Chapter 8: Cardiovascular System Flashcards
What composes the cardiovascular system?
The heart and blood vessels. When this system fails, life at the cellular level isn’t possible and death occurs.
Define leaflets
Flat, leaf-shaped structures that comprise the valves of the heart and prevent backflow of blood.
Define lumen
Tubular space or channel within an organ or body structure; space within an artery, vein, intestine, or tube.
Define regurgitation
Backflow or ejecting of contents through an opening.
Define sphincters
Circular muscles found in a tubular structure or a hollow organ that constrict/dilate to regulate passage of substances through its opening.
Vasoconstriction
Narrowing of the lumen of a blood vessel that limits blood flow, usually as a result of diseases, medication, or physiological processes.
Vasodilation
Widening of the lumen of a blood vessel caused by the relaxing of the muscles of the vascular wall.
Viscosity
Thickness or measure of how resistant a liquid is to flowing. High viscosity = thick and slow-flowing.
3 major types of blood vessels
arteries, capillaries, and veins.
Function of arteries:
Carry blood from the heart to the body’s cells. Arteries carry blood with a high concentration of O2; only exception is the pulmonary artery.
3 layers of artery walls:
tunica externa, tunica media, tunica interna.
Tunica externa
Outer layer of the artery wall, composed of connective tissue that provides strength and flexibility.
Tunica media
Middle layer of the artery wall, composed of smooth muscle, which can alter the size of the lumen of the vessel; either vasoconstriction or vasodilation.
Tunica interna
Inner layer of the artery wall, composed of endothelial cells that create a smooth surface on the inside of the vessel.
Define pulse
A surge of blood felt in the arteries when blood is pumped from the heart.
Function of capillaries:
Microscopic blood vessels that join the arterial system with the venous system. Walls are composed of only a single layer of epithelial cells to allow for O2/CO2 exchange between the cardiovascular system and body cells.
Function of precapillary sphincters:
Regulate blood flow into the capillaries. When more blood is required in a tissue they open and they close when less blood is required in a tissue.
Function of veins:
Return deoxygenated blood to the heart; blood in these vessels has a characteristic purple color due to lack of O2. Blood in the veins contains a high concentration of CO2, with the exception of the pulmonary vein.
Methods used by veins to return blood to the heart (4):
1) Skeletal muscle contraction
2) Gravity
3) Respiratory activity
4) Valves
Define valves:
Small structures within veins that prevent backflow of blood. Found mainly in the extremities and are important for returning blood to the heart from the legs.
Function of the heart:
Muscular pump that propels blood throughout the entire body through a closed vascular network.
Pulmonary circulation
Occurs on the right side of the heart and delivers blood to the lungs, where CO2 is exchanged for O2.
Systemic circulation
Occurs on the left side of the heart and delivers blood to the body tissues, where O2 is exchanged for CO2.
What’s the pericardium?
A sac that encases the heart and is composed of 3 distinct layers; the epicardium, myocardium, and endocardium.
Epicardium
Outermost layer of the heart.
Myocardium
Muscular layer of the heart.
Endocardium
Serous membrane that lines the 4 chambers of the heart and its valves.
4 chambers of the heart:
right atrium (RA), right ventricle (RV), left atrium (LA), and left ventricle (LV). The atria collect blood and ventricles pump blood from the heart.
Where does the right ventricle pump blood?
Pumps deoxygenated blood to the lungs (pulmonary circulation).
Where does the left ventricle pump blood?
Pumps oxygenated blood to the entire body (systemic circulation).
Superior vena cava
Collects and carries deoxygenated blood from the upper body and deposits in the right atrium.
Inferior vena cava
Collects and carries deoxygenated blood from the lower body and deposits in the right atrium.
Tricuspid valve
Prevents backflow of blood from the right ventricle to the right atrium; has 3 leaflets.
Pulmonary arteries
Separate into left and right branches and carry deoxygenated blood to the lungs from the right ventricle. These branch into capillaries that lay next to alveoli where CO2/O2 are exchanged.
Mitral (bicuspid) valve
Prevents backflow of blood from the left ventricle to the left atrium; has 2 leaflets.
Aorta
Largest artery in the body that leads blood away from the left ventricle. Branches into smaller arteries and arterioles to deliver blood to body tissues.
