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Patho Quiz 3 > Quiz 3 > Flashcards

Quiz 3 Flashcards

1
Q

Right v Left Heart Fxn

A
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2
Q

Vessels
types & fxn

A

Arteries:
Carry blood away from the heart

Capillaries:
Exchange fluids between the blood and interstitial space

Veins:
Carry blood to the heart

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3
Q

Circulatory System
blood path

A
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4
Q

Area where the heart is located

A

Mediastinum

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5
Q

Mediastinum

A

where the heart is located

above the diaphragm and between the lungs

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6
Q

Heart wall
Layers

A

Epicardium: outer smooth layer

Myocardium: thickest layer of cardiac muscle

Endocardium: innermost layer

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7
Q

Pericardium & its components

A

Double-walled membranous sac

Parietal: surface layer
Visceral: inner layer

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8
Q

Pericardial cavity

A

Space between the parietal and visceral layers
Contains pericardial fluid (20 mL)

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9
Q

amount of pericardial fluid in the pericardial cavity?

A

(20 mL)

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10
Q

Heart Chambers

A

Right atrium
Left atrium
Right ventricle
Left ventricle

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11
Q

Atria are separated by

A

the interatrial septum.

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12
Q

Ventricles are separated by

A

the interventricular septum.

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13
Q

Thickness of each chamber depends on

A

the pressure or resistance it must overcome to eject blood.

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14
Q

Heart Valves
fxn

A

Ensure one way blood flow

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15
Q

Atrioventricular valves (AVs)

A

One-way flow of blood from the atria to the ventricles

Tricuspid valve: three leaflets or cusps

Bicuspid (mitral) valve: two leaflets or cusps

“Tri before you Bi”

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16
Q

Semilunar valves

A

One-way flow from the ventricles to either the pulmonary artery or to the aorta

Pulmonic semilunar valve
Aortic semilunar valve

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17
Q

Atrial contraction vs. ventricle contraction

A
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18
Q

Great Vessels

A

Superior & inferior venae cavae:
deoxygenated blood systemic circulation → right atrium

R & L pulmonary arteries:
unoxygenated blood from right heart → BOTH lungs
Branch into pulmonary capillaries

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19
Q

Right and left pulmonary arteries
Branch into

A

pulmonary capillaries

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20
Q

Carry oxygenated blood from the lungs to the left side of the heart

A

Pulmonary veins

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21
Q

Delivers oxygenated blood to systemic vessels that supply the body

A

Aorta

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22
Q

Cardiac cycle
consists of…
makes up…

A

One contraction and one relaxation

one heartbeat

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23
Q

Relaxation: ventricles fill
A) systole
B) diastole

A

Diastole

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24
Q

blood leaves the ventricles during…

A

Systole
(Contraction)

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25
Q

Atrial systole and ventricle systole

A
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26
Q

Phases of the cardiac cycle

A

Phase 1: atrial systole or ventricular diastole

Phase 2: isovolumetric ventricular systole

Phase 3: ventricular ejection (semilunar valves open)

Phase 4: isovolumetric ventricular relaxation (aortic valve closes)

Phase 5: passive ventricular filling (mitral and tricuspid valves open)

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27
Q

Unoxygenated (venous) blood from systemic circulation enters the right atrium through

A

the superior and inferior venae cavae

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28
Q

From the atrium, the blood passes through the ____ valve into the right ventricle

A

right AV (tricuspid)

tRicuspid is on the Right
“tri before you bi”

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29
Q

blood flow once it enters right ventricle

A

inflow tract
outflow tract
pulmonic semilunar valve (pulmonary valve)
pulmonary artery
lungs

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30
Q

How many pulmonary veins are there?

A

Oxygenated blood:
lungs → left atrium
via 4 pulmonary veins
(two from left lung & two from right)

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31
Q

From the left atrium, the blood passes through the ____ into the left ventricle

A

left AV valve/mitral valve/bicuspid

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32
Q

Normal Intracardiac Pressures
(waves & what they represent)

A

A wave: Atrial contraction

V wave: Filling of the atrium from the peripheral veins

C wave: Bulging of the mitral valve into the left atrium

X descent: Ejection of blood from both ventricles

Y descent: Flow of blood into the right ventricle

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33
Q

Supplies oxygen and other nutrients to the myocardium

A

Coronary circulation

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34
Q

Right coronary artery
branches

A

Conus artery
Right marginal branch
Posterior descending branch

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35
Q

Left coronary artery
branches

A

Left anterior descending artery
Circumflex artery

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36
Q

Collateral arteries

A

connections/anastomoses between the branches of the coronary circulation

Protects the heart from ischemia

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37
Q

connections, or anastomoses, between the branches of the coronary circulation

A

Collateral arteries

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38
Q

Collateral arteries
Are formed by

A

arteriogenesis or angiogenesis

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39
Q

The Coronary veins

A

Coronary sinus
Great cardiac vein
Posterior vein of the left ventricle

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40
Q

Oxygenated blood enters the coronary arteries through

A

openings in the semilunar valves at the entrance to the aorta.

