CPR 05-06 - Cardiovascular System 1-2 Flashcards
1
Q
List the 3 layers of the heart and their alternate names.
A
2
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3
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A
4
Q
Facts to know about the epicardium.
A
- An extension of the visceral layer of the serous pericardium
- Consists of a single layer of mesothelial cells underlying connective and adipose tissue
- Contains the blood vessels and nerves that supply the heart
5
Q
What are the major components of the intercalated discs?
A
Transverse component - macula adherens (desmosomes) and fascia adherens
Lateral component - macula adherens (desmosomes) and gap junctions
6
Q
What are the arrows pointing to?
A
Atrial natriuretic factor in the perikaryal region. They are electron dense vesicles
7
Q
What does the endocardium consist of?
A
- An inner layer of endothelium and subendothelial connective tissue
- A subendocardial layer which contains the conducting system of the heart (purkinje fibers)
8
Q
What are some key characteristics of purkinje fibers on a light micrograph?
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Large pale cells with large round nuclei. They are pale due to their high content of glycogen and fewer myofibrils.
9
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A
10
Q
What is the skeleton of the heart?
A
The cardiac skeleton, also known as the fibrous skeleton of the heart, is a high density single structure of connective tissue that forms and anchors the valves and influences the forces exerted through them.
11
Q
What are the 3 main components of a heart valve? Describe their composition and location within the heart valve.
A
Spongiosa - atrial side of the valve. Consists of loose connective tissue, collagen fibers, and elastic fibers. Acts as a shock absorber
Fibrosa - middle layer (core) of the valve that is an extension of the fibrous skeleton of the heart
Ventricularis - ventricle side of the valve. Consists of dense connective tissue and many layers of elastic fibers
12
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13
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A
14
Q
What does the tunica intima of most blood vessel consist of?
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15
Q
What does the tunica media of most blood vessels consist of?
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16
Q
What does the tunica adventitia of most blood vessels consist of?
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17
Q
How are BV endothelial cells arranged and what junctional complexes hold them together? What do these cells express on their lumenal side?
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18
Q
What is enothelial activation?
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19
Q
List the many functions BV endothelial cells perform.
A
- Permeability barrier to control composition of interstitium
- Respond to vascular endothelium growth factor (VEGF) to provide for angiogenesis
- Provide signals that control blood pressure by vasconstriction (endothelin, ACE) and vasodilation (NO)
- Produce anticoagulant (thrombomodulin), antithrombogenic (prostacyclin), and prothrombogenic (vWF) signals
20
Q
What are the arrows pointing to? What does this substance do and in what tissues is it found?
A
In BV endothelial cells
21
Q
Why are elastic arteries called “elastic arteries?” What are the common examples of elastic arteries?
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22
Q
Discuss the arrangement of the elastic fibers in elastic arteries.
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23
Q
What is the structural significance of elastic arteries?
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24
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25
Describe the components of the T. Intima, T. Media, T. Adventitia of elastic arteries
26
Label the image and say what tissue it is.
Elastic Artery
27
What is the most abundant type of artery in the body?
Muscular arteries
28
Why are muscular arteries called "muscular arteries?" What is another name for these arteries?
Called "muscular" because they contain more smooth muscle than elastic arteries.
AKA - distributing arteries/named arteries
29
What are the most common examples of muscular arteries?
30
What physical characteristics distinguish a muscular artery from an elastic artery?
Muscular arteries have a scalloped tunica intima and an external elastic lamina.
31
What occurs to muscular arteries as they travel away from the heart?
32
What is the purpose of muscular arteries?
33
34
What is the Vasa Vasorum?
The vasa vasorum is a network of small blood vessels that supply the walls of large blood vessels.
35
Describe the composition of the T. Intima, T. Media, and T. Adventitia of muscular arteries.
36
Label this image and say what tissue it is.
Muscular artery
37
What is this an image of?
Small artery
38
Describe the composition of the T. Intima, T. Media, and T. Adventitia of a small artery
39
Label image and say what tissue it is.
Small Artery
40
What blood vessel is the major determinant of BP and why?
41
What are these images of?
Arterioles
42
Describe the T. Intima, T. Media, and T. Adventitia of arterioles
43
What are the primary physiological functions of arterioles?
Their diameter can be decreased or increased to modulate the resistance to blood flow and, therefore, modulate blood pressure.
They also possess precapillary sphincters that can increase or decrease the capillary blood flow to specific areas of the body (ie - increase blood flow to GI after a meal or to skeletal muscle during exercise).
44
45
What is the luminal diameter of a capillary?
7-9 microns
46
What are rouget cells?
AKA - pericytes
Contractile cells that wrap around the endothelial cells that line _some_ capillaries and venules throughout the body. They are embedded in basement membrane where they communicate with endothelial cells of the body's smallest blood vessels by means of both direct physical contact and paracrine signaling.
47
What are the three types of capillaries and their alternate names?
