Introduction to Cardiopulmonary Flashcards by Demond Fleming

What is the second largest hollow space in the body?

thoracic cavity

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What structures are a part of the thoracic cavity?

ribs
sternum
thoracic vertebrae
heart & lungs
upper abdominal organs

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Mediastinum contains all thoracic viscera except ______

lungs

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________ is located between lung pleurae and contents can ______

mediastinum; shift

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The heart, cardiac vasculature, esophagus, trachea, thymus, thoracic duct and lymph, phrenic nerve, and cardiac neural structures are a part of the _________

mediastinum

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Which structure pumps blood to the whole body and approx the size of a closed fist?

heart

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Where is the apex of the heart located?

sits in the 5th intercostal space of the midclavicular

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Name the three tissue layers of the heart.

pericardium: outer layer “sac”
myocardium: muscular layer
endocardium: inner layer “linning’

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tripled wall sac that contains the heart

pericardium

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What is the visceral layer that contains the coronary vessels on the surface of the heart and is located in the pericardium?

epicardium

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Inner lying of the heart
contains electrical component
contains valves and chordae tendinae

endocardium

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__________ atria receives deoxygenated blood from venae cavae

right

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_____ atria receives oxygenated blood from pulmonary veins

left

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Which atria contains thicker walls to accommodate for the higher pressure of blood coming from pulmonary circulation?

left

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What structure separates the atria?

interatrial septum

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Auricles increase available _______ and pectinate muscles contribute to _________ of atrial contractions

capacity; strength

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_____ ventricle receives deoxygenated blood from right atrium via ______ valve –> sends blood to lungs via pulmonary valve and arteries

right; tricuspid

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______ ventricle receives oxygenated blood from L atrium via _____ valve
sends blood to the body via the aortic valve and aorta
3x thicker

right; mitral (bicuspid)

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What structure separates the ventricles?

interventicular septum

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True or False: Valves have a multi-directional flow?

False: unidirectional

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Atrioventricular (AV) valve functions

prevents backflow during ventricular contraction
tricuspid
mitral (bicuspid)

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Semilunar (SL) valve functions

prevents backflow during ventricular relaxation
pulmonary
aortic

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True or False: all valves must be open at the same time.

false; valves are never open at the same time

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What arteries receive blood during ventricular relaxation while the aortic valve is closed?

Coronary

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L anterior descending artery (LAD) is also known as the

widow maker

LAD blood supply:

anterior left ventricle anterior 2/3 IV septum small part of right ventricle

Circumflex artery blood supply:

L atrium posterolateral left ventricle SA node 40% bundle of HIS

What two main arteries come off the left coronary artery?

left anterior descending artery circumflex

R coronary artery blood supply:

right atrium SA node 60% AV node

R marginal artery blood supply:

lateral right ventricle

R posterior descending blood supply:

inferior left ventricle posterior 1/3 IV septum

Which two main arteries come off the right coronary artery?

right marginal artery and right posterior descending

The R coronary artery supply?

R atrium SA node 60% AV node

R posterior descending supply?

Inferior left ventricle Posterior 1/3 IV septum

R marginal artery supply?

Lateral R ventricle

Designates the coronary artery system that is responsible for the majority of the posterior L ventricular contraction is known as

Coronary dominance

R coronary artery gives off PDA (majority of population) is known as ________

R dominant

When the circumflex gives off PDA this is known as ________

L dominant

The superior vena cava collects blood from _______ and _____. The inferior vena cana collects blood from _____ and ____

upper body and head lower body and trunk

Aorta: coronary arteries arise off the aortic sinus of ______

valsalva

The aortic arch gives rise to 3 arteries that supply BUE and the head

Brachiocephalic trunk: divides into the right common carotid artery [right side of the head and neck] and the right subclavian artery Left common carotid artery: [left side of the head and neck] Left subclavian artery: [left upper extremity]

Oxygenated blood away from the heart; thick walls are __________. Deoxygenated blood to the heart, thinner walls, larger diameter, and valves that prevent backflow are ________

arteries/veins

Capillaries functions:

O2/CO2 and nutrient exchange

Tunica intima: ______ layer made up of ________ cell Tunica media: ________ muscle Tunica adventitia/external: ______ layer made up of ________ and _______

inner; epithelial smooth outer; elastin & collagen

Cardiac myocytes are connected both mechanically and _____.

electrically

Sarcomeres within cardiac myocytes contain _____ and _____ filaments, which are essential for contractility.

actin, myosin

The force of contraction in cardiac myocytes is correlated with the amount of _____ available for binding.

Ca++ (calcium)

Cardiac myocytes have a very high number of _____ to support energy needs.

mitochondria

Cardiac myocytes make up _____% of the myocardial mass.

50%

Due to their high demand for energy, cardiac myocytes produce large amounts of _____.

ATP

The _____ pump is responsible for maintaining the action potential in cardiac cells.

Na-K (sodium-potassium)

The Na-K pump keeps more _____ outside the cell and more _____ inside the cell.

Na; K

During contraction, _____ binds to myocardial filaments, inducing contraction.

Ca++ (calcium)

The _____ absorbs calcium and causes muscle relaxation in cardiac cells.

sarcoplasmic reticulum

An increase in calcium levels leads to increased _____ and a higher _____.

contractility, heart rate (HR)

_____ stores oxygen during diastole and releases it during systole in cardiac cells.

Myoglobin

Automaticity & Conductivity

refers to the pacemaker ability of cardiac cells, allowing them to conduct impulses to one another.

