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Anatomy & Physiology II > Exam 1: Cardiovascular System > Flashcards

Exam 1: Cardiovascular System Flashcards

1
Q

What is Resting Membrane Potential

A

Voltage (charge inside cell) difference across cell membrane when cell is at rest

Intracellular environment is more negative compared to extracellular environment

RMP for neurons is -70 mV

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2
Q

What are the different types of tissues

A

Epithelial
connective
muscle
nervous

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3
Q

what tissues are excitable (can be stimulated to produce electrical signals)

A

Nerve and Muscle tissues

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4
Q

How is action potential triggered

A

by movement of ions

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5
Q

REVIEW GRAPH OF AP FROM A&P I

A
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6
Q

what are the types of muscle tissue

A

skeletal
smooth
cardiac

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7
Q

Describe functions of and characteristics of skeletal muscle

A

functions; locomotion, posture, respiration

It is voluntary and striated

stimulated by motor neurons

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8
Q

Describe functions of and characteristics of smooth muscle

A

functions; contraction of hollow organs, vasoconstriction, vasodilation

It is involuntary and non-striated

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9
Q

Describe functions of and characteristics of Cardiac muscle

A

function; contraction of heart chambers

only found in heart

involuntary and striated

autorhythmic

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10
Q

Define autorhythmic

A

can contract on own without nerve stimulation

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11
Q

What components make cardiac muscle unique

A

branched and networked cardiac myocytes that are joined by intercalated discs

mitochondria-rich (1/3 of cell volume)

larger and branched t-tubules

graded contraction

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12
Q

What are the components of cardiac myocytes

A

*Desmosomes: strong links between adjacent cells

*Gap junctions: allow waves of depolarization to spread rapidly between cells

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13
Q

Define Graded contraction

A

amount of force generated is related to how many cross-bridges are active

-the more cross-bridges (active) = greater force of contraction
*Determined by how much Ca++ bound to troponin

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14
Q

Define pulmonary

A

relating to lungs

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15
Q

define systemic

A

relating to the entire body

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16
Q

In general where do arteries carry blood

A

away from the heart

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17
Q

In general where do veins carry blood

A

to the heart

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18
Q

What is the physical location of the heart

A

within the mediastinum which is located within the thoracic cavity

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19
Q

what is the mediastinum

A

region between pulmonary cavities (lungs)

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20
Q

what is the approximate size of the heart

A

the size of a closed fist

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21
Q

What factors influence heart size

A

age, height, weight, gender
*this is important for treatment of certain heart conditions and/or problems

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22
Q

Describe the hearts shape

A

base = top of heart
apex = bottom where it narrows
*looks like a tilted ice cream cone (point is on person’s bottom left side when viewing anteriorly)

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23
Q

Define Pericardium

A

peri = around
cardium = heart

surrounds the heart providing protection and roots great vessels. There are 2 layers to it.

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24
Q

Name and describe the superficial layer of the pericardium

A

fibrous pericardium:
-made of dense and loose CT, fairly non pliable

-function: anchors heart, prevents overdistension, protects against blunt force

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25
Q

Name and describe the deep layer of the pericardium

A

Serous Pericardium:
-composed of 2 layers

  1. Parietal layer
    -outer/fused to fibrous pericardium
  2. Visceral layer
    -inner/aka epicardium covers heart
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26
Q

what is the function of pericardial fluid

A

found between layers of serous pericardium

Function: reduces friction during heart contraction

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27
Q

Define pericarditis

A

inflammation of the pericardium
*Caused by some viral infections

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28
Q

What are the different portions of the heart wall from superficial to deep

A

Epicardium (AKA visceral pericardium)

Myocardium

Endocardium

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29
Q

Describe the Epicardium (visceral pericardium)

A

superficial, thin, smooth layer of heart wall

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30
Q

Describe the Myocardium

A

Middle layer of heart wall, very thick

-composed of cardiac myocytes (heart muscle cells) that cause contractility

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31
Q

Describe the Endocardium

A

Deep, somewhat thin layer of heart wall

composed of simple squamous epithelium over CT layer

Covers the inner surfaces (chambers) of the heart

smooth texture for easy blood movement

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32
Q

How many chambers does the human heart have

A

4

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33
Q

Is blood oxygenated (O2 rich) or deoxygenated (O2 poor) when travelling through the Right side of the heart

