Exam 2 Study Guide Flashcards

1
Q

anastomoses

A

collateral / alternative routes to prevent blockage of blood supply

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2
Q

bradycardia

A

persistent resting adult heart rate <60 BPM

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3
Q

tachycardia

A

persistent resting adult heart rate > 100 BPM; may lead to fibrillation

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4
Q

fibrillation

A

rapid, irregular contractions; useless for pumping blood ➡️ circulation ceases ➡️ brain death
ex) “looks like a bag of worms”

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5
Q

angina pectoris

A

imbalance associated with coronary circulation; temporary ischemia (blockage) of circulation; can be caused by spasms of coronary arteries or increased demand on the heart; cells are weakened

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6
Q

cardiac tamponade

A

too much fluid in pericardium ➡️ compresses heart ➡️ limits pumping ability

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7
Q

pericarditis

A

inflammation of pericardium; not enough serous fluid

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8
Q

ductus arteriosis

A

connects pulmonary trunk to aorta in baby

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9
Q

ligamentum arteriosum

A

connects pulmonary trunk to aorta in adults

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10
Q

auricles

A

found in atria; appendage that increases atrial volume

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11
Q

pectinate muscles

A

mark right atrial wall and auricles; resemble teeth of a comb

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12
Q

fossa ovalis

A

remnant of foramen ovale in adult; depression in right atrium @ level of interatrial septum

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13
Q

foramen ovale

A

opening that connects atria in baby

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14
Q

trabeculae carneae

A

rounded / irregular muscular columns which project from inner surface of right + left ventricle

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15
Q

valvular prolapse

A

“incompetent valve”; blood backflows so heart repumps same blood over and over; caused by improper closing of valves

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16
Q

myocardial infarction

A

heart attack; prolonged ischemia; fibrosis (no longer functional cells)

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17
Q

congestive heart failure (CHF)

A

progressive condition; due to weakened heart caused by
1) coronary atherosclerosis = plaque buildup

2) persistent high bp
3) multiple MIs
4) valvular insufficiency = leaky valves
5) dilated cardiomyopathy (DCM): ventricles stretch & become flabby; causes = unknown, alcohol

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18
Q

inotropic (pos. & neg.)

A

substances that control contractility

1) positive inotropic agents increase contractility: hypercalcemia; certain hormones (glucagon, thyroxine, epinephrine)
2) negative inotropic agents decrease contractility: acidosis created by hypercapnia (increase in CO2 & H+); hyperkalemia (too much K in blood); hypocalcemia (calcium channel blockers)

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19
Q

chronotropic (pos. & neg.)

A
  • positive factors = ⬆️HR
  • negative factors= ⬇️HR
  • K+ has greatest chronotropic effect
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20
Q

cardiac reserve

A

difference between resting and maximal cardiac output (CO)

  • greater w/ fitness
  • less w/ disease
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21
Q

baroreceptors

A

stretch receptors; monitor changes in BP; causes increased ANS stimulation; pressure sensors in aortic arch, carotid sinuses & large arteries of neck & thorax

-⬇️BP = ⬆️HR

-⬆️BP= ⬇️HR
by cardiac center to match HR

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22
Q

chordae tendineae

A

anchor cusps of AV valves to papillary muscles

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23
Q

papillary muscles

A

muscles located in ventricles; attach to cusps of AV valves via chordae tendineae

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24
Q

coronary circulation

A

circulation to the heart itself

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25
Q

layers of heart wall / pericardium (from outer ➡️ inner)

A

epicardium ➡️ myocardium ➡️ endocardium

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26
Q

epicardium

A

visceral layer of serous pericardium; infiltrated w/ fat

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27
Q

myocardium

A

bundle of cardiac muscle cells forming bulk of fat

-contains fibrous cardiac skeleton of heart= crisscrossing layer of connective tissue; prevents electrical signal to move from contracted atria to relaxed ventricles or vice versa; nonconductor

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28
Q

endocardium

A

inner myocardial surface

  • simple squamous epithelium (endothelium)
  • inside lining of heart is continuous with inside lining of blood vessels which is continuous with lining of lymphoid tissues
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29
Q

importance of ventricle wall thickness

A

thickest in left ventricle so chamber can create enough pressure needed to pump blood into aorta and throughout systemic circulation

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30
Q

purpose of heart valves (why do they open & close?)

A
  • ensure unidirectional blood flow through heart

- open & close in response to pressure changes

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31
Q

major types of valves (2)

A

1) atrioventricular valves between atria & ventricles

2) semilunar valves between ventricles & major arteries

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32
Q

what is the “lub-dup” sound associated with?

