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a & p II exam 1 > chapter 20-heart(cardiovscular system) > Flashcards

chapter 20-heart(cardiovscular system) Flashcards

1
Q

pulmonary circuit

A

right ventricle -> lungs -> left atrium

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2
Q

systemic circuit

A

left ventricle -> body -> right atrium

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3
Q

arteries

A

away from the heart

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4
Q

veins

A

toward the heart

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5
Q

capillaries

A

exchange vessels in between

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6
Q

heart

A

-left of midline, between 2nd rib & 5th intercostal space, posterior to sternum in pericardial cavity in mediastinum
-heart fist-sized, beats 10,000 times/day, 8000L of blood
-surrounded by pericardium (serous & fibrous layers)

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7
Q

serous membrane of the heart

A

visceral & parietal secretes pericardial fluid, reduce friction

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8
Q

pericarditis

A

inflammation of pericardium, usually due to infection, causes friction

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9
Q

cardiac tamponade

A

buildup of fluid in pericardial space restricts heart movement

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10
Q

2 atria (2 chambers of the heart)

A

-superior, thin walls, smooth posterior walls internally, pectinate muscles (ridges) anteriorly
-each has expandable flap called an auricle lateral & superior
-separated by interatrial septum

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11
Q

2 ventricles (2 chambers of the heart)

A

-inferior, thin walls, lined with trabeculae carneae (muscular ridges)
-left & right separated by interventricular septum
-left ventricle 3x thicker, 5x more friction while pumping, round shape
-right ventricle crescent shape, same volume as left

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12
Q

external divisions of heart

A

-coronary sulcus marks division between atria & ventricles
-anterior interventricular sulcus & posterior interventricular sulcus mark division between ventricles

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13
Q

epicardium (heart wall of the heart)

A

-thin
-visceral pericardium
-serous membrane with loose CT attached to myocardium

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14
Q

myocardium (heart wall of the heart)

A

-thick
-cardiac muscle tissue with CT, vessels & nerves

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15
Q

endocardium (heart wall of the heart)

A

-thin
-simple squamous epithelium lining with basal lamina, continuous with endothelium of blood vessels

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16
Q

cardiocytes

A

muscle cells

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17
Q

cardiac muscle tissue

A

-uses actin & myosin sliding filaments to contract
-rich in mitochondria, resists fatigue, dependent on aerobic respiration
-contraction all or none
-longer contractile phase
-fibrous skeleton of heart (tough CT) acts as tendon

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18
Q

heart valves

A

one way, prevent backflow

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19
Q

gap junctions + desmosomes =

A

intercalated discs that connect cardiocytes

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20
Q

atrioventicular valves (heart valves)

A

between atria & ventricles (flaps = cusps)

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21
Q

tricuspid valve

A

right atrium -> right ventricle, 3 cusps

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22
Q

bicuspid (mitral) valve

A

left atrium -> left ventricle, 2 cusps

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23
Q

cusps

A

-flaps
-attached to chordae tendineae from papillary muscles on ventricle wall
-contraction of papillary muscles prevent cusps opening backward during ventricle contraction
-hang loose when ventricle not contracting, allow ventricles to fill with blood

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24
Q

semiluniar valves (heart valves)

A

-between ventricles & arteries
-3 cusps
-no chordae tendineae or muscles
-forced open by blood from ventricular contraction
-snap closed to prevent backflow

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25
Q

valvular heart disease

A

valve function deteriorates to extent that heart can’t maintain adequate circulation
- ex: rheumatic fever

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26
Q

rheumatic fever

A

childhood reaction to streptococcal infection, chronic carditis, VHD in adults

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27
Q

heart murmur

A

leaky valve, born with

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28
Q

mitral valve prolapse

A

murmur of left AV valve, cusps don’t close properly, blood regurgitates back into left atrium

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29
Q

congestive heart failure (CHF)

A

decreases pumping efficiency (diseased calves, damaged muscle, blood backs up, fluid leaks from vessels & collects in lungs and tissues

