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anatomy and physiology ii > Lesson 7 - The Circulatory System: Heart > Flashcards

Lesson 7 - The Circulatory System: Heart Flashcards

1
Q

cardiology

A

study of the heart and its disorders

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2
Q

cardiovascular system

A

consists of heart and blood vessels

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3
Q

the _____ is a pump that keeps blood flowing through vessels

A

heart

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4
Q

_____ deliver blood to body tissues and returns it to the heart

A

vessels

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5
Q

these are blood vessels that carry blood AWAY from the heart

A

arteries

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6
Q

these are vessels that carry blood TOWARDS the heart

A

veins

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7
Q

microscopic vessels that connect the smallest arteries to the smallest veins are called

A

capillaries

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8
Q

circulatory system refers to (3)

A

the heart, vessels, and blood

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9
Q

pulmonary circuit

A

carries blood to the lungs for gas exchange and back to the heart

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10
Q

pulmonary circulation is performed by which side of the heart?

A

the right

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11
Q

systemic circuit

A

supplies oxygenated blood to all tissues of the body and returns it to the heart

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12
Q

systemic circulation is performed by what side of the heart?

A

the left

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13
Q

pulmonary circuit: blood is sent to _____ of the lungs via the _____ _____, and _____ _____, where it picks up oxygen and returns to the heart via _____ _____

A

alveoli, pulmonary trunk, pulmonary arteries, pulmonary veins

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14
Q

deoxygenated blood returns to the heart via… (2)

A

the inferior and superior vena cava

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15
Q

the major arteries and veins entering and leaving the heart are called _____ _____

A

great vessels

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16
Q

oxygenated blood is sent to the body via the _____

A

aorta

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17
Q

the heart is located in the …..

A

mediastinum

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18
Q

mediastinum

A

the space between lungs

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19
Q

shape of the heart: base

what attaches here?

A

wide, SUPERIOR portion of the heart, large vessels attach here

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20
Q

shape of the heart: apex

A

tapered INFERIOR end, tilts to the left

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21
Q

at any age, the heart is the size of…

A

the fist

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22
Q

the heart is enclosed by the _____

A

pericardium

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23
Q

pericaridum

A

a double-walled sac surrounding the heart

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24
Q

functions of the pericardium (4)

A
  • allows heart to beat without friction
    -provides room for expansion
  • resists excessive expansion
  • anchored to diaphragm and sternum for support
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25
Q

fibrous pericardium

A

outermost layer of the pericardium
- a tough, fibrous sac

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26
Q

serous pericardium is comprised of… (2)

A

parietal layer and visceral layer

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27
Q

serous pericardium: parietal layer

A

lines the fibrous pericaridum

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28
Q

serous pericardium: visceral layer

A

aka epicardium
- adheres to the heart surface and outmost layer of the heart itself

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29
Q

pericardial cavity

A

the space between the parietal and visceral layers of the serous pericardium

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30
Q

the pericardial cavity is filled with…

A

pericardial fluid

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31
Q

pericarditis

A

inflammation of the pericardium, my result in friction rub

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32
Q

the heart wall consists of three layers

A
  1. epicardium
  2. myocardium
  3. endocardium
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33
Q

the epicardium is also the…

A

visceral layer of the serous pericardium

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34
Q

epicardium (2)

A
  • serous membrane covering the heart
  • there is sometimes adipose tissue in a thick layer on portions of this
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35
Q

coronary blood vessels travel through what layer of the heart?

A

epicardium

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36
Q

endocardium

A

smooth inner lining of the heart and blood vessels

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37
Q

this layer of the heart covers the valve surfaces and is continuous with the endothelium of blood vessels

A

endocardium

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38
Q

myocardium

A

layer of cardiac muscle

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39
Q

thickness of the myocardium is _____ to workload

A

proportional

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40
Q

vortex of the heart

A

the muscle spiral around the heart that produces a wringing motion during contraction

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41
Q

fibrous skeleton

A

framework of collagenous and elastic fibers in the heart

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42
Q

fibrous rings

A

part of the fibrous skeleton that provides structural support and attachment for cardiac muscle and anchors for valve tissue

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43
Q

what important thing does the fibrous skeleton supply for the heart?

A

electrical insulation between the atria and ventricles which is important in timing and coordination of contractile activity

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44
Q

auricle

A

an earlike flap that increases the chamber volume of the atria

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45
Q

interatrial septum

A

a wall between the atria of the heart

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46
Q

which ventral wall is bigger? left or right? why?

A

left, it pumps blood to the body and not just the lungs so it needs to be stronger to cover the distance

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47
Q

boundaries of the chambers of the heart are marked by….

