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Anatomy and Physiology > Chapter 18: Cardiology > Flashcards

Chapter 18: Cardiology Flashcards

1
Q

the heart is located directly behind the __

A

sternum

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2
Q

what is the base of the heart?

A

superior part

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3
Q

in what part of the heart are the major blood vessels?

A

base

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4
Q

what is the apex of the heart?

A

inferior, pointed tip

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5
Q

how many sides in the heart? how many chambers?

A

2; 4

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6
Q

role of right atrium

A

receives blood from systemic circuit

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7
Q

role of right ventricle

A

pumps blood into pulmonary circuit

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8
Q

role of left atrium

A

receives blood from pulmonary circuit

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9
Q

role of left ventricle

A

pumps blood into systemic circuit

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10
Q

what is the pericardium?

A

sac-like structure wrapped around the heart

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11
Q

what are the 3 layers of the pericardium>

A

fibrous and 2 serous

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12
Q

what is the fibrous pericardium? what is it made of?

A

outermost layer; dense fibrous connective tissue that extends to sternum and diaphragm

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13
Q

what are the two layers of the serous pericardium?

A

outer parietal layer and inner serous layer

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14
Q

what is the pericardial cavity?

A

space between serous layers, containing pericardial fluid secreted from serous membranes

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15
Q

what is the function of the pericardial fluid?

A

to lubricate movements of the heart

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16
Q

what is pericarditis

A

inflammation of pericardium

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17
Q

cardiac tamponade

A

excess accumulation of pericardial fluid

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18
Q

what are the 3 layers of the heart?

A
  1. pericardium
  2. myocardium
  3. endocardium
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19
Q

what is the epicardium?

A

visceral layer of serous pericardium

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20
Q

what is the myocardium made of ?

A

concentric layers of cardiac muscle

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21
Q

what is the role of the myocardium?

A

support blood vessels and nerves

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22
Q

what is the endocardium made up?

A

simple squamous epithelium and areolar tissue

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23
Q

the endocardium is continuous with the __ and covers heart __

A

endothelium; valves

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24
Q

arterial muscle of the myocardium wraps around atria in ___ pattern

A

figure 8

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25
Q

what are the 2 layers of ventricular musculature of the myocardium?

A

sperficial and deeper

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26
Q

the superficial layer of the ventricular musculature surrounds __

A

both ventricles

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27
Q

deeper layers of the ventricular musculature are arranged in what way?

A

around and between the ventricles

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28
Q

T/F cardiac muscle cells are smaller than skeletal muscle cells

A

true

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29
Q

how many nuclei in a cardiac cell

A

1

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30
Q

cardiac cells have ___ that allow branching interactions between cells

A

intercalated discs

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31
Q

t/f cardiac muscle is striated

A

true

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32
Q

cardial muscle is almost entirely dependent on ___ for energy

A

aerobic metabolism

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33
Q

cardiac muscle has abundant stores of __ and __ for oxygen

A

mitochondria and hemoglobin

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34
Q

cardiac muscle has extensive __

A

capillaries

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35
Q

intercalated discs are interconnected with the __ of adjacent cells

A

plasma membrane

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36
Q

intercalated discs are attached by __ and __

A

desmosomes and tight junctions

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37
Q

gap junctions between intercalated discs allows ___ to spread cell to cell which allows cells to functions as a __

A

action potentials; unit

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38
Q

what structures are visible on the anterior surface? (4)

A
  1. all four chambers
  2. auricle
  3. coronary sulcus
  4. anterior inter ventricular sulcus
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39
Q

what is the auricle of each atrium?

A

an expandable pouch

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40
Q

what is the coronary sulcus?

A

groove separating atria and ventricles

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41
Q

what is the anterior inter ventricular sulcus?