A

closing of the heart valves

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33
Q

first sound (S1)

A

occurs as AV valve closes & signifies beginning of ventricular systole (contraction)

  • S1 is louder & longer
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34
Q

second sound (S2)

A

occurs when SL valves close at the beginning of ventricular diastole (relaxation)

-S2 is softer & shorter

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35
Q

systole

A

contraction of heart muscle

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36
Q

diastole

A

relaxation of heart muscle

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37
Q

trace path of blood through heart

A

right atrium ➡️ tricuspid valve ➡️ right ventricle ➡️ pulmonary semilunar valve ➡️ pulmonary trunk ➡️ pulmonary arteries ➡️ lungs ➡️ pulmonary veins ➡️ left atrium ➡️ bicuspid valve ➡️ left ventricle ➡️ aortic semilunar valve ➡️ aorta ➡️ body

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38
Q

right side of heart

{pulmonary vs systemic circuit}

A

pumps blood to lungs to get rid of CO2 & pick up O2 via pulmonary circuit

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39
Q

left side of heart

{pulmonary vs systemic circuit}

A

receives oxygenated blood from lungs; pumps blood to body tissues via systemic circuit

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40
Q

right atrium

{receiving chamber of heart}

A

receives blood returning from systemic circuit

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41
Q

left atrium

{receiving chamber of heart}

A

receives blood returning from pulmonary circuit

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42
Q

right ventricle

{pumping chamber of heart}

A

pumps blood through pulmonary circuit

43
Q

left ventricle

{pumping chamber of the heart}

A

pumps blood through systemic circuit

44
Q

autorhythmic

A

heart muscle is self-excitable

45
Q

importance of Ca2+ in the heart

A
  • plays important role in cardiac muscle fibers
  • 10-20% comes from extracellular fluid (from blood to heart)
  • once it is inside the heart, 80% is released from sarcoplasmic reticulum
  • during excitation-contraction coupling, it binds to troponin ➡ filaments slide
46
Q

flow through the intrinsic conduction system

A

sinoatrial (SA) node ➡ atrioventricular (AV) node ➡ atrioventricular (AV) bundle ➡ bundle branches ➡ purkinje fibers

47
Q

function of pacemaker cells

A

unstable resting potentials = pacemaker potentials / prepotentials

  • cells start at -60mv & slowly drifts toward threshold (-40mv)
  • Na+ gates NEVER close; no resting membrane potential
48
Q

function of depolarization

A

at approx. -40mv Ca2+ channels open

  • use calcium (rather than sodium) for rising phase of action potential
  • Ca2+ channel blockers causes less depolarization to control heart rate
49
Q

repolarization

A

closes Ca2+ gates & opens K+ gate

50
Q

sinoatrial (SA) node

A

in right atrium; pacemaker / generates impulses

51
Q

atrioventricular (AV) node

A

receives signal from SA node by gap junctions; gateway to ventricles ➡ only way signal can spread from atria to ventricles

52
Q

what prevents SA node signal from spreading to ventricles?

A

fibrous cardiac skeleton

53
Q

atrioventricular (AV) bundle

A

connects atria to ventricles

54
Q

bundle branches

A

smaller wires than wires through purkinje fibers ; slows down signal which allows time for atrium to contract; conduc impulses through interventricular septum

55
Q

purkinje fibers

A

depolarizes the contractile cells of both ventricles; larger wires than bundle branches to depolarize ventricle & contract while atrium is relaxed

56
Q

types of myocytes (2)

A

contractile cells

pacemaker cells

57
Q

contractile cell

A

responsible for contraction

58
Q

pacemaker cell

A

noncontractile cells that spontaneously depolarize; initiate depolarization of entire heart

59
Q

where are gap junctions located and why?

A

only in apex to push blood upward & contracts from apex up

60
Q

electrocardiogram (ECG / EKG)

A

graphic recording of electrical activity; composite of all action potentials at a given time; not a tracing of a single AP

61
Q

P wave (of an ECG)

A

corresponds to depolarization of SA node & atria

62
Q

QRS complex (of an ECG)

A

corresponds to ventricular depolarization

63
Q

T wave (of an ECG)

A

corresponds to ventricular repolarization

64
Q

sinus rhythm

A

set by SA node; 70-80 bpm; normal

65
Q

nodal (junctional) rhythm

A

set by AV node; 40-60 bpm; still adequate to maintain circulation

66
Q

intrinsic ventricular rhythm

A

set by AV bundle, bundle branches & purkinje fibers; 20-40 bpm; not adequate to maintain circulation

67
Q

ectopic focus

A

caused by a defect in SA node; abnormal pacemaker; AV node may take over; sets junctional rhythm (40-60 bpm)

68
Q

where is the cardiac center located?

A

medulla oblongata

69
Q

what is the stimulation of the sympathetic nervous system (SNS) {acetylcholine} activated by?