Aortic (semilunar) valve
Prevents regurgitation of blood from the aorta to the left ventricle.
What arteries supply blood to the myocardium of the heart?
Coronary arteries. If blood flow is disrupted to the myocardium, part of the heart muscle may die.
Coronary arteries (2)
right and left coronary arteries
Right coronary artery
Vascularizes the right side of the heart.
Left coronary artery
Vascularizes the left side of the heart. Splits into 2 branches; left anterior descending artery and circumflax artery.
Define conduction tissue:
Specialized cardiac tissue that has the sole function of initiating and spreading conduction impulses.
Sinoatrial (SA) node
Located in the upper portion of the right atrium and possesses its own intrinsic rhythm. It has the ability to initiate and propagate its own heartbeat, which sets the basic pace for the cardiac rate; commonly known as the pacemaker of the heart.
Atrioventricular (AV) node
SA node transmits impulses to the AV node, which causes the atria to contract. AV node is located at the base of the right atrium.
Bundle of His (AV bundle)
Tract of conduction fibers, composed of a right and left branch.
Purkinje fibers
Impulses are directed here from the bundle of His. These fibers extend up the ventricle walls and transmit impulses to the right and left ventricles, causing them to contract.`
Electrocardiograph
Picture produced by recording the weak impulses on the surface of the body caused by electrical impulses from the conduction system of the heart. This produces waves or peaks designated by the letters P, Q, R, S, T.
P wave
Depolarization (contraction) of the atria.
QRS complex
Depolarization (contraction) of the ventricles.
T wave
Repolarization (recovery) of the ventricles.
Blood pressure
The force exerted by blood against arterial walls during 2 phases of heartbeat.
Systole
Contraction phase when blood is forced out of the heart; provides maximum force.
Diastole
Relaxation phase when ventricles are filling with blood; produces the weakest force.
Sphygomomanometer
Instrument that measures blood pressure; recorded as 2 figures separated by a diagonal line; systole/diastole, example: 120/80 mm Hg.
Factors that influence blood pressure:
1) Resistance of blood flow in the blood vessels.
2) Pumping action of the heart.
3) Viscosity of blood.
4) Elasticity of arteries.
5) Quantity of blood in the vascular system.
aneurysm/o
aneurysm (widened blood vessel).
angi/o
vascul/o
vessel (usually blood or lymph).
aort/o
aorta
arteri/o
artery
arteriol/o
arteriole
atri/o
atrium
ather/o
fatty plaque
cardi/o
coron/o
heart
electr/o
electricity
embol/o
embolus (plug)
hamangi/o
blood vessel
my/o
muscle
phleb/o
ven/o
vein
sept/o
septum
scler/o
hardening
sphygm/o
pulse
sten/o
narrowing; stricture
thromb/o
blood clot
valv/o
valvul/o
valve
ventricul/o
ventricle
-cardia
heart condition
-stenosis
narrowing; stricture
brady-
slow
endo-
in, within
extra-
outside
peri-
around
trans-
across
What are some common signs and symptoms of cardiac disorders?
Thoracodynia, dyspnea, cardiac irregularities, and LOC.
Define cardiologist
Specialist in the study and treatment of cardiovascular diseases/disorders.
Define cardiology
Medical specialty concerned with disorders of the cardiovascular system.
What is arteriosclerosis?
A progressive, degenerative disease of arterial walls that causes them to become thickened and brittle, which restricts the flow of blood to tissues and organs. Causes include build up of plaque on the interior artery wall. Arteries usually affected include coronary, carotid, cerebral, and femoral arteries, and the aorta. Sx include angina, diaphoresis, hemiplegia, blurred vision, confusion, and myalgia. Risk factors include HLD, HTN, DM, age, smoking, and family hx. Tx includes statins, antihypertensives, anticoagulants and surgery.
Thrombus
Clot; formed when blood hemorrhages into arterial plaque and this piece breaks off and travels to a more distal part of the body, which can lead to infarction and ischemia.
Infarction
Tissue death that occurs when an artery is completely blocked.
Ischemia
Localized tissue anemia caused by the partial blocking of circulation.
Angina
Chest pain and tightness.
