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BBS1002 > case 2 > Flashcards

case 2 Flashcards

1
Q

right side heart

A

receives oxygen-poor blood.

blood vessels carry blood to/from the lungs –> pulmonary circuit

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2
Q

left side heart

A

receives oxygenated blood.

blood vessels that carry blood to/from body tissue –> systemic circuit

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3
Q

heart bigger structures

A

left + right atrium
left + right ventricles
enclosed within mediastinum

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4
Q

pericardium

A

double walled sac enclosing the heart

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5
Q

fibrous pericardium

A

loosely fitted superficial part

- protect, anchor and prevent overfilling

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6
Q

serous pericardium

A

two layer membrane, froms sac around heart

  • parietal layer: lines internal surface of fibrous. attaches to large arteries and turn inferiorly and continues
  • -> visceral layer (epicardium). essential part.
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7
Q

pericardial cavity

A

between parietal and visceral layer. contains serous fluid.

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8
Q

epicardium

A

superficial, visceral layer of pericardium.

–> infiltrated with fat

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9
Q

myocardium

A

middle layer.

  • -> cardiac muscle, biggest part
  • -> contracts, spiral of circular bundles.
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10
Q

cardiac skeleton ( myocardium)

A

connective tissue fibers –> strengthens myocardium + anchors muscle fibers.
limits spread of action potentials

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11
Q

endocardium

A

inside layer, white squamous epithelium.

  • -> resting on connective tissue + covers fibrous skeleton of valves.
  • continuous
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12
Q

Chambers

A
  • 2 atria
  • 2 ventricles
  • -> separation longitudinally: interatrial septum (separates atria)
  • -> interventricular septum (separates ventricles)
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13
Q

Grooves that indicate boundaries –> sulcus

A
  • coronary sulcus: encricles junction of atria + ventricles.

- anterior interventricular sulcus: cradling the anteror interventricular artery –> continues as posterior.

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14
Q

Right atrium

A 
two parts:
- smooth walled: posterior
- anterior, muscle forms ridges
--> pectinate muscles
regions separated by crista terminalis --> C-shaped ridges
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15
Q

Left atrium

A
  • mostly smooth.

interatrial septum bears shallow despression –> fossa ovalis. (opening fetal heart)

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16
Q

function atria

A

receive blood returning to heart. thin walled.

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17
Q

right atrium blood vessels

A
  • superior vena cava –> above diaphragm
  • inferior vena cava –> below
  • coronary sinus –> myocardium
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18
Q

Left ventricle

A

dominates posteroinferior surface

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19
Q

Trabeculae carneae

A

irregular ridges of muscle, mark walls of ventricles

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20
Q

papillary muscles

A

play a role in valve function

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21
Q

right ventricle

A

pumps blood into pulmonary trunk

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22
Q

left ventricle

A

pumps blood into aorta

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23
Q

atrioventricular (AV) valves

A

located at atrial-ventricular junction

function: prevent backflow into atria.
- -> chordae tendinae (collagen cords) attached to flap. anchor susps to papillary muscles

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24
Q

right AV

A

tricuspid valve

–> 3 flexible cusps

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25
Q

left AV

A 
mitral valve (bicuspid)
--> two flexible cusps
26
Q

How do AV valves work?

A

relaxed: AV flaps hang into ventricles.

- -> contraction ventricles: pressure rises forcing blood superiorly against valves. flaps close.

27
Q

semilunar (SL) valves

A

aortic and pulmonary valves.

function: prevent backflow.

28
Q

How do SL valves work?

A

ventricles contract –> pressure rises above aorta and pulmonary trunk.
valves are forced open.
ventricles relax –> cusps filled and valves closed.

29
Q

coronary arteries

A

left + right coronary arteries, encircle heart in coronary sulcus.

30
Q

left coronary artery

A

two branches:

  • anterior interventricular artery: follows sulcus and supplies to septum and anterior walls of ventricles
  • circumflex artery: supplies left atrium + posterior walls ventricles
31
Q

right coronary artery

A

two branches:

  • right marginal artery: serves myocardium lateral side
  • posterior interventricular artery: heart apex and supplies posterior ventricles. merges with anterior interventricular artery
32
Q

coronary veins

A

after myocardium blood is here collected.

veins join to enlarged vessel: coronary sinus.

33
Q

coronary sinus

A 
3 tributaries:
- great cardiac vein
- middle cardiac vein
- small cardiac vein
several anterior cardiac veins empty directly into atrium
34
Q

cardiac muscle cells

A

self-excitable.
can initate depolarization + rest of the heart in sponaneous and rhythmic way
–> autmaticity
1% is autorhythmic

35
Q

myogenic

A

functions in ordered rhythmic fashion because of inherent properties of cardiac muscle rather than specific neural stimuli

36
Q

contraction heart general

A

either all fibers contract of nothing.

–> gap junctions

37
Q

how does contraction happen?

A

triggered by action potentials.

heart muscle does not depend on NS.

