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Anatomy and Physiology 2 > The cardiovascular system: The heart > Flashcards

The cardiovascular system: The heart Flashcards

1
Q

Where is the heart located?

A

The heart rests on the diaphragm, with 2/3 of it lying to the left of the midline, located within the mediastinuum

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2
Q

What does the mediastunum contain?

A
  1. Heart, ascending aorta, SVC
  2. Trachea
  3. Main stem bronchi
  4. Esophagus
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3
Q

Where is the mediastinum located?

A

Between the lungs, from 1st rib to the diaphragm, from the sternum to the vertebral column

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4
Q

T/F

The whole heart lies within the mediastinum?

A

True

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5
Q

Where is the heart in relation to the thoracic cavity?

A

It is anterior

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6
Q

Label 1-4

A
  1. SVC
  2. Diaphragm
  3. Arch of aorta
  4. Pulmonary trunk
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7
Q

Label 1-4

A
  1. Heart
  2. Pericardial cavity
  3. Aorta
  4. Pulmonary trunk (artery)
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8
Q

What affects the size of the mediastinum?

A
  1. Being supine vs. erect
  2. Rotation
  3. Being AP supine vs. PA erect
  4. Effect of gravity
  5. Inspiration vs expiration
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9
Q

In which position does hte mediastinum appear larger in; supine or erect? Why?

A

Supine; gravity

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10
Q

How were both of these images aquired?

A

A: AP supine
B:PA erect

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11
Q

How was this image aquired?

A

Supine

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12
Q

How do you measure the cardiothoracic ratio?

A

Measure the widest parts of the heart and divide by the size of the widest part of the thorax

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13
Q

What should the CT ratio not exceed?

A

Should not exceed by 50%

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14
Q

What is indicated if the CT ratio is higher than 50%?

A

Cardiomegly

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15
Q

What are the arrows pointing to?

A

A PTX

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16
Q

What are these arrows pointing to?

A

Arm and mass

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17
Q

What are the layers of the pericardium?

A
  1. Fibrous
  2. Serous pericardium
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18
Q

What are the layers of the serous pericardium?

A

Parietal and visceral

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19
Q

What is the fibrous pericardium? What is its function?

A

-It attaches to the adventitial layers of the aorta, pulmonary trunk and SVC
-It stabaliezes the position of the heart and prevents overstretching

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20
Q

What are the charecteristics of the serous pericardium?

A

It is a thinner, more delicate layer

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21
Q

What are the layers of hte heart wall?

A
  1. Epicardium
  2. Myocardium
  3. Endocardium
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22
Q

What is the epicardium?

A

The visceral layer of the serous pericardium

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23
Q

What makes up 95% of the heart wall?

A

The myocardium

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24
Q

What is the myocardium made of?

A

Striated muscle

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25
Q

What is the endocardium?

A

The smooth inner layer that is continous with the endothelial lining of the aorta, SVC, and IVC

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26
Q

What are the 4 main parts of the heart?

A
  1. The apex
  2. The base
  3. 4 chambers
  4. Sulci
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27
Q

What are the 4 chambers of heart?

A

-2 atria
-2 ventricles

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28
Q

What are the 2 sulci of the heart?

A
  1. The coronary sulcus
  2. The interventricular sulcus
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29
Q

Where is the base of the heart directed?

A

Toward the right shoulder

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30
Q

What structures exit the base of the heart?

A

Ascending aorta and pulmonary arteries/trunk exit

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31
Q

What structures enter the base of the heart?

A

The SVC and IVC

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32
Q

What makes up the apex of the heart

A

The tip of the right and left ventricles

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33
Q

Where is the apex of the heart directed?

A

Towards the left hip

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34
Q

What does the coronary sulcus sepearate?

A

The atria from the ventricles

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35
Q

How many interventricular sulci are there?

A

2

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36
Q

What do the interventricular sulci separate?

A

The ventricles

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37
Q

What are the 2 interventricular sulci?

A
  1. Anterior
  2. Posterior
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38
Q

What are the functions of the sulci and what do they contain?

A
  1. Separate the chambers
  2. The coronary vessels travel in the sulci and the sulci contain a variable amound of fat
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39
Q

Label 1-13

A
  1. Brachiocephalic trunk
  2. SVC
  3. Acending aorta
  4. Right pulmonary veins
  5. Right coronary artery
  6. Coronary sulcus
  7. IVC
  8. Arch of aorta
  9. Left pulmonary artery
  10. Left pulmonary vein
  11. Auricle of left atrium
  12. Left ventricle
  13. Anterior interventricular sulcus
  14. Descending aorta
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40
Q

Label 1-10

A
  1. Arch of aorta
  2. Descending aorta
  3. Left pulmonary veins
  4. Left atrium
  5. Coronary sinus (in coronary sulcus)
  6. Left ventricle
  7. Brachiocephalic trunk
  8. Right pulmonary artery
  9. Right atrium
  10. Right ventricle
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41
Q

T/F

We see the left atrium on a normal AP/PA image

A

FALSE

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42
Q

Where does the right atrium recieve blood from?

A
  1. Superior vena cava
  2. Inferior vena cava
  3. Coronary sinus (posterior surface)
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43
Q

Where are the pectinate muscles located?

A

On the anterior surface of the right auricle

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44
Q

T/F

The coronary sinus contains venous blood

A

True

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45
Q

What is the fossa ovalis and where is it located?

A

-It is the remnant of the forament ovale
-Located in the right atrium

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46
Q

Where is the tricuspid valve located and what does it open into?

A

Located in the right atrium and opens into the right ventricle

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47
Q

What causes the valves within the heart to open and close?

A

Pressure

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48
Q

What forms the papillary muscles and what do the papillary muscles connect to?