A

Deoxygenated (O2 Poor)

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34
Q

Is blood oxygenated (O2 rich) or deoxygenated (O2 poor) when travelling through the Left side of the heart

A

Oxygenated (O2 Rich)

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35
Q

what are the 2 superior chambers of the heart known as

A

Right and Left Atriums (Atria is proper plural)

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36
Q

what are the 2 inferior chambers of the heart known as

A

Right and Left Ventricles

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37
Q

what separates the right and left atria of the heart

A

interatrial septum

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38
Q

what separated the right and left ventricles of the heart

A

interventricular septum

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39
Q

Why are the interatrial and interventricular septums necessary

A

separate O2 Rich and O2 Poor blood

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40
Q

what do the valves of the heart allow

A

one-way blood flow and prevent back flow of blood

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41
Q

What are the cusps/leaflets in the heart

A

Flaps that are a part of the valves

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42
Q

How many atrioventricular (AV) valves are in the heart

A

2

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43
Q

What are the names of the AV valves

A

tricuspid valve
bicuspid/mitral valve

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44
Q

Which side of the heart is the Tricuspid valve on and how many flaps does it have

A

right side and has 3 flaps
*tri before you bi

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45
Q

which side of the heart is the Bicuspid/Mitral valve on and how many flaps does it have

A

left side and has 2 flaps

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46
Q

How many semilunar (SL) valves are in the heart

A

2

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47
Q

what makes each of the SL valves unique

A

They each have 2 half moon shaped cusps

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48
Q

What are the names of the SL valves

A

Pulmonary semilunar valve
Aortic semilunar valve

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49
Q

In terms of blood flow, which side of the heart does blood come from when travelling through the Pulmonary Semilunar Valve

A

Right Side
(O2 poor blood comes from rest of body via SVC and IVC, travels through RA, Tricuspid valve, RV, then pulmonary semilunar valve, to pulmonary arteries, to lungs)

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50
Q

In terms of blood flow, which side of the heart does blood come from when travelling through the Aortic Semilunar Valve

A

Left Side
(O2 Rich blood comes from lungs via pulmonary veins, travels through LA, Bicuspid valve, LV, then Aortic semilunar valve, to aorta, to rest of body)

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51
Q

REVIEW FLOW OF BLOOD GRAPHIC

A
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52
Q

What are Chordae Tendinea and what is its function

A

connect Atrioventricular (AV) valves, so Tri- & Bi- cuspid, to papillary muscle within heart

Function: prevents inversion of valves during ventricular contraction

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53
Q

Describe the coronary arteries

A

Left and Right Coronary arteries both originate from/exit the aorta

Function: Supply O2 rich blood to heart tissue

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54
Q

What are the major branches of the left Coronary A. and what do they supply

A

Left Anterior Descending artery
-Supplies: anterior left Ventricle

Left Marginal artery
-Supplies: lateral wall of left ventricle

Circumflex artery
-Supplies: posterior wall of heart

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55
Q

What are the major branches of the Right Coronary A. and what do they supply

A

Right Marginal artery
-Supplies: lateral wall of Right Ventricle

Posterior Descending artery
-Supplies: posterior and inferior portions of heart

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56
Q

What is the function of the cardiac veins

A

Drain O2 poor blood from heart tissue

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57
Q

what are the major veins (cardiac)

A

Great Cardiac Vein (L side)
Middle Cardiac Vein (posterior)
Small Cardiac Vein (R side)

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58
Q

Where do the major cardiac veins drain to

A

Coronary sinus

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59
Q

What is the function of the Coronary Sinus

A

collects O2 poor blood from above and empties into right atrium

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60
Q

How can a coronary blockage occur

A

cholesterol and fatty deposits (plaques) build up in artery

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61
Q

What can result from coronary blockage

A

Infarction

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62
Q

Define Infarction

A

Necrosis (tissue death) due to insufficient blood flow

63
Q

What is a Myocardial Infarction

A

“Heart Attack”
-Necrosis of myocardium due to one or more coronary blockage
*fixed with CABG (Coronary Artery Bypass Graft) surgery

