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Exam 2 Cardiovascular Flashcards

1
Q

Location of heart

A

Mediastinum

Mid thorax, between lungs

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2
Q

Pericardium and it’s layers

A

•a serous membrane

The two layers are as following
•Visceral: lines the organs
•parietal: lines the cavity

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3
Q

Pericarditis

A

Inflammation in pericardium

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4
Q

Chronic pericarditis

A

Increases pericarditis over time
(Gets worse and worse)

Treatment is removing excess fluid

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5
Q

Layers of the heart

A

•Epicardium

•myocardium
(makes up muscle of heart walks)

•endocardium

    •Myocarditis  (inflammation of myocardium)

    •Endocarditis  (Inflammation of endocardium)
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6
Q

Myocarditis and Endocarditis

A

Inflammation of myocardium

and inflammation of endocardium

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7
Q

Four major chambers of the heart

A 
Upper
     •left atrium 
     •Right atrium 
Lower
     •left ventricle 
     • right ventricle
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8
Q

Arteries take blood…

Veins take blood….

A

Away from the heart

Back to the heart

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9
Q

Needed by body’s cells to make atp

A

Oxygen

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10
Q

Bifurcation

A

When one vessel splits into two vessels

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11
Q

Right atrium receives blood from…

A
  • superior and inferior vena cava

* the coronary sinus

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12
Q

The right ventricle…

A

Receives blood from the right atrium

Sends blood to the lungs

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13
Q

Left atrium

A

Receives blood from the pulmonary veins

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14
Q

Left ventricle

A
  • Receives blood from left atrium
  • sends blood all over the body
  • thicker than the right ventricle
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15
Q

Right and left Antrioventricular valves

A
  • Tricuspid on right
  • Bicuspid (Mitral) on left
    * prevents back flow
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16
Q

Heart valves

A

Valves open and close in response to pressure changes as the heart contracts and relaxes

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17
Q

Right and left semilunar valves

A
  • pulmonary valves
  • aortic valves
    * prevents back flow from the arteries into the ventricles
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18
Q

Base

A

Top of heart

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19
Q

Apex

A

Bottom of heart

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20
Q

Heart Disorders

A

Mitral valve prolapse

Heart murmurs

Valvular stenosis

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21
Q

Pulmonary capillaries

A

Blood loses CO2 and gains O2

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22
Q

Systematic capillaries

A

Blood loses O2 and gains CO2

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23
Q

Coronary arteries

A

Branches arise from the ascending aorta

Blood flow delivers oxygenated blood and nutrients to the myocardium

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24
Q

Coronary veins

A

Branches converge at the lm coronary sinus

Removes carbon dioxide and wastes from the myocardium

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25
Q

Left coronary artery

A

Artery on left and right of heart

  • circumflex artery- left atrium, left ventricle
  • anterior interventrucular artery- interventricular septum
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26
Q

Right coronary artery

A

Marginal artery - right lateral heart walls

Posterior interventricular artery-R&L posterior ventricular walls

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27
Q

Cardiac veins

A

•return deoxygenated blood from myocardium

  • great cardiac vein
  • middle cardiac vein
  • small cardiac vein

•empty kitchen not the Coronary Sinus
(Bag on back of heart)

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28
Q

Angina pectoris

A

•Chest pain
I
•insufficient blood flow/
Blockage of coronary artery

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29
Q

Infarct

A

Myocardial infarction- Heart attack

Death of Ischemic Cells

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30
Q

Cardiac Muscle

A

•Intercalated discs
(Gap junctions- electrically coupled)
(Desmosomes- prevent separation)

  • Striated,
  • branched cell
  • 1-3 nuclei, many mitochondria
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31
Q

Intercalated discs

A

(Gap junctions- electrically coupled)

Desmosomes- prevent separation

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32
Q

Autorhythmic fibers

A
  • self excitable

* autorhythmic

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33
Q

Cardiac muscle cells

A

Repeatedly generate action potentials

…..

