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Anatomy and Physiology II > Lesson 8 - The Circulatory System: Heart > Flashcards

Lesson 8 - The Circulatory System: Heart Flashcards

1
Q

cardiac cycle

A

one complete contraction and relaxation of all four chambers of the heart

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2
Q

two main variables govern fluid movement: _____ causes flow, and _____ opposes it

A

pressure, resistance

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3
Q

flow requires a _____ ______

A

pressure gradient

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4
Q

there is an _____ relationship between volume and pressure

A

inverse

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5
Q

blood pressure is measured with?

A

a sphygmomanometer

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6
Q

when the ventricles relax and expand, what happens to its internal pressure?

A

it falls

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7
Q

if the mitral valve is open, blood flows…

A

into the left ventricle

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8
Q

when the ventricles contract, what happens to its internal pressure?

A

it rises

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9
Q

what happens to the aortic semilunar valve when the AV valve closes?

A

it is pushed open and blood flows into the aorta form the left ventricle

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10
Q

the AV valves are _____ when the ventricles are relaxed

A

limp

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11
Q

when the ventricle is relaxed, what is happening to the semilunar valves?

and why?

A

they’re under pressure from blood in the vessels

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12
Q

valvular insufficiency (incompetence)

A

any failure of a valve to prevent reflux (regurgitation)

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13
Q

regurgitation

A

backward flow of blood

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14
Q

valvular stenosis

A

cusps are stiffened and opening is constricted by scar tissue; often caused by rheumatic fever

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15
Q

regurgitation can be heard as a _____ _____

A

heart murmur

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16
Q

mitral valve prolapse (MVP)

A

insufficiency in which one of both mitral valve cusps bulge into the atria during ventricular contraction; often hereditary

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17
Q

auscultation

A

listening to the sounds made by the body

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18
Q

first heart sound (S1)

A

louder and longer “lubb”, occurs with closure of AV valves, turbulence in the bloodstream, and movements of the heart wall

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19
Q

second heart sound (S2)

A

softer and sharper “dubb”, occurs with closure of the semilunar valves, turbulence in the bloodstream, and movements of the heart wall

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20
Q

third heart sound (S3)

A

results from the transition from the expansion of the empty ventricles to their sudden filling with blood

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21
Q

what heart sound is rarely heard in people over 30? what could its presence indicate?

A

S3; enlarged or failing heart

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22
Q

phases of the cardiac cycle (4)

A
  1. ventricular filling
  2. isovolumetric contraction
  3. ventricular ejection
  4. isovolumetric relaxation
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23
Q

phases of the cardiac cycle: ventricular filling

A

ventricles expand as they relax and their pressure drops below that of the atria causing AV valves to open and blood to flow in

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24
Q

ventricular filling occurs in three phases

A
  1. rapid ventricular filling: first third
  2. diastasis: second third, slower filling
  3. atrial systole: last third, atria contract
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25
Q

the P wave occurs at the end of _____ of ventricular filling

A

diastasis

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26
Q

end-diastolic volume (EDV)

A

amount of blood in the ventricles BEFORE ventricular systole

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27
Q

phases of the cardiac cycle: isovolumetric contraction (2)

A
  • atria repolarize, relax, and remain that way for the rest of the cycle
  • ventricles begin to contract closing AV valves
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28
Q

heart sound S1 is heard at the beginning of this phase of the cardiac cycle

A

isovolumetric contraction

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29
Q

why is it called isovolumetric contraction?

A

because although the ventricles contract, they do not eject blood

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30
Q

phases of the cardiac cycle: ventricular ejection

begins when…

A

begins when the ventricles pressure exceeds atrial pressure in the aorta/pulmonary trunk and the semilunar valves open

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31
Q

ventricular ejection - two parts

A

rapid ejection: blood spurts out of ventricles quickly
reduced ejection: slower flow under less pressure

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32
Q

stroke volume (SV)

A

the amount of blood ejected

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33
Q

ejection fraction

A

SV(stroke volume)/EDV(end-diastolic volume)

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34
Q

end-systolic volume

A

blood remaining in the ventricles after ventricular ejection

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35
Q

phases of the cardiac cycle: isovolumetric relaxation

A

blood from aorta/pulmonary trunk briefly flows backward filling cusps and closing semilunar valves

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36
Q

the _____ wave ends and ventricles being to relax and expand during isovolumetric relaxation

A

T

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37
Q

what heart sound occurs during isovolumetric relaxation?

