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PD BIO 305 > Heart 1 > Flashcards

Heart 1 Flashcards

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2
Q

The heart is a muscular organ about the size of what?

A

A fist.

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3
Q

How many chambers does the heart have? What kind of pump is it?

A

Four-chambered double pump.

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4
Q

At rest, the heart of an adult pumps about _____ L/min of blood.

A

5.0L/min

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5
Q

How long does it take for blood to be circulated to the most distal extremities and back to the heart?

A

About ONE minute.

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6
Q

What are the four chambers of the heart called? What two categories are they put into and where are they located?

A

Atria - Two Upper chambers, sometimes called auricles

Ventricles - Two Lower chambers

  1. Right/Left Atrium
  2. Right/Left Ventricle
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7
Q

The right atrioventricular (AV) valve is also known as the ______ valve.

A

Tricuspid valve

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8
Q

The left atrioventricular (AV) valve is also known as the ______ valve.

A

Mitral valve

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9
Q

What are the four heart valves and where are they located?

A
  1. Pulmonary Valve (Right)
  2. Right AV Valve (Tricuspid)
  3. Aortic Valve (Left)
  4. Left AV Valve (Mitral)

Located between the atria and the ventricles.

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10
Q

The pulmonary valve and the aortic valve are also called the __________ valves because they have 3 cusps which resemble half moons.

A

Semilunar

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11
Q

What happens to the valve when the pressure is greater behind it?

A

It opens

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12
Q

What happens when the pressure is greater in front of the valve?

A

It closes.

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13
Q

Heart valves are considered to be ____-way valves.

A

One

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14
Q

The heart wall is separated into what three layers? Describe the characteristics of each layer.

A
  1. Endocardium - a thin layer of endothelium
  2. Myocardium - muscle layer (cardiac muscle)
  3. Epicardium - thin external layer
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15
Q

What is the contraction of the heart muscle stimulated by?

A

Electrical impulses.

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16
Q

When a specialized system of nodal tissue generates and conducts impulses through the heart, what happens?

A

Rhythmic contractions of the myocardium.

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17
Q

In the cardiac conduction system, there are four structural and functional portions. What are they? (*Hint - Backup pacemakers in order…)

A
  1. Sinoatrial node (SA Node/Pacemaker)
  2. Atrioventricular node (AV node)
  3. Atrioventricular bundle (AV bundle or bundle of HIS)
  4. Purkinje fibers
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18
Q

True or false. When an impulse is created at the top of the heart, it does NOT travel throughout the entire heart.

A

False.

Impulses DO travel throughout the entire heart.

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19
Q

What are the characteristics of the Sinoatrial node (SA node)? Where is it located and what is the other name for it?

A

‘Pacemaker’

Located within the posterior wall of the right atrium. Near opening of superior vena cava.

Contracts quicker.

Cells here depolarize quicker than any other cell in heart.

Rhythmical impulses originate in the SA node and spread through atria.

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20
Q

What are the characteristics of the Atrioventricular node (AV node)? Where is it located?

A

Located within the lower right interatrial septum.

Impulse is delayed in the AV node for 1/10 sec to allow atria contraction BEFORE ventricular contraction.

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21
Q

What are the characteristics of the Atrioventricular bundle (AV bundle or bundle of HIS)? Where is it located?

A

Originates in the AV node and divides into “two bundle branches” which then extend down the two sides of the interventricular septum.

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22
Q

True or False. When atria muscles contract, they contract with an impulse.

A

True.

Atria muscles DO contract with an impulse.

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22
Q

How does an electrocardiogram (EKG) operate?

A

Monitors impulses that initiate rhythmical and ventricular contractions throughout the heart.

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23
Q

Impulses start in the ________ node and spread over the _______ muscle fibers producing _______ contraction.

A
  1. SA node
  2. atrial
  3. atrial
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23
Q

After an impulse is started in the ____ node. It reaches the ____ node. The impulse then travels through the ____ _______ and ________ __________. This produces coordinated ___________ contraction.

A
  1. SA node
  2. AV node
  3. AV bundle
  4. Purkinje fibers
  5. ventricular
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24
Q

True or False. An EKG records electrical impulse and spread.

A

True.

An EKG records electrical impulses and spread, not electrical speed or contractions.

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24
Q

What are some of the many factors which may alter the heartbeat rate?

