CV system Flashcards
1
Q
CV system function
A
supply cells/tissues with oxygen/nutrients and to remove wastes (CO2, urea)
2
Q
CV system structures
A
heart
blood vessels
*blood is a connective tissue, not part of this system
3
Q
cardiology
A
study of the heart and the diseases associated with it
4
Q
heart
A
location: within mediastinum
size: closed fist, 300g
5
Q
base of heart
A
wide superior portion
6
Q
apex of heart
A
inferior point
7
Q
heart coverings
A
serous (visceral & parietal) pericardium
fibrous pericardium
8
Q
visceral pericardium
A
innermost delicate epithelium
9
Q
parietal pericardium
A
inner lining of fibrous pericardium
10
Q
pericardial cavity
A
between visceral and parietal pericardium and is filled with serous fluid
11
Q
fibrous pericardium
A
outermost tough, fibrous protective CT layer the prevents over-stretching of the heart
12
Q
heart wall
A
epicardium
myocardium
endocardium
13
Q
epicardium
A
visceral pericardium
14
Q
myocardium
A
cardiac muscle tissue, bulk of heart
15
Q
endocardium
A
smooth inner lining of heart chambers and valves
simple squamous epithelium called endothelium
16
Q
heart chambers
A
atria
ventricles
17
Q
atria
A
upper chambers
receive blood from veins (PASSIVE)
thin walled
flaps called auricles
18
Q
interatrial septum
A
not complete during fetal development
fossa ovalis is remnant of fetal foramen ovale
19
Q
ventricles
A
pump blood from the heart into arteries (ACTIVE)
thick walled
trabecular carneae
20
Q
trabecular carneae
A
irregular inner surface (ridges and folds)
21
Q
arteries
A
carry blood away from the heart
high in O2, low in CO2 EXCEPT pulmonary arteries
22
Q
aorta
A
blood from left ventricle to body
23
Q
pulmonary arteries
A
blood from right ventricle to lungs via pulmonary trunk
24
Q
coronary arteries
A
cary blood to myocardium
richest blood supply
25
veins
carry blood toward the heart
| low in 02, high in CO2 EXCEPT the pulmonary veins
26
superior vena cava
blood from the head and upper limbs
27
inferior vena cava
blood from the trunk and lower limbs
28
coronary sinus
blood from myocardium
drains all coronary veins
posterior side of heart
29
pulmonary veins
blood from lungs to left atrium
| 2 from each side
30
ligamentum arteriosum
remnant of fetal ductus arteriosus
80% of blood goes from R->L atrium
20% of blood goes to R ventricle->pulmonary trunk-> ductus arteriosus->aortic arch
31
heart valves
atrioventricular (AV) valves
| semilunar (SL) valves
32
atrioventricular valves
tricuspid (R AV)
| bicuspid (L AV)
33
tricuspid valve
lies between right atrium and right ventricle
34
bicuspid valve
aka mitral valve
| lies between the left atrium and left ventricle
35
chordae tendineae
tendon-like fibrous cords that connect the cusps of AV valves to the papillary muscle
prevent cusps from swinging back into atria
hold valves shut during contraction
36
papillary muscle
muscular columns that are located on inner surface of the ventricles
37
semilunar valves
```
pulmonary SL (R SL)
aortic SL (L SL)
```
38
pulmonary SL valve
lies within pulmonary trunk
39
aortic SL valve
lies within aorta
40
pulmonary blood flow
```
right atrium (deoxygenated)
tricuspid valve
right ventricle
pulmonary SL valve
pulmonary trunk
pulmonary arteries
capillaries
pulmonary veins
left atrium
bicuspid valve
left ventricle
aortic semilunar valve
ascending aorta
```
41
coronary blood flow
```
ascending aorta
coronary arteries
left & right coronary arteries
capillaries in myocardium
cardiac veins
coronary sinus
right atrium
```
42
left coronary artery
```
circumflex branch (backside)
anterior interventricular (descending) branch (aka widow maker)
```
43
right coronary artery
```
right marginal branch
posterior interventricular (descending) branch
```
44
anastomoses
connections between 2 ore more branches of arteries that supply the same region with blood
provide alternate routs for blood to reach a particular region
45
cardiac veins
great cardiac vein (alongside widow maker)
| middle cardiac vein (alongside posterior IV branch)
46
common causes of heart problems
blood clots
fatty atherosclerotic plaques
smooth muscle spasms w/in coronary vessels
47
ischemia
reduction of blood flow in the presence of normal oxygen
48
hypoxemia
reduction of oxygen with normal blood flow
49
hypoxia
reduction of oxygen and blood flow
50
angina pectoris
severe pain accompanied by myocardial ischemia
crushing pain radiating down left arm
labored breathing, weakness, dizziness, perspiration
during exertion, fades with rest
relieved by vasodilators (nitroglycerin)
51
stable angina
pain on exertion relieved with rest
52
unstable angina