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30
Q

blood flow through the heart: pulmonary circuit (right side)

A

deoxygenated blood -> superior vena cava (head, neck, upper limbs, chest) or inferior vena cava (trunk, viscera, lower limbs) -> right atrium -> tricuspid valve -> right ventricle -> pulmonary semilunar valve -> pulmonary trunk -> right pulmonary arteries -> right lung -> right pulmonary veins

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31
Q

blood flow through the heart: systemic circuit (left side)

A

pulmonary trunk -> left lung -> pulmonary veins -> O2 & CO2 -> left atrium -> bicuspid valve -> left ventricle -> aortic semilunar valve -> ascending aorta -> aortic arch -> brachiocephalic trunk, left common carotid artery, left subclavian artery (head, neck shoulders, upper limbs) or descending aorta (trunk, viscera, lower limbs)

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32
Q

fetal heart (adapted to bypass lungs)

A
  • foramen ovale in right atrium, ~25% of blood bypass directly to left atrium: closes at birth -> fossa ovalis
    -ductus arteriosus connects pulmonary trunk to aorta, ~90% of blood bypasses lungs, closes at birth -> ligamentum arteriosum
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33
Q

cyanosis “blue baby syndrome”

A

failure of the foramen ovale & ductus arteriosus of the fetus’s heart to close, leading to poor oxygenation of blood

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34
Q

coronary circulation

A

-heart: <1% body mass, requires 5% of blood
-too thick for diffusion
-coronary arteries -> capillary beds for diffusion
-blood returns via cardiac veins that empty into right atrium

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35
Q

coronary arteries

A

originated at base of ascending aorta, brach to capillary beds for diffusion (4 major coronary arteries)

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36
Q

coronary artery disease (CAD)

A

partial or complete block of coronary circulation, results in coronary ischemia

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37
Q

myocardial infarction (heart attack)

A

heart tissue denied oxygen dies
-can be from CAD

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38
Q

angina pectoralis

A

pain the chest, especially during activity, as a result of ischemia
-common symptom of CAD

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39
Q

coronary bypass surgery

A

use healthy veins (from legs) to create anatomizes around blockages

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40
Q

heart beat

A

-1% myocardial cells autorhythmic
-depolarization transmitted to other myocardial cells through cardiac conduction system
-cells of nodes can’t maintain resting membrane potential, drift to depolarization

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41
Q

autorhythmic (heart beat)

A

depolarize without neural or endocrine stimulation

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42
Q

sinoatrial (SA) node (heartbeat conduction)

A

right atrium wall near superior vena cava
- “natural pacemaker”

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43
Q

atrioventricular (AV) node (heartbeat conduction)

A

inferior portion of interatrial septum above tricuspid valve

44
Q

AV bundle, bundle braches or Purkinjie fibers (heartbeat conduction)

A

-conducting cells
- connect nodes & myocardium, run-down interventricular septum & around apex

45
Q

depolarization (heartbeat conduction)

A

SA node 80-100 action potential/min, AV node 40-60 action potential/min

46
Q

sinus rhythm

A

-resting heart rate
- ~75bpm set by SA node + parasympathetic stimulation

47
Q

electrical conduction & contraction events of the heartbeat (1-3)

A
  1. action potential is generated at SA node
  2. spreads across the atrial surface & reaches AV node
  3. atrial contraction begins during 100ms delay at AV node
48
Q

how many times does the heartbeat chain of events occur?

