Final Exam Flashcards
why is the fibrous skeleton critical?
The fibrous skeleton of the heart is critical for helping to maintain electrical isolation of the upper and lower chambers so that they contract and relax in turn during a single heartbeat
are the valves and fibrous structure all part of the same skeleton? is there an electrical connection through the skeleton?
the heart valves and white fibrous structures supporting those valves are all part of the skeleton. the only electrical connection through the fibrous skeleton is via the AV node and the AV bundle.
Explain the function and terminology for the heart valves
Atrioventricular Valves- divides the aorta from the ventricles
- Right AV valve=tricuspid valve
- Left AV valve=bicuspid valve=mitral
Semilunar Valves-divide the ventricles from the blood vessels
*Aortic semilunar valve-controls blood flow from Left ventricle to aorta
Pulmonary semilunar- valve controls blood flow from R ventricle to pulmonary trunk
describe in order the pathway of blood through the heart.
- blood enters right atrium from superior and inferior venae cavae
- blood in right atrium flows through right AV valve into right ventricle
- contraction of right ventricle forces pulmonary valve open
- blood flows through pulmonary trunk
- blood is distributed by right and left pulmonary arteries to the lungs, where it unloads CO2 and loads O2
- blood returns from lungs via pulmonary veins to left atrium
- blood in left atrium flows through left AV valve into left ventricle
- contraction of left ventricle (simultaneous with step 3) forces aortic valve open
- blood flows through aortic valve into ascending aorta
- blood in aorta is distributed to every organ in the body where it unloads O2 and loads CO2
- blood returns to heart via venae cavae
what is the importance of the chordae tendinae and the papillary muscles? what are their functions?
the chordae tendineae (tendinous cords) holding ends of AV valves to papillary muscles in the heart wall. these one way flap-type valves are seen throughout the cardiovascular system and help to maintain one-way-flow. Pressure will open them but shut them from the “flap” side. Pressure difference will either open or shut the valve depending on which side of the valve has higher pressure. the pressure in the left ventricle is so great during ventricular contraction that the tendinous cords and contraction of the papillary muscles are needed to prevent the valve flaps from being blown upwards into the atria
*if such and event occurs it is called mitral valve prolapes
what are the layers and membranes of the heart in order from the outside in?
*Parietal Pericardium-lines pericardial cavity
*Parietal Cavity
*Visceral Pericardium- lines heart
*Myocardium-muscle
Endocardium-lines chambers
(Epicardium=visceral pericardium)
is there a fluid that reduces friction that lies between the visceral pericardium and parietal pericardium?
yes, pericardial fluid fills the parietal cavity to reduce friction during contractions of the heart
What makes up the heart wall specifically.
- endocardium
- myocardium
- epicardium
what is the description of the endocardium and it’s functions?
- Lines chambers
- helps prevent clotting
- continuous with endothelium of blood vessels
what is the description of the myocardium and it’s functions?
- heart muscle
- electrically connected muscle cells & some special fibers for conducting electrical current
- contains connective tissue fiber skeleton (anchors reinforces, supports & electrically isolates in places)
what is the description of the epicardium and it’s functions?
- thin outer layer of mesothelium (membrane)
- some adipocytes; simple squamous epithelium & areolar tissue (general term for connective, reticular, and adipose tissue)
are there intercalated cardiac muscles that provide an electric connection?
yes, intercalated discs containing desmosomes & gap junctions which provide electrical connections between adjacent cells
what does the special conducting system of the heart do and what does it include?
Coordinates and conducts electrical activity through the hear, thus coordinating sequence and timing of contraction for arterial and ventricular muscle cells.
- includes:
- Pace maker cells- sinoatrial (SA) node, atrioventricular node and atrioventricular bundle (bundle of his)
- other conducting cells and fibers -right and left bundle branches and purkinje fibers
Explain the difference in the action potentials of the conducting system and pace maker cells
there are 2 types of action potentials generated in different cell types within this system
the first type is seen in specialized cells that are called pacemaker cells. they are modified muscle cells in specific locations. their action potential has a different shape from the other action potentials in the heart because the initial rising phase is generated by a voltage gated calcium channel rather than by voltage gated sodium channels.
