Exam 2 Flashcards
Location of heart
Within mediastinum
2/3 of heart to left of midline
Apex between ribs 5 and 6
Area of chest wall overlying the heart
Precordium
Inner most layer of heart continuous with vessels entering/exiting heart
Endocardium
Middle layer of heart made of contractile cardiac muscle
Myocardium
Thin, outermost layer of heart that forms part of pericardium
Epicardium
Pericardium is a sling-like structure composed of _______ membranes.
Serous Membranes
Three layers of pericardium from inside-out.
Visceral Pericardium (innermost) Parietal Pericardium (middle) Fibrous Pericardium (outermost)
Space between visceral and parietal layers of pericardium.
Pericardial Space or Cavity
Compression of heart due to effusion - life threatening
Cardiac Tamponade
Type of circulation in right heart.
Type of circulation in left heart.
Pulmonary Circulation
Systemic Circulation
Separates right and left atrium.
Interatrial Septum
Separates right and left ventricle
Interventricular Septum
Enlargement of ventricles due to over working of the heart. Caused by high blood pressure.
Ventricular Hypertrophy
Cusps of valves attached to ventricle wall by ________ muscle and ________ ______
Papillary Muscle
Chordae Tendineae
Narrowing of valve forcing heart to pump harder.
Stenosis
“Leaky” valve allowing blood to flow backward
Incompetence
Path of blood - Rt. atrium to pulmonary capillaries. (7 steps)
Rt Atrium Tricuspid Valve Rt Ventricle Pulmonary Semilunar Valve Pulmonary Trunk Rt/Lt Pulmonary Arteries Pulmonary Capillaries in Lungs
Path of blood - Pulmonary capillaries in lungs to Aorta. (7 steps)
Pulmonary Capillaries in Lungs Four Pulmonary Veins Left Atrium Bicuspid (Mitral) Valve Left Ventricle Aortic Semilunar Valve Aorta
A passage that diverts blood from tis normal flow
Shunt
Ventricular Septal Defect - Left ventricle pumps blood both to aorta (normal) and through defect in right ventricle.
Left to Right Shunt
Left to right shunt is _______ because oxygenated blood is still being pumped by left ventricle.
Acyanotic
Right to left shunt is _______ because deoxygenated blood is entering left ventricle and systemic circulation
Cyanotic
Blood supply of myocardium - comes from ________ ______.
Coronary arteries
Blood supply of myocardium - leaves thru _______ ____ to ______ ______ ______ and back to ______ _____
Coronary Veins
Coronary Venous Sinus
Right Atrium
Coronary blood supply - blood flow can increase __ - __ times with exercise.
4 - 5
Coronary blood flow is greatest when…
heart is at rest
Coronary arteries can form __________ (connections between vessels)
Anastomoses
Decreased oxygen to myocardium
Ischemia
Chest pain due to ischemia of heart muscle
Angina Pectoris
Death of myocardial cells due to coronary artery occlusion
Myocardial Infraction (heart attack)
Heart attack symptoms (7)
Crushing chest pain Nausea Sweating Fatigue Heartburn Upset Stomach
Pacemaker & location
Sinoatrial node - upper, posterior wall of right atrium
_____ _____ fibers transmit impulse thru atria.
Atrial Conducting Fibers
__________ ____ slows impulse to give time for ventricle to fill before signal continues and stimulates ventricles.
Atrioventricular Node (AV Node)
Three parts of His-Purkinje System
Bundle of His - inter ventricular septum
Right and left bundle branches - thru interventricular septum
Purkinje Fibers - transmit cardiac impulse through myocardium of ventricles
Heart’s ability to generate the cardiac impulse
Automaticity
The heart conducts the cardiac impulse at regular intervals
Rhythmicity
Disturbance is heart’s normal rhythm.
Dysrhythmia (Arhythmia)
Uncoordinated contraction of myocardium causing the heart muscle to quiver.
Ventricular Fibrillation
Result of ventricular fibrillation
heart unable to pump blood
Cardiac impulses generated from cardiac tissue other than SA node.
