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ANPH 215 - Anatomy and Physiology > Outcome 9 - Cardiovascular System > Flashcards

Outcome 9 - Cardiovascular System Flashcards

1
Q

what are the layers of the pericardium?

A
  1. fibrous pericardium
  2. serous pericardium
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2
Q

what is the purpose of the pericardium?

A
  • it surrounds and protects the heart
  • it allows for vigorous and rapid contractions
  • it holds the heart in the mediastinum
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3
Q

the serous pericardium is double layered, what are they called?

A
  1. parietal layer
  2. visceral layer (epicardium)
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4
Q

what is the fibrous pericardium composed of?

A
  • tough, inelastic, dense irregular connective tissue
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5
Q

what is the pericardial cavity?

A

the space between the parietal and visceral layer

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6
Q

what are the three layers of the heart wall?

A
  1. epicardium
  2. myocardium
  3. endocardium
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7
Q

What are the two layers of the epicardium made out of?

A
  • visceral serous layer (outermost layer) - mesothelium
  • adipose and fibroelastic tissue (inner layer)
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8
Q

describe the myocardium.

A
  • it is a cardiac muscle tissue
  • it has involuntary movements – pumping action
  • 95% of the heart wall
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9
Q

describe the endocardium.

A
  • it is a thin layer of connective tissue with a thin layer of endothelium
  • they provide smooth lining for chambers and over valves
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10
Q

what are the external chambers of the heart?

A
  • auricle
  • sulci
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11
Q

what is an auricle?

A

it is the wrinkled “pouch-like” structure on the anterior surface of the atria

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12
Q

what is the sulci?

A
  • they are grooves that hold the coronary blood vessels and fat
  • they mark the boundary between 2 chambers
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13
Q

what are the 3 sulci?

A
  1. coronary sulcus
  2. anterior inter ventricular sulcus
  3. posterior inter ventricular sulcus
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14
Q

where do you find the coronary sulcus?

A

it is deep in the heart, and it separates the atrium from the ventricles

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15
Q

where do you find the anterior interventricular sulcus?

A

ANTERIORLY between the right and left ventricles, shallowly

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16
Q

where do you find the posterior interventricular sulcus?

A

POSTERIORLY between the right and left ventricles, shallowly

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17
Q

what are the four chambers of the heart?

A

right and left atria
right and left ventricles

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18
Q

what separates the right and left atrium?

A

interatrial septum

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19
Q

what is the fossa ovalis?

A

an oval depression on the septum

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20
Q

what is the valve separating the RIGHT atrium from the RIGHT ventricle?

A

tricuspid valve
aka R atrioventricular valve

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21
Q

the right atrium receives blood from _____, ______, and the _________.

A

from the superior vena cava, inferior vena cave and the coronary sinus

so right side - deoxygenated blood

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22
Q

where do you find the pectinate muscles?

A

on the internal surface, anterior surface and the auricle

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23
Q

what are the cardiac muscle ridges found in the right ventricle called?

A

trabeculae carneae

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24
Q

chordae tendineae attaches the cusps of the valves to ______.

A

papillary muscles

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25
Q

what is the name for the septum that separates the right ventricle from the left ventricles?

A

interventricular septum

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26
Q

what is the valve that separates the right ventricle from the pulmonary trunk?

A

pulmonary valve

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27
Q

the left atrium receives blood from _____ by the ________ ______.

A

from the lungs by the pulmonary veins

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28
Q

what is the valve called between the LEFT atrium and LEFT ventricle?

A

bicuspid valve (2 cusps)
aka mitral or L atrioventricular valve

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29
Q

what is the ligament arteriosum?

A
  • it connects the arch of the aorta and pulmonary trunk
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30
Q

what is the largest part of the heart?

A

the left ventricle

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31
Q

what is the blood flow after blood leaves the L ventricle?

A

Left ventricle –> aortic valve –> ascending aorta –> arch of the aorta –> descending aorta –> rest of the body

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32
Q

what carries the blood from the aorta to the heart wall?