*pacemaker cells do not have a membrane potential. they have pacemaker potentials
what is a pacemaker potential?
the pacemaker potential is slowly depolarizing baseline membrane potential that eventually reaches threshold triggering an action potential
What is the combination of gates that work sequentially to produce a drifting baseline membrane potential (pacemaker potential)?
It is generated by a combination of calcium sodium and potassium channels that work sequentially to generate this drifting baseline membrane potential know as the pacemaker potential.
where are pacemaker cells located?
pacemaker cells are located in the (SA) node the AV node and the uppermost part of the bundle of his (AV bundle)
do the bundle branches and purkinje fibers have a resting membrane potential?
Yes they exhibit resting membrane potentials seen in cardiac muscle cells
do the resting membrane potentials of purkinje fibers and bundle branches still differ from conventional action/resting potentials?
these are still different from the action potentials involved with skeletal muscles and neurons because it involves a voltage gated calcium channel in addition to the normal voltage-gated sodium channel and voltage-gated potassium channel.
what is the sequence of excitation of cells? How many steps are there and name them
The cells of the heart are electrically connected via gap junctions such tat the cells will fire AP's in a specific sequence. 1. SA node 2 Atrial muscle cells 3. AV node 4. AV bundle (bundle of his) 5. R and L bundle branches 6. Purkinje fibers 7. ventricular muscle fibers
Are pacemakers different from myoblasts?
Pacemaker cells and the other cells of the cardiac conduction system are cells that differentiate from other myoblasts in specific locations as heart develops.
what makes them different?
They express channels that are not found in other cells making them able to produce a pacemaker potential, depolarizing baseline that triggers the action potentials
What makes pacemaker cells unusual?
Some of the conducting cells are pacemaker cells
-capable of spontaneously depolarizing over threshold (pacemaker potential)
-action potentials generated by different currents and channels than cardiac muscle cells
what does permeability mean?
a decrease in permeability means a channel closed
an increase in permeability means a channel opened.
Explain in detail and sequential order the action potential of a ventricular cardiocyte (myocyte).
- Voltage-gated Na+ channels open
- Na+ inflow depolarizes the membrane and triggers the opening of still more Na+ channels creating a positive feedback cycle and a rapidly rising membrane voltage.
- Na+ channels close when the cell depolarizes and the voltage peaks at nearly +30 mv
- Ca++ entering through slow Ca++ channels prolongs depolarization of membrane, creating a plateau. plateau falls slightly because some K+ leakage, but most K+ channels remain closed until end of plateau
- Ca++ channels close and Ca++ is transported out of cell. K+ channels open, and rapid K+ outflow returns membrane to its resting potential
what is important about a prolonged calcium influx during the plateau phase?
Calcium influx occurring during the plateau phase is needed to bind to troponin to allow muscle contraction in heart muscle cells, some calcium comes form the sarcoplasmic reticulum, but much of it comes in via these voltage-gated calcium channels. longer action potentials with more calcium influx can actually lead to stronger longer contractions of heart muscle.
*contraction starts a little after the action potential begins and stops about the same time the action potential ends
what are the basic physics of blood flow?
- Flow (F)
- Pressure at 2 points (P1 & P2), difference delta
- Resistance (R)
- F=deltaP/R
What are the principles of volume?
Pressure and flow. fluid doesn’t change its volume under normal conditions found in the body
When pressure is applied what happens
when pressure is applied that pressure is increased within the fluid causing it to generate force (pressure) on the walls of its container
When pressure is present what are the actions that take place?
When pressure in one place (P1) is greater than pressure in (P2) the fluid will flow form point 1 to point 2
The amount of flow is a function of what?
The amount of flow is a function of the difference between the pressures at each point (deltaP) and the resistance to flow inherent to the container or tube.
other than a thick viscous fluid what else resists movement?
the sides of the chamber or tube create friction or turbulence that also adds to resistance
what are the cardiac phases?
*ventricular filling (diastole)
-passive
-active=atrial systole
*ventricular contraction (systole)
-isovolumetric contraction -ventricles contract
to raise pressure
-ejection- pressure high enough to open valves,
blood moves out
*isovolumetric relaxation (early part of diastole)
-ventricles relax after semilunar valve shuts (all
valves closed)
-pressure decreasing until AV valve opens
-volume in ventricle =end systole volume
what happens to valves during the sounds 1-3?
