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Kin 1AA3 > Cardiovascular System > Flashcards

Cardiovascular System Flashcards

1
Q

functions of the CV system

A

transport mechanism for the body
immunity - WBC
tissue repair - blood clotting
body temp - constriction and dilation to regulate

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2
Q

what things do the cardiovascular system transport?

A
  1. macro and micronutrients
  2. gases: O2 and CO2
  3. end products of metabolism (such as lactate which can be used as fuel for the brain and heart), hormones
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3
Q

components of the CV system

A 
1. heart: 2 pumps, L side and R side
left pumps to body
right pumps to lungs
2. blood vessels - network of tubes
3. blood - fluid contained w/in CV sys
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4
Q

pulmonary circulation

A

blood vessel leaves right side of heart and is pumped to lungs to become oxygenated
- the lungs have lots of capillaries

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5
Q

functions of the heart

A
  1. generating BP which dictates blood volume
  2. routing blood and keeping pulmonary, systemic and coronary circulations separate
  3. valves prevent backflow
  4. regulating blood supply through stroke volume and heart rate
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6
Q

heart location

A

mediastinum

- close to midline but 2/3 of it is located more to the left side of the body

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7
Q

apex

A

cone shaped, inferior portion of heart

- directed anteriorly, inf and to the left

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8
Q

pericardium

A

serous membrane around the heart
- 2 main layers:
fibrous pericardium
serous pericardium

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9
Q

mediastinum

A

area in thoracic cavity that contains everything but the lungs

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10
Q

base

A

flat part of heart at opposite end of apex

  • where atria are found and great vessels enter and exit the heart
  • directed posteriorly, superiorly and to the right
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11
Q

fibrous pericardium

A

dense irregular CT

  • forms tough CT sac that attaches to great vessels and anchors the heart to the diaphragm
  • dictates distention of the heart
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12
Q

endocardium

A

inner layer of the heart wall

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13
Q

myocardium

A

cardiac muscle

thicker in certain regions of the heart

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14
Q

serous pericardium

A

thin, transparent double layer of simple squamous epithelium (mesothelium)
- 2 layers:
parietal and visceral (epicardium)

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15
Q

parietal pericardium

A

lines the fibrous outer layer

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16
Q

trabeculae carnae

A

found in ventricles only

extensions of cardiac muscle that make bumpy grooves to prevent suction action of the heart

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17
Q

visceral pericardium

A

aka the epicardium

covers the surface of the heart

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18
Q

pericardial fluid

A

serous fluid found in pericardial cavity b/w visceral and parietal pericardium
- helps prevent friction

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19
Q

how are the chambers of the heart arranged?

A

4 chambers:
2 upper atria (w 2 auricles that are like flaps/side chambers that extend off atria)
2 lower ventricles

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20
Q

sulci

A

grooves on surface of the heart containing coronary blood vessels and fat

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21
Q

coronary sulcus

A

around the heart, encircles and marks boundary b/w atria and ventricles

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22
Q

valves

A

ensure one way flow of blood

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23
Q

posterior interventricular sulcus

A

marks boundary b/w the ventricles posteriorly

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24
Q

atrioventricular (AV) valves

A
  • flat leaf like cusps attached to papillary muscles by chordae tendinae
  • right (tricuspid) has 3 cusps, left (mitral/bicuspid) has 2
  • when valve is open, the canal is the atrioventricular canal
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25
Q

semilunar valves

A
  • each valve has 3 cup like cusps
    right is pulmonary, left is atrial
  • when cusps are filled, valve is closed. when cusps are empty, valve is open
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26
Q

anterior interventricular sulcus

A

marks boundary b/w ventricles anteriorly

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27
Q

is the thickness of the muscle walls even around the heart

A

no. ventricle walls are thicker than atria walls
also left side is thicker than right side
people who have aerobically trained have thicker walls and larger ventricles

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28
Q

chordae tendinae

A

extensions of CT that make tendons
keep valves from inverting due to pressure in ventricles
attach to trabeculae carnae via extensions called papillary muscles

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29
Q

fibrous skeleton of the heart

A

plate of dense fibrous CT b/w atria and ventricles
- acts as anchor for muscles of heart- muscles contract towards plate
- fibrous rings around valves sere as support
electrical insulation: cardiac muscle in atria and ventricles don’t touch bc we want them to contract at diff times

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30
Q

path of blood flow through the heart

A

R atrium (deoxygenated) > tricuspid valve > right ventricle > pulmonary valve to pulm trunk and pulm arteries > pulm capillaries (loses CO2, gains O2) > pulm veins (oxygenated) > L atrium > bicuspid valve > L ventricle > aortic valve > aorta to systemic circulation (loses O2, gains CO2) > sup/inf vena cava and coronary sinus > R atrium

