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Introduction to Healthcare Science > Cardiovascular system > Flashcards

Cardiovascular system Flashcards

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1
Q

What are the components of the cardiovascular system?

A
  • a pump (heart).
  • elastic arteries, large vessels (e.g. Aorta).
  • muscular vessels, the arterioles these have a major role in regulating blood pressure.
  • capillaries, exchange of nutrients and gases with tissues.
  • venules.
  • large veins (e.g. Vena cava).
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2
Q

How does blood move around the body ?

A
  • Heart pumps blood to the elastic arteries.
  • these carry blood to the smaller muscular arteries.
  • these then transmit blood to the smaller arterioles.
  • which pass blood to the capillaries (these have very thin walls which gases and nutrients can diffuse through).
  • the blood is then returned towards the heart by venules, veins and muscular veins.
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3
Q

What are the main vessels leading into the atrium?

A
  • Vena cava (inferior and superior) and pulmonary veins.
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4
Q

What are the main vessels leading out of the ventricles?

A
  • Pulmonary artery and aorta.
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5
Q

What is systole?

A
  • Sequential contraction of the atria and the ventricles.
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6
Q

What is diastole?

A
  • Period of relaxation.
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7
Q

Explain the route of blood flow?

A
  • flows into the right atrium from inferior/superior vena cava, passes right tricuspid valve into right ventricle which pumps blood to the pulmonary arteries where the blood is carried to the lungs.
  • returns from the lungs via the pulmonary veins into the left atrium, passes through the left bicuspid valve into the left ventricle where it is pumped to the aorta.
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8
Q

What are the two independent circulatory routes?

A
  • Pulmonary and systemic circulations.
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9
Q

What is the pulmonary circulation?

A
  • Involves blood leaving the right ventricle through the pulmonary artery.
  • This is deoxygenated blood.
  • It passes through the lungs and enters the left atrium via the pulmonary veins as oxygenated blood.
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10
Q

What is the systemic circulation?

A
  • Involves blood leaving the left ventricle through the aorta.
  • This is oxygenated blood.
  • It passes to the peripheral tissues where oxygen is removed and is returned to the right atrium through the inferior and superior vena cava as deoxygenated blood.
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11
Q

What is the function of the cardiovascular system?

A
  • to provide nutrients and oxygen to tissues and remove waste products.
  • to transport bioactive molecules (e.g. Hormones and cytokines to their target organs).
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12
Q

What is the function of valves within the heart?

A
  • Important in controlling the flow of blood through the chambers of the heart.
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13
Q

Name the valves of the heart.

A
  • between the right ventricle and pulmonary arteries: pulmonary valve.
  • between the right atrium and right ventricle: right atrioventricular (tricuspid) valve.
  • between left ventricle and aorta: aortic valve.
  • between left atrium and left ventricle: left atrioventricular (bicuspid or mitral) valve.
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14
Q

How does the closure of heart valves cause the heart sounds?

A
  • closure of atrioventricular (mitral and tricuspid) valves cause the normal first heart sound.
  • closure of the semi-lunar (aortic and pulmonary) valves cause the normal second heart sound.
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15
Q

Muscle of heart - non stop activity, so it needs its own blood supply - why?

A
  • To provide the heart with oxygen and nutrients which it requires .
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16
Q

How does angina come about?

A
  • Narrowing of the coronary arteries due to atheroma impairs the delivery of oxygen to the myocardium, resulting in pain on exertion.
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17
Q

How does a heart attack/myocardial infarction come about?

A
  • Severe narrowing or blocking of arteries due to thrombosis (a clot) may result in the death of myocardial tissue supplied by the vessel.
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18
Q

What does the conducting system of the heart do?

A
  • Regulates and orchestrates the contraction of the heart to make sure contraction occurs in the right order in this pump.
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19
Q

Name the conducting tissue of the heart?

A
  • sinoatrial (SA) node.
  • atrioventricular (AV) node.
  • right and left branches of the atrioventricular bundle lying between the two ventricles sometimes known as the bundle of His.
  • purkinje plexus at the end of the branches that form at the end of bundles of His supplying the muscle of the ventricles.
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20
Q

How does the conducting system work?

A
  • SA node in right atrium that initiates the contractive impulse.
  • cardiac impulses travel through the atrial myocardium to the AV node where there is a short delay allowing the atria to empty before the ventricles contract.
  • impulses conducted to the ventricles by the atrioventricular bundle (this enters into the interventricular septum and divides into L and R branches which becomes continuous with the purkinje plexus of the corresponding ventricle - so the impulse then spreads through the ventricles).
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21
Q

What is the function of parasympathetic nerves?

A
  • Parasympathetic nerves travelling with the vagus nerve slow the heart rate and constrict coronary arteries.
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22
Q

What is the function of sympathetic nerves?

A
  • Sympathetic nerves from the cervical and upper thoracic region speed up the heart and dilate coronary arteries.
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23
Q

How are cardiac impulses recorded?

A
  • Technique of electrocardiography (ECG).
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24
Q

Explain what you would see on ECG?

A
  • p wave: result of atrial depolarisation.
  • QRS complex: result of ventricular depolarisation.
  • t wave: result of ventricular repolarisation.
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25
Q

If you have an abnormal ECG what does this suggest?

A
  • Defects in the cardiac conducting system or damage to wall of heart (myocardium or endocardium).
26
Q

What is heart block?

A
  • Interruption to the conduct of cardiac impulses (doesn’t signify blockage to pump but blockage to conducting impulse).
  • Congenital or result of ischaemic damage following myocardial infraction.
27
Q

What is atrial fibrillation?

A
  • Uncoordinated excitation arising in the atrial muscle.

- Can be the result of ischaemic damage or hypertension.