Diaphoresis
Excessive sweating.
Hemiplegia
Weakness of paralysis of half the body.
Myalgia
muscle pain.
Hyperlipidemia (HLD)
Elevated level of fatty substances in the blood.
Statins
Drugs that reverse or slow down fat build up.
Antihypertensives
Drugs that control blood pressure.
Anticoagulants
Drugs that reduce thrombus formation.
Angioplasty
Repairs vessels affected by arteriosclerosis.
Endarterectomy
Surgical removal of fatty deposits inside the arteries. Commonly used to treat carotid artery disease, PAD, and diseases of the renal artery and aortic arch.
Coronary Artery Disease (CAD)
Any disease that interferes with the coronary arteries’ ability to supply blood to the myocardium. Causes: arteriosclerosis, HTN, DM, HLD, and radiation therapy to the chest (associated with certain types of cancers). May cause ischemia of the myocardium and necrosis, which leads to MI.
Myocardial Infarction (MI)
Death of the heart muscle. When this happens, the heart releases highly specific substances, such as enzymes, hormones, and proteins.
Endocarditis
Inflammation of the inner lining of the heart and its valves. Once established in the heart, bacteria and other material form vegetation on the valves causing stenosis. Although meds may prove helpful, valvuloplasty may be necessary to repair damaged valves. Predisposing factors: congenital valvular defects, scarlet fever, rheumatic fever, mitral valve prolapse, and prosthetic valves. Tx includes prophylactic treatment (antibiotics) or surgery.
Infective endocarditis
Caused by bacteria that has entered the bloodstream from infections in remote areas of the body that have lodged on damaged endocardial tissue or abnormal valves.
Mitral valve insufficiency
Mitral valve doesn’t close properly due to impeding blood flow to the ventricles, which commonly causes regurgitation.
Regurgitation
Back flow of blood from one chamber into the chamber it just came from.
Valvuloplasty
Surgery used to correct damaged valves.
Bioprosthetic
Device made of human or animal tissue used to replace an extensively damaged valve.
Prophylactic Treatment
preventative treatment.
Varicose veins
Engorged, enlarged, twisted, superficial veins that develop when the valves of the veins are incompetent and fail to prevent backflow of blood. May develop in almost any part of the body; occur most commonly in the greater and lesser saphenous veins of the LEs. May not be painful, but have an unsightly appearance. Tx of mild cases include wearing elastic stockings and LE elevation at rest.
Incompetent (valves)
When valves of the veins don’t function properly.
Esophageal varices
Varicose veins in the esophagus.
Hemorrhoids
Varicose veins in the rectum.
Phlebitis
Inflammation of the veins.
Endovenous ablation
Destroying the tissue within a vein; effective in treating varicose veins and is minimally invasive.
Radiofrequency ablation
Employs lasers and heart to treat varicose veins.
Cryoablation
Employs cold to treat varicose veins.
Sclerotherapy
Employs chemicals to treat varicose veins.
Myxoma
Rare, but the most common primary tumor of the heart that’s composed of mucous and connective tissue. Tends to be benign and most commonly arises in the left atrium. Sx include impeded mitral valve function, decrease in exercise tolerance, dyspnea, pulmonary edema, arthralgia, malaise, and anemia. Tx includes surgical excision.
Aneurysm
Localized abnormal dilation of a vessel, usually an artery.
Fusiform aneurysm
Dilation of the entire circumference of an artery.
Saccular aneurysm
Dilation of 1 side of the srtery.
Dissecting aneurysm
Tear in the inner layer of the artery causes a bubble to form between the layers that fills with blood and expands with each heartbeat.
Angina
Chest pain caused by obstruction or spasms of the coronary arteries that decrease flow to the myocardium; also called angina pectoris.
Arrhythmia
Irregularity in the rate or rhythm of the heart; also called dysrhythmia.
Bradycardia
Abnormally slow heart rate
Fibrillation
Abnormally rapid, uncoordinated quivering of the myocardium that can affect the atria or ventricles.
Heart block
Interference with the normal transmission of electrical impulses from the SA node to the Purkinje fibers.
Tachycardia
Abnormally fast, but regular heart rhythm, possibly up to 200 bpm. Patients with this may experience palpitations.
