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AP2 > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

The heart has _ Chambers

A

4

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2
Q

The heart pumps blood through what circuts?

A

pulmonary and systemic circuits

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3
Q

where does the right side of the heart receive blood from? where does it pump it to?

A

Receives oxygen poor blood from body tissues. Pumps it to the lungs

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4
Q

Does the R side of the heart receive O2 poor or rich blood?

A

oxygen poor blood

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5
Q

Does the L side of the heart receive O2 poor or rich blood?

A

oxygen rich blood

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6
Q

where does the left side of the heart receive oxygen from? where does it pump it to?

A

receives oxygen rich blood from the lungs and pumps it out to body tissues

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7
Q

the heart is the size of the

A

FIST

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8
Q

the heart is found in the

A

mediastinum of the thoracic cavity

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9
Q

the base of the heart is directed to

A

the right shoulder

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10
Q

the apex of the heart is directed to

A

the left hip

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11
Q

the heart is enclosed in a double-walled sac called the

A

pericardium

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12
Q

fibrous pericardium is

A

tough, superficial protection

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13
Q

serous pericardium produces

A

serous fluid

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14
Q

serous paricardium layers

A

1) parietal layer- outer
2) visceral layer (epicardium) - inner

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15
Q

Layers of heart wall

A

epicardium- outer
myocardium- middle
endocardium- inner

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16
Q

Epicardium

A

the visceral serous pericardium

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17
Q

the thick myocardium consists of mainly

A

cardiac muscle- the thickest layer of the heart wall

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18
Q

endocardium
+what is it made up of

A

-thin lining of the chambers
-simple squamous

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18
Q

partitions seperate the heart….

A

longitudinally (L from R)

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19
Q

the interartial septum seperates

A

the top chambers

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20
Q

the interaventricular septum seperates

A

the large inferior chambers

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21
Q

the right and left atria are

A

recieving chambers; holds blood and then pushes it to ventricles

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22
Q

three large veins (name them) enters the…

A

enters the R atrium

1) superior vena cava
2) inferior vena cava
3) coronary sinus- returns blood from the heart wall

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23
Q

four pulmonary veins enter the… from where??

A

Left atrium from the lungs (w o2 rich blood)

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24
Q

the ventricles are the __ chambers

A

discharging

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25
Q

the right ventricle pumps blood

A

into the pulmonary trunks->to lungs

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26
Q

the left ventricle pumps blood

(to where and then to where)

A

into aorta–> body tissues

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27
Q

heart valves make blood flow in….

A

one direction

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28
Q

there are two atrioventricular (AV) valves one at each..

A

atrial-ventricular junction

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29
Q

L A-V Valve=

A

Bicuspid valve= Mitral

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30
Q

R A-V Valve=

A

Tricuspid Valve

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31
Q

AV valves prevent

A

backflow of blood to the atria

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32
Q

When the ventricles are relaxed, the AV valves…

A

hang open

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33
Q

when the ventricles contract…

A

blood is pushed up against the (AV) valves and shut them (“Lub” sound S1) SYSTOLE

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34
Q

Each flap of the AV valves are anchored to

A

chordae tendinea (strings) teathered to papillary muscle

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35
Q

Aortic and semilunar (SL) valve are located at the

A

base of the arteries

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36
Q

Aortic and semilunar (SL) valve are located at the base of the arteries exciting the heart and prevent

A

backflow to ventricles when ventricles relax (diastole)

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37
Q

when ventricular pressure rises above pulmonary and aortic pressure…

A

the semilunar valves open and blood flows to artery

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38
Q

When the ventricles relax, blood briefly flows back to the heart….

