Chapter 12 EXAM 2 Flashcards
Describe the development of the heart.
the heart begins as a dual pump. The heart muscle twists, which causes the wringing action of the contraction.
Describe the right side of the heart.
takes blood from the body and pumps it to the pulmonary component of the circulatory system.
Describe the left side of the heart.
takes blood from the lungs and pumps it to the rest of the body.
Describe the valves.
one-way pumping action accomplished by valves.
What are the three different types of chambers of the heart?
atria
ventricles
vlaves
What is the atria?
located at the base of the heart.
receives blood from either lungs (left) or the rest of the body (right atrium) and help to fill the ventricles.
What are the ventricles?
form most of the muscle mass of the heart.
sends blood out to either the lungs (right ventricle) or the rest of the body (left ventricle).
What are the two types of atrioventricular valves?
tricuspid and bicuspid valves.
What is the function of the atrioventricular valves (AV)?
separates the atria from the ventricles.
Describe the tricuspid valve.
the right AV valve.
has three cusps.
Describe the bicuspid valve.
The left AV valve.
has two cusps.
What are chordae tendineae?
tough, string-like structures attached to the edges of the AV valves.
anchor the valves to the internal walls of the ventricles and help prevent the valves from opening backwards, thus assuring one-way flow.
What are papillary muscles?
cardiac muscle fibers that attach teh chordae tendineae to the ventricles. As the muscle cells of the ventricles contract, the papillary muscles also contract to help hold the valves close.
What are semilunar valves?
separate the ventricles from their respective out-flow tracts (pulmonary artery or aorta). Composed of three cusps.
What is the pulmonary valve?
separates the right ventricle from the pulmonary artery. Opens when pressure in the right ventricle exceeds the pressure in the pulmonary artery.
Describe the aortic valve.
separates the left ventricle from the aorta. Opens when pressure in the left ventricle exceeds the pressure in the aorta.
usually at 80mmHg.
what do valves and surrounding fibrous tissue serve as?
insulators that keep the atria and the ventricles isolated from each other. This is important in sequencing atrial
What is autorhythmicity?
the ability to contract without external stimulation.
What percent of cardiac muscle cells are autorhythmic?
1%
What percent of cardiac muscle cells are contractile?
99%
What is the function of the sinoatrial node (SA node)?
sets the pace for heart rate under normal circumstances.
inherently discharges at 70 to 80 times per minute.
Where is the SA node located?
the right atrial wall near the superior vena cava.
Where is the atrioventricular node (AV node) located?
in the right atrium near the septum, where the ventricles and atria meet.
inherently discharges at 40 to 60 times per minute.
describe the bundle of his.
travels from the AV node through the ventricular septum (on both sides) down to the apex of the heart.
inherently discharges at 20 to 40 times per minute.
Describe the purkinje fibers.
special conductive cells that communicate electrical impulses from the bundle of his to the contractile myocardial cells in the ventricles.
inherently discharge at 20 to 40 times per minute.
Where does the action potential usually originate?
from the SA node, because it’s discharging the most frequently.
Where does the action potential go after leaving the SA node?
travels through specialized internodal tract to the AV node.
Where does the AV node pass the action potential?
from the atria to the ventricles (which are electrically isolated from each other) along the bundles of His.
How long is the delay in propogation of the impulses thought the AV node?
0.1 second.
What is the function of the delay from the AV node impulse?
allows the atria to complete contraction before the ventricles contract.
Where do the bundles of His send the action potential?
along the ventricular septum toward the apex. (purkinje fibers).
Where do the purkinje fibers send the action potential?
to the contractile myocardial cells of both ventricles.
How are cells of the specialized conduction system modified?
to give them autorhythmicity.
Describe the cell membranes of the cells of the specialized conduction system.
far less permeable to potassium than other excitable cells.
they are permeable to sodium and calcium.
Describe the resting membrane potential of pacemaker cells.
wander toward threshold because of a greater influx of calcium relative to the efflux of potassium.
What happens when calcium enters the pacemaker cell?
the voltage gated calcium channels open allowing a more rapid influx of calcium into the cell. As the membrane potential peaks, the membrane becomes more permeable to potassium, which rapidly leaves the cell, reestablishing resting membrane potential.
What is periodicity caused by?
the slow rise toward threshold. This is the pacemaker potential.
How is the peiodicity manifested?
as a relatively constant heart rate.
What does parasympathetic activity do to the constancy of heart rate?
decreases the constanty.
What causes the heart rate to vary?
respiration and oscillations in blood pressure.
What happens if a pacemaker is lost?
pacing is taken over by the cells of the AV node.
heart rate will drop accordingly.
What can cause the loss of a pacemaker?
certain diseases or pathological events (myocardial infarction) can damage or eliminate the SA node.
What happens if the heart rate is determined by the cells of the bundles of His or Purkinje fibers?
the person will lose consciousness due to a heart rate that is too slow to maintain adequate blood pressure and thus blood flow to the brain.
What results from a block in the specialized conduction system?
the atria contracting independently of the ventricals. The atria follow the pace of the SA node and beat at 70 times per minute while the ventricles beat at 50 beats per minute.
