Exam 3 Quiz 3 Flashcards
Describe the function Circulatory system
-contributes to homeostasis by transporting O2, Co2, wastes, electrolytes and hormones from one part of the body to another
What do cells need a constant supply of
-oxygen that is delivered by the circulatory system
what is removed by the cells via the circulatory system
-CO2 and other wastes are removed
What are the 3 basic components of the circulatory system and what do they do/ what are they are
Heart: dual pump that provides pressure to blood to establish pressure gradients needed for blood to flow to the tissues/ cells
Blood vessels: roadways/passageway through which blood is directed and distributed from heart to rest of the body returns the blood back to the heart
-they control the blood flow, they constrict or dilate the blood vessels
Blood: transport medium
what directions do fluid and air travel to
-all things fluid and air in the body move from areas of high pressure to low pressure
Name, in order, the valves of the heart as blood would normally circulate through them:
-tricuspid
-Pulmonary Semilunar Valve
-Mitral Valve
-Aortic Semilunar Valve
How is the heart a dual pump (hint: systemic circuit and pulmonary circuit)
-the pulmonary circuit is the right side of the heart and it pumps oxygen poor blood to the lungs
-the Systemic Circuit is the left side of the heart and it pumps oxygen rich blood to the body
List the flow of blood through the heart
-Deoxygenated blood enters through the superior and inferior vena cava
-blood enters the right atrium
-blood passes the tricuspid value into the right ventricle
-blood passes through the Pulmonary Semilunar Valve and goes into the pulmonary trunk
-the blood goes into the left pulmonary artery, gas exchange happens in the lung capillaries
-the now oxygen rich blood goes into the left atrium via the pulmonary veins
-the blood passes the Mitral(bicuspid) valve and enters the left ventricle
-the blood passes through the aortic valve, goes into the Aorta and goes to the rest of the body
Describe the pulmonary circuit’s pressure
-short, low, pressure circulation
is the volume of blood equal in both of the pulmonary circuit and the systemic circuit
-yes there are equal volumes of blood that are pumped to the pulmonary and systemic circuits
Describe the pressure of the systemic circuit
-the blood encounters much resistance in the long pathways
Compare the anatomy of ventricles that reflects the differences in pressure
-the left ventricle has the most pressure, and the ventricle walls are thicker bc it pumps harder
-the right ventricle walls are thin
Describe the electrical activity of the heart and how it is similar and different to that of skeletal muscle
-similar to skeletal muscle, contraction of cardiac muscle/ contractile cells (myocytes) to eject blood is trigged by Ap sweeping across muscle cell membrane
-electrical stimulus to myocytes come from pace maker cells
-unlike skeletal muscle, the heart generates it’s own Action potentials this is called autorhymicity through special pacemaker cells that make the intrinsic conduction system
what is the intrinsic cardiac conduction system
network of non contractile (autorhythmic) cells that initiate and distribute impulses to coordinate depolarization of heart
Describe the sinoatrial node
-The sinoatrial (SA) node: these are pacemaker cells
-generates the impulses about 75-100 per minute (this is the sinus rhythm)
-depolarizes faster than any other part of myocardium (therefore it drives the other cells)
-the depolarization starts here
What can change heart rate
-the external factors (ANS)
Describe the Atrioventricular (AV) node
-smaller diameter fibers; fewer gap junctions
-delays the impulses approximately o.1 seconds (this is bc of the small diameter and bc there is less distance to travel and also because of the amount of gap junctions)
-depolarizes 50 times per minute in absence of SA node input
-the AV node is the backup for the pacemaker of the heart
Describe the atrioventricular bundle and the right and left bundle branches (remember the bundle of His)
-also known as the bundle of His
-only electrical connection between atria and ventricles
-two pathways in interventricular septum that carry impulses toward the apex of the heart
Describe the Purkinje fibers
-complete pathway into apex and ventricular walls
-AV bundle and Purkinje fibers depolarize only 30 times per minute in absence of AV node input
-the second backup of the SA node
-only buys you time before you die
Describe the sequence of excitation in the heart
-depolarization starts in the Sinoatrial (SA) node
-The Atrioventricular (AV) node)
The Atrioventricular (AV) bundle (bundle of His)
-Right and left bundle branches
Purkinje fibers
What can defects in the intrinsic conduction system cause
-arrhythmias
-uncoordinated atrial and ventricular contraction
-fibrillation
what are arrhythmias
-irregularity in heart’s beating pattern
-irregular heart rhythms
-mechanical inefficiency; interrupt normal pattern of chamber filling and emptying
what is fibrillation
-rapid, irregular contractions; useless for pumping blood
Describe A-fib
-quivering of the atrium
-atrial fibrillation
V-fib
death, this is when they shock you
-ventricular fibrillation
What can a defective SA node result in (hint: ectopic focus)
Ectopic focus: abnormal pacemakers
-if the AV node takes over there will be a “junction rhythm” (40-60 bpm)
what can a defective AV node result in
-partial or total heart block
-few or no impulses from SA node reach ventricles
-ventricles contract slowly
Describe bradycardia
-low heart rate
-less than 60 bpm
-this is not always disease driven or bad, this could happen when you are sleeping
describe tachycardia, is it always disease driven or bad?