A

sulci, grooves

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48
Q

coronary sulcus

A

separates atria above from ventricles below, encircles the heart near the base

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49
Q

anterior and posterior interventricular sulci

A

separate the left and right ventricles; overlie the interventricular septum and extend obliquely down heart, from base and apex

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50
Q

cusps/leaflets

A

the fibrous flaps of the atrioventricular valves

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51
Q

atrioventricular valves control…

A

blood flow between the atria and ventricles

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52
Q

what is another name for the right atrioventricular valve?

A

tricuspid

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53
Q

what is another name for the left atrioventricular valve?

A

bicuspid

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54
Q

tendinous cords are also called

A

chordae tendineae

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55
Q

chordae tendineae

A

strings of connective tissue that attach valve cusps to papillary muscles on the floor of ventricles

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56
Q

what is the purpose of chordae tendineae?

A

they prevent the AV valves from flipping or bulging into atria when ventricles contract

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57
Q

semilunar valves control…

A

flow from the ventricles into great arteries

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58
Q

pulmonary semilunar valve

A

controls the opening between the right ventricle and pulmonary trunk

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59
Q

aortic semilunar valve

A

controls the opening between the left ventricle and aorta

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60
Q

how many cusps do the semilunar valves have?

A

three each

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61
Q

when are cusps of the semilunar valves pressed up against arterial walls?

A

during ventricular contraction and blood ejection

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62
Q

when are the semilunar valves closed?

A

when the ventricles relax, and blood flows back towards them and fills

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63
Q

pathway of blood: steps 1-3

A
  1. blood enters the right atrium from the superior/inferior venae cavae
  2. blood in the right atrium flows through the right AV valve into the right ventricle
  3. contraction of the right ventricle forces the pulmonary semilunar valve open
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64
Q

pathway of blood: steps 4-6

A
  1. blood flows through pulmonary semilunar lavle into the pulmonary trunk
  2. blood is distributed by the right and left pulmonary arteries into the lungs, where it unloads CO2 and loads O2
  3. blood returns from lungs via the pulmonary veins to the left atrium
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65
Q

pathway of blood: steps 7-9

A
  1. blood in the left atrium flows through the left AV valve into the left ventricle
  2. contraction of the left ventricle (simultaneous with step 3) forces the aortic valve open
  3. blood flows through the aortic valve into the ascending aorta
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66
Q

pathway of blood: steps 10 and 11

A
  1. blood in the aorta is distributed to every organ in the body, where it unloads O2 and loads CO2
  2. blood returns to the right atrium via venae cavae
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67
Q

coronary circulation

A

the heart’s own supply of vessels to deliver blood to the myocardium

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68
Q

left coronary artery branches off from where?

A

the ascending aorta

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69
Q

the left anterior descending branch of the left coronary artery is also known as…

ai

A

the anterior interventricular branch

70
Q

the anterior interventricular branch supplies blood where?

A

to both ventricles and anterior two-thirds of the interventricular septum

71
Q

what does the left coronary artery branch into? (2)

a.c.

A
  • anterior interventricular branch
  • circumflex branch
72
Q

where is the circumflex branch of the coronary circuit?

A

passes around the left side of the heart in the coronary sulcus

73
Q

where does the circumflex branch of the coronary circuit end?

A

the posterior side of the heart

74
Q

the circumflex branch of the coronary circuit branches what other artery?

A

the left marginal branch

75
Q

where does the right coronary artery branch off of?

A

the ascending aorta

76
Q

the right coronary artery branches into… (2)

r.p.

A
  • right marginal branch
  • posterior interventricular branch
77
Q

where does the right marginal branch supply the coronary circuit?

l

A

the lateral aspect of the right atrium and ventricle

78
Q

where does the posterior interventricular branch of the coronary circuit supply?

A

the posterior walls of both ventricles and the interventricular septum

79
Q

flow through the coronary arteries is the greatest when the heart _____

A

relaxes

80
Q

what happens to the coronary arteries during ventricular contraction? (2)

A

they compress, the open aortic valve blocks blood flow into them

81
Q

what happens to the coronary arteries during relaxation?

A

blood in the aorta surges back toward the heart and into the openings of the coronary arteries

82
Q

angina pectoris

A

chest pain from partial obstruction of coronary blood flow

83
Q

chest pain is caused by…

A

ischemia of cardiac muscles

84
Q

explain how heart pain occurs

A

obstruction of coronary blood flow causes the myocardium to shift to anaerobic fermentation, producing lactate and stimulating pain

85
Q

myocardial infarction

A

heart attack
- sudden death of a patch of myocardium resulting from long-term obstruction of coronary circulation

86
Q

atheroma

A

blood clot/fatty deposit

87
Q

what happens to cardiac muscles downstream of an atheroma?

A

they die due to lack of circlation

88
Q

what often obstructs coronary arteries?

A

atheromas

89
Q

how can you tell if someone is having a heart attack?

