Test 1 Flashcards
1
Q
Adult heart approximately
A
The size of a fist
2
Q
Right ventricle = moves venous blood to the
A
Pulmonary Circulation
3
Q
Left ventricle = moves arterial blood to the
A
Systemic Circulation
4
Q
separates right and left atria
A
Interatrial septum
5
Q
depression in the interatrial septum; remnants of foramen ovale
A
Fossa ovalis
6
Q
is the term used to describe an interatrial septum that fails to develop properly
A
Atrial Septal Defect
7
Q
separates right and left ventricles
A
Interventricular septum
8
Q
are the most common CONGENITAL cardiac abnormalities ; they are found in 30-60% of all newborns with a congenital heart defect, or about 2-6 per 1000 births
A
Ventricular septal defects
9
Q
In order to pump blood…
A
Right and Left Ventricles of the Heart
Must contract forcefully and overcome aortic and pulmonary pressures
10
Q
end diastolic volume is usually about
A
150 mL
11
Q
How much blood dos the heart eject with each stroke?
A
About 50% the volume ejected is about 70-80mL
12
Q
What are the 3 Layers of the heart
A
Epicardium
Myocardium
Endocardium
13
Q
Lines inner chambers,valves, chordae tendineae, and papillary muscles.
A
Endocardium
14
Q
The different things cardiac muscle has compared to skeletal muscle…
A
Single central nucleus Intercalated discs (help contraction)
15
Q
Also called the
visceral pericardium
A
Epicardium
16
Q
Includes blood capillaries, lymph capillaries, nerve fibers, and epicardial fat
A
Epicardium
17
Q
covers approx. 60- 80% of the heart’s surface and constitutes 20% of total heart weight
A
Epicardial fat
18
Q
The pericardial space usually contains…
What is this used for?
A
Normally contains approximately 10 mL of fluid
Acts as a lubricant, preventing friction as the heart beats
19
Q
Primary function of the heart valves
A
Ensure blood flow in one direction through
heart chambers and Prevent regurgitation
20
Q
• Lies between right atrium and right ventricle • Consists of three separate leaflets • Larger in diameter and thinner than mitral valve
A
TRICUSPID VALVE
21
Q
• Has only two cusps
• Lies between left
atrium and left
ventricle
A
MITRAL (BICUSPID) VALVE
22
Q
What are the distinct features of AV valves?
A
Cusps of AV valves are attached to chordae tendineae (“heart strings”): papillary muscles contract when the ventricular walls contract preventing bulging too far backward.
23
Q
have three cusps shaped like half-moons
A
Semilunar valves
• Pulmonic valve (Right Ventricle)
• Aortic valve (Left Ventricle)
24
Q
Function of the “ventricular valves”
A
Prevent backflow of blood from the aorta and pulmonary arteries into the ventricles during ventricular diastole
25
Associated with closure of tricuspid and mitral
| (AV) valves
First Heart Sound (Lub)
26
Associated with closure of pulmonic and aortic
| (semilunar) valves
Second Heart sound (Dub)
27
receives blood from: Superior vena cava, Inferior vena cava, and Coronary sinus.
Receives blood from: Superior vena cava, Inferior vena cava, and Coronary sinus.
28
Order of blood flow through RIGHT SIDE of heart
```
Right Atrium
Tricuspid Valve
Right Ventricle
Semilunar pulmonic valve
Pulmonary trunk
Pulmonary arteries
Lungs (pulmonary
capillaries)
Pulmonary veins
```
29
Blood flow starting in the LEFT SIDE of the heart
```
Left atrium
Mitral Valve
Left Ventricle
Semilunar Aortic valve
Aorta
Systemic Circulation
```
30
Acute Pericarditis Manifestations
Chest Pain
Friction rub
ECG changes
31
Acute Pericarditis Causes
Infections: viral, bacterial or fungal
autoimmune: RA, SLE
Trauma
Drug toxicity
32
This Pericarditis is associated with systemic lupus erythematosus (SLE), rheumatic fever, and a variety of viral infections.
SEROUS PERICARDITIS
33
This Pericarditis is characterized by production of a clear, straw-colored, protein-rich exudate containing small numbers of inflammatory cells.
SEROUS PERICARDITIS
34
This Pericarditis is characterized by a fibrin-rich exudate. It may be caused by uremia, myocardial infarction, or acute rheumatic f e v e r.