A

groove marking boundary between the two ventricles

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42
Q

what structures are visible on the posterior surface? (5)

A
  1. all 4 chambers
  2. pulmonary veins (4) returning blood to left atrium
  3. superior and inferior vena cavae returning blood to right atrium
  4. coronary sinus
  5. posterior interventricular sulcus
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43
Q

what is the role of the coronary sinus?

A

returns blood from myocardium to right atrium

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44
Q

___ continually supplies cardiac muscle (myocardium) with oxygen/nutrients

A

coronary circulation

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45
Q

____ arise from ascending aorta; fill when ventricles are relaxed (diastole)

A

left and right coronary arteries

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46
Q

myocardial blood flow may increase up to __x the resting level during maximal exertion

A

9

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47
Q

what is supplied by the right coronary artery?

A

right atrium, both ventricles, and parts of the cardiac conducting system

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48
Q

what are the 2 main branches of the right coronary artery?

A
  1. marginal arteries

2. posterior interventricular (posterior descending) artery

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49
Q

what is supplied by the marginal artery?

A

right ventricle

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50
Q

what is supplied by the interventricular artery?

A

interventricluar septum and adjacent parts of ventricles

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51
Q

what is supplied by the left coronary artery?

A

left ventricle, left atrium, interventricular septum

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52
Q

what are the 2 main branches of the left coronary artery?

A
  1. anterior interventricualr artery ( left and anterior descending)
  2. circumflex artery
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53
Q

what is supplied by the circumflex artery?

A

posterior of left ventricle

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54
Q

the circumflex artery follows the _- sulcus to the left and meets branches of the ___ posteriorly

A

coronary; coronary artery

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55
Q

location of great cardiac vein

A

in anterior interventricuar sulcus

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56
Q

what is the function of the great cardiac muscle? what does it drains and where does it empty into?

A

drains area supplied by anterior interventricluar sulcus and empties into coronary sinus

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57
Q

what does the anterior cardiac veins drain and empty to?

A

drain anterior surface of right ventricle; empty into right atrium

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58
Q

what is the coronary sinus?

A

expanded vein that empties into right atrium

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59
Q

the posterior vein or left ventricle drains the area supplied by the __

A

circumflex artery

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60
Q

the middle cardiac vein drains area supplied by __ and empties into the __

A

posterior interventricular artery; coronary sinus

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61
Q

the small cardiac vein drains __ and empties into __

A

posterior of right atrium/ventricle; coronary sinus

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62
Q

blood flow through the coronary circuit is maintained by changing __ and __

A

blood pressure; elastic rebound

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63
Q

left ventriclar contraction forces blood into the __. what does this do to blood pressure

A

aorta; raises blood pressure

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64
Q

what happens to blood pressure and aortic walls during left ventricular relaxation?

A

pressure decreases; aortic walls recoil (elastic rebound)

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65
Q

left ventricular relaxation forces blood in what 2 directions?

A
  1. forward into systemic circuit

2. backward into coronary arteries

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66
Q

the left and right atria are separated by the _-

A

interatrial septum

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67
Q

right and left ventricles are separated by __

A

interventricular septum

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68
Q

atrioventricular valves allow only ___ blood flow from __- to __

A

one-way; atrium to ventricle

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69
Q

location of semilunar valves

A

at exit of each ventricle

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70
Q

semilunar valves allow only ___ blood flow from __ into __ or __

A

one-way; ventricle; aorta or pulmonary trunk

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71
Q

the right atrium receives __ blood from ___ and __

A

deoxygenated; superior/inferior venue cavae and coronary sinus

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72
Q

what is the fossa ovals?

A

remnant of fetal foramen ovale that allowed fetal blood to pass between atria (closes at birth)

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73
Q

the left atrium receives __ blood from __

A

oxygenated; pulmonary veins

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74
Q

the right ventricle receives blood from ___ through __ valve

A

right atrium; tricuspid

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75
Q

what is another name for tricuspid valve?