28
Q

Does blood flow more slowly or quickly through the small vessels?

A
  • Blood flows more slowly through the smaller vessels allowing exchange of nutrients and gases.
29
Q

What is a normal blood pressure for an adult?

A
  • Systolic: around 120 mm Hg (when heart contracting).

- Diastolic: around 80 mm Hg (when heart relaxing).

30
Q

How is the blood pressure maintained within the blood vessels during relaxation of the heart?

A
  • By elastic recoil of blood vessels.
31
Q

What is the regulation of blood pressure affected by?

A
  • Cardiac output and peripheral resistance.
32
Q

Cardiac output is a result of …?

A
  • Heart rate and stroke volume.
  • heart rate regulated by autonomic nervous system.
  • stroke volume is the volume of blood ejected with each contraction. It depends on the circulating blood volume (contracted circulating blood volume due to a large bleed or dehydration then the stroke volume will be reduced) also due to the efficiency of cardiac muscle in contracting.
33
Q

Where does the largest drop in pressure occur?

A
  • Across the small arteries and arterioles (resistance vessels).
34
Q

In which vessels does the flow change from pulsatile to steady flow of blood due to elastic recoil of vessels?

A
  • In the arteries and arterioles.
35
Q

What is the plasma renin-angiotensin system important for?

A
  • For regulating blood pressure.
36
Q

What is hypotension?

A
  • Low blood pressure.
37
Q

What is hypertension?

A
  • High blood pressure.
38
Q

What do the resistance vessels respond to?

A
  • Vascular smooth muscle (largely found in the small arteries and particularly the arterioles) responds to the sympathetic nervous system and also to circulating and local factors including for example: angiotensin 2 and noradrenaline.
39
Q

How does hypotension come about?

A
  • Result of reduced circulating blood volume e.g. Haemorrhage, dehydration, heart failure (inadequate cardiac muscle activity) results in impaired oxygen delivery to tissues which can lead to renal failure or inadequate oxygenation of the brain resulting in unconsciousness.
40
Q

How does hypertension come about?

A
  • High blood pressure, common with advancing age, multiple factors contribute to this including genetic and lifestyle factors.
  • It increases the risk of kidney disease, heart failure and stroke.
41
Q

In which order would a cardiac impulse arise and reach the left ventricle?

A
  • Sinoatrial node -> internodal pathways -> atrioventricular node -> atrioventricular bundle (His) -> left bundle branch -> purkinje fibres.
42
Q

What is heart block?

A
  • A defect in conduction of the cardiac impulse.
43
Q

What is myocardial infraction?

A
  • Myocardial damage caused by blockage of a coronary artery.
44
Q

What is atrial fibrillation?

A
  • Uncoordinated depolarisations of atrial muscle.
45
Q

What is hypertension?

A
  • An age related condition which increases risk of cerebrovascular accidents.
46
Q

What is hypotension?

A
  • A feature observed following severe haemorrhage which may cause unconsciousness.
47
Q

What is patent ductus arteriosus?

A
  • Persistence of blood flow between the pulmonary artery and the aorta following birth.
48
Q

What is the aorta?

A
  • A vessel with a high elastin content, carrying oxygenated blood from the left ventricle.
49
Q

What is the pulmonary vein?

A
  • A thick walled vessel carrying oxygenated blood to the left atrium.
50
Q

What are arterioles?

A
  • A vessel with a high muscle content, the main site of blood pressure regulation.
51
Q

What is a capillary?

A
  • A thin walled vessel, the site of the slowest blood flow velocity in the circulation.
52
Q

How is fetal circulation affected?

A
  • The fetal lungs are not functional so the blood cannot be oxygenated within the lungs.
53
Q

At birth the lungs expand and this effects the pressure gradients within the pulmonary vessels and collectively the changes that occur are …

A
  • closure of the umbilical arteries and the umbilical vein (umbilical vessels).
  • closure of the foramen ovale between the right atrium and the left atrium.
  • reduction in the pulmonary vascular resistance which is associated with closure of the ductus arteriosis.
  • closure of the ductus venosus.
    = and so the normal circulatory pathway established.
54
Q

What is the danger in having high blood pressure in vessels supplying the brain?

A
  • May result in a cerebral haemorrhage.
55
Q

The vessels which arise from the arch of the aorta supply …

A
  • The head, neck and the arms.
56
Q

What is coarctation of the aorta?

A
  • Results from a narrowing of the aorta adjacent to the ductus arteriosus.
  • As a result of narrowing the BP is high in the aorta prior to or proximal to the constriction but is low, beyond or distal to the constriction.
57
Q

What happens when the ductus arteriosus remains patent after birth?

A
  • Oxygenated blood which has been through the lungs, passed into the left side of the heart and into the aorta is shunted by the pulmonary artery back into the lungs again.
  • It’s at high pressure so can lead to damage of lungs and to the right side of the heart.
58
Q

What happens if the foramen ovale remains patent?

A
  • Results in an atrial septal defect (the septum between right and left atrium has a hole in it).
  • This results in passage of blood from the higher pressure left side of the heart into the lower pressure right side. Known as left to right shunt.
59
Q

What is a ventricular septal defect?

A
  • Defect in the wall between left and right ventricle.
  • Leads to left to right shunt of oxygenated blood.
  • Blood passes from left ventricle which is at high pressure into right ventricle which is at lower pressure and can lead to lung damage. Because left to right shunt is oxygenated to deoxygenated side of the heart there’s normally no cyanosis.
60
Q

Name some congenital heart defects?

A
  • coarctation of the aorta.
  • patent ductus arteriosis.
  • patent foramen ovale.
  • ventricular septal defect.

Introduction to Healthcare Science (23 decks)

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