Lab exam 3 Flashcards
How are contractile cells similar to muscle cells
- they are striated, meaning that they have similar arrangements of sarcomeres with thick and thin filaments.
- they have actin and myosin
- when myosin binds to actin force is generated.
How do the cells in the artia and in the ventricles contract
All of the cells of the atria must contract simultaneously, then all of the ventricular contractile cells must contract simultaneously.
_____ cells are specialized fluid filled cells that are able to spread en electrical signal rapidly. These cells make up 1% of the myocardial cells and they serve as the wiring system for the heart.
conducting myocardial cells
_____ is used to study the electrical activity of the heart
electrocardiography (ECG)
the ___ is the artery that is coming off the left ventricle and pumping blood to the rest of the body in the systemic circut
aorta
The _____ is the artery that is coming out of the right ventricle. The pulmonary semilunar valve is connected to it
pulmonary artery
______ valve is between the pulmonary artery and the right ventricle
the pulmonary semilunar valve
the ___ valve is between the right atrium and right ventricle
tricuspid valve (aka the right atrioventricular valve)
the ____ is in between the right and left ventricles
the interventricular septum
the ____ is between the left atrium and ventricle
the bicuspid valve (aka the left atrioventricular valve or mitral valve)
the valve right before the aorta is called the
aortic semilunar valve
what are the two types of myocardial cells
- conducting cells (aka pacemaker or autorhythmic cells)
- contracting cells
_____ are specialized fluid filled cells that are able to spread an electrical signal rapidly.
conducting cells
These cells make up only 1% of myocardial cells. And they are the “wiring system” of the heart
conducting cells
the _____ is the wiring system of the heart, designed to spread a signal rapidly through the atria and then the ventricles. this allows the upper and lower chambers of the heart to function in a coordinated manner.
electrical conduction pathway
the ______ is located in the right atrium. The cells of this structure serve as the pacemaker of the heart because it is where action potentials are generated. the cells at this location are the best at self-depolarizing
sinoatrial node (SA node)
______ is the characteristic where cells will depolarize on their own without any external influence.
autorhythmicity
this pathway is what a signal travels along from the sinoatrial node to the atrioventricular node
internodal pathway
during the electrical conduction pathway the signal slows down at the _____ so that the atria have time to complete their contraction
atrioventricular node
the ____ part of the electrical conduction pathway follows the atrioventricular node and is also the first part of the pathway that is on the ventricles
the bundle of His (aka the AV bundle)
After the bundle of His in the conduction pathway the following step that goes down the interventricular septum is _____
the left and right bundle branches
the last area of the electrical conduction pathway is the ____
Purkinje fibers
What allows an electrical signal to spread from cell to cell in the heart is the presence of ______. They are connexin complexes that connect the cytosol of one cell to another
gap junctions
_____ allows us to view the conduction of the electrical signals through the heart
Electrocardiography
If there is a problem with the heart conduction there may be an issue with ______
pumping
The P wave represents _____ (in an ECG)
atrial depolarization
The first point where the P wave deflects updards is the electrical activity at the _____ (in an ECG)
SA node
The flat area after the P wave is called the _____ and indicated that the signal is not moving - at least not very fast - This is the area representing the delay of the signal at the atrioventricular (AV) node
PR segment
Movement of the depolarization wave through the large mass of the ventricles is reflected in the _____ (in an ECG)
QRS complex
The _____ represents the ventricles repolarizing (in an ECG)
T wave
There is no wave for ______ because it would be a tiny deflection that coincides with the QRS complex. (in an ECG)
atrial repolarization
The _____ is when the atria are depolarizing and contracting (in an ECG)
the PR interval
The _____ interval is when the ventricles are depolarizing and contracting (in an ECG)
QT interval
a _____ abnormality in an ECG may indicate decreased blood flow to regions of the heart itself. This is caled coronary ischemia.
