Lab 1 Flashcards
Put these in order:
- Right atrium
- Left atrium
- Right ventricle
- Left ventricle
- Pulmonary valve
- Pulmonary arteries, veins, and capillaries
- Systemic Arteries, veins, and capillaries
- Tricuspid valve
- Bicuspid valve (AKA Mitral valve)
- Systemic arteries, veins, and capillaries
- Right atrium
- Tricuspid valve
- Right ventricle
- Pulmonary valve
- Pulmonary arteries, veins, and capillaries
- Left atrium
- Bicuspid valve (AKA Mitral valve)
- Left ventricle
What determines function?
Structure determines function
What determines physiology?
Anatomy determines physiology
What does the cardiovascular system do? (Three things)
- Exchanges nutrients and oxygen to tissues
- Removes waste from tissues
- Transports blood
Where is the heart?
- Barely left of your midline
- Inside your thoracic cavity
- Inside the mediastinum
- Inside the pericardial cavity
- Inside the mediastinum
- The heart sits on top of the diaphragm
The heart sits on top of what muscle?
The diaphragm
What does the heart look like roughly? What is it composed of?
- 4 chambers
- 4 valves
- Tubes (vessels) for blood
- Nerves
- Muscle
- Connective Tissue
- Including blood
What do capillaries do?
Capillaries exchange nutrients
What do arteries do?
Arteries (irrigate) like a hose
- Branch
- Supply blood away from the heart
- Not always oxygenated
What do veins do?
Veins (drain) like a stormdrain
- Merge
- Drain
- Remove blood form tissue toward the heart
- Sometimes oxygenated
Where is the systemic circulation?
Body Tissues
Systemic circulation carries oxygenated blood from the left ventricle, through the arteries, to the capillaries in the tissues of the body. From the tissue capillaries, the deoxygenated blood returns through a system of veins to the right atrium of the heart.
Identify three artery locations in the cardiovascular system:
- Betweem the heart (right) and pulmonaru circulation
- Betweem the heart (left) and arterial circulation
- Between the heart (left) and coronary circulation
Pulmonary refers to what organ?
The lungs!
What happens to the blood when it reaches the lungs?
It gets oxygenated
What is the pulmonary circulation important for?
- Oxygenation of blood, exchange of carbon dioxide CO2
- Maintenance of blood pressure: there is also an enzyme (ACE) important for endocrine blood pressure regulation
What is systemic circulation important for?
- Nutrient absorption, nutrient storage, oxygenation of tissue, removal of waste (e.g. urea, drugs, CO2) from tissue, maintenance of blood pressure (sensing)
What about coronary circulation? Does the blood inside the heart chambers provide nutrients and oxygen for heart wall tissue?
No, thats why we have the coronary and veins on the heart!
- It’s technically a part of the systemic circulation, but it operates differently
Lable the heart (anterior view)
Lable the heart (posterior view)
Label the heart with the following:
Carries Blood away - Arterial
- Pulmonary Trunk
- Pulmonary Arteries (1xLeft, 1xRight)
- Ascending Aorta
- Aortic Arch
- Descending Aorta
Carries Blood toward - venous
6. Superior vena cava (SVC)
- Inferior vena cava (IVC)
- Pulmonary veins (2xLeft, 2xRight)
Circle the Ligametum arteriosum
Lable the internal heart features
What forms the base of the heart?
The right and left atria form the base of the heart, and the base faces the right shoulder while the apex points to the left hip
What is a sulci and what are the three sulci? What do they depict of the heart?
- Sulci are grooves that externally mark the boundaries between the four heart chambers
- Coronary Sulcus: Deep sulcus that externall shows the separation of the atria and the ventricles
- Anterior interventricular sulcus and Posterier interventricular sulcus are shallow grooves that depict the surface boundaries between the two ventricles
What are the three great vessels of the heart that return oxygen-poor blood to the right atrium of the heart?
The superior vena cava, inferior vena cava, and coronary sinus
Where does the superior vena cava return blood from?
Superior vena cava reurens blood fromm the head, neck, and arms
Where does the inferior vena cava return blood from?
Inferior vena cava returns blood from the body inferior to the heart
Where does the coronary sinus return blood from?
