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HUBS 192 > CVS and anatomy of heart > Flashcards

CVS and anatomy of heart Flashcards

1
Q

2 vascular system of the cardiovascular system

A

Blood vascular system

Lymphatic vascular system

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2
Q

Blood vascular system (2)

A

A closed supply and drainage system

A continuous loop - starting at the heart and out to the tissues for exchange and then back tot he heart

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3
Q

Lymphatic vascular system (2)

A

An open-entry drainage system (towards the blood vascular space)

A one-way system

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4
Q

What is the only supply path

A

arteries

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5
Q

Where are the major arteries situated and why

A

They are situated to avoid damage

eg. deep in the trunk, on flexor aspects of limbs

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6
Q

Important structures often receive supply from __ sources? And how many arteries does brain have?

A

2,4

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7
Q

What makes up the exchange network

A

Capillaries of varying degree of permeability

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8
Q

3 types of capillaries

A

Continuous - tight control over what enters and leaves (most common)

Fenestrated - leaky

Sinusoidal - very leaky

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9
Q

3 pathways for drainage

A

Deep veins (deep to fascia) - situated next to supply arteries carrying blood opposite to them

Superficial veins - can be quite large

Lymphatics - hard to see even in live tissues as there are no RBC (fluid comes out is clear)

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10
Q

Drainage channels/veins vs. supply network/arteries (pressure, velocity, CSA)

A

Drainage channels are carrying blood at low pressure and low velocity whereas the supply network arteries carries blood at high pressure and high velocity

Cross sectional area of veins is at least twice that of arteries in order to shift the same volume of blood per second

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11
Q

Cardiovascular diseases cause at least ___% of deaths?

A

50

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12
Q

Orientation of heart in the thorax

A

In the mediastinum (middle region of thorax), behind the body of sternum between the points of attachment of the second through to the sixth ribs

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13
Q

Location of apex of heart

A

Lies on the diaphragm on the mid-clavicular line on the left in the space between the 5th intercostal space

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14
Q

PMI - Point of maximal impulse

A

Where the apex beat is observed

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15
Q

How is the apex affected by the rotation and tilt position of the heart

A

It’s pushed against the anterior wall on the left of the mid-clavicular line

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16
Q

__ of the heart sits to the left of the midline

__ of the heart sits to the right of the midline

A

2/3

1/3

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17
Q

left pleural cavity vs. right pleural cavity (volume/size)

A

The left pleural cavity has less volume than the right

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18
Q

Shape of the heart (3)

A

Blunt, cone shaped
pointed end - apex
Broad end - base

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19
Q

Why is the rotation and tilt of the heart important

A

Because it shifts the position of the 4 chambers of the heart in relation to surrounding structures

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20
Q 
After rotation and tilt:
Right atrium becomes \_\_\_\_
Right ventricle becomes \_\_\_
Left atrium becomes \_\_\_
Left ventricle becomes \_\_\_
A

right lateral margin
quite anterior
most posterior structure
left lateral margin

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21
Q

Septum

A

Extension of the heart that separates the chambers of the heart

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22
Q

2 types of septums

A

Interventricular septum

Interatrial septum

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23
Q

Role of ventricles

A

Receives blood from the atria and pump blood out of the heart to arteries

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24
Q

Ventricle myocardium vs. atrium myocardium

A

As more force is needed to pump blood, the myocardium of each ventricle is thicker than any of the myocardium of the atria

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25
Q

Left ventricle myocardium vs. right ventricle myocardium

A

Left > right
As the left pushes blood through most vessels of the body (systemic circuit) whereas the right side pushes only through the nearby pulmonary vessels that serves as gas exchange tissues of the lungs

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26
Q

systemic circuit + route

A

Is the circuit through the rest of the body to provide oxygenated blood and bringing deoxygenated blood back to the heart
Left ventricle pumps blood -> peripheral organs -> right atrium

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27
Q

Pulmonary circuit + route

A

The circuit to the lungs where the blood is oxygenated and then back to the heart again
Right ventricle -> lungs -> left atrium

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28
Q

Atrium

A

Thin walled (receiving) chambers - receives blood from veins

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29
Q

What does the right atrium receive

A

Deoxygenated blood from the periphery which drains into the right ventricle and pumps through the pulmonary circuit to oxygenate blood by passing through the pulmonary semilunar valve

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30
Q

Right atrium receives via (3)

A

Superior vena cava
Inferior vena cava
Coronary sinus

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31
Q

Superior vena cava

A

brings all the deoxygenated blood from head, neck, chest and upper libs which all drains through the large vein

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32
Q

Inferior vena cava

A

drains everything below the diaphragm

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33
Q

Coronary sinus (3)

A
  • Blood that has supplied the heart muscles itself returns and enters through the right atrium
  • Last part of venous drainage of the heart muscle
  • Space where all the veins from the heart muscle has accumulated which has brought the deoxygenated blood from the heart into the sinus space which in turn drains to the right atrium
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34
Q

Left atrium receives

A

Oxygenated blood from the lungs which drains into the left ventricle and pushed out to the aorta

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35
Q

Left atrium receives via

A

4 pulmonary veins

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36
Q

Layers of the heart wall (3)

A

Endocardium
Myocardium
Epicardium

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37
Q

What does the endocardium line

A

all the chambers of the heart including all the veins, arteries and valves

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38
Q

Boundary between the chamber and the wall - refers to what?

