Cardiovascular System Flashcards
1
Q
Precordium
A
Area on anterior chest overlying the heart and great vessels
2
Q
Great vessels
A
Major arteries and veins connected to the heart
3
Q
The heart and great vessels are located between the
A
Lungs in the middle third of the thoracic cage
4
Q
Mediastinum
A
Where the heart and great vessels are located
-between the lungs in the middle third of the thoracic cage
5
Q
The heart extends from the levels of the ___ to ____ intercostal spaces
A
Second and fifth
6
Q
During contraction, which part of the heart is creating the apical impulse by beating against the chest wall
A
The apex (bottom of the heart)
7
Q
Where is the apical pulse palpable
A
The fifth intercostal
-7 to 9cm from Midsternal line
8
Q
The great vessel lies
A
Bunched above the base of the heart
9
Q
The superior and inferior venae cavae return ____ ___ blood to the ___ side of the heart
A
Return DE-OXYGENATED VENOUS
To the RIGHT side
10
Q
Pulmonary artery leaves the __ ventricle
A
Right
-carries venous blood to lungs
11
Q
Pulmonary veins return what type of blood?
A
Freshly oxygenated blood to left side of the heart
12
Q
What carries oxygenated blood out to the body?
A
Aorta
13
Q
Pericardium
A
Tough, fibrous, double walled sac surrounding/protecting the heart
14
Q
What is found in between the two layers of the pericardium?
A
Pericardial fluid
-aids in reducing friction allowing for smooth movement of heart muscle
15
Q
Myocardium
A
Muscular wall of the heart
-does the pumping
16
Q
Endocardium
A
Thin layer of endothelial tissue lining the inner surface of heart chamber and values
17
Q
Atrium vs ventricle
A
Atrium- thin walled reservoir for holding blood
Ventricle- thick walled muscular pumping chamber
18
Q
How many chambers are there in the heart
A
Fourt
19
Q
How are the chambers separated
A
By swinging door like structures called valves
20
Q
Function of valves
A
Prevent back flow of blood
21
Q
What does it mean by the valves are unidirectional
A
They can open only one way
-open and close passively in response to pressure gradients in the moving blood
22
Q
What valves separate the atria and ventricles
A
Atrioventricular valves
23
Q
The right AV valve
A
Tricuspid valve
24
Q
Left Av valve
A
Bicuspid or mitral valve
25
Two different types of atrioventriclar valves
Tricuspid (right) and mitral (left)
26
The valves thing leaflets are anchored by collagenous fibres to papillary muscles embedded in the ventricle floor called
Chordae tendineae
27
When do the AV valves open
During hearts filling stage or diastole
28
Why do AV valves open
During diastole so that ventricles can fill with blood
29
When do the AV valves close
During the pumping phase or systole
30
Why do AV valves close
To prevent regurgitation of blood back up into atria
31
When do the papillary muscles contract
During systole
-so that the valve leaflets meet and untie to form a perfect seal without turning themselves inside out
32
Where are the semilunar valves
Between ventricles and pulmonary arteries
33
Each semi lunar valve has
Three cusps that look like half moons
34
What are the two semilunar valves
Pulmonic valve (right side) and aortic valve (left side)
35
Semilunar valves open during
Pumping (systole) to allow blood to be ejected from the heart
36
Where are there no valves
Between the venae cavae and right atrium, or between pulmonary veins and left atrium
37
Because there are no valves between venae cavae and right atrium, and the pulmonary veins and left atrium what can happen on the left side of the heart
Abnormal high blood pressure in the left side of the heart produce symptoms of pulmonary congestion, heart failure
38
Because there are no valves between venae cavae and right atrium, and the pulmonary veins and left atrium what can happen on the right side of the heart
Abnormally high pressure in the right side of the heart manifests as distension of neck veins and abdomen
39
Blood flows from liver to
Right atrium via inferior vena cava
40
Superior vena cava drains venous blood from
Head and upper extremities
41
From right atrium venous blood travels through tricuspid valve to
Right ventricle
42
From right ventricle, enough blood flows through
Pulmonary valve to pulmonary artery
43
Pulmonary artery delivers
unoxygenated blood to lungs
44
Lungs oxygenate the blood then travels to
Pulmonary veins where it returns fresh blood to left atrium
45
From left atrium arterial blood travels through
Mitral valve to left ventricle
46
Left ventricle ejects blood through
Aortic valve into aorta
47
What are the two phases of the cardiac cycle
Diastole and systole
48
Diastole vs systole
Diastole- ventricles relax and fill with blood
Systole- hearts contraction and blood is pumped from ventricles (into pulmonary and aortic arteries)
49
In diastole the ___ valves are open
AV
50
During diastole the pressure in the ___ is higher than in the __
Atria, ventricles
-so that blood pours rapidly into the ventricles
51
Early or protodiastolic filling
First passive filling phase
52
Presyostole or atrial systole
Toward end of diastole, atria contract and push last amount of blood into ventricles
-atrial kick
53
Presystole or atrial systole causes a
Small rise in left ventricular pressure
54
As ventricular pressure rises due to the increased volume at the end of diastole, what happens
The mitral and tricuspid valves swing shut
55
First heart sound (S1) is caused by
Closing of the AV valves
56
What is the signal of systole
S1
57
For a very brief time after S1 what is happening
