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A&P 2 lecture > chapter 20: the heart > Flashcards

chapter 20: the heart Flashcards

1
Q

Right side of the heart carries blood

A

to pulmonary circuit

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2
Q

Left side of the heart carries blood to

A

systematic circuit

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3
Q

Pulmonary circuit

A

carries blood to and from gas exchange surfaces of the lungs

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4
Q

systematic circuit

A

transports blood to and from the rest of the body

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5
Q

location of the heart

  • cavity
  • near
  • posterior to
  • extends from
  • ___ of heart is to the left of the midline
A
  • throacic
  • anterior chest wall
  • sternum
  • T5 to T9
  • 2/3
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6
Q

Base of heart location

A

~3rd costal cartilage

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7
Q

Apex of heart

  • definition
  • location
A
  • inferior pointed tip

- ~5th intercostal space

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8
Q

Mediasteum

  • definition
  • what does it contain (5)
A

region between two pleural cavities

-contains heart, great vessels, thymus, esophagus and trachea

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9
Q

Tissues of the heart

A

pericardium

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10
Q

pericardium

  • definition
  • 2 layers
A
  • lining of the pericardial cavity
    1. fibrous pericardium
      1. serous pericardium
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11
Q

fibrous pericardium

  • location
  • definition
  • function
A
  • outer most portion
  • dense network of collagen fibers
  • stabilizes position of heart and associated vessels
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12
Q

serous pericardium

  • definition
  • 2 components
A
  • inner “double” serous membrane; fluid secreting layer
  • provides lubrication
    1. visceral pericardium
      1. parietal pericardium
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13
Q

visceral pericardium

  • location
  • what does it do
  • known as
A
  • inner most layer
  • covers and adheres close to outer surface of heart
  • epicardium
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14
Q

Parietal pericardium

  • definition
  • location
A
  • lines inner surface of pericardium

- adjacent to fibrous pericardium

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15
Q

The heart wall

-3 components

A
  1. epicardium
  2. myocardium
  3. endocardium
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16
Q

epicardium

  • known as
  • 2 components
A
  • visceral pericardium
    1. mesothelium
      1. areolar tissue (connective tissue)
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17
Q

mesothelium

A

fluid secreting cells

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18
Q

myocardium

  • -definition
  • what are the cardiac muscle cells called
A
  • cardiac muscle tissue; muscular wall of heart

- cardiomyocytes

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19
Q

endocardium

  • 2 components
  • what type of epithelium
  • function
A
    1. areolar tissue
      1. endothelium
  • simple squamous epithelium
  • covers all inner surfaces of heart
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20
Q

Cardiac muscle cells

  • 3 general characteristics
  • 1 special feature
A
    1. striated
      1. small
      2. branched with a single nucleus
  • intercalated discs
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21
Q

Intercalated discs

  • definition
  • contains
  • function
A
  • specialized membranes b/n adjacent cells
  • gap junctions
  • allows all cells of the heart to become excited at the same time = heart contracts as a unit
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22
Q

Auricle of right atrium

A

expands to fill with blood

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23
Q

left pulmonary artery

A

carries deoxygenated blood to lungs

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24
Q

Pathway of blood through heart

-right side (9 steps)

A
  1. superior vena cava
  2. fossa ovalis (l atrium)
  3. coronary sinus (l atrium)
  4. right atrioventricular valve (r AV valve, tricuspid valve) (r ventricle)
  5. inferior vena cava (r ventricle)
  6. papillary muscle
  7. pulmonary semilunar valve
  8. left and right pulmonary arteries
  9. to lungs
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25
Q

pathway of blood through heart

-left side (7 steps)

A
  1. Left and right pulmonary arteries
  2. left atrium
  3. left atrioventicular valve (left AV valve, bicuspid valve)
  4. left ventricle
  5. aortic semilunar valve
  6. aorta
  7. to body
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26
Q