ST segment alteration
_____ _____ which is damage or death to heart tissue. It can also mean a heart attack
Myocardial infarction (also a ST segment alteration)
This ECG abnormality: _____ are conduction problems in the AV node
PR interval alterations
This ECG abnormality: _____ aka _____ can indicate ion channel defects, low calcium or potassium levels or drug related complications
QT interval alterations (aka elongations)
normal heart rhythm that originates at the sinoatrial node is called _____
sinus rhythm
sinus rhythm sets the _____, which under normal resting conditions is between 60 - 100 beats per minute.
heart rate
sometimes heart rate (beats per minute) is abnormally fast. This condition is called _____
tachycardia
What is abnormally slow heart rate called
bradycardia
A _____ originates at the sinoatrial node (sinus) but is irregular. the length of one cardiac cycle to the next can vary because of this.
sinus arrhythmia
This state is called _____ when an action potential signal is generated by other cells of the heart before the SA node cells can. This results in a sequence with no normal conduction. The signal originates somewhere in the ventricles and the SA node is not able to regain control as the pacemaker of the heart
ventricular tachycardia
When the electrical signal originates elsewhere other than the SA node the cells that originated that signal are called _____
ectopic pacemaker
This condition is reported by a person that feels a jump in their heart occasionally. It is called ______. In this condition there is mostly normal sinus rhythm with the occasional ectopic origin. Normal rhythm would be seen on the ECG with a random weird spike and inverted T wave.
premature ventricular contractions (PCV)
in a condition called _____ there is no sinus or ectopic rhythm. all cells of the heart are depolarizing at their own rates. there is no coordination - the heart will not work as a pump under this condition. A defibulator must be installed to correct this condition.
ventricular fibrillation
A _____ delivers a jolt of electricity to the heart, causing all of the cells to depolarize at once. This allows the cells and the SA node to take over as the pacemaker of the heart and set the heart back to the normal sinus rhythm. This is needed in people experiencing ventricular fibrillation.
defibrillator
With no outside influence the heart would beat at ____ bpm
100
What is the neurotransmitter released at the SA node by each branch of the ANS
parasympathetic releases acetylcholine onto the muscarinic receptors
sympathetic releases norepinephrine onto B1 receptors
the measurement of the number of cardiac cycles per minute is the definition of _____
heart rate
the measure of electrical activity in the heart is called _____
electrocardiograph
the pacemaker of the heart is the
sinoatrial node
when this neurotransmitter binds to its receptors at the cells of the heart’s pacemaker heart rate decreases
acetylcholine
when this neurotransmitter binds to its receptors at the cells of the heart pacemaker heart rate increases
norepinephrine
the special 1% of myocardial cells that spread an impulse very rapidly through the heart cells are called _____
conducting cells
the amount of blood pumped out of the left ventricle with every contraction is called
stroke volume
the amount of blood pumped out of the left ventricle every minute is called
cardiac output
The electrical conduction pathway. List 6 steps.
- sinoatrial node
- internodal pathway
- atrioventricular node
- bundle of His
- right and left bundle branches
- Purkinje fibers
action potentials can spread from one cells to the next because myocardial cells have these cell-to-cell connections
gap junctions
during an ecg these _______ are placed on the participants
electrodes
Blood pressure is measured in these units
Millimeters of mercury mmHg
heart rate is measured in these units
beats per minute bpm
the contraction phase of the cardiac cycle is called
systole
the relaxation or refilling phase of the cardiac cycle is called
diastole
this measurement is the number of cardiac cycles per minute
heart rate
excessively high blood pressure is called
hypertension
measuring blood pressure requires the use of this instrument to listen for specific sounds
stethoscope
the highest pressure measured during blood pressure monitoring is called the ___ blood pressure
systolic
the name of the instrument used to measure the pressure of blood in a blood vessel is
sphygmomanometer
the name of the sounds heard while measuring blood pressure are called the _____ sounds
Korotkoff
list the three factors that affect blood pressure
total peripheral resistance, total blood volume, cardiac output
the number one cause of death for women and men in the US is _____. blood pressure analysis helps us to determine what individuals are at risk for this.
cardiovascular disease
elevated blood pressure at rest is called _____. A major risk factor for heart disease.
hypertension
The amount of blood pumped by the left ventricle during one contraction.
stroke volume
The time when the heart is contracting.
systole
The part of the cardiovascular system that carries blood from the right ventricle to the lungs, then to the left atrium
pulmonary circulation
The time when the heart is relaxing.
diastole
The amount of blood pumped out of the left ventricle every minute.
cardiac output
The part of the cardiovascular system that carries blood from the left ventricle, to the body, then back to the right atrium.
systemic circulation
This occurs when blood vessels increase in inner diameter, resulting in less resistance.