A

slight start of back flow shuts semilunar valves (S2 sound “dup”)

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39
Q

There are no valves at the entrances of the

A

vena cava or pulmonary veins

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40
Q

blood flows into the atrium then to

the right side of the heart pumps blood into the

A

pulmonary circuit

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41
Q

blood flows into the atrium then….

the left side of the heart pumps blood into the

A

systemic circuit

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42
Q

Equal volumes of blood are pumped to the pulmonary and systemic circiuts at the same time but…(wall thickness)

A

The R ventricular wall is thinner than the L ventricular wall because the L ventricular wall has to pump against more resistance

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43
Q

The R ventricular wall is thinner than the L ventricular wall because

A

the L ventricular wall has to pump against more resistance

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44
Q

(Coronary Circulation)
The heart receives little or no nourishment from the blood

A

passing through the chamber

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45
Q

(Coronary Circulation)
The heart receives little or no nourishment from the blood passing through the chamber SO

A

a series of vessels, the coronary circulation, exists to supply blood to the heart itself

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46
Q

(Coronary Circulation) The heart receives little or no nourishment from the blood passing through the chamber SO a series of vessels, the coronary circulation, exists to supply blood to the heart itself

What supplies the blood?

A

The Left and Right coronary arteries

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47
Q

Intercalated discs connect

A

cardiac muscle fibers into a functional unit

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48
Q

Microscopic Anatomy:
Cardiac muscle is

A

striated, contract with sliding filament

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49
Q

Microscopic Anatomy:
Cardiac cells are

A

short, fat, branched, 1 or 2 nucleus per cell

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50
Q

Intercellular space is filled with

A

a matrix of loose connective tissue

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51
Q

Intercellular space is filled with a matrix of loose connective tissue that connects

A

the muscle to the cardiac skeleton

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52
Q

cardiac cells are connected to eachother at

A

intercalated discs

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53
Q

intercalated discs contain

A

-desmosomes for mechanical coupling
-gap junctions for electrical coupling

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54
Q

Cardiac muscle cells have

A

-Large mitochondria: occupies 25-35% of cells total volume
-Have myofribrils arranged in sarcomeres

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55
Q

Some cardiac cells are self excitable and….

A

start their own depolarization. these (through gap junctions) excite the rest of the heart

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56
Q

all fibers of the heart contract….

A

as a unit or not at all because unlike skeletal muscles motor units, gap junctions electrically tie all cardiac muscle cells together

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57
Q

the hearts cell action potentials and absolute refractory period is longer than…

preventing…

A

a skeletals muscles, preventing tetanic contractions

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58
Q

caridac muscle has more mitocondria than…

indicating…

A

skeletal muscles

indicates reliance on aerobic respiration

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59
Q

pacemaker cells trigger action potentials throughout…

A

the heart

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60
Q

Setting the basic rhythm: the intrinsic conduction system

The heart does not rely on the

A

nervous system to provide stimulation

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61
Q

Setting the basic rhythm:

the intrinsic conduction system consists of cardiac pacemaker cells that instead of having a stable resting potential have a

A

pacemaker potential

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62
Q

Setting the basic rhythm: the intrinsic conduction system

What is a pacemaker potential?

A

a gradual depolarization ( caused by special ion channels) that reaches threshold for action potentials- depolarizing phase Ca++ entry and polarizing K+ exit

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63
Q

impulses pass through the cardiac pacemaker cells in the following order: sinoatrial node

A

a) SA node in R atrium- quick pacemaker starts the beat
b) AV node at bottom of interatrial steptum near top of interventricular septum
c) AV bundles splits to bundle branches in interventricular septum
d) bundle branches divide to give subendocardial conducting network (purkinje fibers)

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64
Q

Modifying basic rhythm: Extrinsic innervation of the heart

The ANS modifies the heartbeat through

A

cardiac centers in the medulla

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65
Q

cardiac centers in the medulla

a) the cardioacceleratory center

A

projects to the sympathetic neurons that increase heart rate and contractile force

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66
Q

cardiac centers in the medulla

b) the cardio inhibitory center

A

projects to parasympathetic neurons that decrease HR through the vagus nerve

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67
Q

Action potentials in the contractile cardiac muscle cells are generated by the following mechanisms

  1. When cardiac muscle cells are stimulated through their gap junctions
A

through their gap junctions their volt gated Na+ channels open and Na+ enters so the cell depolarizes

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68
Q

Action potentials in the contractile cardiac muscle cells are generated by the following mechanisms

  1. Depolarization then opens slow
A

Ca++ channels and so Ca++ enters produces plateau phase of the AP

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69
Q

Action potentials in the contractile cardiac muscle cells are generated by the following mechanisms

  1. after roughly 200msec
A

Ca++ channels close, K+ channels open. K+ leaves cell and so cell depolarizes

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70
Q

An electrocardiogram..

