Chapter 1 - Basics Flashcards
1
Q
The space between the lungs in the middle of the chest.
A
Mediastinum
2
Q
The upper portion of the heart, formed mainly by the left atrium and small amount of right atrium.
A
the base
3
Q
The base of the heart lies at approximately:
A
the 2nd intercostal space, immediately anterior to esophagus and descending aorta
4
Q
The lower portion of the heart, formed by the tip of the left ventricle:
A
apex
5
Q
The apex of the heart lies at approximately:
A
5th intercostal space, midclavicular line
6
Q
Two upper chambers of the heart
A
atria
7
Q
Two lower chambers of the heart
A
ventricles
8
Q
The right atrium receives blood low in oxygen from:
A
superior vena cava
inferior vena cava
coronary sinus
9
Q
The left atrium receives blood low in oxygen from:
A
lungs (right and left pulmonary veins)
10
Q
Right atrium thickness
A
2 mm
11
Q
Left atrium thickness
A
3 mm
12
Q
Valves through which blood is pumped from atria to ventricles
A
atrioventricular (tricuspid/mitral)
13
Q
The purpose of the ______________ is to pump blood.
A
ventricles
14
Q
The right ventricle pumps blood to the:
A
lungs
15
Q
The left ventricle pumps blood out to the:
A
body
16
Q
The outside of the heart has grooves called:
A
sulci
17
Q
The _________ _________ and their major branches lie in these grooves.
A
coronary arteries
18
Q
This groove encircles the outside of the heart separates the atria from the ventricles and contains the coronary blood vessels and epicardial fat.
A
coronary sulcus
19
Q
The right and left sides of the heart are separated by an internal wall of connective tissue called a:
A
septum
20
Q
This portion of the septum separates the right and left atria.
A
interatrial septum
21
Q
This portion of the septum separates the right and left ventricles.
A
interventricular septum
22
Q
The septa separate the heart into two functional:
A
pumps
23
Q
The job of the right side of the heart is to pump unoxygenated blood from the body to and through the lungs to the left side of the heart. This is called:
A
pulmonary circulation
24
Q
The right side of the heart is a ____-______ system.
A
low-pressure
25
The left side of the heart is a ____-_______ pump.
high-pressure
26
The job of the left heart is to receive oxygenated blood from the lungs and pump it out to the rest of the body. This is called the:
systemic circulation
27
Blood is carried from the heart to the organs of the body through:
arteries
arterioles
capillaries
28
Blood is returned through the right heart through:
venules
| veins
29
Right ventricle thickness
3-5 mm
30
Left ventricle thickness
13-15 mm
31
Because the wall of the left ventricle is much thicker than the right, the interventricular septum normally:
bulges to the right
32
Each ventricle holds ~______ of blood when it is full.
150 mL
33
Each ventricle normally ejects about ________ with each contraction.
70-80 mL (about half)
34
The amount of blood ejected from a ventricle with each heartbeat:
stroke volume
35
The percentage of blood pumped out of a ventricle with each contraction:
ejection fraction
36
Ejection fraction is used as a measure of:
ventricular function
37
A normal Ejection fraction is between:
50-65%
38
A person is said to have impaired ventricular function when the ejection fraction is less than:
40%
39
Examples of patients who may have a poor ejection fraction include those with:
congestive heart failure (CHF)
severe cardiomyopathy
myocardial damage from previous heart attack
40
The walls of the heart are made up of three tissue layers:
endocardium
myocardium
epicardium
41
The heart's innermost layer:
endocardium
42
Thin, smooth layer of epithelium and connective tissue in the heart; line the heart's inner chambers, valvues, chordae tendineae, and papillary muscles:
endocardium
43
The endocardium is continuous with the innermost layers of the _______, _____, and ____________ of the body, completing a continuous, closed circulatory system.
arteries, veins, and capillaries of the body
44
The middle layer of the heart is a thick, muscular layer that consists of cardiac muscle fibers (cells) responsible for the pumping action of the heart:
myocardium
45
The myocardium is divided into two areas:
subendocardial area
| subepicardial area
46
The muscle fibers of the myocardium are separated by connective tissues that have a rich supply of _______ and __________.
capillaries
| nerve fibers
47
The variation in thickness of the myocardium that varies from one heart chamber to another is related to the amount of ____________________ that must be overcome to pump blood out of the different chambers.