pain on exertion, no relief with rest
| usually due to atherosclerosis
53
Prinzmetal angina
associated with vasospasm
| idiopathic
54
myocardial infarction
pathological term
ischemic necrosis due to lack of oxygen
caused by thrombus or embolus in coronary artery
may result in sudden death if conduction system interrupted and ventricular fibrillation occurs
55
heart attack
clinical term
56
MI tests
ECG (EKG): wider QRS, arrhythmias
troponin levels elevated w/in 30 minutes, normal within 5-7 days
CKMB - creatinine kinase, cardiac; elevated 1-2h after, normal w/in 2-3 days
neutrophilic response within 4-7 days; could result in cardiac tampanade
57
MI treatments
clot dissolving agents (TPA, streptokinase)
heparin
angioplasty
58
reperfusion damage
when oxygen deprived tissue's blood supply is reestablished
formation of free radicals
damage to enzymes, neurotransmitters, nucleic acids, phospholipids
59
reperfusion damage implications
```
heart disease
parkinson's
alzheimer's
cataracts
rheumatoid arthritis
aging
```
60
antioxidants
defend body against free radicals
| include enzyme catalase, vitamin A, C, E
61
cardiac conduction system
sinoatrial (SA) node
atrioventricular (AV) node
atrioventricular (AV) bundle (right and left branches)
purkinje fibers
62
SA node
located in right uppermost atrial wall
aka pacemaker; initiates cardiac impulses (60-100bpm)
travels through atrial fibers via gap junctions in intercalated discs to AV node
63
AV node
located in interatrial septum
delay signal that allows for ventricular filling
impulse travels to AV bundles
64
AV bundles
aka bundle of His
only electrical connection between atria and ventricles
located in superior interventricular septum
enters both right & left branches downward toward apex and purkinje fibers
65
perkinje fibers
aka conduction myofibers
large diameter
located within papillary muscles of ventricles
conduct impulse into mass of ventricular muscle tissue
cause ventricles to contract
66
electrocardiogram (ECG/EKG)
recording of the electrical changes that occur in the myocardium during the cardiac cycle
67
EKG uses
evaluate conduction pathways
heart enlargement
heart regions damaged
68
rules to remember (EKG)
depolarization precedes contraction
| repolarization precedes relaxation
69
heartbeat waves
P wave
QRS complex
T wave
70
P wave
small upward wave
represents atrial depolarization (movement of electrical impulse through atria)
0.1s after P wave begins, atria contract
71
QRS complex
begins as downward deflection, continues as large, upright, triangular wave, ends as downward wave
represents onset of ventricular depolarization
shortly after QRS begins, ventricles start to contract
72
T wave
dome-shaped, upward deflection
represents ventricular repolarization
just before ventricles relax
shape indicates slow process
73
enlarged P wave
enlargement of atrium possibly due to mitral stenosis
74
enlarged Q wave
MI
75
enlarged R wave
ventricular hypertrophy
76
cardiac cycle
atria and ventricles contract alternately
blood flows from areas of high pressure to low pressure
complete cycle includes systole and diastole of atria and ventricles
77
systole
phase of contraction
78
diastole
phase of relaxation
79
blood pressure
systolic/diastolic
80
pulse pressure
systolic - diastolic
81
cardiac muscle contraction
1. rapid depolarization due to opening of Na+ channels
2. plateau due to opening of Ca++ channels
3. repolarization due to opening K+ channels
4. refractory period; longer than contraction
82
relaxation (quiescent) period
early ventricular diastole (0.4s)
1. follows t-wave
2. ventricular pressure drops
3. SL valves close
4. brief isovolumetric relaxation
5. when ventricular pressure drops below atrial, AV valves open
83
ventricular filling
mid-late ventricular diastole (0.1s)
1. rapid ventricular filling after AV valves open
2. SA node fires (P wave), atria contract filling ventricles
3. atria relax, ventricles depolarize (QRS)
84
ventricular systole
1. impulse passes through AV node to ventricles
2. ventricles contract
3. ventricular pressure increases rapidly
4. AV valves close (lubb)
5. lasts 0.3s
85
isovolumetric contraction phase
start of contraction to SL valve opening = 0.05s
86
ventricular ejection phase
opening of SL valves to closing SL valves
87
phase: ventricular contraction (systole)
blood flow: ventricles into arteries
valves: SL open, AV closed
pressure: V high
88
phase: atrial relaxation (diastole)
blood flow: atria fill
valves: SL open, AV closed
pressure: A low, but rises
89
phase: ventricular relaxation (diastole)
blood flow: ventricles fill
