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BIO 235 Final > Chapter 20: The Cardiovascular System: The Heart > Flashcards

Chapter 20: The Cardiovascular System: The Heart Flashcards

1
Q

Where is the heart located?

A

It lies in the mediastinum, the anatomical region that extends from the sternum to the vertebral column, from the 1st rib to the diaphragm

It rests on the diaphragm near the midline of the thoracic cavity

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2
Q

Describe the apex and base of the heart

A

Apex is pointed and formed by the tip of the left ventricle

the base is its posterior aspect formed by the atria (upper chamber), mostly the left atrium

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3
Q

Describe the anterior and inferior surface of the heart

A

Anterior - deep to the sternum and ribs

Inferior - part of the heart between the apex and right surface and rests mostly on the diaphragm

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4
Q

Differentiate between the right and left surfaces of the heart

A

Right - faces right lung and enters from inferior surface to base
Left - face left lung and extends from base to apex

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5
Q

Define the pericardium and its 2 main parts

A

pericardium - membrane that surrounds and protects the heart

  1. Fibrous pericardium - tough, inelastic, dense irregular connective tissue that prevents overstitching, provides protections, and anchors the heart in the mediastinum
  2. Serous pericardium - deeper, thinner, delicate membrane that forms a double layer around the heart; outer parietal layer is fused to the fibrous pericardium and inner visceral layer aka epicardium adheres tightly to the heart
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6
Q

Define pericardial fluid

A

Thin film of lubriccating serous fluid between the parietal and visceral layers of the serous pericardium

It reduces friction as the heart moves and is located in the pericardial cavity

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7
Q

Describe the 3 layers of the heart wall

A
  1. Epicardium (external layer) is composed of 2 tissue layers: outermost is the visceral layers of the serous pericardium composed of mesothelium; beneath is a variable layer of delicate fibroeslastic tissue and adipose tissue, thickest over ventricular surfaces
  2. Myocardium (middle) is responsible for the pumping action of the heart and is composed of cardiac muscle tissue and the fibers are composed of endomysium and perimysium and organized in bundles that swirl diagonally around the heart
  3. Endocardium (inner) is a thin layer of endothelium overlying a thin layer of connective tissue that provides a smooth lining for the chambers of the heart to minimize surface friction and covers the heart valves
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8
Q

List the 4 chambers of the heart

A

The two superior receiving chambers are the atria and the two inferior pumping chambers are the ventricle

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9
Q

Define the auricle

A

A wrinkled pouch like structure on the anterior surface of each atrium that slightly increases the capacity of an atrium so that it can hold a greater volume of blood

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10
Q

What is the significance of a sulcus?

A

Each sulcus marks the external boundary between two chambers of the heard - they are a series of grooves that contain coronary blood vessels and fat

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11
Q

Coronary vs anterior interventricular sulcus vs posterior interventricular sulcus

A

Coronary - encircles most of the heart and marks the external boundary between the superior atria and inferior ventricles

anterior - shallow groove on the antihero surface that marks the external boundary between the right and left ventricles on the anterior aspect of the heart

posterior - marks external boundary between the ventricles on the posterior aspect of the heart

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12
Q

The right atrium receives blood from which 3 veins?

A

superiro vena cava, inferior vena cava, and coronary sinus

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13
Q

Describe the following aspects of the right atrium: pectinate muscles, interatrial septum, fossa ovals, tricuspid valve

A

The anterior wall fo the atrium is rough due to pectinate muscles which are muscular ridges that extend into the auricle

Interatrial septum - a thin portion between the right and left atrium

Fossa ovalis - a oval depression in the septum, which is a remanent of the foramen oval, an opening in the septum that closes soon after birth

tricuspid valve - blood passes from the right atrium to the right ventricle through this valve that consists of 3 cusps

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14
Q

Describe the following components of the right ventricle: trabecular carneae, chordae tendineae, papillary muscles, inter-ventricular septum, pulmonary valve

A

Trabecular carneae - cardiac muscle fibers that form a series of ridges inside the ventricle

Chordae tendineae - cords connected to the tricuspid valve which are intern connected to a cone-shaped trabeculae cornea called papillary muscles

Interventricular septum - suppurates the right and left ventricle

Pulmonary valve - blood passes from right valve into a large artery called the pulmonary trunk which divides into the right and left pulmonary arteries and caries blood to the lungs

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15
Q

How does blood flow in and out of the left atrium?