resistance
48
The heart's outermost layer is the
epicardium
49
The epicardium is continuous with the inner lining of the _____________ at the heart's apex
pericardium
50
The epicardium contains (4):
blood capillaries
lymph capillaries
nerve fibers
fat
51
The ____ ________ ______ lie on the epicardial surface of the heart.
main coronary arteries
52
The main coronary arteries feed this area first, before entering the myocardium and supplying the heart's inner layers with oxygenated blood.
epicardium
53
Decreased supply of oxygenated blood to a body part or organ
ischemia
54
The heart's ________ ________ is at the greatest risk of ischemia because this area has a high demand for oxygen and is fed by the most distal branches of the coronary arteries.
subendocardial area
55
The double-walled sac that encloses the heart and helps protect it from trauma and infection:
pericardium
56
The rough outer layer of the pericardial sac is called the
fibrous parietal pericardium
57
The parietal pericardium anchors the heart to some of the structures around it, such as the sternum and diaphragm, by means of:
ligaments
58
The inner layer of the pericardium consists of two layers:
parietal
| visceral
59
The parietal layer of the pericardium lines the inside of the
fibrous pericardium
60
The visceral layer of the pericardium adheres to the outside of the heart and forms the outer layer of the:
heart muscle
61
The visceral layer of the pericardium is also called the:
epicardium
62
The pericardial space lies between:
the visceral and parietal layers of the pericardium
63
The pericardial space normally contains about ___ mL of serous fluid
20
64
This fluid acts as a lubricant, preventing ______ as the heart beats
friction
65
Inflammation of the pericardium is called
pericarditis
66
Pericarditis can elicit the secretion of
more serous fluid
67
Pericarditis can be caused by (4)
bacterial or viral infection
rheumatoid arthritis
destruction of the heart muscle in heart attack
other causes
68
There are two types of valves in the heart:
atrioventricular (AV) valves
| semilunar (SL) valves (pulmonic/aortic) - also known as tricuspid and bicuspid
69
The purpose of valves in the heart is to ensure blood flows in one direction through the heart's chambers and to prevent the:
backflow of blood
70
The term used to describe a malfunctioning heart vale:
valvular heart disease
71
Types of valvular heart disease (3)
Valvular stenosis
valvular prolapse
valvular regurgitation
72
If a valve narrows, stiffens, or thickens, the valve is said to be:
stenosed
73
The heart must work harder to pump blood through a
stenosed valve
74
If a valve flap inverts, it is said to be
valvular proplapse
75
Valvular Prolapse can occur (2)
if one valve flap is larger than the other
| if the chordae tendineae stretch markedly or rupture
76
Blood can flow backward, or _____________, if one or more of the heart's valves do not close properly.
regurgitate
77
Valvular regurgitation is also known as valvular (2)
incompetence
| insufficiency
78
____________ valves separate the atria from the ventricles.
Atrioventricular (AV) valves
79
The AV valve that lies between the right atrium and right ventricle is:
tricuspid
80
The tricuspid has how many flaps?
3
81
The tricuspid valve is larger in diameter and thinner than the
mitral valve
82
the mitral valve is also called
bicuspid
83
the bicuspid has how many flaps?
2
84
The bicuspid lies between the
left atrium and left ventricle
85
The AV valves open when a forward pressure gradient forces blood in a:
forward direction
86
The AV valves close when a backward pressure gradient pushes blood:
backward
87
The AV valves require almost no backflow to cause
closure
88
About 70% of the blood returning from the SVC and IVC flows directly through the atria and into the ventricles before the atria contract. This is called:
passive filling
89
As the atria fill with blood, the pressure with the atrial chamber:
rises
90
Pressure in the atrial chamber forces open the tricuspid and mitral valves and the ventricles begin to fill, gradually increasing ___________ in the ventricles.
pressure
91
When the atria contract, an additional 10-30% of the returning blood in the atria is added to filling of the ventricles. This additional blood contribution is called
the atrial kick
92
The tricuspid and mitral valves completely close when the pressure within the _________________ exceeds that of the _______.
ventricles; atria
93
Dysrhythmias such as ___________ and __________ negatively affect normal atrial contraction.