A

AV valve

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76
Q

contraction of right ventricle forces blood through the ___ valve into the __

A

pulmonary semilunar valve; pulmonary trunk

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77
Q

t/f the left ventricle is much thicker than the right

A

t

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78
Q

the left ventricle receives blood from the ___ through the __ valve

A

left atrium; mitral valve

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79
Q

what is another name for the mitral valve?

A

bicuspid valve

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80
Q

with contraction of the left ventricle, blood exists through the __ into the __

A

aortic semilunar valve; ascending aorta

81
Q

the cusps of the AV valves attach to __

A

cord tendoneae

82
Q

the chordae tendoneae are anchored to thickened cone-shaped ___

A

papillary muscles

83
Q

what is the moderator band?

A

thickened muscle ridge providing rapid conduction

84
Q

the moderator band tenses __ just before ventricular contraction and prevents ___ of AV valve

A

papillary muscles ; slamming or inversion

85
Q

which ventricle has thinner walls and pumps blood with minimal effort and low pressure?

A

the right

86
Q

which ventricle sends blood to the entire systemic circuit

A

left

87
Q

which ventricle sends blood to the pulmonary trunk?

A

right

88
Q

during ventricular relaxation, what causes the semilunar valves to remain shut

A

blood pressure form pulmonary and systemic circuits

89
Q

during ventricular contraction, what keeps the AV valves closed?

A

pressure of contracting ventricle and the cordae tendoneae are tightened by the papillary muscles to keep cusps from inverting

90
Q

what happens if the AV cusps invert during ventricular contraction?

A

regurgitation (backflow)

91
Q

to open the semilunar valves, the ventricular pressure overcomes the pressure in the __ and ___

A

pulmonary trunk; aorta

92
Q

what is the cardiac skeleton?

A

flexible connective tissue frame

93
Q

the cardiac skeleton is made of interconnected bands of ___ and encircles the __ to stabilize their positions

A

dense connective tissue; heart valves, base of aorta and pulmonary trunk

94
Q

the cardiac skeleton electrically isolates the ___ of the atria and ventricle

A

myocardium

95
Q

how many cusps on a semilunar valve?

A

3

96
Q

the semilunar valves prevent back flow from __ and ___

A

aorta and pulmonary trunk

97
Q

do the semilunar valves require muscular brace? why/whynot

A

no, because the cusps support each other

98
Q

what is valvular heart disease?

A

valve function deteriorates until heart cannot maintain adequate blood flow

99
Q

what is arteriosclerosis

A

thickening/toughening of arterial walls

100
Q

what is coronary artery disease?

A

arteriosclerosis of the coronary vessels

101
Q

arteriosclerosis of the rain can lead to __

A

strokes

102
Q

what is atherosclerosis?

A

formation of lipid deposits in the arterial tunica media and damage to the endothelium

103
Q

what is the most common form of arteriosclerosis?

A

atherosclerosis

104
Q

atherosclerosis is often associated with elevated __

A

blood cholesterol

105
Q

what forms in the vessels due to atherosclerosis?

A

plaque

106
Q

what are the two ways of treating atherosclerosis?

A
  1. replace damaged segment of vessel

2. compressing plaque with balloon angioplasty

107
Q

a balloon angioplasty is most effective for what types of plaques?

A

small, soft

108
Q

t/f there is a very low surgical mortality associated with a balloon angioplasties

A

true

109
Q

coronary artery disease is characterized by

A

areas of partial or complete blockage of coronary circulation

110
Q

what is coronary ischemia?

A

reduced blood flow to the heart

111
Q

coronary artery disease is usually caused by what 2 things

A

atherosclerosis in a coronary artery or associated blood clot

112
Q

what is the medical term for a blood clot?

A

thrombus

113
Q

the cardiac cycle is the period between __ and ___

A

start of one heartbeat and the next

114
Q

what are the 2 phases of the cardiac cycle?