A

monitors and amplifies the electrical signal of the heart

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71
Q

A typical EKG has 3 deflections

A

1) P-wave: atrial depolarization
2) QRS wave: ventricrular depolarization
3) T-wave: ventricular repolarization

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72
Q

the cardiac cycle describes the

A

mechanical event associated with blow flow through the heart

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73
Q

systole is the

A

contractile phase

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74
Q

a cardiac cycle consists of a series of

A

pressure and volume changes in the heart during one heartbeat

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75
Q

during mid and late diastole , ventricular filling occurs

A

as blood flows passively into the ventricles

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75
Q

What branches from the L coronary artery?

A

-Anterior interventricular artery

-circumflex artery

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76
Q

What part of the heart does the anterior interventricular a. serve?

A

front of ventricles

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76
Q

What part of the heart does the circumflex serve?

A

L atrium and back of L ventricle

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77
Q

What branches from the R coronary a.

A

-R marginal a.

-posterior interventricular a.

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78
Q

What part of the heart does the right marginal a. serve?

A

R side of heart

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79
Q

What part of the heart does the posterior interventricular a. serve?

A

back of ventricles

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80
Q

What part of the heart does the coronary sinus serve?

A

posterior heart

81
Q

what branches from the coronary sinus

A

-great cardiac vein
-middle cardiac vein
-small cardiac vein

82
Q

What part of the heart does the great cardiac vein serve? 2

A

anterior interventricular sulcus and left coronary groove

83
Q

What part of the heart does the middle cardiac vein serve?

A

posterior interventricular sulcus

84
Q

What part of the heart does the -small cardiac vein serve

A

r margin of heart

85
Q

what part of the heart do the anterior cardiac veins serve

A

front of heart

86
Q

at the end of diastole, the atria

A

contracts pushing the last bit of blood into the ventricles

87
Q

during (ventricle) systole…2 steps

A

A) ventricles contract causing closure of AV valves (1st heat sounf “lub”)
b) and then opening of the semilunar valves, ejecting blood into the main arteries

88
Q

in early diastole there is…

A

isometric relaxation as semilunar valves shut (“DUB”)

89
Q

the first heart sound, lub, corresponds to

A

closure of the AV valves in early systole

90
Q

the second heart soung, dub, corresponds to

A

closure of the Semilunar valves in diastole

91
Q

what are heart murmers?

A

extraneous heart sounds due to turbulent backflow through a valve that does not close tightly

92
Q

stroke volume and HR are regulated to alter

A

cardiac output

93
Q

cardiac output is defined as the

A

amount of blood pushed out of 1 ventricle in 1 minute

94
Q

cardiac output equation

A

C.O= S.V.x HR
product of stroke volume and heart rate

95
Q

cardiac output at rest is typically

A

around 5L/min (5,000 mL/min)

96
Q

stroke volume is the amount

normal stroke volume at rest

A

of blood pushed out of a ventricle per beat

(around 70mL at rest)

97
Q

cardiac output changes with

A

demand

98
Q

cardiac reserve is the difference

A

between resting and maximal cardiac output

so

C.O=70mL/beat x 70beat/min=4,900mL/min

99
Q

stroke volume represents the difference between

+equation

A

the EDV (the fill) and the ESV (the remainder)

S.V.= EDV-ESV

100
Q

the frank-sterling law of the heart states the critical factor controling S.V. is

A

the critical factor controlling stroke volume is preload, the degree of stretch of cardiac muscle cells immediately before they contract

101
Q

the most important factor determining the degree of strech of cardiac muscle is

which is influenced by

A

The EDV.