A

coronary arteries that branch from the ascending aorta

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33
Q

what does the fibrous skeleton do for the heart?

A
  • it provides a structural foundation and prevents the overstretching of valves
  • it also provides a point of insertion for bundles of cardiac muscle fibres
  • acts as an electrical insulator
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34
Q

the 4 dense CT rings that surrounds the valves, fuse together by _______. These fuse rings then become a part of _______.

A

fuse together by trigones
fused rings become part of the interventricular septum

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35
Q

what is an important role of the fibrous rings?

A

they prevent the valves from overstretching and becoming leaky

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36
Q

what are the two types of valves in the heart?

A
  1. atrioventricular valve
  2. semilunar valve
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37
Q

what are the two kinds of atrioventricular valve?

A
  1. triscuspid (RA and RV)
  2. bicuspid/mitral (LA and LV)
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38
Q

what are the two kinds of semilunar valves?

A
  1. aortic valve
  2. pulmonary valve
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39
Q

when do the semilunar valves close?

A

during ventricular relaxation

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40
Q

what are the two coronary arteries?

A
  1. L coronary artery
  2. R coronary artery
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41
Q

what does the left coronary artery divide into?

A
  • the anterior interventricular branch aka the left anterior descending branch
  • circumflex branch
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42
Q

where does the LAD supply blood to?

A

walls of both VENTRICLES

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43
Q

what does the circumflex branch supply blood to?

A

walls of the left atrium and ventricle

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44
Q

what does the right coronary artery branch into?

A
  • posterior interventricular branch
  • marginal branch
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45
Q

where does the posterior interventricular branch supply blood to?

A

the right and left VENTRICLES

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46
Q

where does the marginal branch supply blood to?

A

RIGHT ventricle

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47
Q

during ____, blood is shunted into the right and left coronary artery.

A

relaxation

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48
Q

what does the deoxygenated blood from the myocardium drain into?

A

coronary sinus

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49
Q

what drains into the great cardiac vein?

A

both right and left ventricles + left atrium

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50
Q

what drains into the middle cardiac vein?

A

both right and left ventricles

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51
Q

what drains into the small cardiac vein?

A

the right atrium and right ventricle

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52
Q

what drains into the anterior cardiac vein?

A

right ventricle

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52
Q

what is myocardial infarction (MI)?

A

the death of cardiac muscle tissue due to interrupted blood supply
*complete blood flow obstruction

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53
Q

what is ischemia?

A

the reduction of blood flow to the cardiac muscle tissues
- hypoxic state which weakens tissue cells

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54
Q

what is angina?

A

it describes chest pain that could radiate to the t-spin, shoulder, arm, jaw, neck
- associated with MI and ischemia

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55
Q

what is the short axis plane?

A

oblique coronal

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56
Q

what is the horizontal long axis?

A

oblique transverse
(heart oriented towards you, and you cut anteriorly/posteriorly)

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56
Q

what is the vertical long axis?

A

oblique sagittal

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57
Q

how does ATP production occur in skeletal muscles? cardiac muscles?

A

skeletal - can occur anaerobically
cardiac - almost exclusively on aerobically

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58
Q

what are autorhythmic fibres?

A

“self-exciting” muscle fibres
- meaning they generate AP without stimulus

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59
Q

what are the autorhythmic fibres composed of?

A

~1% cardiac muscle fibers
99% contractile muscle fibers

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60
Q

what does the autorhythmic fibers do?

A
  • act as a pacemaker - setting rhythm of excitation for the heart beat
  • forms conduction systems - gives pathways for ap to travel
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61
Q

what are the 5 different autorhythmic fibers?

A
  1. sinoatrial node (SA node)
  2. atrioventricular node (AV node)
  3. bundle of his (aka av bundle)
  4. right and left bundle branches
  5. purkinje fibers
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62
Q

what is the sa node?

