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HUBS192 > Heart > Flashcards

Heart Flashcards

1
Q

cardiovascular system

components

A

heart
arteries
veins/lymphatics
capillaries

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2
Q

heart

A

acts as a pump for the blood

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3
Q

arteries

A

supply blood to the heart

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4
Q

veins/lymphatics

A

drains deoxygenated blood from heart to lungs

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5
Q

capillaries

A

where gas exchange occurs

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6
Q

components of the cardiovascular system are made up of vascular tissue which is made of

A

connective tissue

cells - consists of epithelia and muscle

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7
Q

blood vascular system

A

a closed supply and drainage system - a continuous loop

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8
Q

lymphatic (vascular) system

A

an open-entry drainage system - a one-way system

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9
Q

left pump sends

A

blood away from the heart

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10
Q

right pump sends

A

blood back towards the heart and lungs

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11
Q

organisation of the cardiovascular system

supply side

A

arteries are the only supply path
major arteries are situated to avoid damage e.g. deep in the trunk
important structures often receive supply from two sources (two separate arteries)
arteries change their name at each major branch

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12
Q

organisation of the cardiovascular system

exchange network

A

capillaries of varying degrees of permeability
continuous (controlled - tight)
fenestrated (leaky)
sinusoidal (very leaky)

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13
Q

organisation of the cardiovascular system

drainage

A

3 pathways for drainage - deep veins, superficial veins, lymphatics
cross sectional area of veins is at least twice that of arteries (to shift the same volume of blood/seconds)

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14
Q

heart structure

A

blunt, cone shaped, size approximately that of a closed fist

heart is rotated posteriorly and tilted so the apex is pointed anteriorly

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15
Q

Apex

A 
pointed end (bottom)
sits against 5th/6th ribs - PMI (point of maximal impulse) = apex beat
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16
Q

Base

A 
broad end (top)
sits between 2nd and 3rd ribs
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17
Q

4 chambers of the heart

A

right atrium
right ventricle
left atrium
left ventricle

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18
Q

right atrium

A

receiving chamber

deoxygenated blood from body to right ventricle

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19
Q

right ventricle

A

pumping chamber

deoxygenated blood from heart to lungs

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20
Q

left atrium

A

receiving chamber

oxygenated blood from lungs to left ventricle

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21
Q

left ventricle

A

pumping chamber

oxygenated blood to body

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22
Q

atrial chambers

A

thin walled receiving chambers
right atrium receives deoxygenated blood from
left atrium receives oxygenated blood

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23
Q

right atrium receives deoxygenated blood from

A

superior vena cava
inferior vena cava
coronary sinus

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24
Q

left atrium receives oxygenated blood

A

four pulmonary veins

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25
Q

layers of the heart wall

A

endocardium
myocardium
epicardium
pericardium

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26
Q

endocardium

A 
tissue in the heart
simple squamous epithelium (endothelium)
loose irregular fibrous connective (FCT)
(small) blood vessels
Purkinje fibres
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27
Q

myocardium

A

heart muscle
myocardial thickness - right side = 0.5cm, left side = 1.5cm
left side thicker as it pumps oxygenated blood with high pressure and velocity, thus requiring more muscle tissue

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28
Q

epicardium

A

tissue of the outer of the heart
visceral pericardium - adheres to the epicardium
(large) blood vessels
loose irregular FCT, adipose

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29
Q

pericardium

A 
sac heart is in
serous pericardium
parietal pericardium
pericardial fluid
visceral serous pericardium
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30
Q

serous pericardium

A

layer that forms a closed cavity around the heart

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31
Q

serous pericardium

A

layer that forms a closed cavity around the heart

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32
Q

parietal pericardium

A

outer layer of seroud pericardium

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33
Q

pericardial fluid

A

fills the cavity

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34
Q

visceral serous pericardium

A

inner layer of cavity that borders the heart

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35
Q

pericardial layers

A

fibrous pericardium (top layer of pericardium)
parietal layer of serous pericardium
pericardial cavity
visceral serous pericardium