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41
Q

Deoxygenated blood from the coronary veins enters the right atrium through the

A

coronary sinus.

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42
Q

Coronary lymphatic vessels
fxn

A

drain fluid to the paratracheal lymph nodes.

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43
Q

Transmission of electrical impulses are called

A

Cardiac action potentials

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44
Q

Conduction system

A

Sinoatrial (SA) node

Atrioventricular (AV) node

Bundle of His (AV bundle)

Right and left bundle branches

Purkinje fibers

Ventricular myocardium

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45
Q

Sinoatrial (SA) node
fxn (2)

A

Pacemaker of the heart
Intranodal pathways

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46
Q

Refractory period

A

Heart muscles cannot contract.
Ensures that diastole (relaxation) will occur

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47
Q

Completes the cardiac cycle

A

Refractory period

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48
Q

Inside of the cell becomes less negatively charged

A

Depolarization: activation

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49
Q

Sum of all cardiac action potentials

A

electrocardiogram (ECG)

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50
Q
A
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51
Q

EKG components and their meaning

A

P wave: atrial depolarization

PR interval: time from the onset of atrial activation to the onset of ventricular activation

QRS complex: sum of all ventricular depolarizations

ST interval: ventricular myocardium depolarized

QT interval: “electrical systole” of the ventricles

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52
Q

Which EEG component varies inversely with the heart rate?

A

QT interval

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53
Q

time from the onset of atrial activation to the onset of ventricular activation

A

PR interval

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54
Q

ventricular myocardium depolarized

A

ST interval

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55
Q

Automaticity

A

Property of generating spontaneous depolarization to threshold

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56
Q

Automatic cells

A

all heart cells capable of spontaneous depolarization

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57
Q

Regular generation of an action potential by the heart’s conduction system

A

Rhythmicity

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58
Q

depolarizes spontaneously 60–100 times per minute

A

SA node

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59
Q

Automaticity vs. Rhythmicity

A
60
Q

The ______ nervous system influences the rate of impulse generation (firing), depolarization, and repolarization of the myocardium

A

Autonomic

61
Q

Autonomic nervous system
influences on heart action

A

-rate of impulse generation (firing), depolarization, and repolarization

-strength of contraction

-changes in the heart and circulatory system faster than metabolic or humoral agents

62
Q

Cardiac innervation

A

Sympathetic nerves:
Increases conductivity & contraction strength

Parasympathetic nerves:
Decreases conduction & contraction

63
Q

Adernergic
Receptors in Heart

A

α- or β-adrenergic receptors
Norepinephrine or epinephrine
Acetylcholine

64
Q

Stimulation of both the β1 and β2

A

↑ HR (chronotropy)
&
↑contractile force (inotropy)

65
Q

negative vs positive chronotropy

A

Negative chronotropy: decreases heart rate
Positive chronotropy: increases heart rate

66
Q

+ vs - chronotropy

A

Negative inotropy: decreases force of contraction
Positive inotropy: increases force of contraction

67
Q

Overall β1 and β2 stimulation

A

Heart pumps more blood.
β2 stimulation increases coronary blood flow.

68
Q

β3 receptors

A

↓ contractility (negative inotropic)

“safety mechanism” to prevent an overstimulation of the heart by the sympathetic nervous system

69
Q

receptor that provides a “safety mechanism” to prevent SNS overstimulation of the heart

A

B3
(negative inotropic effect)

70
Q

Myocardial cells
Nearly identical to

A

skeletal muscle cells

71
Q

Specialized intercellular junctions

A

Intercalated disks

72
Q

Myocardial cells
components

A

Intercalated disks

T tubules

Actin, myosin, and the troponin-tropomyosin complex

73
Q

Actin, myosin, and the troponin-tropomyosin complex
includes…

A

Troponins T, I, and C
Titin

74
Q

features that distinguish myocardial cells from skeletal cells

A

faster AP transmission (via intercalated disks)

make more ATP (lots of mitochondria)

transverse tubules: easier access to ions

all enable the myocardium to work constantly, which skeletal muscles are not required to do

75
Q

T/F
Both myocardial cells and skeletal muscle cells work constantly.

