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developmental concepts > lecture four: cardiopulmonary system > Flashcards

lecture four: cardiopulmonary system Flashcards

1
Q

components of the cardiovascular system

A

heart, vasculature, blood

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2
Q

functions of the cardiovascular system

A
  • delivers oxygen and nutrients to cells and organs in the body
  • transports hormones to target cells
  • removes metabolic waste (i.e. carbon dioxide)
  • protects body against disease through circulation of WBCs, antibodies, and complement cells
  • regulates body temp
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3
Q

main function of the heart

A

to pump blood to the body!

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4
Q

vasculature of the cardiovascular system

A
  • closed network of vessels that transports blood throughout the body
  • three types of vessels
    • arteries: transport blood away from the heart
    • veins: transport blood toward the heart
    • capillaries: connection between arteries and veins to allow for exchange of oxygen, nutrients, and waste
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5
Q

cycle of blood flow

A

deoxygenated blood from body travels into R atrium —> through tricuspid valve to R ventricle —> through pulmonary artery to lungs —> oxygenated blood through pulmonary vein to L atrium —> through mitral valve into L ventricle —> through aorta out to body

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6
Q

when does vasculature development begin?

A

begins 3-4 weeks after conception

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7
Q

vasculogenesis

A
  • formation of arteries and veins
    • mesodermal cells differentiate into vessels
    • occurs ONLY during embryonic development
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8
Q

angiogenesis

A
  • formation of vascular branches from existing blood vessels
    • occurs during embryonic development AND throughout life (i.e. during healing)
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9
Q

vasculature anatomy

A
  • 3 blood vessel layers
    • tunica externa (adventitia): outer connective tissue layer
    • tunica media: middle smooth muscle layer
    • tunica intima: inner endothelial layer
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10
Q

large elastic arteries

A
  • i.e. aorta, left common carotid artery
  • located in tunica media
  • contain elastic fibers to allow for expansion and recoil
  • maintains constant flow of blood during diastole
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11
Q

medium muscular arteries

A
  • i.e. femoral artery, axillary artery
  • located in tunica media
  • contains smooth muscle fibers to allow for regulation of diameter and control of blood flow to different parts of the body
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12
Q

small arteries and arterioles

A
  • controls filling of capillaries
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13
Q

what are the three classes of veins?

A

large veins, medium/small veins, and venules

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14
Q

distinguishing features of veins

A
  • larger and more compliant than arteries
  • thin walls (especially the tunica media)
  • large lumens (larger blood reservoir)
  • one way valves present
    • typically located in veins inferior to heart
    • facilitate blood flow toward heart
    • affected by autonomic nervous system and skeletal muscle pump
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15
Q

autonomic nervous system regulates ______ and _______

A

BP and peripheral vascular resistance

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16
Q

sympathetic nervous system

A

increase HR and cause vasoconstriction

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17
Q

parasympathetic nervous system

A

decrease HR and cause vasodilation

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18
Q

baroreceptors

A
  • located in aorta and carotid sinus
  • detect changes in BP
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19
Q

chemoreceptors

A
  • located in aorta and carotid bodies
  • detect changes in pH and O2
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20
Q

the heart develops approximately _______ after conception

A

3 weeks
(recognizable structure after 20 days - heart tube that begins to elongate)

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21
Q

circulation begins at approximately _________ (rhythmic pulsations of primitive heart tube)

A
  • 4 weeks gestation
    • week 3: heart and vessels develop
    • week 4: heart begins to beat and pump blood
    • week 7: heart forms into a 4 chamber structure
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22
Q

shunting systems

A
  • small passages for blood to travel through in order to bypass body parts that are not yet developed
    • foramen ovale
      • R atrium —> L atrium
    • ductus arteriosus
      • R pulmonary artery —> aorta
    • ductus venous
      • inferior vena cava —> umbilical vein
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23
Q

neonatal circulation development

A
  • shunting systems close and form new structures
    • foramen ovale —> fossa ovalis
    • ductus arteriosus —> ligaments arteriosum
    • umbilical vein —> ligamentum teres
    • ductus venous —> ligamentum venosum
    • umbilical arteries —> lateral umbilical ligaments

*watch videos from slide!