A

The endocardium

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39
Q

What is the endocardium made up of (4)

A

Squamous epithelium
Loose irregular fibrous connective tissue
(small) blood vessels
Purkinje fibres/cells

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40
Q

Squamous epithelium

A

Part of the endocardium
Single non-stick layer of flat/endothelium cells
Stops blood from coagulating inside the blood vessels against the blood wall

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41
Q

Myocardium (2)

A

Layer of the heart with muscle

Seen most in the heart wall

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42
Q

Epicardium

A

Continuous layer that covers the heart surface

Upon the myocardium

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43
Q

What is the epicardium surrounded by (2)

A

Loose irregular Fibrous connective tissue, adipose

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44
Q

Components of the epicardium

A

Visceral pericardium
Blood vessels (large)
Surrounded by loose irregular fibrous connective tissue and adipose

45
Q

Visceral serous pericardium (3)

A

Part of the epicardium

Thin layer, part of the membrane that sits over the heart that forms a visceral layer of the pericardium

Serous membrane

46
Q

Serous membrane

A

Membrane that forms a closed space

47
Q 
Blood vessels (large)
Coronary artery vs. coronary vein
A

What the epicardium is adherent to

Thicker wall + higher pressure = coronary artery
Thinner collapsed all + lower pressure = cardiac vein

48
Q

Pericardial space

A

Potential space where the heart sits

49
Q

Pericardium (3)

A

Protective outer covering
2 layers
Described as a serous membrane
The visceral serous pericardium part of it is fused to the epicardium

50
Q

Pericardial cavity

A

The space between the 2 layers of serous pericardium which is filled with serous fluid, produced by cells that form the serous membrane which protects the heart from any kind of external shock

51
Q

2 layers of the percardium

A

Fibrous pericardium

Serous pericardium

52
Q

Fibrous pericardium

A

Tough, loose fit, inelastic sac around the heart

53
Q

Serous pericardium - 2 layers

A

Inner layer = fuse and become visceral layer of the membrane

Outer layer that faces the air = parietal pericardium

54
Q

Visceral and parietal layer switching

A

The single serous layer changes from being visceral to the parietal layer at the base of the heart and anchors the base, whereas the apex of the heart runs free

55
Q

Wall thickness - Right ventricle

A
  1. 5cm
    - muscle is 1/3 thickness of the left side
    - less muscle because it only needs to push the blood from the right hand side of heart to the capillaries of the lungs so is a short journey
    - same volume of blood as left side but less pressure needed
56
Q

Wall thickness - left ventricle

A
  1. 5cm
    - 3 times more muscle thickness than right side because the same volume of blood is pushed to the aorta and goes to everywhere else in the body through the systemic circuit
    - Therefore more pressure so more force
57
Q

Heart valve function

A

Allow the heart to act as a pump that forces continuous flow of blood up in one direction - prevents back flow of blood

58
Q

2 heart valves

A

Atrioventricular (AV) valves aka. cupsid valves

Semilunar valves

59
Q

Atrioventricular valves - location and function

A

Valves between the atria an ventricles
Control flow between atrial chambers and ventricular chamber and prevent back flow of blood from the ventricle back up to the atrium during ventricular contraction

60
Q

AV valves - right vs.left

A

Right: 3 leaflets - tricuspid valves (cusps)
Left: 2 leaflets - bicuspid valves (mitral valves)

61
Q

What is mitral valves anther name for?

A

The left AV valves/bicuspid valves

62
Q

Operation of AV valves (ie. when are they open or closed)

A

Diastole (filling phase of ventricles) - AV open

Systole (during ventricular contraction) - AV closed

63
Q

Semilunar valves - location and function

A

Where the pulmonary artery joins the right ventricle (pulmonary valve) and where the aorta joins the left ventricle (aortic valve)
Prevents blood returning to ventricles during diastole (filling phase)

64
Q

Semilunar valves - left vs. right

A

Left: aortic semilunar valve - 3 cusps
Right: pulmonary semilunar valve - 3 cusps

65
Q

Operation of semilunar valves (ie. opening and closing)

A

Ventricular systole - open, as blood flows out of heart

Ventricular diastole - closed, as blood starts to back flow

66
Q

Papillary muscles in left ventricle - where it is and relationship to AV valves

A

Muscle coming off the ventricular wall

1 muscle per AV valve eg. tricuspid valves = 2 papillary muscles and bicuspid valves = 2 papillary muscles

67
Q

Why does the semilunar valves not require papillary muscle or chordae tendinae

A

Because it is small in size

68
Q

Diastole - describe, valves open/close

A

Atrial contraction/blood filling phase where blood is forced through the ventricles
AV open
semilunar valves shut