A
  • it is known as the pacemaker of the heart
  • it creates an ap of the fastest rate
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63
Q

what is the role of the av node?

A
  • it slows down the ap from the sa node
  • will fire ap if the something were to happen to the sa node –> rate is much slower than the sa node’s (40-60 bpm)
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64
Q

where do you find the sa node? av node?

A

sa - right atrium next to the opening for the inferior vena cava
av - in the wall of the septum between atrium and ventricle; anterior to the coronary sinus opening

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65
Q

what are internodal tracts? where are they found?

A

myocytes extending from the sa node to the av node
- found throughout right atrium

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66
Q

what are Bachman’s bundles? where are they found?

A

myocytes extending from sa node to av node
- found throughout the left atrium

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67
Q

when does the atria contract?

A

follow an ap that is triggered by the sa node

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68
Q

when ap travels from the sa node to the av node, what is happening?

A
  • the ap slows down/slight pause due to the fewer gap junctions here (0.1 sec delay)
  • this will allow for the atria to empty their blood into the ventricles
69
Q

what are the 5 steps to ap propagation?

A
  1. sa triggers ap: atrial contraction
  2. ap from sa to av: ventricle filling
  3. av node to av bundle
  4. av bundle into right and left bundle branch
  5. right and left bundle branch into purkinje fibres
70
Q

what do the purkinje fibres do?

A

they are large diameter nerve cells, thus rapidly conducting ap to stimulate the rest of the ventricular myocardium

71
Q

when do ventricles contract?

A

following ap

72
Q

when do the pulmonary trunk and aorta’s valves open?

A

when the pressure in the ventricles exceed the pressure in the p. trunk and aorta

73
Q

what is the rate of a sa node?

A

initiation of ap every 0.6 secs
100x/min

74
Q

what does an ecg show?

A

the electrical signals of an ap from each part of the heart during one cardiac cycle

75
Q

by comparing an ecg to a normal one, what is determined?

A
  1. abnormal conduction path
  2. heart enlargement
  3. damaged areas
  4. cause of chest pain
76
Q

what does the p wave show in an ecg?

A
  • atrial depolarization
  • contraction of the atria at the end of the p-wave
77
Q

what does the qrs cmplex on an ecg show?

A
  • rapid ventricular depolarization
  • ventricular muscle fibres contracting
78
Q

what does the t-wave in an ecg show?

A

ventricular repolarization; ventricles relaxing

79
Q

why don’t we see atria relaxation on an ecg?

A

ventricles have more electrical activity so it masks the electrical activity of the atria

80
Q

what is one cardiac cycle?

A

all the events (systole, diastole of both atria and ventricles) that occur in ONE heart beat

81
Q

how do you measure a cardiac cycle length?

A

secs/beat

82
Q

what is occurring during relaxation in the heart?

A

it’s when the myocardium is receiving its oxygen and nutrients that is needed

83
Q

pressure in the left side of the heart is greater than the right side, therefore, the volumes on either side differences. t/f

A

false.
volume is the same.

84
Q

what are the five phases of the cardiac cycle?

A
  1. ventricular filling
  2. atrial contraction
  3. isovolumetric contraction
  4. ventricular ejection
  5. isovolumetric relaxation
85
Q

during ventricular filling, what is occurring?

A
  • the heart is at rest (both a and v are relaxed)
  • av valves are open to allow for passive filling of the ventricles
  • no electrical activity
86
Q

what is happening during atrial contraction?

A
  • initiated by atrial depolarization
  • active filling is now occurring, atria is being squeezed
  • at the end of this phase, ventricular depolarization starts
87
Q

what is end diastolic volume?

A

the volume inside the heart that is at its greatest
***vol in the ventricle at the END of RELAXATION

88
Q

what is occurring during isovolumetric contraction?

A

onset of ventricular systole
- increased pressure in the ventricles causes the av valves to close
- semilunar valves are still closed as well

89
Q

what is occurring during ventricular ejection?