Atrial flutter
| atrial fibrillation
94
Ineffectual atrial contraction can result in a (3)
loss of atrial kick
decreased stroke volume
subsequent decrease in cardiac output
95
Chordae tendineae are thin strands of
connective tissue
96
One each end, chordae tendineae are attached to:
papillary muscles
| underside of the AV valves
97
Papillary muscles project inward from the lower portion of the
ventricular walls
98
Papillary muscles contract and relax with
the ventricles
99
Papillary muscles adjust their tension on the chordae tendineae, preventing them as well as valve cusps from bulging too far into
the atria
100
The chordae tendineae and papillary muscles serve as
anchors
101
The pulmonic and aortic valves are called
semilunar (SL) valves
102
The SL valves have how many cusps?
3
103
The cusps of the SL valves are shaped like?
half-moons
104
The openings of the SL valves are ______ and ______ than the AV valves
smaller; thicker
105
Unlike the AV valves, the SL valves are not attached to
chordae tendineae
106
When the ventricles contract, the SL valves
open
107
The SL valves close as ventricular contraction ends and the pressure in the pulmonary artery and aorta exceeds that of the
ventricles
108
Blood from the tissues of the head, neck, and upper extremities is emptied into the
superior vena cava
109
Blood from the lower body returns via the
inferior vena cava
110
The right atrium receives blood from (3)
inferior vena cava
superior vena cava
coronary sinus
111
The largest vein that drains the heart is the
coronary sinus
112
The repetitive pumping process that includes all of the events associated with blood flow through the heart is the
cardiac cycle
113
The cardiac cycle has two phases for each heart chamber:
systole
| diastole
114
The period during which the chamber is contracted and blood is being ejected
systole
115
The period of relaxation during which the chambers are allowed to fill
diastole
116
The myocardium receives its fresh supply of oxygenated blood from the coronary arteries during
ventricular diastole
117
The cardiac cycle depends on (2)
ability of the cardiac muscle to contract
| the condition of the heart's conduction system
118
The efficiency of the heart as a pump may be affected by abnormalities of the (3)
cardiac muscle
valves
conduction system
119
During atrial diastole, blood from the superior and inferior ____ ____ and the coronary _____ enter the right atrium.
vena cava
| sinus
120
As the right atrium fills and distends (during atrial diastole), the ____________valve is pushed open allowing blood to fill the right ________.
tricuspid valve
| ventricle
121
During atrial diastole, the left _____ received blood from the four pulmonary veins (two from right and two from left). The flaps of the ______ valve open as the left atrium fills allowing blood to flow into the left _________.
atrium
mitral
ventricle
122
The __________ circulation consists of coronary arteries and veins.
coronary
123
With normal activity, ___ - ___ % of the fresh oxygen in blood is taken out by the myocardium by means of the coronary arteries.
65-75%
124
The coronary removal rate of oxygen is the highest of any tissue during normal activity and one that cannot be:
significantly improved
125
The only way the heart can improve its oxygen uptake is by increasing:
coronary blood flow
126
With strenuous activity, coronary blood flow can increase significantly to ensure there is an adequate supply of oxygen to the:
myocardium
127
At rest, coronary blood flow averages about:
250 mL/min
| 4-5% of the total cardiac output
128
The main coronary arteries lie on the __________ surface of the heart.
epicardial
129
Coronary arteries that run on the surface of the heart are called
epicardial coronary arteries
130
Branches of the main coronary arteries penetrate the heart's muscle mass and supply the _____________ with blood.
subendocardium
131
The diameter of the coronary arteries supplying the subendocardium is much smaller - and are often referred to as "feeder branches" or
collateral circulation
132
The freshly oxygenated blood is supplied to the heart itself by two main vessels:
right coronary artery
| left coronary artery
133
The LCA & RCA are the very first branches off the base of the
aorta
134
The openings of the LCA & RCA lie just beyond the cusps of the
aortic SL valve
135
When the heart contracts, blood flow to the tissues of the heart is significantly _________ because the heart's blood vessels are compressed.
reduced
136
The coronary arteries fill when the ventricles are relaxed in
diastole
137
The three major coronary arteries include the
Left anterior descending (LAD)
Circumflex (CX) artery
Right coronary artery (RCA)
138
A person is said to have CAD if there is more than _____ % diameter narrowing (stenosis) in one or more of these vessels.