69
Q

Systole - describe, valves open/closed

A

Ventricular contraction where blood is forced out of ventricles through the semilunar valves and into arteries
semilunar valves open
AV shut

70
Q

Role of cardiac circulation

A

It’s the way myocardial cells receive blood via coronary arteries

71
Q

Role of coronary arteries

A

supply blood to the heart muscle

72
Q

What are the coronary arteries

A

First branch coming off the aorta that goes into the coronary circulation to the heart (encircles the myocardium)

73
Q

Where do the opening to the coronary arteries lie

A

Behind the leaflets of the aortic semilunar valve

74
Q

What happens to the coronary arteries during ventricular relaxation

A

The aortic valves are closed and the back flow of blood closes the valves and fills the coronary artery

75
Q

Where do the opening to the coronary arteries lie

A

Behind the leaflets of the aortic semilunar valve

76
Q

What happens to the coronary arteries during ventricular relaxation

A

The aortic valves are closed and the back flow of blood closes the valves and fills the coronary artery

77
Q

Location of the coronary arteries

A

They run through the epicardium above the myocardium and dives down into the muscle (along the surface of the heart is a lot of adipose and hidden beneath would be the coronary vessels)

78
Q

How many main branches does the left and right coronary arteries have

A

2

79
Q

2 branches of the left coronary artery

A

Circumflex artery

Anterior interventricular artery

80
Q

Left circumflex artery

A

Circumflexes between the left atria and the left ventricles to supply left marginal and posterior heart

81
Q

Anterior interventricular artery

A

runs along the interventricular septum and then branches out a lot especially to the left ventricle

82
Q

Location of the right coronary artery

A

between the atria and ventricle and branches

83
Q

Drainage route

A

blood - capillary networks in the myocardium - cardiac veins - coronary sinus - right atrium

84
Q

Coronary veins (2)

A

Great cardiac vein

Small cardiac vein

85
Q

Great cardiac vein - drainage route

A

Drains anterior interventricular artery and circumflex artery and back to the posterior of the heart via coronary sinus

86
Q

Small cardiac vein - drainage route

A

Drains the right side of the heart and back to the posterior of the heart via coronary sinus

87
Q

Any domination between right or left coronary arteries?

A

No

88
Q

Both ventricles receive their blood supply from where?

A

The branches of the right and left coronary arteries

89
Q

Each atrium receives blood only from …?

A

a small branch of the corresponding coronary artery

90
Q

Part of heart that receives the most abundant blood supply and why

A

Myocardium of the left ventricle as it does the most work hence needs most oxygen and nutrients

91
Q

What is the capillary network

A

long thin structures between the myocardial cells

92
Q

What are capillaries formed by

A

endothelial cell walls that form a thin tube, joined together by tight junction

93
Q

25% mitochondria correspond to what type of muscle

A

cardiac muscle

94
Q

Where are intercalated disks located

A

between 2 neighbouring cardiac cells

95
Q

3 types of intercellular junction

A

Adhesion belts
Desmosomes
Gap junctions

96
Q

Adhesion belts (3)

A

Links actin to actin
Sit in vertical portion (perpendicular to the ventricle contraction)
Physical propagation of contraction - during contraction, actin of neighbouring cell stimulate the next cell to contract

97
Q

Desmosomes (4)

A

Link cytokeratin to cytokeratin
Not a contractile protein
Flexible skeleton in a cell between the neighbouring cells
During contraction, they keep the cells together so they do not come apart

98
Q

Gap junctions (3)

A

Horizontal portion parallel to contraction plane
Allow electrical coupling/electrical propagation
Electrochemical communication through neighbouring cells

99
Q

Vagus (parasympathetic autonomic nerves) ___ heart rate

A

Decrease

100
Q

T1-4 spinal nerves (sympathetic) ____ heart rate

A

Increase

101
Q

Where is the Sinoatrial node (SA) located

A

At the junction of superior vena cava and the right atrium

102
Q

Where does the interatrial bundles conduct the AP from and to?

A

From the right atrium to the anterior part of the left atrium

103
Q

Where does the internodal bundles conduct the AP from and to?

A

From the SA node to the AV node

104
Q

How does the AP reach the purkinje fibres from the AV node

A

Right and left branches of AV bundles (bundle of His) conducts the AP from the AV node to the right and left ventricles down the interventricular septum and to the purkinje fibres

105
Q

Another name for purkinje fibres

A

Subendocardial fibres

106
Q

Role of purkinje fibres

A

Conduct AP to all parts of the ventricles, stimulating them to contract almost simultaneously

107
Q

What are purkinje cells

A

Originally cardiac muscle cells but have become modified for conduction role and not contractile anymore

108
Q

Characteristics of purkinje cells (5)

A

(some) peripheral myofibrils which are redundant and put to the side
Central nucleus
Mitochondria, glycogen (for conduction use)
ICD’s - lots of gap junctions, not a lot of adhesion belts and desmosomes
1% cardiac cells

HUBS 192 (1 decks)

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