64
Q

what is a “widowmaker” and why is it dubbed this

A

Blockage of left anterior descending artery

-So serious bc this artery supplies the L ventricle, and if blood cannot get here, it cannot get to the aorta to be pumped to the brain and rest of the body

65
Q

What makes cardiac muscle unique

A

-It is branched and networked

-joined by intercalated discs

-there is a high level of communication between cardiac myocytes
*this allows for coordinated contraction of cardiac muscle tissue

66
Q

What is cardiac syncytium

A

arrangement of cardiac myocytes to form an interconnected mass

When one cell becomes excited, all cells become excited and heart can contract as one unit

“All or nothing” principle

67
Q

What are the two types of Syncytia in the heart

A

Atrial syncytium: coordinated contraction of both Atria

Ventricular syncytium: coordinated contraction of both Ventricles

68
Q

What are the types of Cardiac myocytes

A

Contractile Cells
Autorhythmic Cells

69
Q

what is Autorhythmicity

A

ability to spontaneously generate action potentials without external nervous system influence

70
Q

Describe the relationship between the different cardiac myocytes

A

Autorhythmic cells produce action potentials which causes the spread of action potentials through contractile cells

71
Q

Where are autorhythmic cells located

A

near top of Right Atrium

72
Q

Describe autorhythmic myocytes

A

autorhythmic cells that fire at their own intrinsic rates

73
Q

what is the most important autorhythmic myocyte

A

Sinoatrial (SA) node
*located at top of R atrium

74
Q

what are the other autorhythmic myocytes

A

-Atrioventricular (AV) node

-Bundle of His
*split into: Bundle Branches

-Purkinje fibers
(Run up sides of Ventricles, cause them to contract)

75
Q

Why is the Sinoatrial (SA) node so important

A

Called the “Pacemaker”
-spontaneously generates APs at regular intervals (~70 BPM)

Medical intervention needed:
*If SA node not functioning: AV node beats at 50 BPM

*If AV node not functioning: Purkinje fibers beat at ~15-30 BPM

76
Q

List the specific sequence of the spread of excitation in Autorhythmic myocytes

A
  1. SA node: signal spreads across atria (0.4s), atria contract
  2. AV node: signal delay (0.11s), allows atria to fully empty
  3. Purkinje fibers: signal reaches ventricles (0.08s), ventricles contract
77
Q

Describe process of cardiac muscle excitation-contraction coupling

A

-Action Potential from adjacent cell opens voltage-gated Ca++ channels

-Ca++ enters cell

-Induces Ca++ release from Sarcoplasmic Reticulum

-Ca++ binds to troponin = muscle contraction!

78
Q

What makes Action Potentials in Contractile myocytes unique

A

-Long refractory period compared to skeletal muscle
*this prevents tetanus (We want repeated contraction, NOT long periods of constant contraction in heart –this is deadly)

79
Q

what is the resting membrane potential in skeletal muscle fibers and contractile cardiac myocytes

A

-90 mV

80
Q

REVIEW GRAPH OF AP FOR A CONTRACTILE CARDIAC MYOCYTE

A
81
Q

What are the phases of an AP for a contractile cardiac myocyte

A

Phase 0=depolarization
-Fast Na+ channels open
*Na+ rushes into cell
-At ~-40mV, L-type Ca++ channels open
*slow and steady Ca++ influx (into cell)

Phase 1=Early Repolarization
-some K+ channels open
*some K+ comes out of cell

Phase 2=Plateau
-More L-type Ca++ channels open
*allows Ca++ into cell
-Also at same time more K+ channels open
*K+ moves out of cell
——-creates plateau (counterbalance of Ca++ in and K+ out)

Phase 3=Repolarization
-Ca++ channels close
-K+ channels still open
*still getting K+ out

Phase 4=Resting Membrane Potential
-All channels are closed
-back to RMP of -90mV

82
Q

what is “pacemaker potential”

A

Phase 1 of AP in autorhythmic myocytes

-slow positive increase of ‘RMP’ between APs
-Keeps autorhythmic cells READY to fire at a moment’s notice