A

False
myocardial cells do

76
Q

Contraction occurs when the ___ shortens, causing ….

A

sarcomere
adjacent Z lines to move closer together.

77
Q

Myocardial contraction
steps

A

sarcomere shortens
adjacent Z lines come closer together

A band width (thick myosin filaments) doesnt change

I band: narrows

increased overlap between the thick and thin filaments

78
Q

Cross-bridge cycling

A

Attachment of actin to myosin at the cross bridge

Myosin head molecule undergoes a position change.

Causes thin filaments to slide past thick filaments (contraction).

79
Q

Calcium
Is stored in which 2 locations?

A

tubule system and the sarcoplasmic reticulum

80
Q

Calcium
when does it enter the myocardial cell?

A

from the interstitial fluid after electrical excitation, which increases membrane permeability to calcium

81
Q

increases membrane permeability to calcium

A

electrical excitation

82
Q

Calcium
Diffuses toward the myofibrils, where it binds with

A

troponin

83
Q

Excitation contraction coupling

A

AP triggers the cycle
↓
cross-bridge activity & contraction

Requires calcium

Calcium–troponin complex facilitates the contraction process.

84
Q

facilitates the contraction process

A

Calcium–troponin complex

85
Q

what begins myocardial relaxation?

A

Troponin release of calcium

85
Q

substances that facilitate relaxation

A

Calcium, troponin, and tropomyosin

86
Q

volume of blood flowing through either the systemic or the pulmonary circuit

A

Cardiac output

87
Q

CO equation

A

HRxSV

88
Q

Normal adult cardiac output at rest

A

5 L/min

89
Q

Ejection fraction

A

66% for women and 58% for men

stroke volume/end-diastolic volume

90
Q

Is an indicator of ventricular function

A

Ejection fraction

91
Q

Preload
determined by two primary factors

A

Amount of venous return to the ventricle

Blood left in the ventricle after systole or end-systolic volume

92
Q

When preload exceeds physiologic range….

A

further muscle stretching causes a decline in cardiac output.

93
Q

Aortic systolic pressure is a good index of afterload for the _______

A

left ventricle.

94
Q

Total peripheral resistance (TPR)
represents (pre/after)load.

A

after

95
Q

Frank-Starling law of the heart

A

volume of blood at end diastole

Myocardial stretch determines contraction force

More stretch = Increased force of contraction

96
Q

the major way that the right and left ventricles maintain equal minute outputs, despite stroke (beat) output variation

A

Frank-Starling law of the heart

97
Q

Laplace’s law

A

Contractile force depends on the chamber radius & wall thickness

Small w/ thick walls = increased contraction force.

In ventricular dilation, the force needed to maintain ventricular pressure lessens available contractile force.

98
Q

Determinants of the force of contraction

A

myocardium stretching (changes in ventricular volume/preload)

nervous system input to ventricles

myocardial O2 supply

99
Q

Inotropic agents
+ and -

A

Norepinephrine
Epinephrine

Ach (released from vagus nerve)

100
Q

T/F
Hypoxia decreases contractility

A

True

101
Q

Average heart rate in healthy adults

A

~70

102
Q

controls resting heart rate

A

parasympathetic system

103
Q

HR
Neural reflexes

A

Baroreceptor reflex: ↓BP = ↑HR & arterioles constrict

Bainbridge reflex: △HR from IV infusions

104
Q

Stuff that affects CO

A
105
Q

Systemic circulation that supplies the skin and the extremities

A

Peripheral vascular system

106
Q

Structure of Blood Vessels

A

Tunica intima: Innermost or intimal layer

Tunica media: Middle or medial layer

Tunica externa (adventitia): Outermost or external layer

107
Q

Vasculogenesis

A

Growth of vessels from progenitor or stemlike cells that originate in the bone marrow and other body tissues

108
Q

Processes for growing new blood vessels

A

Angiogenesis
Arteriogenesis
Vasculogenesis

109
Q

Arteriogenesis vs Angiogenesis

A

Arteriogenesis:
Branching from larger vessels (arterioles)

Angiogenesis:
Branching of small vessels (capillaries)

110
Q

contain fewer elastic fibers and more muscle fibers; can contract (vasoconstriction) and relax (vasodilation).