Bruit
Soft blowing sound heard on auscultation and associated with vascular action, the movement of blood as it passes obstruction, or both; also called a murmur.
Cardiomyopathy
Disease or weakening of the heart muscle that diminishes cardiac function. Causes include viral/bacterial infections, metabolic disorders, and general systemic disease.
Coarctation
Narrowing of a vessel, especially the aorta.
Embolism
Intravascular mass that dislodges from one part of the body and causes obstruction in another area, commonly leading to life-threatening conditions.
Pulmonary embolism
Deadliest form of embolism that blocks blood flow to the lungs. When treated, mortality rate drops considerably.
Heart failure (HF)
Disorder that occurs when the heart is unable to effectively pump the quantity of blood required by the body. Common causes include CAD, HTN, DM, and obesity.
Congestive Heart Failure (CHF)
When blood returning to the heart backs up and causes congestion in the lungs, liver, abdomen, and LEs.
Hyperlipidemia (HLD)
Excessive amounts of lipids (cholesterol, phospholipids, and triglycerides) in the blood. Associated with increased risk of atherosclerosis.
Hypertension (HTN)
Elevated BP persistently higher than 140/90 mm Hg.
Normal: < 120/80 mm Hg
Pre-HTN: 120-139/80-89 mm Hg
HTN stage 1: 140-159/90-99 mm Hg
HTN stage 2: >160/100 mm Hg
Hypotension
Low BP persistently lower than 90/60 mm Hg.
Mitral Valve Prolapse (MVP)
Structural defect in which the mitral (bicuspid) valve leaflets prolapse into the left atrium during ventricular contraction (systole), resulting in an incomplete closure and backflow of blood. Signs and sx include a characteristic murmur upon auscultation and palpitations of the heart.
Palpitation
Sensation of an irregular heartbeat, commonly described as pounding, racing, skipping a beat, or flutter.
Peripheral Artery Disease (PAD)
Common circulatory disorder characterized by reduced flow of blood to the extremities, especially the legs, resulting in muscle cramping and pain, and is commonly the result of atherosclerosis. May trigger an MI or CVA.
Phlebitis
Inflammation of a deep or superficial vein of the arms or legs (more commonly the legs).
Thrombophlebitis
More serious condition caused by thrombus formation in the veins.
Rheumatic Heart Disease (RHD)
Serious pathological condition caused by rheumatic fever, commonly causing permanent scarring of the heart valves, especially the mitral valve.
Thrombosis
Abnormal condition in which a blood clot develops in a vessel and obstructs it at the site of its formation.
Deep vein thrombosis (DVT)
Blood clot that forms in the deep veins of the body, especially those in the legs or thighs; also called deep venous thrombosis. May break away and travel through the body.
Electrocardiography (ECG, EKG)
Procedure that graphically records the spread of electrical excitation to different parts of the heart using small metal electrodes applied to the chest, arms, and legs. Helps diagnose abnormal heart rhythms and myocardial damage.
Holter Monitor Test
Uses a small, portable system to record and store the electrical activity of the heart over a 24-48 hr period; also called an event monitor test. Useful in diagnosing cardiac arrhythmias that would be missed in an ECG of only a few minutes’ duration.
Stress test
ECG taken under controlled exercise stress conditions (bicycle or treadmill. May show abnormal ECG tracings that don’t appear on an ECG taken when the patient is resting.
Cardiac biomarkers
Blood test that measures the amount of several substances released by the heart when it’s damaged or under stress; also called cardiac enzyme test. Helps diagnose and differentiate various cardiac conditions.
Lipid panel
Series of blood tests (total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglycerides) used to assess risk factors of ischemic heart disease.
Angiography
Procedure that records a radiographic image of the inside of a blood vessel after injection of a contrast medium.
Arteriography: angiography of an artery.
Venography: angiography of a vein.
Aortography
Angiography of the aorta and its branches after injection of a contrast medium. Helps diagnose aortic insufficiency.
Coronary angiography
Specialized type of angiography that helps diagnose stenosis or obstruction of arteries that supply blood to the myocardium.
Doppler US
Ultrasonography used to assess the direction and speed of blood flow through blood vessels by reflecting sound waves off of RBCs; also called ultrasonography using sound pitch.