Ectopic Focus
ECG measures…
The electrical activity of the heart
ECG - Atrial depolarization
P-wave
ECG - QRS complex
Ventricular depolarization
ECG - T-wave
Ventricular repolarization
Cardiac Cycle - Contraction of heart muscle
Systole
Cardiac Cycle - Relation of heart muscle
Diastole
The events that occur in the heart during one heartbeat.
Cardiac Cycle
Atria contract pumping blood into ventricles.
Atrial Systole
Ventricle contract pumping blood into pulmonary trunk and aorta.
Ventricular Systole
Heart relaxes allowing blood to fill chambers.
Diastole
Three ways the autonomic nervous system can affect heart activity.
Alter the rate at which the cardiac impulse is fired.
Change the speed at which it travels through the heart.
Increase the force of myocardial contraction.
Increased SA node activity –> increased HR
Increased speed of impulse through conduction system
Increased force of myocardial contraction
SYMPATHETIC stimulation of heart
Potential clinical results (3) of excessive sympathetic stimulation of the heart.
Racing heart due to “fight or flight” response
Circulatory shock; heart failure
Tachydysrhythmia (rhythm of too fast HR)
Term for too slow of heart rate? Less than __bpm.
Bradycardia
60
Decreased SA node activity –> decreased HR
Decreased speed through conduction system
NO effect on FORCE of heart contraction
PARASYMPATHETIC stimulation of heart
Potential clinical results of excessive parasympathetic stimulation of heart.
Bradycardia - HR less than 60bmp (too slow)
Term for too fast of heart rate?
Tachycardia
The amount of blood pumped by each ventricle in 1 minute.
Cardiac output
Cardiac output = ____ ____ x ____ _____
Heart Rate x Stroke Volume
Amount of blood pumped by ventricle in each heart beat.
Stroke Volume
Normal HR
60-100 bpm
Average HR
72 bpm
Resting HR differs according to: (8)
size gender age exercise autonomic NS control hormone influence pathology medications
Average resting SV
60 - 80 ml per beat
Ventricles normally only pump approximately ___% of blood
67
Starling Law of the heart
The greater the stretch on myocardial fibers, the greater the force of contraction (the more blood in the ventricle, the more forceful the contraction, the greater the SV)
A positive ______ effect can increase the force of contraction without stretching myocardial fibers. (sympathetic stimulation)
Inotropic effect
Amount of blood in ventricle at the end of resting phase (aka preload)
End Diastolic Volume
The percentage of blood pumped from ventricle following contraction? Typically ___%
Ejection Fraction
Resistance to blood flow from the ventricles
Afterload
A change in myocardial contraction not related to stretch of myocardium
Inotropic Effect
Positive inotropic effect
increases the force of myocardial contraction
Negative inotropic effect
decreases the force of myocardial contraction
Chronotropic Effect
A change in HR
Positive chronotropic effect comes from _______ stimulation
sympathetic
Negative chronotropic effect comes from _______ stimulation.
parasympathetic
A change in speed of the transmission of the cardiac impulse
Dromotropic Effect
Left ventricle fails to pump blood to the aorta.
left heart failure
Left heart failure is usually due to _______ ______ or ______ ________.
Myocardial Infarction
Chronic Hypertension
Backward Failure (left heart failure)
Blood backs up in pulmonary circulation
Pulmonary Edema - fluid build-up in lungs
Forward Failure (left heart failure)
Systemic circulation does not effectively receive oxygenated blood
Increased sympathetic stimulation
Right heart failure
Right ventricle fails to pump blood into pulmonary arteries
Usually due to left-sided heart failure or chronic lung disease
Pulmonary Circulation (3 parts)
Rt Ventricle –> Lungs –> Lt Atrium
Systemic Circulation (3 parts)
Lt Ventricle –> rest of body –> Rt Atrium
Arteries branch until they become smaller and smaller vessels called ________.
arterioles
Smallest vessels
Connect arterioles with venules
Exchange of oxygen
Capillaries
Small _______ converge to form larger veins.
venules
Blood vessel layers from inside-out
Tunica Intima
Tunica Media
Tunica Adventitia
Tunica Media - which layer and what it’s made of.