Superior vena cava

A

delivers blood from upper extremities

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27
Q

coronary sinus

A

opening of coronary circulation

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28
Q

right atrioventricular valve

  • 2 other names
  • function
A
    1. right AV valve
      1. tricuspid valve
  • prevents backflow
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29
Q

inferior vena cava

A

delivers blood from lower body

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30
Q

papillary muscle

  • 1 component
  • definition of that component
A
  • chordae tendinae

- cords attached to valves and anchored to papillary muscle

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31
Q

Left pulmonary arteries

-carries what type of blood

A

oxygen poor blood to lungs

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32
Q

left pulmonary veins

-carries what type of blood

A

oxygen rich blood to heart

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33
Q

left atrioventricular valve

-3 other names

A
  1. left AV valve
  2. bicuspid valve
  3. mitral valve
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34
Q

coronary circulation

  • definition
  • function
  • what happens if it becomes partially or completely blocked?
A
  • supplies blood to heart muscle
  • penetrates myocardium -delivers O2 and nutrients
  • myocardial infarction - heart attack!
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35
Q

5 major arteries of the coronary circulation

A
  1. right coronary artery
  2. left coronary artery
  3. anterior interventricular artery
  4. posterior interventricular artery
  5. circumflex artery
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36
Q

3 veins of the coronary circualtion

A
  1. coronary sinus
  2. great cardiac vein
  3. middle cardiac vein
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37
Q

origin of the heart beat

  • 3 things
  • 2 types of cells
A
    1. the heart beats (contracts) 60-80 times per min. (~75 bpm average)
      1. the heart is “self excitatory”- stimulates itself; “automaticity”
      2. the conducting system of the heart initiates and distributes the stimulus
    1. contractile cells
      1. conducting cells
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38
Q

contractile cells

A

produce contraction that propel blood

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39
Q

conducting cells

  • function
  • smaller or bigger than contractile cells
  • lacks 2 things
  • do they contract
A
  • initiate and spread electrical impulses
  • smaller
  • lacks actin and myosin
  • no
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40
Q

Action potentials

  • 3 steps
  • 2 periods
A
    1. resting
      1. depolarization
      2. repolarization
    1. absolute refractory period
      1. relative refractory period
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41
Q

threshold mV

A

-60 mV

42
Q

resting phase

  • cause
  • mV
A
  • lots of protein inside and leakage of K+ out of cell

- -70mV

43
Q

depolarization

-cause

A

-movement of Na+ in through open channels

44
Q

repolarization

-cause

A

Na+ channels close, K+ channels are fully open and K+ exits

45
Q

absolute refractory period

  • occurs when
  • definition
A
  • between depolarization and repolarization

- cannot have another action potential during this time

46
Q

relative refractory period

  • occurs when
  • definition
A
  • occurs after an action potential

- can get another action potential but it takes more energy

47
Q

when does contraction of a skeletal muscle occur

A

after action potential

48
Q

action potential in a cardiac myocyte

  • conducting cells
  • contractile cells
  • 3 phases
A
  • initiate and conduct action potentials
  • conduct action potentials and contract
    1. depolarization
      1. plateau
      2. repolarization
49
Q

depolarization in a cardiac myocyte

-cause

A

-Na+ entry through open channels

50
Q

plateau phase in a cardiac myocyte

  • cause
  • what moves
  • what does this maintain
A
  • opening of slow Ca++ channels, closing of Na+ channels
  • ca2+ ions move from outside to inside and from inside SR into sarcoplasm
  • maintains a slightly positive membrane potential
51
Q

repolarization of cardiac myocyte

-cause

A

closing of Ca++ channels; opening of K+ channels

52
Q

absolute refractory period in cardiac myocyte

  • long or short
  • continues until
  • when can it initiate another action potential
A
  • long
  • relaxation is underway
  • when the heart has already relaxed
53
Q

the conducting system of the heart

-6 steps

A
  1. Sinoatrial (SA) node
  2. intermodal pathways
  3. atrioventricular (AV) node
  4. AV bundle
  5. Bundle branches (R and L)
  6. Purkinjie fibers
54
Q

Sinoatrial node

-function

A

initiates the action potential- “pacemaker”

55
Q

Purkinjie fibers

A

small branches that penetrate the myocardium and deliver action potential

56
Q

when does the pacemaker (SA node) spontaneously depolarizes

A

about every 0.8 secs

57
Q

which node is faster? SA node or AV node?