A

stress, anxiety, excitement, exercise

70
Q

significance of parasympathetic nervous system (PNS) {epinephrine}

A

opposes SNS; dominates autonomic stimulation; slows HR & causes vagal tone = activity of vagus nerve

71
Q

cardiac cycle

A

all events associated with blood flow through the heart during one complete heartbeat

72
Q

phases of the cardiac cycle

A

ventricular filling ➡ ventricular systole ➡ isovolumetric relaxation of ventricles

73
Q

ventricular filling (phase of the cardiac cycle)

A
  • AV valves are open, pressure low
  • 80% of blood passively flows from atria into ventricles
  • atrial systole occurs, delivering remaining 20% into ventricles
  • SA node fires, atria depolarize
  • P wave appears on ECG
74
Q

ventricular systole (phase of the cardiac cycle)

A
  • atria repolarize & relax
  • ventricles depolarize
  • QRS complex appears on ECG
  • ventricles contract
  • rising ventricular pressure results in closing AV valves (S1 sound is heard)
75
Q

isovolumetric relaxation of ventricles (phase of the cardiac cycle)

A
  • T wave appears on ECG
  • ventricles repolarize and relax
  • causes backflow of blood in aorta & pulmonary trunk which closes semilunar valves (S2 is heard)
  • atria relaxed & filling, AV valves remain closed
  • starts over with ventricular filling when atrial pressure exceeds that in ventricles ➡ AV valves open
76
Q

dicrotic notch

A

brief rise in aortic pressure caused by backflow of blood rebounding off semilunar valves

77
Q

cardiac output (CO)

A

volume of blood pumped by each ventricle in one minute

- CO = heart rate (HR) * stroke volume (SV)

78
Q

stroke volume (SV)

A

volume of blood pumped out by a ventricle with each beat

- SV = end diastolic volume (EDV) - end systolic volume (ESV)

79
Q

heart rate (HR)

A

number of beats per minute (BPM)

80
Q

end diastolic volume (EDV)

A

volume of blood in ventricles at the end of diastole (right before systole / contraction)
- approx. 120 ml of blood

81
Q

end systolic volume (ESV)

A

volume of blood remaining in each ventricle after systole

82
Q

ejection fraction

A

SV / EDV

83
Q

factors that affect SV (3)

A

preload
contractility
afterload

84
Q

preload

A

degree of stretch

- increased preload = increased SV

85
Q

contractility

A

inherent strength and vigor of the heart’s contraction during systole; independent of muscle stretch and EDV
- increased contractility = increased SV

86
Q

inotropic agents

A

substances that control contractility

  • positive agents increase contractility (hypercalcemia; certain hormones (glucagon, thyroxine, epinephrine)
  • negative agents decrease contractility (acidosis by hypercapnia {increase in CO2 & H+}; hyperkalemia, hypocalcemia)
87
Q

afterload

A

arterial blood pressure ventricles must overcome to eject blood during systole
- increased afterload = decreased SV

88
Q

frank-starling law of the heart

A

SV is proportional to EDV

89
Q

venous return

A

amount of blood returning to heart; most important factor stretching cardiac muscle

90
Q

when ischemia takes place in the heart, what is the biggest concern?

A

oxygen

91
Q

aneurysm

A

weakening of artery

92
Q

vein

A

merges from postcapillary venules; have all tunics but thinner walls w/ large lumens compared w/ corresponding arteries; blood pressure lower than in arteries

93
Q

artery

A

any of the muscular-walled tubes forming part of the circulation system by which blood (mainly that which has been oxygenated) is conveyed from the heart to all parts of the body.

94
Q

precapillary sphincters

A

cut off smooth muscle @ metarterioles to regulate blood flow

95
Q

portal systems

A

blood flows through two consecutive capillary beds before returning to the heart
ex) hypothalamus - anterior pituitary; glomerulus - peritubular capillaries; small intestines - liver

96
Q

perfusion

A

rate of blood flow per given mass of tissue; measured in ML/min/g; important for delivery of nutrients, oxygen & removal of waste

97
Q

mean arterial pressure (MAP)

A

pressure that propels the blood to the tissues; diastole last 2/3rd of the time, systole lasts 1/3rd of the time
- MAP= [2(DBP) + SBP] / 3

98
Q

orthostatic hypotension

A

temporary low BP & dizziness when suddenly rising from sitting or reclining position

99
Q

hypotension

A

low blood pressure (< 90/60)

100
Q

hypertension

A

high BP; sustained elevated arterial pressure of 140/90 or higher

101
Q

route of blood from heart back to heart again

A

arteries ➡ arterioles ➡ capillaries (exchange) ➡ venules ➡ veins

102
Q

structure of blood vessel wall

A

all vessels consist of lumen; walls of vessels (except capillaries) have 3 layers / tunics=

1) tunica intima / interna
2) tunica media
3) tunica externa

103
Q

lumen

A

central blood - containing space surrounded by a wall