Module 11: Cardiovascular System Flashcards
What are the 3 types of blood vessels in the body?
- arteries, 2. veins, 3. capillaries
arteries
large blood vessels that carry blood away from the heart.
endothelium
the walls of arteries are lined with connective tissue, muscle tissue, and elastic fibers with an innermost layer of epithelial cells
endothelial cells
found in blood vessels, secrete factors that affect the size of blood vessels, reduce blood clotting, and promote the growth of blood vessels
arterioles
smaller branches of arteries, they are thinner than arteries and carry the blood to the tiniest of blood vessels
capillaries
the tiniest of blood vessels, carry nutrient-rich, oxygenated blood from the arteries and arterioles to the body cells
venules
waste-filled blood then flows back to the heart which combine to form large vessels
veins
the large vessels of venules, have thinner walls compared with arteries and bring deoxygenated blood back to the heart
valves
prevent the backflow of blood and keep the blood moving in one direction
What colour is oxygenated blood?
Bright red blood in arteries
What colour is deoxygenated blood?
Dark red/ maroon in veins
Why are my veins blue?
From the outside of the body, blood in veins appears blue because the colour reflects off the skin
How much blood is in the body?
the average adult has about 5 quarts (4.7 liters) of blood in his or her body
What is the length of all the blood vessels?
the total length of all the blood vessels in the body is 60,000 miles
What does EDRF stand for?
Endothelium-Derived Relaxing Factor
List the order of how blood leaves the heart and returns to it
- heart
- arteries
- arterioles
- tissue capillaries
- venules
- veins
- heart
vena cavae
deoxygenated blood flowing through two large veins on its way from the tissue capillaries to the heart
where does oxygen-poor blood enter?
Enters the right side of the heart and travels through that side and into the pulmonary artery
pulmonary artery
a vessel that divides in two; one branch leading to the left and the other to the right, continues dividing and subdividing within the lungs and finally reaching the lung capillaries
pulmonary veins
the newly oxygenated blood from the pulmonary capillaries returns immediately to the heart
what is the important exception of the pulmonary veins?
they are the only veins that carry oxygen-rich blood in the body
pulmonary circulation
the circulation of blood through the vessels from the heart to the lungs and then back to the heart again
where does oxygen-rich blood enter?
the left side of the heart from the pulmonary veins
aorta
the largest single artery in the body
systemic circulation
blood flows from the heart to tissue capillaries and back to the heart
carotid arteries
supply blood to the head and neck
pulse
the beat of the heart felt through the walls of arteries
pulse points
specific places along the body where you can feel the pulse easily
facts about the human heart
weighs less than a pound, roughly the size of an adult fist, and lies in the thoracic cavity just behind the breastbone in the mediastinum
where is the heart located?
behind the breastbone in the thoracic cavity/ mediastinum, the bottom of the heart (apex) below the 5th rib, the top of the heart (base) below the 2nd rib, and rests in the diaphragm tilted to the left
apex
the lower border of the heat that forms a blunt point just below the 5th rib
base
the upper border of the heart just below the 2nd rib
atria (singular: atrium)
the two upper chambers of the heart (right and left)
ventricles
the two lower chambers of the heart (right and left)
superior vena cava
one of the largest veins in the body, drains blood from the upper portion of the body
inferior vena cava
one of the largest veins in the body, carries blood from the lower part of the body
where does vena cava blood go?
oxygen-poor blood that has passed through all of the body toward the right atrium
right atrium
the thin-walled upper right chamber of the heart
tricuspid valve
the right atrium contracts to force blood through this valve, cusps are the flaps of the valves into the right ventricle that form a one-way passage
right ventricle
the lower right chamber of the heart, as it contracts it pumps blood through the pulmonary valve into the pulmonary artery
where does the pulmonary artery bring the blood?
it branches to carry oxygen-deficient blood to each lung, which loses its large quantity of carbon dioxide into the lung tissue and is expelled at the same time as oxygen enters and is brought back to the heart via
what veins bring the oxygen-rich blood back to the heart from the lungs?
the pulmonary veins (only veins that carry oxygen-rich blood)
What is the flow of newly oxygenated blood in the heart?
enters the left atrium of the heart from the pulmonary veins, then contracts to force blood through the mitral valve into the left ventricle, propels blood through the aortic valve into the aorta
which chamber has the thickest walls in the heart? and why?
the left ventricle because it must pump blood with great force so that the blood travels through arteries to all parts of the body
septa (singular: septum)
partitions that separate the four chambers of the heart
interatrial septum
separates the two upper chambers (atria)
interventricular septum
a muscular wall that lies between the two lower chambers (ventricles)
endocardium
a smooth layer of endothelial cells that lines the interior of the heart and heart valves
myocardium
the middle, muscular layer of the heart wall which is the thickest layer
pericardium
a fibrous and membranous sac that surrounds the heart and is composed of two layers, the visceral pericardium and the parietal pericardium
what are the 3 layers of the heart?