Carotid artery US
US procedure that determines blood flow problems caused by clots, plaque, or tears on the walls of the carotid arteries.
Echocardiography (ECHO)
US test that produces images of blood passing through the heart, valves, and chambers and assesses cardiac output. A transducer is placed on the chest to direct ultra high-frequency sound waves toward cardiac structures.
Myocardial Perfusion Imaging (MPI)
Noninvasive imaging test using a radioactive tracer in conjunction with a stress test to show how well blood flows (perfuses) through the heart muscle at rest and during exercise; also called a nuclear stress test.
Single-Photon Emission Computed Tomography (SPECT)
Myocardial perfusion test that involves injection of a radioactive tracer into the blood while a gamma camera moves in a circle around the patient to create individual images shown as “slices” of the heart (tomography). Shows how well blood flows through the heart and how efficiently the heart is pumping with the patient at rest or during exercise.
Cardiac Magnetic Resonance Imaging (MRI)
Specialized MRI procedure that shows images of the heart chambers, valves, major vessels, and pericardium. Helps evaluate the effects of CAD, plan tx strategies, and monitor progression of disorders over time.
Magnetic Resonance Angiography (MRA)
Type of MRI that provides a highly detailed image of blood vessels. Unlike angiography, MRA detects blood flow, the condition of the blood vessel walls, and blockages without using a contrast medium.
Multiple-Gated Acquisition scan (MUGA scan)
Nuclear procedure that uses radioactive tracer s to detect how effectively the heart walls move as they contract and calculates the ejection fraction rate (EFR) (amount of blood the ventricles can pump out in 1 contraction). EFR is the most accurate prediction of overall heart function. The gamma camera is coordinated (gated) with the patient’s ECG.
Cardiac catheterization (CC)
Passage of a catheter into the heart through a vein or artery to provide a comprehensive evaluation of the heart. Gathers info about the heart, including blood supply through the coronary arteries and blood flow and pressure through the heart’s chambers, and enables blood sample collection and x-rays of the heart.
Electrophysiology Study (EPS)
Special catheterization test that involves insertion of electrode catheters into the heart to study and map the conduction system and safely reproduce the abnormal heart rhythm affecting the patient’s heart. This info helps determine the best medication, treatment, or device to correct the abnormal heart rhythm.
Angioplasty
Endovascular procedure that reopens narrowed blood vessels to restore forward blood flow. Most commonly performed on coronary, carotid, renal, or peripheral arteries occluded by atherosclerosis.
Percutaneous Transluminal Coronary Angioplasty (PTCA)
Angioplasty of the coronary arteries that involves insertion of balloon catheter through the right femoral artery to the site of stenosis to enlarge the lumen of the artery and restore blood flow. Commonly performed in conjunction with stent placement.
Cardiac Ablation
Procedure in which a catheter is inserted through a vein in the groin and threaded to the heart to correct structural problems causing arrhythmia. Employs a radiofrequency (heat) laser, or cryoenergy (cold) to cause scarring of abnormal areas, thus correcting arrhythmias of the heart.
Coronary Artery Bypass Graft (CABG)
Placement of a vessel graft from another part of the body to bypass the blocked area of the coronary artery and restore blood supply to the heart muscle. 2 most common vessels used for CABG are internal mammary arteries and saphenous veins of the leg.
Implantable Cardioverter-Defibrillator (ICD)
Small, battery-powered device inserted within the chest of a patient who’s at high risk for developing an arrhythmia, such as ventricular tachycardia, ventricular fibrillation, or cardiac arrest; also called Automatic Implantable Cardioverter-Defibrillator (AICD). It monitors and restores the heart to normal heart rhythm by delivering an electrical shock to the heart.
Open Heart Surgery
Surgical procedure in which the sternum is cut in half vertically to open the chest and expose the heart, its valves, or the arteries. During the operation a heart-lung machine takes over circulation and O2 exchange to allow surgery on the resting heart. Types include CABG, valve replacement, and heart transplant.
Pacemaker insertion
Implantation of a battery-powered device inside the chest to control heart rate and rhythm. The pacemaker uses a wire positioned in the heart to coordinate the heartbeat with an electrical pulse.