vasodilation
The sum of all opposition to blood flow in the arterioles.
peripheral resistance
The number of heartbeats per minute.
heart rate
This occurs when the lumen of the blood vessels narrows, resulting in more resistance.
vasoconstriction
The period of time from the end of one heartbeat through the end of the next beat.
cardiac cycle
when blood pressure is measured in one of the systemic arteries (typically the brachial artery) the measurement reflects the pressure that the _____ is working against
left ventricle
As heart disease develops it is the _____ that is commonly the chamber that is most negatively affected
left ventricle
systolic blood pressure is measured when the left ventricle is ______ or in _____
contracting/systole
diastolic blood pressure is measured when the left ventricle is _____ or in _____
relaxed and refilling/diastole
what is the equation for pulse pressure
pulse pressure = SBP - DBP
what is the equation for mean arterial pressure
MAP (mean arterial pressure) = DBP + 1/3 (SBP - DBP)
the average pressure vessels face over time is called _____
mean arterial pressure (MAP)
MAP = DBP + 1/3 (SBP - DBP)
in a clinical setting blood pressure is measured using the _____ method.
auscultation method (listening)
A _____ is used to measure pressure and a _____ is used to listen for the sounds
sphygmomanometer
stethoscope
True or false: arm level relative to the heart can significantly affect the accuracy of the resting
true
Before you start to take the BP measurement you need to locate the brachial artery at the _____
antecubital fossa
Before taking BP you need to locate the _____ artery
brachial
true or false: When placing the cuff on the arm for a BP reading you should align the arrow or the tubes of the cuff on the artery.
true
The ends of the stethoscope are _____ meaning that they use both ears
binaural
proper placement of the stethoscope is the ear pieces facing ____ from the user when placing them in the ear
away
Turn the valve of the bulb attached to the cuff in this direction _______ to close it
clockwise
When you start to take a manual blood pressure you need to bring the pressure meter on the sphygmomanometer up to _____ mmHg. If you hear heart beats at this point you need to raise the pressure further
140 mmHg, sometimes higher like 160 mmHg
When beginning to take blood pressure the pressure on the sphygmomanometer from the cuff inflating needs to be high enough to cut off blood flow. at this point you should hear _______
no sounds because there is no blood passing through the vessel
The next step of taking blood pressure we release the release valve a little. Pressure on the sphygmomanometer is slowly going down 2-3 mmHg per second. when the pressure in the cuff is equal or slightly less than the highest pressure in the artery blood will start to squeeze through and the first sound will be heard. This first sound marks _____
systolic blood pressure
After hearing the first sound when taking blood pressure the pressure will continue to fall about 2-3 mmHg per second. When finding diastolic pressure we want to listen for _____
the disappearance of all sound.
The sounds one listens for when measuring blood pressure are known as _____
Korotkoff sounds
There will be no sound when the pressure in the cuff exceeds the pressure in the artery. The blood flow is _____ so there is no sound
Occluded
As pressure in the cuff is lowered some blood will begin to pass through. Partial compression of the vessel causes the blood that does squeeze out to swirl around. this swirling motion is called _____
turbulent flow
when taking blood pressure sound is only heard when there is _____ flow (specific kind)
turbulent
When the pressure inthe BP cuff falls below the lowest pressure in the artery the blood flow returns to normal, free flow, called _____
laminar flow
during blood pressure reading the first sound is heard when the blood first starts to squeeze through the occluded vessel, that flow is called _____ flow. the last sound is heard just prior to the return to free or _____ flow
turbulent, laminar
how many distinct korotkoff sounds are there
5
What happens with endurance athletes and the korotkoff sounds
It is not uncommon to hear sounds all the way to a pressure reading of 0. when that happens you read their diastolic pressure as the most muffled sound you hear. or the 4th korotkoff sound.
what is the first korotkoff sound definition
tapping sound, may be soft at first. the 1st sound heard as pressure is lowered in the cuff; coincides with systolic blood pressure reading. this indicates the onset of turbulent flow and the highest pressure in the artery.
what is the second korotkoff sound
sound gets longer (dragged out) described as a murmur
what is the third korotkoff sound
sharp tapping sound. louder
what is the fourth korotkoff sound
muffled quiet
what is the fifth korotkoff sound
sound disappears, coincides with diastolic blood pressure. this represents the return to laminar flow.