S1=”lubb” closing of AV valves
S2=”dub” closing of semilunar valves
S3=heard during ventricular filling
what does the frank starling mechanism posit? (sterlings law of the heart)
increased venous return=increased stroke volume
*the increase in stroke volume is greater than the increase in venous return ( because of EDV-end diastolic volume)
what are the events that lead to the starling law of the heart?
the frank starling principle is due to both increase in volume of blood returned to the heart (increased veous return and EDV) and due to increased force of contraction of the ventricle wall (decreased ESV)
on is a direct result of the increased stretch in the ventricular wall. The increased stretch leads an elastic recoil that helps increase force, and this stretch also leads to a more favorable length-tension relationship for cardiac muscle, which also helps increase force generated by ventricular myocyte.
what does sympathetic activity and innervation dot to the heart? what are two hormones involved?
Sympathetic activity and innervation (norepinephrine, epinephrine) speeds up the heart and increases the force of contraction of the heart.
what does the parasympathetic innervation do to the heart rate? name a hormone and receptor?
parasympathetic innervation (acetylcholine onto a muscarinic cholinergic receptor) will slow down the heart rate.
how do alterations in the heart rate happen?
alterations in the heart rate happen by increasing the speed of the pacemaker potential or decreasing the speed of the pacemaker potential.
what is the heart rate of a heart that doesn’t receive innervation?
the rate of a heart that does not receive innervation is about 100 bpm. the heart is said to have a parasympathetic tone (e.g. avg bpm 72)
What do some of the most common types of signaling pathways include?
A protein known as the G-Protein
Why are G-proteins called G-proteins? Also, what do they do?
These proteins are called G-proteins because they bind and break down a GTP molecule as they perform their action, much like myosin binds and breaks down ATP as it helps create muscle contractions.
Receptors that have G-Protein involved in their signaling pathway are called what?
G-Protein Coupled Receptors or GPCRs
Do G-proteins utilize a second messenger during their signaling pathway?
Most G-proteins utilize a second messenger, a chemical whose concentration rises within the cell cytosol so that it will bind and activate another protein such as an enzyme or calmodulin.
Calmodulin
An intracellular protein that binds calcium ions and mediates many of the second messenger effects of calcium.
Second messenger pathways
- cAMP (cyclic adenosine monophosphate)
- Calcium
- Inosital trisphosphate (IP3)
- Diacylglycerol
- cGMP (cyclic guanosine monophosphate)
What is the time to activity in the target cell? How long does it take to effect things?
- Cell membrane receptors = seconds to minutes
- Intracellular receptors= hours to days
! Water soluble hormones will only use cell membrane receptors !
! Lipid Soluble (hydrophobic) hormones generally have intracellular receptors with some cell membrane receptors !
what do kinase enzymes do?
they attach phosphate groups
What are some divisions of the ANS (Autonomic Nervous System)? Also< what are the hormones and receptors responsible for carrying out some of the ANSs functions
- Sympathetic Division (Fight/Flight/Fright)
- Epinephrine (hormone from adrenal modulla)
- Norepinephrine- sympathetic fibers
*Alpha receptors - contract smooth muscle
usually inhibit hormone secretion
*Beta receptors-relax smooth muscle
usually stimulates hormone secretion
Is the sympathetic division of the ANS needed for emergency situations?
The sympathetic division, of the ANS, generates the reactions known as fight, fright, flight in an extreme activation of the system.
What other division of the ANS does the sympathetic division work with to achieve homeostasis?
The sympathetic division of the ANS works every minute of every day in balance with the parasympathetic division to regulate homeostasis and cycles of activity and rest in your body.
What occurs in the body during an extreme activation of the sympathetic division of the ANS?
-increased blood pressure
-increased heart rate
-halted urine production
-halted digestion
-conservation of fluids and energy
-blood directed away form kidney and intestines
(vasoconstriction)
-blood directed toward skeletal muscles
(vasodilation)
-dilated pupils and relaxed ciliary muscles for
flattened lenses.