A

S2

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38
Q

why is isovolumetric relaxation called ‘isovolumetric’?

A

semilunar valves are closed and AV valves have not yet opened, so no change in blood volume

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39
Q

most of the ventricular filling occurs during what?

A

atrial diastole

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40
Q

atrial systole lasts about…

A

0.1 seconds

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41
Q

ventricular systole lasts about…

A

0.3 seconds

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42
Q

quiescent period

A

when all four chambers are in diastole, lasts about 0.4 second

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43
Q

congestive heart failure (CHF)

A

results from the failure of either ventricle to eject blood effectively

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44
Q

what is congestive heart failure usually due to? (4)

mi.ch.vi.cd.

A

a heart weakened by a myocardial infarction, chronic hypertension, valvular insufficiency, or congenital defects in heart structure

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45
Q

left ventricular failure (2)

what happens and what does it cause?

A

blood backs up into the lungs causing pulmonary edema, shortness of breath and a sense of suffocation

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46
Q

right ventricular failure (5)

A

blood backs up into the vena cava causing systemic generalized edema, enlargement of the liver, ascites, distension of jugular veins, swelling of the fingers/ankles/and feet

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47
Q

ascites

A

pooling of fluid in abdominal cavity

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48
Q

heart rhythm and contraction are controlled by two cardiac centers

A
  • cardioacceleratory center
  • cardioinhibitory center
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49
Q

where are the two cardiac centers located?

A

the medulla oblongata

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50
Q

cardioacceleratory center

how does it communicate with the heart?

A

communicated with heart via the right and left cardiac nerves carrying sympathetic postganglionic nerve fibers

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51
Q

cardioinhibitory center

A

communicated with heart via right and left vagus nerves carrying parasympathetic preganglionic nerve fibers

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52
Q

sympathetic stimulation _____ heart rate and contraction rate

A

increases

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53
Q

sympathetic pathway - heart innervation: stimulatory signals from the _____ center descend to the upper thoracic segments of the spinal cord where they synapse with sympathetic _____ neurons in the _____ horn, whose axons enter sympathetic _____ _____

A

cardioacceleratory, preganglionic, chain ganglia

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54
Q

sympathetic pathway - heart innervation: some fibers synapse with _____ neurons at the level of entry, other ascend to _____ ganglia

A

postganglionic, cervical

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55
Q

sympathetic pathway - heart innervation: _____ fibers pass through the _____ _____ in mediastinum and continue as _____ nerves to the heart

A

postganglionic, cardiac plexus, cardiac

56
Q

sympathetic pathway - heart innervation: fibers terminate in _____ and _____, in the atrial and ventricular myocardium (and also in the aorta, pulmonary trunk, and coronary arteries)

A

SA and AV nodes

57
Q

parasympathetic stimulation _____ heart rate

A

decreases

58
Q

parasympathetic pathway - heart innervation: beings with nuclei of the _____ nerves in the _____ _____; exiting this structure and traveling through the _____

A

vagus, medulla oblongata, mediastinum

59
Q

parasympathetic pathway - heart innervation: _____ fibers of the _____ travel through the _____ _____, synapse with _____ neurons in the plexus or the epicardium of _____ near the SA and VA nodes

A

preganglionic fibers, vagus, cardiac plexus, postganglionic, atria

60
Q

parasympathetic pathway - heart innervation: short _____ fibers of the _____ _____ nerve lead mainly to the SA node; fibers of the _____ _____ nerve lead mainly to AV node

A

postganglionic, right vagus, left vagus

61
Q

there is little or no _____ innervation of the myocardium or ventricles

A

parasympathetic

62
Q

cardiac output (CO)

A

amount ejected by each ventricle in one minute

63
Q

cardiac output (CO) equation

A

heart rate (HR) x stroke volume (SV)

64
Q

cardiac reserve

A

difference between a person’s maximum and resting cardiac output

65
Q

how is cardiac reserve different in those with heart disease?

A

they have litter reserve and little tolerance for exertion

66
Q

what artery is used to check pulse in the wrist?