Why is the auscultation method for measuring blood pressure better than using the pulse?
palpating the radial pulse for identification of SBP occurs later than the first sound is heard. that why the auscultation method is still considered best.
what is total blood volume
the total amount of blood in the cardiovascular system
both cardiac output and total peripheral resistance are heavily regulated by the _____
autonomic nervous system
What are the target cells for altering heart rate (location and type of myocardial cells)?
conducting cells at the sinoatrial node
what is the neurotransmitter released at the target cells on the SA node of the sympathetic system
norepinephrine
which specific receptors are found in the heart for norepinephrine
Beta 1
what is the neurotransmitter released at the target cells of the parasympathetic system
acetylcholine
which specific receptors are found in the heart for acetylcholine
muscarinic
what are the target cells for altering stroke volume (location and type)
contractile cells at the left ventricle
what type of adrenergic receptor is found on arterioles that will stimulate smooth muscle contraction and vessel constriction
alpha 1
which signal molecule is most likely going to bind to and activate Alpha 1 receptors
norepinephrine
what type of signal molecule is norepinephrine and where does it come from
it is a monoamine neurotransmitter from the sympathetic postganglionic neurons
what type of adrenergic receptor is found on arterioles that will stimulate smooth muscle relaxation and vessel dilation
beta 2
which signal molecule binds to beta 2 receptors on the arterioles
epinephrine
what type of signal molecule is epinephrine and where does it come from
monoamine neurohormone from the adrenal medulla chromaffin cells
What happens with the influence of the parasympathetic and sympathetic system on the heart during the rest and digest stage of life
the parasympathetic has no influence on stroke volume and little on arterioles and total peripheral resistance. instead the decrease in stroke volume and total peripheral resistance observed during rest is due to a reduction in sympathetic input.
what is the primary integrating center for regulation of the cardiovascular system
medulla oblongata
high blood pressure is called
hypertension
hypertension is a risk factor for _____
cardiovascular disease
what is normal systolic and diastolic blood pressure
<120/<80 (and)
what is elevated blood pressure numbers
120-129/<80 (and)
what is the blood pressure reading for stage 1 of hypertension
130-139/80-89 (either or)
what is the blood pressure reading for stage 2 of hypertension
Greater than or = to 140/greater than or = to 90 (either or)
what is the blood pressure for hypertension crisis (emergency response)
> 180/>120 (either of these they dont both have to meet this)
true or false: high blood pressure needs to be recorded multiple times for a diagnosis of hypertension. a single high measurement is not enough for a diagnosis
true
what are the recommendations for blood pressure for older adults by the american college of physicians
otherwise healthy adults should maintain a SBP of <150 mmHg. Adults with a history of hypertension or other related health issues should maintain a SBP of <140 mmHg
the technical name for red blood cells
erythrocytes
the technical name for white blood cells
leukocytes
the technical name for platelets
thrombocytes
these are proteins or glycoproteins on the surface of a cell, which can stimulate an immune response
antigen
the technical term for antibody is
immunoglobulin
one of two or more possible forms of a gene coding for a specific characteristic
allele
to test positive/negative (choose one) for something means that a specific characteristic, trait, or condition is present
positive
to test positive/negative (choose one) for something means that a specific characteristic, trait, or condition is absent
negative
If the incorrect blood type is transfused into a person the blood cells will clump in a process called
agglutination
these Y shaped proteins are produced by white blood cells called B-lymphocytes. they bind and mark foreign substances for destruction
Antibodies (immunoglobulins)
what are the two blood type classification systems
the ABO system and the Rh system
Blood type is based on the presence or absense of specific _____ on the extracellular side of the erythrocyte cell membranes
antigens
The specific set of genes that a person possesses (e.g., (A,O))
genotype
Clumping of cells when antibodies bind
agglutination
One of two or more different forms of a gene that create slightly different proteins.
allele
Surface protein or marker that causes an immune response.