All four valves are closed
58
What happens due to the brief period of time where all the valves are closed
Ventricular walls contract within the closed system increasing the pressure to a higher level —> ISOMETRIC CONTRACTION
59
When the pressure in the ventricle finally exceeds pressure in the aorta (isometric contraction) what happens
The aortic valve opens and blood is ejected rapidly
60
What happens once all the ventricles are ejected
Pressure falls, and when pressure is below aorta pressure some blood flows backward toward ventricle causing aortic valve to shut
61
What is the cause of the second heart sound (S2)
Closure of semilunar valves
-end of systole
62
Isometric or isovolumic relaxation
After end of systole, all four valves are closed and ventricles relax
-but atria have been filing with blood from lungs and so pressure in atrias are higher than ventricles again, so mitral valve drifts open and diastolic filling begins again
63
During inspiration ___ pressure is decreased, this pushes more
Intrathoracic pressure
-pushes more blood into venae cavae increasing venous return to right side of the ehart
64
moRe to the
Right
65
Less to the
Left
66
Normally ___ is a silent event
Diastole
67
S3
In some conditions ventricular filling creates vibration that can be heart over the chest
-ventricles are resistant to filling during protodiastole
68
Where is S2 loudest
At the base
69
S4
End of diastole at presystole, when ventricle is resistant to filling
-atria contracts and pushes blood into a non compliant ventricle, creating vibrations
70
S4
End of diastole at presystole, when ventricle is resistant to filling
-atria contracts and pushes blood into a non compliant ventricle, creating vibrations
71
What three conditions cause murmurs
1. Increase in velocity of blood flow
2. Decrease in viscosity of blood
3. Structural defects in valves or unusual opening in the chambers
72
Murmur
Gentle, blowing, swooshing sound
73
Increases in velocity of blood flow example
Flow murmur, exercise, thyrotoxicosis
74
Example of decreases in viscosity of blood
Anemia
75
Four characteristics of sound
1. Frequency
2. Intensity
3. Duration
4. Timing
76
Sinoatrial node
Intrinsic rhythm know as the pacemaker
77
Sequence of conduction
SA node across atria to AV to bundle of his to fascicles branches then ventricles
78
P wave
Depolarization of the atria
79
P wave
Depolarization of the atria
80
P-R interval
Time necessary for atrial depolarixaiton plus time for the impulse to travel through the AV node to the ventricles
81
QRS complex
Depolarization of the ventricles
82
T wave
Repolarixaiton of ventricles
83
Order of an ECG wave
P wave, P-R interval, QRS complex, T wave
84
Electrical events slightly ___ the mechanical events in the heart
Precede
85
How much blood does a resting adult pump per minute throughout the body
4 and 6 L
86
Preload
Venous return that builds during diastole
-length to which ventricular muscle is stretched at the end of diastole before contraction
87
Frank startling law
The greater the stretch the stronger the hearts contraction
88
After load
Opposing pressure that the ventricle must generate to open the aortic valve against the higher aortic pressure
89
Where is the carotid artery located
In the groove between the trachea and sternomastoid msucle
90
Function of the jugular vein
Empties unoxygenated blood directly into the superior vena cava
91
What do the jugular veins tell us
About activity on the right side of the heart
92
What are the two jugular veins
Internal jugular vein and external jugular vein
93
Internal jugular vein
Deep and medial to sternomastoid muscle
-not usually visible
94
When can you see pulse from internal jugular vein
Supine position, seen in sternal notch
95
External jugular vein
Superficial- lies lateral to sternomastoid muscle above clavicle
96
Fetal considerations
-fetal heart function at 3 weeks gestation
-oxygenation at placenta
-blood doesn’t pump through pulmonary system instead via foremen ovale into left side of heart
-ductus arteriosus moves from pulmonary artery to aorta
97
When does the foremen ovale close
Within first hour of after birth due to new pressure
98
When does the ductus arteriosus close
10 to 15 hours after birth
99
Heart position in the chest as an infant
More horizontal than in adults
100
Heart considerations in pregnant women
-blood volume inc 30/40%
-inc SV, CO, pulse
-decrease in BP
101
Why does blood pressure decrease in pregnancy
Peripheral vasodilation
102
Blood pressure and aging- why?
Systolic blood pressure increases
-thickening and stiffening of large arteries
-increases pulse wave velocity and arteries cannot store volume ejected
103
Left ventricular wall in OA
Thickness increases
-adaptive to accommodate vascular stiffening which makes an increase in workload
104
Variations in S1
-loud/accentuated
-faint/diminished
-varying intensity
-split
105
Examples of loud S1
Hyperkinetic states in which blood velocity is increased: exercise, fever, anemia, hyperthyroidism
Mitral stenosis
106
Examples of faint S1
First degree heart block
Mitral insufficieny
Severe hypertension
107
Varying intensity of S1 examples
Arteries fibrillation
Complete heart block with changing PT interval
108
Split S1 example
Normal but uncommon
109
Variations in S2
-accentuated
-dismissed
110
Example of accentuated S2
Systemic hypertension
Exercise and excitement
Mitral stenosis, heart failure
Aortic or pulmonic stenosis
111
Examples of dismissed S2
Shock
Aortic or pulmonic stenosis
