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z a&p ii exam i > Chapter 19 PowerPoint > Flashcards

Chapter 19 PowerPoint Flashcards

1
Q

What is coronary circulation?

A

The Blood Supply to the Heart
= Coronary circulation
supplies blood to muscle tissue of heart
coronary arteries and cardiac veins

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2
Q

Coronary arteries:
Which two?
Originate?
Causes blood to flow into them?

A

left and right

originate at aortic sinuses

high blood pressure, elastic rebound forces blood through coronary arteries between contractions

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3
Q

Coronary arteries?

A

branches of the ascending aorta that supply blood to the heart; the left coronary artery feeds the left
side of the heart, the left atrium and ventricle, and the interventricular septum; the right coronary artery feeds the
right atrium, portions of both ventricles, and the heart conduction system

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4
Q

What does the right coronary artery supply blood to?

A

Right Coronary Artery
Supplies blood to:

right atrium
portions of both ventricles
cells of sinoatrial (SA) and atrioventricular nodes

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5
Q

What two branches of RCA?

A

marginal arteries (surface of right ventricle)

posterior interventricular artery

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6
Q

Marginal artery?

A

branches of the right coronary artery that supply blood to the superficial portions of the right
ventricle

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7
Q

Posterior interventricular artery?

A

(also, posterior descending artery) branch of the right coronary artery that runs
along the posterior portion of the interventricular sulcus toward the apex of the heart and gives rise to branches that
supply the interventricular septum and portions of both ventricles

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8
Q

What does the left coronary artery supply blood to?

A

Left Coronary Artery
supplies blood to:

left ventricle
left atrium
interventricular septum

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9
Q

Two branches of LCA?

A

Circumflex artery

Anterior interventricular artery

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10
Q

What are the five cardiac veins and what do the drain/empty into?

A

great cardiac vein
Drains blood from area of anterior interventricular artery into coronary sinus

anterior cardiac veins
empty into right atrium

posterior cardiac vein, middle cardiac vein, and small cardiac vein
empty into great cardiac vein or coronary sinus

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11
Q

Describe CAD?

A

Coronary artery disease (CAD)

areas of partial or complete blockage of coronary circulation

cardiac muscle cells need a constant supply of oxygen and nutrients

reduction in blood flow to heart muscle produces a corresponding

reduction in cardiac performance

reduced circulatory supply, coronary ischemia, results from partial or complete blockage of coronary arteries

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12
Q

reduced circulatory supply, ____ ____, results from partial or complete blockage of coronary arteries

A

Coronary ischemia

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13
Q

What is classified as a heartbeat?

A

a single contraction of the heart

the entire heart contracts in series

1st, the atria
then the ventricles

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14
Q

What are the two types of cardiac muscle cells?

A

Conducting system
controls and coordinates heartbeat

Contractile cells
produce contractions that propel blood

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15
Q

Cardiac Muscle Tissue
Intercalated discs
interconnect cardiac muscle cells:

secured by ____
linked by ____ ____
convey force of contraction
propagate action potentials

A

Cardiac Muscle Tissue
Intercalated discs
interconnect cardiac muscle cells:

secured by desmosomes
linked by gap junctions
convey force of contraction
propagate action potentials

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16
Q

What is a unique feature of cardiac muscle?

A

Intercalated discs interconnecting cardiac muscle cells

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17
Q

Intercalated disc?

A

hysical junction between adjacent cardiac muscle cells; consisting of desmosomes, specialized
linking proteoglycans, and gap junctions that allow passage of ions between the two cells

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18
Q

4 characteristics of cardiac muscle cells?

A

small size

single, central nucleus

branching interconnections between cells

intercalated discs

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19
Q

The Cardiac Cycle
Begins with action potential at ____ ____
transmitted through ____ ____
produces action potentials in cardiac muscle cells (____ ____)

A

The Cardiac Cycle
Begins with action potential at SA node
transmitted through conducting system
produces action potentials in cardiac muscle cells (contractile cells)

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20
Q

Electrocardiogram (ECG or EKG)?

A

electrical events in the cardiac cycle can be recorded on an electrocardiogram

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21
Q

the ____ ____ is a system of specialized cardiac muscle cells
initiates and distributes electrical impulses that stimulate contraction

A

the Conducting System is a system of specialized cardiac muscle cells
initiates and distributes electrical impulses that stimulate contraction

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22
Q

What is automaticity?

A

Cardiac muscle tissue contracts automatically

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23
Q

What is the conducting system?

A

a system of specialized cardiac muscle cells that
initiates and distributes electrical impulses that stimulate contraction

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24
Q

Autorhythmicity?

A

ability of cardiac muscle to initiate its own electrical impulse that triggers the mechanical contraction
that pumps blood at a fixed pace without nervous or endocrine control

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25
Q

3 structures of the conducting system and there location?