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36
Q

Atrioventricular (AV) valves

function

A

prevent blood returning to atria during ventricular contraction

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37
Q

AV valves

right side

A

tricuspid valve

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38
Q

AV valves

left side

A

bicuspid (mitral) valve

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39
Q

semilunar valves

function

A

prevent blood returning to ventricles during filling (diastole)

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40
Q

semilunar valves

right side

A

pulmonary (semilunar) valve

3 cusps

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41
Q

semilunar valves

left side

A

aortic (semilunar) valve

3 cusps

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42
Q

semilunar valves

operation

A

pushed open as blood flows out of heart

close as blood starts to backflow

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43
Q

diastole

A

when heart is not contracting
AV valves open
semilunar valves closed
rising pressure

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44
Q

systole

A

when heart is contracting
AV valves closed
semilunar valves open
falling pressure

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45
Q

chordae

A

attaches AT valve leaflet to papillary muscles to stop it from prolapsing into the atrial chamber
papillary muscle contracts to put tension into the chordae tendineae to shut the valve in a slow controlled manner rather than shutting fast under the high pressure of the moving blood

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46
Q

myocardium

extended structure

A 
striated
short, branched cells
one (or sometimes 2) nuclei per cell
central (oval shaped) nucleus
cytoplasmic organelles packed at the poles of nucleus
interconnected with neighbouring cells via intercalated disks (ICD's)
mitochondria = 20% of volume of cell
irregular branched sarcomeres
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47
Q

intercalated disks

A

3 intracellular junctions

48
Q

3 intracellular junctions of intercalated disks

A

adhesion belts
desmosomes
gap junction

49
Q

adhesion belts

A

link actin to actin

vertical position

50
Q

desmosomes

A

link cytokeratin with cytokeratin

51
Q

gap junction

A

electrochemical communication

horizontal portion

52
Q

conduction system of the heart

A

it’s actions greatly increase the efficiency of heart pumping
this system is responsible for the coordination of heart contraction and of atrioventricular valve action
autonomic nerves alter the rate of conduction impulse generation

53
Q

conduction cells (TS)

A

(some) peripheral myofibrils
central nucleus, mitochondria, glycogen, lots of gap junctions, some desmosomes and few adhesion belts
1% cardiac cells

54
Q

great saphenous vein

A

longest vein in the body

55
Q

3 layers of the walls of blood vessels

A 
tunica intima (inner)
tunica media (middle)
tunica adventitia (externa - outer)
56
Q

tunica intima

structure

A
  • endothelium
    a simple squamous epithelium which lines the lumen of all vessels
  • subendothelium
    a sparse pad of loose FCT cushioning the endothelium
  • Internal Elastic Lamina (IEL)
    a condensed sheet of elastic tissue
    the IEL is well developed in arteries and less developed in veins
57
Q

tunica media

structure

A
  • smooth muscle
  • a variable content of connective tissue fibres, mainly elastin and collagen
  • thickness of the media is proportional to both vessel diameter and blood pressure
  • thickest layer in arteries because this layer is made of muscle which is needed to pump the blood around the body under a certain amount of pressure
58
Q 
tunica adventitia (externa)
structure
A
  • loose FCT with a high content of collagen and variable amount of elastin
  • in larger vessels, the adventitia contains vasa vasorum (the little extra ones)
  • lymphatics and autonomic nerves are also found in this region
59
Q

elastic artery

A

tunica media is dominated by elastin and elastic content

60
Q

muscular artery

A

tunica media is dominated by smooth muscle

61
Q

arterioles

function

A

the resistance vessels of the circulation thus determines blood pressure

62
Q

capillaries

function

A

site of exchange between blood and tissues

63
Q

venules

A

start of the collecting (drainage) system

64
Q

veins

functions

A

low pressure, large volume transport system
one-way (unidirectional) flow
capacitance vessels