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34
Q

SA node

Sinoatrial

A

“Natural pacemaker of the heart”

  • impulses in right atrium 75 times per minute
  • initiate action potentials the most frequently
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35
Q

AV node

Atrioventricular

A
  • receives impulses
  • Contains autorhythmic fibers
  • ab node comes pacemaker at slower rate (50 bpm)
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36
Q

Signals from nervous system and hormones

A

modifies the heart rate and forces contraction

do not set the fundamental rhythm

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37
Q

Arrhythmias

A

Irregular heart rhythms

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38
Q

Fibrillation

A

Rapid irregular contractions

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39
Q

Heart block

A

-av node defect

  • beat slower than atria
  • implant pacemaker
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40
Q

Membrane potential

A

Measured by mV

Roughly -90 millivolts

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41
Q

Electrocardiogram (EKG)

A

measured in mV

Deflection waves 
(P wave- depolarization of atria)
(QRS wave- depolarization of ventricles)
                   (AV node)
                    (Atrial repolarization obscured)
(T wave- repolarization of ventricles)

Measuring voltage over time

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42
Q

Depolarization

A

Sodium flows into cell

Potassium flows out

Facilitated by Sodium

Causes muscle contraction

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43
Q

Repolarization

A

Opening of potassium channels

Facilitated by Potassium

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44
Q

Plateau

A

Maintained depolarization
Due to calcium

Facilitated by Calcium

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45
Q

Systole

A

Contraction

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46
Q

Diastole

A

Relaxation

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47
Q

Cardiac cycle Events

A

•electrical events
(Depolarization and repolarization)

  • pressure changes
  • volume changes
  • mechanical events
  • heart sounds
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48
Q

Mechanical events

A

….

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49
Q

Atrial contraction / Atrial systole

A

Contraction

Forces blood into ventricles

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50
Q

Isovolumetric contraction

A

.

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51
Q

Ventricular ejection

A

.

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52
Q

Stethoscope

A

Device allowing us to listen to heartbeat

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53
Q

Murmurs

A

Unusual heart sounds good

When blood goes somewhere it isn’t supposed to

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54
Q

Lub (S1)

A

First sound, longer, ab valves closing

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55
Q

Dup (s2)

A

Second sound, shorter, semilunar valves closing

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56
Q

Cardiac output (CO)

A

Volume of blood ejected from the ventricles into the aorta / pulmonary trunk every single minute

(Ml or L)

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57
Q

Stroke volume (SV)

A

Amount of blood pumped out of the ventricle every beat

(70ml/beat)

  • 60% of blood chamber
  • preload, contractility, and afterload
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58
Q

End diastolic volume

Relaxed). (EDV

A

Amount of blood in ventricle during diastole

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59
Q

End systolic volume

ESV

A

Amount of blood remaining in ventricle after systole

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60
Q

Preload

A

Amount of stretch put on ventricles

Cardiac muscles stretch just before contraction

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61
Q

Stretching muscle fibers

A

Increases force of contraction

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62
Q

Venous return

A

Blood going to heart

Connects two sides of heart

Most important factor in stroke volume

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63
Q

Contractility

A

Increase in contractility

Results in ejection or more blood from heart

Increases SV

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64
Q

Positive inotropic agents

A

Increase contractility

Sympathetic nervous system

Ca2+ (calcium)

Epinephrine

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65
Q

Negative inotropic agents

A

Decrease contractility

Calcium channel blockers

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66
Q

Afterload

A

Pressure ventricles must
overcome to eject blood

Increases ESV

Increased pressure

Amount of blood pressure found in aorta / pulmonary trunk

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67
Q

Hypertension

A

High blood pressure

Reduces ability of ventricle to eject blood

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68
Q

Autonomic nervous system

A

Sympathetic and Parasympathetic nerves

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69
Q

Sympathetic nerves

A

stimulate increased heart rate during stress

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70
Q

Parasympathetic nerves

A

Slow and steady heart rate after demand is over

71
Q

Hormones that increase heart rate

A

Epinephrine

Thyroxine

72
Q

Tachycardia

A

High Heart Rate >100 bpm

73
Q

Bradycardia

A

Low heart Rate

<60 bpm

74
Q

Heart rate

A

Faster in females

Fastest in fetus

Heat increases

Exercise decreased HR

Decreases with age

75
Q

End diastolic volume

A

Stretches the heart

Increased preload

76
Q

Positive inotropic agents

A

Increased sympathetic, catecholamines, or thyroid hormones in the blood

Increased calcium

Increase force of contraction of all levels of stretch

77
Q

Decreased steroid blood pressure during diastole

A

Semilunar valves open sooner when blood pressure in aorta

pulmonary artery is lower

Increased stroke volume

78
Q

Hypocalcemia

A

Low calcium blood levels

Depress heart activity

79
Q

Hypercalcemia

A

High calcium blood levels

Increase heart activity

80
Q

Hypernatremia

A

High sodium blood levels

Blocks calcium and contraction

81
Q

Hyperkalemia

A

High potassium levels (k+)