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24
Q

congenital heart disease

A
  • 1% of live births have congenital heart disease
  • leading non-infectious cause of death in first year of life
  • embryonic heart development
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25
Q

cardiovascular development (infancy and childhood part one)

A
  • left side of heart becomes predominant (left ventricular wall becomes twice as thick by adulthood)
  • heart is initially oriented horizontally —> changes to vertical orientation with lung expansion and growth
  • heart size increases at similar rate as body weight increase
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26
Q

heart volume in infancy and childhood

A
  • 40 mL at birth —> 80 mL at 6 months —> 160 mL at age 2
  • ratio of heart volume to body weight remains constant = 10 mL/kg of body weight
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27
Q

cardiovascular development (infancy and childhood part two)

A
  • changes in myocytes (cardiac muscle fibers)
    • increase in
      • cross-sectional area of muscle fibers
      • number of myofibrils per cross sectional area
      • force production
        • increased contraction of myoctye
        • myofibrils mature and change from a random orientation to being oriented in the same direction
      • stroke volume —> increased efficiency
    • no increase in number of myocytes
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28
Q

cardiovascular development (infancy and childhood part three)

A
  • vascular changes
    • increased heart vascularization
      • at birth 1 vessel for every 6 muscle fibers
      • adulthood 1:1 ratio
    • increase in size of arteries and veins and body weight and height increases
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29
Q

in infancy and childhood, fetal hemoglobin (Hb) levels are ________ post-natal Hb levels

A
  • greater than (>)
  • fetal blood has more Hb and less O2 saturation —> as infant’s lungs begin to function, blood has less Hb and more O2 saturation
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30
Q

O2 saturation in umbilical vein

A

70%

31
Q

O2 saturation in arterial blood after birth

A

97%

32
Q

Hb levels from newborn to adulthood

A
  • newborn Hb levels: 20g / 100 mL
  • 3 to 6 month old Hb levels: 10g / 100 mL
  • adult Hb levels: 14 to 16 g / mL
33
Q

in infancy and childhood, blood volume _______

A
  • INCREASES
    • 300 to 400 mL at birth to 5 L in adults
34
Q

in infancy and childhood, stroke volume _______

A
  • INCREASES
    • directly proportional to heart size
    • 4 mL at birth, 40 mL in children, 60 mL in adults
35
Q

in infancy and childhood, heart rate _______

A
  • DECREASES
    • in newborns, heart rate is faster to compensate for lower stroke volume (110 bpm)
    • at 1 years old, heart rate decreases to 105 bpm
36
Q

in infancy and childhood, blood pressure _______

A
  • INCREASES
    • influenced by development of autonomic nervous system and peripheral vascular resistance
    • increase is strongly related to increase in height and weight
37
Q

cardiovascular development in adolescence

A
  • heart size and weight continue to grow
    • left ventricular size increases as body mass increases
      • increased stroke volume as left ventricle can pump more blood with each heartbeat
    • as body weight increases, BP increases
    • gender differences noted (boys > girls)
38
Q

cardiovascular development in adulthood

A
  • heart size may increase due to fatty deposition
    • most evident in women (increase seen between 30s-60s)
39
Q

changes in heart with aging

A
  • decrease in number of myocytes but increase in size (increased fat deposition)
  • decrease in number of pacemaker cells in sinioatrial node —> slower HR
    • fibrous tissue and fat deposition can develop in pacemaker pathways
  • left ventricular wall becomes thicker —> decreased SV
    • heart and vascular system become less compliant (stiffer)
  • myocardium becomes darker
    • increased aging pigment lipofuscan
  • thickening and calcification of valves
40
Q

changes in blood and vessels with aging

A
  • vessels
    • thicker, stiffer, and less flexible
    • increased peripheral resistance of blood vessels —> increased BP —> heart works harder —> heart musculature and walls become thicker
  • blood
    • decreased blood volume due to decrease in fluid with aging
    • decreased number of RBCs
    • number of most WBCs typically remains the same
      • lymphocytes decrease in number —> decreased ability to fight infection and impaired immune function
41
Q

adult heart disease

A
  • leading cause of death
  • 1 million heart attacks a year
  • 5 million adults with heart failure
42
Q

pulmonary system components

A
  • lungs
    • site of gas exchange (bring in oxygen and remove carbon dioxide)
  • airways
    • pathway for air to lungs
  • blood vessels
    • transport oxygen and carbon dioxide
  • thorax
    • provide mechanical force
43
Q

primary function of pulmonary system

A

gas exchange!

44
Q

conducting zone of pulmonary system

A
  • passageway for air to travel into and out of lungs
  • nose, pharynx, larynx, trachea, bronchi, and bronchioles
45
Q

respiratory zone of pulmonary system

A
  • located deep in the lungs
  • respiratory bronchioles, alveolar ducts, and alveoli
46
Q

the respiratory center is in the _________

A

brain stem (medulla oblongata and pons)

47
Q

the sympathetic nervous system system does bronchial ___________ while the parasympathetic nervous system system does bronchial ___________