A
  • increased contraction of the ventricles which causes the pressure in the ventricles to be higher than the p. trunk and aorta – SL valves open
  • blood ejected from ventricles
  • repolarization of ventricles initiated
90
Q

what is occurring during the isovolumetric relaxation?

A
  • ventricle relaxation (diastole) which causes the pressure to fall = sl valve closing
  • *av valves are still closed therefore, no passive filling yet
91
Q

how do you calculate cardiac output? what’s the units?

A

co = sv * hr
co (ml/min)

sv = stroke volume (ml/beat)
hr = heart rate (beats/min)

92
Q

what is the stroke volume? how is it calculated?

A

it is the volume of blood ejected by the VENTRICLES during each contraction

the difference between the end diastolic volume and the end systolic volume.

ex. sv = 130 ml - 60 ml = 70 ml/beat

93
Q

what is the end systolic volume?

A

when the ventricles are the least full
*** vol in the ventricle at the END of CONTRACTION

94
Q

what is ejection fraction?
how do you calculate ejection fraction?

A

it is the percentage of blood ejected from the ventricle in one beat
EJ = SV/EDV *100%

95
Q

during stress the ejection fraction will increase by 10x. t/f

A

false.
it’ll only increase by ~5%

96
Q

what are the three factors that effect the stroke volume?

A
  1. preload
  2. contractibility
  3. afterload
97
Q

what is preload?

A

the degree of stretch the heart gets before it contracts

98
Q

what is contractibility?

A

the force of contraction of individual ventricular muscle fibers

99
Q

what is after load?

A

the pressure that must be exceeded before blood can be ejected from the ventricles

100
Q

↑ preload = ______ SV
↑ contractibility = ______ SV
↑ afterload = _____ SV

A

↑ preload/contractibility = ↑ SV
↑ afterload = ↓ SV

101
Q

how do you increase preload?

A

by increasing EDV
- increasing the length of diastole
- increasing venous return
- vasoconstriction

102
Q

how does moderate exercise and extreme exercise differ in terms of edv?

A

moderate exercise = ↑ edv
↑ hr = ↓ diastole + ↑↑ venous return = ↑ edv

extreme exercise =
↑↑ hr = ↓↓ diastole + ↑ venous return = ↓ edv

103
Q

how does positive inotropic agents affect contractility?

A

positive ino = stimulate SNS, E/NE =
increase ca2+ flow during cardiac ap = increase contractility

104
Q

how does negative inotropic agents affect contractility?

A

negative ino = inhibit SNS; channel-blockers, beta-blockers =
decrease ca2+ flow during cardiac ap = decrease contractility

105
Q

what is the pressure in the r ventricle? left ventricle?

A

right = ~20 mmHg
left = ~80 mmHg

106
Q

why does sv decrease if afterload increases?

A

it’ll take more time to exceed the higher pressure, so there is less time to squeeze out blood during systole (shortening the ventricular ejection period)

107
Q

what is considered the short term control of bp and co?

A

hr (which is controlled by a negative feedback loop)

108
Q

how does the stimulation of the sympathetic nerves affect the output to the heart? parasympathetic nerves?

A

sympathetic = cardiac accelerator = increases the span. depolarization in sa/av node which increases heart rate; it also increases contractility to increase stroke volume

parasympathetic = decrease rate of spontaneous depolarization of SA and AV node which decreases heart rate

109
Q

what else impacts heart rate?

A
  • hormones (E/NE, thyroid hormones that enhance E/NE)
  • cations (Na+, K+, Ca2+)
  • age, gender, physical fitness, body temp.
110
Q

what’s the general blood flow through vessels?

A

arteries, arterioles, capillaries, venues veins

111
Q

arteries carry blood _______ heart.
veins carry blood _______ heart.

A

arteries - AWAY from heart
veins - TO heart

112
Q

what is the difference between arteries and veins?