A

radial artery

67
Q

what artery is used to check pulse in the neck?

A

common carotid

68
Q

tachycardia

A

persistent, resting HR above 100bpm

69
Q

causes of tachycardia (6)

s.a.s.h.f.b.

A

stress, anxiety, stimulants, heart disease, fever, or blood loss

70
Q

bradycardia

A

persistanting, resting adult HR below 60bpm

71
Q

causes of bradycardia (2)

A

common in endurance-trained athletes, also caused by hypothermia

72
Q

positive chronotropic agents

A

factors that raise HR

73
Q

negative chronotropic agents

A

factors that lower HR

74
Q

the autonomic nervous system does/doesn’t initiate heartbeat

A

does NOT; it modulates rhythm and force

75
Q

sympathetic postganglionic fibers are _____

A

adrenergic

76
Q

sympathetic postganglionic fibers release what hormone?

A

norepinephrine (NE)

77
Q

the adrenal medulla secretes.. (2)

A

norepinephrine (NE) and epinephrine (Epi)

78
Q

what happens when NE and Epi bind the B-adrenergic receptors in the heart?

A

it activates cAMP second-messenger systems in cardiomyocytes and nodal cells, leading to the opening of Ca2+ channels in the plasma membrane

79
Q

what does sympathetic stimuli do to calcium flow in the heart?

A

increases inflow accelerating the depolarization of the SA node

80
Q

what does sympathetic stimulation do to calcium reuptake?

A

increased cAMP accelerated uptake of Ca2+ by the SR, allowing cardiomyocytes to relax more quickly

81
Q

sympathetic division: by accelerating both contraction and relaxation, _____ (through cAMP) increases heart rate as high as 230 bpm

A

norepinephrine

82
Q

at excessively high heart rates, diastole becomes…

A

too brief for adequate filling, causing both stroke volume and cardiac output to be reduced

83
Q

parasympathetic vagus nerves have _____, _____ effects on the SA and AV nodes

c.i.

A

cholinergic, inhibitory

84
Q

parasympathetic division: _____ binds to muscarinic receptors opening _____ chemically gated channels in nodal cells

A

acetylcholine, K+

85
Q

parasympathetic division: as _____ leaves the nodal cells, they become _____ and fire less frequently, causing what?

A

K+, hyperpolarized, causing heart rate to slow down

86
Q

parasympathetic division: steady background firing of the _____ nerves continually keeps HR _____ to the usual

A

vagus, down

87
Q

vagal tone

A

constant firing of the vagus nerves that keep heart rate down

88
Q

inputs to the cardiac centers in the _____ _____ are diverse

A

medulla oblongata

89
Q

_____ in muscles and joints inform cardiac centers about changes in _____, causing HR to increase before metabolic demands on muscles arrive

A

proprioceptors, activity

90
Q

_____ in the aorta and internal carotid arteries send signals to the medulla regarding _____ _____, so HR can be adjusted accordingly

A

baroreceptors, heart rate

91
Q

baroreflex

A

if BP decrease, HR increases and vice versa

92
Q

_____ detect chemical stimuli in the aortic arch, carotid, and medulla oblongata

A

chemoreceptors

93
Q

chemoreflex (2)

A
  • CO2 accumulation lowers pH, both conditions stimulate receptors to increase HR and increase tissue perfusion
  • also respond to low O2, resulting in decrease in HR
94
Q

hypercapnia

A

carbon dioxide accumulation

95
Q

hypoxemia

A

low oxygen levels

96
Q

autonomic neurotransmitters (2)

n.a.

A

norepinephrine and acetylcholine

97
Q

blood-borne adrenal catecholamines (2)

A

norepinephrine and epinephrine - potent cardiac stimulants

98
Q

_____ stimulates catecholamine secretion

A

nicotine

99
Q

_____ hormone increases the number of adrenergic receptors on the heart so it is more responsive to adrenergic stimulation

A

thyroid

100
Q

_____ inhibits cAMP breakdown, prolonging adrenergic effect

A

caffeine

101
Q

hyperkalemia of the heart (3)

A

(1) excess K+ diffuses into cardiomyocytes (2) making them less excitable and resulting in a (3) slow, irregular heartbeat

102
Q

hypokalemia of the heart (3)

A

(1) deficiency of K+ inside the cell causes the cell to (2) hyperpolarize and therefore requires (3) increased stimulation

103
Q

hypercalcemia of the heart

does what?