A

Received blood from the lungs via the pulmonary veins and passes into the left ventricle via the bicuspid (mitral) valve

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16
Q

Describe the left ventricle and its following components: aortic valve, ligaments arteriorsum

A

The left ventricle is the thickest chamber and forms the apex of the heart

Blood passes from the left ventricle through the aortic valve into the ascending aorta - some flow into coronary arteries and the remained passes into the arch of the aorta and descending aorta where it is carried throughout the body

Ligamentum arteriosum - connects the arch of the aorta and pulmonary trunk and is the remanent of the ductus arteriosus that closes shortly after birth

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17
Q

How does myocardial thickness relate to its function?

A

Ventricles pump blood under higher pressure and thus are thicker

Additionally, the left has a much larger workload as it must pump blood throughout the body and thus is thicker than the right

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18
Q

What is the fibrous skeleton of the heart?

A

The fibrous skeletal consists of four dense connective tissue rings that surround the valves of heart, fuse with one another, and merge with the interventricular septum

This is in addition to cardiac muscle tissue and prevents overstitching of the valves and serves asa point of insertion for bundles of cardia muscle fibers

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19
Q

Describe the operation of the atrioventricular valves (AV)

A

The AV include the tricupsid and bicuspid valve

When ventricles are relaxes, papillary muscles are relaxed, chordae tendineae are slack, and blood moves from a higher pressure in the atria to a lower pressure in the ventricles through open AV valves

When ventricles contract, the blood drives the cusps upward until their edges meet and close the opening

If AV valves or chordae tendinaea are damaged, blood may regurgitate (flow back( into the atria when ventricles contract

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20
Q

Describe the operations of the semilunar valves (SV)

A

SV are in both the aortic and pulmonary valves because they are made up of 3 crescent moon-shaped cusps

Each cusp attaches to the arterial wall by its convex outer margin and they allow ejection of blood from heart into arteries but prevent bacflow into the ventricles

When ventricles contract, pressure builds up and the SL valves open when pressure in the ventricles exceeds pressure in the arteries, permitting ejection of blood from the ventricles into the pulmonary trunk and aorta

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21
Q

What is the difference between systemic and pulmonary circulations?

A

The left side of the heart is the pump for systemic circulation - it receives red oxygenated blood from the lungs and the ventricle elects blood into aorta and carries it throughout the body here it looses O2 and gains CO2

The right side of the heart is the pump for pulmonary circulation - it receives all of the dark-red deoxygenated blood returning and the blood is ejected from the right ventricle into the pulmonary arteries were it is is taken to the lungs to be exhaled and picks up O2

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22
Q

Describe the major features of coronary circulation

A

Coronary circulation - myocardium’s own network of blood vessels as nutrients cannot diffuse quickly enough from blood

Coronary arteries branch from the ascending aorta and encircle the heart and while the heart is contracting there is little blood flow when when the heart contracts the high pressure in the aorta propels through the arteries into the coronary veins

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23
Q

Define collateral circulation

A

Anastomoses are are where blood from branches of more than one artery that supply the same region connect

They provide alternate routes known as collateral circulation for blood to reach a particular organ or tissue

The myocardium as many anastomoses that provide detours for arterial blood if a main route becomes obstructed

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24
Q

The left and right corral arteries deliver blood to the heart. How do they branch out?