_________ is the property of cardiac cells that allows them to conduct impulses, which can be either shorter or longer.

Contractility

Irritability

is the ability of cardiac cells to contract on their own and/or send impulses without being stimulated by another source.

_____ refers to the heightened sensitivity of cardiac cells, making them respond more easily to stimuli.

Irritability

Parasympathetic stimulation via the Vagus nerve results in a _____ in heart rate and contractility.

decrease

The _____ Vagus nerve controls the SA node, while the _____ Vagus nerve controls the AV node.

right, left

The _____ nerve controls the parasympathetic response in the heart, which decreases heart rate and contractility.

Vagus

The _____ nervous system increases heart rate, contractility, and causes coronary artery vasodilation.

sympathetic

The heart is innervated by the _______

cardiac plexus

Alpha -1 (a1) =

vasoconstriction = increased SVR "alpha contricts"

Stimulation of β1 receptors leads to an increase in both______and ______ ultimately increasing _____.

HR ; SV; CO "beta boots"

Stimulation of β2 receptors causes __________, leading to a decrease in _____.

vasodilation; systemic vascular resistance (SVR) "beta dilates"

The _____ node is known as the "pacemaker" of the heart and typically fires at a rate of _____ bpm.

SA (sinoatrial), 60-100

The SA node is located in the _____ atrium near the _____ vena cava.

right, superior

The _____ node is known as the "gatekeeper" of the heart and typically fires at a rate of _____ bpm.

AV (atrioventricular), 40-60

The AV node is located between the _____ septum and the _____ septum.

interatrial, interventricular

The action potential is generated by the _____ node, initiating the heartbeat.

SA (sinoatrial)

After the action potential is generated, the impulse travels through the _____ and _____ atria, causing the muscles to contract.

right, left

At the _____ node, depolarization slows due to the presence of _____ ions, allowing time for ventricular filling.

AV (atrioventricular), calcium (Ca++)

The _____ of _____ conducts the impulse from the AV node to the intraventricular septum.

Bundle of His

The _____ and _____ bundle branches depolarize their corresponding ventricles, resulting in ventricular contraction.

right, left

The _____ fibers spread electrical activity from the endocardium to the epicardium, ensuring the contraction moves from the inside to the outside of the heart.

Purkinje

During atrial systole, blood is ejected into the _____, which are relaxed. During atrial diastole, the atria are _____ and preparing for the next cycle of filling.

ventricles relaxed

In early ventricular systole, the _____ valves close, but there is not enough pressure yet to open the _____ valves. In late ventricular systole, the _____ valves open, allowing blood to be ejected from the ventricles.

atrioventricular (AV), semilunar (SL) semilunar (SL)

In late ventricular diastole, all chambers are relaxed, leading to _____ ventricular filling.

passive

During early ventricular diastole, the drop in pressure causes the _____ valves to close.

semilunar (SL)

The first heart sound, S1 ("LUB"), is caused by the closure of the _____ valves.

atrioventricular (AV)

S1 occurs during early _____ systole and is associated with the peak of the _____ wave on an ECG.

ventricular, R

The second heart sound, S2 ("DUB"), is caused by the closure of the _____ valves.

semilunar (SL)

S2 marks the termination of ventricular _____ and the beginning of ventricular _____.

systole, diastole

S2 occurs at the end of the _____ wave on an ECG.

Stroke volume (SV) refers to the _____ of blood ejected per contraction of the heart. Cardiac output (CO) is the volume of blood ejected from the _____ ventricle per minute.

volume left

The normal range for cardiac output is approximately _____ to _____ liters per minute.

4, 6

Preload refers to the concept of “_____,” indicating how full the heart's chambers are before contraction. Contractility is described as “_____,” relating to how effectively the heart muscle can contract. Afterload is concerned with “_____,” which assesses the resistance the heart must overcome to eject blood.

How full is the tank? How good is the squeeze? How loose is the vasculature?

_______refers to the degree to which the heart muscle can stretch before contraction.

Preload

Preload is directly proportional to _____. The more blood that returns to the heart, the greater the volume that can _____ during contraction.

stroke volume (SV) leave

Frank-Starling Law states that

greater volume of blood is ejected when a greater volume returns to the heart if myocardial fibers are too stretched or too shortened, the strength of contraction is decreased.

Best **clinical indicator** of cardiac function

Ejection fraction

Measurement of how well the heart is functioning _______ ________ Normal: ______ If CI falls below ______, patient is likely in cardiogenic shock

Cardiac Index (CI) better indicator than EF ~ 2.5-4.0 L/min/m2 ~ 2.2 L/min/m2

A rightward shift in the Oxyhemoglobin Dissociation Curve indicates that hemoglobin is more willing to _____ oxygen to the tissues. A leftward shift in the Oxyhemoglobin Dissociation Curve indicates that hemoglobin holds on to oxygen more tightly, making it _____ available to tissues.

release less

Oxyhemoglobin Dissociation Curve: Factors that can cause a rightward shift in the curve include increased levels of _____, increased temperature, and decreased pH (acidosis).

carbon dioxide (CO2)