Chapter 20 - Heart

Question 1

what are the 3 blood circuits of the body?

Answer 1

1. Coronary circuit
   Supplies heart
2. Pulmonary circuit
   Supplies blood to lungs
3. Systemic circuit
   Blood supply to limbs

Question 2

what are the 3 types of blood vessels? hint - has to do with oxygen levels.

Answer 2

1. Arteries
   A = away from heart
   Oxygenated blood away from heart
   (Mostly labeled in red in models)
2. Veins
   Returning less oxygenated blood to heart
   (mostly labeled in blue in models)
3. Capillaries
   Anastomosis structure
   Exchange dissolved gasses, nutrients, and wastes between blood and surrounding tissues

Question 3

what are the 4 chambers of the heart?
what are the different sides / areas of the heart?
*what is the mediastinum?
*what are auricles?

Answer 3

Right Atrium, Left Atrium, Right Ventricle, Left Ventricle
Base, Apex, Anterior side, Posterior side
*the cavity where the heart is. In-between the pleural cavities of the lungs.
*the little toes-like projections from the atria.

Question 4

what are the lining layers around the heart? (not the heart itself, around the heart)
name the 2 main types, then the 2 subtypes.
name them in the image.
*what is the fluid space between the layers? what is inflammation of this fluid? what condition does excess fluid cause?

Answer 4

Pericardium:
1. Fibrous
2. Serous (double layered fist in balloon)
- Visceral (inside) (aka epicardium)
- Parietal (outside)
*pericardial fluid is the space between visceral and parietal. Pericarditis.
Cardiac tamponade is the condition of excess fluid, heart has restricted movements because of lack of space.

Question 5

name the 3 main grooves of the heart.

Answer 5

1. Coronary Sulcus
   between atria and ventricle
2. Anterior Interventricular Sulcus
   Between left and right ventricles on anterior side
3. Posterior interventricular Sulcus
   Between left and right ventricles on posterior side

Question 6

what are the 3 layers of heart muscle?

Answer 6

Epicardium (outside) (aka visceral pericardium)
Myocardium (middle)
Endocardium (inside)

Question 7

name the 3 septums of the heart

Answer 7

Interatrial septum (Separates atria)
Interventricular septum
Atrioventricular septum
- between right atrium and left ventricle (diagonal)

Question 8

name the 4 heart valves

Answer 8

Atrioventricular Valve
- Tricuspid Valve (or r av valve)
- Bicuspid Valve ( l av valve)
Semilunar Valves (“half moon shaped”)
- Pulmonary valve - For pulmonary artery
- Aortic valve - For aorta

Question 9

name the 2 vena cava

Answer 9

Superior VC
Inferior VC

Question 10

know the pulmonary trunk, pulmonary arteries, and pulmonary veins. Be specific!
know the aorta

Answer 10

Right and Left pulmonary arteries carry blood away from the heart and pulmonary trunk.
Right and Left pulmonary veins carry blood back to the heart from the lungs
*distinctly label “right” and “left” in lab exam.

Question 11

what is the remnant of flap that closes between the atria in fetuses and adults?
This is closed in adults.

Answer 11

(foramen ovale in fetus) –> fossa ovalis (adults)

Question 12

Label the muscles of the heart.
what are the strings that attach papillary muscles to cusps of valves?

Answer 12

Pectinate muscles
- Only in atrium
- On the outside of the atrium?
Trabeculae Carneae
- Lines inside of ventricles
Papillary muscle
- Corresponds with av tricuspid and bicuspid valves
*Chordae tendineae

Question 13

name the smooth part of the upper part of the ventricle towards the semilunar valves

Answer 13

conus arteriosus

Question 14

valvular heart disease

Answer 14

• Deterioration of valve function
• may develop after carditis (inflammation of the heart)
• may result from Autoimmune disease

Question 15

name the coronary arteries

Answer 15

• Right Coronary Artery
  - marginal artery
  - posterior interventricular artery
• Left Coronary Artery
  - Circumflex Artery
  - Anterior interventricular Artery

Question 16

name the coronary veins. Remember to use “cardiac” for vein names!

