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MEDSCI 142 > Module 3.1 - Cardiovascular Anatomy > Flashcards

Module 3.1 - Cardiovascular Anatomy Flashcards

1
Q

total blood volume

A

5L

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2
Q

blood output from one pump (ventricle)

A

5L per min

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3
Q

pulmonary circuit blood volume

A

9%

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4
Q

pulmonary circuit pressure

A

medium pressure circuit due to proximity of lungs to heart (“low pressure” used for veins in tissues)

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5
Q

systemic circuit blood volume

A

84%

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6
Q

systemic circuit pressure

A

high pressure circuit as it encounters high systemic resistance

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7
Q

systemic arteries pressure

A

120 - 80 mmHg

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8
Q

pulmonary arteries/trunk pressure

A

~27 mmHg

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9
Q

blood vessel function

A

expand/contract to direct blood to the target circuit/organ

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10
Q

deoxygenated blood

A

never see purple/blue blood outside body since as soon as blood comes in contact with air, it picks up oxygen

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11
Q

ventricular pumps blood volume

A

7% (most of the time in circulation)

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12
Q

valves in filling phase

A

inlet: open
outlet: closed to prevent arterial blood from returning to the pump

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13
Q

ventricles in filling phase

A

high volume
low pressure

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14
Q

valves in ejection phase

A

inlet: closed to prevent high-pressure blood in pumping chamber from returning to veins
outlet: open

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15
Q

ventricles in ejection phase

A

low volume
high pressure

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16
Q

atrium

A

receiving chamber/reservoir

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17
Q

atrium ejection phase

A

inlet valve closed => atrium accumulates venous blood

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18
Q

atrium filling phase

A

accumulated blood enters ventricle quickly

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19
Q

auricle

A

an appendage that increases capacity of atrium

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20
Q

position of pump inlet/outlet

A

lie closer together on same side => walls of pumping chamber can shorten in length AND width

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21
Q

blood flow through heart

A

right side = deoxygenated
left side = oxygenated
vertical orientation = systemic circuit
horizontal orientation = pulmonary circuit

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22
Q

pressures

A

RA: 5 mmHg
RV: 27 mmHg
LA: 8 mmHg
LV: 120 mmHg

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23
Q

trends in pressures

A
  • pulmonary has lower return/receiving pressure than systemic as small circuit => pressure retained
  • left pressure is 4 times right
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24
Q

valve expansion

A

passive - rely on elastic recoil

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25
Q

chordae tendineae

A

prevent valves from inverting (flaps from bursting upwards into atrium during systole)
- in atrioventricular valves

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26
Q

types of valves

A
  • atrioventricular
  • semilunar
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27
Q

atrioventricular valves

A

INTO ventricle

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28
Q

semilunar valves

A

OUT OF ventricle

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29
Q

atrioventricular valves

A
  • bicuspid / mitral (left)
  • tricuspid (right)
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30
Q

semilunar valves

A
  • aortic (left)
  • pulmonary (right)
    both have 3 cusps
    no tendonous chords or papillary muscle
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31
Q

papillary muscles

A

apply enough tension to prevent valves from being pushed back
- not related to valve opening
- in atrioventricular valves

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32
Q

semilunar valves mechanism

A

pressure of blood trying to re-enter the ventricle forces the free edges of the cusps tightly together by filling up the pockets
- more force => pushed tighter together

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33
Q

ventricle pressure/wall thickness/volume

A

left:right
pressure - 5:1
wall thickness - 3:1
volume: 120 mL for both

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34
Q

inlet valve diameter

A

large diameter to admit blood at low pressure

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35
Q

outlet valve diameter

A

small diameter as blood leaves at high pressure (can be forced out)

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36
Q

orientation of heart

A

one third of heart’s mass lies to the right of the midline of the body and two thirds to the left

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37
Q

right border

A

formed mainly by right atrium

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38
Q

superior border

A

= blood vessels = base

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39
Q

inferior border

A

formed mainly by right ventricle sitting on the diaphragm (+ apex)

