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physiology Cardiac anatomy and coronary circulation > midterm physio > Flashcards

midterm physio Flashcards

1
Q

weight of heart

A

300 grams

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2
Q

rate of heart

A

70 >100,000/day, >35 million/year

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3
Q

where is heart located?

A

mediastinum

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4
Q

What is heart bordered by?

A

right and left parietal pleurae, sternum, spine, and diaphragm

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5
Q

what fraction of the heart lies left of the midline?

A

2/3

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6
Q

Apex

A

lower point of heart (pointy) lies on diaphragm at approx. 5th intercostal space

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7
Q

Base of heart

A

upper border of heart (broad)

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8
Q

Length of heart

A

approx 5 in. long

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9
Q

Pericardial sac

A

wraps around heart and roots of great vessels

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10
Q

Fibrous pericardium

A

tough, nonelastic outer layer, attached by fibrous bands to sternum, central tendon of diaphragm, spine

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11
Q

Serous pericardium (parietal)

A

lines fibrous pericardium

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12
Q

Serous pericardium (visceral epicardium)

A

adheres to heart surface

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13
Q

Pericardial cavity space

A

lubricated-protects against friction as heart beats

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14
Q

how many mL of serous fluid does the pericardial cavity have?

A

8-10 mL

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15
Q

What is pericardial effusion?

A

abnormal build up of fluid —-> cardiac tamponade

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16
Q

How do you treat cardiac tamponade?

A

Cardiocentesis

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17
Q

how many layers does the heart wall have?

A

3

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18
Q

Epicardium

A

outermost layer of heart wall. Made up of epithelial cells

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19
Q

What is the main cornary vessels on the heart surface?

A

epicardium

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20
Q

Myocardium

A

muscular middle layer. About 3 times thicker on left. Muscles attach to valvular rings

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21
Q

What is the myocardium responsible for?

A

ejecting blood

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22
Q

Endocardium

A

inner layer, serous membrane, lines surface of heart chambers

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23
Q

Septum

A

wall seperating R and L side of heart.

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24
Q

What are the 2 different septums on the heart?

A

atrial septum and ventricular septum (upper 1/4 is membranes and lower 1/3 is muscle in vent septum)

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25
Q

Right heart function

A

collects all venous return and propels it into the pulmonary circulation

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26
Q

Left heart function

A

collect blood returning from pulmonary circulation and propels it into systemic circulation

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27
Q

Right and Left atria

A

thinner walls than ventricles. most serve as resevoirs for ventricles. seperated by right and left interatrial septum

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28
Q

Right atrium receives blood from what?

A

superior vena cava, inferior vena cava, coronary sinus and Thebesian veings

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29
Q

Where does the superior vena cava get blood from?

A

arms and head

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30
Q

Where does the inferior vena cava get blood from?

A

abdomen and legs

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31
Q

Coronary sinus

A

very poorly oxygenated blood, comes from coronary circulation

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32
Q

Thebesian veins

A

venous return from heart muscle that doesnt go to coronary sinus

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33
Q

Left atrium receives blood from how many pulmonary veins?

A

4

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34
Q

Right and Left ventricles

A

thicker walls than atria. R. vent 4-5mm and L. vent 12-15 mm. In newborn walls are approx equal

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35
Q

Right ventricle

A

receives deoxygenated blood from RA, propels blood into pulmonary circulation. generates low pressures

36
Q

Left ventricle

A

receives oxygenated blood from LA. and some deoxygenated blood from Thebesian veins and propels blood into systemic circulation

37
Q

Heart valves

A

mechanical devices that permit flow in only one direction

38
Q

AV valves

A

seperate atria from ventricles

39
Q

Tricuspid valve

A

3 leaflets, on right side of heart

40
Q

Mitral (bidcuspid)

A

2 leaflets; on left side of heart. thicker and stronger than tricuspid

41
Q

papillary muscles

A

arise from endocardial surface. Attach to chordae tendineae

42
Q

Chordae tendineae

A

attach to AV valves

43
Q

Papillary muscles and chordae tendineae are know as what?

A

anchors

44
Q

valves open and close how?

A

passively

45
Q

Vavles open during what?

A

diastole (relax)

46
Q

Vavles close during what?

A

ventricular systole

47
Q

AV valves are what?

A

leakproof

48
Q

S1

A

sound of AV valves closing, lubb sound. may also impact of heart against chest wall.