- endocardium, 2. myocardium, 3. pericardium
visceral pericardium
one of the two layers of the pericardium that adheres to the heart
parietal pericardium
one of the two layers of the pericardium lining the outer fibrous coat (parietal means wall)
pericardial cavity
between the visceral and the parietal pericardial layers, normally contains 10-15 mL of pericardial fluid
What is the purpose of pericardial fluid?
lubricates the membranes as the hearts beat
what are the two phases of the heartbeat?
diastole and systole
diastole
when the ventricle wall relaxes and blood flows into the heart from the vena cavae and the pulmonary veins. The tricuspid and mitral valves open
systole
the walls of the right and left ventricles contract to pump blood into the pulmonary artery and the aorta. The tricuspid and mitral valves are closed
“lubb-dubb”
the audio sounds of the normal cardiac cycle that can be heard with a stethoscope
“lubb”
the sound associated with the closure of the tricuspid and mitral valves at the beginning of systole (S1)
“dubb”
the sound associated with the closure of the aortic and pulmonary valves at the end of systole (S2)
murmur
sometimes the flow of blood through the valves can produce an abnormal swishing sound
sinoatrial node (SA)
aka a pacemaker of the heart, an electrical pulse that is responsible for initiating the heartbeat rests with a small region of specialized muscles tissue in the posterior portion of the right atrium
How does a pacemaker work?
the current of electricity generated by the pacemaker causes the walls of the atria to contract and force blood into the ventricles
atrioventricular node (AV node)
a region withing the interatrial septum that immediately sends the excitation wave to a bundle of specialized muscle fibers called the atrioventricular bundle
atrioventricular bundle or bundle of His
a bundle of specialized muscle fibers that divides into the left bundle branch and the right bundle branch
what do the left and right bundle branches do?
they form the conduction myofibers that extend through the ventricle walls and contract on stimulation causing systole to occur
electrocardiogram (ECG or EKG)
the record used to detect the electrical changes in the heart muscle as the heart beats
deflections
represent the electrical changes as a wave of excitation spreads through the heart (usually appears as 5 waves on an ECG)
What are the deflection waves called?
P, QRS, and T waves
normal sinus rhythm (NSR)
the heart rhythm originating in the SA node and travelling through the heart
sympathetic nerves
nerves that speed up the heart rate during conditions of emotional stress or vigorous exercise
parasympathetic nerves
nerves that slow the heart rate when there is no need for extra pumping
blood pressure
the force that the blood exerts on the arterial walls
sphygmomanometer
an instrument used to measure blood pressure
sphygm/o
pulse
man/o
pressure
-meter
instrument
how is blood pressure expressed?
