intro to cardiovascular system Flashcards

1
Q

Name the 3 layers of cardiac muscle

A

(innermost layer to the outermost)endocardium, myocardium and epicardium.

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2
Q

Name the two parts of the major vein that drain venous blood back into the heart.

A

Inferior vena cava and the superior vena cava, empty out into the right atrium.

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3
Q

Name the two chambers and the valve of the right side of the heart.

A

The right atrium, the tricuspid valve (remember: you have to try it to be right) and the right ventricle.

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4
Q

Explain how blood flows through the right side of the heart.

A

Venous blood drains into the right atrium via the IVC and SVC. Then the right atrium contracts to force blood through the triscuspid valve before it is pumped into the right ventricle. The right ventricle contracts to pump blood through the pulmonary valves into the pulmonary artery. This blood is going to the lungs to be oxygenated.

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5
Q

Which ventricle is bigger, the left or right? Why?

A

The left ventricle is bigger because; -it must pump blood to the whole body, not just the lungs. -it must pump this blood at a higher pressure to reach the periphery.

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6
Q

Name the two chambers of the left side of the heart and the valve between them.

A

The left atrium, the bicuspid or mitral valve and the left ventricle.

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7
Q

Explain how blood flows through the left side of the heart.

A

Oxygenated blood returns to the left atrium from the lungs via the 2 pulmonary veins. The left atrium contracts to push blood through the mitral valve into the left ventricle. The left ventricle contracts to push blood through the aortic valves into the aorta, and onto the periphery.

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8
Q

In which vessel type does gas exchange take place in the periphery?

A

Capillaries-they are only one cell thick and enable easy diffusion and exchange of gases and fluid.

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9
Q

Does the myocardium have the potential to store energy?

A

No- the myocardium requires a constant supply of oxygen because it is always producing its own energy to use on a minute to minute basis.

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10
Q

How is venous blood from the cardiac tissue itself returned to the right atrium?

A

It is returned via the coronary sinus. The coronary sinus collects all the cardiac venous blood and drains directly into an opening in the right atrium, bypassing the systemic venous circulation.

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11
Q

Where does the heart get its own blood supply from?

A

The aorta has small openings in it called the coronary orifices. These orifices are closed off by the aortic valves during systole, but are opened during diastole. oxygenated blood drains into the coronary orifices during diastole, supplying the myocardium with blood.

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12
Q

What is the location and function of the sinoatrial node?

A

The sinoatrial node is located on the right atrium, near the opening of the SVC. It is a cluster of specialised pacemaker cells that maintain heart rate by generating action potentials.

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13
Q

Depolarisation of the sinoatrial node results in the contraction of which heart chambers?

A

The right and left atria will contract simultaneously.

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14
Q

The Sinoatrial node is located on the right atrium. Given that both atria contract from the depolarisation of the SA node, how then does the left atrium get the message to contract?

A

Bachmann’s bundles: This is a connecting bridge or bundle of nerves from the right atrium to the left atrium. When the SA node depolarises, then the AP spreads to the left atrium via Bachmann’s bundles.

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15
Q

What is the location and function of the atrioventricular node?

A

The AV node is located on the surface between the atria and ventricles (middle of the heart). The AV node recieves the AP from the SA node and delays the signal long enough to allow all the blood to drain from the atria into the ventricles. Finally, the AV node will pass the signal onto the ventricles, where they contract.

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16
Q

The atrioventricular node is located in the centre of the heart. Given that both ventricles contract from the depolarisation of the AV node, how then do both ventricles get the message to contract?

A

The Bundle of His and the Perkinje fibres: Bundle of His- these are two main roads from the AV node, one to take the AP to the right ventricle and one for the left ventricle. Perkinje fibres-these are the networks of smaller streets from the bundle of His, that spread the AP into every part of the large ventricles.

17
Q

What is the concept of excitation-contraction coupling?

A

This is the concept that once an action potential is generated, then the depolarisation will always be followed by contraction of the myocardium.

18
Q

What does this wave on the ECG represent?

A

This is a P-wave

The P-wave indicates atrial depolarisation by the SA node, and thus atrial contraction.

Note that the single P-wave is indicative of the contraction of both atria contracting.

19
Q

What does this segment on the ECG represent?

A

This is the PR segment

It represents the AV node recieving and delaying the AP from the SA node.

During this time, the ventricles are filling up in preparation for systole.

20
Q

what does this wave on the ECG represent?

A

This is the QRS complex.

It represents ventricular depolarisation and contraction.

