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Human Anatomy > Cardiovascular system lecture 13&14 > Flashcards

Cardiovascular system lecture 13&14 Flashcards

1
Q

functions of cardiorespiratory system

A
  • To carry oxygen to cells and to collect carbon dioxide
  • To carry nutrients to cells and to collect waste
  • To pick up oxygen from the lungs
  • To pick up nutrients from the intestines
  • To carry hormones and other signalling substances
  • Thermoregulation
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2
Q

cardiorespiratory system

A

• The heart comprises two, side-by-side
pumps, serving different blood circuits
• The heart and lungs comprise the pulmonary circuit
• The systemic circuit moves blood to and from capillaries at cells
• By definition, arteries take blood away from
the heart; veins take blood towards the heart

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3
Q

circulatory system- blood’s journey

A

oxygenated blood from lungs to left atrium, through left atrioventricular valve (mitral valve) to left ventricle then through aortic valve to rest of body

deoxygenated blood from body to right atrium, through right atrioventricular valve to right ventricle, through pulmonary valve to lungs

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4
Q

valve that separates left atrium and ventricle

A

mitral valve

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5
Q

valve that separates right atrium and ventricle

A

tricuspid valve

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6
Q

early diastole

A

AV valves open
semilunar valves closed
all chamber relaxed, ventricles filling

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7
Q

atrial systole

A

AV valves open
semilunar valves closed
L+R atria contract; further ventricular filling

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8
Q

ventricular contraction

A

AV and semilunar valves closed

L+R ventricles start to contract

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9
Q

ventricular ejection

A

AV valves closed
semilunar valves open
L+R ventricles fully contract; blood leaves heart

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10
Q

ventricular relaxation

A

AV and semilunar valves closed

ventricles relax

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11
Q

Atrioventricular valves

A

(prevent backflow into atria)
• Tricuspid valve (right AV valve)
• Mitral valve or bicuspid valve (left AV valve)

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12
Q

Semilunar valves (prevent backflow into ventricles)

A
  • Aortic valve (between left ventricle and aorta)

* Pulmonary valve (between right ventricle and pulmonary artery)

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13
Q

intercostal space

A

the space between the ribs

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14
Q

where to listen to Aortic valve

A

2nd intercostal space, right sternal margin

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15
Q

where to listen to Pulmonary valve

A

2nd intercostal space, left sternal margin

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16
Q

where to listen to Tricuspid valve

A

5th intercostal space, right sternal margin

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17
Q

where to listen to Mitral valve

A

5th intercostal space, in line with middle of clavicle

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18
Q

Chordae tendineae

A 
• Largely collagen, with elastin
components
• As ventricles contract, tricuspid and
mitral valves close
• Pressure in ventricles increases
dramatically
• Chordae tendinae prevent the eversion of the valves into the lower pressure atria
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19
Q

ventricles

A

• Ventricles have thick walls, since they
pump blood over long distances
– LV pumps to the body
– R V pumps to the lungs
• Thickness can be diagnostic
– pumping to body requires more effort, so left ventricle usually thicker
– in arteriosclerosis, LV distended
– in emphysema, RV has to pump harder and becomes even larger

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20
Q

coronary circulation

A

• Shortest circulation in the body
• Arterial supply via left and right coronary arteries
• Both arise from base of aorta, and both divide to run anteriorly and posteriorly
• Blood from the coronary circulation is returned to the heart via the coronary sinus
• Blood is emptied into right atrium via
– superior vena cava (blood from body superior to diaphragm)
– inferior vena cava (blood from body inferior to diaphragm)
– coronary sinus (blood from myocardium

21
Q

innervation of the heart

A
  • Because the heart needs to be both excited and calmed as appropriate, innervation is via the sympathetic (via spinal nerves) and parasympathetic (via vagus) components of the ANS
  • Depolarisation initiated at sinoatrial node
  • Travels via atrial myocardium to atrioventricular node
  • AV bundle
  • Left and right bundle branches
  • Purkinje fibres
22
Q

Hepatic portal system

A
  • Special set of veins that carry blood from capillary beds in the intestines to capillary beds in the liver
  • It is the only part of the venous system that does not carry blood from capillary beds straight back to the heart
23
Q

difference between arteries and veins

A
  • Arteries “beat” along with the heart and blood pressure is high
  • Arteries have thick, muscular walls; veins have thin, non-muscular walls
  • At any one time, veins contain about 70% of the body’s blood
  • Veins have low blood pressure and flow is powered by gravity – but only on the way down!
  • Bringing blood back to the heart from the lower extremities against gravity is difficult
  • Veins have valves that prevent backflow, which helps blood move against gravity (arteries do not)
  • Muscular movements in surrounding structures help blood move against gravity
  • If muscles aren’t working, blood collects in veins and valves fail (varicose veins) blood into the veins, and there is nothing to send it back
24
Q

capillaries

A

• about 1 m m long, with an internal diameter of about 10µm
• This is just large enough for red blood cells to pass through in single file
• Capillaries can be divided into three structural types:
1. Continuous capillaries
2. Fenestrated capillaries
3. Sinusoidal capillaries

25
Q

Continuous capillaries

A
  • Most c o m m o n
  • Abundant in skin, muscles
  • Adjacent cells are joined by tight junctions
  • Tight junctions are actually loose enough to allow limited movement of fluids and small solutes in and out of the capillaries
  • Capillaries in the brain are an exception: tight junctions really are tight; this is the blood-brain
26
Q