Depolarization

82
Q

Regular aerobic exercise

A

increase cardiac output

•decrease triglycerides

•

•

•

83
Q

Transplant

A

Need donor with similar antigens

84
Q

Intra-aortic balloon pump

A

Helps failing hearts

85
Q

Heart ventricular assist devices

A

AIDS in pumping of ventricles

86
Q

Coronary artery disease

A

Obstructed lumen

Atherosclerotic plaque

87
Q

Congestive heart failure

A

Inadequate for tissue needs

Progressive Disease

High blood pressure

Coronary atherosclerosis (clogged vessels)

Myocardial infarction

Can result in pulmonary or systemic edema

88
Q

Heart defects in babies

A

Coarctation of the aorta

Increase workload

Septal defects

Patient ductus arteriosus

Systemic blood with oxygenated pulmonary blood

89
Q

Tetralogy of fallout

A

Multiple defects in babies

90
Q

Hypertrophied

91
Q

Atherosclerosis

A

Changes in walls of great arteries

lipid deposits

92
Q

An increase stoke volume would cause…

A

An increase of cardiac output (CO)

Co= SV • HR

93
Q

This part of the conduction system causes ventricular myocardial cells to contract…

A

Purkinje Fibers

94
Q

P wave

A

Atrial contraction

95
Q

Tunica interna

Tunica intima

A

Innermost layer of blood vessels

96
Q

Tunica media

A

Middle layer of blood vessel

Has smooth muscle and elastic fibers

97
Q

Tunica externa

A

Outermost layer of blood vessels

98
Q

Arteries

A

Take blood away from the heart to the tissues

Walls of arteries are elastic

Absorbs pressure created by ventricles of the heart

Smooth muscle in the tunica media

Regulates blood flow

99
Q

Capillary beds

A

Smallest substance exchange

Vessels connect arterioles and venules

Single layer of endothelium

Basement membrane

Exchange of nutrients

10-100/ bed

100
Q

Veins

A

Return blood to heart

Brings blood back in

101
Q

Arterioles

A

Smallest arteries

feed blood into capillary beds

Thin

Construct and dilate to control flow of blood into tissues

102
Q

Venules

A

Drain capillary beds, empty into vein

103
Q

Muscular arteries

Distributing arteries

A

Smooth muscle

fewer elastic tissue

Most of the body arteries

Distributes blood

104
Q

Elastic arteries

Conducting arteries

A

Aorta and major branches

More elastic fibers

Less smooth muscle

Withstands great pressure

105
Q

Vascular shunt

A

Connects arterioles and venules

106
Q

precapillary sphincter

A

Smooth muscle fibers

Surrounding capillary

Regulate blood flow

107
Q

Metarteriole

A

Feeds capillary bed

108
Q

Postcapillary Venule

A

drains capillary bed

109
Q

Continuous Capillaries

A

Intercellular clefts (allows passage of fluids through vessels)

Small solutes

Skin and muscles

110
Q

Fenestrated capillaries

A

Found in intestines, endocrine glands, kidneys

Has Oval pores with delicate membrane

111
Q

Sinusoidal capillaries

A

Found in liver, bone barrow, lymphoid tissue

Usually fenestrated

112
Q

Veins

A

Formed from venules

Thinner tunica interna and tunica media

Thicker tunica externa

Low pressure

Elastic tissue; less smooth muscle

Contain valves

Blood Reservior: 65%
Found in veins

113
Q

Venous sinuses

A

Coronary sinus

114
Q

Varicose veins

A

Overworked valves give way

Becomes twisted

Obesity and pregnancy exert pressure on lower vessels

———-

115
Q

Arteries anastomoses

A

.joints- movement may hinder flow

Present in brain, heart, abdominal organs

116
Q

Venous anastomoses

A

More abundant

117
Q

Vascular anastomoses

A

Provides alternative route for blood flow

Arterial anastomoses

Venous anastomoses

118
Q

Blood reservoirs

A

Largest portion of blood;
In Systemic veins and venules

Systemic veins and venules (blood reservoirs) 64%

119
Q

Capillary exchange

A

Gas exchange

Diffusion- simple diffusion;
substances such as oxygen, carbon dioxide, glucose, amino acids

Transcytosis- large, lipid-insoluble molecules (Like insulin).

