Exam 4: The Heart Flashcards

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1
Q

Cardiovascular system

A

–Essential for life

–If it fails, often fatal outcome

–Composed of heart and blood vessels

–Circulates blood continuously to maintain homeostasis

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2
Q

Trasportation of the blood through the body

A

–Allows exchange of substances between capillaries and cells

–Perfusion

–Adequate perfusion

–Requires continual pumping of the heart and open vessels

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3
Q

Perfusion

A

delivery of blood per time per gram of tissue

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4
Q

Adequate Perfusion

A

sufficient blood delivered to maintain health of body cells

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5
Q

The Heart characteristics

A

–Center of the cardiovascular system

–Hollow, four-chambered organ

–Composed of two pumps

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6
Q

What are the two pumps that the heart is composed of

A

Right sided pump

Left sided pump

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7
Q

Right sided pump

A

–receives deoxygenated blood from body

–pumps it to the lungs

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8
Q

Left Sided Pump

A

–receives oxygenated blood from lungs

–pumps it to the body

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9
Q

What characterizes the left and right artium

A

Superior chambers for recieving blood

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10
Q

What characterizes the left and right ventricles

A
  • inferior chambers for pumping blood away
  • receive blood from respective atria
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11
Q

Heart: The Great Vessels functions

A
  • transport blood directly to and from chambers
  • continuous with each chamber
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12
Q

The Heart: The great vessels

A

pulmonary trunk

aorta

superior and inferior vena cava

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13
Q

Heart: Pulmonary Trunk Functions

A
  • splits into pulmonary arteries
  • receives deoxygenated blood from right ventricle
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14
Q

Heart: Aorta Function

A

•receives oxygenated blood from left ventricle

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15
Q

Heart: Superior and Inferior Vena Cava Function

A

•drain deoxygenated blood into right atrium

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16
Q

Heart: Pulmonary Veins

A

•drain oxygenated blood into left atrium

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17
Q

What are the 2 types of valves found in the heart?

A

Atriventricular

Semilunar

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18
Q

Atrioventricular Valves

A
  • between atrium and ventricle of each side
  • right AV valve
  • left AV valve
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19
Q

Right AV valve

A

Tricuspid

Located between the right atrium and right ventricle

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20
Q

Left AV Valve

A

bicuspid or mitral

Located between the left atrium and left ventricle

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21
Q

Semilunar Valves Functions

A
  • boundary between ventricle and arterial trunk
  • open to allow blood to flow through heart
  • close to prevent backflow
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22
Q

What are the two Semilunar Valves?

A

Pulmonary

Aortic

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23
Q

Where is the pulmonary smilunar valve located?

A

Between right ventricle and pulmonary trunk

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24
Q

Where is the aortic semilunar valve located?

A

Between left ventricle and the aorta

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25
Q

Circulation Routes: Pulmonary Circulation

A
  • carries deoxygenated blood from right side of heart
  • goes through blood vessels to the lungs
  • pick up of oxygen and release of carbon dioxide
  • back through vessels to left side of heart
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26
Q

Circulation Routes: Systemic Circulation

A
  • moves oxygenated blood from left side of heart
  • moves through vessels to systemic cells
  • exchange of nutrients, gases, and wastes
  • returns blood in vessels to right side of heart
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27
Q

What is the basic pattern for blood flow?

A

•right heart ► lungs ►left heart ► systemic tissues ► right heart

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28
Q

Pericardium

A

–Membrane surrounding and protecting the heart

–Confines while still allowing free movement

–2 main parts

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29
Q

What are the two parts of the pericardium?

A
  • Fibrous pericardium
  • Serous pericardium
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30
Q

Fibrous Pericardium

A

tough

inelastic

dense irregular connective tissue – prevents overstretching

protection

anchorage

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31
Q

Serous Pericardium

A

thinner

more delicate membrane double layer:

– parietal layer fused to fibrous pericardium

– visceral layer also called epicardium

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32
Q

What does the pericardial fluid do? Where is it secreted?