A

Left -> circumflex branch & anterior interventricular branch

Right -> marginal branch & posterior interventricular branch

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25
What are the 4 principal tributaries caring blood into the coronary sinus?
Great cardiac vein Middle cardiac vein Small cardiac vein Anterior cardiac vein
26
Describe the general histology of cardiac muscle fibers
- They are shorter and less circular than skeletal muscles - They have branching which gives a staircase appearance - One centrally located nucleus (sometimes 2) - Ends of cardiac fibers are connected to one another by thickenings called intercalated discs - Have larger and more numerous mitochondria
27
Describe desmosomes and gap junctions within cardiac muscle fibre
Within intercalated discs are desmosomes and gap junctions Desmosomes hold fibers together and gap junctions allow muscle APs to conduct from one muscle fibre to another
28
Describe autorhymitc fibers and their 2 main functions
They repeatedly generate APs that trigger heart contractions and have 2 important functions: 1. act as a pacemaker - setting the rhythm of electrical excitation that causes contraction 2. from the cardiac conduction system, a network of specialized cardiac muscle fibers that provide a path for each cycle of cardiac excitation to progress through the heart
29
Describe the 5 steps of the cardiac conduciton system
1. Excitation begins in the sinoatrial (SA) node located in the right atrial wall, which repeatedly depolarize to threshold spontaneously, termed the pacemaker potential. When threshold it reached an AP propagates via gap junctions causing the two atria to contract simultaneously 2. AP reached the atrioventricular (AV) node, located in the interatrial septum, where it slows allowing time for the atria to empty their blood into the ventricles 3. AP then enters the atrioventricular (AV) bundle - the only place where APs can conduct from atria to ventricles 4. AP enters right and left bundle branches that extend through the interventricular septum towards apex 5. Purkinje fibers rapidly conduct the PA at the apex upward to the remainder of the ventricular myocardium, causing ventricular contraction pushing blood toward SV
30
What is an artificial pacemaker useful for?
When the SA node becomes damage or diseases an artificial pacemaker can send out small electrical currents to stimulate the heart to contract
31
What are the 3 steps of an action potential in a ventricular contractile giber?
1. Depolarization - resting potential is close to -90mV and when it is brought to threshold its fast voltage gated Na+ channels open, causing rapid influx producing a rapid depolarization 2. Plateau (maintained depolarization) due to Ca2+ inflow when voltage-gated slow Ca2+ channels open and K+ outflow when some K+ channels open 3. Repolarization due to closure of Ca2+ channels and K+ outflow when additional voltage-raged K+ channels open
32
How does the refractory period differ in cardiac muscle compared to skeletal muscle?
Another contraction cannot begin until relaxation is well under way thus, tetanus (maintained contraction) cannot occur
33
Describe the 3 following waves in an ECG: P wave, QRS complex, and T wave
P wave - small upward deflect on the ECG representing atrial depolarization which spreads from the SA node though contractile fibers in both atria QRS complex - begins as a downward deflection and then contained as a upright triangular eave and then back down representing rapid ventricular depolarization as the PA spreads through the ventricular contractile fibers T wave - smaller and wider upward deletion that indicates ventricular depolarization as the ventricles start to relax * The ECG is flat during the plateau period of steady depolarization
34
What is the clinical significant of ECG readings?
The size of waves can provide clues on abnormalities Ex. large P wave indicates enlargement of atrium, large Q wave may indicate myocardial infarction, large R wave indicated enlarged ventricles, flat T waves indicates lack of oxygen
35
How do ECG waves correlate with atrial and ventricular diastole?
1. Depolarization of atrial contractile fibers produces P wave 2. Atrial systole (contraction) 3. Depolarization of ventricular contractive fibers produces QRS complex 4. Ventricular systole (contraction) 5. Depolarization of ventricular contractive fibers produces T wave 6. Ventricular diastole (relaxation)
36
Describe the pressure and volume changes during the atrial systole of the cardiac cycle