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31
Q

papillary muscles

A

contract when the ventricles contract

- are extensions of the trabeculae carnae

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32
Q

coronary circulation

A

blood supply to the heart

- when heart relaxes, high pressure of blood in aorta pushes blood into coronary vessels

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33
Q

anastomosis

A

redundancy in blood vessels so that if one gets blocked, then blood still reaches most important areas

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34
Q

right coronary artery

A

exits aorta just superior to point where aorta exits heart

  • lies in coronary sulcus
  • extends to post aspects of heart
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35
Q

branches of right coronary artery

A

right marginal artery

posterior interventricular artery

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36
Q

left coronary artery

A

exits aorta just superior to the point where aorta exits heart

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37
Q

branches of left coronary artery

A

anterior interventricular artery

circumflex artery

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38
Q

right marginal artery

A

branches from right coronary artery

supplies lateral wall of right ventricle

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39
Q

posterior interventricular artery

A

branches from right coronary artery
lies in posterior interventricular sulcus
- supplies posterior and inferior aspects of the heart

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40
Q

anterior interventricular artery

A

branches from left coronary artery
aka left anterior descending artery or the widow maker
- main artery that supplies the left side of the heart
- sits in anterior interventricular sulcus

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41
Q

circumflex artery

A

branches from left coronary artery

  • extends to posterior aspect of heart
  • also runs in coronary sulcus
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42
Q

great cardiac vein

A

drains left side of heart

- sits in anterior interventricular sulcus

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43
Q

small cardiac vein

A

drains right margin of heart

similar in location to right coronary artery

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44
Q

coronary sinus

A

large venous cavity that empties into right atrium

- loc on posterior in coronary sulcus

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45
Q

smaller veins that drain other regions of the heart are?

A

middle cardiac vein: sits in posterior interventricular sulcus
anterior cardiac vein: sits somewhat where marginal branch of right cardiac artery is

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46
Q

cardiac muscle cells

A
  • have very few nuclei (1-2), found centrally bc there are fewer myofibrils than in skeletal muscle
  • elongated and branching cells, don’t run entire length of muscle
  • contain actin and myosin myofilamnets
  • myofibrils aren’t quite as organized as in skeletal muscle
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47
Q

what do gap junctions in cardiac muscle allow for?

A

for cardia muscle of atria and of the ventricles to behave as a single unit electrically

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48
Q

intercalated disks

A

specialized cell to cell contacts

- folds in sarcomere that hold cells together and allow them to fit together

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49
Q

desmosomes

A
  • plasma membrane structures used to hold cells together

- act as staples to keep cells together when cardiac muscle cells contract

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50
Q

sarcoplasmic reticulum

A
  • releases Ca2+

- not as highly organized as and has less contact w t-tubules

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51
Q

t-tubules

A

transverse tubules

  • larger and less frequent
  • located where z-disc is located
52
Q

path of conduction through the heart

label them on a diagram

A 
SA node
AV node
AV bundle/bundle of his
R & L branches
purkinje fibers
53
Q

SA node

A

sinoatrial node

  • depolarizes quickly
  • generates spontaneous APs that pass to atrial muscle cells and to the AV node
  • located near opening of sup. vena cava
  • dictates pace of whole heart system
54
Q

AV node

A

atrioventricular node

  • APs conducted more slowly here than any other part of system
    • this ensures that ventricles get the signal to contract after the atria have fully contracted to squeeze blood into ventricles before they contract
  • found near coronary sinus and AV valve
55
Q

AV bundle

A

bundle of his

  • passes through hole in fibrous cardiac skeleton to reach interventricular septum
  • this hole is the only place that a signal can go from atria to ventricles
56
Q

right and left branches

A
  • extend to beneath endocardium to apices of right and left ventricles and through interventricular septum
  • number of gap junctions increase and also diameter of cardiac cells increase. this allows for FAST AP conduction through L & R branches
57
Q

purkinje fibers

A
  • large diameter cardiac muscle cells with few myofibrils (muscle cells) because job is to send fast signal, not contraction
  • many gap junctions conduct AP to ventricular muscle cells quickly
58
Q

node

A

lump or mass of specialized cardiac cells

59
Q

tetanus

A

sustained contraction of the heart

60
Q

regular cardiac cell resting membrane potential

A

~90mV

  • extracellular fluid high in concentration in Na+ and Ca2+
  • intracellular fluid is high in conc of K+
    • these concentrations are v similar to in a neuron
61
Q

regular cardiac cell depolarization

A
  • occurs rapidly when voltage gated fast sodium channels open and Na+ flows into cell
  • contraction happens slightly after depolarization
62
Q

regular cardiac cell plateau

A
  • maintained depolarization
  • Na+ channels close, K+ channels open and K+ leaves cell; results in slight repolarization
  • to compensate for this, voltage gated slow Ca2+ channels open and Ca2+ enters cell, balancing and resulting in little change in membrane potential
63
Q

regular cardiac cell repolarization

A
  • Ca2+ channels close
  • voltage gated K+ channels open and K+ leaves cell
    Na+/K+ pump works to re-establish resting membrane potential
64
Q

regular cardiac cell refractory period

A

is longer than contraction period
- this allows the heart to fully contract and relax and allow the chambers of the heart to fully fill before contracting again