Venus return to the heart

Influenced by- respiuratory pump, skeletal muscle pump, fill time

102
Q

contractility is

A

the contractile strength achieved at a given muscle length

103
Q

contractility is influenced by

A

EPI, TH, symph NS, Ca++

ESV!

(e.g. increase norepi-> increase ca++ in heart cells= decrease ESV increase S.V. and C.O)

104
Q

afterload is the ventricular pressure that must be overcome before

A

blood can be ejected by the heart and does not become a significant determinant of stroke volume except in hypertensive individuals

105
Q

Regulation of HR:

sympathetic stimulation in pacemaker cells

A

increases HR by making pacemaker potential steeper

106
Q

Regulation of HR:

parasympathetic inhibition of cardiac pacemaker cells

A

decreases HR by aCH by changing K+ and flattning pacemaker potential

107
Q

Regulation of HR:

hormones such as epinephrine and Thyroxine

A

increase HR

108
Q

Regulation of HR:

other factors influencing HR

A

age, gender, excersise, and body temp

109
Q

Homeostatic imbalance of HR:

Congestive heart failure occurs when

A

pumping efficiency of the heart is so low that blood circulation cant meet tissue needs

110
Q

Homeostatic imbalance of HR:

pulmonary congestion (and possibly pulm edema) occurs when

A

the L side of the heart is failing and blood backs up into pulmonary circut

111
Q

the three major types of blood vessels are

A

capillaries, veins, arteries

112
Q

arteries carry blood..

A

away from the heart

113
Q

veins carry blood…

A

towards the heart

114
Q

in systemic circulation arteries carry..
veins carry..

A

oxygen rich blood
oxygen poor blood

115
Q

in pulmonary circut arteries carry
veins carry

A

oxygen poor blood
oxygen rich blood

116
Q

most blood vessels have _ layers

A

3

117
Q

tunica intima-

A

endothelium- lowers friction for smooth flow

118
Q

tunica media-

A

smooth muscle+elastin
controls dilation (constriction/ relaxation)

119
Q

tunica externa-

A

lots of collegen to reinforce + connect the vessel

120
Q

vaso vassorum (tunica externa)

A

small vessels in outer layer of big vessels wall

121
Q

Arteries are _resivoirs, _vessels, or _vessels

A

pressure resivoirs, distributing vessels, or resistance vessels

122
Q

elastic arteries

A

contain lots of elastin, allows them to abosrb big pressure pulses from nearby heart

123
Q

muscular arteries

A

distributing arteries- have lots of smooth m. in tunica media

124
Q

arterioles

A

are small and play a big part in fine tuning blood flow into capillaries

connect artries and capillaries

125
Q

cappilaries are _ vessels

A

exchange

126
Q

cappilaries are the smallest vessels and allow for exchange between

What do they exchange?

A

blood+ intersitial fluid: exchange materials such as nutrients/ waste and respiratory gases

127
Q

continuous capillaries

A

-most common type; eg. in blood brain barrier
-only allows small, nonpolar molecules to be exchanged

128
Q

fenestrated cappilaries

A

have pores in cells allowing for more exchange; eg in small intestine

129
Q

sinusoid capillaries

A

-slightly larger, very leaky capillaries; still fenestrated+ large intercellular clefts; eg in spleen

130
Q

capillary beds are

A

microcirulatoy networks that consist of a vascular shunt and true capillaries

131
Q

capillary beds

  1. when tissue is active precapillary sphincters …
A

relax which increases the flow into true capillaries

132
Q

capillary beds

  1. when tissue is inactive pre capillary sphincters
A

contract which decreases the flow into true capillaries and send blood into vascular shunt

133
Q

veins are blood _ and _ blood towards the heart

A

blood resivoirs

return blood

134
Q

venules are often formed where

A

capillaries converge

135
Q

venules

A

-are leaky/ absorbative (sometimes more absorbative than caps)
-allow WBCs in and out

136
Q

venules join to form

A

veins

137
Q

veins are

A

-blood resivoirs
-thin-walled vessels
-large lumens
-contain about 65% of total blood volume

138
Q

compared to arteries, veins have

A

-more volume
-lower pressure
-more interconnected and variable

139
Q

blood flows from

A

high to low pressure against resistance

140
Q

blood flow is

A

the amount of blood going through an area in a certian period of time

units mL/min

141
Q

blood pressure is

A

the force exerted by blood against the vessel walls

unit: mmHg

142
Q

resistance is
what causes it?