A

excessive Ca2+ decreases heart rate

104
Q

hypocalcemia of the heart

A

deficiency of Ca2+ increases heart rate

105
Q

three variables go into stroke volume

p.c.a.

A
  1. preload
  2. contractility
  3. afterload
106
Q

preload

A

amount of tension (stretch) in the ventricular myocardium immediately before it begins to contract

107
Q

Frank-Starling law of the heart

A

stroke volume is proportional to end-diastolic volume aka ventricles eject as much blood as they receive

108
Q

contractility

A

refers to how hard the myocardium contracts for a given preload

109
Q

positive inotropic agents

A

increase contractility

110
Q

negative inotropic agents

A

decrease contractility

111
Q

examples of positive inotropic agents (4)

c.n.g.d.

A

calcium, norepinephrine, glucagon, digitalis

112
Q

examples of negative inotropic agents (2)

A
  • hyperkalemia
  • vagal stimulation on artia (ventricles not innervated)
113
Q

afterload

A

sum of forces a ventricle must overcome before it can eject blood

114
Q

what are the greatest contributors to afterload? (2)

a.p.

A

blood pressure in the aorta and pulmonary trunk

115
Q

factors that increase afterload (2)

h.a.

A

hypertension, atherosclerotic plaques

116
Q

cor pulmonale

r

A

right ventricular failure due to obstructed pulmonary circulation (high afterload)

117
Q

high afterload causes these common complications of lung disease (2)

e.c.

A

emphysema, chronic bronchitis

118
Q

exercise has what impact on cardiac output?

A

increases it

119
Q

At the beginning of exercise, how does the body signal the heart to increase cardiac output?

A

signals from joints and muscles reach the cardiac center of the brain where it sends out sympathetic signals to increase cardiac output

120
Q

increased cardiac output due to exercise increases… (2)

v.p.

A

venus return and preload

121
Q

exercise produces _____ _____

A

ventricular hypertrophy

122
Q

ventricular hypertrophy causes…

A

increased stroke volume, allowing the heart to beat more slowly at rest

123
Q

coronary artery disease (CAD)

A

degenerative disease in the coronary arteries usually resulting from atherosclerosis

124
Q

what can increase risks for getting coronary heart disease? (3)
what do they do?

h.d.s.

A

hypertension, diabetes, and smoking
- damage inner lining of arteries

125
Q

how does coronary heart disease progress? (2)

A
  1. monocytes adhere and penetrate walls of vessels and become macrophages
  2. macrophages and smooth muscle cells absorb cholesterol and fat, becoming frothy foam cells and form yellow fatty streaks
126
Q

outcomes of coronary heart disease progression (2)

A
  1. fatty streaks have the potential to progress into life-threatening atheromas
  2. alternatively, damaged vessels can scar and accumulate calcium
127
Q

atheromas

A

plaques of fatty tissue

128
Q

atherosclerosis

l

A

an accumulation of lipid deposits and necrotic tissue that obstructs the lumen and may cause a heart attack

129
Q

arteriosclerosis

A

hardening of the arteries

130
Q

major risk factors of coronary artery disease (2)

A
  • excess low-density lipoproteins (LDL) in the blood
  • defective LDL receptors in arterial walls
131
Q

other risk factors of coronary artery disease (8)

h.a.o.s.l.h.d.

A

heredity, aging, obesity, smoking, lack of exercise, stress, hypertension, diet

132
Q

eating what can lower blood cholesterol?

A

soluble fibers

133
Q

how is coronary artery disease often treated?

A

with a coronary artery bypass graft

134
Q

coronary artery bypass graft

A

sections of a vessel are used to construct a detour around the obstruction in the coronary artery

135
Q

balloon angioplasty

A

another treatment for CAD; catheter is threaded into the coronary artery and inflated to press and flatten atheromas against the aterial wall

136
Q

laser angioplasty

A

atheroma is vaporized with a lazer

137
Q

restenosis

A

regrowth of atheromas

Anatomy and Physiology II (19 decks)

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