83
Q

what are the 3 causes of pacemaker potential

A
  1. Increased influx of Na+
    -“funny” channels open in response to hyperpolarization
    -Allow Na+ into cell, pushes up voltage
  2. Decreased efflux of K+
    -K+ channels close during hyperpolarization of AP, limiting K+ leaving the cell, pushes up voltage
  3. Differential influx of Ca++
    -some Ca++ channels open before threshold, pushes voltage to threshold
    -once threshold is reached, L-type Ca++ channels open, producing AP
84
Q

REVIEW GRAPH OF AP FOR AN AUTORHYTHMIC CARDIAC MYOCYTE

A
85
Q

what are the phases of an AP for an autorhythmic cardiac myocyte

A

Phase 1=Pacemaker Potential
-In hyperpolarized state, “funny” channels open
*Allows Na+ into cell
-As we approach threshold, some Ca++ channels open
*Ca++ into cell
——pushes cell to threshold

Phase 2=Depolarization
-L-type Ca++ channels open
*more Ca++ into cell

Phase 3=Repolarization
-Ca++ channels close
-K+ channels open
*K+ moves out of cell

86
Q

Why are autorhythmic myocytes never truly at rest

A

As soon as we hit -60mV, pacemaker potential occurs automatically, which triggers rest of AP

87
Q

What is an electrocardiogram (EKG or ECG)

A

Record of *electrical activity of the heart
(Repolarization and depolarization)
-Electrical events correlate with physical activity

88
Q

what are the different parts of an EKG

A

P wave
QRS Complex
T wave

89
Q

what *electrical and =physical activity is recorded during the P wave of an EKG

A

*Depolarization of atria
=onset of atrial contraction

90
Q

what *electrical and =physical activity is recorded during the QRS complex of an EKG

A

*Depolarization of ventricles
=onset of ventricular contraction

91
Q

what *electrical and =physical activity is recorded during the T wave of an EKG

A

*Repolarization of Ventricles
=onset of ventricular relaxation

92
Q

How to interpret EKG

A

-Are all waves present & normal
Ex. QRS for every P
If not: heart block-APs from SA node blocked from reaching ventricles (looks like P waves w/o QRS complex)

Ex. Long QT Syndrome
Lengthy QT interval, affects repolarization of heart
(Causes seizures, fainting, etc.)

93
Q

What is Tachycardia

A

high heart rate
>100BPM

94
Q

What is Bradycardia

A

Low heart rate
<60BPM

95
Q

When is heart rate measured to obtain the most accurate value

A

when resting, not active

96
Q

what is fibrillation sometimes called

A

“Quiver”

97
Q

what is Atrial Fibrillation (A-fib)

A

irregular contractions atria
*irregular spacing of QRS complex and no P waves on EKG

-A-fib is compatible with life and full activity

98
Q

How to treat A-fib

A

Beta blockers
(block beta-adrenergic receptors to drop heart rate and re-establish SA node)

99
Q

what is ventricular fibrillation (V-fib)

A

EMERGENCY! Results in cardiac arrest
-ventricular twitches instead of proper contractions
-loss of consciousness within seconds

100
Q

how to treat v-fib

A

FATAL unless intermediate intervention occurs
(CPR and defibrillation)

101
Q

What is a defibrillator

A

applies a strong electrical current that depolarizes most/entire heart at once
-gives SA node a chance to re-establish normal sinus rhythm

102
Q

Describe the Cardiac cycle

A

Pattern of contraction and relaxation of heart chambers
-Initiated by spontaneous AP from SA node

103
Q

What role do the atria play in the cardiac cycle

A

Primer pumps
-push blood into ventricles

104
Q

what role to the ventricles play in the cardiac cycle

A

power pumps
-“force” blood into pulmonary and systemic circulation

105
Q

Define diastole

A

Relaxation
-blood fills chamber

106
Q

Define systole

A

contraction
-blood is pushed out of chamber

107
Q

REVIEW CARDIAC CYCLE GRAPHIC

A
107
Q

what are the steps of the cardiac cycles

A
  1. Passive filling of atria and ventricles
  2. atrial systoles
    -blood forced into ventricles
  3. ventricular systole
    -a. isovolumetric contraction: ventricles contract, blood is not pushed out yet
    -b. Ejection:
    semilunar valves get pushed open and blood is pushed out of ventricles
  4. ventricular diastole
    -a. isovolumetric relaxation:
    No blood filling ventricles yet

Go back to 1.

