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Cardio-respiratory Studies 1 > Senario Two - The Heart > Flashcards

Senario Two - The Heart Flashcards

1
Q

where is the apex of the heart

A

anterior point - formed by the left ventricle

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2
Q

where is the base of the heart

A

posteriorly - formed by the atria

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3
Q

what are the valves of the heart?

A

semi-lunar valves: aortic and pulmonary a/v valves: bicuspid (L) and tricuspid (R)

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4
Q

what is the difference in the structure of the ventricles?

A

left side - wall is much thicker & lumen is smaller

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5
Q

what is the pericardium?

A

membrane surrounding and protecting the heart keeps it in position within the mediastinum two parts - fibrous pericardium and serous pericardium

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6
Q

what is the structure of the fibrous pericardium?

A

Outermost layer (most superficial) Tough, dense, inelastic, irregular CT

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7
Q

what is the function of the fibrous pericardium?

A

attaches to the diaphragm and the vessels entering and leaving the heart prevents over stretching of the heart and anchors it within the mediastinum

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8
Q

why is the fibrous pericardium fused with the diaphragm?

A

fused at the central tendon, means in deep breathing it facilitates movement of blood by the heart

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9
Q

what is the structure of the serous pericardium

A

thin and delicate forms a double layer (1) outer parietal layer - fuses to fibrous pericardium (2) inner visceral layer - adheres tightly to the surface of the heart - aka epicardium lubricating pericardial fluid between the layers

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10
Q

what is the epicardium?

A

the outer layer of the heart wall

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11
Q

what is the structure of the epicardium?

A

thin outer layer of mesothelium inner layer of delicate fibroelastic tissue and adipose tissue (thickest over ventricles)

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12
Q

what is the function of the epicardium?

A

houses major cardiac vessels blood, nerve and lymph supply to myocardium smooth and slippery outer surface to the heart

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13
Q

what is the structure of the myocardium?

A

middle layer of heart wall - makes up 95% of heart cardiac muscle arranged in a spiral around the heart to facilitate strong pumping

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14
Q

what is the function of the myocardium?

A

responsible for contraction of the heart and circulation of blood

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15
Q

what is the endocardium?

A

innermost layer of thin endothelium of the heart wall

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16
Q

what is the structure of the endocardium

A

thin layer of endothelium providing a smooth lining for chambers and valves houses purkinje fibres

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17
Q

what is the role of the endocardium?

A

reduce friction as blood flows with the heart continuous with the endothelium of BVs

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18
Q

what is the histology of the epicardium

A

simple squamous epithelium

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19
Q

what is the cell type of the myocardium

A

cardiac muscle fibres and loose endomysial CT

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20
Q

what is the projection of the a/v valve cusps when open?

A

into the ventricles

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21
Q

what is the projection of the s/l valve cusps when open?

A

into lumen of the artery

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22
Q

what are the trabeculae carnae?

A

raised bundles of cardiac muscle fibres - form the papillary muscles

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23
Q

what are the chordae tendinae

A

in the ventricles attach to the outer margins of the valve, and papillary muscles when papillary muscles contract, edges of valve pulled taught = valve closes

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24
Q

how to the semi-lunar valves open or close?

A

open when pressure of the contraction forces them upwards close when pressure falls and the blood falls into the concave upper edge

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25
Q

how do the semi-lunar valves attach

A

by their convex margin to the wall of the aorta

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26
Q

how many cusps to semi-lunar valves

A

3

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27
Q

how many cusps to A/v valves?

A

mitral - 2 tricuspid - 3

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28
Q

what is the pathway of the cardiac conduction system

A

SAN –> atria –> AVN –> L & R bundle branches –> purkinje fibres –> ventricles

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29
Q

The conducting system: step 1

A

SAN spontaneously depolarises due to pacemaker potential Action potential generated and propagates through both atria - via gap junctions of intercalated discs in atrial muscle fibres Cause the atria to contract

30
Q

The conducting system: step 2

A

AP from SAN reaches AVN in intertribal septum AP slows due to change in cell structure - allowing time for blood to empty into ventricles

31
Q

The conducting system: step 3

A

AP enters the AV bundle (bundle of His)

32
Q

The conducting system: step 4

A

AP travels from bundle of His to the L and R bundle branches to the apex of the heart (running through the IV septum)

33
Q

The conducting system: step 5

A

Purkinje fibres at apex of heart conduct the AP from apex to the rest of the ventricular myocardium ventricles contract and blood is ejected through S/l valves

34
Q

The cardiac cycle: step 1

A

Atrial contraction - due to AP reaching SAN – AV valves are open – last 20-30mls of blood flow into ventricles

35
Q

The cardiac cycle: step 2

A

Isovolumetric Contraction of the ventricles - as AP reaches AVN – atria are relaxed – S/L and AV valves closed – pressure in ventricles rise

36
Q

The cardiac cycle: step 3

A

Ventricular Ejection - AP reaches purkinje so ventricles fully contracted – pressure in ventricles risen higher than aortic pressure - due to isovolumetric contraction - pushes s/l valves open – blood flows from ventricle to aorta