-abnormally high heart rate
-more than 100 bpm
-not always disease driven or bad
describe pacemakers
-some pace makers shock the heart
-small devices placed in the chest to help control abnormal heart rhythms
-uses electrical impulses to prompt heart to beat at a normal rate
-speed up, slow down, allow ventricles to contract normally if atria are quivering (atrial fibrillation)
-some are both pacemakers and defibrillators
-defibrillators send large waves of electricity to shock heart back into normal rhythm
what role does the ANS have in heart beat and what is it
heart beat is modified by the ANS
-this is an extrinsic innervation of the heart
where are the cardiac centers located and what is it
-in the medulla for both subdivisions of the ANS
-this is an extrinsic innervation of the heart
what does the cardioacceleratory center innervate and what is it
-innervates the Sa and AV nodes, heart muscle and coronary arteries through SNS neurons (innervates more parts of the heart)
-this is an extrinsic innervation of the heart
what does the cardioinhibatory center do and what is it
-inhibits SA and AV nodes through PNS fibers in vagus nerves to slow the pace of the heart
-this is an extrinsic innervation of the heart
Describe electrocardiogram
can be called ECG or EKG
-composite of AP’s generated by nodal and contractile cells at a given time
-ECG looks at all the Ap’s that are happening in the heart
What are the 3 waves of an EKG?
P wave, QRS complex, T wave
What does the p wave mean mechanically and electrically
Electrically: atrial depolarization
Mechanically: Atrial contraction
What does the QRS complex represent at a mechanical and electrical level?
ventricular depolarization and atrial repolarization (electrical level)
Ventricular contraction and atrial rest(mechanical level)
What does the T wave represent?
ventricular repolarization
what is normal sinus rhythm
60-100 bpm
describe junctional rhythm
-the Sa node is non functional
-p waves are absent and heart is paced by the AV node at 40-60 beats/min
describe second degree heart block
some waves are not conducted through the AV node; hence more P than QRS waves are seen
-in this tracing the ratio of P-waves to QRS waves is mostly 2:1
describe ventricular fibrillation
-these chaotic grossly irregular ECG deflections are seen in acute heart attach and electrical shock
Describe the Myocardium structure
-bundles of cardiac muscles are arranged spirally around atria and ventricles
-during contraction, the “wring” blood and propulsion occurs
-wringing starts in the apex and pushes blood towards the top
Describe the Microscopic Anatomy of Cardiac Muscle
-individual cardiac muscles cells are short, fat, branches and interconnected, while skeletal muscles are long and cylindrical
- the contractile cells of the heart are packed with the mitochondria
-there are numerous large mitochondria (they make up about 25-35% of the cell volume)
-there are adjacent cells joined by intercalated discs with 2 membrane junctions
-there are desmosomes and gap junctions
-cardiac muscle cells are very aerobic bc they have a lot of mitochondria
what are intercalated discs
-a junction between branches of the different cells
what is the role of gap junctions and desmosomes in the microscopic anatomy of cardiac muscle
-desmosomes: prevent cells from separating during contracting (they anchor)
-Gap junction allows ions to pass; allow AP to spread from one cell to the next (these are for communication)
Pacemaker cells can generate AP’s without any nervous stimulation, but how do they stimulate contractile cells?