108
Q

Describe the heart sounds
(“lub dup”)

A

1st sound-“lub”=AV valves closing

2nd sound-“dup”=SL valves closing

3rd sound-faint=Turbulent blood flow into ventricles
don’t always hear this one

109
Q

what is systolic blood pressure

A

Ventricular contraction forces blood into aorta
-highest pressure in aorta
(120 mmHg pressure)

110
Q

what is diastolic blood pressure

A

decrease in aortic pressure
-lowest pressure in aorta
(80 mmHg pressure)

111
Q

Describe intrinsic regulation of the heart

A

Cardiac output (CO)
-amount of blood (volume) pumped per minute

Stroke volume (SV)
-volume of blood pumped per beat

Changes in heart rate (HR) & stroke volume (SV) = changes in cardiac output (CO)

Venous return
-flow of blood back to the heart
-can influence SV and CO

112
Q

what is Starling’s law of the heart

A

stroke volume of left ventricle increases as volume of blood in left ventricle increases
-Due to preload (stretch) of cardiac muscle
-Greater preload=greater force of contraction

113
Q

REVIEW SCENARIO WHERE STARLING’S LAW CAN BE PUT INTO PRACTICE

A
114
Q

Describe extrinsic regulation of the heart from Sympathetic NS

A

Sympathetic nervous system
-project to heart as cardiac nerves
-nerves synapse at SA node, AV node, & ventricular myocardium
-secretion of Norepinephrine (NE)
*binds to adrenergic receptors
*increased influx of Ca++ into cardiac myocytes
-excitatory influence (Fight or Flight response)

115
Q

Describe Extrinsic regulation of the heart from Parasympathetic NS

A

Parasympathetic Nervous System
-Vagus nerve
-synapses at SA node & AV node
-secretion of Acetylcholine (Ach)
*binds to muscarinic receptors
*increased number of K+ in open position, makes depolarization more difficult
-inhibitory influence (rest and digest)

116
Q

What is Vagal tone

A

represents efficacy of Vagus nerve (parasympathetic) activity

High vagal tone=good
-resilience to stress, Heart rate can be lowered when needed

Low vagal tone=bad
-inability to “relax” the heart

117
Q

what is Heart Rate Variability (HRV)

A

beat to beat variation in heart rate

High HRV=good
-lots of variability can accommodate a variety of situations
-good adaptability

Low HRV=bad
-associated with frequent stress
-less variation between beats, regularly high HR
*leads to pathology or even fatality

118
Q

Describe arteries

A

Elastic blood vessels that have lots of smooth muscle
-empty into arterioles, which then empty into capillaries

119
Q

what are capillaries

A

site of gas/nutrient/etc. exchange with tissues

120
Q

what are veins

A

blood vessels that have thinner walls, less elastic, less smooth muscle
-receive blood from venules

121
Q

Describe flow of blood between vessels

A

Heart -> arteries -> arterioles -> capillaries -> venules -> veins -> heart

122
Q

what are the layers of blood vessels from superficial to deep

A

Tunica externa
Tunica media
Tunica intima

123
Q

What is the function of the Tunica externa and what tissue is it composed of

A

Tissue: collagenous CT
Function: prevents the vessel from shifting position too much

124
Q

What is the function of the Tunica media and what tissue is it composed of

A

Tissue: smooth muscle
Function: performs vasodilation and vasoconstriction (changes BP)

125
Q

What is the function of the Tunica intima and what tissue is it composed of

A

Tissue: endothelium (simple squamous epithelium
Function: helps to regulate capillary exchange and blood flow

126
Q

what are the different capillary types

A

Continuous capillaries
Fenestrated capillaries
Sinusoidal capillaries

127
Q

Describe Continuous Capillaries

A

-very common in nearly all tissues
-tight junctions between endothelial cells
*allows for exchange of small molecules like H20, glucose, gasses, and certain hormones

128
Q

Describe Fenestrated Capillaries

A

-Found in kidneys & small intestines
-Fenestrations (pores) allow the exchange of larger molecules like nutrients, waste products, & large hormones-peptide)

129
Q

Describe Sinusoidal Capillaries

A

-Rare: found where cells & very large molecules need to be transported (spleen, bone marrow, liver, etc.)
-Contain extensive intercellular gaps