Middle layer - elastic tissue and smooth muscle
Smooth muscle is ________ in arteries to support _______ ______.
thicker
higher pressure
Tunica Adventitia - which layer and what it’s made of.
Outermost - connective tissue
Vessels that conduct blood from larger arteries to arterioles
Conductance Vessels
Vessels that constrict and dilate to alter blood flow.
Resistance Vessels
Vessels that allow for the exchange of nutrients and waste.
Exchange Vessels
Type of vessel - Storage of blood. Approximately 70% of blood volume is found in venous circulation.
Capacitance Vessels
Veins contain ___-___ ______ to prevent the back-flow of blood
one-way valves
Brachiocephalic artery or trunk branches to… (2 parts)
Right Common Carotid Artery
Right Subclavian Artery
Three main branches of Aortic Arch
Brachiocephalic Trunk
Left Common Carotid Artery
Left Subclavian Artery
Descending Aorta –> _______ Aorta –> ________ Aorta
Thoracic Aorta
Abdominal Aorta
_______ _______ arteries branch off of the thoracic aorta.
Posterior Intercostal Arteries
6 branches off of abdominal aorta.
Celiac Trunk Superior Mesenteric Artery Inferior Mesenteric Artery Renal Arteries (right and left) Gonadal Arteries (ovarian and testicular) Lumbar Arteries
The aorta ends at the __ _____ by branching into a right and left ________ ____ artery.
L4 Level
Common Iliac Artery
Veins can be classified and either ____ or ________.
deep or superficial
Two veins that drain directly into SVC.
Brachiocephalic Veins (right and left) Azygos Vein - drains thorax
Three veins that drain directly into IVC
Rt/Lt common iliac veins
Renal Veins
Hepatic Veins
Four major superficial veins
thumbs up… thumb towards ______, pinky towards _______, “V” in elbow pit, longest vein in body
Cephalic Vein
Basilic Vein
Median Cubital Vein
Great Saphenous Vein
Since the brain requires a continuous supply of oxygen, it receives dual blood supply from….
Vertebral Arteries (left and right) Internal Carotid Arteries (left and right)
External Carotid Arteries supply ____, ____ and _____
neck, face and scalp
Supply most of the blood to the brain.
Internal Carotid Arteries
A dilated region at the origin of the internal carotid that functions as a baroreceptor.
Carotid Sinus
Baroreceptor
Pressure receptor
Monitors blood pressure to the brain
Left and right _______ arteries join together on the brain stem to form the ______ ______.
Vertebral Arteries
Basilar Artery
The ______ carotids and _______ arteries connect to form the circle of ______
Internal Carotids
Basilar Arteries
Circle of Willis
Occlusion of the blood supply to the brain can result in ________, ________ and/or _______.
Dizziness
Confusion
Stroke
(2) Venous drainage of head and brain.
External Jugular Veins
Internal Jugular Veins
External Jugular Veins drain _______ head and neck and empty in __________ veins.
Posterior
Subclavian
Internal Jugular Veins drain ______ head, neck and _____.
Anterior
Face
Internal Jugular Veins join with __________ veins to form ____________ veins.
Subclavian
Brachiocephalic
Which jugulars drains most of the blood from the venous sinuses of brain?
Internal Jugular Veins
Hepatic Circulation
Blood supply to liver
Three groups of vessels associated with hepatic circulation.
Portal Vein
Hepatic Veins
Hepatic Artery
The portal vein is formed by the joining of the ________ ________ and ______ veins.
Superior Mesenteric
Splenic
The portal vein carries blood rich in digestive end products from the ________ _____ to the ______.
Digestive Organs
Liver
Hepatic Artery - branch of ______ _____ and supplies _______ to the ______.
Celiac Trunk
Oxygen to the liver
Hepatic Veins - drain deoxygenated blood from _____ and empties into the ___ (abbreviation)
Liver
IVC
The umbilical cord has one large _____ and two smaller umbilical ______.
Vein
Arteries
Carries oxygenated blood from placenta to fetus.
Umbilical Vein
Umbilical Arteries originate from the right and left ________ ______ arteries of the fetus.
Common Iliac
Carries deoxygenated blood and waste products to the placenta.