A
  • arteries have the extra internal elastic lamina and external elastic lamina that is between the smooth muscles
  • the smooth muscle of the arteries are much more dense
  • veins have valves and larger lumen (hold more blood)
  • arteries can contract and relax
113
Q

what does the internal/external elastic lamina do?

A

it allows for the diffusion of O2 and nutrients and to remove wastes

114
Q

what are the 3 layers that make up the wall of vessels?

A
  1. tunica interna
  2. tunica media
  3. tunica externa
115
Q

what are the 3 components of the tunica interna in arteries?

A
  1. the inner endothelial layer - continuous squamous epithelial
  2. basement membrane - allows for the anchoring of endothelial layer to connective tissue
  3. internal elastic lamina - allows for the diffusion due to the holes
116
Q

what does the tunica media consists of?

A

smooth muscle cells and lots of elastic fibers

117
Q

what does the tunica externa consists of?

A

elastic and collagen fibers as well as nerves and tiny blood vessels to supply the tissue of the vessel walls

118
Q

what are the different types of capillaries?

A
  1. continuous
  2. fenestrated (porous)
  3. sinusoid (most open)
119
Q

where do you find continuous capillaries?

A

lungs, skeletal muscles and smooth muscles

120
Q

where do you find fenestrated capillaries?

A

kidneys, villi of intestines, choroid plexuses, endocrine glands

121
Q

where do you find sinusoid capillaries?

A

spleen, liver, rbm endocrine glands

122
Q

what forms the valves found in veins?

A

tunica interna

123
Q

describe the venous sinuses.

A
  • no smooth muscles, no valves and have dense ct that replaces the outer layers
124
Q

what is anastomosis?

A

the joining of two or more vessels supplying the same body region

125
Q

what is collateral circulation?

A

alternative route of blood flow due to anastomosis - allows for perfusion despite the primary blood supply getting blocked

126
Q

what is an end artery?

A

an artery that doesn’t undergo anastomosis
*therefore if it is blocked, there will be no perfusion to the part or all of that organ

127
Q

what is blood flow? total blood flow?

A

bf = the volume of blood that flows through any tissue at any given time (ml/min)

total bf = volume of blood circulating through blood vessels per minute

128
Q

what are flows dependent on?

A

pressure differences and resistance

129
Q

greater difference in pressure = _____ flow.
greater resistance = ______ flow.

A

higher pressure difference = increase flow
greater resistance = decrease flow

130
Q

what are the other two mechanisms that assist in pumping blood back to the heart?

A
  1. skeletal muscle pump
  2. respiratory pump
131
Q

what is the flow rule with pressure differences?

A

flows from an area of higher pressure to lower pressure

132
Q

what does vascular resistance depend on?

A

vessel size and length, blood viscosity

133
Q

what is blood pressure? how is it generated?

A

the pressure exerted by the blood on the walls of the arteries during ventricular sys and dia

generated by the ventricular contractions

134
Q

where is blood pressure the highest? lowest?

A

highest - aorta
lowest - superior vena cava

135
Q

what influences bp?

A
  • cardiac output
  • blood volume
  • vascular resistance
136
Q

what is normal arterial pressure during systole?

A

90-120 mmHg

137
Q

what is normal arterial pressure during diastole?

A

60-80 mmHg

138
Q

what is considered high bp? low bp?

A

high = >=140 mmHg sys, >=90 mmHg dia

low = <90 mmHg sys

139
Q

what happens when the vasomotor nerves get stimulated?

A

it’ll cause vasoconstriction which increases blood pressure

140
Q

what happens during high bp?

A

the stimulation of vagus nerves – decrease rate decreases

141
Q

what happens during low bp?

A

the stimulation of cardiac accelerator nerves which increases rate and contractility

142
Q

what does E/NE do and its effect on bp?

A

it’ll increase blood pressure by increasing heart rate and contractility which results in increased cardiac output.

E/NE = ↑ CO = ↑ BP = ↑ HR and ↑ contractility

143
Q

what does aldosterone, antidiuretic hormones do and its effect on bp?