A

Muscular arteries

111
Q

Capillaries
Substances move through via… (4)

A

Junctions between endothelial cells

Fenestrations (oval windows or pores)

Vesicles moved by active transport

Diffusion

112
Q

Endothelium roles

A

Transport
Coagulation & fibrinolysis
Immune system
Tissue growth & wound healing
Vasomotion: contraction and relaxation of vessels

113
Q

do we have more arteries or veins?

A

veins

114
Q

distance blood travels in a unit of time

A

velocity

115
Q

T/F
Low hematocrit reduces the flow through the blood vessels.

A

False
High

116
Q

Laminar vs Turbulent flow

A
117
Q

Vascular compliance

A

The increase in volume a vessel is able to accommodate for a given increase in pressure.

118
Q

the opposite of compliance

A

stiffness

119
Q

Which is more compliant?
Veins
Arteries

A

Veins

120
Q

Mean arterial pressure (MAP)

A

Is the average pressure in the arteries throughout the cardiac cycle

121
Q

total peripheral resistance is primarily a function of ….

A

the diameter of the arterioles

122
Q

Vessels arrangement and effect on resistance

A

series (greater resistance)
parallel (lesser resistance)

123
Q

Baroreceptors
fxn

A

Reduce BP to normal by decreasing CO & PVR

Can also increase BP when needed

124
Q

Arterial receptors: chemoreceptors

A

Are sensitive to oxygen, carbon dioxide, or pH
Regulate blood pressure

125
Q

Antidiuretic hormone

A

Increases blood volume by reabsorption of water from tubular fluid in the distal tubule and the collecting duct of the nephron

126
Q

Renin-angiotensin-aldosterone system
hormones & their fxn

A

Aldosterone: stimulates reabsorption of sodium, chloride, and water to increase blood volume and stimulate thirst

Angiotensin II: vasoconstrictor

127
Q

Natriuretic peptides

A

Cause loss of sodium, chloride, and water through their effects on kidney function, decreasing blood volume

128
Q

Adrenomedullin

A

Powerful vasodilatory activity

129
Q

Nitric oxide, prostaglandins, endothelium-derived relaxing factor
affect BP how?

A

vasodilation

130
Q

Venous pressure
Main determinants

A

venous volume

Compliance

131
Q

Mechanisms that affect venous pressure

A

Skeletal muscle pump
Respiratory pump

132
Q

Coronary perfusion pressure

A

difference between pressure in the aorta and pressure in the coronary vessels

133
Q

Autoregulation

A

organs to regulate blood flow by altering the resistance in its arterioles

134
Q

maintains optimal perfusion pressure, despite systolic effects, especially in the coronary arteries

A

Autonomic self regulation

135
Q

Myoglobin (in heart muscle)
fxn

A

stores oxygen for use during the systolic phase

136
Q

Autoregulation
Between __ and __ mmHg

A

60 -140

137
Q

Lymphatic system
Both ducts drain into the

A

subclavian

138
Q

Afferent vs efferent lymphatic vessels

A

Afferent vessels carry lymph to the nodes.

Efferent vessels carry lymph away from the nodes

139
Q

Chest x-ray vs Echocardiogram

A

CXR:
size and contour of the heart and related structures

Echo:
most effective and widely used noninvasive modality for evaluating the structures of the heart

140
Q

Stress testing

A

“exercise testing”
Elicits S/S of heart Dz & CAD that may not appear at rest

injection of a radiotracer

141
Q

Computed tomography (CT)

A

evaluates coronary artery disease and myocardial ischemia during stress testing.

142
Q

Magnetic resonance imaging (MRI)

A

anatomy and physiology of the great blood vessels and myocardium in three dimensions

143
Q

Angiography

A

fluoroscopically visualizes the coronary arteries

144
Q

most common cause of morbidity and mortality in older adults

A

Cardiovascular disease

145
Q

Aging effects

A

Myocardial & vessel stiffening
Changes in neurogenic control over vascular tone
AFIB more common
↓ exercise capacity
LV hypertrophy & fibrosis

146
Q

Arterial stiffening

A

Cross-linking of collagen
Increased collagen
Changes in elastin
Decreased baroreceptor activity

Patho Quiz 3 (1 decks)

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