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40
Q

left border

A

formed mainly by left ventricle as well as the left auricle/atrium

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41
Q

apex

A

points inferiorly, anteriorly and to the left

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42
Q

rheumatic fever

A

body produces antibodies that attack own tissue - vulnerable: collagenous leaflet of outlet (esp aortic) valve => cusps lose integrity => seams between cusps fuse => aortic stenosis (narrowing) => ventricles need to work harder to eject blood out => walls thicken => lumen shrinks => holds less volume => coronary arteries struggle to supply blood to the heart => ischemia => heart failure

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43
Q

pericardium (peritoneum, pleura)

A

universal way of body dealing with friction
- lubricating outside of organ by enclosing in a double-walled bag

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44
Q

visceral pericardium

A
  • inner wall
  • adheres to heart
  • forms outer surface of heart
  • aka epicardium
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45
Q

parietal pericardium

A
  • outer wall
  • lines a tough fibrous sac (fibrous pericardium)
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46
Q

both layers of pericardium are:

A
  • single layer of squamous mesothelial cells
  • continuous where great vessels enter/exit heart
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47
Q

order of layers of heart

A

lumen -> endocardium -> myocardium -> epicardium / visceral pericardium -> pericardial space (serous fluid) -> parietal pericardium -> fibrous pericardium -> outside pericardial sack

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48
Q

cardiac tamponade

A

if left ventricle punctured => blood goes into pericardial space and doesn’t return => affect heart’s ability to fill (passive process)
- can’t be caught easily
- pericardial cavity filling up with fluid

49
Q

fibrous skeleton of heart

A
  • present in mitral / aortic
  • absent in pulmonary and incomplete in tricuspid (associated with low-pressure pulmonary pump)
  • made of dense connective tissue
50
Q

where fibrous skeleton is incomplete….

A

there is fatty connective tissue

51
Q

fibrous skeleton function

A
  • provide structural support for high pressure valves of heart
  • insulate ventricular myocardium from electrical activity of atria except at AV node
52
Q

flow of electrical conduction through heart

A

SA node (initiate) -> atrial muscle -> atrial node -> atrioventricular bundle -> bundle of His -> right and left bundle branches -> Purkinje fibres

53
Q

SA node

A

modified cardiac cells
- can depolarise/repolarise by themselves
- also influenced by nerves (sympathetic => speed up and parasympathetic => slow down)
- right atrial wall near opening of superior vena cava

54
Q

purkinje cells

A
  • not branched
  • don’t contract
  • good at conducting AP
55
Q

SA node -> atrial muscle speed

A

slow
0.5 m/s

56
Q

SA node -> atrial muscle result

A

uniform atrial contraction

57
Q

atrioventricular node speed

A

very slow
0.05 m/s

58
Q

AV node result

A

100 ms delay
- needed as without this, atria contract at same rate as ventricle which can’t keep up => want ventricle to contract after atria has had a chance to contract

59
Q

AV bundle -> purkinje fibres speed

A

fast
5 m/s

60
Q

AV bundle -> purkinje fibres result

A

complete/uniform ventricular contraction (systole)

61
Q

nerves speed

A

50 m/s

62
Q

five stages of the cardiac cycle

A

1) ventricular filling
2) atrial contraction
3) isovolumetric ventricular contraction
4) ventricular ejection
5) isovolumetric ventricular relaxation

63
Q

cardiac cycle

A

includes all events associated with one heartbeat
- forcing blood from areas of high to low pressure

64
Q

ventricular filling

A
  • vent P < atrial P
  • mitral valve opens
  • blood enters ventricle
  • ventricle fills 80% of its capacity (~105 mL)
  • aorta P = 90 mm Hg
  • LA P = 5 mm Hg
  • LV P = < 5 mm Hg
65
Q

atrial contraction

A
  • atrial systole / ventricular diastole
  • 0.1 sec
  • natural depolarisation of SA node => LA contracts to complete filling (last 25 mL top up)
  • only small rise in atrial pressure
  • end diastolic volume = ~130 mL
66
Q

why only small rise in atrial pressure during atrial contraction

A

1) atrial muscle layer is thin
2) no inlet valves for atria
=> nothing to prevent backflow into veins