(enemy detection)
What are the hormones and receptors involved?
What are some characteristics of a parasympathetic activation?
Relax and take care of living
- Parasympathetic Division
- Acetycholine for parasympathetic fibers
- Muscarinic cholinergic receptors
- Cleaning blood
- making urine
- digesting food
! during sex the body is relaxed and excited parasympathetic and sympathetic divisions !
what are the characteristics of arteries
away from heart
- aorta
- arteries
- large, medium, small
- arterioles
What do capillaries do
exchange
what are the characteristics of veins
toward heart
- venules
- veins-large, medium, small
- vina cava -inferior and superior
what do large arteries tend to have?
what do medium/small arteries have?
very thick internal elastic layer while some medium/smaller arteries have a proportionally large muscular layer
why do veins have a larger radius relative to arteries at same distance from heart?
it allows for similar flow in veins with lower pressure and velocity than the matched artery
what is involved in controlling the perfusion of capillary eds, local and systemic?
local controls
- oxygen
- carbon dioxide
- K+
- nitric oxide
systemic control
- norepinephrine
- epinephrine
- vasopressin (ADH)
- angiotensin
define perfusion.
blood flowing into capillary beds
are precapillary sphincters involved in control of blood flow?
precapillary sphincters control the flow of blood into a capillary bed thus controlling the level of perfusion of that bed and the tissue it supplies.
what is a metarteriole?
a metarteriole is a more direct passage through the capillary bed
with less perfusion do you get more blood flow through the metarteriole?
with less perfusion more blood would flow through the metarteriole
an arteriovenous anastomosis is a direct connection that serves for a bypass for what?
an arteriovenous anastomosis is a direct connection between the arteriole and venule that serve as a bypass for the capillary bed
explain what regulates the level of perfusion at a local level?
the level of perfusion of capillary beds is under primarily local controls from chemical signals, through sympathetic signals (nerves and hormones) can regulate perfusion in some situations.
list the local effectors of vasodilation and vasoconstriction
vasodilators
- low O2 and or high CO2 - lactic acid - nitric oxide (NO) from endothelium - high K+ or H+ in interstitial fluid - local inflammation (e.g. histamine, NO)
vasoconstrictors
- prostaglandins - throwboxanes - endothelin
what is the endothelin and what produces it as well as releases it?
endothelin is a chemical messenger produced and released by endothelium
is adenosine a vasodilator?
adenosine is also listed as a vasodilator it may by an important local vasodilator for the heart
where are baroreceptors and chemoreceptors located?
baroreceptors and chemoreceptors in the arteries superior to the heart
specifically where are baroreceptors and what are their functions?
there are baroreceptors )fundamentally stretch receptors) in the aortic arch and carotid sinuses.
- they trach blood pressure for flow of blood to
the body (aortic arch) and brain (carotid sinus)
what do chemoreceptors form?
there are chemoreceptor cells clustered to form aortic bodies (where corotids branch from aorta) and carotid bodies (where internal and external carotids branch )
peripheral chemoreceptors in these blood vessels detect oxygen, carbon dioxide and PH levels in the blood
what do the peripheral chemoreceptors detect in the blood?
peripheral chemoreceptors in these blood vessels detect oxygen, carbon dioxide and PH levels in the blood
-the pressure, blood gas and PH information is
all transmitted to the brain stem via the vagus
(X) and glossopharngeal (IX) cranial nerves
what can these receptors affect? how does it affect it?
signals from these receptors can affect the ananomic nervous system drive to the heart to increase blood pressure (baroreceptors) and respiratory rythms (chemoreceptors) to keep blood gases and PH within normal reange
what are the 3 main types of capillaries?
continuous capillaries
fenestrated capillaries
sinusoids
describe continuous capillaries.
structure of a continuous capillary: small gaps between endothelial cells called intercellular clefts that let fluid in and out of the capillary
*specialized continuous capillaries in the brain have tight junctions between epithelial cells rather than clefts to form the blood-brain barrier
describe fenestrated capillaries
structure of fenestrated capillaries: capillaries with pores that span the epithelial cells
-these make these capillaries more porous than
continuous capillaries
-found in choroid plexus of brain, most classical
endocrine organs, intestines and kidneys
describe sinusoids
structure of sinusoids: flattened or irregularly shaped with large gaps between adjacent epithelial cells
-allows for greater exchange with surrounding
tissues
-found in liver spleen and bonemarrow
do arteries act as a reserve for pressure?
do veins act as a reserve for blood volume?