37
Q

The cardiac cycle: step 4

A

Isovolumetric Relaxation – Aortic pressure > ventricular pressure due to blood leaving the ventricles – causes S/l valves to close – AV valves closed

38
Q

The cardiac cycle: step 5

A

Ventricular Filling – atria fills with blood – atria pressure > ventricular pressure so AV valves open – blood moves down concentration gradient to the ventricles - fills to 3/4 full

39
Q

What does P wave represent

A

depolarisation of atrial fibres

40
Q

What does the QRS complex reprsent

A

depolarisation of ventricles

41
Q

what does T wave represent

A

repolarisation of ventricular fibres

42
Q

What are the three phases of the cardiac cylce

A

atrial systole ventricular systole relaxation period when atria are in systole, ventricles are in diastole and vice versa

43
Q

what steps of the cardiac cycle occur in atrial systole?

A

atrial contraction

44
Q

what steps of the cardiac cycle occur in ventricular systole?

A

isovolumetric contraction and ventricular contraction

45
Q

what steps of the cardiac cycle occur in the relaxation period?

A

isovolumetric relaxation and ventricular filling

46
Q

what is the effect of increased HR on the cardiac cycle

A

relaxation period decreases systole time only decreases slightly

47
Q

What is the course of the left coronary artery

A

divides into anterior IV branch- supply both ventricles divides into circumflex branch - supply L atrium and L ventricle

48
Q

what is the course of the right coronary artery

A

divides into: - posterior IV branch - supply both ventricles - marginal branch - wall of right ventricle - small atrial branches - supply the right atrium

49
Q

what does the great cardiac vein drain?

A

blood from both ventricles and left atrium

50
Q

what does the middle cardiac vein drain?

A

both ventricles

51
Q

what does the small cardiac vein drain?

A

right atrium and ventricle

52
Q

what does the anterior cardiac vein drain?

A

the right ventricle - opens directly into the right atrium

53
Q

where do the great, middle and small cardiac veins go?

A

open into the large coronary sinus on the posterior heart - empties directly into the right atrium

54
Q

What is the equation for calculating BP?

A

BP = CO x TPR

55
Q

what effects TPR?

A

smooth muscle contraction or relaxation in arteriole vessels symphathetic input = vasoconstriction = smaller lumen = higher TPR = higher BP small change in TPR = large change in BP

56
Q

what is cardiac output?

A

CO = SV x HR the amount of blood ejected from the LV per MINUTE

57
Q

what is stroke volume?

A

the amount of blood ejected from the LV per CONTRACTION

58
Q

How does blood volume effect cardiac output & blood pressure?

A

increased venous return –> increased stretch of muscle before contraction –> stronger contraction –> more blood ejected –> increased SV and CO –> increased BP STARLINGs LAW

59
Q

what is the effect of the parasympathetic nervous system on cardiac output & blood pressure?

A

causes decreased heart rate means decreased CO and decreased BP no effect on SV

60
Q

what is the effect of the sympathetic nervous system on cardiac output & blood pressure?

A

Increased TPR - due to vasoconstriction Increased heart rate Increase in contractility - due to fight or flight reflex overall increase in CO and increase in BP

61
Q

What is the baroreceptor reflex

A

Part of the ANS response detects stretch of the heart If high amount of stretch - triggers parasymphatetics - vasodilation, decreased HR and decreased contractility If low amount of stretch - triggers symphathetics - increased HR, increase contractility, vasoconstriction

62
Q

what are the two main regulators of blood pressure

A

Autonomic nervous system Blood volume

63
Q

How does the body regulate BP through blood volume?

A

If there is a decrease in BP (e.g. dehydration or blood loss), then CO decreases - decreased perfusion to the kidneys Detected by baroreceptors in kidneys - cause increased renin production Renin causes Ang I to convert to Ang II - which acts to cause vasoconstriction AND aldosterone release from adrenals Aldosterone causes increased sodium and water retention blood volume increases –> SV increases –> BP increases

64
Q

define BP

A

force exerted on the blood vessel walls

65
Q

what is systolic BP and how is it effected?

A

left ventricular contraction effected by stroke volume

66
Q

what is diasystolic BP and how is it effected?

A

left ventricular relaxation effected by TPR

67
Q

what is a normal volume for CO?

A

5l/min

68
Q

what is a normal volume for SV?

A

70ml/contraction

69
Q

what is a normal volume for EDV and ESV?

A

EDV 120-160ml ESV 60-70ml

70
Q

what is a normal HR?

A

60-100bpm

71
Q

histology of a cardiac muscle cell - 7 points

A

50-100 micrometers long, 14 wide one centrally located nucleus connect to other fibres via thickenings of sacrolemma - intercalated discs discs contain desmosomes - hold fibres together discs contain gap junctions - allow AP to transmit between muscle fibres - contract as a single coordinated unit larger and more numerous mitochondria smaller SR therefore less Calcium reserves

Cardio-respiratory Studies 1 (5 decks)

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