A

~370ms

49
Q

electrical conduction & contraction events of the heartbeat (4-6)

A
  1. impulse travels down the interventricular septum from AV node by way of AV heading toward Purkinje fibers
  2. Purkinje fibers signal papillary muscles to contract, the distribute impulse to ventricular myocardium, atrial contraction -> ventricular contraction
  3. ventricular contraction is finished
50
Q

normal average heart rate

A

~70-80 bpm
max = ~230bpm, but inefficient about 180

51
Q

bradycardia

A

-slow heart rate
-heart rate slower than normal <60

52
Q

tachycardia

A

-fast heart rate
-heart rate faster than normal >100

53
Q

electrocardiogram (EKG/ECG)

A

recording of electrical events of heart

54
Q

EKG events

A

P-wave: depolarization wave from SA node through atria ~80ms
QRS complex: atrial depolarization & ventricle depolarization ~80ms
T wave: ventricle depolarization ~160ms

55
Q

EKG used to diagnose heart problems:

A
  • P-R longer than 200ms = damage to AV node or conducting cells
    -large ORS = enlarged heart
  • Q-T longer than 380ms = coronary ischemia or myocardial damage
56
Q

total heart block

A

damaged AV node, no impulses transmitted through, atria & ventricles beat independently (atria fast, ventricles slow)

57
Q

cardiac arrhythmias

A

abnormal pattern of cardiac activity

58
Q

fibrillation

A

rapid, irregular, out-of-phase contraction due to activity in areas other than SA node: defibrillation to stop all activity so SA node can resume control

59
Q

cardiac cycle

A

alternating contraction & relaxation
-increase in heart rate = decreased cycle time, decreased diastole time = decreased time to fill
-atrial contraction adds ~30% more to ventricles

60
Q

systole

A

contraction, high pressure, blood gets pushed to next chamber

61
Q

diastole

A

relaxation, low pressure, chamber fills with blood

62
Q

atrial systole begins (cardiac cycle event #1)

A

atrial contraction forces a small of additional blood into relaxed ventricles
-atrial systole ends atrial diastole begins
-0 mess & atrial systole

63
Q

ventricular systole - first phase (cardiac cycle event #2)

A

ventricular contraction pushes AV valves closed but doesn’t create enough pressure to open semilunar valves
-atrial diastole & ventricular systole
-100-370 mesc

64
Q

ventricular systole - second phase (cardiac cycle event #3)

A

as ventricular pressure rises & exceeds pressure in the arteries, the semilunar valves open & blood is ejected
-atrial diastole & ventricular systole
-100-370 mesc

65
Q

ventricular diastole - early (cardiac cycle event #4)

A

as ventricles relax, pressure in ventricles drops; blood flows back against cusps of semilunar valves & forces them closed, blood flows into relaxed atria
-ventricular diastole
-370-800mesc

66
Q

ventricular diastole- late (cardiac cycle event #5)

A

all chambers are relaxed, ventricles fill passively
-ventricular diastole
-370-800mesc

67
Q

“lubb” (heart sound)

A

S1: AV valves close at start of ventricular systole

68
Q

“dubb” (heart sound)

A

S2: semilunar valves close at start of ventricular diastole

69
Q

cardiac output

A

amount of blood pumped by each ventricle in 1 min, depends on heart rate & stroke volume: CO = HR * SV
-change HR to increase CO
-@160-180 bpm CO at max: increased HR = decreased time to fill ventricles, if not full = decreased SV & CO

70
Q

stroke volume (SV)

A

amount of blood pumped by ventricle
-usually constant

71
Q

HR (heart rate) triggers

A
  1. autonomic nervous input sympathetic = increased HR
  2. hormones
  3. venous return = more blood increases HR
  4. other factors: ions, drugs
72
Q

heart conditioning:

A

conditioning can increase SV & decrease HR
-fit athletes can increase max CO by 700% & decrease resting HR by 50% with same CO due to increased SV

73
Q

autonomic innervation (heart rate effector)

A

-SA node, AV node & atrial myocardium innervated by both sympathetic (NE) & parasympathetic (Ach) nerve fibers equally
-sympathetic dominates in ventricles

74
Q

cardiac centers in medulla oblongata monitor BP & gasses to adjust HR:

A

a. cardioacceleratory center: sympathetic
b. cardioinhibitory center: parasympathetic

75
Q

parasympathetic (autonomic innervation) tone reduces rate of SA node:

A

-72-80bpm females
-64-72bpm males
-40bpm athletes

76
Q

hormones (heart rate effector)