as a fraction e.g., 120/80 mm Hg
120 = is the systolic pressure
80 = is the diastolic pressure
hypertension
high blood pressure that is defined as blood pressure greater than 140/90 mm Hg and has an associated risk with heart attacks and strokes
systole in a healthy adult
pressure range is less than 120 mm Hg
diastolic in a healthy adult
pressure is less than 80 mm Hg
artery
the largest type of blood vessel; carries blood away from the heart to all parts of the body
capillary
the smallest blood vessels; materials pass to and from the bloodstream through the thin walls
carbon dioxide
gas (waste) released by body cells, transported via veins to the heart, and then to the lungs for exhalation
coronary arteries
blood vessels that branch from the aorta and carry oxygen-rich blood to the heart muscle
normal sinus rhythm
heart rhythm originating in the sinoatrial node with a rate in patients at rest of 60 to 100 beats per minutes
oxygen
a gas that enters the blood through the lungs and travels to the heart to be pumped via arteries to all body cells
angi/o
vessel
aort/o
aorta
arter/o, arteri/o
artery
arther/o
yellowish plaque, fatty substance
atri/o
atrium, upper heart chamber
brachi/o
arm
cardi/o
heart
cholesterol/o
cholesterol (a lipid substance)
coron/o
heart
cyan/o
blue
myx/o
mucus
ox/o
oxygen
pericardi/o
pericardium
phleb/o
vein
rhythm/o
rhythm
steth/o
chest
thromb/o
clot
-scope
instrument
valvul/o, valv/o
valve
vas/o
vessel
vascul/o
vessel
ven/o, ven/i
vein
ventricul/o
ventricle, lower heart chamber
arrythmias
abnormal heart rhythms (dysrhythmias)
List the different types of heart arrythmias
- bradycardia and heart block, 2. flutter, 3. fibrillation
bradycardia and heart block (atrioventricular block)
failure of proper conduction of impulses from the SA node through the AV node to the atrioventricular bundle (bundle of His)
Biventricular pacemaker
a newer type of pacemaker that reduces exacerbations of heart failure that require hospital admission
cardiac pacemaker
an artificial heart that overcomes arrhythmias and keeps the heart beating at the proper rate
List the different types of congenital heart disease
- coarctation of the aorta (CoA), 2. patent ductus arteriosus (PDA), 3. septal defects, 4. tetralogy of Fallot
flutter
rapid but regular contractions, usually of the atria
fibrillation
very rapid, random, inefficient, and irregular contractions of the heart (350 beats or more per minute)
atrial fibrillation (AF)
the most common type of cardiac arrhythmia, electrical impulses move randomly throughout the atria to quiver instead of contracting in a coordinated rhythm
what are common symptoms of arrhythmias?
palpitations, fatigue, and shortness of breath
palpitations
uncomfortable sensations in the chest from missed heartbeats
paroxysmal AF
irregular heartbeats occur periodically and episodically
permanent or persistent AF
irregular heartbeats continue indefinitely
ventricular fibrillation (VF)
electrical impulses move randomly throughout the ventricles
cardiac arrest
sudden stoppage of heart movement
defibrillation
application of an electrical shock stops electrical activity in the heart for a brief moment so that normal rhythm takes over
What types of medication convert fibrillation into a normal sinus rhythm?
digoxin, beta-blockers, and calcium channel blockers
implantable cardioverter-defibrillator (ICD)
a small electrical device that is implanted inside the chest (near the collarbone) to sense arrhythmias and terminate them with an electric shock
automatic external defibrillators (AED)
device found in public spaces that can be used in an emergency situation to reverse ventricular fibrillation
catheter ablation
a minimally invasive treatment to treat cardiac arrhythmias, using radiofrequency energy is delivered from the tip of a catheter inserted through a blood vessel and into the heart, destroys tissue that causes arrhythmias
congenital heart disease
abnormalities in the heart at birth
coarctation of the aorta (CoA)
narrowing (coarctation) of the heart
patent ductus arteriosus (PDA)
passageway (ductus arteriosus) between the aorta and the pulmonary artery remains open (patent) after birth
septal defects
small holes in the wall between the atria (atrial septal defects) or the ventricles (ventricular septal defects)
tetralogy of Fallot
congenital malformation involving four (tera-) distinct heart defects
pulmonary artery stenosis
pulmonary artery is narrow or obstructed
ventricular septal defect
large hole between two ventricles lets venous blood pass from the right to the left ventricle and out to the aorta without oxygenation
shift of the aorta to the right
aorta overrides the interventricular septum. Oxygen-poor blood passes from the right ventricle to the aorta
hypertrophy of the right ventricle
myocardium works harder to pump blood through a narrowed pulmonary artery
an infant describe as a “blue baby”
a condition of cyanosis of the extreme disease present at birth
transposition of the great arteries (TGA)
pulmonary artery arises from the left ventricle and the aorta from the right ventricle
congestive heart failure (CHF)
the heart is unable to pump its required amount of blood
systolic CHF
the left ventricular dysfunction results in a low ejection fraction (the amount of blood that leaves the left ventricle), less blood is pumped from the heart
diastolic CHF
the heart can contract normally but is “stiff” or less compliant when relaxed or filling with blood
what is the most common cause of diastolic CHF?
