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Anatomy&Physiology 2 > heart > Flashcards

heart Flashcards

1
Q

location of the heart

A

mediastinum
superior surface of the diaphragm
left of the midline
anterior to vertebral column, posterior to the sternum

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2
Q

covering of the heart

A

pericardium
a double walled sac surrounding the heart
superficial fibrous pericardium
deep 2 layer serous pericardium

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3
Q

superficial fibrous pericardium

A

tough dense CT that protects the heart, anchors it to surrounding structures and prevents heart overflow with blood

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4
Q

serous pericardium

A

parietal layer: lines internal surface of fibrous pericardium; attached at superior margin to large arteries exiting the heart

visceral layer or epicardium lines the external surface of the heart; an integral part of the heart wall

allows heart to work in a friction free environment

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5
Q

layers of the heart wall

A

epicardium
myocardium
endocardium

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6
Q

epicardium

A

visceral layer of the serous pericardium

integral part of the heart wall

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7
Q

myocardium

A

muscle heart/cardiac musc
forms the bulk of the heart and contracts
musc cells connected to eachother by criss crossing CT fibers and arranged in spiral or circular bundles

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8
Q

fibrous skeleton of the heart

A

part of myocardium
network of collagen and elastin
reinforces the myocardium
anchors cardiac muscle fibers
supports where the great vessels leave the heart
not electrically excitable-limits spread of AP
acts as a tendon and insertion that gives cells something to exert force against (support)

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9
Q

endocardium

A

inside the heart
squamous epithelium layer
continuous with endothelial linings of the blood vessels

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10
Q

path of blood through the heart

A 
coronary sinus+IVC+SVC
right atrium
tricuspid AV
right ventricle
pulmonary SL
pulmonary trunk
pulmonary artery
lungs
pulmonary veins
Left atrium
bicuspid AV
left ventricle
Aortic SL
aorta
body systems
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11
Q

ventricles

A

discharging chambers of the heart
walls marked by papillary muscles and trabeculae carneae muscles
R&L ventricle separated by the interventricular septum

R ventricle- pumps blood into pulmonary trunk and its wall is nearly flattened

L ventricle- pumps blood into aorta its wall is 3 X as thick, nearly a circular cavity

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12
Q

the left ventricular wall is thicker because

A

it has to push blood against a greater resistance

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13
Q

atria

A

receiving chambers of the heart
each has a protruding auricle -little ear flap to increase atrial volume
atrial walls marked by pectinate muscles

blood enters right atria from superior/inferior vena cava, and the coronary sinus

blood enters the left atria from the pulmonary veins

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14
Q

pulmonary circulation

A

right side of the heart
receives deoxygenated blood from the body tissues
takes blood in pulm arteries to the lungs to pick up o2 and release co2

short low pressure circulation

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15
Q

systemic circulation

A

left side of the heart
receives oxygenated blood from the lungs via pulmonary veins
takes blood to all parts of the body accept alveoli to supply nutrients and oxygen
long pathway and encounters 5X more resistance to blood flow

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16
Q

heart valves are to ensure

A

unidirectional blood flow

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17
Q

atrioventricular valves

A

between the atria and ventricles
prevent backflow of blood into aorta when ventricles are contracting
anchored to papillary muscles by chordae tendineae to prevent valve reversion during ventricular systole

blood flows down when atrial pressure increases so valves open.
papillary muscles relax during diastole

tricuspid: bt right atria and ventricle
Bicuspid: bt left atria and ventricle

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18
Q

atrioventricular valves compared to

A

right side up umbrella

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19
Q

semilunar valves

A

moon shaped cusps attached to artery wall
open when ventricular pressure increases and exceeds pressure in arteries-blood is then ejected into aorta and pulmonary trunk

cusps close when ventricles relax and blood flows back to heart

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20
Q

semilunar valves compared to

A

upsidedown umbrella

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21
Q

coronary circulation

A

shortest circulation

the functional blood supply to the heart muscle itself

collateral routes (anastomoses) ensure blood delivery to heart even if major blood vessels are blocked

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22
Q

cardiac muscle cells

microscopic anatomy

A

short, striated, fat, branching, uninucleate, interconnected

connective tissue endomysium acts as both a tendon and insertion

intercalated disks anchor cells together and allow free passage of ions

behaves as a functional syncytium

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23
Q

myofibrils in 2 interlocking cardiac muscle cells are firmly anchored to the membrane at the

A

intercalated disk

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24
Q

intrinsic conduction system of the heart

A

autorhythmic cells
intitiate action potentials
have unstable resting potentials called pace maker potentials
use calcium influx rather than sodium for rising phase of the AP

self excitable and can initiate their own depolarization and that of the rest of the heart in a spontaneous and rhythmic way

make up 1% of cardiac tissue

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25
Q

autorhythmic cells are found in

A 
SA node
AV node
AV bundle
R/L bundle branches
ventricular walls PJ fibers
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26
Q

sequence of excitation

A

SA node-AV node-AV bundle of HIS-bundle branches-purkinje fibers-conduction myofibers

27
Q

SA node

sinoatrial

A

generates impulse about 75 times a min
no sarcomere, just forming AP

responsible for initiation and pace of heart beat

happens when enough Na+ and Ca++ leak into cells of SA node to reverse resting potentials (Na takes to thresh, Ca forms AP_

pacemaker potential propagates through both atria by gap junx
both atria contract pumps blood to ventricles