21
Q

what does this segment on the ECG represent?

A

This is the ST segment.

It represents the period of time where no ions are moving after ventricular contraction, but before ventricular repolarisation.

In depolarisation of the myocardium, we see a Na+ ion influx into the cell.

During repolarisation, we see a K+ ion efflux out of the cell.

The ST segment represents the time between these two stages, where no ions move at all.

22
Q

what does this wave on the ECG represent?

A

This is the t-wave.

It represents ventricular repolarisation and the K+ efflux that causes this. Ventricular repolarisation is a time when the ventricle is relaxing after its big contraction

23
Q

What is a sinus rhythm and what do you need to have one?

A

The sinus rhythm is defined as the normal regular rhythm of the heart set by the pacemaker cells of the SA node.

A sinus rhythm is created when every P-wave you have is followed by a QRS complex.

a sinus rhythm is basically having both ventricles contract appropriately every time both atria contract.

24
Q

Describe the ‘lub’ part of a haert beat-what does this represent?

(S1 heart sound)

A

The S1 heart sound or the ‘lub’ is the sound of the atrioventricular valves shutting.

This would be the tricuspid and mitral valves shutting.

These valves shut after atrial contraction to stop blood flowing back.

25
Q

Describe the ‘dub’ part of the heart beat-what does this represent?

(S2 sound)

A

The ‘dub’ sound or S2 sound is the shutting of the semilunar valves after ventricular contraction.

The semilunar valves would be the pulmonary and aortic valves shutting.

This occurs after ventricular contraction to prevent blood falling back.

26
Q

What is the effect of aging on the heart’s conduction system?

A

Aging causes a loss in pacemaker cells, and thus in automaticity of the heart.

(automaticity=the ability to generate its own spontaneous AP’s)

This causes decreased action potential generation and propagation within the heart.

27
Q

Why are arterioles described as ‘resistance’ vessels?

A

Because:

  • arterioles carry blood through them at a very high pressure
  • arterioles have a thicker tunica media (muscle layer) to maintain this pressure from the heart.
28
Q

Why are veins described as ‘capacitance’ vessels?

A

Because:

  • veins have the ability to hold and store blood in the periphery by stretching.
  • veins can do this because they have a wider diameter and a thinner muscular layer.
29
Q

Arteries have higher pressure and veins have lower pressure.

As a system, how does this gradient affect bloodflow?

A

This pressure gradient is needed to enable blood flow in the right direction.

Blood, or any fluid will always flow from a region of **high pressure to one of low pressure across its pressure gradient. **

This gradient ensures that **blood flows from the heart and back to the heart from the periphery. **

30
Q

What does systolic pressure represent?

A

Systolic pressure represents the pressure in the aorta during ventricular contraction.

31
Q

What does diastolic pressure represent?

A

Diastolic pressure refers to the **benchmark pressure inside the aorta during ventricular relaxation and refilling. **

This will be the minimum pressure that the ventricle must generate during systole, in order for the blood to leave the ventricle on the pressure gradient.

so, if the diastolic pressure is 80mmHg, then the ventricle will produce pressure of 120 mmHg during systole to force the blood out when it contracts.

32
Q

What is cardiac preload?

A

Cardiac preload refers to how stretched the cardiac muscle fibres are inside the ventricle.

Think of the cardiac muscle as an elastic band. The more stretched the band is, the more force it will have when it snaps.

The same applies with the heart, the more stretched the cardiac muscle fibres, the stronger the contraction.

This rule is called ‘Starling’s law’.

33
Q

What is cardiac afterload?

A

Cardiac afterload refers to the amount of pressure inside the systemic blood vessels.

The higher the pressure inside these peripheral vessels, the harder the heart must contract to force blood out into it, because of the pressure gradient.

34
Q

How do ACE inhibitor drugs help to reduce cardiac afterload?

A

ACE inhibitors stop the production of a potent vasoconstrictor, called Angiotensin 2. This causes the blood vessels to become more dilated, decreasing total peripheral resistance and thus cardiac afterload.

35
Q

What is the relationship between the diameter of a blood vessel and the peripheral resistance it generates?

A

They are inversely proportional to each other.

The larger the diameter of the vessel, the smaller the amount of pressure inside it.

36
Q

Name the 2 skeletal muscle pumps that help to shunt venous blood back into right atrium.

A
  1. The gastrocnemius, or calf muscle pump.
  2. The thoracic pump (involving the diaphragm and its pull on the IVC during exhalation and inhalation).