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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
Right heart function
collects all venous return and propels it into the pulmonary circulation
26
Left heart function
collect blood returning from pulmonary circulation and propels it into systemic circulation
27
Right and Left atria
thinner walls than ventricles. most serve as resevoirs for ventricles. seperated by right and left interatrial septum
28
Right atrium receives blood from what?
superior vena cava, inferior vena cava, coronary sinus and Thebesian veings
29
Where does the superior vena cava get blood from?
arms and head
30
Where does the inferior vena cava get blood from?
abdomen and legs
31
Coronary sinus
very poorly oxygenated blood, comes from coronary circulation
32
Thebesian veins
venous return from heart muscle that doesnt go to coronary sinus
33
Left atrium receives blood from how many pulmonary veins?
4
34
Right and Left ventricles
thicker walls than atria. R. vent 4-5mm and L. vent 12-15 mm. In newborn walls are approx equal
35
Right ventricle
receives deoxygenated blood from RA, propels blood into pulmonary circulation. generates low pressures
36
Left ventricle
receives oxygenated blood from LA. and some deoxygenated blood from Thebesian veins and propels blood into systemic circulation
37
Heart valves
mechanical devices that permit flow in only one direction
38
AV valves
seperate atria from ventricles
39
Tricuspid valve
3 leaflets, on right side of heart
40
Mitral (bidcuspid)
2 leaflets; on left side of heart. thicker and stronger than tricuspid
41
papillary muscles
arise from endocardial surface. Attach to chordae tendineae
42
Chordae tendineae
attach to AV valves
43
Papillary muscles and chordae tendineae are know as what?
anchors
44
valves open and close how?
passively
45
Vavles open during what?
diastole (relax)
46
Vavles close during what?
ventricular systole
47
AV valves are what?
leakproof
48
S1
sound of AV valves closing, lubb sound. may also impact of heart against chest wall.
49
Semilunar valves
each has 3 half moons, dont have papillary muscles, open with vent. contraction, close during diastole, allow undirectional flow from vents. to arteries
50
S2
sound of semilunar valves closing. dupp sound
51
Valvular insufficiency
imperfect closing ---> causes a leak (regurgitation)
52
Prolapse
usually due to a torn papillary muscle or chordae
53
Stenosis
narrowing of valve, due to infection, congenital; leads to backpressure
54
Damage to cornary arteries can impair what?
myocardial function and electrical conduction
55
What is the normal coronary blood flow?
225 mL/min (4-5% of CO)
56
At rest venous PO2 of heart is?
2-30mmHg
57
CvO2 of heart is what?
8-9 vol % therefor, O2 extraction is very high, and not much extraction reserve if inc. metabolism.
58
Coronary arteries originate where?
at root of aorta
59
Inlets
sinus of valsalva; just above aortic cusps.
60
RCA
rises from anterior sinus of valsalva. passes around AV groove and splits into 2 branches (posterior descending and marginal)
61
Anastomoses are what?
connections; a good thing
62
LCA
rises from posterior sinus of Valsalva.
63
lefts main coronary artery has what 2 branches?
left anterior descending which passes down AV groove and Circumflex which passes posteriorly
64
Blockages in LCA is called what by doctors?
Widow Maker
65
Coronary blood flow
most of blood flow is during diastole. Most of coronary venous return is to right atrium
66
Intra Aortic Balloon Pump
balloon goes up aorta, during diastole it inflates and pumps blood back to coronary artery
67
As VO2 increases what happens?
coronary arteries dilate
68
Sympathetic nervous system
Fight or Flight. coronary arteries dilate (Beta effect).
69
Parasympathetic nervous system
Rest and Digest. coronary arteries indirectly cause constriction
70
+ chronotropic effect
inc HR
71
- chronotropic effect
dec HR
72
- inotropic effect
dec. force of contraction
73
+ inotropic effect
inc force of contraction
74
Heart disease of all types cause what number of deaths in US
1/4
75
Atherosclerosis (ASHD)
systemic disease, most common cause of CAD
76
Pathology of ASHD
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
Plaques can do what?
impede blood flow
78
Acute coronary occlusion
usually preceded by serious ASHD
79
Pathology of Acute coronary occlusion
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
Angina pectoris
chest pain due to myocardial ischemia. usually a result of ASHD. O2 demand exceeds blood flow to muscles.
81
Angina pectoris usually occurs when?
with exercise, or emotional distress
82
Angina pectoris is frequently relieved by what?
rest
83
Other treatments for angina pectoris
Beta blockers, O2, nitroglycerin
84
Acute Myocardial infarction (AMI)
occlusion of coronary artery -->muscle death
85
Symptoms of AMI
(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
Treatment of AMI
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
Morbidity/Mortality of AMI due to?
arrhythmias, dec CO, congestive heart failure, rupture of infacted area

physiology Cardiac anatomy and coronary circulation (1 decks)

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