50
139
The RCA originates from the right side of the
aorta
140
The RCA travels along a groove between the _______ and _____________
right atrium
| right ventricle
141
A branch of the RC supplies the (6):
Right atrium
Right ventricle
Inferior surface of the left ventricle in about 85% of population
Posterior surface of the left ventricle in about 85% of population
SA node in about 60% of population
AV node in 85-90% of population
142
In ~90% of the population, the RCA forms the posterior descending artery and supplies the inferior wall of the left ventricle. In the remaining 10% of the population, the __________ artery forms the PDA.
CX artery
143
The left coronary artery (LCA) originates from the left side of the
aorta
144
The first segment of the LCA is called the left main coronary artery. It is about the width of a soda straw and less than
1" long
145
The LMCA supplies oxygenated blood to its two primary branches:
LAD (aka anterior interventricular)
| CX
146
The LAD can be seen on the epicardial surface on the front of the heart. It travels along the groove that lies between the right and left ventricles and is called:
anterior interventricular sulcus
147
In more than 75% of patients, the LAD travels around the apex of the left ventricle and ends along the left ventricle's:
inferior surface
148
In 25% of patients, the LAD stops at or before the heart's
apex
149
The major branches of the LAD are
septal artery
| diagonal artery
150
The septal branches of the LAD supply blood to the
interventricular septum
151
The LAD supplies blood to (3):
Anterior surface of left ventricle
Part of lateral surface of left ventricle
Most of interventricular septum
152
The ___________ artery circles around the left side of the heart.
CX
153
The CX is embedded in the _____________________________ on the back of the heart.
epicardium
154
The CX supplies blood to (6):
Left atrium
Lateral surface of the left ventricle
Inferior surface of the left ventricle in 15% of pop
Posterior surface of the left ventricle in 15% of pop
SA node in ~40% pop
AV node in 10-15% pop
155
Blockage of the LMCA is commonly called _____________ because of its association with SCA when occluded
the widow maker
156
The coronary (cardiac) veins travel alongside the
arteries
157
Blood that has passed through the myocardial capillaries is drained by branches of the cardiac veins that join the
coronary sinus
158
The coronary sinus is the largest vein that drains the
heart
159
The coronary sinus lies in the _______ that separates the atria and the ventricles
sulcus
160
The coronary sinus receives blood from the great, middle, and small cardiac veins; a vein of the left atrium; and the ________ vein of the left ventricle
posterior
161
The coronary sinus drains into the right
atrium
162
The anterior cardiac veins do not join the coronary sinus but empty directly into the right
atrium
163
A condition caused by a similar sequence of pathologic events - a temporary or permanent blockage of a coronary artery.
Acute coronary syndrome(s) (ACSs)
164
The usual cause of an ACS is the rupture of an
atherosclerotic plaque
165
A chronic disease of the arterial system characterized by abnormal thickening and hardening of the vessel walls:
arteriosclerosis
166
A form of arteriosclerosis in which the thickening and hardening of the vessel walls are caused by a buildup of fatlike deposits (plaque) in the inner lining of large- and middle-sized muscular arteries.
atherosclerosis
167
Vascular pathways that serve as an alternate route for blood flow around the blocked artery to the heart muscle.
collateral circulation
168
The presence of collateral circulation that builds over time, may prevent an MI, despite complete blockage of a
primary artery
169
As the heart chambers fill with blood, the heart muscle is
stretched (Frank Starling law of the heart
170
The most important factor determining the amount of blood pumped out by the heart (stroke volume) is the amount of blood flowing into the right heart from the systemic circulation or
venous return
171
The mechanical activity of the heart is reflected by the _______ and _______ ____________.
pulse
| blood pressure
172
The force exerted by the circulating blood volume on the walls of the arteries
blood pressure
173
The resistance to the flow of blood determined by blood vessel diameter and the tone of the vascular musculature
peripheral vascular resistance (PVR)
174
The term that may be used when referring to the normal state of balanced tension in body tissues.
tone
175
BP is equal to CO X
PVR
176
BP is affected by any condition that increases:
PVR or CO
177
An increase in either CO or PVR typically results in an increase in
BP
178
A decrease in either CO or PVR will result in a decrease in
BP
179
The amount of blood pumped into the aorta each minute by the heart is
cardiac output
180
Cardiac output is defined as the stroke volume multiplied by the
heart rate
181
nL CO in avg. adult
~4-8 L/min
182
CO at rest is
~5 L/min
183
Because the ___________________________________ system is a closed system, the volume of blood leaving one part of the system must equal that entering another part.
cardiovascular