A
  1. Sympathetic impulses
  2. Parasympathetic impulses
  3. Hormones
  4. Body temperature
  5. Exercise
  6. Emotion
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25
Q

In the cardiac cycle, there are two main functions (*blood pressure). What are they referred to as, and what are their functions?

A 
1. Systole
     Phase of Contraction
     Emptying of the atria and 
     ventricles
2. Diastole
     Phase of Relaxation
     Filling of the atria and   
     ventricles.
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26
Q

From the two main functions, the cardiac cycle has a total of four processes. What are they? What is their order?

A
  1. Mid-diastole
  2. Atrial systole
  3. Ventricular systole
  4. Early diastole
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27
Q

During the ‘Mid-diastole’ process. The _______ and _______ are relaxed.

The _______ and _______ valves are open, the ______ and _______ valves are closed.

A
  1. atria
  2. ventricles
  3. tricuspid
  4. mitral
  5. aortic
  6. pulmonary
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28
Q

Before the end of the ‘Mid-diastole’ phase, __to__% of ventricular filling occurs.

A

65 to 85%

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29
Q

During the ‘Atrial systole’ process. The ________ contract and pump the additional __to__% of the blood into the _________. As the _____ contract, the orifices of the ______ ______ and _________ veins narrow; however, there is some regurgitation of blood into the ______.

A
  1. atria
  2. 20 to 35%
  3. ventricles
  4. atria
  5. venae cavae
  6. pulmonary
  7. veins
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30
Q

Which valves are closed during isovolumetric contraction?

A

All four valves are closed

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31
Q

What is considered to be an average PULSE PRESSURE?

A

40-50 mm Hg

This is the difference between systolic and diastolic(120/80)

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31
Q

What is bradycardia and what are some factors that cause it?

A

Bradycardia is a decrease in heart rate to less than 60 beats/minute.
It can be caused by expiration, fear (?), and grief

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32
Q

Nerves affect cardiac pumping in two ways: chronotropic and inotropic. What does each of those alter?

A

Chronotropic- changes the heart rate

Inotropic- changes the strength of contraction

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33
Q

What is the average heart rate in the S.A node?

A

72-75 beats/minute

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34
Q

What is the heart rate in the A.V node?

A

50-60 beats/minute

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34
Q

What is the heart rate in the ventricles?

A

30-40 beats/minute

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35
Q

What is the maximum sympathetic stimulation in the heart?

A

250 beats/minute

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36
Q

One catecholamine has a significant impact on the permeability of cardiac cells to Na+ and Ca++. Which is it and what is it’s influence?

A

Norepinephrine; increases the permeability

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37
Q

What is the overall impact of sympathetic control on the cardiac system?

A

It increases the rate and force of contraction

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38
Q

What is the overall impact of parasympathetic control on the cardiac system?

A

It decreases the rate and force of contraction

39
Q

Under parasympathetic control, what is the maximum stimulation?

A

20-30 beats/minute (Bradycardia)

40
Q

Which catecholomine increases the permeability (when under parasympathetic control) of K+?

A

Acetylcholine

41
Q

What does the term inotropic refer to?

A

The strength or force of contraction

42
Q

Name four factors that have a positive inotropic effect on the heart?

A

Frank Starling’s Law of the heart, greater fill greater force
Catecholamines- epinephrine or norephinephrine
Xanthines- caffeine, theophylline
Digitalis- drug used for cardiac failure

43
Q

What does the term chronotropic refer to?

A

The rate of contraction (how fast the heart beats)

44
Q

What does the term dromotropic refer to?

A

The rate of conduction of impulse through the specialized conduction system

45
Q

What is stroke volume?

A

The amount of blood pumped out of each ventricle per beat (about 60 to 80 ml)

46
Q

What is the equation that renders cardiac output?

A

Stroke volume x heart rate = cardiac output

47
Q

What is the Fick Principle?

A

CO (Cardiac Output) = oxygen consumption ml/minute

arterial O2 - venous O2

48
Q

What are 5 causes of abnormal cardiac rhythms?

A 
Abnormal rhythms in the SA node
Shift of pacemaker activity from SA node
Blockage of impulses
Bradycardium
Tachycadia
48
Q

What is tachycardia?

A

An accelerated heart rate of over 100 beats/minute

49
Q

Why is the QRS a greater event than the P or T wave?

