chapter 11 Flashcards
heart coverings
________ (double walled sac)
_________ (visceral layer of pericardium covering myocardium)
pericardium
epicardium
layers of heart wall
epicardium, myocardium, and endocardium
heart has four chambers:
right atrium
left atrium
right ventricle
left ventricle
right side of the heart is the _______ pump
left side of the heart is the ________ pump
_____: receiving chambers, thin walled, relatively small
pulmonary
systemic
atria
blood enters the ____ via three veins
1. _______ - from body regions above diaphgragm
2. _______ - from body areas below diaphragm
3. ________ - collects blood that drains from myocardium
blood enters ____ via four pulmonary veins
RA superior vena cava inferior vena cava coranary sinus LA
blood flow from the body \_\_\_\_\_\_\_\_ to the lungs \_\_\_\_\_\_ from the lungs \_\_\_\_\_\_\_\_ to the body \_\_\_\_\_\_\_
RA
RV
LA
LV
right heart circulation blood to lung
pulmonary circulation
left heart circulates blood to peripheral tissues
systemic circulation
fundamental blood supply of the heart
the _____ circulation in the body
the myocardium is too ______ to make diffusion a practical means of nutrient delivery
-the _____ branches to the right coronary arteries and the left coronary, which carry ______ blood to the heart when it is __________
coronary circulation shortest thick aorta arterial relaxed
coronary circulation contd.
________: anterior descending artery supplies the anttier wall and anterior part of inter ventricular septum
-____ artery supplies the lateral wall
____________: supplies the posterior wall and posterior part of interventricular septum
left coronary artery
circumflex
right coronary artery
conduction of the heart
SA node —> AV node —> AV bundle (bundle of His) —> right and left branches –> purkinje fibers
ECG
atrial depolarization
P wave
ECG
AV nodal delay
PR segment
ECG Ventricular depolarization (atria repolarizing simultaneously)
QRS complex
ECG
time during which ventricles are contracting and emptying
ST segment
ECG
ventricular repolarization
T wave
ECG
time during which ventricles are relaxing and filling
TP interval
blood pressure
the highest pressure is reached during ventricular contraction (_______ pressure)
- the pressure is the lowest when ventricles are relaxed (_____ pressure)
cardiac output: typically __ L/min is amount of blood pumped out by each ventricle
systolic
diastolic
5
arise during embryogensis (usually weeks __ through __); seen in 1% of live births
causes:
-german ______, ____ syndrome, and other undetermined causes
- defective heart _____ partitions
_______ cardiac valves
oftern result in ____ between left (______) and right (_______) circulations
Some congenital abnormalities can be corrected surgically, others are compatible with life, and others are fatal in the neonatal period
• Prevention is to attempt to protect the developing fetus from intrauterine injury
congential heart disease 3, 8 measles, down chamber malformed shunting systemic pulmonary
caused by a failure of proper closure of the foramen _____ or by a defect in the septum
- most common type is _____________ (90% of cases), ________ associated w down syndrome
- blood moves from the left atrium into the right atrium because of the pressure differences
-makes up __% of all congential heart defects
clinical symptoms:
recurrent ____ infections, heart ____, and _______
-fixed, widely split second heart _____
atrial septal defect (ASD) ovale ostium secundum ostium primum 10 chest failure arrythmias sound
failure of fusion of the interventricular septum
blood shunts through a hole in the interventricular septum
-makes up ___% of all congenital heart lesions
clinical features:
heart _____, failure to _____, recurrent ____ infections
ventricular septal defect (VSD)
30
failure, thrive, chest
characterized by
a. _____ of the right ventricular outflow tract
b. right ventricular ________
c. ____
and d. overriding _____
right to left shunt leads to early ______; degree of _____ determines the extent of shunting and cyanosis
patients learn to _____ in response to cyanotic spell; increased arterial resistance decreases ________ and allows more blood to reach the lungs
______ shaped heart on xray
tetralogy of fallot stenosis hypertrophy VSD aorta cyanosis stenosis squat shunting boot shaped
systemic complication of pharyngitis due to group A (B-hemolytic) streptococci
affects children 2-3 weeks after an episode of streptococcal pharyngitis (_______)
-caused by ______. Bacterial ___ protein resembles proteins in human tissue. Presence of _______ bodies (granulomatous lesion) in myocardium and _______ cells (multinucleated macrophages)
-clinical diagnoses based on Jones criteria (one to two major) and one minor.
