Cardiovascular System Flashcards
Main function and structure of Resistance/Muscular artery
Muscular element is most significant, plays major role in regulation of blood pressure
Main function and structure of arteriole
Muscular tissue is most significant (although smaller amount than resistance artery), plays major role in regulation of blood pressure
Main function and structure of Capillary
Assembled of only endothelium and basal tissue, slows rate of blood flow to maximise exchange
Structure of Venules
Muscle tissue is less significant, larger lumen
Structure of Veins
Large proportion of fibrous tissue, large lumen and relatively large smooth muscle layer
Functions of Heart
Pumping blood around the body and generating blood
pressure
Sending deoxygenated blood to the lungs to be oxygenated
Sending oxygenated blood to the whole body
Separates pulmonary and systemic circulation
Provides unidirectional (one-way) blood flow and prevents back flow (valves)
Which part of the heart is more muscular
Left part (Ventricle)
Why is the left ventricle more powerful
As the systemic circuit comprises of many parallel circuits therefore requires greater pressure
Functions of CVS
- Oxygen and CO2 transport
- Nutrient and waste product transport
- Disease protection and healing
- hormone delivery
- body temperature regulation
What is the adaptation of Ohm’s law used for calculation of cardiac output.
Q = ΔP/R
ΔP - Mean Arterial Pressure Q - Cardiac Output
R - Total Peripheral Resistance
What is Polycythaemia?
Elevated red blood cell count in Haematocrit
Describe the main function and structure of Conduit/Elastic Arteries
Large Proportion of elastic tissue and smooth muscle. Main function is to conduct blood under High pressure
What is starling’s law?
the stroke volume of the heart increases in response to an increase in the volume of blood in the ventricles
Which side of the heart is located most anteriorly ?
Right (Pulmonary)
Which side of the heart is located most posteriorly ?
Left (Systemic)
What separates the Right and Left Ventricles?
Anterior Interventricular Groove
What separates the Right Atrium and Ventricle?
Anterior Atrioventricular Groove
Where is the right auricle located?
Superior surface of the right atrium
What vessels supplies the lungs with deoxygenated blood?
Pulmonary Arteries
Where do the pulmonary arteries arise from?
Pulmonary Trunk from Right ventricle
Where does the Inf. Vena Cava arise from?
Diaphragm, brings blood from lower half of body
Where does the Sup. Vena Cava arise from?
Joining of Brachiosophalic and Subclavian artery.
What are the 3 parts of the pericardium?
Fibrous Pericardium
Parietal Pericardium
Visceral Pericardium
What is the gap between the parietal and visceral pericardium called?
Pericardium Cavity (Full of pericardiac fluid)
What forms the majority of the view on the posterior aspect of the heart?
Left Ventricle
What are the roles of the valves in the heart?
To prevent flowback in the heart during constriction
What valve separates the Right Ventricle and Pulmonary Trunk?
Semi Lunar Valve
What valve separates the Right Atrium and Ventricle?
Tricuspid Valve
What do the Chorda Tendini do?
They prevent the tricuspid valves from ‘blowing back’ into the right atrium.
Where do the Chorda Tendini attach?
Papillary Muscles and Tricuspid Valves
What is the Fossa Ovalus?
A fossa in the right atrium and left ventricle. Open as foetus to allow blood to ‘skip’ pulmonary system.
What is the Coronary Sinus?
A collection of veins delivering deoxygenated blood to the right atrium
What is the coronary’s sinus relationship to the position of the AVN?
It is slightly inferior
What is the AVN?
Atrio Ventricular Nodes
What is the SAN?
Sino-Atrial Nodes
What is known as the pacemaker?
The SAN
What are the layers of the heart wall?
Pericardium,
Myocardium
Endocardium
Function of Pericardium?
Fixes the heart to the mediastinum,
Gives protection against infection
Provides the Lubrication for the heart
What is the function of the Myocardium?
Stimulates heart contractions and relaxation
Provides scaffolding for heart chambers
What is the function of endocardium?
Controls myocardial function
Controls blood-heart barrier
What are the main cells of the myocardium?
Cardiomyocytes
What are the main identifiable structures in a cardiomyocyte?
T-Tubule Sarcomere Z Disk Intercalated Disk (Joint with neighbouring cell) Sarcoplasmic Reticulum
Characteristics of cardiomyocytes?
Single centrally located nucleus
Branching structure
Plenty of mitochondria
Abundant reserve of myoglobin
What two fibres make up the cardiac autorythmic system?
Pacemaker Cells
Conduction fibres
What is sarcoplasmic reticulum?