Defibrillation
Lifesaving procedure to restart the heart during cardiorespiratory arrest by delivering a high-voltage electrical current through the heart. An automated External Defibrillator (AED) analyzes heart rhythm and delivers a shock to stimulate the heart in cardiac arrest.
Cardioversion
Defibrillation technique using low-energy shocks to reset the heart’s rhythm back to its normal pattern. Helps treat arrhythmias that arrhythmic drugs can’t treat. Not typically performed in an emergency procedure, but is normally a scheduled outpatient procedure.
Angiotensin-Converting Enzyme (ACE) inhibitors
Lower BP by inhibiting the conversion of angiotensin I (an inactive enzyme) to angiotensin II (an active vasoconstrictor). These can treat HTN and aid in the management of HF.
Benazepril; Lotensin
Lisinopril; Prinivil, Zestril
Angiotensin II Receptor Blockers (ARBs)
Lower BP by blocking the angiotensin II enzyme from causing vasoconstriction.
Losartan; Cozaar
Valsartan; Diovan
Antiarrhythmatics
Prevent, alleviate, or correct cardiac arrhythmias (dysrhythmias) by stabilizing the electrical conduction of the heart.
Amiodarone; Cordarone
Digoxin; Lanoxin
Anticoagulants
Inhibit the body’s natural coagulation response to prevent the formation of clots in blood vessels.
Warfarin; Coumadin
Dabigatran; Pradaxa
Beta blockers
Block the affect of adrenaline, which slows nerve impulses through the heart, causing a decrease in heart rate. Prescribed for HTN, angina, and arrhythmias.
Calcium channel blockers
Block movement of Calcium (required for blood vessel contraction) into myocardial cells and arterial walls, causing heart rate and BP to decrease.
Amlodipine; Norvasc
Diltiazem; Cordizem CD
Diuretics
Act on kidneys to increase excretion of water and sodium. Reduces fluid build up in the body and helps treat pulmonary edema and HTN.
Furosemide; Lasix
Hydrochlorothiazide; Hydrodiuril
Nitrates
Dilate blood vessels of the heart, causing and increase in the amount of O2 delivered to the myocardium, and widen blood vessels in the body, allowing more blood flow into the heart.
Nitroglycerin; Nitrolingual, Nitrogard, Nitrostat
Isosorbide; mononitrate, Imdur
Statins
Lower cholesterol in the blood and reduce its production in the liver by blocking the enzyme that produces it.
Atorvastatin; Lipitor
Simvastatin; Zocor
Simva/Ezetimb; Vytorin
AAA
Abdominal aortic aneurysm
ACE
Angiotensin-Converting Enzyme (inhibitors)
AED
Automated External Defibrillator
AICD
Automatic Implantable Cardioverter-Defibrillator
ARB
Angiotensin Receptor Blocker
AV
atrioventricular; arteriovenous
BP, B/P
blood pressure
CA
cancer; cardiac arrest; chronological age
CABG
coronary artery bypass graft
CAD
coronary artery disease
CC
cardiac catheterization
CHF
congestive heart failure
CK
creatine kinase (cardiac enzyme); conductive keratoplasty
CO2
carbon dioxide
CV
cardiovascular
DVT
deep vein thrombosis; deep venous thrombosis
ECG; EKG
electrocardiogram, electrocardiography
ECHO
echocardiogram, echocardiography; echoencephalogram, echoencephalography
EPS
Electrophysiology Study
HTN
hypertension
ICD
implantable cardioverter-defibrillator
LA
left atrium
LV
left ventricle
MI
myocardial infarction
MPI
myocardial perfusion imaging
MRA
magnetic resonance angiography; magnetic resonance angiogram.
MRI
magnetic resonance imaging
MUGA scan
multiple-gated acquisition scan
MVP
mitral valve proplapse
O2
oxygen
PAD
peripheral artery disease
PTCA
percutaneous transluminal coronary angioplasty
RA
right atrium
RHD
Rheumatic Heart Disease
RV
residual volume; right ventricle
SA, S-A
sinoatrial
HF
heart failure
Hg
mercury
SPECT
single-photon emission computed tomography
US
ultrasound; ultrasonography