Fenestrated capillaries

A
  • Similar to continuous capillaries, but with pores in some cells
  • Much more permeable
  • Common in the small intestine (where capillaries pick up nutrients from digested food) and in endocrine organs (where hormones enter the circulatory system) and in the kidney
27
Q

Sinusoidal capillaries

A
  • Very leaky
  • Found only in liver, bone marrow, spleen and adrenal medulla
  • Have fenestrations and fewer tight junctions, allowing large molecules and even blood cells to pass in and out
  • Lining contains macrophages that destroy bacteria
  • Irregular shape of lumen slows blood, giving time for all of this to occur
28
Q

thermoregulation

A

• Central channels are vessels that traverse a capillary bed and connect arterioles to venules
• They consist of a metarteriole and a thoroughfare channel
• Contraction of precapillary sphincters forces the blood directly from the metarteriole to the thoroughfare channel, bypassing the rest of the capillary bed
• Important in thermoregulation and in the
control of blood pressure
• In many animals, including humans, the
circulatory system also controls temperature via countercurrent heat exchange
• At low external temperatures, blood
flows through veins intimately associated with arteries
• The warm blood from the heart transfers
heat to the cooler blood returning from the extremities
• This cools arterial blood and warms the
venous blood, minimising heat loss to
the environment

29
Q

Capillary hydrostatic pressure (CHP)

A

forces fluid out of the circulatory system, but

pressure drops moving from arterial to venous end of capillaries

30
Q

Blood colloid osmotic pressure (BCOP)

A

tends to pull water and solutes into capillaries

31
Q

Net filtration pressure (NFP)

A

is the difference between these

32
Q

foetal circulation

A

• No gas exchange in lungs; pulmonary vessels
vasoconstricted
• Three shunts ‘short-circuit’ circulation:
– ductus venosus
– foramen ovale
– ductus arterosus

33
Q

Ductus venosus

A

Connects umbilical vein to inferior vena cava

bypassing liver

34
Q

Foramen ovale

A

Right atrium to left atrium (bypassing lungs)

35
Q

Ductus arteriosus

A

Pulmonary trunk and aorta (bypassing lungs)

36
Q

Circulatory events at birth

A 
• Umbilical artery and vein close
• 1 Ductus venosus
Vein through liver closes (leaving
hepatic portal system as remnant)
2. Foramen ovale
Foramen ovale in heart closes (called
fossa ovalis in adult heart)
3. Ductus arteriosus
Ductus arteriosus closes (leaving
ligamentum arteriosum)
37
Q

name the Ischaemic heart diseases

A
  • Coronary artery occlusions

* Myocardial infarction

38
Q

name the Valvular heart diseases

A
  • Degenerative valvular diseases
  • Rheumatic heart disease
  • Bacterial endocarditis
39
Q

name the different shocks

A
  • Hypovoleamic shock
  • Cardiogenic shock
  • Septiceamic shock
  • Anaphylactic shock
40
Q

Ischaemic Heart Diseases

A
  • This is a generic name for a group of closely related syndromes that result from myocardial ischaemia.
  • In over 90%, this is due to a reduction in coronary blood flow. (Decrease in supply)
  • Other conditions arise as a result of increases in demand e.g. hypertrophy, shock, increase heart rate, etc.
41
Q

Diminished Coronary Perfusion

A
  • Fixed coronary obstruction
  • More than 90% of patients with IHD
  • One or more lesions that causes at least 75% reduction of the cross-sectional area of at least one of the major epicardial arteries.
42
Q

Angina Pectoris

A 
• This is a symptom complex. Symptoms caused by transient myocardial ischaemia that falls short of inducing the cellular necrosis that defines
myocardial infarction.
• Three variants:-
• Stable angina
• Prinzmental angina
• Unstable angina
43
Q

Effects of ischaemia on myocytes

A
  • Onset of AT P Depletion
  • Loss of contractility
  • AT P reduced
  • to 50% of normal
  • To 10% of normal
  • Irreversible injury
  • Microvascular injury
44
Q

Laboratory detection of myocardial infarction

A

• This is based on the measurement of intracellular macromolecules leaked
from the damaged myocytes into the circulation
• Creatine kinase – particularly the M B isoenzyme
• Lactate dehydrogenase
• Troponin – Troponin I and Troponin T

45
Q

Effects of valvular disease

A

• Stenosis – tightening of the valvular opening resulting in decreased flow of
blood through the opening.
• Incompetence – incomplete closure of the valvular opening, allowing
backflow of blood through the valvular opening
• Mixed.

46
Q

Rheumatic fever

A

• Once the most common cause of valvular heart disease.
• It is an acute immunologically mediated , multi-system inflammatory disease
that occurs a few weeks after an episode of Group A (ß-hemolytic)
streptococcal pharyngitis.

47
Q

what is shock

A

A state of generalised hypoperfusion of all cells and tissues due to reduction in blood volume or cardiac output or redistribution of blood resulting in an inadequate effective circulating volume
• A systemic (whole body) event resulting from failure of the circulatory system
• It is at first reversible, but if protracted leads to irreversible injury and death.

48
Q

causes of shock

A
  • Hypovoleamia
  • Cardiogenic (pump failure)
  • Anaphylactic (peripheral pooling) (return failure)
  • Septic (Septiceamic) – Complex reasons
49
Q

Vicious circle of pathology

A

pump failure
vessel injury
peripheral pooling
and repeat

Human Anatomy (12 decks)

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