65
Q

veins

structure

A

irregular, flattened shape with large lumen and thin wall

have spare capacity (can take up extra blood volume) - capacitance vessels

66
Q

veins

3 layers

A

intima
media - much thinner than arteries, a few layers of smooth muscle (often in two distinct layers) as doesn’t need to pump blood under pressure
adventitia - often the thickest layer of a vein

67
Q

valves in veins

A

prevent blood from back flowing when skeletal muscle pumps blood
as skeletal muscle pushes blood it travels in both directions but the valves shut to keep the blood flowing forward

68
Q

capillaries

function

A

site exchange between blood and tissues

69
Q

capillary function demands

A

very thin walls
large total cross sectional area of capillary bed
slow and smooth blood flow

large total area of the capillary bed (compared to arterioles) means much slower blood flow

70
Q

capillaries

3 structures

A

continuous capillaries
fenestrated capillaries
sinusoidal capillaries

71
Q

continuous capillaries

A

the most widespread
8-10µm diameter
e.g. skeletal and cardiac muscle

72
Q

fenestrated capillaries

A

leaky
8-10µm diameter
e.g. glomerulus in the kidney and small intestine

73
Q

sinusoidal capillaries

A

very leaky
30-40µm diameter
e.g. liver sinusoids

74
Q

lymphatic system

structure - lymphatic vessels

A
  • commence as large, blind ending capillaries
  • from small intestine, a special group of lymphatic vessels called lacteals drain fat-laden lymph into a collecting vessel called the cisterna chyli
  • larger (thin wall) collecting vessels have numerous valves to prevent backflow
75
Q

mammalian cardiovascular system

A

four chambered heart
blood flows in one direction - unidirectional
arterial blood flows away from the heart
venous blood flows towards the heart

76
Q

the heart is two pumps that lie ‘in series’

meaning…

A

there is equal flow through the two circuits

77
Q

heart cycle

A

relaxation (heart full of blood to be pumped = lots pressure) –> atria contract –> ventricles contracts –> relaxation
right and left pumps contract simultaneously
atria contract first and ventricles contract second
valves open and close to direct blood

78
Q

AV valves control flow between..

A

the atria and ventricles

79
Q

Aortic and pulmonary valves control flow

from…

A

the ventricles out to the circulatory vessels

80
Q

cellular mechanism of cardiac contraction

A

sarcomeres
Ca2+ levels go up and more Ca2+ is released from the sarcoplasmic reticulum (SR) –> myosin binds to actin to form cross-bridge –> myosin pulls on actin to shorten the sarcomere and generate force –> every myocyte activated during each heartbeat

81
Q

To increase force of cardiac contraction 3 physiological differences occur

A

every cardiomyocyte is activated during each heartbeat
extent of cross-bridges formed not maximised at rest
- increased cytosolic Ca2+ level
- increased number of cross-bridges formed
- increased force of contraction

82
Q

cellular mechanism of cardiac relaxation

4 details

A
  • decrease in cytosolic Ca2+ levels, Ca2+ pumped back into the SR
  • cross-bridges release when ATP binds to myosin
  • reduction in force means the heart can relax
  • all cardiac myocytes relax each beat
83
Q

starting at atrial systole, 1st step of the cardiac cycle

A

AV valves are open to let the blood through from the atria into the ventricles

84
Q

step 2 of the cardiac cycle

A

at isovolumetric ventricular contraction:
aortic and pulmonary valves are still closed
ventricles begin to contract
massive and rapid increase of pressure

85
Q

step 3 of the cardiac cycle

A

ventricular ejection:

aortic and pulmonary valves open allowing the highly pressurised blood out through the aortic and pulmonary arteries

