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Pathophysiology Cardiac > Module #1 - Heart: Anatomy and Function > Flashcards

Module #1 - Heart: Anatomy and Function Flashcards

1
Q

What are the 3 circulation systems of the cardiovascular system?

A

Pulmonary Circulation

Systemic Circulation

Coronary Circulation

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2
Q

Where is the pulmonary circulation supplied from?

A

Right side of the heart

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3
Q

Describe Blood flow in the pulmonary circulation (start w/ heart)?

A

R side of heart –> pulmonary trunk

Pulmonary trunk –> R/L Pulmonary arteries

Pulmonary arteries –> Capillaries surrounding alveoli

Capillaries –> pulmonary veins

Pulmonary veins –> L side of the heart

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4
Q

What is the function of pulmonary circulation?

A

Deliver blood to lungs for gas exchange

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5
Q

What is the pressure of the pulmonary circulation system compared to systemic pressure?

A

“Low pressure”

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6
Q

How does the volume of blood pumped per heart beat through the pulmonary circulation compared to systemic circulation?

A

Same amount of volume

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7
Q

Describe blood flow in the systemic circulation?

A

L side of the heart –> aorta

Aorta –> major blood vessels of body

Major blood vessels –> capillaries w/in each organ of the body

Capillaries –> venous system

Inferior/superior vena cava –> R side of the heart

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8
Q

What is the function of systemic circulation?

A

Deliver blood to every region of the body for gas exchange

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9
Q

How does the pressure of the systemic circulation compare to the pulmonary system?

A

High pressure

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10
Q

What is the function of coronary circulation?

A

Blood supply to the heart itself

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11
Q

Describe blood flow in the coronary circulation

A

L side of the heart –> aorta

Aorta –> R/L coronary arteries

R/L Coronaries –> Regional arterial branches

Arterial branches –> Coronary capillaries

Coronary capillaries –> Coronary veins

Coronary veins –> Coronary sinus

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12
Q

What are collateral arteries of the coronary circulation?

A

Anastomoses –> connections between r/l pathways or 2 branches of R or L coronary artery

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13
Q

What is arteriogenesis?

A

Collateral growth

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14
Q

When does arteriogenesis occur?

A

In response to coronary artery obstruction

remodeling allows for new/alternative blood flow pathways to supply myocardium

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15
Q

Describe blood flow through the 4 chambers of the heart

A

Right atrium –> Tricuspid valve (right AV valve)

Tricuspid valve –> Right ventricle

Right ventricle –> Right semilunar valve (pulmonary semilunar valve)

Lungs –> Left atrium

Left atrium –> Mitral valve (left AV valve)

Mitral valve –> Left ventricle

Left ventricle –> Left semilunar (aortic semilunar valve)

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16
Q

Where does the right atrium get its blood and what kind of blood does it get?

A

“Low oxygenated blood” from SVC, IVC, Coronary sinus (via coronary gens)

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17
Q

What does the tricuspid valve (right av valve) do?

A

Regulate blood flow from R atria –> R ventricle

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18
Q

Where does the right ventricle receive its blood and what kind of blood does it receive?

A

“Low oxygenated” from the R atrium

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19
Q

What is the shape of the right ventricle, and why is it shaped that way?

A

Triangularly shaped

Functions as “bellow” –> allows pumping of large volume into “low pressure” pulmonary circulation

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20
Q

What does the right semilunar valve do?

A

Regulate blood flow from right vent rile to pulmonary trunk

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21
Q

Where does the left atrium get its blood from and what kind of blood is it?

A

“Oxygenated blood” from 4 pulmonary veins (2 from right; 2 from left)

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22
Q

What does the mitral valve (left av valve) do?

A

Regulated blood flow between left atrium and left ventricle

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23
Q

Where does the left ventricle get its blood and what kind of blood is it?

A

“Oxygenated blood” from the left atrium

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24
Q

What is the shape of the left ventricle and why is it shaped like that?

A

“Bullet shaped” –> allows forceful pumping of blood into “high pressure” circulation

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25
Q

What does the left semilunar valve (aortic semilunar valve) do?

A

Regulates blood flow between left ventricle and aorta

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26
Q

Which phase is systole?

A

Contraction phase

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27
Q

What happens during systole?

A

Blood ejected from R/L ventricles into circulation

28
Q

Which phase is diastole?

A

Relaxation phase

29
Q

What happens during diastole?

A

Blood fills R/L ventricles

30
Q

Describe what happens during systole during the cardiac cycle

A

Isovolumetric contraction **first sound

Ventricular ejection

31
Q

Describe what happens during diastole during the cardiac cycle

A

Isovolumetric relaxation **second sound

Ventricular filling

Atrial systole

32
Q

Describe the mechanical events during the cardiac cycle

A

Atrial kick (atrial systole)

Isovolumetric ventricular contraction

Ventricular ejection

Isovolumetric Relaxation

Ventricular Filling

33
Q

What happens during Atrial kick?