130
Q

what are capillary networks

A

-final destination of arterial blood from heart
-exchange of materials between blood & other tissues

131
Q

what are portal venous systems

A

-where capillary bed pools into another capillary bed
-linked by veins

132
Q

How many portal systems exist in the human body

A

2 portal systems

133
Q

What are the portal systems in the human body and what are their functions

A

Hepatic Portal system
-directs blood from GI tract to liver

Hypophyseal portal system
-carries hormones from hypothalamus to anterior pituitary

134
Q

what are the regions of the aorta

A

Ascending aorta

Aortic arch

Descending aorta
-becomes thoracic aorta within thorax & abdominal aorta within abdomen

135
Q

what are the branchings of the aorta from R to L

A

Brachiocephalic A.
*branches into R. Common Carotid A. & R. Subclavian A.

Left Common Carotid A.

Left Subclavian A.

136
Q

what are the arteries of the head and neck

A

R & L Common Carotid Aa.
*branch into internal & external carotid Aa.

Circle of Willis-supplies most of blood flow to brain
*internal carotid Aa. and others

Basilar A.
*supplies posterior brain

137
Q

what are the arteries of upper & lower limbs

A

Major pulse points: upper limbs
-Brachial artery
-Radial artery

Femoral artery

138
Q

Veins of head and neck

A

internal and external jugular veins

139
Q

Veins of upper and lower limbs

A

Median Cubital Vein
-common site for blood draws

Saphenous Veins
-often used for coronary artery bypass grafts (CABG)

140
Q

which direction does blood flow in terms of pressure

A

high pressure to low pressure

141
Q

Describe process of pressure and resistance

A

Driving pressure (where pressure is lower) from ventricles forces blood into vessels

Blood exerts pressure against walls of blood vessels, but vessels resist against blood flow

Resistance influenced by: Blood viscosity, vessel length, vessel radius

Ventricles have to exert enough force to overcome resistance in blood vessels

BP measures pressure against artery walls

142
Q

What is systolic pressure

A

pressure of blood against artery walls during ventricular systole (average: 120 mmHg)

what it tells us:
force of contraction of heart

143
Q

What is diastolic pressure

A

pressure of blood against artery walls during ventricular diastole (average: 80 mmHg)

what it tells us:
condition of systemic blood vessels
*reflects ability to store energy in elastic walls
Ex. increase in diastolic pressure = decrease in vessel elasticity

144
Q

how is arterial blood pressure measured

A

Auscultatory method
-non-invasive method that uses Korotkoff sounds

145
Q

what are Korotkoff sounds

A

sounds in vessels due to changes in blood flow from BP cuff

146
Q

what measurements are derived from BP

A

pulse pressure
mean arterial pressure (MAP)

147
Q

what is pulse pressure

A

systolic minus diastolic pressure
-represents force that heart generates with each contraction
*Normal: 40-60 mmHg

148
Q

what is mean arterial pressure (MAP)

A

average pressure in the arteries during one cardiac cycle
*Normal: 70-100 mmHg

149
Q

what is vascular compliance

A

how much a vessel is able to stretch
-more stretch=greater compliance

Compliant arteries=GOOD
-The more compliant an artery, the more blood flow it can accommodate w/o increasing BP and overtaxing cardiovascular system

Compliance decreases as we age

veins have thinner walls, so more compliant than arteries

150
Q

what is critical closing pressure

A

pressure where vessel collapses if flow/pressure too low

151
Q

what is shock

A

occurs from rapid drop in BP
-can cease blood flow

-some blood flow/force is needed to keep vessel open (if we drop below that, vessel can collapse)

-necrosis of tissues if supply lost for too long

152
Q

what is an aneurysm

A

bulge in vessel
-Radius of vessel and pressure applied is higher here
-can cause vessel to rupture

153
Q

How do veins return blood to heart

A

Active mechanisms of venous return-
*skeletal muscle pumps:
skeletal muscle contracts, presses on veins, squeezing blood back to heart

*gravity:
returns blood from upper body (head, neck, shoulders)

*respiratory pump:
pressure on thoracic cavity squeeze veins

*one-way valves:
prevent back flow

*smooth muscle:
squeezes blood back to heart

Anatomy & Physiology II (3 decks)

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