Umbilical arteries
Fetal Modification - Connects umbilical vein to inferior vena cava.
Ductus Venosus
Opening within intertribal septum which allows blood to flow from right to atrium thereby bypassing fetal lungs.
Foramen Ovale
Allows blood to flow from pulmonary artery to aorta bypassing fetal lungs.
Ductus Arteriosus
Wave traveling thru the arteries with each beat of the heart.
Pulse
Information a pulse provides (4)
Heart Rate
Regularity of heart beat
Strength of heart beat
Occlusion or blockage of artery
Failure of vessels to transport blood results in…
Ischemia
“5 cool Ps” symptoms of ischemia
Pain Pulselessness Pallor Paresthesia Paralysis Coolness
Pallor
Coloration of skin (pale)
Paresthesia
Altered sensation (tingling)
5 functions of blood vessels
Delivery Blood Pressure Regulation Exchange of nutrients and waste Redistribution of blood Temperature regulation
The pressure in the arteries at the peak of ventricular contraction.
Systolic Pressure
The pressure in the arteries during ventricular relaxation.
Diastolic Pressure
Blood pressure for normal adult…
120/80
Systolic Pressure - Diastolic Pressure = ______
Pulse Pressure
Instruments used measuring blood pressure.
Sphygmomanometer
Stethoscope
Artery compressed until blood flow is stopped to measure blood pressure.
Brachial Artery
Sounds heard through stethoscope.
Korotkoff Sounds
First sound heard when taking blood pressure.
Systolic Pressure
Recorded when Kotfkoff sounds disappear
Diastolic Pressure
Elevation of blood pressure
Hypertension
Blood vessel with highest blood pressure
Aorta
Blood vessel with lowest blood pressure
Vena cavae
7 generalized vessels between aorta and vena cavae (highest to lowest in terms of blood pressure)
Aorta Large arteries Small arteries Arterioles Capillaries Venules Small veins Large veins Vena Cavae
Three mechanisms that return blood back to heart.
Skeletal Muscle Pump
Respiratory Pump
Venoconstriction
Increase in vessel diameter causes a decrease in resistance and decrease in BP
Vasodilation
Vasodilation - relaxation of ______ _____ in vessels
smooth muscle
Decrease in vessel diameter causes an increased resistance and an increase in BP
Vasoconstriction
BP = ______ ______ x _______ _______
Cardiac Output
Vascular Resistance
Cardiac Output = __ x __
SV x HR
Most important factor in vascular resistance.
Diameter of vessel
Rapidly acting mechanism for maintaining blood pressure.
Baroreceptor Reflex
4 parts of baroreceptor reflex
“C.A.B Glo’s MO Motor”
Carotid and Aortic Baroreceptors –> Glossopharyngeal –> Medulla Oblongata –> Motor Nerves
Slowly Acting Mechanism for maintaining blood pressure.
Hormone regulated long-term maintenance
Four elements that move out of the blood stream at the capillary level
Oxygen
Water
Electrolytes
Glucose
% of materials that return to blood stream after exiting at capillary level.
85%
Three characteristics of capillaries
Thin walled with pores
Numerous
Slow blood flow
Three forces involved in the exchange of substances across the capillary wall.
Diffusion
Filtration
Osmosis
Particles move from high concentration to low concentration
Diffusion
Substance moves/separates from high pressure to low pressure.
Filtration
Diffusion of water
Osmosis
The accumulation of fluid in interstitial space.
Edema
Four mechanisms of edema formation.
Heart Failure
Sever Burn
Kidney Disease
Blocked Lymphatic Drainage
Five characteristics of vessels and circulation as you age.
B.R.A.V.I.
Baroreceptors become less effective
Roughening of endothelial lining of vessels
Artery walls thicken
Valves become less effective
Increased Capillary membrane permeability
Two consequences of thickening artery walls.
Decreased blood flow
Increased blood pressure
Consequences of roughening of endothelial lining of vessels.
Increased blood clot formation
Consequence of valves becoming less effective.
More susceptible to varicosities (varicose veins)
Consequences of baroreceptors becoming less effective.
Dizziness
Falls
Consequence of increased capillary membrane permeability.
Increased edema formation