A

they have heavy pressure or squeezing pain radiating into the left arm

90
Q

some painless heart attacks may disrupt _____ _____ pathways leading to fibrillation and cardiac arrest

A

electrical conduction

91
Q

venus drainage

A

route by which blood leaves an organ

92
Q

5-10% of coronary blood drains directly into heart chambers by way of _____ _____ _____

A

small cardiac veins

93
Q

most coronary blood returns to the right atrium via these four veins

g.pi.lm.c.

A
  1. great cardiac vein
  2. posterior interventricular (middle cardiac) vein
  3. left marginal vein
  4. coronary sinus

the first three merge into the conorary sinus

94
Q

the great cardiac vein drains blood from what portion of the heart?

A

anterior aspect

95
Q

the posterior interventricular (middle cardiac) vein drains blood from what portion of the heart?

A

posterior aspect

96
Q

the left marginal vein drains blood from what portion of the heart?

a->lm

A

apex up the left margin

97
Q

the coronary sinus drains blood from what portion of the heart?

A

receives blood from the left marginal, middle cardiac, and great cardiac veins and empties into the right atrium

98
Q

the heartbeat is myogenic meaning…

A

signals original in the heart itself

99
Q

the heart is autorhythmic, meaning…

A

it has a built in pacemaker and electrical system so it does not rely on the nervous system for its rhythm

100
Q

cardiomyocyte features (4)

A
  • striated, short, thick, BRANCHED muscle
  • ONE central nucleus surrounded by glycogen
  • SR lacks terminal cisterns
  • large T tubules
101
Q

intercalated discs

A

connections between cardiomyocytes

102
Q

intercalated discs contain… (3)

A

interdigitating folds, mechanical junctions, and electrical junctions

103
Q

interdigitating folds

A

membranes of cells folded to lock cells together and increase surface of contact

104
Q

desmosomes

A

mechanical junctions of intercalated discs
- mechanical linkages that prevent contracting cardiomyocytes from being pulled apart

105
Q

gap junctions

A

electrical junctions in intercalated discs
- allow ions to flow between cells, and they stimulate their neighbors and contract in unison

106
Q

cardiac muscle depends almost exclusively on what to make ATP?

A

aerobic respiration

107
Q

what adaptations help cardiac muscle to depend on aerobic respiration? (3)

A
  • rich in myoglobin and glycogen
  • hugh mitochondria
  • hardly uses anaerobic fermentation or O2 debt mechanisms
108
Q

cardiac muscle is adaptable to different organic fuels including… (5)

A

fatty acids (60%), glucose (35%), ketones, lactate, and amino acids (5%)

109
Q

the heart is more vulnerable to _____ _____ than lack of a _____ _____

A

O2 deficiency, specific fuel

110
Q

cardiac conduction system (2)

what does it do? what does it consist of?

A
  • coordinates the heartbeat
  • consists of an internal pacemaker and nerve-like conduction pathways through the myocardium
111
Q

cardiac conduction system pathway (5)

A
  1. SA node fires
  2. signals spread through atria
  3. AV node fires
  4. AV bundle carries signal through the interventricular septum
112
Q

sinoatrial (SA) node

A

patch of modified cardiomyocytes in the right atrium that serve as the pacemaker that initiates each heartbeat

113
Q

what initiates heartbeats and determines heart rate?

A

the SA node

114
Q

atrioventricular (AV) node

A

patch of modified cardiomyocytes that serve as an electrical gateway to the ventricles

115
Q

what prevents electrical signals from passing to the ventricles?

A

the fibrous skeleton, the AV node is the only way to receive electrical signals

116
Q

atrioventricular (AV) bundle

A

pathway from which signals leave the AV node

117
Q

the AV bundle forks into..

A

the right and left bundle branches

118
Q

subendocardial branches

A

Purkinje fibers
- processes arising from lower end of bundle branches that extensively branch through the ventricular myocardium

119
Q

where do the AV bundle branches travel?

A

the interventricular septum

120
Q

once signals reach the end of the conduction system, they are perpetuated by…

A

cardiomyocytes via gap junctions

121
Q

systole

A

heart contraction

122
Q

diastole

A

heart relaxation

123
Q

blood pressure is read as…

A

systolic pressure/diastolic pressure

124
Q

sinus rhythm

A

normal heartbeat triggered by the SA node

125
Q

ectopic focus

A

a region of spontaneous firing other than the SA node

126
Q

what may govern the heart rhythm if the SA node is damaged?

A

an ectopic focus

127
Q

nodal (junctional) rhythm

A

if the SA node is damaged, heart rate is set by the AV node (40-50 bpm vs. 70-80bpm)

128
Q

does the SA node have a stable resting membrane potential?