Coronary sinus is a smaller vein that returns blood from the coronary circulation
After the blood comes from the body from either the superior vena cava, inferior vena cava, or coronary sinus, it enters into the ____________ and from there enters the _______________ . From here, blood enters the __________________ which is the only vessel that removes blood from the right ventricle. This large artery divides into _____________________ which carry blood to the lungs where it is oxygenated. Oxygen rich blood returns to the _______________ through two ____________________ and two ____________________.. The blood passes into the ________________________ which then pumps this blood into the large _____________ where is distributes blood to systemic circulation.
After the blood comes from the body from either the superior vena cava, inferior vena cava, or coronary sinus, it enters into the right atrium and from there enters the right ventricle. From here, blood enters the pulmonary trunk which is the only vessel that removes blood from the right ventricle. This large artery divides into left and right pulmonary arteries which carry blood to the lungs where it is oxygenated. Oxygen rich blood returns to the left atrium through two right pulmonary veins and two left pulmonary veins. The blood passes into the left ventricle which then pumps this blood into the large aorta where is distributes blood to systemic circulation.
Describe the three form features of the aorta
The aorta starts out as a short ascending aorta then curves to the left to form the aortic arch, descends posteriorly, and continues as the descending aorta
What is the difference between the external fetal heart and new born heart and where does a fetus get oxygen from?
The fetal heart contains a short vascular channel the ductus arterious which connects the pulmonary trunk and the aorta. The fetus obtains oxygen not from their lungs but through the placenta. After childbirth, the ductus arterious changes into a ligament and remains as the ligamentum arteriosum.
What is a special feature of an internal fetal heart and how does it change after birth?
The fetal heart has a foramen ovale which allows blood to bypass the lungs and go from the right atrium to the left atrium. After birth the fossa ovalis tissue membrane forms over the foramen.
What structure separates the right and left atria?
The interatrial septum
Describe the internal structure and features of the right and left ventricles. What separates them?
The ventricles have ridges of muscles called trabeculae carneae. The larger of these muscles, the papillary muscles have string like cords attatched to them called the chordae tendineae. The opposite of these cords are attached to the valves between the atria and ventricles. The interventricular septum separates the right and left ventricles.
Blood passing between the right atrium and the right ventricle go through what valve?
Blood passing between the right atrium and the right ventricle go through right atrioventricular (AV) valve, the tricuspid valve.
Blood passing between the left atrium and the left ventricle go through what valve?
Blood passing between the left atrium and the left ventricle go through the left atrioventricular (AV) valve called the bicuspid valve. This is clinically called the mitral valve
After the blood has gone through the right AV valve (the tricuspid valve) and is in the right ventricle, what valve opens to allow blood to be pumped into the pulmonary trunk?
The pulmonary (semilunar) valve allows blood to enter in the pulmonary trunk from the right ventricle
After the blood has gone through the left AV valve (the bicuspid valve) and is in the left ventricle, what valve opens to allow blood to be pumped into the aorta?
The aortic (semilunar) valve allows blood to be pumped into the aorta from the left ventricle
Once the pulmonary semilunar valve opens and the blood goes into the pulmonary trunk, the blood flows into _________ circularion.
Pulmonary: Pulmonary circulation takes blood from the right ventricle to the lungs and back to the left atrium
Once the aortic semilunar valve opens and the blood goes into the aorta, the blood flows into _________ circularion.
systemic circulation: Systemic circulation takes blood form the left ventricle to the body tissues and back to the right atrium
Lable the following coronary arteries on the heart:
A. Left coronary artery
B. Anterior interventricular branch of the…
C. Circumflex branch of the…
D. Right Coronary Artery
E. Marginal Branch of the…
F. Posterior Interventricular Branch of the…
What is a mnemonic to remember this?
Law Abiding Citizens respect the Rotations Per Minute
Label the following Coronary Veins on the heart
G. Great Cardiac Vein
H. Middle Cardiac Vein
I. Small Cardiac Vein
^^These all flow to vv
J. Coronary Sinus
What is an anastomosis?
Branches that overlap so that blood can go on alternate paths
Memorize the track of coronary circulation
What the fuck is coronary circulation!? XD
The walls of the heart have their own blood supply and circulation, the coronary cirulation
Coronary Circulation: Where do the right and left coronary arteries come from and what do they do?