Periphery layer of endoplasmic reticulum, important in cardiomyocytes for absorption and storage of calcium
What is the main substrate for oxidative phosphorylation in cardiomyocytes?
Lipids
What do T-Tubules do?
Increase surface area of cardiomyocytes. Allows for maximum Ca2+ absorption Required for excitation of the cells.
Where are T-Tubules found?
In the outer membrane, present as indentations increasing surface area
Where could you find a gap junction in cardiac muscle?
Between the cardiomyocytes, more specifically the intercalated disks
What are gap junctions?
intercellular channels that allow for direct chemical communication between adjacent cells through diffusion of ions and small molecules without contact with the extracellular fluid.
What are desmosomes?
fasteners through the plasma membrane of adjacent cells by means of intermediate filaments composed of keratin or desmin to form a dense plaque.
What are Tight junctions?
act as barriers that regulate the movement of water and solutes between epithelial layers.
Are tight junctions present in cardiomyocytes?
NO!!!!!!
What proteins are present in the gap junctions?
Connexin
Innexin
Pannexin
What is Connexon?
6 Connexin subunits
What is Innexon?
6 Innexin subunits
What is Pannexon?
6 Pannexin subunits
What are the main pacemakers in the heart?
SAN AVN Bundle of His (Their) Purkinje Fibres Bachmann's Bundle
What does the SAN do?
- establishes rhythm at the highest rate of pulse generation (70-100 bpm)
- impulse spreads from the SA node throughout specialized internodal pathways:
What is the AVN?
- intrinsic rate of AV node is 40-60 bpm
- delays the impulse from SA node by ~100-120 ms to let ejected blood fully migrate from atria before ventricles contract
- it electrically connects the right atrium and right ventricle
What is the Bundle of His
- intrinsic rate of the bundle of His is 20-40 bpm
- transmits impulses from the atrioventricular node to the ventricles of the heart
- branches into the left and the right bundle branches
- speed of impulse is 1 m/s
What are the purkinje fibres?
- intrinsic rate of Purkinje fibers is 15-30 bpm
- distribute the impulse to the myocardial contractile cells in the ventricles
- speed of impulse is 5 m/s
- excitation and contraction begin at the apex and travels toward the base of the heart
What is Bachmann’s bundle?
a specialized pathway band that conducts the impulse directly from the right atrium to the left atrium
What is the importance of Calcium?
regulation of Ca2+ homeostasis is central to the control of the heart
- It is responsible for depolarisation and execution
- Responsible for activation of contraction of cardiac muscle
- Important signal molecule and second messenger
What is the basic mechanism of contraction?
1 – Na+ channels
2 –L-type Ca2+ channels
3 – Ca2+ induced Ca2+ release from Ryanodine receptors (RYR)
4 – Ca2+ stimulates the contractile apparatus
What is the basic mechanism of Relaxation?
1 – Ca2+ reuptake into SR
2 – withdrawal of Ca2+ to the extracellular media
3 – Exchange of Ca2+ for 3Na+ then 3Na+ exchanged for 2K+
4 – Activation of K+ channels
Where are Ryanodine Receptors found?
On the sarcoplasmic reticulum
What helps exchange Ca2+ for 3Na+ in relaxation?
A Na+/Ca2+ exchanger
What helps swap 3Na+ for 2K+ in relaxation?
Na+/K+ ATPase
What is SERCA?
Sarco Endoplasmic Reticulum Calcium ATPase
What is SERCA’s function?
It helps ‘pump’ Ca2+ ions into the sarcoplasmic reticulum
How is SERCA activated?
It is constantly inhibited by PLB, when PLB is phosphorylated the SERCA is activated
Average diastolic (relaxed) sarcoma length is?
2-2.2 um
Maximal length of sarcomere is?
2.6 um
What is average man’s resting cardiac output?
5L/min
What is the average man’s exercise cardiac output?
Fit young person: 20L/min
World Class Athlete: 35L/min
What is Diastole?
Heart muscles at rest
What is systole?
Heart muscles contracting
Roughly, how long is spent in diastole?
2/3 of the time
What does MAP stand for?
Mean Arteriole Pressure
How do you calculate MAP?
Diastolic Pressure + 1/3 Pulse Pressure
What unit is pressure measure in?
mmHg
What is Pulse Pressure?
Systolic - Diastolic pressure
How do you work out Diastolic pressure?
Lower end of Aortic Pressure
How do you work out Systolic Pressure?
Upper end of Aortic Pressure
What causes the characteristic ‘Lubb’ ‘Dubb’ sounds?
Closing of AV and Aortic valves respectively
What are the phases of the cardiac cycle?