Answer 16

*remember these are “cardiac” labels instead of “coronary”
Great Cardiac Vein (along anterior interventricular sulcus)
Coronary Sinus
Small Cardiac Vein
Middle Cardiac Vein

Question 17

what is Coronary Artery Disease (CAD)?
is it reversible?
what are some treatments? brief read through…

Answer 17

not reversible.
Coronary ischemia
- Reduced blood supply
Cause is formation of a fatty deposit
- Atherosclerotic plaque
… (look up in powerpoint…)

Question 18

what is the medical term for chest pain?

Answer 18

Angina pectoris
- Commonly one of the first symptoms of CAD
- Pain may radiate from sternal area to arms, back, and neck = “Referred pain”

Question 19

what is the medical term for a heart attack?

Answer 19

myocardial infarction

Question 20

what are 2 kinds of noninvasive surgeries for heart attacks?

Answer 20

atherectomy
- Long catheter is inserted into coronary artery to remove plaque
balloon angioplasty
- Tip of the catheter has a balloon, inserted and inflated against vessel walls.

Question 21

what is a coronary artery bypass

Answer 21

rerouted blood around obstructed portion.
up to 4 coronary arteries can be rerouted during a single operation.

Question 22

Conducting System:
what are 2 types of cardiac muscle cells?
what are the subtypes of these?

Answer 22

Autorhythmic cells (labeled in image)
- Pacemaker
- Sinoatrial (SA) node
- Atrioventricular (AV) node
- Conducting cells
- Internodal pathways of atria
- AV Bundle of His
- Bundle branches
- Purkinje fibers of ventricles

Contractile cells
- Contractions that propel blood
- form bulk of atrial and ventricular walls
- receive stimulus from Purkinje fibers

Question 23

what do the P wave, Q wave, and QRS complex represent?

Answer 23

Upwards peak = depolarization, or positive inflection
Downwards peak = repolarization, or negative inflection
P Wave - atrial depolarization
Q Wave - along interventricular septum
QRS complex - ventricular depolarization

Question 24

what are abnormal heat rates? what is an ectopic pacemaker?

Answer 24

Bradycardia - abnormally slow heart rate
Tachycardia - abnormally fast heart rate
Ectopic pacemaker
Abnormal cells generate high rate of action potential, bypasses conducting system

Question 25

what are intercalated discs?
what are chemical characteristics of these cells along with depolarization and repolarization?

Answer 25

Interconnected cardiac contractile cells
1. rapid depolarization
- sodium (Na+) enters
2. Plateau
- extracellular calcium (Ca+) enters
3. Repolarization
- potassium rushes out of cell

Question 26

what is systole? what is diastole?

Answer 26

Systole (contraction - “assists” contraction)
- first “lub” sound of S1
Diastole (relaxation)
- “dub” sound of S2

Question 27

what are the heart sounds?
what is a heart murmur?

Answer 27

S1 - loud sound as AV valves close
S2 - loud sound as semilunar valves close
S3, S4 - soft sounds (blood flowing into ventricles and atrial contraction)
Heart murmur - regurgitation through valves

Question 28

what are cardiac output (CO), heart rate, and stroke volume?

Answer 28

volume pumped by left ventricle in one minute.
CO = heart rate x stroke volume
HR is beats/minute
SV is mL/beat. SV is the amount of blood pumped by the left ventricle in one contraction.
*fun fact, the heart usually pumps about 5 liters of blood per minute at rest.

Question 29

what is the equation to find stroke volume?

Answer 29

SV = EDV - ESV
EDV is end-diastolic volume, or the amount of blood in each ventricle at the end of ventricular diastole
ESV is end-systolic volume, or the amount of blood remaining in each ventricle at end of ventricular systole

Question 30

know some of the autonomic innervations…

Answer 30

Cardioacceleratory center
- Controls sympathetic neurons that increase heart rate
Cardioinhibitory center
- Controls parasympathetic neurons that slow heart rate
*only know vagus nerve for exam

Question 31

what are the adrenal hormones that increase heart rate?

Answer 31

epinephrine (E)
norepinephrine (NE)
T3 (thyroid hormone)

Question 32

what is the Bainbridge reflex? (atrial reflex)

Answer 32

• Adjustments in heart rate in response to increase in venous return (the amount of blood returning to heart through veins)
• Stretch receptors are triggered, which increase heart rate by stimulating sympathetic activity