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Cardiac Rehabilitation > Lecture 3 - Cardiac Anatomy > Flashcards

Lecture 3 - Cardiac Anatomy Flashcards

1
Q

What is the pressure in the RA and RV (during end diastolic and peak systolic)?

A 
RA = 3-4mmHg
RV = 5-6/25mm Hg
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2
Q

What is the pressure in the LA and LV (during end diastolic and peak systolic)?

A 
LA = 8mmHg
LV = 9/120mmHg
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3
Q

What are the normal blood levels for men and women?

A 
Women = 4-4.5L
Men = 5-6L
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4
Q

Is the pulmonary circulation a high or low pressure system?

A

Low pressure, has less resistance and does not have to pump blood very far (just to the lungs)

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5
Q

What is the role of the artery?

A

transport blood to tissues and organs under high pressure

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6
Q

What is the role of the arteriole?

A

Act as control passages (resistance vessels) of blood through to the capillaries

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7
Q

What is the role of the capillaries?

A

Exchange fluids, nutrients, electrolytes, hormones and other substances.

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8
Q

What is the role of the venules?

A

Collect blood from capillaries and merge into larger veins

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9
Q

What is the role of the vein?

A

Pump blood back to the heart under low pressure and act as a reservoir for blood

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10
Q

What happens to the pressure as you go through the circulatory system

A

Decreases

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11
Q

Why is the venous system able to store blood?

A

75-80% of our blood rests in the venous system because they are good for storage and compliant. Can have high volumes at low pressure therefore reduces the work of the heart.

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12
Q

Why do arteries and veins differ in their structure?

A

Veins have more blood that needs to be pumped back to the heart. The Valves stop back flow Their structure is suited for storage of blood

Arteries: Their structure facilitates the absorption of the hearts energy when it pumps blood to them.

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13
Q

What are the three layers of the artery?

A

Tunica Intima - Inner endothelium

Tunica Media - middle - Alters radius of artery therefore alters blood flow.

Tunica Externa - connective tissue with elastic fibre, gives vessels their tensile strength to resist pressures. Also there to reinforce and protect it.

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14
Q

List TWO structural differences between arteries and veins.

A

Arteries: Thick elastic walls and stores energy in systole and recoils in diastole

Veins: Thinner walls and has small changes in pressure in response to large changes in volume

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15
Q

What blood vessel carries oxygenated blood from the lungs to the left atrium?

A

Pulmonary Vein

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16
Q

Where is the base of the heart roughly located?

A

Where the AV valves are

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17
Q

What do the LV and RV look like?

A 
LV = Bean 
RV = Crescent shaped when viewed in cross section, triangular from the side
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18
Q

Why is the RV smaller than the LV

A

because it has to do less work compared to the LV

19
Q

Are the SV in both ventricles the same?

A

Yes - usually synchronised - if not then there is a problem

20
Q

What can cause the heart to atrophy?

A

Bed rest, cancer

21
Q

Under what physiological circumstances does the heart enlarge?

A

Exercise and Pregnancy

22
Q

Under what pathological circumstances does the heart enlarge? and what could it lead to?

A

HTN and MI

Could lead to HF or Ventricular arrhythmia

23
Q

What type of hypertrophy occurs in people with HTN?

A

Concentric hypertrophy

24
Q

What is the function of the Interventricular septum?

A
  • Acts as a barrier between the LV and RV
  • Passage for AV conduction.
  • Changes motion pathway and shape
25
Q

Describe the properties of the pericardium

A
  • Made up mainly of collagen
  • Tensile strength
    More you stretch collagen the more it will fight back
26
Q

What happens to the pericardium at higher levels of stretch?

A

Doesn’t want to expand any more due to the tensile strength of the collagen fibres. It is more distensible at lower levels of stretch

27
Q

The major role of the pericardium is?

A
  • Prevents overstretching of the heart.
  • Maximises the frank starling mechanism
  • Restricts overstretching of the heart
28
Q

List the THREE layers of the heart wall.

A

Epicardium - Outer layer
Myocardium - Middle
Endocardium - Inner layer

29
Q

Describe how the muscle layers of the heart assists with contraction

A
  • Muscle layers of the heart fold over each other and go in different directions.
  • This produces more tensile tension and maximise contraction force and ejection of blood
30
Q

Compare and Contrast fibroblasts and Myocytes in the heart

A

Fibroblasts - secrete collagen and are 50% of cell number of the heart

Myocytes - Are bigger in size compared to fibroblasts but there are less of them

31
Q

What do Myofibrils contain?

A

Contain contractile proteins - which are made up of sarcromeres which are made up of actin and myosin.

32
Q

Describe one difference between skeletal and cardiac muscle

A

Skeletal muscle cells need neural input whereas cardiac muscles don’t they have the capacity of carry on beating without any neural input.

33
Q

What are Intercalated Discs composed of and what is its function?

A

Composed of gap junctions and desmosomes

Desmosomes hold cells together and gap junctions facilitate AP propagation they are both electrically coupled

34
Q

Which component releases Calcium in the cell?

A

SR

35
Q

How does the ECM affect the heart?

A

Gives structural integrity and support to the cells

(Like a scaffold)

36
Q

What happens when the ECM becomes disrupted?

A

The heart and cells don’t have the optimal support and structure from it to contract efficiently.

37
Q

Describe how the TIMP’s and MMP’s could affect the heart?

A

MMP’s: Degrading enzymes (Pacman)
TIMP’s: Degrade MMP’s (Ghosts)
When these are not in balance then damage occurs in the heart and cause remodelling

38
Q

Give an example of a disease in the heart caused by the imbalance of the ECM

A

Chagas Disease

39
Q

What else happens to the heart during concentric hypertrophy?

A

Stiffens - collagen fibres get thicker therefore the tensile properties cause it to stiffen.

40
Q

What happens to the heart in HTN?

A

Bigger and less flexible

41
Q

How can high blood pressure affect the chordinae tendinae?

A

Can actually tear it - therefore damaging the valves.

42
Q

What is Valvular Stenosis?

A

Valves become stiff and don’t open all the way.

43
Q

What is Valvular Regurgitation and what does it cause?

A

Backflow of blood because the valves don’t close properly.

Causes: SV to reduce and atrial distension due to the back up of blood. (atria hypertrophy)

Cardiac Rehabilitation (4 decks)

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