away from bed when not needed

101
Q

veins

A

carry blood towards the heart

large lumen and thin walls make veins good storage vessels

contains up to 65% of blood supply

102
Q

venous valves

A

prevent backflow of blood

most abundant in veins in limbs

103
Q

venous sinuses

A

flattened veins with extremely thin walls

104
Q

varicose veins

A

dilated and painful veins due to incompetent (leaky) valves

105
Q

blood volume

A

volume of blood flowing through a vessel, organ, or entire circulation in a given period

overall is relatively constant when at rest, but at any given moment, varies at individual organ level, based on needs

106
Q

blood pressure

A

force per unit area exerted on the wall of blood vessels by blood

107
Q

total blood vessel length

A

longer=more resistance

108
Q

greatest influence on resistance

A

blood vessel diameter

109
Q

relationship between flow, pressure, and resistance

A

pressure increases=blood flow speeds up

resistance increases=blood flwo decreases

110
Q

steepest drop in BP occurs where?

A

arterioles

111
Q

mean arterial pressure (MAP)

A

pressure that propels blood to tissues

diastolic pressure + 1/3 pulse pressure (normal=93 mmHg)

112
Q

muscular pump

A

contraction of skeletal muscles “milks” blood back toward the heart; valves prevent backflow

113
Q

respiratory pump

A

pressure changes during breathing move blood toward the heart by squeezing abdominal veins as thoracic veins expand

114
Q

sympathetic vasoconstriction

A

under sympathetic control, smooth muscles constrict, pushing blood back toward heart

115
Q

capillary BP

A

ranges from 35 mm Hg at the beginning of the capillary bed to ∼17 mm Hg at the end of the bed

116
Q

venous BP

A

small pressure gradient; about 15 mmHg

117
Q

3 main factors regulating BP

A

cardiac output, peripheral resistance, blood volume

118
Q

short term regulation of BP

A

neural controls (baroreceptors and chemoreceptors) and hormonal controls

119
Q

neural controls

A

maintain MAP by altering blood vessel diameter and altering blood distribution in response to various organ demands

alter blood vessel diameter which alters resistanceor alter blood distribution to organs in response to specific demands

baroreceptors and chemoreceptors

120
Q

baroreceptors

A

pressure sensitive mechanoreceptors that respond to changes in arterial pressure and stretch

vasodilation

decreased CO

121
Q

chemoreceptors

A

detect increase in CO2, or drop in pH or O2

cause increased BP by increasing CO or increasing vasoconstriction

122
Q

hormonal controls

A

adrenal medulla hormones (epinephrine and norepinephrine), angiotensin 2, ADH, and atrial natriuretic peptide

123
Q

long term regulation of BP

A

renal controls alter blood volume via kidneys by direct renal mechanism or indirect renal mechanism

124
Q

direct renal mechanism

A

alters blood volume independently of hormones

increased BP/blood volume=increased urine output to decrease BP

decreased BP/blood volume=kidneys conserve water and BP rises

125
Q

indirect renal mechanism (renin-angiotensin-aldosterone)

A

decreased arterial BP=release renin from kidneys

angiotension to angiotension 1

ACE from the lungs converts angiotensin 1 to angiotensin 2

stimulates aldosterone secretion which causes ADH to be released

triggers thirst center-drink more water

acts as potent vasoconstrictor-increased BP

126
Q

primary hypertension

A

90% of cases

no underlying cause identified

no cure but can be controlled

127
Q

secondary hypertension

A

less common

due to identifiable disorders

treatment focuses on underlying disorder

128
Q

orthostatic hypotension

A

temporary low BP and dizziness when suddenly rising from sitting or reclining position

129
Q

chronic hypotension

A

a hint of poor nutrition and warning sign for Addison’s disease or hypothyroidism

130
Q

acute hypotension

A

an important sign of circulatory shock

131
Q

circulatory shock

A

Condition where blood vessels inadequately fill and cannot circulate blood normally

132
Q

hypovolemic shock

A

from large scale blood loss

133
Q

vascular shock

A

from extreme vasodilation and decreased peripheral resistance

134
Q

cardiogenic shock

A

when an inefficient heart cannot sustain adequate circulation.

DPT 503 (22 decks)

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