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ANAPHY > The Cardiovascular System: The Heart > Flashcards

The Cardiovascular System: The Heart Flashcards

1
Q

Thoracic cavity between two lungs

A

~2/3 to left of midline

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2
Q

surrounded by pericardium: (2 parts)

A
  1. Fibrous pericardium
  2. serous pericardium
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3
Q

Inelastic and anchors heart in place

A

Fibrous pericardium

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4
Q

Inside is ___________ - double layer around heart

A

serous pericardium

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5
Q

layer fused to fibrous pericardium

A

Parietal

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6
Q

Inner ___________ layer adheres tightly to heart

A

visceral

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7
Q

Filled with _____________ - reduces friction during beat.

A

pericardial fluid

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8
Q

Heart Wall

A

Epicardium
Myocardium
Endocardium

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9
Q

outer layer

A

Epicardium

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10
Q

cardiac muscle

A

Myocardium

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11
Q

Responsible for the pumping action of the heart

A

Myocardium

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12
Q

makes up approximately 95% of the heart wall

A

Myocardium

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13
Q

thin layer of endothelium

A

Endocardium

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14
Q

provides a smooth lining for the chambers of the
heart and covers the valves of the heart

A

Endocardium

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15
Q

“itis”

A

Inflammation

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16
Q

is an inflammation of the myocardium that usually occurs as a complication of a viral infection, rheumatic fever, or exposure to radiation or certain chemicals or medications.

A

Myocarditis

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17
Q

refers to an inflammation of the endocardium and typically involves the heart valves. Most cases are caused by bacteria (bacterial endocarditis).

A

Endocarditis

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18
Q

Tx of Myocarditis and Endocarditis

A

Tx- intravenous antibiotics

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19
Q

Chambers of the Heart

A

• 4 chambers
• 2 upper chambers = Atria
• 2 lower chambers = ventricles
• Wall thickness depends on work load

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20
Q

receive blood from blood vessels returning blood to the heart, called _______

A

veins

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21
Q

eject the blood from the heart into blood vessels called ___________

A

arteries

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22
Q

• Atria thinnest
• Right ventricle pumps to lungs & thinner than left

A

Wall thickness depends on work load

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23
Q

Forms the right border of the heart and receives blood from three veins:

A

the superior vena cava,
inferior vena cava, and
coronary sinus.

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24
Q

thin partition between the right left atrium

A

interatrial septum

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25
Q

A prominent feature of this septum is an oval depression called the __________, the remnant of the ________, an opening in the interatrial septum of the fetal heart that normally closes soon after birth

A

fossa ovalis

foramen ovale

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26
Q

blood passes from the right atrium into the right ventricle

A

tricuspid valve

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27
Q

• Forms the right border of the heart and receives blood from three veins: the superior vena cava, inferior vena cava, and coronary sinus.
• interatrial septum - thin partition between the right left atrium
• A prominent feature of this septum is an oval depression called the fossa ovalis, the remnant of the foramen ovale, an opening in the interatrial septum of the fetal heart that normally closes soon after birth
• tricuspid valve - blood passes from the right atrium into the right ventricle

A

Right Atrium

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28
Q

• forms most of the anterior surface of the heart.
• inside of the right ventricle contains a series of ridges formed by raised bundles of cardiac muscle fibers called trabeculae.
• interventricular septum – separate right ventricle from the left ventricle
• blood passes from the right ventricle through the pulmonary valve into a large artery called the pulmonary trunk, which divides into right and left pulmonary arteries and carries blood to the lungs.

A

Right Ventricle

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29
Q

forms most of the anterior surface of the heart.

A

Right Ventricle

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30
Q

inside of the right ventricle contains a series of ridges formed by raised bundles of cardiac muscle fibers called __________

A

trabeculae.

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31
Q

separate right ventricle from the left ventricle

A

interventricular septum

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32
Q

blood passes from the right ventricle through the _________ into a large artery called the ___________, which divides into right and left pulmonary arteries and carries blood to the lungs.

A

pulmonary valve

pulmonary trunk

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33
Q

• receives blood from the lungs through four pulmonary veins.
• Blood passes from the left atrium into the left ventricle through the bicuspid (mitral) valve.
• It is also called the left atrioventricular valve.

A

Left Atrium

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34
Q

receives blood from the lungs through four pulmonary veins.

A

Left Atrium

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35
Q

Blood passes from the left atrium into the left ventricle through the ____________

A

bicuspid (mitral) valve.

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36
Q

It is also called the left atrioventricular valve.

A

Left Atrium

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37
Q

• the thickest chamber of the heart, averaging 10–15 mm
• blood passes from the left ventricle through the aortic valve into the ascending aorta.