A

Atria contract –> force additional blood into ventricles

AV valves = open

Semilunar valves = closed

34
Q

What happens during isovolumetric ventricular contraction?

A

Ventricles begin to contract –> AV snap shut (1st sound)

Ventricular pressure increases –> semilunar valves = shut

All valves = shut

35
Q

What happens during ventricular ejection?

A

Ventricular pressure exceeds vascular pressure forcing semilunar valves open

Blood ejects from ventricles

AV valves = close

Semilunar valves –> push open

36
Q

What happens during isovolumetric relaxation (beginning of diastole)?

A

Ventricular pressure falls below atrial pressure –> semilunar valves snap shut = 2nd heart sound

All valves = shut

@ End of this phase, venous blood returns to heart –> arterial pressures increase –> semilunar valves open = start of next phase

37
Q

What happens during ventricular filling?

A

Ventricles passively fill w/ blood

AV valves = open

Semilunar valves = closed

38
Q

What is the total time of the cardiac cycle (assuming there is a resting heart rate of 70 bpm)?

A

0.8 sec/beat

** systolic = 0.3 sec/beat; diastolic = 0.5 sec/beat

39
Q

What is the total time of the cardiac cycle (assuming there is an exercising heart rate of 180 bpm)?

A

0.33 sec/beat

**systolic = 0.2 sec/beat; diastolic = 0.13 sec/beat

40
Q

Based on the total time of the cardiac cycle in a resting/exercising heart, what is the increase in HR due to?

A

Dramatic shortening of the diastolic phase of the cardiac cycle

**ie less time to fil/less time for coronary circulation to occur

41
Q

What is the first heart sound that is heard and what is causing this sound?

A

S1 = lub

AV valves snap shut during the beginning of ventricular systole

42
Q

What is the second heart sound that is heard and what is causing this sound?

A

S2 = dub

Semilunar valves snap shut @ transition between ventricular systole and early diastole

43
Q

What is the third heart sound?

A

S3

Heart in kids/young adults

Vibration of ventricular walls from rush of blood into ventricles during rapid filling

44
Q

What is splitting of second heart sound?

A

Delayed interval between aortic/pulmonary semilunar valves –> reduplication of sound (physiological splitting)

45
Q

When do you heart splitting of the second heart sound?

A

Common during inspiration –> right pulmonary valve delayed

Hear in various pathologies

46
Q

What is a heart mumur?

A

Abnormal sounds heart over heart

47
Q

What causes a heart murmur?

A

Turbulent blood flow

Classic cardiac mumurs = valve dz

48
Q

What happens in stenosis that would cause a heart murmur?

A

Opening of valve is narrowed

49
Q

What happens during regurgitation/insufficiency that would cause a heart murmur?

A

Valve mechanically incompetent –> back flow

50
Q

What is a bruit?

A

Abnormal sounds heart throughout vascular system?

51
Q

What causes a bruit?

A

Turbulent blood flow

52
Q

What is resting heart rate (RHR)?

A

Normal = 70 bpm

53
Q

What is maximum heart rate (MHR) and how would you figure it out?

A

Estimate of maximum heart rate

220 - age = MHR

208 - (0.7 x age) = MHR

54
Q

What is the traditional method for calculating target heart rate (THR)?

A

MHR x chosen %

55
Q

What is the Karvonen formula that is used to calculate the heart rate reserve method?

A

[(MHR – RHR)] x chosen % + RHR

56
Q

What is the average resting stroke volume?

A

70 mL

57
Q

What is the average stroke volume in elite athletes?

A

90 - 100 mL

58
Q

What is the maximum SV during exercise in elite athletes?

A

150 - 200 mL

59
Q

How do you calculate cardiac output?

A

CO = SV x HR

60
Q

What is the average CO @ rest?

A

5 L/min

61
Q

What is the maximum CO during exercise?

A

20 - 30 L/min

62
Q

What is the ejection fraction (EF)?

A

% of the blood that is ejected from the ventricle

**proportion of the blood pumped out of the left ventricle w/ each beat

63
Q

How do you calculate the ejection fraction (EF)

A

EF = SV / EDV (end diastolic volume)

64
Q

What is the normal left ventricular EF (LVEF) @ rest?

A

55 - 68%

65
Q

What is the normal right ventricular EF (RVEF) @ rest?

A

slightly less than LVEF

66
Q

What are the clinical base line for EF?

A

Normal = 50 (or 55) - 70%

Below Normal = 40 - 50%

Diagnostic/increased risk of arrhythmia = < 35 - 40%

67
Q

What happens to EF during exercise?

A

Increase 5 - 15% above resting value

Pathophysiology Cardiac (4 decks)

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