valves: AV open, SL closed
pressure: V low, but rises
90
phase:
blood flow: atria to ventricles
valves: AV open, SL closed
pressure: A high
91
lubb
S1: closing of AV valves (ventricular systole); loud and long
mitral stenosis: diastolic
92
dupp
S2: closing of SL valves (ventricular diastole); short and sharp
aortic stenosis: systolic
93
murmur
incomplete closing of valve cusps
94
cardiac output (CO)
volume of blood pumped by each ventricle in one minute; average is 5L; HR x SV
95
stroke volume (SV)
volume of blood pumped out by a ventricle with each beat (EDV - ESV); average is 50-70mL
96
end diastolic volume (EDV)
average is 120-150mL
97
end systolic volume (ESV)
average is 50-60mL
98
blood pressure (BP)
the pressure exerted by blood on the wall of arterioles
mean (systemic) arterial blood pressure (MABP)
Maximum during systole, minimum during diastole
normal range is 120/80
CO x TPR
99
total pressure resistance (TPR)
pressure within arterioles
100
CV regulation: autonomic nervous system
located in medulla of brainstem
parasympathetic (normal) decreases (CN X, vagus)
sympathetic (stress) increases (white rami communicates)
101
CV regulation: chemicals
hormones (epinephrine increases rate and force)
ions (calcium increases, potassium, sodium decreases)
atrial natriuretic peptide (ANP)
102
CV regulation
```
decreases with age
females higher, males lower
temperature (heat increases)
emotion
disease
```
103
chronotropic
rate of contraction
104
inotropic
force of contraction
105
baroreceptors
aortic/carotid sinuses
increase in BP, vasodilation, decrease heart rate
decrease in BP, vasoconstriction, increase heart rate
106
chemoreceptors
aortic/carotid bodies
| detects changes in pH, temperature, ions, and hormones
107
artery
1. strong, thick-walled
2. carry blood under great pressure
3. carry blood that is high in oxygen, low in CO2 (except pulmonary)
4. branch into arterioles
5. may unite with branches of other arteries supplying the same region forming anastomosis
108
hemodynamics
study of the forces in blood movement
109
arteriole
1. small artery
2. carry blood to capillaries
3. regulates blood pressure
110
vasoconstriction
decreased blood flow, increased blood pressure
111
vasodilation
increased blood flow; decreased blood pressure
112
capillary
1. smallest, thinnest blood vessels
2. permit exchange of gases, nutrients, and wastes between blood and tissues
3. endothelium, basement membrane, no tunica media
113
types of capillaries
continuous
fenestrated
sinusoids
114
continuous capillary
plasma membranes form continuous ring around lumen
| found in skeletal/smooth muscle, CTs, lungs
115
fenestrated capillary
endothelial plasma membrane contain pores
| found in glomeruli of kidneys, villi of small intestine
116
sinusoids
contain spaces between the endothelial cells with basement membranes being incomplete or absent
found in liver, spleen
117
capillary exchange
simple passive diffusion
vesicular transport
bulk flow
118
simple passive diffusion
1. most common
2. substances include oxygen, CO2, glucose, hormones
3. lipid soluble pass directly through endothelial cell membrane
4. water soluble pass through fenestrations between endothelial cells
119
vesicular transport
formation of a vesicle to move in/out of cell, fuses with cell membrane
120
bulk flow
filtration, absorption
121
vein
1. carry blood toward heart
2. thin walled
3. carry blood under low pressure
4. contain valves to preven regurgitation
5. carry blood high in CO2 (except pulmonary)
122
venule
carry blood from veins to capillaries
123
blood distribution
```
60-70% in veins/venules
10-12% in arteries/arterioles
10-12% in pulmonary vessels
8-10% in heart
4-5% in capillaries
```
124
BP factors
1. cardiac output
2. blood volume
3. peripheral resistance
125
peripheral resistance
opposition to blood flow primarily due to friction
1. blood viscosity
2. vessel length
3. vessel radius
126
neuro regulation of CV system
1. medulla
2. three centers: higher brain centers, baroreceptors, chemoreceptors
3. from CV center to SA node; vasomotor center to smooth muscle of peripheral vessels
127
negative feedback high BP
1. BP increase detected by baroreceptors in carotid or aorta
2. Impulse sent to CV & vasomotor centers
3. CV center sends impulse to SA node to decrease HR, lowering CO/BP
4. vasomotor center sends an impulse the arterioles causing vasodilation, lowering BP
128
hormones that increase BP
1, epinephrine, norepinephrine (increases CO, vasoconstriction)
2. antidiuretic hormone (increases reabsorption of H2O by collecting ducts in kidneys, vasoconstriction)