A

Left Ventricle

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38
Q

the thickest chamber of the heart, averaging 10–15 mm

A

Left Ventricle

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39
Q

blood passes from the left ventricle through the _________ into the ascending aorta.

A

aortic valve

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40
Q

• Superior & inferior Vena Cavae
— Delivers deoxygenated blood to R. atrium
from body
— Coronary sinus drains heart muscle veins
• R. Atrium -> R. Ventricle
• pumps through Pulmonary Trunk
• -> R & L pulmonary arteries
• -> lungs

A

Great Vessels Of Heart-Right

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41
Q

• Pulmonary Veins from lungs
— oxygenated blood
• -> L. atriumè Left ventricle
• -> ascending aorta -> body
• Between pulmonary trunk & aortic arch is ligamentum arteriosum (fetal ductus arteriosum remnant) - which connects the arch of the aorta and pulmonary trunk.

A

Great Vessels Of Heart-Left

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42
Q

Pulmonary Veins from lungs

A

oxygenated blood

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43
Q

Between pulmonary trunk & aortic arch is _____________(fetal ductus arteriosum remnant) - which connects the arch of the aorta and pulmonary trunk.

A

ligamentum arteriosum

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44
Q

Designed to prevent back flow in response to pressure changes

A

Valves

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45
Q

Between atria and ventricles

A

Atrioventricular (AV) valves

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46
Q

Right

A

tricuspid valve (3 cusps)

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47
Q

Left

A

bicuspid or mitral valve

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48
Q

near origin of aorta & pulmonary trunk

A

Semilunar valves

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49
Q

valves respectively

A

Aortic & pulmonary

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50
Q

• Designed to prevent back flow in response to pressure changes
• Atrioventricular (AV) valves
— Between atria and ventricles
• Right = tricuspid valve (3 cusps)
• Left = bicuspid or mitral valve
• Semilunar valves near origin of aorta & pulmonary trunk
• Aortic & pulmonary valves respectively

A

Valves

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51
Q

• narrowing of a heart valve opening that restricts blood flow is known as stenosis.
• mitral stenosis - scar formation or a congenital defect causes narrowing of the mitral valve.
• Mitral valve prolapse (MVP) backflow of blood from the left ventricle into the left atrium
• aortic stenosis - aortic valve is narrowed, and in aortic insufficiency there is backflow of blood from the aorta into the left ventricle.
• Rheumatic fever - acute systemic inflammatory disease that usually occurs after a streptococcal infection of the throat.

A

Heart Valve Disorders

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52
Q

• Blood flow through vessels in myocardium = coronary circulation
• Left & right coronary arteries
— Branch from the ascending aorta and supply
oxygenated blood to the myocardium
• Most of the deoxygenated blood from the myocardium drains into a large vascular sinus in the coronary sulcus on the posterior surface of the heart, called the coronary sinus
• Empties into right atrium

A

Blood Supply Of Heart

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53
Q

Blood flow through vessels in myocardium =

A

coronary circulation

54
Q

Branch from the ascending aorta and supply
oxygenated blood to the myocardium

A

Left & right coronary arteries

55
Q

Most of the deoxygenated blood from the myocardium drains into a large vascular sinus in the coronary sulcus on the posterior surface of the heart, called the

A

coronary sinus

56
Q

Empties into right atrium

A

Blood Supply Of Heart

57
Q

only 1% of the cardiac muscle fibers become autorhythmic fibers

A

Conduction System

58
Q

• only 1% of the cardiac muscle fibers become autorhythmic fibers;
• Two important functions:
1. They act as a pacemaker, setting the rhythm of electrical excitation that causes contraction of the heart.
2. they form the cardiac conduction system, a network of specialized cardiac muscle fibers that provide a path for each cycle of cardiac excitation to progress through the heart.

A

Conduction System

59
Q

setting the rhythm of electrical excitation that causes contraction of the heart.

A

pacemaker

60
Q

a network of specialized cardiac muscle fibers that provide a path for each cycle of cardiac excitation to progress through the heart.

A

cardiac conduction system

61
Q

Two important functions of Conduction System

A
  1. pacemaker
  2. cardiac conduction system (CCS)
62
Q

• Normally begins at sinoatrial (SA) node
• -> Atria & atria contract
• -> AV node - slows
• -> AV bundle (Bundle of His)
• -> bundle branches -> Purkinje fibers
• -> apex and up- then ventricles contract pushing the blood upward toward semilunar valve.