65
Q

calcium-induced calcium release (CICR)

A

movement of Ca2+ though plasma membrane and T-tubules into sarcoplasm and stimulates the release of more Ca2+ from the SR
- allows contraction to occur for sustained amount of time

66
Q

some diff b/w cardiac and skeletal muscle physiology

A
  1. cardiac APs conducted from cell to cell;
    skeletal AP conducted along length of entire fiber
  2. cardiac rate of propagation is slow bc of gap junctions and small diameter fibers;
    skeletal AP propagation is faster bc of large diameter fibers and it is conducted along a single cell fiber
67
Q

autorhythmicity

A
  • SA node action potentials

- self generating APs at regular time intervals

68
Q

autorhythmic resting membrane potential

A

-60mV – threshold is about -50mV

isn’t really stable, but is very close to threshold therefore makes it easier to generate APs

69
Q

autorhythmic pacemaker potential

A

Na+ leakage into cells causes resting membrane potential to move towards threshold, results in

  • inside of cell becoming more electrically positive
  • K+ channels closing
70
Q

autorhythmic depolarization phase

A

Ca2+ channels open

K+ channels close

71
Q

autorhythmic repolarization phase

A

Ca2+ channels close

K+ channels open

72
Q

APs in pacemaker cells

A

take longer to reach threshold as they go down this list

SA node: 100bpm
AV node: 60-70bpm
Purkinje fibers: 25-30bpm

73
Q

artificial pacemaker

A

stimulates depolarization at a regular interval if something was wrong w SA node

74
Q

which area of the heart would be least detrimental to function if it were injured

A

left atrium bc no important autorhythmic cells in there

75
Q

electrocardiogram

A

ECG/EKG
a record of electrical events in the myocardium that can be correlated with mechanical events
– basically measures the movement of APs through the heart

76
Q

P wave

A

depolarization of atrial myocardium

- signals onset of atrial contraction

77
Q

QRS complex

A

ventricular depolarization

  • signals onset of ventricular contraction
  • repolarization of atria simultaneously
78
Q

T wave

A

repolarization of ventricles

- ventricular relaxation

79
Q

PQ interval

A

aka PR interval

  1. 16 seconds
    - start of atrial excitation to start of ventricular excitation
80
Q

ST segment

A

represents time b/w beginning of depolarization and repolarization (plateau phase)

81
Q

QT interval

A
  1. 36 seconds

- start of ventricular depolarization to end of ventricular repolarization

82
Q

the cardiac cycle

A

all events that happen within 1 beat of the heart

  • repetitive systole (contraction) and diastole (relaxation) of heart chambers
  • blood moves from areas of high to low pressure; contraction of the heart produces the pressure and these pressure changes open and close valves
83
Q

systole

A

chamber contracts and ejects blood from the one chamber to whatever’s next

84
Q

diastole

A

relaxation of cardiac muscle

  • chamber fills w blood in this time
  • atria and ventricles differ slightly in their timing of each state
85
Q

phases of the cardiac cycle

A 
atrial contraction/systole
isovolumetric contraction
ventricular ejection
isovolumetric relaxation
passive ventricular filling
86
Q

atrial contraction/systole

A

1st

active ventricular filling when atria contract so that all blood gets into ventricles

87
Q

isovolumetric contraction

A

2nd

systolic, no volume changes, all valves closed, causing pressure to increase

88
Q

ventricular ejection

A

3rd

when enough pressure builds up in ventricles, it pushes semilunar valves open

89
Q

isovolumetric relaxation

A

4th
diastole
- vent begin to relax, no volume changes, valves closed causing pressure to drop

90
Q

ventricular filling

A

5th aka passive filling
- atria had been continuing to fill w blood and pressure increases causing valves to open and blood moves to area where pressure is lower

91
Q

when do mechanical events in the heart happen relative to electrical events?

A

electrical events happen just before mechanical events

92
Q

pressure changes in the heart

A
  • atrial pressure stays pretty low

- if the pressure after a valve is greater than the pressure before a valve, the valve will not open

93
Q

why is having high BP a bad thing?

A

the higher the pressure is in your heart, the harder your heart has to work to build pressure in order to open/close valves to get blood to move

94
Q

when do AV valves open?

A

when the atrial pressure exceeds ventricular pressure

95
Q

when do semilunar valves open?