A

-the friction between blood and vessels
-comes from: blood viscosity, vessel length, vessel diameter

143
Q

Flow calculation

A

Flow=pressure gradient/ resistance

144
Q

if peripheral resistance increases then

A

blood flow decreases

145
Q

if blood pressure increases at source then

A

blood flow increases

146
Q

the most important factor influencing local blood flow

A

peripheal reistance

147
Q

constriction or resistence of blood vessels dramatically changes

A

local flow

148
Q

what happens to BP when blood flows from arteries through capillaries and into veins

A

decreases

149
Q

the pumping action of the heart generates

A

blood flow

150
Q

list High BP to low BP in vessels

A

Aorta, Arteries, Arterioles, Capillaries, Venuoles, Veins, Vena Cava, R atrium

151
Q

systemic BP is highest in the _ and falls thoughout the circut until it reaches 0 mmHg in the

A

highest in the aorta lowest in the R atrium

152
Q

arterial BP reflects

A

how much the arteries close to the heart can be streched (compliance or distendability) and the volume forced into them at a given time

153
Q

when the L ventricle contracts, blood is forced into the….

producing….

A

aorta, producing a peak pressure, called systolic pressure, abut 120mmHg in a healthy adult

154
Q

diastolic pressure occurs when the

A

ventricles enter diastole, the aortic valve closes, and the walls of the aorta recoil, which maintain a pressure at 70-80mmHg, so that blood continues to flow forward into smaller vessels

155
Q

pulse pressure is the difference in

A

systolic and diastolic pressure

156
Q

the mean arterial pressure (MAP) represents…
calculation…

A

the pressure that propels blood into tissues

(1/3) systolic pressure + (2/3) diastolic pressure

157
Q

capillary pressure is _, and ranges from

A

is low, ranging from 15-40mmHg, protects the capillaries from rupture but is still adequate to exchange between blood and tissues

158
Q

venus blood pressure is

A

low, not pulsatile, and changes very little during the cardiac cycle, reflecting culmulative effects of pheripheral resistance

159
Q

blood pressure is regulated by

A

short and long term controls

160
Q

maintaining blood pressure involves

A

cardiac output (which party depends on blood volume and peripheral resistance)

161
Q

baroreceptors are

A

-neurons that sense blood pressure moment to moment

they are clusters of neurons in the medulla oblongata, cardioacceleratory, cardioinhibitory, and vasomotor centers. forms the cardiovascular center that regulates BP by altering cardiac output and blood vessel diameter

162
Q

short term neural controls help maintain

A

adequate MAP

163
Q

baroreceptors located in the aortic arch and carotid sinus detect..
send impulses….

A

detect stretch and send impulses to vasomotor center, inhibiting its activity and promoting vasodilation of arterioles and veins

164
Q

vasomotor center

A

part of the medulla wired to sympathetic NS

165
Q

chemoreceptors detect

A

a rise in CO2 levels of the blood and stimulat the cardioacceleratory and vasomotor centers which increase vasoconstiction and cardiac output

166
Q

the cardioaccelratory and cardioinhibitory centers are

A

part of the medulla wired to autonomic NS

167
Q

(BP)

the hypothalamus and cortex can modify…

A

arterial pressure by signaling the medullary centers

168
Q

Hormonal Control

epinepherine and norepinephrine

A

increase BP, Increase C.O. and cause vasoconstriction, increasing resistance

169
Q

Hormonal Control

Angiotestin II acts as a
increases the release of what

A

vasoconstrictor increasing BP

also increases the release of ADH and release of aldosterone

170
Q

Hormonal Control

aldosterone

A

increases Na+ (and H2O) retention increases BP

171
Q

Hormonal Control

artrial natriuretic peptide acts as a

A

stimulant of Na+ excretion ( and H2O) and also dialates blood vessels

decreases BP

172
Q

Hormonal Control

antidiruretic hormone

A

increases H2O retention to conserve blood volume, increases vessel constriction

increases BP

173
Q

Long-Term Regulation: Renal Mechanisms

The direct renal mechanism

A

counteract changes in BP by autonomic adjustments in filtration (and thus urine production)