A

-epinephrine, norepinephrine, thyroxine all increase HR by acting at SA node
-beta-blockers drugs to treat hypertension block B-receptors for E/NE, thus preventing sympathetic stimulation

77
Q

caffeine (heart rate effector)

A

rapid depolarization of the SA node, increased HR

78
Q

nicotine (heart rate effector)

A

stimulates sympathetic neurons, increases HR

79
Q

hyperkalemia (heart rate effector)

A

high K+ inhibits repolarization, beats weak, and the heart can stop

80
Q

hypokalemia (heart rate effector)

A

low K+, hyperpolarization, cells less responsive, decreased HR

81
Q

hypercalcemia (heart rate effector)

A

high Ca+, muscle cells excitable, increases HR, can cause prolonged contraction, heart seizes

82
Q

hypocalcemia (heart rate effector)

A

low Ca+, contractions weak, heart can stop

83
Q

temperature (heart rate effector)

A

affects metabolic rate of cardiocytes
-high temp = increased HR
-low temp = decreased HR

84
Q

a severe case of pericarditis could lead to a what where the fluid restricts movement of the heart?

A

cardiac tamponade

85
Q

what of the heart has pectinate muscles?

A

atria

86
Q

what are the expandable flaps of the heart intended to accommodate excess blood volume?

A

auricles

87
Q

the visible branchy appearance of muscle lining the ventricles is called the what?

A

trabeculae carneae

88
Q

you have a very thick chunk of heart, which you are told is from the inferior lateral
aspect. from which chamber wall did it come?

A

left ventricles

89
Q

what is the layer of the heart wall where the cardiocytes are located?

A

myocardium

90
Q

the abundance of mitochondria in cardiocytes tells you what about their method of ATP production?

A

aerobic respiration dependent

91
Q

where is the tricuspid valve located?

A

right side between atrium & ventricle

92
Q

the bumps in the ventricles where the chordae tendineae attached are called the what?

A

papillary muscles

93
Q

name the valve that prevents backflow into the left ventricle.

A

aortic semilunar valve

94
Q

what is the condition of
fluid accumulation in the thoracic cavity due to decreased heart pumping efficiency?

A

congestive heart failure (CHF)

95
Q

blood from the right ventricle goes into what vessel next?

A

pulmonary trunk

96
Q

what is the state of blood in the pulmonary veins: oxygenated or deoxygenated?

A

oxygenated

97
Q

the first branch off the aorta is the what & it brings blood to the left or right side of the upper body?

A

brachiocephalic trunk, right side

98
Q

two specializations of the fetal heart allow for bypass of the pulmonary circuit:
the ductus arteriosus & the what?

A

foramen ovale

99
Q

the coronary sulcus, the anterior interventricular sulcus & the posterior
interventricular sulcus serve as handy anatomical landmarks but what are their importance to heart function?

A

contain the coronary vessels that bring blood to/from the heart tissue for diffusion of nutrients & wastes

100
Q

ischema

A

lack of oxygen to the tissues

101
Q

the collection of autorhythmic myocardial cells in the superior right atrium make up the what?

A

sinoatrial node (SA node)

102
Q

cells of the what depolarize spontaneously 40-
60 times per minute?

A

atrioventricular node (AV node)

103
Q

why are the papillary muscles stimulated to contract by the Purkinje fibers before the impulse is conducted throughout the myocardium?

A

to ensure AV valves stay closed during ventricular contraction (papillary muscles pull on chord tendineae to prevent back-flap of cusps into atria)

104
Q

on an ECG, ventricular repolarization is represented by what wave?

A

T wave

105
Q

during systole of a chamber, the pressure on the blood is what?

A

high

106
Q

when heart rate is increased, the time spent in diastole is what?

A

decreased

107
Q

considering the equation CO = HR x SV, why at a certain point does an increased heart rate not result in increased cardiac output?

A

SV decreases, not enough time to fill ventricles

a & p II exam 1 (4 decks)

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