1. Continuous/Somatic
2. Fenestrated/Visceral
3. Discontinuous/Sinusoidal
48
Describe the structure and composition of continuous capillaries. Describe their physiological significance.
49
What tissues typically contain somatic capillaries?
50
Label this image and say what type of tissue it is
51
Describe the structure and composition of a fenestrated capillary. Describe their physiological significance.
52
What tissues typically contain visceral capillaries?
53
Label the image. Mention what the arrows are pointing to and say what type of tissue this is.
Arrows are pointing to the fenestrations of the fenestrated capillaries
54
Describe what a capillary fenestration is and what it is not.
A fenestration is a pore in the membrane of an endothelial cell of a visceral capillary. It is not a hole in the basal lamina. The basal lamina is still present at a fenestration.
55
Describe the structure and composition of a discontinuous capillary. What are their physiological significance?
56
What tissues typically contain sinusoidal capillaries?
57
What type of tissue is this and what are the arrows pointing to?
The is liver tissue and the arrows are pointing to discontinuous/sinusoidal capillaries.
58
Describe structure, composition, and general function of a postcapillary venule.
59
On which blood vessel do most vasoactive agents act?
Venules
60
What are high enothelial venules (HEVs). Discuss their structure and function.
They are postcapillary venules in the lymphatic system. They consist of prominent (high) cuboidal endothelial cells with ovoid nuclei. These cells are held together by "looser than usual" junctional complexes, including zonula occludens (tight junctions). These loose complexes are what convey HEVs with their primary purpose of facilitating the entry of immune cells from the lumen into the connective tissue.
61
What is this an image of and what are the arrows pointing to?
That is a high endothelial venule and the arrows are pointing to the high endothelial cells.
62
When will immune cells migrate through a HEV into connective tissue?
63
Discuss the location and basic strucural composition of muscular venules.
64
65
Label this image and say what type of tissue it is
Medium Vein
66
Describe the composition of the T. Intima, T. Media, and T. Adventitia of medium veins.
67
What is usually considered the defining characteristic of a medium sized vein? Describe this characteristic.
68
69
Label this image and say what type of tissue it is.
Large (muscular) vein
70
Describe the composition of the T. Intima, T. Media, and T. Adventitia of large muscular veins.
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72
Facts to know about lymphatic vessels
* Start off as just blind ended lymph capillaries
* Bundles of filament anchor the vessels to the connective tissue
* No clear cut separation into tunics
* No tight junctions
* Not presen in nervous tissue, bone marrow, and cartilages
73
What is the cardiovascular disease triad?
The three major clinical manifestations of cardiovascular disease: coronary heart disease, cerebrovascular disease, peripheral vascular disease.
74
What are the major symptoms of coronary heart disease?
Angina
Heart Attach
Heart Failure
Sudden Death
75
What are the major symptoms of cerebrovascular disease?
Stroke
Transient Ischemic Attack (temporary blockage of blood flow to an area of the brain)
Dementia
76
What are the major symptoms of peripheral vascular disease?
Gangrene
Intermittent Claudication (lower leg pain/cramping)
77
How does hypertension affect the small blood vessels?
78
What are the characteristic changes that hypertension causes in muscular arteries? What can these changes lead to?
79
Label this image and say what tissue it is?
This is a muscular artery that has undergone hypertensive changes
80
What is atherosclerosis?
A disease in which the inside of an artery narrows due to the build up of plaque. It is characterized by lesions of the T. Intima called _atheroma_ or _fibro fatty plaques_ that protrude into and obstruct the vascular lumen, also weakening the T. media.
81
What is arteriosclerosis?
Hardenining of the arteries with old age
82
What are the common symptoms and risk factors associated with heart disease?
_Symptoms:_ chest pains, shortness of breath, back pain, pain radiating to the jaw
_Risk Factors:_ smoking, hypertension, diabetes mellitus, hypercholesterolemia, lack of exercise, unhealth diet, stress, type A personality
83
Describe the histopathogenesis of artherosclerotic plaque formation.
84
Label this image and say what type of tissue it is.
This is an arthersclerotic blood vessel
85
What is this an image of?
The myocardium of a person with artherosclerosis
86
What is percutaneous coronary intervention (PCI)?
A non-surgical procedure used to treat stenosis (narrowing) of the coronary arteries of the heart found in coronary artery disease (ie - balloon angioplasty)
87
Facts to remeber about Marfan's Syndrome for the CPR exam.
88
What is an aortic dissection? What predisposes a person to an aortic dissection? What region of the aorta does it most commonly affect?
A condition in which the T. Intima of the aorta is lacerated leading to blood entering into the T. Media. The laceration typically extends to somewhere between the middle and outer third of the T. Media. Frequently, the hematoma eventually bursts through the T. Adventitia.
Most frequently affects the thoracic aorta with the vast majority of cases associated with hypertension and a smaller number with connective tissue disorders (ie- marfan's)
89
What is the major cause of peripheral artery disease? How is it typically diagnosed? What are the associated risk factors and sequelae? What are the symptoms?