A

systole and diastole

115
Q

at the beginning of the cardiac cycle, all 4 chambers are __n

A

diastole

116
Q

during diastole, what is happening to the ventricles?

A

passively filling

117
Q

what happens during atrial systole?

A

atria contract and ventricles finish filling

118
Q

after atrial systole, the atria are then in __ for the rest of the cardiac cycle

A

diastole

119
Q

what happens in the first phase of ventricular systole?

A

contracting ventricles push AV valves closed, but no enough pressure to open semilunar valves

120
Q

what type of contraction occurs in the first phase of ventricular systole?

A

isovolumetric contraction

121
Q

what happens in the 2nd phase of ventricular systole?

A

increasing pressure opens semilunar valves

122
Q

what type of contraction occurs in the 2nd phase of ventricular systole?

A

ventricular ejection

123
Q

what happens in early ventricular diastole

A

ventricles relax and their pressure drops, blood in aorta and pulmonary trunk back flows, closes semilunar valves

124
Q

what happens during isovolumetric relaxation?

A

all valves closed, no volume change, blood passively filling the atria

125
Q

what happens during late ventricular diastole?

A

all chambers relaxed, AV valves open and ventricles passively fill

126
Q

T/F tetanic contractions occur in cardiac muscle

A

false

127
Q

t/f the refractory period for cardiac muscle continues into relaxation

A

true

128
Q

T/F cardiac muscle has short actions potentials

A

false, long

129
Q

what are the 3 stages of cardiac muscle action potential?

A
  1. rapid depolarization
  2. plateau
  3. depolarization
130
Q

what happens during rapid depolarization?

A

voltage gated fast sodium channels open

131
Q

what happens during g the plateau stage?

A

fast sodium channels close and Na is actively pumped out, slow calcium channels open

132
Q

what happens during depolarization?

A

slow calcium channels close and slow potassium channels open

133
Q

what is cardiac output?

A

amount of blood pumped from left ventricle each minute

134
Q

cardiac output is determined by ___ and ___

A

heart rate and stroke volume

135
Q

t/f the cardiac output is precisely adjusted to meet the needs of tissues

A

t

136
Q

cardiac output = ___ x___

A

heart rate x stroke volume

137
Q

heart rate is measured as

A

number of contractions per minute

138
Q

stroke volume is measured as

A

volume of blood pumped out of ventricle per contraction

139
Q

what is autorhymicity?

A

cardiac muscles ability to contract at ts own pace independent of neural or hormonal stimulation

140
Q

what is the conducting system?

A

network of specialized cardiac muscle cells that initiate/distribute a stimulus to contract

141
Q

what are the 5 components of the conducting system?

A
  1. SA node
  2. internodal pathways
  3. atrioventricular node
  4. AV bundle and bundle branches
  5. purkinje fibers
142
Q

the SA node acts as the __

A

pacemaker

143
Q

each heartbeat begins with an action potential started in the __

A

SA node

144
Q

where if the SA node located?

A

in the posterior wall of the right atrium, near the superior vena cava

145
Q

the internal pathways are formed by __ cells

A

conducting

146
Q

the internodal pathways distribute signals through both __

A

atria

147
Q

the AV nodes relay signals from __ to __

A

atria to ventricles

148
Q

the AV nodes have __ cells that can take over if _ fails

A

pacemaker; pacing in SA node

149
Q

T/f the pacing of the AV is faster than that of the SA node

A

false, slower

150
Q

the AV bundle has __ cells that transmit signal through __

A

conducting; interventricular septum

151
Q

which bundle branch is larger?