49
Q

Semilunar valves

A

each has 3 half moons, dont have papillary muscles, open with vent. contraction, close during diastole, allow undirectional flow from vents. to arteries

50
Q

S2

A

sound of semilunar valves closing. dupp sound

51
Q

Valvular insufficiency

A

imperfect closing —> causes a leak (regurgitation)

52
Q

Prolapse

A

usually due to a torn papillary muscle or chordae

53
Q

Stenosis

A

narrowing of valve, due to infection, congenital; leads to backpressure

54
Q

Damage to cornary arteries can impair what?

A

myocardial function and electrical conduction

55
Q

What is the normal coronary blood flow?

A

225 mL/min (4-5% of CO)

56
Q

At rest venous PO2 of heart is?

A

2-30mmHg

57
Q

CvO2 of heart is what?

A

8-9 vol % therefor, O2 extraction is very high, and not much extraction reserve if inc. metabolism.

58
Q

Coronary arteries originate where?

A

at root of aorta

59
Q

Inlets

A

sinus of valsalva; just above aortic cusps.

60
Q

RCA

A

rises from anterior sinus of valsalva. passes around AV groove and splits into 2 branches (posterior descending and marginal)

61
Q

Anastomoses are what?

A

connections; a good thing

62
Q

LCA

A

rises from posterior sinus of Valsalva.

63
Q

lefts main coronary artery has what 2 branches?

A

left anterior descending which passes down AV groove and Circumflex which passes posteriorly

64
Q

Blockages in LCA is called what by doctors?

A

Widow Maker

65
Q

Coronary blood flow

A

most of blood flow is during diastole. Most of coronary venous return is to right atrium

66
Q

Intra Aortic Balloon Pump

A

balloon goes up aorta, during diastole it inflates and pumps blood back to coronary artery

67
Q

As VO2 increases what happens?

A

coronary arteries dilate

68
Q

Sympathetic nervous system

A

Fight or Flight. coronary arteries dilate (Beta effect).

69
Q

Parasympathetic nervous system

A

Rest and Digest. coronary arteries indirectly cause constriction

70
Q

+ chronotropic effect

A

inc HR

71
Q
  • chronotropic effect
A

dec HR

72
Q
  • inotropic effect
A

dec. force of contraction

73
Q

+ inotropic effect

A

inc force of contraction

74
Q

Heart disease of all types cause what number of deaths in US

A

1/4

75
Q

Atherosclerosis (ASHD)

A

systemic disease, most common cause of CAD

76
Q

Pathology of ASHD

A

cholesterol deposits under arterial intima, (CRP) ; which is an inflamm. agent that actively pulls cholesterol and macrophages from blood in arterial wall. Areas of deposit are invaded by fibrous tissue and may become calcified.

77
Q

Plaques can do what?

A

impede blood flow

78
Q

Acute coronary occlusion

A

usually preceded by serious ASHD

79
Q

Pathology of Acute coronary occlusion

A

plaque enlarges and breaks wall of intima. blood platelets adhere to rough surfaces therefor a clot is formed and grows until it occludes artery (thrombus) or it breaks and moves downstream (embolus), or arterial spasm (not common)

80
Q

Angina pectoris

A

chest pain due to myocardial ischemia. usually a result of ASHD. O2 demand exceeds blood flow to muscles.

81
Q

Angina pectoris usually occurs when?

A

with exercise, or emotional distress

82
Q

Angina pectoris is frequently relieved by what?

A

rest

83
Q

Other treatments for angina pectoris

A

Beta blockers, O2, nitroglycerin

84
Q

Acute Myocardial infarction (AMI)

A

occlusion of coronary artery –>muscle death

85
Q

Symptoms of AMI

A

(10% of MI’s are silent) chest pain (crushing; may radiate to arm, jaw back), sweating, SOB, pale, nausea, pain may not be relieved by nitro.

86
Q

Treatment of AMI

A

rest, O2 (only if evidence of hypoxia), morphine for pain, hypothermia, anti arrhythmics if needed, diuretics if in CHF, thrombolytics, aspirin, angioplasty (stent, laser balloon), coronary artery bypass graft

87
Q

Morbidity/Mortality of AMI due to?

A

arrhythmias, dec CO, congestive heart failure, rupture of infacted area

physiology Cardiac anatomy and coronary circulation (1 decks)

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