1. Depolarization of SA node cause atrial depolarization (p wave) 2. Atrial deporlaization causes atrial systole, forcing blood through the open AV valves into ventricles 3. Atrial systole contributes 25mL of blood volume in each ventricle, ending with 130mL in each at the end, known as the end-disastolic volume (EDV) 4. QPR complex marks onset of ventricular depolarization
37
Describe the pressure and volume changes during the ventricular systole of the cardiac cycle
5. Ventricular depolarization causes ventricular systole, pressure rises in ventricles and pushes blood against the AV valves, forcing them shut - ~0.5 seconds SL and AV valves are shut known as isovolumetric contraction - cardiac muscles are contracting but not yet shortening 6. When left ventricular pressure surpasses aortic pressure (80mmHg) and right ventricular pressure rises above pressure in pulmonary trunk (20mmHg) both SL valves open, known as ventricular ejection 7. The ventricle ejects blood and the volume remaining in each ventricle at the end of systole, about 60mL, is the end-systolic volume (ESV) 8. The T wave marks onset of ventricular depolarization
38
What is the stroke volume?
The volume ejected per beat from each ventricle equals the end-diastolic volume (EDV) - end systolic volume (ESD) SV = EDV - ESV
39
Describe the pressure and volume changes during the relaxation period of the cardiac cycle
9. Ventricular depolarization causes ventricular diastole - pressure in chambers fall and blood in aorta and trunk begin to flow backward toward regions of lower pressure in ventricles - as pressure rises all 4 valves close, a period known as isovolumetric relaxation 10. When ventricular pressure drops below atrial pressure, the AV voles open, and ventricular filling begins
40
There are 4 heart sounds cause by closing of the valves but which 2 are loud enough to be heard?
S1 (lubb) - caused by blood turbulence associated with closure of the AV valves soon after ventricular systole begins (louder and longer) S2 (dupp) - blood turbulence associated with closure of the SL valves at the beginning of ventricular diastole
41
Define heart murmur
Abnormal sound consisting of a clicking, rushing, or gurgling noise They are most frequently discovered in children between the ages of 2 and 4 and they often subside/disappear with growth In adults, they indicate a valve disorder
42
Define cardiac output
the volume of blood ejected from the left (or right) ventricle into the aorta (or pulmonary trunk) each minute CO = SV x HR
43
Define cardiac reserve
the difference between a persons maximum cardiac output and cardiac output at rest Athletes many have cardiac reserves 7x their resting CO where those with heart disease may have little to no reserve
44
Describe the following 3 factors that regulate stroke volume: preload, contractility, afterload
Preload (stretch): a greater preload prior to contraction increases the force of contraction, a relationship known as the frank-starling law of the heart Contractility: the strength of contraction at any given preload Afterload: ejection of blood from the heart begins when pressure in the right ventricle exceeds the pressure in the pulmonary trunk and when the pressure in the left ventricle exceeds the pressure in the aorta
45
Preload is proportional to the end-diastolic volume (EDV) - what 2 key factors determine the EDV?
1. The duration of the ventricular diastole 2. Venous return - the volume of blood returning to the right ventricle When heart read increases, stroke volume decreases due to the short filling time causing a lower EDV
46
What substances influence contractility?
Positive inotropic agents increase contractility and negative inotropic agents decrease it Positive agents often promote Ca2+ inflow during cardiac potentials which strengthens the force of the next contraction
47
Where is the cardiovascular centre located?
Medulla oblongata
48
Describe the autonomic regulation of heart rate
Proprioceptors, chemoreceptors (chemical changes in blood), and baroreceptors (stretching of arteries) detect changes in activity and send nerve impulses to the cardiovascular center The cardiovascular center directs output but increasing or decreasing the frequency of nerve impulses in both the sympathetic and parasympathetic branches of the ANS Sympathetic: cardiac accelerator nerves extend out to the SA node, AV node, and myocardium - they trigger the release of NE, which binds to mardiac muscle fibers which a) in SA node speeds rate of spontaneous depolarization and b) in contractile fibers in ventricle/atria enhances Ca2+ entry increasing contractility Parasympathetic: nerves reach heart via left and right vagus (X) nerves which release AcH that decreases HR by slowing the rather of spontaneous depolarization in autorhymic fibers