A

Sequence of AP propagate through the conduction system

63
Q

• Depolarize spontaneously
• sinoatrial node ~100times /min
• also AV node ~40-60 times/min
• in ventricle ~20-35 /min
• Fastest one run runs the heart = pacemaker
• Normally the sinoatrial node

A

Pacemaker

64
Q

Depolarize spontaneously

A

Pacemaker

65
Q

sinoatrial node

A

~100times /min

66
Q

also AV node

A

40-60 times/min

67
Q

in ventricle

A

20-35 /min

68
Q

Fastest one run runs the heart

A

pacemaker

69
Q

Normally the sinoatrial node

A

pacemaker

70
Q

• if the pacing rate is so slow (20–35 bpm) that blood flow to the brain is inadequate.
• artificial pacemaker - a device that sends out small electrical currents to stimulate the heart to contract.
• A pacemaker consists of a battery and impulse generator and is usually implanted beneath the skin just inferior to the clavicle.
• Many of the newer pacemakers, referred to as activity-adjusted pacemakers, automatically speed up the heartbeat during exercise.

A

Artificial Pacemakers

71
Q

if the pacing rate is so slow (20–35 bpm) that blood flow to the brain is ________

A

inadequate

72
Q

a device that sends out small electrical currents to stimulate the heart to contract.

A

artificial pacemaker

73
Q

A pacemaker consists of a battery and impulse generator and is usually implanted beneath the skin just inferior to the __________.

A

clavicle

74
Q

Many of the newer pacemakers, referred to as ____________, automatically speed up the heartbeat during exercise.

A

activity-adjusted pacemakers

75
Q

Recording of currents from cardiac conduction on skin

A

electrocardiogram (EKG or ECG)

76
Q

is a composite record of action potentials produced by all the heart muscle fibers during each heartbeat.

A

ECG

77
Q

3 waves

A

P wave
QRS complex
T-wave

78
Q

represents atrial depolarization

A

P wave

79
Q

• Contraction begins right after peak
• Repolarization is masked in QRS

A

P wave

80
Q

• rapid ventricular depolarization
• Contraction of ventricle

A

QRS complex

81
Q

• ventricular repolarization
• Just after ventricles relax

A

T-wave

82
Q

indicate enlargement of an atrium;

A

Larger P waves

83
Q

may indicate a myocardial infarction

A

Enlarged Q wave

84
Q

generally indicates enlarged ventricles

A

Enlarged R wave

85
Q

If ______ is flatter than normal = heart muscle is receiving insufficient oxygen—exp, in coronary artery disease.

A

T wave

86
Q

The _______ in hyperkalemia (high blood K level).

A

T wave may be elevated

87
Q

in coronary artery disease and rheumatic fever.

A

P–Q interval lengthens

88
Q

_______ in acute myocardial infarction and depressed when the heart muscle receives insufficient oxygen.

A

S–T segment is elevated

89
Q

________ by myocardial damage, myocardial ischemia (decreased blood flow), or conduction abnormalities.

A

Q–T interval may be lengthened

90
Q

A single ______ includes all the events associated with one heartbeat.

A

cardiac cycle

91
Q

cardiac cycle consists of :

A

systole and diastole of the atria PLUS
systole and diastole of the ventricles

92
Q

lasts about 0.1 sec, the atria are contracting
(P -wave). The ventricles are relaxed (diastole).

A

atrial systole

93
Q

which lasts about 0.3 sec, the ventricles are contracting. The atria are relaxed in (atrial diastole).

A

ventricular systole

94
Q

Ventricular pressure drops below atrial pressure & AV valves open -> ventricular filling occurs

A

after T-wave -> ventricular diastole

95
Q

Finishes filling ventricle (25mL)

A

After P-wave -> atrial systole

96
Q

• Pressure pushes AV valves closed
• Pushes semilunar valves open and ejection occurs
• Ejection until ventricle relaxes enough for arterial pressure to close semilunar valves

A

After QRS -> ventricular systole

97
Q

Cardiac cycle

A
  1. Relaxation period
  2. Atrial systole
  3. Ventricular systole
98
Q

the volume ejected per beat from each ventricle, equals end-diastolic volume minus end-systolic volume

A

Stroke volume (SV = EDV - ESV)

99
Q

At rest, the stroke volume is about _____

A

130 mL - 60mL = 70 mL (a little more than 2 oz).

100
Q

is the volume of blood ejected from the left ventricle (or the right ventricle) into the aorta (or pulmonary trunk) each minute.

A

Cardiac output (CO)

101
Q

Cardiac output equals the Stroke volume, multiplied by the Heart rate (HR)

A

CO(mL/min) = SV(mL/beat) • HR (beats/min)

102
Q

Three factors regulate SV and ensure that the left and right ventricles pump equal volumes of blood:

A

Preload
Contractility
Afterload

103
Q

the degree of stretch on the heart before it contracts

A

preload

104
Q

the forcefulness of contraction of individual ventricular muscle fibers

A

contractility

105
Q

the pressure that must be exceeded before ejection of blood from the ventricles can occur.