-Action potentials spread to cardiac muscle cells via gap junctions allows a functional syncytium
Why do the atria and ventricles each form a functional syncytium and contract as separate units
-this is important because if they don’t contract as separate units the blood wont follow the normal pathway
what does synchronous contraction of the chambers produce
-produces the force needed to eject blood
Are atrial and ventricular contractile cells connected via gap junctions
No, if this was the case the atria and the ventricles would contract at the same time
-instead atrial contractile cells are connected to the same cells via gap junctions, and this is the same case for the ventricles
how is skeletal muscle contraction different from cardiac muscle contractions ( hint motor units)
-skeletal muscle contractions are generated by motor units and motor unit requirement
-cardiac muscle does not have motor units or motor unit requirement
Describe the types of cardiac cells and their electrical activity (dont forget functional syncytium and AP’s)
- Autorhythmic (pacemaker) cells: initiate and conduct Action potential that stimulate…
- Contractile cells (cardiac myocytes): which generate action potentials in response that produce mechanical work (contraction)
-they contract via functional syncytium
-they make up the 99% of heart cells
-both types of cells exhibit action potentials but they look different
Describe the action potentials autorhythmic (pacemaker) cells
-unstable (not a flat line) resting potentials (aka pacemaker potentials) due to open slow Na+ channels
-the Na+ channels are also called funny channels and the flow of Na+ current is called the funny current
-the pacemaker cells are always depolarizing because of the pacemaker potentials
-at the threshold the Ca2+ channels open
-explosive Ca2+ influx produces rising phase of AP
-repolarization results from inactivation of Ca2+ channels and opening of voltage- gated K+ channels
what is different in the action potentials in neurons and skeletal muscles and the autorhythmic (pacemaker)cells
-in neurons and skeletal muscles Na+ voltage gated channels open at threshold which causes the action potentials
-in autorhythmic (pacemaker) cells, the Calcium channels open at threshold, calcium enters which causes the rise in action potentials
-when repolarization happens, its because the Ca+ voltage gated channels inactivate and the K+ voltage gated channels activate
-the membrane potential is -60 mV and the threshold is -40
-the action potential reaches about 5 mV
list the steps of an action potential in autorhythmic cells
- Pacemaker potential: this slow depolarization is due to both opening of Na+ channels and closing of K+ channels. The membrane potential is never a flat line
- Depolarization: the action potentials begins when the pacemaker potential reaches threshold. depolarization is due to Ca2+ influx through Ca2+ channels
- Repolarization: is due to Ca2+ channels inactivating and K+ channels opening. This allows K+ efflux, which brings the membrane potential back to its most negative voltage
Describe the action potentials of cardiac muscle contraction
-this is for contractile cells
-depolarization opens voltage- gated fast Na+ channels in sarcolemma
-the depolarization wave also opens slow Ca2_ channels in sarcolemma allowing extracellular Ca2+ to enter the cell
-Ca2+ surge prolongs depolarization phase (the plateau)
-Reversal of membrane potential from -90mV to +30 mV (this sis similar to skeletal muscle)
-depolarization wave in T-tubules causes the sarcoplasmic reticulum is to release Ca2+
Describe the role of calcium in the action potentials of contractile cells (what does it do, what does it bind to etc)
-the influx of Ca2+ triggers opening of Ca2+ sensitive channels in the sarcoplasmic Reticulum which liberates bursts of Ca2+
-Excitation Contraction Coupling occurs as Ca2+ binds to troponin and sliding of filaments begins
- duration of AP and longer contractile phase is much greater in cardiac muscle than in skeletal muscle
-repolarization results from inactivation of Ca2+ channels and opening of voltage gated K+ channels
why is a longer contractile phase needed in the AP in the contractile cells
-these are needed to allow full contraction of atrial and ventricular cells
Describe the steps of Action Potentials in Contractile Cells
1: Depolarization: is due to Na+ influx through fast voltage gated Na+ channels. positive feedback cycle rapidly opens many Na+ channels, reversing the membrane potential. Channel inactivation ends this phase
