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ANP 1105 > Lecture 10 - Heart > Flashcards

Lecture 10 - Heart Flashcards

1
Q

What are the 3 layers of the heart from superior to deep?

A
  1. pericardium
  2. myocardium
  3. endocardium
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2
Q

What are the layers of the pericardium? (4)

A

-superior fibrous pericardium
-parietal layer
-pericardial cavity
-visceral layer

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3
Q

What are the functions of the pericardium?

A

-protects + anchors heart
-stops over-expending
-frictionless movement

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4
Q

What is the myocardium?

A

cardiac muscle forming the bulk of heart

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5
Q

What are the functions of the myocardium?

A

-support great vessel + valves
-direct AP
-fibrous skeleton of heart

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6
Q

What is the endocardium?

A

-inner myocardial surface

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7
Q

What are the functions of the endocardium?

A

-continuous w/ vessels leaving and entering the heart
-one cell

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8
Q

What are the vessels that return blood to the heart?

A

-superior/ inferior venae cavae (no O2) –> right atria
-left/right pulmonary veins (O2 full) –> left atria

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9
Q

What are the vessels that take blood away from the heart?

A

=ascending aorta <– left ventricle
-brachiocephalic
-left common carotid
-subclavian arteries

=pulmonary trunk <– right ventricle
-left/ right pulmonary artery (no O2)

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10
Q

What are the anterior vessels that supply the exterior of the heart?

A

-right coronary artery
-marginal artery
-left coronary artery
-circumflex artery
-left anterior descending/ intraventricular

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11
Q

What are the anterior vessels that drain the exterior of the heart?

A

-anterior cardiac vein
-small cardiac vein
-great cardiac vein

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12
Q

Draw out the heart from the front view

A

-have fun look up photo

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13
Q

What are the posterior vessels that supply the exterior of the heart?

A

-left circumflex artery
-right coronary artery
-posterior intraventricular artery

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14
Q

What are the posterior vessels that drain the exterior of the heart?

A

-posterior cardiac vein
-middle cardiac vein
-small cardiac vein
-coronary sinus

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15
Q

Draw out the heart from the back view

A

-have fun

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16
Q

What are the atrial walls made of?

A

pectinate

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17
Q

What is the pulmonary circuit of the blood flow?

A
  1. right atrium
  2. tricuspid valve
  3. right ventricle
  4. pulmonary semi-lunar valves
  5. pulmonary trunk to arteries
  6. lungs
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18
Q

What is the systemic circuit of blood flow?

A
  1. pulmonary veins
  2. left atrium
  3. bicuspid valves
  4. left ventricle
  5. aortic semi-lunar valves
  6. aorta
  7. circulatory system
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19
Q

What is it called when there is a blockage in the heart?

A

myocardial infarction

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20
Q

What is the solution to myocardial infarction?

A

=anastomosis
-provide alternative routes given an artery gets blocked
-deliver blood
-useless when ventricles work

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21
Q

Where does the coronary sinus empty into?

A

right atrium

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22
Q

What is the anatomy of the heart valves?
-draw

A

-atrioventricular valve (AV) (tricuspid/mitral)
-chordae tendinae
-papillary muscles

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23
Q

Cardiac vs skeletal?
-form

A

-short/fat
-lay cylindrical

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24
Q

How is cardiac muscle interconnected?

A

intercalated disks
= flow ions
=desmosomes and gap junctions

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25
Q

Cardiac vs skeletal?
-nuclei

A

-1/2 nuclei
-multinuclei

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26
Q

Cardiac vs skeletal?
-interconnected

A

-intercalated disks
-motor unit grouping

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27
Q

Cardiac vs skeletal?
-cell to cell influence

A

-automaticity
-independence

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28
Q

Cardiac vs skeletal?
-mitochondrion

A

-20-40%
-2-5%

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29
Q

Cardiac vs skeletal?
-Ca2+ distribution

A

-low t-tubule, simple
-many t-tubule, elaborate

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30
Q

Cardiac vs skeletal?
-sarcoplasmic reticulum

A

-less developed
-complex

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31
Q

Cardiac vs skeletal?
-energy consumption

A

-aerobic
-anaerobic

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32
Q

What would happen if the cardiac muscles had a long absolute refractory period?

A

-tetanic contractions = stop heart pumping

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33
Q

What is the 3 step cardiac depolarization?
-draw

A
  1. Na+ influx
  2. Ca2+ influx
  3. K+ influx
    -drawing = look at notes
34
Q

What is considered the pacemaker of the heart?

A

sinoatrial node
-fastest
-located at the top right atrium

35
Q

What are the 5 steps of action potential generation of the heart?

A
  1. sinoatrial node
  2. atrioventricular node
  3. bundle of His
  4. right & left bundles
  5. Purjinki fibres
36
Q

Draw out and label the 6 parts of the cardiac pacemaker potential

A
  1. slow Na+ open
  2. Ca2+ open
  3. Ca2+ close & K+ open
  4. permeability change
  5. pacemaker potential
  6. action potential
    -drawing = look at notes
37
Q

What is the parasympathetic innervation of the heart?

A

-decrease depolarization
-K+ more permeable
-diastolic potential more negative

38
Q

What is the sympathetic innervation of the heart?

A

-increase depolarization and repolarization

39
Q

What are the 2 cardiovascular centres of the medulla oblongata?
-pathway
-function

A

=cardioacceleratory
-motor nerves to the heart
-increase rate and force of the heartbeat (nodes + muscle)

=cardioinhibitory
-dorsal vagal nucleus medulla
-inhibit impulse from vagus (nodes)

39
Q

What is an ECG?
-what do?