A

Because the ventricles have more cells than the atria

50
Q

At rest is the heart more positive or negative? What about when it is firing?

A

At rest: heart is more +

When firing: heart is more -

51
Q

What is the normal heart rate?

A

60-100 beats/minute

52
Q

What is ‘Frank Starling’s law of the heart’?

A

Greater the filling during ‘diastole’, the greater the force of contraction during ‘systole’.

53
Q

How do Xanthines interact with the heart, and what are two types of drugs in this category?

A

Positive effect on strength/force of contraction.

  1. Caffeine
  2. Theophylline
54
Q

What is dromotropic and how does it effect the heart?

A

Rate of conduction of impulse.

(+) or (-) effect on heart.

55
Q

There are two ways that nerve can affect the cardiac pumping. What are they?

A
  1. Heart Rate - Chronotropic

2. Strength of Contraction - Inotropic

56
Q

The cardiac membrane in the heart is a little more permeable to ________.

A

Sodium (Na)

57
Q

Under parasympathetic control, acetylcholine does what?

A

Increases the permeability of the membrane to K+ (Potassium)

58
Q

Under sympathetic control, norepinephrine does what to cardiac cells?

A

Increases the permeability of the cardiac cells to Na+ and Ca2+

59
Q

For an athlete, what is the average heart rate and stroke volume? Cardiac output?

A

Beats per minute lower but stroke volume higher

60
Q

For an asthenic person, what is the average heart rate and stroke volume? Cardiac output?

A

Beats per min higher but stroke volume lower

61
Q

What is the Fick Principle and how does it work?

A

Measurement of the Cardiac Output

Amount of substance taken up by an organ/whole body per unit of time = arterial level of substance minus venous level of substance (A-V difference) x blood flow.

62
Q

On an EKG, the first wave is called the ___ wave and is associated with ___________ in the _____.

A
  1. P wave
  2. DE-polarization
  3. atria
63
Q

On an EKG, the second wave is called the ___ wave (complex) and is associated with ___________ of the __________.

A
  1. QRS complex
  2. DE-polarization
  3. ventricles
63
Q

On an EKG, the third wave is called the ___ wave and is associated with ___________ of the __________.

A
  1. T wave
  2. RE-polorazation
  3. ventricles
64
Q

The repolarization is not monitored in the ‘QRS’ wave on an EKG. Why?

A

It is too small of an electrical event to show up.

65
Q

An impulse moving in the heart from a negative (-) to a positive (+) lead shows up as a __________ spike on an EKG.

A

POSITIVE

66
Q

What is the formation and electrode connectivity in ‘Einthoven’s Triangle’?

A

Left Shoulder
Right Shoulder
Left Leg

67
Q

There are 12 different leads that can be used to record EKG’s. What are the different categories?

A

3 Standard Limb Leads
3 Augmented Limb Leads
6 Chest Leads

68
Q

In ‘Lead I’ where are the positive and negative leads located?

A 
NEGATIVE = Right Arm
POSITIVE = Left Arm
69
Q

In ‘Lead II’ where are the positive and negative leads located?

A 
NEGATIVE = Right Arm
POSITIVE = Left Leg
69
Q

In ‘Lead III’ where are the positive and negative leads located?

A 
NEGATIVE = Left Arm
POSITIVE = Left Leg
70
Q

In ‘Lead aVR’ where are the positive and negative leads located?

A 
NEGATIVE = Left Arm
NEGATIVE = Left Leg
POSITIVE = Right Arm
70
Q

In ‘Lead aVL’ where are the positive and negative leads located?

A 
NEGATIVE = Right Arm
NEGATIVE = Left Leg
POSITIVE = Left Arm
70
Q

In ‘Lead aVF’ where are the positive and negative leads located?

A 
NEGATIVE = Right Arm
NEGATIVE = Left Arm
POSITIVE = Left Leg
70
Q

Which of the 6 chest leads are mainly negative and which are mainly positive?

A

V1 - V3 = Mainly Negative

V4 - V6 = Mainly Positive

71
Q

Deviations from a normal heart rate or from normal electrical activity are referred to as _________.

A

Cardiac arrhythmia.

72
Q

Cardiac arrhythmia can results from what three things?

A
  1. Abnormal rhythmicity in the SA node.
  2. Ectopic Pacemaker (Ex. shift from SA node to another part of heart)
  3. Abnormal pathway or blockage of impulses in conduction system.
73
Q

What is ischemia defined as?