hypertension
pulmonary edema
fluid accumulation in the lungs
left ventricular assist device (LVAD)
a booster pump implanted in the abdomen, with a cannula (tube) inserted into the left ventricle. It pumps blood out of the heart to all parts of the body
coronary artery disease (CAD)
disease of the arteries surrounding the heart
atherosclerosis
the deposition of fatty compounds on the inner lining of the coronary arteries, usually a result of CAD
thrombotic occulsion
blocking of the coronary artery by a clot
ischemia
blood flow is decreased or stopped entirely
necrosis
death (part of something)
myocardial infarction
blood flow is decreased or stopped entirely, leading to the death of a part of the myocardium (aka a heart attack?)
acute coronary syndromes (ACSs)
conditions caused by myocardial ischemia, conditions are unstable angina and myocardial infarction
unstable angina
chest pain at rest or chest pain of increasing frequency
What does AMI stand for?
Acute Myocardial Infarction
nitrates
a drug known as a vasodilator that increase coronary blood flow and lowers blood pressure
aspirin
a drug to prevent clumping of platelets
beta-blockers
a drug to reduce the force and speed of the heartbeat and to lower blood pressure
ACE inhibitors
a drug to reduce high blood pressure and the risk of future heart attack even if the patient is not hypertensive
calcium channel blockers
a drug to relax muscles in blood vessels
statins
a drug to lower cholesterol levels
coronary artery bypass grafting (CABG)
an open heart operation to treat CAD by replacing clogged vessels
percutaneous coronary intervention (PCI)
a catheterization with balloons and stents opens clogged coronary arteries
endocarditis
inflammation of the inner lining of the heart
petechiae
pinpoint hemorrhages
hypertensive heart disease
high blood pressure affecting the heart
mitral valve prolapse (MVP)
improper closure of the mitral valve
auscultation
listening with a stethoscope
murmur disease
an extra heart sound, heard between normal beats
bruit
an abnormal sound or murmur heard on auscultation
thrill
a vibration felt on palpation of the chest, often accompanied by a murmur
pericarditis
inflammation of the membrane (pericardium) surrounding the heart
pericardial friction rub
heard as a scraping or grating sound
cardiac tamponade
compression of the heart caused by collection of fluid in the pericardial cavity
xenograft valve
is tissue that is transferred from an animal of one species (pig) to one of another species (human)
rheumatic heart disease
heart disease caused by rheumatic fever
vegetations
lesions on the heart that look like cauliflower
aneurysm
local widening (dilation) of an arterial wall
what does AAA stand for?
Abdominal Aortic Aneurysm
What does EVAR stand for?
Endovascular Aneurysm Repair
What does TEVAR stand for?
Thoracic Endovascular Aneurysm Repair
deep vein thrombosis (DVT)
blood clot (thrombus) forms in a large vein usually in a lower limb
hypertension (HTN)
high blood pressure
peripheral arterial disease (PAD)
blockage of arteries carrying blood to the legs, arms, kidneys, and other organs
where is the carotid artery located?
neck
where is the femoral artery located?
thigh
where is the popliteal artery located?
back of the knee
intermittent claudication
absence of pain or discomfort in a leg at rest, but pain, tension, and weakness after walking has begun
embolic protection devices
parachute-like filters used to capture embolic debris during stenting
Raynaud disease
recurrent episodes of pallor and cyanosis primarily in fingers and toes
Raynaud phenomenon
similar condition of arterial insufficiency but is secondary to arterial narrowing from other conditions
varicose veins
abnormally swollen and twisted veins, usually occurring in the legs
hemorrhoids
varicose veins near the anus
BNP test
measurement of BNP (brain natriuretic peptide) in blood
cardiac biomarkers
chemicals are measured in the blood as evidence of a heart attack
lipid tests (lipid profile)
measurement of cholesterol and triglycerides (fats) in a blood sample
saturated fats
fats from animal origin, such as milk, butter, and meats increase cholesterol in blood
polyunsaturated fats
fats from vegetable origin, such as corn and safflower oil decrease cholesterol in blood
lipoprotein electrophoresis
lipoproteins (combinations of fat and protein) are physically separated and measured in a blood sample
What does LDL stand for?
Low-Density of Lipoprotein
What does HDL stand for?