A

increases blood volume = ↑ BP

144
Q

what does atrial natriuretic peptide do?

A

it decreases the blood volume = decrease bp

145
Q

what hormones increase vascular resistance? what does increasing vascular resistance do to bp?

A

angiotensin II, antidiuretic hormones (ADH) vasopressin, NE/E

increasing vr = ↑BP

146
Q

what hormones causes vasodilation (decrease vascular resistance) and what does decreasing vascular resistance do for bp?

A

ANP, E, nitric oxide

decreasing vr = decreasing bp

147
Q

what is autoregulation?

A

the ability of tissue to automatically adjust blood flow within capillaries to match the required metabolic demands by vasoconstriction and vasodilation of arterioles

148
Q

what are the two main stimuli that causes autoregulation?

A
  1. physical changes in tissues (i.e heat = vd; cooling = vc)
  2. VC and VD chemicals released by local cells
149
Q

what is unique about the autoregulation in the lungs in response to low o2?

A

low o2 in the lungs = vasoconstriction

150
Q

the mean arterial pressure is the average bp in the arteries. what affects it?

A

cardiac output and resistance

151
Q

what do we use to measure bp?

A

sphygomomanometer and stethoscope

152
Q

where do you usually measure bp?

A

brachial artery

153
Q

what is auscultation?

A

listening to the blood hitting against the walls

154
Q

what is the first sound you hear when measuring bp?

A

systolic pressure

155
Q

the disappearance of sound is the ____ pressure.

A

diastolic

156
Q

what are korotkoff sounds?

A

sounds that are produced due to the pressure cuffs changing the flow of the blood through the artery

157
Q

what is shock?

A
  • the failure of the cv system to deliver enough o2 and nutrients to meet the metabolic needs of the cells
  • inadequate floor of blood to tissues
158
Q

what are the four kinds of shock?

A
  1. hypovolemic
  2. cardiogenic
  3. vascular
  4. obstructive
159
Q

when does hypovolemic shock occur?

A

when there is a decrease in blood volume

160
Q

how do you decrease blood volume?

A

internal/external hemorrhaging
excessively sweating, diarrhea, vomiting
diabetes mellitus or insipidus - excess urination

161
Q

when does cardiogenic shock occur? what is the usual cause?

A

due to poor heart function (valve issues, excessive preload and afterload, arrhythmias)

usual cause = MI

162
Q

when does vascular shock occur?

A

because of inappropriate vasodilation

163
Q

what are some examples of inappropriate vasodilations?

A
  • anaphylaxis - histamine release
  • neurogenic shock - head trauma=issues with cv centre
  • septic shock - toxins from pathogens
164
Q

when does obstructive shock occur?

A

when there is an obstruction to blood flow

165
Q

what are the 4 divisions of the largest artery in the body?

A

ascending, arch, thoracic and abdominal

166
Q

what splits into the right and left common iliac arteries? where do they supply blood to?

A

the abdominal aorta
the pelvis and lower limbs

167
Q

what are the five changes that occur after birth?

A
  1. ductus arteriosus
  2. foramen ovale
  3. ductus venosus
  4. umbilical vein
  5. umbilical arteries
168
Q

what is ductus ateriosus? what is the result called?

A

connecting of the pulmonary trunk to the aorta

results in ligaments arteriosum

169
Q

what is foramen ovale? what is the result called?

A

the opening between the right and left atria

called = fossa ovalis

170
Q

what is ductus venosus? what is the result called?

A

change that allows blood to bypass the hepatic portal vein and flow into the inferior vena cava

called = ligaments venosum

171
Q

what is umbilical vein? what’s the result called?

A

carrying of o2 from placenta to fetal circulation

becomes = ligamentum teres

172
Q

what is umbilical arteries? what are the results called?

A

carrying of co2 blood from fetal circulation to placent

becomes = medial umbilical ligaments

ANPH 215 - Anatomy and Physiology (14 decks)

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