-Major includes _____, previous ________, streptococci (elevated ___ & ______, ______ (swelling/pain in joints) and ______ (rash). —–Minor includes ____ and ___ changes
-acute attack usually resolves but may progress to chronic rheumatic heart disease and repeated exposure to group A (B-hemolytic) streptococci results in relapse of the _____ phase and increases risk for chronic disease
-treatment: _____ and ________ for fever
valvular heart disease acute rheumatic fever strep throat molecular mimicry M aschoff antischkow carditis group A (B-hemolytic) streptococci ASO anti-DNAse titer polyarthritis erythema fever ECG acute antibiotic salicylates
valve scarring that arises as a consequence of rheumatic fever.
usually seen after __+ years after ARF. results in _______ with a classic ____mouth apeparance and may also affect the ____ valve. complications include infectious _______
treatment: endocarditis ________ and valve _______ if necessary for severe diseases
valvular heart diseases CHRONIC RHEUMATIC HEART DISEASE 20+ mitral stenosis fish aortic endocarditis prophylaxis replacement
inflammation of endocardium that affects the surface of cardiac valves; usually due to:
______ infection (streptococcus ______)
divided into two groups:
1. ___________ endocarditis: caused by organisms of low virulence, small vegetations that do not destroy the valve and associated with mild symptoms of infection
2. _________ endocarditis: highly virulent organism (staphylococcus _____). high virulence organism that infects normal valves, most commonly the ______ valve. results in large vegetations that destroy the valve.
-staphylococcus ________ is associated with endocarditis of prosthetic valves
-streptococcus _____ is associated with endocarditis in patients with underlying ______carcinoma
1. _______ endocarditis is due to sterile vegetations that arise in association with ____
clinical symptoms and treatment:
acute: sudden high fever with _____; new onset of ____. broad spectrum antibiotics; may need surgical treatment if severe
subacute: _____
onset with low grade fever
broad spec antibiotics; prohylaxis of ______ with antiobiotics in susceptible individuals before dental procedures
endocarditis bacterial viridans subacute infective acute infective aureus tricuspid epidermis bovis colorectal libman-sacks SLE chills murmur insidious SBE
endocarditis
antibiotic is taken __ mins to __ hour before patients dental cleaning or surgical procedure. the antibiotic helps protect the ______ and the ____ from becoming infected by any bacteria that may be released into the blood during the procedure. the dose of antibiotic is usually much ____ than what is given for a typical infection, but only needs to be taken __ time prior to the procedure
30, 1 bloodstream heart larger 1
causes of pericarditis \_\_\_\_\_ (most common \_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_ and \_\_\_\_\_\_ surgery symptoms: \_\_\_ pain worsening with inspiration and supine position. diffuse concave \_\_\_ elevations with \_\_\_ depression in most ECG leads and normal \_\_\_ - MB
viruses traveling overseas bacteria open heart chest ST PR CK (creatine kinase)
causes of infectious myocarditis viruses (most common \_\_\_\_\_\_\_\_ A/B) \_\_\_\_ and \_\_\_\_\_\_ diffuse myocardial \_\_\_\_\_\_\_ and necrosis with \_\_\_\_\_\_\_ \_\_\_\_\_\_\_ infiltrate - treat the \_\_\_\_\_\_ cause
coxsackievirus parasites, protozoa degeneration mononuclear inflammatory underlining
primary myocardial disease
two types:
1. ________: inflammation heart muscle, mostly caused in US by _____; onset ___, may lead to ____ heart failure
2. ________
-__________: dilation of all four chambers of the heart & most common form. results in ____ dysfuction (ventricles cannot pump) causes: idiopathic, genetic ______, _______, _______, ____ abuse
- _____________: massive hypertrophy of the ____ ventricle and due to the genetic mutations in ______ proteins; most common form is ____ dominant. diastolic failure due to ____ in cardiac output. sudden death due to ventricular ________’; common cause of sudden death in young _____
syncope with exercise. biopsy shows _______ hypertrophy with disarray.
-____________: decreased compliance of the ventricular endomyocardium that restricts filling during diastole. causes include _______. results in _____ heart failure, with decrease ____ amplitude.
myocarditis viruses abrupt acute cardiomyopathy dilated cardiomyopathy systolic mutation, myocarditis, pregnancy, alcohol hypertrophic cardiomyopathy left sarcomere autosomal decreased arrthymias athletes myofiber restrictive cardiomyopathy amyloidosis congestive QRS
valvular heart disease
can be caused by a __________ aortic valve abnormality or by _____aortic stenosis
severe aortic stenosis places a great strain on the ___ ventricle, and eventual heart failure. aortic stenosis is caused by degenerative changes in valve _______________, followed by _______, which restricts valve ______.
resulting in __________: overload of the right ventricle of the heart resulting from pulmonary hypertension
nonrheumatic aortic stenosis congential bicuspid calcified left leaflet connective tissue calcifaction mobility cor pulmonale
coronary heart disease
caused by _________ of the large coronary arteries, where the arteries narrow owing to accumulation of fatty materials
- the _____ Deposits, consisting of neutral fat and cholesterol, accumulat ein the arteries by diffusion from the bloodstream
other risk factors that play a less important role:
- ______ accompanied by high blood lipids and elevated blood pressure
- _______: type A, which is aggressive, hard driving, and competitive
- _____ induced arrythmias and myocardial infarcts; the heart beats faster and more forcefuly, increasing myocardial oxygen requirements
atherosclerosis lipid obesity personality cocaine
bad cholesterol
carries cholestrol from the bloodstream to the cells
LDL low density protein