174
Q

Long-Term Regulation: Renal Mechanisms

The indirect renal mechanism is the renin-angiotestin-aldosterone mechanism which

A

increases BP and adjust (as needed)

-decreased BP= increase renin release; renin helps make AT1; AT1 is convereted to AT2 by ACEs

-AT2 constricts vessels, stimulates thirst, increase ADH and aldosterone

175
Q

The goal of blood pressure regulation is to

A

keep BP high enough to provide adequate tissue profusion, but not so high that blood vessels are damaged

176
Q

alterations in blood pressure may result in

A

hypotention or transient or persistent high blood pressure

177
Q

circulatory shock is any condition where

A

blood flow is inadequate and cannot meet the needs of the tissue

178
Q

hypovolemic shock results from

A

significant loss of blood volume

179
Q

cardiogenic shock results from

A

heart pumps inefficiently usually due to infarction

180
Q

vascular shock is characterized by

A

lots of vasodialation- poor circulation- drop in BP

181
Q

intrinsic and extrinsic controls determine how

A

blood flows through tissues

182
Q

tissue perfusion is involved in

A

delivery of oxygen and nutrients to, and removal of wastes from tissue cells

183
Q

autoregulation

A

local regulation of blood flow

184
Q

how does autoregulation work

A

intrinsic adjustments of blood flow (constriction or dialation) based on local tissue needs

185
Q

metabolic controls of autoregulation are most strongly stimulated by

A

O2 levels (locally)

if low, dialate
if high, constrict

186
Q

myogenic control involves

A

local response (contraction) of smooth muscle in response to stretch

187
Q

blood flow to skeletal muscles varies with

A

levels of activity and fiber type

188
Q

muscular autoregulation occurs almost entirely in response to

A

O2 levels decrease locally during excerise so they dialate

189
Q

cerebral blood flow is regulated
related by

A

CO2 increase with activity
PH decrease with activity

Causing dilation

190
Q

autoregulatory controls of blood flow to the longs is opposite to

A

from what they are in the systemic circut because we want to load into veins only when there is O2

-low pulmonary O2 causes vasoconstriction instead of dilation seen in the systemic circut

191
Q

slow blood flow through capillaries promotes

A

diffusion of nutrients and gases and bulk flow of fluids

192
Q

velocity, or speed of blood changes as

A

it passes through the systemic system

193
Q

velocity (blood flow) is fastest

A

in aorta and decreases as total vessel diameter increases, so is slowest in the capillaries

194
Q

flow through capillaries reflects the action of

A

action of arterioles and sphincters that are the autoregulatory controls

195
Q

capillary exchange of nutrients, gases, and metabolic wastes occur between __ and __ through__

A

between blood and interstitial space through diffusion

196
Q

hydrostatic pressure (HP) Is

A

the force of fluid against a membrane

it is blood pressure- higher at arteriole end of capillary

197
Q

collodid osmotic pressure (OP) is created by

A

large solutes in plasma (e,g. albumins)

198
Q

Fluids will leave the capillaries if

A

net HP excedes OP, but fluid will enter capillaries if OP exceeds HP

-generally some fluids leave capillaries near arterioles, where some (but not all) is reabsorbed into plasma near venuoles

199
Q

Just need part 3 flashcards done

A
200
Q

where is the SA NODE

A

r atrium- quick pacemaker starts the beat

201
Q

where is the AV node

A

bottom of the interatrial septum near top of interventricular septum

202
Q

where does the AV split to bundle branches

A

interventricular septu,

203
Q

bundle branches divide to give

A

subendocardial conducting network (purkinje fibers)

AP2 (6 decks)

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