FIBRINOUS PERICARDITIS
35
This Pericarditis is characterized by a grossly cloudy exudate. It is almost always caused by bacterial infection.
PURULENT PERICARIDITIS
36
This Pericarditis is characterized by a bloody exudate. It usually results from tumor invasion of the pericardium, but can also result from tuberculosis or other bacterial infections.
HEMORRHAGIC PERICARDITIS
37
Define CARDIAC TAMPONADE
Represents an increase in pericardial sac pressure caused by an accumulation of fluid or blood in the pericardial sac
38
Define Myocardial Disease
Disorders originating from within the
myocardium, but not from cardiovascular
disease
39
Inflammation of the heart muscle (and conduction system) without evidence of myocardial infarction
Myocarditis
40
Causes of Myocarditis
viral (#1 cause), drug toxicity (e.g., cocaine), autoimmune diseases
41
Most often presents as biventricular heart failure in young persons who do not have valvular, rheumatic, or congenital heart disease
Myocarditis
42
Diseases of the heart muscle that are non-inflammatory and are not associated with hypertension, congenital heart disease, valvular disease, or coronary artery disease
Primary Cardiomyopathies
43
most common form of Cardiomyopathy Progressive cardiac hypertrophy and dilation & impaired pumping ability in one or both ventricles
Dilated Cardiomyopathy
44
are common during Dilated Cardiomyopathy and may be a source of thromboemboli
Mural thrombi
45
Causes: Dilated Cardiomyopathy
idiopathic, infectious myocarditis, alcohol
46
Characterized by ventricular hypertrophy and impaired diastolic ventricular filling. Is often inherited as an autosomal dominant characteristic; several genes have been implicated in the genesis of this disorder. Sudden death may occur if left ventricular outflow obstruction continues.
Hypertrophic Cardiomyopathy
47
Least common of the primary cardiomyopathies
Ventricular filling is restricted because of excessive rigidity and stiffness of the ventricular walls
Causes is unknown
Restrictive Cardiomyopathy
48
Relatively uncommon, life-threatening condition of the endocardial surface of the heart, including the heart valves
Infective Endocarditis (Bacterial Endocarditis)
49
The primary antibiotic regimen for select patients is_________, 2g orally 30-60 min before the procedure.
AMOXICILLIN
50
Patients who are allergic to penicillins can be treated with...
cephalexin (2g) or azithromycin or clarithromycin
51
Because cardiac fibers are electrically coupled by the gap junctions, the entire myocardium behaves as a...
coordinated unit or FUNCTIONAL SYNCYTIUM.
52
The cardiac troponin complex consists of three proteins, What are they?
* cardiac troponin C (cTnC)
* cardiac troponin I (cTnI)
* cardiac troponin T (cTnT)
53
cardiac troponin T (cTnT): T is for...
"tropomyosin binding"
54
cardiac troponin I (cTnI): I is for...
"inhibitory"
55
cardiac troponin C (cTnC): C is for...
"calcium binding"
56
What is the Clinical Application of Troponin
Cardiac troponins are the prefered markers for detecting myocardial cell injury
57
The two Tracts of the SA node...
```
Internodal Tracts (continues on)
Interatrial Tracts
```
58
What is the path of a signal from the SA node traveling down the Internodal tract?
SA NODE>>Internodal Tract>>AV Node>>AV Bundle>>R/L Bundle Branches>>Purkinje Fibers
59
Describe Non-Pacemaker or “Fast Response” Action Potentials
• Occur in the atria,
ventricles and Purkinje fibers
• Undergo “rapid”
depolarization
60
Describe Pacemaker or “Slow Response”
| Action Potentials
• Occur in the SA node
and AV node
• Undergo “slow” depolarization
61
What happens in Phase 0 (Rapid Depolarization) Fast Response Cardiac Action Potentials?
* Upstroke of the AP
* “Fast” Na+-channels open
* Several types of K+- channels closed
62
What happens in Phase 1 (Early/Initial Repolarization) Fast Response Cardiac Action Potentials?
* Transient outward current as K+ channels open
| * “Fast” Na+-channels are closed
63
What happens in Phase 2 (Plateau Phase) Fast Response Cardiac Action Potentials?