67
Q

isovolumetric ventricular contraction

A
  • ventricular systole / atrial diastole
  • 0.3 sec
  • isometric ventricular muscle contraction
  • all valves closed (mitral: closes due to backflow towards atrium, aortic: still closed due to insufficient ventricular pressure)
  • first heart beat
  • atrial P < increasing vent P < arterial P
  • highest volume
  • ends when vent P > arterial P
  • mitral regurgitation likely
68
Q

mitral regurgitation

A

blood regurgitation from LV to LA during ventricular systole due to failure of valves closing properly
- as soon as vent P > atrial P, regurgitation may occur

69
Q

ventricular ejection

A
  • ventricular systole continues
  • 0.25 sec
  • vent P > aortic P (both rise steeply as blood is ejected into aorta faster than it runs off into distributing arteries)
  • aortic valve opens
  • blood leaves ventricle
70
Q

isovolumetric ventricular relaxation

A
  • ventricle relaxes
  • 0.4 sec (total diastole)
  • atrial P < decreasing vent P < arterial P (vent P drops suddenly as its size increases - no contraction)
  • all valves closed (aortic: closes due to backflow in aorta, mitral: still closed as vent P < atrial P)
  • second heart beat
  • ends when vent P > atrial P
71
Q

ventricles in isovolumetric relaxation/contraction

A

vent P is isolated from the rest of the circulation

72
Q

stroke volume

A

volume ejected per beat from each ventricle
- ~70 mL (130 - 60 mL) at rest

73
Q

ejection fraction

A

indicator of how efficient ventricle is at emptying itself
= stroke volume / end diastolic volume
normally 60-70%

74
Q

normal ranges of measured blood pressure

A

max. arterial (systolic) pressure/min. of arterial (diastolic) pressure
- young women: 115/75
- other: 120/80

75
Q

min. arterial pressure

A

how good peripheral blood vessels are

76
Q

why does ventricular pressure go up and down during ventricular ejection

A

up: more stretched => greater force => fill artery faster than it drains
max.: ventricle ejects blood into artery = blood flowing out of artery
down: blood flowing out of artery > blood flowing into artery from ventricle

77
Q

ventricular volume ejected

A

ejects ~60-70 mL per cardiac cycle for both aortic (left) and pulmonary trunk (right)

78
Q

rate of ventricular volume change during filling/ejection

A
  • filling/ejection is fastest at the beginning (exponential)
    => phases can be shortened without affecting volume filled/ejected too much
79
Q

why is the second heart beat split

A

second heart beat is due to backflow of blood that has left the ventricle back towards the ventricle closing the outlet valves
- aortic has higher pressure (120 mmHg) => blood returns faster => first split
- pulmonary (27 mmHg) has lower pressure => slightly slower beat

80
Q

classes of blood vessels

A

1) elastic arteries
2) muscular arteries
3) arterioles
4) capillaries
5) venules
6) veins

81
Q

elastic artery structure

A
  • very large
  • elastic walls
  • middle tunic: many thin sheets of elastin
82
Q

elastic artery function

A
  • systole: expand to store bolus of blood leaving ventricle
  • diastole: push blood out into arterial tree by elastic recoil
    => smooth pulsatile flow of blood leaving ventricles
  • shock/pressure absorber
83
Q

elastic artery examples

A

aorta, pulmonary trunk

84
Q

muscular artery structure

A
  • medium-sized
  • middle tunic: many layers of circular smooth muscle wrapped around the vessel
85
Q

muscular artery function

A
  • distribute blood around body at high pressure, lungs at medium pressure
  • rate of blood flow adjusted by smooth muscle to vary radius (flow directly proportional to radius^4 => small change in radius has large effect on flow rate)
86
Q

arteriole structure

A
  • thicker muscular wall relative to their size than any other blood vessel
  • middle tunic: between 1 and 3 layers of circular smooth muscle wrapped around vessel
87
Q

arteriole function

A
  • control of blood flow into capillary beds (last chance to alter blood pressure)
  • greatest pressure drop occurs/greatest resistance to flow
  • degree of constriction of arterioles throughout body determines total peripheral resistance thus mean arterial blood pressure
88
Q

capillary structure

A
  • size of RBC
  • thin-walled single layer endothelium with external basement membrane
  • no smooth muscle in wall => can’t adjust diameter
  • no connective tissue
89
Q