A

Sinoatrial (SA) node – wall of right atrium

Atrioventricular (AV) node – junction between atria and ventricles

Conducting cells – throughout myocardium

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26
Q

Conducting Cells
interconnect ____ and ____ nodes
distribute stimulus through ____

in the atria they form ____ ____
in the ventricles the form ____ ____ and the ____ ____

A

Conducting Cells
interconnect SA and AV nodes
distribute stimulus through myocardium

in the atria they form internodal pathways
in the ventricles the form AV bundle and the bundle branches

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27
Q

Internodal pathway?

A

specialized conductile cells within the atria that transmit the impulse from the SA node
throughout the myocardial cells of the atrium and to the AV node

28
Q

Prepotential:
AKA?
What is it?

gradually ____ toward threshold
____ node depolarizes first, establishing heart rate

A

Prepotential

also called pacemaker potential

resting potential of conducting cells

gradually depolarizes toward threshold
SA node depolarizes first, establishing heart rate

29
Q

SA node generates ____-____ action potentials per minute
____ stimulation slows heart rate
AV node generates ____-____ action potentials per minute

A

SA node generates 80–100 action potentials per minute
parasympathetic stimulation slows heart rate
AV node generates 40–60 action potentials per minute

30
Q

SA node:
Where?
Contains what type of cells?
Connected to what?
What does it begin?

A

The Sinoatrial (SA) Node:

in posterior wall of right atrium

contains pacemaker cells

connected to AV node by internodal pathways

begins atrial activation (Step 1)

31
Q

AV node:
Where?
What does it receive?
What does it do?
What begins after?

A

The Atrioventricular (AV) Node:

in floor of right atrium

receives impulse from SA node (Step 2)

delays impulse (Step 3)

atrial contraction begins

32
Q

AV bundle:
Where?
What does it do?
Where does it carry the impulse?

A

The AV Bundle:

in the septum

carries impulse to left and right bundle branches
which conduct to Purkinje fibers (Step 4)
and to the moderator band
which conducts to papillary muscles

33
Q

Purkinje fibers:
Where?
What ends here?
What begins here?

A

distribute impulse through ventricles (Step 5)

atrial contraction is completed

ventricular contraction begins

34
Q

The Electrocardiogram (ECG or EKG):

a recording of ____ events in the heart

obtained by ____ at specific body locations

abnormal patterns diagnose ____

A

The Electrocardiogram (ECG or EKG):

a recording of electrical events in the heart

obtained by electrodes at specific body locations

abnormal patterns diagnose damage

35
Q

Five steps of heart contractions

A
  1. SA node begins atrial activation
  2. AV node receives impulse
  3. AV node delays impulse
  4. AV bundle –> bundle branches –> purkinje fibers
  5. Purkinje fibers distribute impulse through ventricles
36
Q

SA node?

A

known as the pacemaker, a specialized clump of myocardial conducting cells located in the
superior portion of the right atrium that has the highest inherent rate of depolarization that then spreads throughout
the heart

37
Q

Pacemaker cells?

A

cluster of specialized myocardial cells known as the SA node that initiates the sinus rhythm

38
Q

AV node?

A

lump of myocardial cells located in the inferior portion of the right atrium within the
atrioventricular septum; receives the impulse from the SA node, pauses, and then transmits it into specialized
conducting cells within the interventricular septum

39
Q

AV bundle?

A

(also, bundle of His) group of specialized myocardial conductile cells that transmit the
impulse from the AV node through the interventricular septum; form the left and right atrioventricular bundle
branches

40
Q

Left and right bundle branches?

A

The left bundle branch conducts impulses to the left ventricle, and the right bundle branch conducts impulses to the right ventricle

41
Q

ECG?

A

Electrocardiogram (ECG) surface recording of the electrical activity of the heart that can be used for diagnosis of
irregular heart function; also abbreviated as EKG

42
Q

Features of a ECG and what occurs at those features?

A

P wave
atria depolarize

QRS complex
ventricles depolarize

T wave
ventricles repolarize

P–R interval
from start of atrial depolarization
to start of QRS complex

Q–T interval
from ventricular depolarization
to ventricular repolarization

43
Q

Bradycardia?

A

abnormally slow HR

44
Q

Tachycardia?

A

abnormally fast HR

45
Q

Ectopic pacemaker?

A

abnormal cells
generate high rate of action potentials
bypass conducting system
disrupt ventricular contractions

46
Q

Purkinje fibers distribute the stimulus to the ____ cells, which make up most of the muscle cells in the heart

resting potential
of a ventricular cell about ____ mV
of an atrial cell about ____ mV

A

Purkinje fibers distribute the stimulus to the contractile cells, which make up most of the muscle cells in the heart

resting potential
of a ventricular cell about –90 mV
of an atrial cell about –80 mV

47
Q

Two types of refractory periods?