* Long-lasting (L-type) Ca+2 channels open leading to inward calcium movement
* Efflux of K+ through several types of K+- channels
64
Cardiac contraction has an absolute requirement for Ca+2 influx through these channels...
L-type Ca+2 channels
65
The influx of calcium during an action potential serves as a trigger to induce calcium release from the sarcoplasmic reticulum (calcium-induced calcium release = CICR), which then promotes actin-myosin interaction and hence contraction; occurs via...
ryanodine receptors (RyR2)
66
What happens in Fast Response Cardiac Action Potentials Phase 3 (Late or Final Repolarization)?
* Continual efflux of K+ through several types of K+-channels
* L-type Ca+2-channels eventually close
67
What happens in Fast Response Cardiac Action Potentials Phase 4 (RMP)
* K+-channels remain open
| * Calcium extrusion mechanisms become highly active
68
The electrical and mechanical events in cardiac muscle overlap, this prevents...
Tetany
69
What happens in Phase 0 Slow Response Cardiac Action Potentials?
Is the upstroke of the AP
| Is caused by an increase in Ca+2 conductance
70
What happens in Phase 3 Slow Response Cardiac Action Potentials?
repolarization Is caused by an increase in K+ conductance
71
What happens in Phase 4 Slow Response Cardiac Action Potentials?
slow depolarization
Is caused by an increase in Na+ conductance, which results in an inward current called I_f
72
I_f is “turned on” by
repolarization of the membrane potential during the preceding action potential
73
reflects the time required for excitation to spread throughout cardiac tissue.
Conduction Velocity (CV)
74
CV is fastest in the______ and Slowest in the ______
CV is fastest in the Purkinje system
CV is slowest in the AV node
75
produce changes in heart rate
Chronotropic effects
76
changes in HR are reflected on the ECG by changes
| in the
R-R intervals
77
produce changes in conduction velocity, primarily in the
| AV node
Dromotropic effects
78
cetylcholine (ACh), acts at...
muscarinic receptors
79
norepinephrine (NE), acts at...
β1-receptors
80
quantity of blood remaining in either ventricle at the end of ventricular diastole
End Diastolic Volume (EDV)
average 130ml
81
quantity of blood remaining in either ventricle at the end of ventricular systole
End Systolic Volume (ESV)
82
Three distinct phases of ventricular filling
1. Rapid Passive Filling
2. Slow passive filling (Diastasis, no one contracts)
3. Atrial Systole
83
The third heart sound is associated with
The end of rapid passive filling of the ventricles.
84
occurs when a valve does not open properly.
VALVULAR STENOSIS
85
The_______ valve is the valve that is most frequently involved in rheumatic heart disease.
mitral
86
Most frequent heart valve problem, occurring in approximately 7% of the population, most often in young women...
Mitral valve prolapse
87
```
is the most common
cause of calcific aortic
stenosis in persons
older than 60 years of
age.
```
degenerative
| calcific aortic stenosis,
88
```
is the most common
cause of calcific aortic
stenosis in persons
older than 60 years of
age.
```
degenerative calcific aortic stenosis,
89
The greater the preload, the greater the force of contractiond
HETEROMETRIC REGULATION (Pre-load)
Frank-Starling Law of the Heart
90
Enhanced contractility results in more complete ejection of blood from the heart,
HOMOMETRIC REGULATION
91
The BACK PRESSURE exerted on the aortic & pulmonary semilunar valves by arterial blood in the aorta and pulmonary trunk respectively
Afterload
92
Cardiac Contractility is also called...
Inotropism or Inotropy
93
cardiac output or performance is enhanced by:
↑ Preload ↑ Inotropy ↑ Heart rate ↓ Afterload
94
This type of Angina is associated with atherosclerotic disease that produces fixed obstruction of the coronary arteries.
Classic angina or exertional angina
95
This type of Angina is caused by spasms of the coronary arteries.
Variant angina or Prinzmetal's angina
| also referred to as vasospastic angina.
96
is considered to be a clinical syndrome of myocardial ischemia that falls between stable angina and myocardial infarction
Unstable angina
97
Myocardial Infarctions that traverses the entire ventricular wall from the endocardium to the epicardium.
Transmural infarction
98
Myocardial Infarctions that is limited to the interior one-third of the wall of the ventricle.
Subendocardial infarction