86
Q

step 4 of the cardiac cycle

A

isovolumetric relaxation:

heart relaxes

87
Q

step 5 of the cardiac cycle

A

passive filling:

blood enters the heart into the atria

88
Q

‘Lubb’ sound

A

AV valves closing

89
Q

‘Dupp’ sound

A

pulmonary and aortic valves closing

90
Q

features of a blood pressure trace regarding systole

A
  • periods of systole (rising pressure)
  • systole is typically shorter than diastole
  • systolic pressure is the highest point on the trace
91
Q

features of a blood pressure trace regarding diastole

A
  • periods of diastole (falling pressure)
  • diastole is typically longer than systole
  • diastolic pressure is the lowest point on the trace
92
Q

two kinds of cells in the heart

A

electrical

contractile

93
Q

electrical cells

A
  • 1% of cardiac cells
  • ‘pale’ striated appearance
  • low actin and myosin
  • moves electrical signals that cause the heart contractions through the heart as rapidly as possible
94
Q

contractile cells

A
  • 99% of cardiac cells
  • striated appearance
  • high actin and myosin
95
Q

how action potentials propagate along the surface of the membrane of electrical and contractile cells

A

depolarisation starts at the sinoatrial node (SA node)
this signal spreads to neighbouring cells
in a contractile cell - increased cytosolic Ca2+ level, crossbridge attachment and contraction

96
Q

what connects cardiac cells

A

intercalated disks
gap junctions

intercalated disks connect most cells of the heart

97
Q

gap junctions…

A
  • have pores with low resistance to ionic current

- allow current flow between adjacent cells

98
Q

gap junctions and spreading the impulse

A
  • along conduction pathway
  • between electrical and contractile cells
  • between contractile cells
99
Q

gap junctions cause … for spreading the impulse

and equals…

A
  • increased speed of the impulse throughout the heart
  • millions of cardiac cells to behave as one
  • makes a functional syncytium
100
Q

conduction pathway

locations

A
  1. SA node
  2. internodal bundles
  3. AV node
  4. AV bundle, bundle branches
  5. Purkinje fibres
101
Q

SA (sinoatrial) node

A

pacemaker
generates the electrical signal
electrical signal sent in 3 different directions:
- right atrium
- across the interatrial bundle (made of electrical cells so signal moves extremely fast) into the left atrium
- atrioventricular node

102
Q

internodal bundles

A

where the signal is sent through to get to the AV node

103
Q

AV (atrioventricular) node

A

collects the electrical signal and pauses it to allow the atria to contract and ventricles to relax

104
Q

AV bundle

bundle branches

A

right and left bundle branches

105
Q

Purkinje fibres

A

spreading up the ventricular walls to reach all the contractile cells of the ventricular wall to allow for maximum contraction

106
Q

why does the contraction start at the apex of the heart not in the middle

A

having the contraction start at the apex and head towards the base of the heart means we have one efficient contraction to get as much blood out as possible in one big pump

107
Q

excitation and the conduction pathway

A
  1. quiescence ends when excitation spreads from the SA node
  2. the atria are fully depolarised and contract
  3. atria repolarise and relax, while AV node sends excitation to ventricles
  4. ventricles fully depolarised and contract
  5. ventricles begin to repolarise and relax
  6. ventricles fully repolarised and relaxed, heart is back to quiescence
108
Q

Electrocardiogram (ECG)

A

‘Lead’ - virtual line between two surface electrodes

a single lead detects a difference between electrodes

109
Q

Key features of an ECG

A

P - first bump
QRS - big peak
T - last bump

110
Q

6 parts of an ECG

A
  1. P
  2. between P and Q
  3. QRS
  4. between QRS and T
  5. T
  6. after T
111
Q

ECG

P

A

atrial depolarisation
initiated by the SA node
causes the P wave

112
Q

ECG

between P and Q

A

with atrial depolarisation complete

the impulse is delayed at the AV node

113
Q

ECG

QRS

A

ventricular depolarisation begins at apex
causing the QRS complex
atrial repolarisation

114
Q

ECG

between QRS and T

A

ventricular depolarisation is complete

115
Q

ECG

T

A

ventricular repolarisation begins at apex

causing the T wave

HUBS192 (2 decks)

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