A

when the ventricular pressure is greater than aortic/pulmonary trunk pressure

96
Q

end diastolic volume

A

volume in the ventricle at end of diastole (relaxation), when the heart is full

97
Q

end systolic volume

A

volume of blood leftover in the ventricle at the end of contraction

98
Q

stroke volume (SV)

A

the amount of blood ejected from the left ventricle per heartbeat
- ml/beat
- norm is 80-100ml/beat
calculated by taking: EDV - ESV

99
Q

heart sounds

A

made by turbulent flow of blood
lubb is 1st
dupp is 2nd
woosh is occasional 3rd and 4th

100
Q

“lubb”

A

first sound

fluid vibrations made as AV valves close at beginning of ventricular systole

101
Q

“dupp”

A

second sound

results from closure of aortic and pulmonary semilunar valves at beginning of ventricular diastole

102
Q

“woosh”

A

occasional 3rd and 4th sounds
caused by turbulent flow of blood into ventricles detected near the end of first third of diastole or during atrial systole

103
Q

cardiac output (CO)

A

the volume of blood pumped to the body per minute by the heart
- typically refers to the left ventricle
CO = HR x SV

104
Q

heart rate (HR)

A

number of times the heart beats per minute

- measured in beats/min lol

105
Q

cardiac reserve

A

diff between CO at test and max CO during exercise

106
Q

regulation of stroke volume

A

3 factors regulate SV:
preload
afterload
contractility

107
Q

preload

A
  • amt of stretch of ventricle walls before contraction when heart is full
  • frank-sterling law of the heart: the greater the stretch, the greater the force of contraction bc of recoil ability therefore the blood flows out faster
108
Q

frank-sterling law of the heart

A

the greater the stretch (preload), the greater the force of contraction bc of recoil ability therefore the blood flows out faster

109
Q

afterload

A

the pressure the contracting ventricles must produce to overcome the pressure in the aorta and move blood into the aorta (open semilunar valves)

110
Q

contractility

A

the forcefulness of contraction of the ventricle muscle fibers
– basically the strength of contraction
controlled by inotropic agents

111
Q

inotropic agents

A

substances that come in contact w cardiac uscle fibers and increase of decrease contractility of the heart

112
Q

positive inotropic agents

A

open Ca2+ channels, increase contractility

sympathetic NS: cardiac accelerator nerves release norepinephrine OR hormones from adrenal medulla (epinephrine or NE)

113
Q

negative inotropic agents

A

decrease contractility
drugs: calcium channel blockers, beta blockers (beta adrenergic receptors are triggered when epinephrine and norepinephrine bind

114
Q

factors that regulate HR

A 
age
ANS
hormones
gender
physical fitness
temperature
115
Q

neural and hormonal control of HR

A

parasympathetic nerve stimulation
sympathetic nerve stimulation
hormonal control by somatic NS

116
Q

parasympathetic nerve stimulation w regards to HR

A

vagus nerve decreases HR bc NT Ach hyperpolarizes heart by opening more K+ channels therefore taking longer to reach threshold

117
Q

sympathetic nerve stimulation w regards to HR

A

cardiac accelerator nerves increase HR and contractility

- NE released at SA and AV nodes and opens Ca2+ channels

118
Q

hormonal control by somatic NS w regards to HR

A

epinephrine and NE from adrenal medulla released in response to many factors
- slower acting but lasts longer

119
Q

where is the cardiovascular centre located?

A

in the brainstem

120
Q

what do higher brain centres have the ability to do?

A

they can override input from sensory receptors

121
Q

sensory receptors that input info to CV centre

A

proprioceptors: monitor movements
chemoreceptors: monitor blood chemical levels (O2 and CO2 levels)
baroreceptors: monitor BP

122
Q

rheumatic fever and its effect on the mitral valve

A

it causes inflammation of muscles, joints and CT in body bc the “fever” it produces a protein similar to these structures that the immune system tried to attack.
- the result is a scarred and more fibrous mitral valve

123
Q

stenosis

A

a narrowing of a passageway, where it doesn’t open as it should

124
Q

what is an echocardiogram?

A

an ultrasound of the heart

it sents ultrasonic sound waves towards tissues and when the waves bounce off of them, they are collected and read

125
Q

treatment for mitral valve stenosis (medications)

A

duretics, blood thinners, beta/calcium blockers, anti-arrythmics, antibiotics

126
Q

treatment for mitral valve stenosis (procedures)

A

percutanious balloon mitral valvuloplasty where you put balloon in and inflate it where mitral valve is in hopes of making it work

mitral valve replacement: tissue valve from animal or human specimen or mechanical sewn in place
- ball and cage kind prone to clotting so they now do a different kind of artifical valve

Kin 1AA3 (11 decks)

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