A

afterload

106
Q

• Degree of stretch = Frank-Starling law
— Increase diastolic Volume increases strength of contraction -> increased S.V.
— Increased venous return -> increased S.V.
• When HR exceeds about 160 beats/min, SV usually declines due to the short filling time
• High back pressure in artery -> decreased S.V. — Slows semilunar valve opening

A

Control of Stroke Volume (S.V.) Preload

107
Q

Degree of stretch

A

Frank-Starling law

108
Q

When HR exceeds about 160 beats/min, _________ due to the short filling time

A

SV usually declines

109
Q

• positive inotropic agents - substances that increase contractility
— Ex. stimulation of the sympathetic div of ANS, hormones such as Epi & NE increase Ca2+ level and drug digitalis.
• negative inotropic agents - decrease contractility
— Ex. inhibition of the sympathetic div of the ANS, anoxia, acidosis, some anesthetics, and increased K level in the interstitial fluid have negative inotropic effects.
• Calcium channel blockers - reduce Ca2+ inflow

A

Control of Stroke Volume (S.V.)
Contraction

110
Q
  • substances that increase contractility

Ex. stimulation of the sympathetic div of ANS, hormones such as Epi & NE increase Ca2+ level and drug digitalis.

A

positive inotropic agents

111
Q
  • decrease contractility

Ex. inhibition of the sympathetic div of the ANS, anoxia, acidosis, some anesthetics, and increased K level in the interstitial fluid have negative inotropic effects.

A

negative inotropic agents

112
Q

reduce Ca2+ inflow

A

Calcium channel blockers

113
Q

• pressure that must be overcome before a semilunar valve can open.
• increase in afterload causes stroke volume to decrease,
• More blood remains in the ventricles at the end of systole.
• Conditions that can increase afterload include hypertension and narrowing of arteries by atherosclerosis

A

Control of Stroke Volume (S.V.) Afterload

114
Q

___________ causes stroke volume to decrease

A

increase in afterload

115
Q

• loss of pumping efficiency by the heart.
• Causes: coronary artery disease, congenital defects, long-term high blood pressure, myocardial infarctions, and valve disorders.
• As a result, blood backs up in the lungs and causes pulmonary edema, that can cause suffocation if left untreated.
• If right ventricle fails first, blood backs up in the systemic veins and, over time, the kidneys cause an increase in blood volume. Resulting peripheral edema - most noticeable in the feet and ankles.

A

Congestive Heart Failure

116
Q

loss of pumping efficiency by the heart.

A

Congestive Heart Failure

117
Q

As a result, blood backs up in the lungs and causes ________, that can cause suffocation if left untreated.

A

pulmonary edema

118
Q

If right ventricle fails first, blood backs up in the systemic veins and, over time, the kidneys cause an increase in blood volume. Resulting ___________- most noticeable in the feet and ankles.

A

peripheral edema

119
Q

• Pacemaker adjusted by nerves
— Cardiovascular center in Medulla
• Parasympathetic- ACh slows
— via vagus nerve (CN X)
• Sympathetic - Norepinephrine speeds
• Sensory input for control:
— Baroreceptors (aortic arch & carotid sinus)-monitor the stretching of major arteries and veins caused by the pressure of the blood flowing.
— Chemoreceptors- O2, CO2, pH

A

Controls- Heart Rate

120
Q

adjusted by nerves

A

Pacemaker

121
Q

ACh slows

A

Parasympathetic

122
Q

Norepinephrine speeds

A

Sympathetic

123
Q

Sensory input for control

A

• Baroreceptors (aortic arch & carotid sinus)
• Chemoreceptors

124
Q

monitor the stretching of major arteries and veins caused by the pressure of the blood flowing.

A

Baroreceptors (aortic arch & carotid sinus)

125
Q

O2, CO2, pH

A

Chemoreceptors

126
Q

• Epinephrine & norepinephrine increase
H.R.
• Thyroid hormones stimulate H.R.
• Hyperthyroidism causes tachycardia

A

Hormones

127
Q

Hyperthyroidism causes

A

tachycardia

128
Q

• Increased Na+ or K+ decrease H.R. &
contraction force
• Increased Ca2+ increases H.R. &
contraction force

A

Ions

129
Q

Increased ______ decrease H.R. &
contraction force

A

Na+ or K+

130
Q

Increased ______ increases H.R. &
contraction force

A

Ca2+

131
Q

• Aerobic exercise (longer than 20 min) strengthens cardiovascular system:
• Brisk walking, running, bicycling, cross-country skiing, and swimming are examples of aerobic activities.
• Well trained athlete -> doubles maximum C.O.
• Resting C.O. about the same but resting H.R.
decreased (40–60 bpm)
• Regular exercise also helps to reduce blood pressure, anxiety, and depression; control weight; and increase the body’s ability to dissolve blood clots.

A

Exercise and the Heart

ANAPHY (17 decks)

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