Bulk flow- passive process; higher pressure to lower pressure

120
Q

Filtration in reabsorption

A

Filtration- from blood capillaries into interstitial fluid;
•blood hydrostatic pressure and interstitial fluid osmotic pressure promotes filtration

Reabsorption-
•interstitial fluid hydrostatic pressure and blood colloid osmotic pressure promotes reabsorption

121
Q

Venous blood return

A

Steady pressure

  • respiratory pump-
  • muscular pump-
122
Q

Maintaining blood pressure

A
  • Short term

- long term

123
Q

Systemic blood pressure

A

BP of vessels- force exerted on vessel wall by blood (mm Hg)

                    - resistance to flow 
                      - pressure gradient keeps blood moving from high to low
124
Q

Blood pressure

A

Systolic and Diastolic blood pressure

Higher the BP the higher the blood flow

Aorta-highest pressure
Venacava- lowest pressure

Determined by CO, blood volume, resistance,

125
Q

Arterial blood pressure

A

Systolic pressure- 120 mm Hg

Diastolic pressure- 70-80 mm Hg; ventricles relax

Capillary blood pressure- enters at 40 mm Hg; exits at 20 mm Hg

126
Q

Monitoring arterial blood pressure

A

Pulse pressure= Systolic- diastolic
-indicates elasticity of arteries

Mean Arterial Pressure (MAP)= diastolic + (pulse pressure/3)
-average pressure; propels blood to tissues

127
Q

Measuring blood pressure

A

Listen for Korotkoff sounds

Sphygmomanometer- BP cuff

First sound- indicates systolic pressure

Diastolic pressure 70-80 mm Hg

128
Q

Pulse

A

Alternating expansion and recoiling of elastic arteries

Changes occur during activity, posture changes, and emotional pressure

129
Q

Maintaining blood pressure

A

Regulated by cardiac output, peripheral resistance, and blood volume

Short term regulation: neural and hormonal
Long term: renal

Peripheral resistance- amount of friction the blood encounters in the blood vessels

130
Q

Total Peripheral Resistance (TPR)

Factors of resistance

A

Opposition to blood flow is due to friction

Higher resistance leads to lower flow

  • blood viscosity- thickness of fluid; plasma proteins
  • vessel length- usually constant; obesity-409 miles/2.2lb of fat
  • vessel diameter- vasoconstriction
131
Q

Vessel diameter

A

Decrease diameter increase resistance

Vasoconstriction- can change frequently

132
Q

Vessel length

133
Q

Blood viscosity

134
Q

Short term bp controls

A

•Neural control-
Vasomoter center- changes in diameter
Vasomotor tone- construction
Baroreceptors- mechanoreceptors- become stretched/ pressure sensitive

Etc.etc…

•Hormonal control-

135
Q

Primary hypertension

A

Factors:

Diet

Obesity

Age

Stress

Smoked

136
Q

Secondary hypertension

A

Excessive renin secretion

137
Q

Pharmaceutical hypertension treatment

A

Ace inhibitors

Diuretics

Beta blockers (beta 1 receptor)

Vasodilators

Calcium channel blockers

(All decrease blood volume)

138
Q

Shock

A

Hypovolemic

139
Q

Responses to shock

A

Renin-angiotensin-aldosterone system

Secretion of antidiuretic hormone

Release of local Vasodilators

140
Q

Responses to hypovolemic shock

A

(Low volume shock)

Baroreceptors in carotid sinus and arch of aorta

141
Q

Symptoms of shock

A

Tachycardia

Weak, rapid pulse

Hypotension

Altered mental status

Thirst

Decreased urine output

142
Q

Special circulatory routes

A

Coronary circulation

Hepatic portal circulation

143
Q

Aging in the cv system

A

Loss of compliance of aorta

Increased systolic blood pressure

Decline in max heart rate

Loss of cardiac muscular strength

144
Q

Filtration

A

Promoted by blood hydrostatic pressure and Interstitial fluid osmotic pressure

145
Q

Reabsorption

A

Promoted by Interstitial fluid

hydrostatic pressure and blood colloid osmotic pressure

146
Q

Cardiac output

A

Venous return (SV)

Neural and hormonal control (HR)