28
Q

AV node

atrioventricular

A

autorhythmic rely on SA
loc in spetum bt lower RA+LV

delays the impulse about .1 sec to allow ventricles to fill
av fires
impulse passes form atria to ventricles via the atrioventricular bundle (bundle of HIS)

av bundle splits in 2 in the interventricular septum (R/L bundle branches)
bundle branches carry the impulse towards the apex of the heart
purkinje fibers carry impulse to apex and ventricular walls
keeps papillary muscles contracted and AV valves closed

ventricles contract

29
Q

heartbeat

A

slow Ca++ gates open
ER releases more Ca++
Ca++ moves into the muscle

plateau phase
Ca++ inward flow and K+ outward flow decreases
rapid repolarization
muscle tension increases-providing sustained contraction needed to eject blood from the heart

K+ moves out fast-quick repolarization

goes to autorhytmic cells

30
Q

ECG/EKG

A

graphic record of heart activity
composite of all action potentials generated by nodal and contractile cells at a given time

has 3 distinguishable waves
P
QRS
T

31
Q

P wave

A

atria depolarize

approximately .1 second after P wave begins atria contract

32
Q

QRS wave

A

results from ventricular depolarization and precedes ventricle contraction

has complicated shape bc the paths of depol waves through ventricular walls change continuously, producing corresponding changes in current direction

33
Q

T wave

A

ventricle repolarization
potassium comes out
repol is slower than depol so the T wave is more spread out and has a lower amplitude than the QRS wave

34
Q

extrinsic innervation of the heart

A

heart is stimulated by: sympathetic cardio acceleratory center thru sympathetic NRE ganglion

heart is inhibited by: parasympathetic cardio inhibitory center thru vagus ACH nerve X

brain cant say start/stop to the heart, can only change the rhythm

35
Q

heart sounds are associated with

A

closing of the heart valves

36
Q

first heart sound (lub) occurs

A

as AV valves close

signifies the beginning of systole

37
Q

second heart sound (dub) occurs

A

when SL valves close

the beginning of ventricular diastole

38
Q

heart murmur

A

abnormal heart sounds

39
Q

steps 1 of cardiac cycle

ventricular filling

A

AV valves are open, atrial Depol
SL valves closed
ventricular volume increases

heart is at rest blood is filling the ventricles

40
Q

step 2 of cardiac cycle

Isometric systole

A

AV valves are closed
SL valves are closed
ventricular volume is constant
ventricular pressure increases

135mL in each vent before they contract

41
Q

step 3 of cardiac cycle

ventricular ejection

A

AV valves are closed
SL valves are open
ventricular volume decreases with pressure

about 70 mL is ejected

42
Q

step 4 of cardiac cycle

isovolumetric relaxation

A

AV valves are closed
SL valves are closed
ventricular volume is constant
ventricle is in diastole

about 65mL left in each ventricle

43
Q

cardiac output

A

the amount of blood pumped out by each ventricle in 1 minute

CO=heart rate (bpm) X Stroke volume

44
Q

stroke volume

A

blood pumped out by one ventricle with each beat

about 70mL/beat

correlated with the force of ventricular contraction

45
Q

all blood circulates the body in

A

1 minute

46
Q

cardiac reserve

A

the difference between pumped blood and what could be pumped
work the heart is able to perform beyond that required of it under ordinary circumstances

between resting and maximal cardiac output

47
Q

cardiac reserve of non athletic people

A

4-5X the resting cardiac output

20-25L/min

48
Q

cardiac reserve of athletes

A

7 times resting cardiac out put

up to 35L/min

49
Q

fran starling law of the heart

A

preload or degree of stretch is the critical factor in controlling stroke volume

more stretch from slow heart beat and exercise increase stroke volume

too much stretch from blood loss and rapid heart beat decrease SV because there is not enough time to fill

50
Q

ventricle filling is a function of

A

venous pressure

51
Q

contractility is the increase in contractile strength independent of

A

stretch and EDV

52
Q

increase in contractility comes from

A

increased sympathetic stimuli
certain hormones (glucagon/thyroid hormone)
Ca++, epinephrine, NRE

53
Q

agents that decrease contractility

A

acidosis
increased extracellular K+
calcium channel blockers

54
Q

because the heart is a double pump

A

each side can fail independently of eachother

55
Q

pulmonary congestion/pulmonary edema

A

left ventricular failure
right ventricle pumps more
increase in pressure in lungs
less gas exchange

56
Q

peripheral congestion/systemic edema

A

Right ventricular failure
left ventricle pumps more
increased pressure in systemic arteries
more fluid stays behind impairing vision and causing extremities to swell

57
Q

angina pectoris

A

chest pain or discomfort due to coronary heart disease
heart muscle does not get as much blood as it needs
ischemia

58
Q

endocarditis

A

inflammation of endocardium and heart valves

59
Q

arrhytmias

fibrillation

A

rapid irregular or out of phase contractions

control of rhythm taken away from SA by other regions

60
Q

arrhythmias

junctional rhythm

A

Cardiac rhythms arising from the atrioventricular (AV) junction occur as an automatic tachycardia or as an escape mechanism during periods of bradycardia

61
Q

arrhythmias

heart block

A

damage to AV node interferes with electrical communication between atria and ventricle

ventricle depol at 30 times per min

62
Q

hypertrophic cardiomyopathy

A

parts of heart become thickened making it hard to contract and relax

63
Q

congestive heart failure

A

heart fails to pump enough blood to body

Anatomy&Physiology 2 (10 decks)

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