Antigen
Immunoglobulins that bind to a pathogen and cues its disposal/destruction.
antibody
antigens that are coded in an individuals DNA are celled _____. in other words they are normal in that individual
self-antigens
antigens that are not coded for in the DNA are called _____ and these will elicit an immune response
foreign antigens
if a foreign antigen is introduced into a body the immune system will produce _____. these proteins will bind to and mark the foreign antigen for destruction
antibodies or immunoglobulins
when antibodies bind to antigens on erythrocytes the blood cells will clump together in a process called _____
agglutination
lack of blood flow is called _____
ischemia
low oxygen levels is called _____
hypoxia
cell death is called _____
necrosis
A patient that receives the wrong blood could suffer a reaction that leads to _____, _____, _____and death
blood vessel blockage, ischemia, hypoxia
close to _____% of transfusions with the incorrect blood type - with volumes of 50ml or less- end in death. 50ml is 1/100 of total blood volume.
20%
The average transfusion is ____ L according to the red cross. someone receiving this amount of incorrect blood would have little to no chance of surviving.
1.4 L (3 pints)
the _____ classification system of blood typing is based off the presence of the A or B antigens
ABO classification system
How does a certain antigen or antigens correspond to the kind of blood type? list all 4 different ABO types
- people with A antigen have type A blood
- people with B antigen have type B blood
- people with A and B antigens have type AB blood
- people with neither antigens have type O blood
Which ABO alleles are dominant?
Both A and B alleles are dominant, if they are present they will be expressed.
The two allele combination make up the _____ for the blood type trait
genotype
When are the antibodies for the A and B antigens developed
early in live
in which component of the blood are antibodies located?
Plasma (globulins)
List the foreign antigen and the antibody for type A blood
foreign antigen: B antigen
antibody: anti B antibodies
List the foreign antigen and the antibody for type B blood
foreign antigen: A antigen
antibody: anti A antibodies
List the foreign antigen and the antibody for type AB blood
Foreign antigen: none
antibodies: no antibodies
List the foreign antigen and the antibody for type O blood
foreign antigen: both A and B antigens
antibodies: anti A and anti B antibodies
Which blood type can donate erythrocytes to any other blood type?
O- blood type
It has no antigens that would set off an immune response
which blood type can receive erythrocytes from any other blood type?
Type AB+ blood. They have no antibodies for A B or Rh
What is the Rh factor
the Rhesus antigen or factor. Those with the Rh antigen are positive and those without are negative
when are antibodies for the Rh antigen produced
when someone who is Rh negative is exposed to the Rh antigen. This can be problematic in transfusions and in pregnancy.
If a woman is Rh _____ and her fetus is Rh _____ the mother could produce antibodies to the Rh antigen when she comes into contact with the babies blood.
Mother: Rh -
Baby: Rh +
What happens in erythroblastosis fetalis or hemolytic disease of the newborn (HDN)?
When a mother is Rh - and has an Rh + baby she will develop Rh antibodies when their blood is mixed. Then on her second pregnancy she will have these antibodies that could attack the baby. The mother’s antibodies are small enough to pass the placenta and can attack the babies erythrocytes. the symptoms of this are anemia, low blood cell count, edema in the newborn. A blood transfusion may be needed.
How does one avoid erythroblastosis fetalis or hemolytic disease of the newborn (HDN)?
If the mother is Rh - she will be given a shot of the antigen for the Rh antigen (a medication called RhoGAM). Administered around the time of birth. to prevent the mother from producing the Rh antibodies when she is exposed.
erythrocytes with a certain antigen will react with the antibodies for that antigen. the antibodies will bind to the antigen and cause _____. Which will look like grains in the trays
agglutination
what did we use to poke our fingers in the blood typing lab
lancet
erythrocytes, leukocytes and thrombocytes make up this major component of blood
formed (cellular) elements
proteins and glucose are found in this major component of blood
plasma (organic molecules)
antibodies fall into this sub-category of plasma proteins
globulins
Blood type is based on the presence of antigens on these cells
erythrocytes
when antibodies bind to antigens on erythrocytes, the cells will clump together this clumping is called
agglutination
If when testing blood type clumping occurs with the Anti-D and anti B the blood type is
B+
someone with type A blood has these antibodies
anti B antibodies
when testing for the Rh factor, the blood cells will clump only if the blood is Rh _____
positive Rh+
the Rh factor may only be of concern if the mother is Rh _____
Rh-
what are the possible genotypes for someone with type B blood
(B,O), (B,B)
what is the name of the hormone that stimulates red blood cell production
erythropoietin (EPO)
having low hemoglobin or red blood cell count is called
anemia
What are the possible genotypes for AB blood
(A,B) only