3. angiotensin II (vasoconstriction, secretion of aldosterone)
4. aldosterone (increases Na+, water reabsorption in DCT
129
hormones that decrease BP
1. atrial natriuretic peptide (vasodilation, loss of salt/water in urine)
2. histamine (vasodilation)
130
pulse
1. pressure wave that travels through arteries following ventricular systole
2. strongest in arteries closest to heart
3. commonly measured in radial artery
4. normal is 70-80bpm
131
tachycardia
pulse > 100bpm
132
bradycardia
pulse < 60bpm
133
sphygmomanometer
instrument used to measure BP; typically use brachial artery
134
pulmonary circuit
vessels that carry blood the right ventricle to the lungs, and vessels that return the blood to the left atrium
1. pulmonary trunk
2. R&L pulmonary arteries
3. capillaries in lungs
4. R&L pulmonary veins
135
top CV diseases
1. ischemic heart disease
2. hypertension
3. congenital septal defects
136
ischemic heart disease
primary cause is atherosclerosis within vessels restricting blood flow; coronary artery disease
137
congenital septal defects
acyanotic: ventricular/atrial septal defect
cyanotic: tetralogy of Fallow; transposition of great vessels
138
tetralogy of Fallow
dextraposed aorta -> pulmonary stenosis -> right ventricular hypertrophy -> blood leaks R->L ventricle
139
transposition of great vessels
pulmonary trunk & aorta switched; often accompanied by septal defects
140
circle of willis
sits around sella turcica; blood-brain barrier
left and right internal carotid (also from middle cerebral)
left and right anterior cerebral
anterior communicating
left and right posterior cerebral (from basilar
141
pulse deficit
difference between cardiac contractions vs. pulse; normal is below 10.
142
branches of the aorta
ascending aorta
aortic arch
descending aorta
143
branches of the ascending aorta
```
right coronary (myocardium)
left coronary (myocardium)
```
144
branches of the aortic arch
brachiocephalic (right arm/head)
left subclavian (left arm)
left common carotid (left head)
145
branches of the common carotid arteries
internal common carotid (brain)
| external common carotid (scalp)
146
branches of the subclavian arteries
axillary (armpit)
| vertebral (cervical vertebrae/skull)
147
vertebral arteries
anastomose into basilar artery
148
branches of axillary arteries
becomes brachial distally (upper arm)
radial (lateral forearm)
ulnar (medial forearm)
149
descending aorta
becomes thoracic within thoracic cavity
| becomes abdominal within abdominal cavity
150
branches of abdominal aorta
celiac trunk (liver, stomach, spleen)
superior mesenteric (sm intestine, cecum, ascending/transverse colon, pancreas)
inferior mesenteric (descending/sigmoid colon, rectum)
suprarenal & renal
gonadal
common iliac
151
common iliac arteries
becomes external iliac within pelvis (lower extremities)
becomes femoral in leg (thigh)
becomes popliteal in knee
152
branches of popliteal arteries
```
posterior tibial (lower leg)
anterior tibial (foot/toes)
```
153
superior vena cava
right & left brachiocephalic
154
branches of brachiocephalic veins
jugular (branches into internal and external)
| subclavian
155
branches of subclavian veins
cephalic
| axillary
156
branches of axillary veins
basilic
| brachial
157
median cubital vein
anastomose with basilic & cephalic veins
| common venipuncture site
158
coronary sinus
drains directly into right atrium
159
inferior vena cava
hepatic
renal & suprarenal
gonadal
common iliac
160
hepatic vein
becomes hepatic portal vein
| branches: gastric, mesenteric, splenic
161
common iliac vein
internal
| external
162
external iliac vein
```
femoral
great saphenous (longest vein, begins median ankle)
```
163
atrial natriuretic peptide
1. increased blood pressure/volume
2. stretched atrial walls
3. ANP released
4. stimulates water/Na+ release, inhibits aldosterone, surpasses thirst, dilates blood vessels
5. increased fluid loss, reduced fluid gain, reduced blood pressure
164
hydrostatic pressure (HP)
force generated by pressure on capillary wall
165
oncotic (colloid osmotic) pressure (OP)
force exerted by proteins (albumin) present in blood or interstitial fluid on capillary walls
166
HP > OP
fluid forced out of capillary (24L/day)
167
HP < OP
fluid reabsorbed into capillary (20.4L/day)
168
lymphatic capillaries
absorb remaining fluids (3.6L/day)
169
net filtration pressure
difference between hydrostatic and oncotic pressure
170
total capillary net filtration pressure
```
CH - capillary hydrostatic pressure
CO - capillary oncotic pressure
IH - interstitial hydrostatic pressure
IO - interstitial oncotic pressure
(CH + IO) - (CO + IH)
```