38
Q

cardiac pacemaker cells

A

make up intrinsic conduction system. unstable resting potential

  • -> continuously depolarizing.
  • -> pacemaker potentials
39
Q

places where pacemaker cells are found

A
  1. sinoatrial node
  2. atrioventricular node
  3. atrioventricular bundle
  4. right + left bundle branches
  5. subendocardial conducting network
40
Q

sinoatrial (SA) node

A

located in right atrial wall. genrates 75 impulses/min.
sets pace for the heart. no other region has a faster depolarization rate.
–> hearts pacemaker + sinus rhythm.

41
Q

atrioventricular (AV) node

A

depolarization spreads via internodal pathway to AV node.

location: in inferior portion of interatrial spetum (above tricuspid)
- impulses delayed for 0.1 s –> atria can complete contraction.

42
Q

atrioventricular (AV) bundle

A

impulse sweeps to AV bundle (bundle of His).

location: superior part of interventricular septum

43
Q

bundle of his branches

A

right and left bundle branches

44
Q

subendocardial conducting network

A

long strand cells with few myofibrils –> Purkinje fibers.
through interventricular septum.
total time: 0.22 s

45
Q

cardioinhibitory center

A

sends impulses to parasympathetic dorsal vagus nuclues –> medulla.
sends inhibitory impulses to heart via vagus nerves

46
Q

cardiac cycle

A

all evetns associated with blood flow through the heart during one complete heartbeat
- artrial systole + diastole + ventricular systole + diastole

47
Q

ventricular filling: mid-to-late diastole

A

blood flows passively through atria and open AV valves into ventricles.
–> atria contract: rise in pressure, proprels blood ouf tof atria into ventricles

48
Q

ventricular systole

A

ventricles contract, walls close in on blood. pressures rises –> closing AV valves. split second ventricles are closed chambers. –> isovolumetric contraction phase

49
Q

isovolumetric relaxation: early diastole

A

ventricles relax. end systolic volume (ESV) no longer compressed, pressure drops and blood in aorta and pulmonary trunk flow back–> closing SL valves

50
Q

heart sounds

A

1st: tricuspid + mitral
2nd: pulmonary and aortic valves
heart sound: phonocardiogram

51
Q

pressure volume curve:

A

stroke volume: EDV (end diastolic volume - ESV ( end systolic volume)

52
Q

stroke volume factors:

A

contractility
preload
afterload

53
Q

contractility (stroke volume)

A

inotropy –> ability of heart muscle to contract.
increasing: though influx of Ca2+ or maintaning Ca2+ levels.
increases slope and shifts ESV to the left
–> permits ventricles to generate more pressure. also increases ejection velocity –> increase stroke volume.

54
Q

preload (stroke volume)

A

left ventricular wall stress at ED.
increase: increase in stroke volume, cardiac output + arterial pressure.
–> increasing end-systolic volume
increased afterload reduces velocity of fiber shortening and ejection velocity.

55
Q

afterload (stroke volume)

A

pressure required to open aortic valve. , stroke volume is reduces and ESV increased. if afterload is decreased –> stroke volume increases and EDV decreases

56
Q

Blood volume

A

determined by water + sodium.

mainly regulated by kidneys

57
Q

increase blood volume

A
  • increases central venous pressure
    increases right atrial pressure + right vetricular EDV and volume.
    –> increase in ventricular preload increases stroke volume by Frank-Starling mechanism.
  • increase in right ventricular stroke volume: increase in pulmonary venous bloof flow to left ventricle, increasing left ventricular preload + stroke volume –> decrease cardiac output + arterial blood pressure
58
Q

ANS influence on the heart

A
  • emotional/physical stress –> activate SNS –> norepinephrine: binds to B1-adrenergic receptors. SA node fires more rapidly
  • enhances contractility + speed relaxation. enhancing Ca2+ movement.
    movement in contractile cells lower ESV.
  • parasympathetic: mediated by acetylcholine, hyperpolarizes membrane via opening K+ channels.
  • rest: autonomic divisions send impulses to SA node, dominant influence is inhibitory. the heart is vagal tone, heart rate is generally slower.
59
Q

nicotinic acetylcholine receptors

A

respond to acetylcholine, drugs –> nicotine. primary receptor in muscle for motor nerve-muscle communication that controls contraction.
activation –> depolarization of plasma membrane. leads to regulation of genes or release of neurotransmitters

60
Q

muscarinic acetylcholine receptor

A

work with G-proteins
act as main end-receptor stimulated by acetylcholine . more sensitive to muscarine than to nicotine. activation: resulsts in inhibiting/ exciting of postsynaptic neurons
–> parasympathetic nervous system.

61
Q

adrenergic receptors

A

alfa + beta. targets of noradrenaline + adrenaline. stimulate SNS.
alfa: vasoconstriction + descreased motility of smooth muscle in GI
beta 1: increase cardiac output via increasing heart rate, conductiong velocity, stroke volume + rate of relaxation, by increacing Ca2+ concentration.

62
Q

dobutamine

A

drug used in treatment of heart failure. direct stimulation of B1-adrenergic receptors of SNS, causing threshold to be reached faster. increase in heart rate + cardiac output.

BBS1002 (10 decks)

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