The Cardiovascular System Flashcards
A 63-year-old female presented to the emergency department with chest pains, fatigue, swelling of the legs, an irregular heartbeat, and unexplained cough. She stated that she was diagnosed with a heart murmur years ago, but her doctor told her to not worry about it. We started a series of tests on her to rule out several conditions. What we found is that she had aortic stenosis, which is narrowing of the aortic heart valve, This causes a murmur that her doctor should have been worried about years ago. We also noticed that she had a significantly enlarged heart and we diagnosed her with left-sided heart failure. What was the primary underlying cause of the heart failure in this patient?
A. Aortic Stenosis
B. Stroke
C. Heart Attack
D. Advanced age
Correct Answer: Aortic Stenosis
A 24-year-old male PhD candidate was walking around across campus late one night when a mugger approached him with a knife. The student decided to fight rather than hand over his wallet. The mugger stabbed the student in the chest, penetrating the heart and ran away with the knife. The student collapsed and was later found unresponsive by fellow students. During an autopsy, the only abnormality noted was a large volume of blood found around the heart in the pericardial space. What was listed as the cause of this young man’s death?
A. Pericardial effusion
B. Pleural effusion
C. Pericardial tamponade
D. Infection from the wound
Correct answer: Pericardial tamponade
A baby boy is born healthy at 38 week gestation. AN Apgar score test was performed at one and five months. The Apgar test is one for the APPEARANCE (skin color), PULSE, GRIMACE, ACTIVITY (predicted movements a newborn makes), and RESPIRATORY effort. During the first test at one minute after delivery, his score was lower than normal because his toes were blue. During the next test at five minutes, the toes and distal end of the feet were blue. What does a blue tint to the skin tell you about
The right side of the blood transport system receives oxygen-poor blood
from tissues. Pumps to lungs to get rid of CO2, pick up O2 via the…
Pulmonary circuit
The left side receives oxygenated blood from lungs. Pumps to body tissues via the…
Systemic circuit
Receives blood returning from systemic circuit
right atrium
Receives blood returning from pulmonary
circuit
left atrium
Pumps blood through pulmonary circuit
right ventricle
Pumps blood through systemic circuit
left ventricle
Protects, anchors to surrounding
structures, and prevents overfilling
Superficial fibrous pericardium
Parietal layer lines internal surface of
fibrous pericardium
– Visceral layer (epicardium) on external
surface of heart
– Two layers separated by fluid-filled
pericardial cavity (decreases friction)
Deep two-layered serous pericardium
Inflammation of pericardium
– Roughens membrane surfaces
pericardial friction rub (creaking sound)
heard with stethoscope
Pericarditis
Excess fluid sometimes compresses heart; limited pumping ability
Cardiac tamponade
Three layers of heart wall:
– Epicardium
– Myocardium
– Endocardium
Visceral layer of serous pericardium
Epicardium
Cardiac skeleton: crisscrossing, interlacing
layer of connective tissue
* Anchors cardiac muscle fibers
* Supports great vessels and valves
* Limits spread of action potentials to specific
paths
* Spiral bundles of contractile cardiac muscle
cells
Myocardium
– Lines heart chambers; covers cardiac
skeleton of valves
– continuous with endothelial lining of blood
vessels
Endocardium
Remnant of foramen ovale
of fetal heart
Fossa ovalis
Encircles junction of atria and ventricles
Coronary sulcus (atrioventricular
groove)
Anterior position of interventricular septum
Anterior interventricular sulcus
Landmark on posteroinferior surface
Posterior interventricular sulcus
Appendages that increase atrial volume
Auricles
Provide additional surface area for blood flow within the atria and helps blood flow toward tricuspid valve
Pectinate muscles
Three veins empty into right atrium:
Superior vena cava, inferior vena cava,
coronary sinus
How many pulmonary veins empty into left
atrium?
four
Irregular ridges
of muscle on walls
Trabeculae carneae
Anchor chordae
tendineae
Papillary muscles
Ensure unidirectional blood flow through
heart
Heart valves
– Prevent backflow into ventricles when
ventricles relax
– Open and close in response to pressure
changes
Semilunar valves
Who gets blood first?
The heart
– Delivered when heart relaxed (Diastole)
– Left ventricle receives most blood supply
Functional blood supply to heart muscle itself
– Provide additional routes for blood delivery
– Cannot compensate for coronary artery
occlusion
anastomoses (junctions)
_______collect blood from capillary beds
Cardiac veins
________empties into right atrium; formed
by merging cardiac veins
Coronary sinus
-great cardiac vein
-middle cardiac vein
-small cardiac vein
-Thoracic pain caused by fleeting
deficiency in blood delivery to
myocardium–> myocardial ischemia
– Tx: sublingual Nitroglycerin, Rest
Angina pectoris
-Interruption of coronary blood flow
myonecrosis
– Areas of cell death repaired with non-
contractile scar tissue
– SOB, N/V, referred pain, diaphoresis
– EKG, cardiac isoenzymes(troponin, CK-MB,
Myoglobin)
– Tx: MONA, CABG, angiography
Myocardial infarction (heart attack)
Junctions between
cells - anchor cardiac cells