A

Absolute refractory period

Relative refractory period?

48
Q

What is the absolute refractory period?

A

long
cardiac muscle cells cannot respond

49
Q

What is the relative refractory period?

A

short
response depends on degree of stimulus

50
Q

The cardiac cycle:
What is it?
What two phases does it include?

A

the period between the start of one heartbeat and the beginning of the next

includes both contraction and relaxation
Two (2) phases:
within any one chamber
Systole (contraction)
Diastole (relaxation)

51
Q

Systole?

A

Contracting

period of time when the heart muscle is contracting

52
Q

Diastole?

A

Relaxation

period of time when the heart muscle is relaxed and the chambers fill with blood

53
Q

Blood Pressure
in ____ chamber:

rises during ____
falls during ____

blood flows from ____ to ____ pressure
controlled by timing of contractions
directed by ____-____ ____

A

Blood Pressure
in any chamber:

rises during systole
falls during diastole

blood flows from high to low pressure
controlled by timing of contractions
directed by one-way valves

54
Q

Cardiac Cycle and Heart Rate

@ ____ beats per minute (bpm)

cardiac cycle lasts about ____ msec

A

Cardiac Cycle and Heart Rate

@ 75 beats per minute (bpm)

cardiac cycle lasts about 800 msec

55
Q

When heart rate increases
all phases of cardiac cycle ____, particularly ____

A

When heart rate increases
all phases of cardiac cycle shorten, particularly diastole

56
Q

4 phases of the cardiac cycle?

A

Atrial systole
Atrial diastole
Ventricular systole
Ventricular diastole

57
Q

Atrial systole:

atrial contraction begins
right and left ____ ____ are open

Atria eject blood into ventricles
filling ventricles

Atrial systole ends
____ ____ close

ventricles contain maximum blood volume
known as ____-____ ____ (____)

A

Atrial systole:

atrial contraction begins
right and left AV valves are open

Atria eject blood into ventricles
filling ventricles

Atrial systole ends
AV valves close

ventricles contain maximum blood volume
known as end-diastolic volume (EDV)

58
Q

End-diastolic volume (EDV)?

A

(also, preload) the amount of blood in the ventricles at the end of atrial systole just prior
to ventricular contraction

59
Q

Ventricular Systole
Ventricles contract and build pressure
____ valves close causing ____ ____

Ventricular ejection
ventricular pressure exceeds vessel pressure opening the____ ____ and allowing blood to leave the ventricle
amount of blood ejected is called the ___ ____ (____)

A

Ventricular Systole
Ventricles contract and build pressure
AV valves close causing isovolumetric contraction

Ventricular ejection
ventricular pressure exceeds vessel pressure opening the semilunar valves and allowing blood to leave the ventricle
amount of blood ejected is called the stroke volume (SV)

60
Q

Isovolumetric contraction?

A

(also, isovolumetric contraction) initial phase of ventricular contraction in which tension and
pressure in the ventricle increase, but no blood is pumped or ejected from the heart

61
Q

Ventricular ejection?

A

second phase of ventricular systole during which blood is pumped from the ventricle

62
Q

Stroke volume (SV)?

A

amount of blood pumped by each ventricle per contraction; also, the difference between EDV and
ESV

63
Q

Ventricular systole:
Ventricular pressure falls
____valves close
ventricles contain ____-____ ____ (____), about ____ percent of end-diastolic volume

A

Ventricular systole:
Ventricular pressure falls
semilunar valves close
ventricles contain end-systolic volume (ESV), about 40 percent of end-diastolic volume

64
Q

Ventricular Diastole
ventricular pressure is higher than atrial pressure
____ heart valves are closed

ventricles relax (____ relaxation)
Atrial pressure is higher than ventricular pressure

AV valves open
passive _____ filling
passive ____ filling

A

Ventricular Diastole
ventricular pressure is higher than atrial pressure
all heart valves are closed

ventricles relax (isovolumetric relaxation)
Atrial pressure is higher than ventricular pressure

AV valves open
passive atrial filling
passive ventricular filling

65
Q

8 Phases of the cardiac cycle?

A
  1. Atrial systole-contraction begins
  2. Atrial systole-blood ejected into ventricles
  3. Atrial systole ends
  4. Ventricular systole-ventricles contract and build pressure
  5. Ventricular systole-ventricular ejection
  6. Ventricular systole-ventricular pressure falls
  7. Ventricular diastole-ventricles relax
  8. Ventricular diastole-ventricles passively fill

z a&p ii exam i (4 decks)

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