The right and left coronary arteries branch off the base of the ascending aorta just superior to the aortic semilunart valve. These small arteries are supplied with blood when the ventricles are resting. When the ventricles contract, the cusps of the aortic valve open to cover the openings of the coronary arteries so that they dont explode from pressure!
Coronary Circulation: Where do the anterior interventricular branch and circumflex branch come from?
The anterior interventricular branch and circumflex branch divide off of the left coronary artery
Coronary Circulation: Where do the posterior interventricular branch and marginal branch come from?
The posterior interventricular branch and marginal branch come from the right coronary artery
Coronary Circulation: Explain the track once the blood is in the arteries then goes into the posterior interventricular branch, marginal branch, anterior interventricular branch, and circumflex on the heart
Arteries branch into smaller vessels, called arterioles, which penetrate the heart muscle and divide into narrower vessels, called capillaries, which deliber oxygen to the cardiac muscle. Capillaries drain into venules, which exit the heart muscle and connect to veins that recieve oxygen-poor blood, returning to the right atrium!
Coronary Circulation: After the blood is in the coronary capillaries, what veins of coronary circulation collect the draining blood from the right and left anterior as well as the posterior portions of the heart? What do these three veins all empty into?
The great cardiac vein collects the draining blood of the left anterior portion of the heart, the small cardiac vein drains the right anterior portion of the heart, and the middle cardiac vein collects the blood draining from the posterior portion of the heart. These three veins all empty into the coronary sinus which empties the oxygen-poor blood into the right atrium
What happens when the aortic valve is open? What are the three sacs in it for?
When its open. the right and left coronary arteries are closed off so they do burst from pressure. The three sacs hold blood to weigh the valve down so it doesnt open
Explain the layers of the pericardium
- Fibrous pericardium attaches to diaphragm and also to the great vessels of the heart in the mediastinum
- Serous pericardium is a double membrane composed of an outer parietal layer and inner visceral layer
- Between the two top layers is a pericardial cavity filled with serous fluid that helps to reduce friction
- The outer parietal pericardium is attached to the fibrous pericardium
- The inner visceral pericardium covers the cardiac muscle
Describe the layers of the heart wall
The epicardium is the visceral layer of the pericardium. The majority of the heart wall is myocardium or cardiac muscle tissue. The endocardium is a thin layer of the endothelium deep to the myocardium that lines the inside chambers of the heart and the valves
How does a heart valve work? What happens when out valves don’t work properly?
The heart is a pressure pump that allows its doors (ventricles) to open when there is enough pressure pushing them open. If the valves don’t work properly, prolapse, stiffening, even shearing resulting in reduced cardic output will occur.
What is systole? What happens during it?
Contraction
-During systole, blood pressure within the heart chamber increases and blood is ejected
What is diastole?
Relaxation
During diastole, blood pressure within the heart chambers is low and blood fills the chamber
What causes heart sounds and how do we measure this?
Heart sounds are due to the closing of certain valves
- Lubb (long AV)
- Dup (short SL)
We measure this by auscultation using stethoscopes and fetoscopes
Electrical Conduction System: What is the Sinoatrial (AV) Node?
- Stimulates Atria to contract
- Called the pacemaker because ot initiates action potentials first; located in the wall of the right atrium just inferior to the opening of the superior cena cava; stimulates the atria to contract
Electrical Conduction System: What is the Atrioventricular (AV) node?
- Slows down heart action potentials
- Recieves action potentials from the atrial muscle fibers; located in the lower interatrial septum anterior to the opening of the coronary sinus; sends the action potentials to the AV bundle (bundle of His)
Electrical Conduction System: What is the AV bundle (bundle of His)
- Located in a membranous septum between the atria and ventricles superior to the interventricular septum; this is the electrical connection between the atria and ventricles; sends action potentials to the bundle branches
Electrical Conduction System: What is the right and left bundle branches?
- In the interventricular septum
- Located in the interventricular septum; sends action potential to the Purkinje (conduction) fibers
Electrical Conduction System: What is the Purkinje Fibers?
- Stimulates Ventricles to Contract
- Located in the apex of the myocardium, as well as in the lateral walls of the right and left ventricles; sends action potentials to the ventricular cardiac muscle fibers and papillary muscles and stimulates them to contract
Label the electrical conduction system structures on the heart
Does the brain make the heart beat?