A

left

152
Q

__ cells of the bundle branches transmit signals to __ then spread out in __

A

conducting; apex of heart; ventricular walls

153
Q

the purkinje fibres radiate upward through __

A

ventricular walls

154
Q

the purkinje fibres propagate action potentials as fast as __

A

myelinated neurons

155
Q

the purkinje fibres stimulate __ and trigger __

A

ventricular myocardium; contraction

156
Q

what is an electrocardiogram? (ECG/EKG)

A

recording of heart’s electrical activities from the body surface

157
Q

an ECG assesses the performance of

A

nodal, conducting, and contractile components

158
Q

t/f appearance of ECG differs with placement and number of electrodes

A

true

159
Q

the P wave represents

A

arterial depolarization

160
Q

the QRS complex represents

A

ventricle depolarization

161
Q

ventricle depolarization has a larger wave due to __

A

Larger ventricle muscle mass

162
Q

ventricles begin contracting shortly after __ wave peak

A

R

163
Q

atrial depolarization also occurs after __ wave, but is not visible because __

A

R; masked by QRS

164
Q

what does the T wave represent?

A

ventricular repolarization

165
Q

what happens during the P-R interval?

A

start of arterial depolarization to start of ventricular depolarization

166
Q

a P-R interval >200msec may mean __

A

damage to conducting pathways or AV node

167
Q

what is the Q-T interval

A

time for ventricles to undergo a single cycle

168
Q

the Q-T interval may be lengthened by __

A

electrolyte imbalances, medications, conduction problems, coronary iscemia, myocardial damage

169
Q

what is a cardiac arrhythmia?

A

abnormal patterns of cardiac electrical activity

170
Q

t/f about 5% of healthy people experience a few abnormal heartbeats each day

A

t

171
Q

t/f cardiac arrhythmia is not a clinical issue unless the pumping efficiency is reduced

A

t

172
Q

what is pacemaker potential?

A

the gradual spontaneous depolarization

173
Q

pacemaker potential in the SA node establishes __

A

heart rate

174
Q

parasympathetic stimulation ___ (increases/decreases) heart rate

A

decreases

175
Q

Each from the parasympathetic neutrons opens __ channels in the plasma membrane which slows rate of __ and lengthens rate of __

A

K+; depolarization; depolarization

176
Q

binding of norepinephrine from sympathetic neutrons increases __- and decreases __

A

depolarization; depolarization

177
Q

a normal heart rate ranges from __to __

A

60-100

178
Q

bradycardia

A

lower than normal heart rate

179
Q

tachycardia

A

higher than normal heart rate

180
Q

what are the 2 cardiac centers in the medulla oblongata ?

A
  1. cardioinhibitory center

2. cardioacceleratory center

181
Q

what is the end-diastolic volume?

A

blood in the ventricle at the end of ventricle diastole

182
Q

what is the end systolic volume?

A

blood in the ventricle at the end of systole

183
Q

the amount of blood pumped out is the __ volume

A

stroke

184
Q

stroke volume = ___ -___

A

EDV-ESV

185
Q

venous return

A

amount of venous blood returned to the right atrium

186
Q

venous return varies based on __, __ and __

A

blood volume, muscular activity, rate of blood flow

187
Q

what is filling time?

A

length of ventricular diastole

188
Q

what is preload?

A

amount of myocardial stretch

189
Q

what are the factors affecting stroke volume?

A

end diastolic volume, preload, contractility, afterload

190
Q

what is the Frank-Starling law of the heart?

A

greater EDv causes greater preload; more stretching causes stronger contractions and more blood being ejected

191
Q

what is contractility ?

A

amount of force produced during contraction at a given preload

192
Q

contractility is increased by __

A

sympathetic stimulation, some hormones

193
Q

contractility is reduced by

A

beta blockers and calcium channel blockers

194
Q

what is after load?

A

ventricular tension required to open semilunar valves and empty

195
Q

as after load increases, stroke volume __

A

decreases

196
Q

after load increases whenever blood flow is

A

constricted

197
Q

cardiac output can be changed by affecting either _ or __

A

heart rate or stroke volume

198
Q

heart failure

A

condition in which the heart cannot meet the demands of peripheral tissues

Anatomy and Physiology (13 decks)

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