2: Plateau phase: is due to Ca2+ influx through slow Ca2+ channels. This keeps the cell depolarized because few K+ channels are open
3: Repolarization: is due to Ca2+ channels inactivating and K+ channels opening. This allows K+ efflux, which brings the membrane potentials back to it’s resting voltage
Can the blood of the heart nourish the heart, why or why not
-no, although the heart is more or less continuously filled with blood, this blood provided little nourishment to heart tissue
-the myocardium is too thick for diffusion to occur
What is coronary circulation
-functional blood supply to heart muscle itself
what is the arterial supply of the coronary circulation provided by
- the left and right coronary arteries which both arise from the aorta
what do coronary veins do
-they return deoxygenated blood from heart tissue to the right atrium
what can bloakcage of coronary arterial circulation cause
-this can be serious and and it can be sometimes fatal
Describe Angina Pectoris
-choked chest
-thoracic pain caused by deficiency in bloody delivery to myocardium
what can Prolonged Coronary Blockage lead to
-it can lead to myocardial infarction (heart attack)
why is your heart weaker after a heart attack
-after a heart attack your heart is weaker because of all of the scars that are left behind
-most adult cardiac tissue is amitotic; most areas of cell death result in non functional scar tissue
Describe Bypass Surgery (hint: also answer the veins and arteries used)
-formally known as Coronary Artery Bypass Graft (CABG) surgery AKA heart bypass or bypass surgery
-take and use a segment of healthy blood vessel from another part of body
-internal mammary (thoracic) arteries, great saphenous veins or radial artery are primarily used
how does the number of the arteries bypassed influence the name
Single, double, tiple, quadruple and quintuple bypass
What does Propofol do when it is given to a patient, also when is it given to a patient
-it is a general anesthetic throughout the bypass surgery
-it is a sodium channel blocker therefore it blocks action potentials
What is Angioplasty and what is it used for (also list the other names it goes by)
-Percutaneous coronary intervention (PCI) percutaneous transluminal coronary angioplasty (PTCA), or coronary angioplasty is a procedure used to treat stenotic (narrowed) coronary arteries
Describe the steps of an Angioplasty
- catheter in the radial or femoral artery, traced into coronary arteries
- balloon inflated compressing plaque and stretching artery wall
- oftentimes, expandable wire mesh tube (stent) will be implanted to support new stretched open position of artery
what does the stent do in an angioplasty
-anchors vessels open
Describe the process of the AV values opening and compare the pressure of the ventricles and the atria
-when the AV values open; atrial pressure is greater than ventricular pressure
1. blood returning to the heart fills atria, putting pressure against atrioventricular valves are forced to open
2. as the ventricles fill, atrioventricular value flaps hang limply into ventricles
Describe the process of the AV valves closing and compare the pressure of the ventricles and the atria
- ventricles contract, forcing blood against atrioventricular valve cusps
- atrioventricular valves close
- papillary muscles contract and chordae tendineae tighten, preventing valve flaps from everting into the atria
Describe the process of the semilunar valve opening
-as ventricles contract and intraventricular pressure rises, blood is pushed up against semilunar valves, forcing them open
Describe the process of semilunar valves closing
-as ventricles relax and intraventricular pressure falls, blood flows back from arteries, filling the cusps of semilunar valves and forcing hem to close
Describe the heart sounds (how many are there and what are they associated with)
-there are two heart sounds (lub-dup) and they are both associated with the closing of heart valves
where does the first sound of the heart happen and what does it mean
-the first sound (lub) occurs as the AV values close and signifies the beginning of systole
where does the second sound of the heart happen and what does it mean
-second sound occurs where SA valves close at beginning of ventricular diastole
Describe heart murmurs, what are they and what do they indicate
-abnormal heart sounds most often indicative of valve problems
where can sounds of the aortic valve be heard, what sound is heard and what does that sound signify
-these sounds are heard in the 2nd intercostal space at the right sternal margin
-the aortic valve closes
-sounds like Dub
-means the end of systole and the beginning of diastole