No, the heart beats without any stimulation from nerves. The brain can influence speed
What is intrinsic activity of the heart?
- Makes the heart beat by itself
- Is caused by the specialized, noncontractile cells called autrorhythmic cells
- These cells initiate action potentials that result in contraction of cardiac muscle fibers
- Provide a pathway for conducting the action potential to all cardiac muscle fibers
- A resting heart will beat at 60-80 BPM for most people
- A heart that has been removed from a body may beat at 80-100 BPM
Discuss the three types of heart rates
- Normal Sinus Rhythm
- Irregular Heart Rates
- Tachycardia (fast >100BPM)
- Exercise and stress
- Caffeine and other stimulants
- Reduced Cardiac Output (increase heart rate)
- Prolonged tachycardia can turn into ventricular fibrilation (blood doesn’t pump)
- Bradycardia (Slow <60 BPM)
- Athlete
- Alcohol and other depressants
- Reduced Cardia Output (increase Filling Time and SV)
- Tachycardia (fast >100BPM)
- Intrinsic Firing Rate
- These heart structures have autonomic foci (or ranges of pacemake ability)
- SA node: 60-100 BPM
- Atrial foci: 60-80 BPM
- Ventricular foci: 20-40 BPM
- These heart structures have autonomic foci (or ranges of pacemake ability)
What does an electrocardiogram do?
- It measures the electrical activity of the heart based on placement of 3-15 electrode leads
- The direction of electrical activity is added as a ventor sum to obtain the ECG trace
Where are electrode leads placed on the body for ECG
What are the three main parts to a Standard ECG Trace?
- P wave: Represents atrial depolarization that spreads from the sinoatrial (SA) node just before the atria contracts
- QRS Complex: short downward deflection (Q), tall upward deflection (R), medium downward deflection (S); represents ventricular depolarization that spreads from the AC node to the AV bundle, to the right and left bundle branches and to the Purkinje fibers just before the ventricles contract
- Atrial repolarization also takes place here
- T wave: represents ventricular repolarization and occurs just before the ventricles relax
What happens at each segement in the Standard ECG trace?
- P-Q interval: Beginning of P to beginning of Q. Conduction (excitation) time from SA node to purkinje fibers
- S-T Segment: End of S to beginning of T. It represents the time that the ventricular fibers are fully depolarized.
- Q-T Interval: Beginning of Q to End of T. Time from beginning of ventricular depolarization to end of ventricular repolarization
What is the formula for Cardiac Output?
CO = HR x SV
- Heart Rate
- Stroke Volume
When does the coronary circulation fill?
Well it actually fills at most when the aortic valve closes (during each diastole) due to a recoil of aortic pressure and coronary artert opening dilating with ventricular relaxation
How do you calculate Heart Rate (HR) Pulse?
You can count the number of pulses in 15 seconds from your radial or carotid arterues and multiply by 4 to get your heart rate in BPM
How do we figure out heart rate from an ECG?
What is a heart attack?
- Heart attach is synonymous with Myocardial infarction
- Myocardial = Muscle layer of heart
- Infraction = loss of blood flow
- If medication is not administered within 30 minutes of symptoms, then irreversible damage can occur
- Heart attach symptoms often manifest as referred pain but may be reported different based on sex
What is an X-Ray?
X-Ray (minimally invasive)
-Uses Gamma Rays and a Scintillation Detector to get 2D projection
What is a computed tomography?
Computed tomography (minimally invasive)
- X-Ray that spins and can image in 3D
What is an ultrasound?
Ultrasound (not invasive)
-Uses ultrasound pressure vibrations plus a detector to look at attenuation of vibrations
What is an MRI?
MRI (not invasive)
-Uses procession of Nuclei in a strong magnetic field to obtain tissue type data a place in space
What did doctors do before imaging?
They cut people open and hoped for the best!!
What are three specialized imaging for the heart?
- Contrast angiography for coronary circulation
- 4D ultrasound of heart valve
- Volumes collected over time
- Very rapid
- Doppler Ultrasound + ECG
- Uses Doppler Effect
- Toward transducer is red,
- Away is blue