A

Reduces friction

secreted into pericardial cavity

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33
Q

What are the three layers of the heart wall?

A

Epicardium

Myocardium

Endocardium

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34
Q

Epicardium

A

(visceral layer of serous pericardium)

  • outermost heart layer
  • serous membrane of simple squamous epithelium
  • underlying areolar connective tissue
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35
Q

Myocardium

A
  • middle heart layer
  • composed of cardiac muscle tissue
  • thickest of three layers
  • contraction generates force to pump blood
  • may change in thickness with age
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36
Q

Endocardium

A
  • covers internal surface of heart and external surface of valves
  • composed of simple squamous epithelium
  • underlying layer of areolar connective tissue
  • continuous with blood vessel inner lining
37
Q

What are the superficial features of the heart?

A

–Small, muscular organ

–Two smaller atria and two larger ventricles

–Sulci, grooves, containing coronary vessels

–Coronary sulcus

–Interventricular sulcus

38
Q

Coronary Sulcus

A
  • deep groove separating atria from ventricles
  • extends around circumference of heart
39
Q

Interventricular Sulcus

A
  • groove separating ventricles
  • extends from coronary sulcus toward heart apex
  • anterior interventricular sulcus on anterior side
  • posterior interventricular sulcus on posterior side
40
Q

What can be seen from the anterior view of the heart?

A

–Right atrium and right ventricle prominent

–Right auricle

wrinkled, flaplike extension of right atrium

–Aorta and pulmonary trunk seen

–Small portion of left auricle

–Anterior interventricular and coronary sulci

41
Q

what are the characteristics of cardiac muscle?

A

–Shorter and less circular than skeletal muscle fibers

–Branching

–Usually one centrally located nucleus

–Fibers connected by intercalated discs

–Mitochondria are larger and more numerous than skeletal muscle

–Same arrangement of actin and myosin

42
Q

Fibers connected by intercalated discs

A

Desmosomes (hold fibers together) and gap junctions (allow action potential conduction from one fiber to the next)

43
Q

What does the Heart’s conduction system consist of?

A

Sinoatrial (SA) Node

Atrioventricular (AV) Node

Atrioventricular (AV) Bundle

Purkinje Fibers

44
Q

Sinoatrial Node (SA Node)

A
  • in posterior wall of right atrium
  • initiates heartbeat
  • referred to as “pacemaker” of heart
45
Q

Atrioventricular Node (AV Node)

A
  • in floor of right atrium
  • between right AV valve and coronary sinus opening
46
Q

Atrioventricular (AV) Bundle

A
  • extends from AV node though interventricular septum
  • divides into left and right bundles
47
Q

Purkinje Fibers

A
  • extend from left and right bundles
  • from apex of heart through walls of ventricles
48
Q

Where is electrical activity initiated?

A

Sinoatrial (SA) Node

49
Q

What is trasmitted throught the conduction system?

A

Action Potential

50
Q

What are the Mechanical and Electrical events of the cardiac muscle cells?

A
  1. Depolarization
  2. Plateau
  3. Repolarization
  4. Refractory period
51
Q

Depolarization

A
  • action potential transmitted through conduction system
  • triggers opening of fast voltage-gated Na+ channels in sarcolemma
  • entrance of sodium into cardiac muscle cells
  • resting membrane potential from -90 mV to +30 mV
  • voltage-gated Na+ channels close to inactivated state
52
Q

Plateau

A
  • opening of voltage-gated K+
  • K+ leaves cardiac muscle cells
  • opening of slow voltage-gated Ca2+ channels in sarcolemma
  • entrance of Ca2+ into cells
  • stimulates sarcoplasmic reticulum to release more Ca2+
  • no electrical change in sarcolemma
  • remains in depolarized state
53
Q

Repolarization

A
  • closure of voltage-gated Ca2+ channels
  • K+ remain open
  • reversal of membrane potential back to -90 mV
54
Q

Refractory Period time interval during which second contraction cannot be triggered

–Lasts longer than contraction itself

–Tetanus (maintained contraction) cannot occur

–Blood flow would cease

A
55
Q

Systole

A

Contraction

56
Q

Diastole

A

Relaxation

57
Q

What are the steps shown on an EKG?