49
How do hormones and cations influence the heart?
Hormones: Epi, NE, and thyroid hormones enhance hearts pumping effectiveness by increasing HR and contractility Cations: cations are crucial for production of AP in particular, K+, Ca2+, and Na+ - High K+ decrease HR and contractility as it blocks AP generation - High Na+ decrease HR and contractility as it blocks Ca2+ inflow
50
Tachycardia vs bradycardia
Tachycardia - elevated resting heart rate that is one sign of hyperthyroidism Bradycardia - a resting heart rate under 50b/min, typically in athletes
51
Men typically have a higher resting HR than women True or False
False
52
Define arteriosclerosis
Thickening of the walls of arteries and loss of elasticity One form is atherosclerosis, a progressive disease characterized by the formation of walls in the large and medium arteries of lesions called atherosclerotic plaques
53
Define ventricular fibrillation
Most deadly arrhythmia, in which contractions of the ventricular fibers are completely asynchronous so that the ventricles quiver rather than contract in a coordinated way Circulatory failure and death will occur unless there is immediate medical intervention
53
Define ventricular fibrillation
Most deadly arrhythmia, in which contractions of the ventricular fibers are completely asynchronous so that the ventricles quiver rather than contract in a coordinated way Circulatory failure and death will occur unless there is immediate medical intervention
54
Which of the following deflection waves are correctly matched with the following event? A) P wave/ atrial repolarization B) T wave/ atrial repolarization C) P wave/ ventricular depolarization D) QRS complex/ ventricular depolarization
D) QRS complex/ ventricular depolarization
55
During exercise oxygen delivery rises as cardiac output rises because A) respiration increases B) skeletal muscle fibers increase in numbers C) skeletal muscle fibers increase in size D) skeletal muscle develop more capillary networks
D) skeletal muscle develop more capillary networks
56
A patient involved in a car accident has severed the vagus nerve (X). Which of the following symptoms will the patient exhibit? A) bradycardia B) increase in heart rate C) increased strength of contraction D) decreased preload
B) increase in heart rate
57
Which chamber of the heart has the thickest walls? A) right atrium B) right ventricle C) left atrium D) left ventricle
D) left ventricle
58
A patient has pulmonary edema but not peripheral edema. Which of the following is probably true of the patient's heart? A) The patient's left ventricle is failing. B) The patient's right ventricle is failing. C) The patient's left atrium is failing. D) The patient's right atrium is failing.
A) The patient's left ventricle is failing.
59
Closure of the aortic and pulmonary semilunar valves is the onset of A) ventricular systole B) depolarization of the SA node C) atrial systole D) ventricular diastole
D) ventricular diastole
60
End-diastolic volume (EDV) is A) blood ejected out of the ventricle B) blood located in the atria at the end of diastole C) blood ejected from the atria D) blood in the ventricle at the end of relaxation
D) blood in the ventricle at the end of relaxation
61
Cardiac muscle differs from skeletal muscle in that cardiac muscle cells A) are involuntary B) are organized in bundles C) are wrapped in connective tissue sheaths D) are larger than skeletal muscle cells
A) are involuntary
62
An individual appears in the ER with severed chordae tendineae in the right ventricle. The result of this would be A) decrease blood volume to the pulmonary trunk B) eversion of the tricuspid valve C) all of these are results of severed chordae tendineae D) reduced valve efficiency
C) all of these are results of severed chordae tendineae
63
Identify the structure in the adult that represents the remnant of the fetal connection between the pulmonary trunk and the aorta. A) ligamentum arteriosum B) foramen ovale C) ligamentum venosum D) ductus arteriosus
A) ligamentum arteriosum
64
The plateau phase of the cardiac action potential is, in part, due to voltage-gated potassium channels voltage-gated fast sodium ion channels voltage-gated slow calcium channels ligand-gated channels
voltage-gated slow calcium channels
65
A P-Q segment on an electrocardiogram indicates A) time required for action potential to travel from SA to Purkinje fibers B) time from ventricle depolarization to ventricular repolarization C) synchronized contraction of the atria chambers
A) time required for action potential to travel from SA to Purkinje fibers
66