capillary function

A
  • allow exchange of gases, nutrients, wastes between blood and surrounding tissue fluid
  • slow blood flow to allow time for exchange to occur
  • leaky vessels (more/less depending on location)
  • most of lost plasma immediately recovered due to osmotic gradient
  • net loss => lymphatic system
90
Q

venule volume/pressure

A

high volume, low pressure

91
Q

venule structure

A
  • small venules: endothelium plus a little connective tissue
  • larger venules: single layer of smooth muscle
92
Q

venule function

A
  • drain capillary beds
  • during infection/inflammation, site where WBC leave blood circulation to attack bacteria in tissue alongside
93
Q

vein pressure

A

low pressure

94
Q

vein structure

A
  • thin/soft walls that stretch easily
  • similar to muscular artery but less muscle/connective tissue
  • larger veins (esp in legs): valves to prevent backflow
95
Q

vein function

A
  • acts as venous pump that returns blood to right atrium (except portal veins: drain blood to another capillary bed)
  • small change in venous blood pressure causes large change in venous blood volume
    => act as reservoir storing blood (64% in systemic veins/venules, 13% in systemic arteries/arterioles)
  • vasoconstriction
96
Q

vein reservoir function + taking blood out

A

when blood taken out, ~1 L of removal required for hypovolumetric shock (only need 4L out of the 5L to function)

97
Q

coronary arteries

A
  • normal muscular arteries but important due to the tissue that they supply (myocardium)
  • run alongside cardiac veins in the interventricular sulci
98
Q

coronary arteries lumen

A

approx. 2-4 mm in diameter

99
Q

coronary arteries entrance

A

aorta just behind/downstream of aortic valve (leaflets)
- blood enters when ventricle relaxes and blood tries to flow back
=> greatest flow when heart relaxing (can’t fill when contracting as muscles push)

100
Q

atheroma

A
  • plaques (fatty substances) that cause atherosclerosis
    can cause coronary artery to narrow in which if ~20% of its normal cross-section is narrowed, significant obstruction to blood flow occurs (ischemia)
101
Q

ischemia

A
  • reduced blood flow / oxygen supply
  • during exercise, the myocardium supplied by diseased artery gets low oxygen => chest pain (angina)
  • severe => death (infarction) of local area of myocardium
102
Q

body’s way of supplying ischemic muscle

A

sometimes artery-to-artery junctions (anastomoses) between small penetrating branches of main coronary arteries widen slowly so ischemic muscle area can be supplied by distant artery

103
Q

coronary arteries clinical significance

A

atherosclerosis (narrowing) => ischemia (low blood flow) => angina (chest pain) / severe cases: infarction (death of local area of myocardium)
- widening anastomoses allow supply by distant artery

104
Q

atherosclerosis

A

type of arteriosclerosis (artery narrowing due to age)

105
Q

cardiac veins

A
  • return deoxygenated blood drained from myocardium to right atrium
  • great cardiac vein, middle cardiac vein, small cardiac vein -> coronary sinus (opens into RA)
  • anterior cardiac vein -> directly into RA
  • no clinical importance
106
Q

atrial fibrillation

A

irregular, often rapid heart rhythm (arrythmia) due to chaotic signals in the atria causing fluttering

107
Q

arrythmia

A

irregular heartbeat

108
Q

atrial fibrillation can cause

A

blood clots in heart => poor blood flow

109
Q

causes of atrial fibrillation

A

coronary artery disease, heart attack, high BP etc.

110
Q

blood vessel wall thickness

A

elastic>venacava>muscular>vein>precapillarysphincter>arteriole>venule>capillary

111
Q

blood vessel internal radius size

A

venacava>aorta>muscular>arteriole=precapillary sphincter>venule>true capillary

112
Q

fibrous skeleton is penetrated by

A

atrioventricular bundle (not AV node)

113
Q

pectinate muscle

A

trabeculae carneae (in ventricles) for the auricles

114
Q

atria/great veins are

A

more posterior than ventricles/great arteries

115
Q

mediastinum

A

midline (central portion of thoracic cavity)

116
Q

thrombosis

A

when blood clots block veins/arteries

117
Q

ventricular/atrial septal defect

A

hole in ventricles/atria

118
Q

midline incision =>

A

left atrium is the least likely to be seen

MEDSCI 142 (8 decks)

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