Enhanced CO increases MAP

147
Q

Peripheral resistance

A

Amount of friction the blood encounters in the blood vessels

148
Q

Blood volume

A

Regulated by the kidneys

149
Q

Control mechanisms of BP

A

Short term: neural and hormonal

Long term: renal

150
Q

Blood viscosity

A

Thickness of a fluid

Increased viscosity (more resistance)

Usually constant

Ratio of rbcs to plasma and plasma proteins

151
Q

Vessel length

A

The longer the vessel the more resistance

Usually constant

Obesity- 400miles/2.2lb of fat

152
Q

Vessel diameter

A

Decrease diameter increase resistance

Vasoconstriction (can change frequently)

153
Q

BP controls

A

Vasomotor center

Baroreceptors

Chemoreceptors

Higher brain centers

154
Q

Vasomotor center

A

Oversees changes in diameter

Vasomotor tone- construction of arterioles

155
Q

Baroreceptors

A

Carotid sinus reflex- protects blood supply to brain

Aortic reflex- maintains BP or systemic circuit

Inhibits vasomotor center causing arterioles & veins to vasodilate

Heart Rate and contraction force reduced

156
Q

Chemoreceptors

A

Respond to change in: oxygen, carbon dioxide

Located in aortic arch

Increase CO and Vasoconstriction

Return of blood to heart & lungs

157
Q

Higher brain centers

A

Hypothalamus
-mediated fight or flight response

-mediates blood flow during exercise or body temp changes

Cerebral cortex can modify sympathetic system

158
Q

Vasoconstrictors

Hormonal Controls

A
  1. Adrenal medulla hormones
    - NE and epinephrine vasoconstriction
  2. Angiotensin ||
    - stimulates release of aldosterone and ADH
    - vasoconstriction up
  3. ADH
    - vasoconstriction up
159
Q

Vasodilators Hormonal Controls

A
  1. ) Ateual natriuretic peptide (ANP)
    - hormone produced by atria
    - vasoconstriction down

OTHER CHEMICALS

  1. ) Inflammatory chemicals
    - histamine
    - vasoconstriction down (redness)
  2. )Alcohol
    - ADH release
    - Vasoconstriction down (flushed appearance)
160
Q

Renal regulation

A

Direct renal mechanism

Kidneys alter BP through blood volume

If BP is high, or BV high fluid filters out of the blood faster, produce more urine

If BP is low, or BV is low, kidney has time to return water to blood, less urine produced.

161
Q

Renin-angiotensin mechanism

A

Drop in blood pressure

Drop in fluid volume

162
Q

Angiotensin ||

A

Activation is caused by Renin

Angiotensin || causes

  • release of aldosterone
  • release of ADH
  • stimulates thirst center
  • vasoconstrictor
163
Q

Decreased bp and bv

A

Leads to either

1.) endocrine mechanism
A. ADH

2.)Neural mechanism
A.Baroreceptors, chemoreceptors stimulated
B.general sympathetic activation
C. Cardiovascular centers stimulated

164
Q

Autoregulation

A

The ability of a tissue to automatically adjust its own blood flow

165
Q

Orthodontic Hypotension

A

Temporary low BP

Seen in elderly due to aged SNS

Reduced blood flow to brain

166
Q

Chronic hypotension

A

Low blood viscosity

167
Q

Hypertension

A

High BP

Normal during fever, physical exertion, and emotional stress

168
Q

Chronic hypertension

A

Progressive disease

Major cause of heart failure, renal failure, and stroke

Heart works harder against greater resistance, myocardium enlarges,

Causes small tears in blood vessel walls

169
Q

Homeostatic imbalances

A

Normal:

  • less than 120 systolic
  • less than 80 diatomic

Prehypertension:

  • 120-139 systolic
  • 80-89 diastolic

Stage 1 hypertension:

  • 140-159 systolic
  • 90-99 diastolic

Stage 2 hypertension:

  • 160+ systolic
  • 100+ diastolic
170
Q

Primary hypertension

A

90% of hypertensive population

No underlying cause

Factors:

  • diet
  • obesity
  • age
  • stress
  • smoking
171
Q

Secondary hypertension

A

10% of hypertension population

Causes:

  • excessive renin secretion
  • arteriosclerosis
172
Q

Treating hypertension

A

Loose weight

Limit alcohol consumption

Exercise

Reduce intake of sodium

don’t smoke

Manage stress

173
Q

Hypertension medication

A

Diuretics

ACE inhibitors

Beta blocks

Vasodilators

Calcium channel blockers

174
Q

SV x HR =CO

A

Cardiac output

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