A

dilation; constriction

48
Q

chemoreceptors detect changes in ________, __________, and ________

A

blood pH, carbon dioxide, oxygen

49
Q

control of ventilation

A
  • stretch receptors in the lungs
  • sensory and motor nerves for muscles of ventilation
    • intercostal muscles and diaphragm
50
Q

tidal volume

A

amount of air inhaled or exhaled at rest with each breath

51
Q

residual volume

A

amount of air remaining in lungs following expiration

52
Q

minute ventilation

A

total volume of air inspired and expired in one minute

53
Q

prenatal pulmonary development

A
  • 4 to 8 wks of gestation
    • differentiation of trachea and bronchi
    • lung buds form
    • bronchi begin to form in the lungs
54
Q

neonatal pulmonary development

A
  • 8 weeks to 7 months
    • 6 wks: primitive alveoli form and development continues until birth
    • 8 wks: conducting zone developed
    • 24 wks: surfactant is produced
    • 26 to 28 wks: viable respiratory zone (vascularized terminal sacs and surfactant)
55
Q

pulmonary development at birth

A
  • rib cage is horizontal and ventilatory muscles are not fully developed
  • lack of efficient diaphragmatic breathing
56
Q

pulmonary development following achievement of sitting

A
  • ribs become angled
  • diaphragm forms a dome shape
  • ventilatory muscles become stronger
  • increased efficiency of breathing
57
Q

during pulmonary development in infancy and childhood, there is an _______ in the number of _______ (until age 8) and _____________

A

increase; alveoli; pulmonary vascularization

58
Q

airways are _________ in children

A
  • SMALLER
    • decreased smooth muscle in bronchiole walls until age 3–4 yrs
    • decreased alveolar elasticity until puberty
    • decreased collateral ventilation mechanism
    • implications
      • increased occurrence of bronchiole collapse
      • decreased lung compliance and distensibility —> increased work of breathing
      • increased risk of respiratory infections until age 6-8 years
59
Q

adolescence pulmonary development

A
  • increased size of proximal airways and vasculature
  • increase in alveolar size, elastic fibers in alveolar walls, and capillaries to alveoli
    • increased gas exchange
  • 19 years old: smooth muscle in arterial walls of alveoli are fully developed
    • efficient control of blood flow through vasoconstriction and vasodilation
60
Q

functional impairments in pulmonary development are evident beginning in the _____ decade of life

A

7th (60s)

61
Q

thoracic wall and muscular changes in adulthood and aging

A
  • stiffer bony thorax, thoracic kyphosis, and decreased joint mobility
  • decreased expansion of chest wall during breathing
  • decreased strength and endurance of inspiratory muscles (accessory breathing muscles must work harder)
  • altered length-tension relationship of muscles due to structural changes in thoracic cavity (changes lead to increased work of breathing)
62
Q

lung changes in adulthood and aging

A
  • decreased compliance and elasticity due to changes in collagen and elastin
  • decrease in vital capacity (~75%) and increase in residual volume (~70%) by age 70 due to impaired elastic recoil
    • total lung volume does not change
  • body responds to these changes with an increase in breathing rate in order to increase minute ventilation
63
Q

alveolar changes in adulthood and aging

A
  • decreased elasticity —> increased susceptibility to collapse during expiration
  • increased size of lungs and alveoli due to increased residual volume —> more time required for inspired air to reach alveoli
  • increased number of mucous glands and mucus in airway —> more resistance to airflow
64
Q

vascular changes in adulthood and aging

A
  • smaller capillary bed around alveoli
  • decreased blood volume/flow in capillary bed
65
Q

in adulthood and aging, pulmonary system is working _________ and ______ oxygen is delivered to the body

A

harder, less

66
Q

cardiovascular system adaptations to long term exercise

A
  • increased
    • maximum cardiac output and stroke volume
    • plasma volume
    • hemoglobin
    • HDL
  • decreased
    • resting heart rate
    • systolic and diastolic BP
    • LDL
67
Q

HDL cholesterol (high density lipoprotein)

A
  • “good” cholesterol
  • absorbs cholesterol in blood and carries it back to liver where it is flushed from the body
  • high levels of HDL can lower risk for heart disease and stroke
68
Q

LDL cholesterol (low density lipoprotein)

A
  • “bad” cholesterol
  • makes up most of your body’s cholesterol
  • high levels raise risk for heart disease and stroke
69
Q

pulmonary system adaptations to long term exercise

A
  • increased
    • minute ventilation (due to increased tidal volume and breathing frequency)
    • vital capacity
    • tidal volume
  • decreased
    • inspiration/expiratory reserve
    • respiratory rate at sub maximal exercise
70
Q

_________, _________, and _________ reflect the efficiency of the cardiopulmonary system

A

cardiac output, minute ventilation, maximal aerobic capacity

71
Q

cardiac output

A
  • efficiency of the cardiovascular system
  • SV x HR = cardiac output
72
Q

minute ventilation

A
  • efficiency of the pulmonary system
  • tidal volume x respiratory rate = minute ventilation
73
Q

maximal aerobic capacity

A
  • maximal ability of an individual’s body to transport and use oxygen for energy production
    • determined by level of cardiovascular and pulmonary fitness

developmental concepts (7 decks)

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