A
  1. Cardiac action potential arises in SA node
  2. Atrial contraction/ atrial systole
  3. Action potential enters AV bundle and out over ventricles
  4. Contraction of ventricles/ ventricular systole
  5. Repolarization of ventricular fibers
  6. Ventricular relaxation/ diastole
58
Q

What appears when cardiac ation potential arises in SA node?

A

P wave

59
Q

What appears on the EKG when Action potential enters AV bundle and out over ventricles

A

QRS complex

Masks atrial repolarization

60
Q

When does the T-Wave appear on the EKG?

A

Repolarization of ventricular fibers

61
Q

What is Cardiac Output?

A

volume of blood ejected from left (or right) ventricle into aorta (or pulmonary trunk) each minute

62
Q

What is the equation for Cardiac Output (CO)?

A

CO = stroke volume (SV) x heart rate (HR)

63
Q

What is the cardiac reserve?

A

Difference between maximum CO and CO at rest

64
Q

Entire blood volume flows through pulmonary and systemic circuits each

A

Minute

65
Q

Stoke Volume

A

amount of blood ejected from a ventricle (left/right) in one beat of the heart

66
Q

3 factors ensure left and right ventricles pump equal volumes of blood

A
  1. Preload
  2. Contractility
  3. Afterload
67
Q

What happens with a greater preload?

A

increased force of contraction

68
Q

Preload: Frank-Starling law of the heart

A

the more the heart fills with blood during diastole, the greater the force of contraction during systole

Preload proportional to EDV

69
Q

What is EDV? What are the 2 factors that determine EDV?

A

End-Diastolic Volume

2 Factors:

  1. Duration of ventricular diastole
  2. Venous return – volume of blood returning to right ventricle
70
Q

Preload

A

Degree of stretch on the heart before it contracts

71
Q

Contractility

A

Strength of contraction at any given preload

72
Q

What do Positive inotropic agents do to Contractility?

A

–increase contractility

  • Often promote Ca2+ inflow during cardiac action potential
  • Increases stroke volume
  • Epinephrine, norepinephrine, digitalis
73
Q

What do Negative Inotropic agents do to contractility?

A

decrease contractility

-Anoxia, acidosis, some anesthetics, and increased K+ in interstitial fluid

74
Q

Afterload

A

Pressure that must be overcome before a semilunar valve can open

75
Q

What can increase in afterload cause?

A

–causes stroke volume to decrease

•Blood remains in ventricle at the end of systole

76
Q

What increases afterload?

A

Hypertension and atherosclerosis

77
Q

Regulation of Heart Rate

A

–Cardiac output depends on heart rate and stroke volume

–Adjustments in heart rate important in short-term control of cardiac output and blood pressure

–Autonomic nervous system and epinephrine/ norepinephrine most important

78
Q

Where does autonomic regulation of the heart rate originate?

A

Cardiovascular center of medulla oblongata

79
Q

What does Autonomic Regulation do?

A

Increases or decreases frequency of nerve impulses in both sympathetic and parasympathetic branches of ANS

80
Q

What are the 2 seperate effects that Norepinephrin have?

A
  • In SA and AV node speeds rate of spontaneous depolarization
  • In contractile fibers enhances Ca2+ entry increasing contractility
81
Q

What do parasympathetic nerves do and what does this do to the heart rate?

A

nerves release acetylcholine which decreases heart rate by slowing rate of spontaneous depolarization

82
Q
A

Depolarization

83
Q
A

Plateau

84
Q
A

Repolarization

85
Q
A

P-Wave

86
Q
A

QRS Complex

87
Q
A

T- Wave

88
Q
A