A

=electrocardiogram
-records electrical changes during heart activity

40
Q

What does an ECG look like?
-name the parts
-what does each part indicate?

A

-p-wave = atrial depolarization
-QRS complex = ventricular depolarization
-t-wave = ventricular repolarization
(image in notes)

41
Q

What can be identified in the S-T segment?

A

myocardial ischemia (blockage of coronary artery)

42
Q

What can be identified in the Q-T interval?

A

ventricular arrhythmia (twitch instead of pump)

43
Q

How many standard limb leads are there?
-what does the diagram look like?

A

12
-in notes

44
Q

What does systole indicate?

A

action of pumping out (contracting)

45
Q

What does a diastole indicate?

A

action of filling in (relax)

46
Q

What comes first the systole or diastole?

A

atrial systole then diastole, ventricular systole then diastole

47
Q

What are the steps during ventricular diastole: mid to late diastole? (7 steps)

A

-pressure atria > pressure ventricle
-AV valve open, SL valve closed
-80% ventricular filling, AV start close
-P wave = atrial systole
-atrial pressure increase
-20% of blood enters the ventricles (EDV)
-atrial diastole

48
Q

What diagnostic can be determined at the QRS complex?

A

-if big = hypertrophy

49
Q

What does the ECG look like for sinus rhythm?
-draw

A

-normal consistent ECG
(image in notes p.53)

50
Q

What does the ECG look like for ventricular fibrillation?
-draw

A

-inconsistent, different sized and close waves with no structure
(image in notes p.53)

51
Q

What does the ECG look like for a 2nd-degree heart block?
-draw

A

-distanced repetition, very large but thin QRS
(image in notes p.53)

52
Q

What does the ECG look like for a nonfunction SA node?
-draw

A

-super small waves, inconsistent separation
(image in notes, p.53)

53
Q

What are the steps that occur during ventricular systole? (6)

A

-QRS complex and T-wave
-ventricles contract
-AV valves close
-isovolumetric contraction
-SL valves open
-ventricular ejection

54
Q

What are the steps to isovolumetric relaxation? (5)

A

-early diastole
-ventricles relax
-pressure decreases
-backflow = SL valves close (dicrotic notch)
-ESV

55
Q

What are the steps to return to the beginning of the cardiac cycle? (4)

A

-atria diastole
-pressure atria > pressure ventricles
-AV valves open
-restarts

56
Q

What are the 4 phases of the cardiac cycle?

A
  1. ventricular diastole
  2. ventricular systole
  3. isovolumetric relaxation
  4. back to 1
57
Q

How long is each cardiac cycle?

A

0.8 secs

58
Q

How long is each atrial systole?

A

0.1 sec

59
Q

How long is each ventricular systole?

A

0.3 sec

60
Q

How long is the quiescent period?

A

0.4 sec

61
Q

State the 2 driving forces of the cardiac cycle.

A

-blood flow controlled by pressure changes
-blood flow from high to low pressure through any openings

62
Q

What is it called when the resting heart rate is over 100bpm?

A

tachycardia

63
Q

What is it called when the resting heart rate is under 60bpm?

A

bradycardia

64
Q

What is the first heart sound?

A

closure of AV valves = start ventricular systole

65
Q

What is the second heart sound?

A

closure of SL valves = end ventricular systole

66
Q

What are 3 reasons for heart murmurs + sound?

A

-valve obstruction -> high pitch
-valve insufficiency -> sound when not supposed to
-pulmonary valve stenosis -> turbulent and noisy

67
Q

What is the equation for cardiac output?

A

CO = SV(EDV-ESV) x HR

CO - cardiac output
SV - stroke volume
EDV - end diastolic volume
ESV - end systolic volume
HR - heart rate

68
Q

What is cardiac output meaning?

A

amount of blood pumped from left ventricle into aorta per minute

69
Q

What is the average CO for a healthy male?

A

5L/min

70
Q

How does CO change?
-fit person
-well-trained marathon runner

A

-4-5 times higher
-7 times higher

71
Q

What is the cardiac reserve?

A

-the difference between at rest and when really pushed

72
Q

What are the 4 ways heart rate is determined?

A

-autonomic fibres (symp=NE & para=Ach)
-circulating hormones (Epinephrine)
-plasma electrolytes (Ca2+/Na+ & K+/H+)
-body temp (hot & cold)

(increase & decrease)

73
Q

What are the resting conditions of the heart rate?

A

-parasympathetic NS is dominant

74
Q

Why does tachycardia lead to reduced CO?

A

-not adequate filling = EDV goes down

75
Q

What is the Frank-Starling Law of the Heart?

A

-preload (heart will pump whatever volume of blood it receives)
-afterload (pressure ventricles must overcome to force open valves and eject blood)

76
Q

What are the preload details?

A

-wide range
-EDV proportional to SV
-ventricles beat-to-beat independent by FS mechanism
-ventricles pump same amount over time

77
Q

What are the afterload details?

A

-healthy = 80mm in aorta, 10mm pulmonary trunk
-hypertension = increased ESV and SV because hard to push out

78
Q

State 2 types of extrinsic influences on stroke volume.

A
  1. contractability
  2. Ca2+ influx
    I. sympathetic stimulation
    II. drugs (digoxin)
    III. parasympathetic NS
79
Q

How to increase stroke volume?

A

=increase EDV
-increase venous return (exercise & decrease HR)

=decrease ESV
-increase contractibility (epinephrine, thyroxine, Ca2+)

80
Q

How to increase heart rate?

A

=increase sympathetic
=decrease parasympathetic
-exercise, fright, anxiety

ANP 1105 (12 decks)

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