High-Density of Lipoprotein
angiography
x-ray imaging of blood vessels after injection of contrast material
arteriography
x-ray imaging of arteries after injection of contrast materials via a catheter into the aorta or an artery
computed tomography angiography (CTA)
3-D x-ray images of the heart and coronary arteries using computed tomography (64-slice CT scanner)
digital subtraction angiography (DSA)
video equipment and a computer produce x-ray images of blood vessels
electron beam computed tomography (EBCT or EBT)
electron beams and CT identify calcium deposits in and around coronary arteries to diagnose early CAD
coronary artery calcium score
derived to indicate future risk of heart attack and stroke
Doppler ultrasound studies
sound waves measure blood flow within blood vessels
duplex ultrasound
combines Doppler and conventional ultrasound to allow physicians to image the structure of blood vessels and measure the speed of blood flow
high risk on the coronary artery calcium score
> 400 (associated with a nearly 25% chance of a heart attack or stroke occurring within 10 years)
intermediate risk on the coronary artery calcium score
100-399
low risk on the coronary artery calcium score
0-99
echocardiography (ECHO)
echoes generated by high-frequency sound waves produce images of the heart
transesophageal echocardiography (TEE)
a transducer placed in the esophagus provides ultrasound and Doppler information, this technique detects cardiac masses, prosthetic valve function, aneurysms, and pericardial fluid
positron emission tomography (PET) scan
images show blood flow and myocardial function following uptake of radioactive glucose
technetium Tc 99m sestamibi scan
technetium Tc 99m sestamibi is injected intravenously is taken up in cardiac tissue, where it is detected by scanning
What does ETT-MIBI stand for?
Exercise Tolerance Test combined with a radioactive tracer (sestamibi) scan
thallium 201 scan
concentration of radioactive thallium is measured to give information about blood supply to the heart muscle
cardiac MRI
images of the heart are produced using radiowave energy in a magnetic field
What does MRA stand for?
Magnetic Resonance Angiography
Gadolinium
the most common contrast agent used for MRI procedures
cardiac catheterization
thin, flexible tube is guided into the heart via a vein or an artery
electrocardiography (ECG)
recording of electricity flowing through the heart
telemetry
electronic transmission of data
tele/o
distant
Holter monitoring
an ECG device is worn during a 24-hour period to detect cardiac arrhythmias
stress test
exercise tolerance test (ETT) determines the heart’s response to physical exertion (stress)
catheter ablation
brief delivery of radiofrequency energy to destroy areas of heart tissue that may be causing arrhythmias
coronary artery bypass grafting (CABG)
arteries and veins are anastomosed to coronary arteries to detour around bloackges
What does ICD stand for?
Implantable Cardioverter-Defibrillator
What does AICD stand for?
Automatic Implantable Cardioverter-Defibrillator
Cardioversion
another technique using lower energy to treat atrial fibrillation, atrial flutter, and supraventricular tachycardia
endarterectomy
surgical removal of plaque from the inner layer of an artery
extracorporeal circulation
heart-lung machine diverts blood from the heart and lungs while the heart is repaired
What does ECMO stand for?
Extracorporeal Membrane Oxygenation
heart transplantation
a donor heart is transferred to a recipient
percutaneous coronary intervention (PCI)
balloon-tipped catheter is inserted into a coronary artery to open the artery; stents are put in place
What does DESs stand for?
Drug-Eluting Stents
drug-eluting stents
are coated with polymers that elute (release) antiproliferative drugs to prevent scar tissue formation leading to restenosis
thrombolytic therapy
drugs to dissolve clots are injected into the bloodstream of patients with coronary thrombosis
What does tPA stand for?
Tissue Plasminogen Activator
steptokinase
a drug to help restore blood flow to the heart and limit irreversible damage to the heart muscles
transcatheter aortic valve replacement (TAVR)
placement of a balloon-expandable aortic heart valve into the body via a catheter
what does TAVR stand for?
Transcatheter Aortic Valve Replacement
Mitral valve prolapse (MVP)
a condition in which the valve between the left atrium and ventricle becomes enlarged and protrudes into the left atrium during systole
Raynaud’s disease
an abnormality that refers to the intermittent ischemic attacks that affect arterioles of the skin
Patent ductus arteriosus
a congenital heart disease in which the blood flows from the aorta into the pulmonary artery through this small opening
ventricular fibrillation
a serious cardiac arrhythmia that can result in sudden cardiac arrest
diastolic congestive heart failure
a condition when fluid backs up in the lungs and other parts of the body
deep vein thrombosis
a condition when a blood clot forms in a large vein, usually in a lower limb