A

SA node

58
Q

what mV is the threshold at for the SA node

A

-40 mV

59
Q

Electrocardiogram

  • known as
  • definition
  • 3 steps
  • 6 components
A
  • “EKG” or “ECG”
  • Action potentials passing through the conducting system are strong enough to be detected by electrodes on the body surface
    1. atrial excitation begins
      1. impulse delayed at AV node - Atria contract
      2. impulse travels toward purkjinie fibers
      3. ventricular contraction begins
  • P wave, Q, R, S, QRS complex, T wave
60
Q

P wave

A

depolarization of atria

61
Q

QRS complex

A

depolarization of ventricles

62
Q

T wave

A

repolarization of ventricles

63
Q

What is not seen in the electrocardiogram?

A

atrial repolarization (masked behind QRS complex)

64
Q

The cardiac cycle

  • definition
  • 2 stages
A

Period between start of one heart beat and beginning of the next

  • 1.systole
    2. diastole
65
Q

Systole

  • definition
  • 2 types
  • pressure
A
  • contraction
    1. atrial systole
      1. ventricular systole
  • increase pressure
66
Q

Diastole

  • definition
  • 2 types
  • pressure
A
  • relaxation
    1. atrial diastole
      1. ventricular diastole
  • decrease pressure
67
Q

overview of the cycle

  • 3 steps
  • how many sec for each heart beat
A
  1. Atria contract (atrial systole); ventricles relax (ventricular diastole) - 0.1 sec
  2. Atria relax (atrial diastole); ventricles contract (ventricular systole) - 0.3 sec
  3. Atria relax (atrial diastole); ventricles relax (ventricular diastole) (when heart rate increases this phase gets alot shorter)- 0.4 sec
    - 0.8 sec
68
Q

4 phases of the cardiac cycle

A
  1. Late Diastole
  2. Atrial Systole
  3. Ventricular systole
  4. ventricular diastole
69
Q

Late diastole

  • definition
  • AV valves
  • Semilunar valves
  • Blood flow right side
  • blood flow left side
  • period of passive filling
A
  • atria and ventricles are relaxed
  • open
  • closed
  • Blood will enter the RA and flow into the RV through the open AV valve
  • Blood will enter the LA and flow into the LV through the open AV valve
  • ~70% of the ventricular volume enters this way
70
Q

Atrial systole

  • definition
  • conducting system (3)
  • ECG
  • ventricles are in systole and diastole
  • Blood pumped right side
  • blood pumped left side
A
  • atria contract
    1. Action potentials initiated as SA node
      1. Travels through internodal branches to AV node
      2. Atria are depolarized
  • diastole
  • RA pumps blood through open AV valve to RV
  • LA pumps blood through open AV valve to LV
71
Q

Ventricular systole

  • atria are in systole and diastole
  • 2 steps
A
  • diastole
    1. isovolumetric contraction
      1. ventricular ejection
72
Q

isovolumetric contraction

  • definition
  • conducting system (2)
  • ECG
  • how do ventricles contract
  • ventricular pressure increases or decreases
  • when ventricular pressure is > atrial pressure
  • heart sound
  • blood flow
A
  • same volume
    1. AV node to AV bundle to R and L bundle branches to Purkinjie fibers
      1. ventricles are depolarizing
  • isometrically
  • increasing
  • AV valves close on left and right
  • Lubb - 1st heart sound
  • No blood enters or exits - maintain same volume
73
Q

Isometric contraction

A

tension of muscle without movement

74
Q

Ventricular ejection

  • ventricular pressure
  • semilunar valves
  • Blood pumped right side
  • blood pumped left side
  • volume ejected
A
  • increasing
  • open when ventricular pressure > aortic and pulmonary artery pressure
  • Blood pumped through open semilunar valves into pulmonary trunk
  • Blood pumped through open semilunar valves into aorta
  • stroke volume: volume of blood ejected in one beat
75
Q

ventricular diastole

-2 components

A
  1. isovolumetric relaxation

2. ventricular filling

76
Q

isovolumetric relaxation

  • definition
  • conducting system
  • ECG
  • ventricular pressure
  • when ventricualr pressure
A
  • same volume
  • repolarization
  • T wave
  • decreasing
  • semilunar valves close
  • dubb - 2nd heart sound
  • AV valves open
77
Q