A

Lack/Restriction of bloodflow.

73
Q

What are some of the major factors of ectopic pacemakers? (There are 8 of them)

A
  1. Localized ischemia
  2. Localized heart damage
  3. Dilation of heart
  4. Toxic irritants (nicotine, caffeine, alcohol)
  5. Lack of sleep
  6. Anxiety
  7. Extremes in body temperature
  8. Change in body pH
73
Q

During an ‘Atrial Premature Beat’, what happens?

A
  1. Premature depolarization of SA node / ectopic pacemaker
  2. Some P waves are normal / some are abnormal
  3. LITTLE clinical significance.

May precede a flutter or fibrillation

73
Q

During an ‘AV Nodal Premature Beat’, what happens?

A
  1. From ectopic discharge of AV node then proceeds down the Bundle of HIS
  2. Normal QRS complex
  3. Not proceeded by a P wave
74
Q

What is the definition of a ‘Bigeminy’?

A

One normal beat and one PVD beat.

74
Q

What is the definition of a ‘Trigeminy’?

A

Two normal beats and one PVD beat.

75
Q

Why is the ‘QRS’ complex bigger in a Premature Ventricular Depolarization (PVD or PVC)?

A

Because the impulse has to travel through intercalated discs and takes longer.

76
Q

Throwing a ‘Premature Ventricular Depolarization’ (PVD or PVC) may be dangerous when one of three things occur. What are the three things?

A
  1. More than 6-7/min
  2. Occur in pairs or triplets
  3. Occur early in cycle (during the T wave)
77
Q

During a ‘SA Block,’ what happens?

A
  1. Pacemaker temporarily stops for at LEAST one complete cycle.
  2. P waves before and after block are identical
78
Q

During an ‘Atrial Flutter’, what happens?

A
  1. Originates in an atrial pacemaker
  2. P waves very rapid/coordinated (Look simliar to each other)
  3. 2:1, 3:1, 4:1
  4. Treatment = Digitalis
78
Q

During an ‘Atrial Fibrillation’, what happens?

A
  1. Caused by many ectopic pacemakers in atria
  2. Uncoordinated or irregular P waves
  3. Decrease in cardiac output
  4. QRS-T usually look normal
78
Q

True or False:

During an ‘Atrial Fibrillation’, multiple ectopic pacemakers ARE usually firing at the same time.

A

FALSE

Multiple ectopic pacemakers are NOT usually firing at the same time.

78
Q

True or False:

During an ‘Atrial Fibrillation’, you should be able to count the spikes on the EKG between the QRS complexes.

A

TRUE

You should be able to count the ‘squibble marks’. (Ventricular Fibrillation you won’t be able to.)

78
Q

During a ‘Ventricular Flutter’, what happens?

A
  1. Caused by a single ectopic pacemaker in ventricles
  2. Has smooth sine wave appearance
  3. Very Fast = Very Dangerous
  4. Abnormal heart filling = Decreased cardiac output
  5. Often leads to fibrillation
  6. Decreased coronary flow
79
Q

True or False:

Ventricular Flutter is usually caused by a single ectopic pacemaker.

A

TRUE

Only a single ectopic pacemaker.

80
Q

During a ‘Ventricular Fibrillation’, what happens?

A
  1. Caused by many ventricular ectopic pacemakers
  2. Uncoordinated, chaotic twitching, bag of worms
  3. Blood pressure drops
  4. Unless stopped death will occur in a short time
81
Q

What is the technical term used for ‘Heat Attack’?

A

Myocardial Infarction

82
Q

What are the three phases that are also referred to as the ‘Classical Triad’?

A
  1. Ischemia
  2. Injury
  3. Infarction
82
Q

What is the ischemia phase? What does it show up?

A

Characterized by a symmetrical inversion of the T wave

Most pronounced in the chest leads

Cause by a delay in the recovery at the epicardial regions

Altered repolarization

(1st PHASE)

82
Q

What is the injury phase? When does it show up?

A

ST elevation = infarction is fresh (acute)

2nd PHASE

83
Q

What is the ‘infarction’ phase? When does it occur?

A

Significant Q wave - much wider than normal

Q may be 1/3 of the height of the QRS

May last for many years after the infarction

(3rd PHASE)

PD BIO 305 (19 decks)

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