What are ectopic foci?
in any area of the heart, the specialized conductin system cells or contractile myocardial cells can become irritable and can take over the pacing function from the SA node.
What is the result of ectopic foci?
causes the heart to contract out of synchrony with the pacing system because the cardiac muscle cells are in communication with each other.
What is a PVC?
the beat resulting from an ectopic focus in the ventricles.
premature ventricular contraction.
What can occur if there are multiple foci?
multiple action potentials can be generated and chaotic contractions can occur. can cause atrial or ventricular fibrillation.
What causes the rising phase of action potentials in cardiac muscle cells?
the influx of sodium.
What causes the plateau phase of action potentials in cardiac muscle cells?
the slow influx of calcium
What causes the falling phase of action potentials in cardiac muscle cells?
increase in permeability to calcium and increased permeability to potassium.
What are the two sources of calcium?
sarcoplasmic reticulum and extracellular fluid.
What can calcium trigger?
further release of calcium from the sarcoplasmic reticulum.
also prolongs the cardiac muscle contraction.
also prolongs the cardiac action potential.
What does the amount of calcium released into the cytosol determine?
the extent of cross bridge activity.
What does an increase in extracellular potassium lead to?
a decrease in concentration gradient, and a hypopolarization or hyperexcitability of the membrane.
What does an increase in extracellular calcium lead to?
an increase in the strength of contraction.
What causes the refractory period?
the inactivity of sodium channels during the action potential.
How long does the heart remain refractory?
250msec, which is approximately the length of a cardiac muscle contraction.
What does the refractory period prevents?
tetanus or wave summation from occurring.
Why is the refractory period important?
allows for atrial and ventricular filling.
How is electrical activity of the heart transmitted?
through the electrolyte solutions in the body.
What does an ECG do?
measures depolarization and repolarization of different portions of the heart.
does not measure mechanical events.
What is the P wave
represents depolarization of the atrial muscle.
What is the PR segment?
partially attributable to the conduction delay through the AV node. Measured from the end of the P wave and the beginning of the QRS complex.
What is the QRS complex?
represents ventricular depolarizations (masks the atrial repolarization).
What is the ST segment?
this represents the plateau phase of the cardiac muscle action potential. during this time period, the ventricles are contracting.
What is the T wave?
repolarization of the ventricles.
What is the TP interval?
the time at which the heart is at rest.
greatly influences the BPM.
What is atrial flutter?
rapid but regular contraction of atria. The ventricles contract rapidly but not at the same rate as the atria. Due to an ectopic atrial focus of stimulation.
What is ventricular flutter?
rapid ventricular contraction due to a single ectopic ventricular focus of stimulation. All P and T waves are obliterated.
What is atrial fibrillation?
completely uncoordinated depolarization of the atria. Due to multiple ectopic foci.
What is a complete heart block?
loss of coordination between the atria and ventricles. P waves are independent of the QRS complexes.
What are cardiac myopathies?
damage to the heart muscle.
What is tachycardia?
fast heart rate.
What is brachycardia?
slow heart rate.
What is ventricular systole?
a period of contraction. emptying, squeezing of the heart muscle.
What is ventricular diastole?
period of relaxation. Filling.
What happens during early diastole?
the atria are also in diastole.
cooresponds to the TP interval.
because blood is flowing from the veins into the atria, the pressure in the atria is slightly higher than in the ventricles. this causes the AV valves to remain open.
What happens when the AV valves are open?
blood will continue to flow into the ventricles and the ventricular pressure will rise slightly before the atria contract.
What happens in late diastole?
the SA node fires and the atria begin to depolarize. This is evidenced by the P wave. leads to contraction of the atria.
What happens when the atria contract?
more blood is pushed into the ventricles.
The AV valves are open; the pressures in the atria are slightly greater than the pressures in the respective ventricles. When the atria contract, the ventricles are already 80% of EDV.
What is EDV?
acheived when the ventricles are filled.
What happens when EDV is reached.
the signal from the SA node passes to the aV node and the ventricles begin to depolarize as evidenced by hearing the first heart sound. luuuub.
What happens after the ventricles depolarize?
the ventricular pressure increases, forcing the aortic and pulmonic valves to open.
What is the isovolumetric ventricular contraction?
the time before the aortic and pulmonic valves open.
What happens once the aortic and pulmonic valves are open?
ejection begins as evidenced by a rapid rise in arterial blood pressure.
What is systolic pressure?
the peak of the blood pressure curve. During this time, the ventricular volume is rapidly diminishing until the ventricles are through contracting.
What is the volume of the EDV?
135ml
What is the volume of ESV?
65ml
What happens once most of the blood has left the ventricle?
ventricular pressure falls. This results in closure of the aortic valve.
What does closing of the aortic valve case?
turbulence as evidenced by the second heart sound. Also causes a dip in the aortic pressure waveform called the dicrotic notch.
What happens shortly after the peak of ejection?
the ventricles repolarize and the T wave is observed on the ECG.
What is isovolumetric ventricular relaxation?
located at approximately the middle of the T wave.
the volume remains the same, as the heart relaxes.
as long as the ventricular pressure is above that of the atria, the AV valves are closed.