A

no it does not

129
Q

describe the resting membrane potential of the SA node (3)

A
  1. it starts at -60mV and drifts upwards
  2. when it reaches -40mV, channels open causing faster depolarization to 0mV
  3. repolarization occurs, and the pacemaker potential starts over again
130
Q

pacemaker potential/prepotential

A

the gradual depolarization of the SA node due to a slow influx of Na+

131
Q

what causes the faster depolarization that occurs from -40mV to 0mV?

A

at -40mV, voltage-gated channels for Ca2+ and Na+ open allowing them to enter the cells

132
Q

how does repolarization of the SA node occur?

A

when membrane potential reaches 0mV, K+ channels open and causes the ion to leave the cell, restarting the process

133
Q

when the SA node fires, it sets off the ______

A

heartbeat

134
Q

signal from the SA node stimulates the _____ to contract almost simultaneously

A

artia

135
Q

signal from the SA node reaches the AV in..

A

50 ms

136
Q

why do signals slow down through the AV node?

A

due to thin cardiomyocytes with fewer gap junctions

137
Q

why is it important that signals from the AV node are slowed down before reaching the ventricles?

A

it allows them more time to fill with blood

138
Q

after the AV node, how do signals travel through the AV bundle and Purkinje fibers?

A

it moves very quickly, and causes the ventricles to contract in near unison

139
Q

ventricular systole progresses from..

A

the apex of the heart

140
Q

cardiomyocytes have a stable resting potential of…

A

-90mV

141
Q

cardiomyocyte action potential: depolarization

A

stimulus opens voltage-gated Na+ channels, where it peaks at +30mV

142
Q

cardiomyocyte action potential: when do sodium channels inactivate?

A

at +30mV

143
Q

cardiomyocyte action potential: plateau

specific process

A

voltage-gated slow Ca2+ channels open allowing Ca2+ to enter the cell which triggers opening of the Ca2+ channels on the SR, flooding the cytosol with calcium

144
Q

cardiomyocyte action potential: why is the plateau phase important?

A

it sustains contraction for expulsion of blood from the heart

145
Q

cardiomyocyte action potential: repolarization

A

Ca2+ channels close, K+ channels open allowing K+ to enter quickly and repolarize the cell to its resting potential

146
Q

cardiac muscles have a long…

A

absolute refractory period

147
Q

why is the long absolute refractory period of cardiac muscle important?

A

it prevents wave summation and tetanus, which would stop the pumping action of the heart

148
Q

interpretation of the electrocardiogram: P wave

A

atrial depolarization

149
Q

interpretation of the electrocardiogram: QRS complex

A

ventricular depolarization

150
Q

interpretation of the electrocardiogram: T wave

prior to…

A

ventricular repolarization immediately PRIOR to diastole

151
Q

interpretation of the electrocardiogram: PR interval

a->v

A

signal conduction through the AV node before activating the ventricles

152
Q

interpretation of the electrocardiogram: QT interval

A

duration of ventricular depolarization

153
Q

when is the QT interval shorter?

A

during exercise

154
Q

interpretation of the electrocardiogram: QRS interval

not ventricular depolarization

A

atrial repolarization and diastole

155
Q

why can’t you read atrial repolarization on the electrocardiogram?

A

it is concealed by the QRS wave

156
Q

interpretation of the electrocardiogram: PQ segment

S->A

A

signal conduction from the SA to AV nodes, atrial systole begins

157
Q

interpretation of the electrocardiogram: ST segment

A

ventricular systole and ejection of blood

158
Q

the ST segment corresponds to what?

A

the plateau of cardiomyocytes’ action potentials

159
Q

deviations of an ECG can indicate… (4)

m.a.h.e.

A
  • myocardial infarction
  • abnormalities in conduction pathways
  • heart enlargement
  • electrolyte and hormone imbalances
160
Q

deviations of an ECG: ventricular fibrillation (Vfib)

A

random electrical signals result in no pumping action; hallmark of a heart attack and quickly fatal

161
Q

deviations of an ECG: atrial fibrillation (Afib)

A

weak rippling contraction in the atria due to chaotic signals, the atria fail to stimulate ventricles

162
Q

what is the most common atrial arrhythmia in elderly individuals?

A

atrial fibrillation

163
Q

is Afib or Vfib not immediately fatal?

A

Afib

164
Q

deviations of an ECG: heart block

A

failure of part of the conduction system
- includes bundle branch block and total heart block

165
Q

deviations of an ECG: total heart block

a

A

AV node failure, 20-40 bpm heartrate

166
Q

what heart arrhythmia is this?

A

premature ventricular contraction

167
Q

what heart arrhythmia is this?

A

heart block

168
Q

what heart arrhythmia is this?

A

atrial fibrillation

169
Q

what heart arrhythmia is this?

A

ventricular firbillation

170
Q

what heart arrhythmia is this?

A

trick question - this is sinus (normal) rhythm

171
Q
A

anatomy and physiology ii (19 decks)

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