Ventricular filling

  • AV valves
  • semilunar valves
  • blood flow
A
  • open
  • closed
  • ventricles are passively filling
78
Q

Cardiodynamics

  • definition
  • 3 important terms
A
  • examines the factors the effect cardio output
    1. End-diastolic volume
      1. End-systolic volume
      2. Stroke volume
79
Q

cardio output (CO)

  • definition
  • indication of
A
  • amount of blood pumped by left ventricle in one minute

- blood flow through tissues

80
Q

End-diastolic volume

A

amount of blood in each ventricle at the end of ventricular diastole

81
Q

End-systolic volume

A

amount of blood in each ventricle at the end of ventricular systole

82
Q

Stoke volume

  • definition
  • formula
A
  • amount of blood pumped out of the heart in a single heart beat
  • SV= EDV-ESV
83
Q

How do we determine cardio output?

A

Cardio output (CO) = heart rate (HR) x stroke volume (SV)

84
Q

What is a normal cardiac output?

A

CO = 75 bpm x 80 ml/beat = 6000 ml/min

85
Q

Factors affecting stroke volume

-5

A
  1. Venous return (VR)
  2. Filling time (FT)
  3. Increased by sympathetic stimulation
  4. Decreased by parasympathetic stimulation
  5. Increased by E, NE, glucagon, thyroid hormone
86
Q

3 factors that determine stroke volume

A
  1. Preload
  2. Contractility
  3. after load
87
Q

preload

  • definition
  • frank-starling law of the heart
A

-degree to which cardiac muscle cells are stretched just before contracting
-more in = more out; increased VR = increased CO
increased FT = increased CO

88
Q

What determines the degree to which the heart is stretched?

A

the EDV; greater the EDV = larger the preload

89
Q

Contractility

  • definition
  • example
  • 2 types of action
A
  • amount of force produced during a contraction
  • increased contractility = decreased ESV = increased SV
    1. positive inotropic action
      1. negative inotropic action
90
Q

positive inotropic action

A

increase contractility

91
Q

negative inotropic action

A

decrease contractility

92
Q

afterload

  • definition
  • increased afterload =
A
  • pressure in the pulmonary trunk and aorta the heart must overcome to eject blood
  • increased afterload = longer period of isovolumetric contraction = increased ESV = decreased SV
93
Q

3 factors affecting heart rate

A
  1. Autonomic nervous system
  2. hormones and chemicals
  3. other (age, sex, and temp)
94
Q

autonomic nervous system

  • definition
  • 2 branches
A
  • innervated through cardiac plexus
    1. sympathetic
      1. parasympathetic
95
Q

sympathetic NS

  • definition
  • effect on heart rate
  • effect on force
A
  • cardioacceleratory center in medulla oblongata; sympathetic nerves supply SA node
  • increase
  • increase
96
Q

parasympathetic NS

  • definition
  • effect on heart rate
  • effect on force
A
  • cardioinhibitory center in medulla oblogata; parasympathetic nerves supply SA node
  • decrease
  • decrease
97
Q

Hormones and chemicals

-5

A
  1. norepinephrine
  2. epinephrine
  3. thyroid hormones
  4. calcium channel blockers
  5. beta blockers
98
Q

how does norepinephrine, epinephrine and thyroid hormones effect heart rate and contractility?

A
  • increase heart rate

- increase contractility

99
Q

how does calcium channel blockers and beta blockers effect heart rate and contractility?

A
  • decrease heart rate

- decrease contractility

100
Q

age effecting HR

  • young
  • old
A
  • higher

- lower

101
Q

sex effecting HR

  • females
  • male
A
  • higher

- lower

102
Q

temp effecting HR

  • hot
  • cold
A
  • higher

- lower

A&P 2 lecture (17 decks)

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