Arteries act as a reserve of pressure within the cardiovascular system, but veins act as reserve for blood volume
what has to happen for your blood to start circulating faster?
when you need to get blood circulating faster constriction of larger veins will greatly increase venous return helping to boost cardiac output
what portion of the nervous system controls vasoconstriction of veins?
sympathetic innervation controls the vasoconstriction of veins
do most tissues have a simple pathway?
most tissue have the simple pathway
is there a portal system in the hypothalamus and pituitary?
there is a portal system in the hypothalamus and pituitary
what is the portal system between the liver and intestine called?
the hepatic portal system
where are AV shunts most commonly found?
AV shunts are most common in fingers and toes for conserving heart
does the blood supply to and from the brain have lots of anastomoses?
the blood supply to and from the brain has lots of anastomoses
what are the differences in arterial and venous systemic circulation?
Arterial
- conduit between heart and capillaries
- pressure reservoir
- damp oscillations in pressure and flow
- control distribution to capillary networks
Venous side
- conduit between capillaries and heart
- volume reservoir
- low pressure aided by various mechanisms
* one way valves
* skeletal muscle pumping
* respiratory pumping
Is TPR affected by arterial diameter?
Total Paripheral Resistance (TPR)
Arteriole diameter -big factor in TPR
why are baroreceptors called different things according to where they are found?
baroreceptors in the arterial side monitor blood pressure and sometimes are called high pressure baroreceptors while those in the venous side (primarily right atrium and a few large veins ) are called low pressure baroreceptors.
describe pressur flow and resistance
Blood flow (F)- is always from an area of higher pressure to lower pressure
Hydrostatic pressure (P)-is the pressure exerted by any fluid
resistance (R)- is the measure of forces tat impede flow
what is the equation fro flow?
F=^(greek delta)P/R
name and describe the different pressures that arise in the body?
blood pressure capillary pressure venous pressure pulse pressure mean arterial pressure (MAP)
how is blood pressure usually reported?
usually reported as arterial pressure at about level of heart
-systolic BP/diastolic BP
what is another name for capillary pressure and what is it a major factor in determining?
capillary pressure of capillary hydrostatic pressure (CHP)-is a major factor in determining the level of exchange of fluids with surrounding tissue
Is venous pressure usually low?
venous pressure is usually quite low; this is why there are additional mechanisms to help maintain good flow within the venous side of the systemic circuit
what is pulse pressure?
pulse pressure is the difference between systolic and diastolic pressure. It is a crude measure of total peripheral resistance and compliance (elasticity) of blood vessels.
what is MAP a measurement of?
mean arterial pressure is a measurement of the average force behind the blood flow withing the arterial side of the systemic circuit
Is MAP and indicator of something?
it is a good indicator of whether or not there is sufficient force to get a adequate brain blood flow and of the degree of stimulation of baroreceptors that signal blood pressure to the ANS
how is MAN equated?
MAP=DP + 1/3 (SP-DP)
MAP (mean arteriole pressure)
DP (diastolic pressure)
SP (systolic pressure)
when does BP fall?
when is BP the lowest?
- Pressure falls as blood flows through the circuit
- lowest pressure as blood re-enters the heart (superior vena cava)
what type of blood vessel has the greatest ability to change radius?
arterioles have the greatest ability to change radius of all the blood vessels, and thus, their changes usually determine the minute to minute changes in (TPR) total periperal resistance
is the blood flow the same at all points in the systemic system ?
does velocity slow at any point?
- blood flow same at all points in system
- velocity slows in capillaries
- small readius
- many capillaries
where is blood pressure the slowest?
blood flow is the slowest in the caillaries
do capillaries have a large cross section?
capillaries actually has the largest cross sectional area of any point within the circuit
flow is the result of differences in pressures at 2 points?
Flow (F)=P(point 1)——P(point 2)
P=pressure