- Atrial Contaction
- Isovolumetric Contraction
- Ventricular Ejection
- Isovolumetric Relaxation
- Atrial Filling
- Ventricular Filling
What is Cardiac output (CO)?
Amount of blood pumped by the heart per minute
What is heart rate (HR) ?
Number of beats per minute
What is stroke volume (SV)?
Amount of blood pumped per beat
What is the calculation for CO?
CO = HR * SV
What is significant about venous return?
It is the SAME as cardiac output
What is End-Diastolic Volume (EDV) ?
Volume of blood in ventricles just before systole.
Relares to the length of sarcomeres in cardiac muscle prior to systole
What is End-systolic volume (ESV)?
Volume of blood in a ventricle and end of contraction.
It is used clinically as a measurement of systolic function
How can you calculate Stroke Volume (SV)?
SV = EDV - ESV
What is Ejection Fraction (EF)?
This is the % of blood ejected from a ventricle with each heartbeat
How do you calculate Ejection Fraction (EF)?
EF = SV/EDV
What is the Frank-Starling Law?
Stroke volume (SV) of the heart increases in response to an increase in the volume of blood filling the heart when all other factors remain constant.
What helps regulate the heart rate?
Sympathetic stimulation can raise the heart rate to close to 200bpm
Vagal Stimulation can suppress the heart rate to 20bpm and also decrease strength of contraction
What can regulate the SAN?
Acetylcholine and Noradrenalin
How does Acetylcholine regulate the SAN?
It increases K+ permeability thus decreasing rate of spontaneous depolarisation
How does noradrenaline regulate the SAN?
Increases Na+/Ca2+ permeability thus increasing rate of spontaneous depolarisation
What is Resting membrane potential?
It is a voltage difference across the plasma membrane
What’s the typical resting membrane potential in cardiomyocytes?
-90 to -80 mV
What is an action potential?
Change of voltage polarity across the plasma membrane
What molecules help form the typical cardiac membrane potential?
- Potassium Channels (K+) (Main)
- Sodium Channels (Na+)
- Calcium Channels (Ca2+)
- Chloride Channels (Cl-)
What is the major ion for membrane potential maintenance?
Potassium (K+)
What is Phase 4?
Resting membrane potential
What is Phase 0?
Depolarisation as Na+ starts to enter in abundance.
What is Phase 1?
Early Repolarisation,
K+ ‘leak’ through the membrane increases.
Inactivation of sodium channels
What is Phase 2?
The Plateau,
Ca2+ Channels activated increasing concentration inside the cell
K+ ‘leak’ still occurring
What is Phase 3?
Rapid Repolarisation,
Calcium Channels inactivated.
K+ leaving and Ca2+ absorption by organelles cause return to resting membrane potential
What is different about the action potential in pacemaking and contractile cardiac cells?
- In pacemaking cells they don’t have a Phase 2 (Plateau).
- In Pacemaking cells the depolarisation is mainly caused by influx of Ca2+.
- The resting potential in pacemaking cells are - 60mV
What is the basic sequence of electrical events in the heart?
- SAN depolarises
- Waves of depolarisation spread across both atria
- AVN slows the signal from the atria to ventricles
- Wave of depolarisation spreads to the bundle of His
- Depolarisation spreads throughout the myocardium of the heart via the Purkinje fibres
- Once depolarisation has occurred depolarisation of the ventricles begin
What does the P wave represent?
Atrial depolarisation
What does the QRS complex represent?
Ventricular depolarisation
What does the T wave represent
Ventricular repolarisation
What does the U wave represent?
Papillary muscle repolarisation and repolarisation of the Purkinje fibres
What is the PR interval?
Start of the P wave to the start of the QRS complex
What is the QT interval?
Start of the QRS complex to the end of the T wave
What is the ST segment?
End of S wave to start of T wave
What two ways can you measure heart rate?
- Atrial Rate; frequency of P waves
- Ventricular Rate; Measuring the RR interval
How do you calculate heart rate using RR interval?
- Measure the RR interval.
- Divide length by 5.
- Then divide 60 by this number
What artefacts could you have on the ECG?
Muscle Tremor
Sloping Baseline
Patient movement artefact
Alternating current interference
What is sinus bradycardia?
Slow heart rate
- defined as under 60 BPM in adults
What is sinus tachycardia?
Heart rate exceeding normal resting rate
- Above 100 BPM is accepted as tachycardia
What is Sinus arrhythmia?
Normal increase in heart rate during inspiration.
What is Atrial Fibrillation?
abnormal heart rhythm characterised by rapid and irregular beating.
No clear P waves