Which of the following terms is not associated with cardiac muscle fibers? mononucleated striated intercalated discs voluntary
voluntary
67
An ECG electrocardiogram when compared to a previous test can determine all except enlarged heart if regions of the heart are damaged if the conducting pathway is abnormal brain waves
brain waves
68
Which of the following statements about sinoatrial node (SA) is incorrect? A) It propagates action potentials that reach the Purkinje cells. B) It is in the left atrial wall. C) It can depolarize spontaneously without nervous stimulation. D) It is the pacemaker of the heart.
B) It is in the left atrial wall.
69
Oxygen is presented to the myocardium by A) blood flow through the heart B) coronary arteries C) coronary sinus D) passing through the fossa ovalis
B) coronary arteries
70
The mechanism of closing a semilunar valve is A) an increase in ventricular pressure B) a decrease in ventricular pressure C) an increase in atrial pressure D) a decrease in atrial pressure
B) a decrease in ventricular pressure
71
Atrioventricular valves open A) the same time semilunar valves open B) during ventricular systole C) due to increased tension from chordae tendineae D) when atrial pressure is greater than ventricular pressure
D) when atrial pressure is greater than ventricular pressure
72
Blood flows into coronary vessels when the heart relaxes when the pulmonary artery is under pressure when the heart contracts when the aorta is under low pressure
when the heart relaxes
73
The left side of the heart pumps oxygenated blood to all tissues except myocardium of the heart head and upper arms trunk and lower limbs of the body pulmonary alveoli of the lungs
pulmonary alveoli of the lungs
74
These provide detours for arterial blood if a main route becomes obstructed. valves branches anastomoses radicals
anastomoses
75
Which of the following vessels transport deoxygenated blood into the right atrium? circumflex branch marginal branch right coronary artery coronary sinus
coronary sinus
76
Which of the following structures contain valves that regulate blood flow? A) the superior and inferior vena cava and the entry into the right atrium B) between the atrium and ventricle on the left side and the right side C) the right and left pulmonary veins and entry into the left atrium D) between the coronary sinus and the right atrium
B) between the atrium and ventricle on the left side and the right side
77
The left coronary artery branches into the posterior interventricular branch circumflex branch marginal branch All of the choices are correct.
circumflex branch
78
The exchange of nutrients and gases occurs across the membranes of arteries capillaries veins arterioles
capillaries
79
The coronary sinus returns blood from the myocardium into the left atrium right ventricle right atrium left ventricle
right atrium
80
Which heart valve can be described as containing three flaps with chordae tendineae and allowing deoxygenated to pass through it? aortic semilunar valve pulmonary semilunar valve bicuspid valve tricuspid valve
tricuspid valve
81
Which chambers of the heart contain deoxygenated blood? left and right ventricular chambers left atrium and left ventricle right atrium and right ventricle left and right atrial chambers
right atrium and right ventricle
82
The contraction of the papillary muscles and the attached chordae tendineae function to eject blood into the greater vessels close the semilunar valves prevent the valve cusps from entering into the atrial chambers opens and stabilizes the atrioventricular valves
prevent the valve cusps from entering into the atrial chambers
83
An analysis of the electrocardiogram can reveal all except stroke volume an enlarged heart abnormalities in the conduction pathway damaged areas in the heart
stroke volume
84
When the SA node reaches threshold it triggers an action potential that is spread across the atria. FALSE TRUE
TRUE
85
An increase in extracellular potassium (hyperkalemia) would result in increase in stroke volume decrease in heart rate decrease in afterload increase in heart rate
decrease in heart rate
86
Atrial repolarization on an electrocardiogram is masked by the QRS complex QRS complex the P wave T wave
masked by the QRS complex
87
A patient is presented in the emergency room complaining of chest pain. The electrocardiogram indicated a myocardial infarction, what was irregular on the ECG? elevated T wave enlarged Q wave wide QRS complex P wave
enlarged Q wave
88
Ventricular repolarization is identified on the ECG by which wave/complex? T P-Q QRS P
T

BIO 235 Final (11 decks)

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