A

The trabeculae carneae form the papillary muscles, and the papillary muscles connect to the chordae tendineae

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49
Q

What is the function of the chordae tendineae?

A

It attaches the cusps of the tricuspid valve to the papillary muscles to prevent the cusps from entering into the atria and the backflow of blood into the atria during contraction of the ventricles

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49
Q

What are the 2 pulmonary arteries?

A

The right and left pulmonary arteries

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49
Q

What does the pulmonary valve open into?

A

Opens into the pulmonary trunk

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50
Q

Where does the left atrium recieve blood from?

A

Recieves blood from 4 pulmonary veins

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51
Q

T/F

Blood coming from the pulmonary veins are oxygenated

A

True

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52
Q

Where is the mitral valve located?

A

In the left atrium

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53
Q

Which ventricle is thicker? Why?

A

The left ventricle-It is reponsible for pumping blood to the entire body

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54
Q

How many cusps does the aortic and pulmonary valve contain?

A

3 cusps

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55
Q

Where is the pulonary trunk in relation to the aortic valve?

A

It is anteior to the aortic valve

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56
Q

Label 1-7

A
  1. SVC
  2. Right atrium
  3. Inferior vena cava
  4. Aorta
  5. Main pulmonary artery
  6. Left auricle
  7. Left ventricle
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57
Q

What is the most superior part of the heart?

A

The right atrium

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58
Q

What is the most posterior part of the heart?

A

The left atrium

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59
Q

What is the most inferior part of the heart?

A

The left ventricle

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60
Q

What is the most anterior part of the heart?

A

The right ventricle

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61
Q

What position of the chest would we use to acess ventricular enlargment?

A

Lateral

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62
Q

How much space should the heart take up behind the body of the sternum?

A

The heart should take up less than 33%/1/3 of the retrosternal space

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63
Q

Label 1-5

A
  1. Pulmonary valve
  2. Chordeae tendineae
  3. Interventricular septum
  4. Papillary muscle
  5. Trabeculeae carnieae
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64
Q

What is occuring physiologically to the cusps, muscles and chambers when the mitral and tricuspid valves are open?

A
  1. The Cusps project into the ventricle
  2. The atria contract
  3. Ventricles, papillary muscles, and chordae tendineae are relaxed
  4. Blood enters the ventricles
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65
Q

T/F

Blood goes from high presssure to low pressure

A

True

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66
Q

What is occuring physiologically to the cusps and muscles when the ventricles contract?

A
  1. The blood forces the cusps together to close
  2. The papillary muscles contract, which tightens the chorae tendineae
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67
Q

Label 1-3

A
  1. Cusp of tricuspid valve
  2. Chordae tendineae
  3. Papillary muscle
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68
Q

What does each cusp of the semilunar vavles attach to?

A

Each cusp attaches to the arteriole wall

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69
Q

Where do the free borders of the semilunar vavles project into?

A

The free borders project into the lumen of the artery

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70
Q

T/F

When the ventricles contract, the blood flows into the artery

A

True

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71
Q

How are the semilunar vavles closed?

A

When the ventricles relax, the blood flows back towards the heart and fills the free edges of the cusps, thus closing the semilunar valve

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72
Q

Label 1-8

A
  1. AV
  2. PV
  3. TV
  4. MV
  5. PV
  6. AV
  7. TV
  8. MV
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73
Q

What is the defenition of stenosis?

A

Narrowing

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74
Q

What is meant when describing an insufficient/incompetent vavle in the heart?

A

The failure for the valve to completely close

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75
Q

When does the foramen ovale become the fossa ovalis?

A

When it closes at birth

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76
Q

What is the foramen ovale?

A

The opening between the atria

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77
Q

What does the ductus arteriousus become once it closes at birth?

A

It becomes the ligamentum arteriousum

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78
Q

Where is the ductus arteriosus located?

A

Located between the pulmonary trunk and the distal part of the aortic arch

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79
Q

T/F

When a baby has fetal heart, are the lungs functional?

A

No, the blood bypasses

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80
Q

If either the ductus arteriosus or the foramen ovale is open after birth, what can this lead to?

A

Can lead to pulmonary hypertension and right ventricular enlargment

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81
Q

What is being demonstrated here?

A

Patent ductus arteriosus

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82
Q

What is dextrocardia?

A

When the heart sits to the right of the body

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83
Q

What is meant by the term levocardia?

A

The normal position of the heart

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84
Q

What is the average weight of the heart in males and females?

A

Males: 310 g
Female: 225 g

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85
Q

What makes up the right heart border?

A

Mostly the right atrium

86
Q

What makes up the inferior heart border?

A

Some of the right atrium and right ventricle across to the apex

87
Q

What makes up the left heart border?

A

The left ventricle and some of the left auricle

88
Q

Which way does the left heart border slope from the apex?

A

Slopes superiorly and medially from the apex

89
Q

Label 1-8

A
  1. SVC
  2. Right atrium
  3. Right ventricle
  4. Ascending aorta
  5. Pulmonary trunk
  6. Coronary sulcus
  7. L ventricle
  8. Anterior interventricular sulcus
90
Q

What 2 fibers make up the conduction system of the heart?

A
  1. Contractile fibers
  2. Autorythmic fibers
91
Q

What percentage of cardiac cells do the contractile fibers make up?

A

Make up 99% of cardiac cells

92
Q

What percentage of cardiac cells do the autorythmic fibers make up?

A

1%

93
Q

What is the function of contractile fibers of the heart?

A

They are teh working fibers that are responsible for contractions

94
Q

What is the function of the autorythmic fibers of the heart?

A

-They are self excitable nodal cells that generate AP, that trigger contractions

95
Q

What are the nodal and conducting cells of the heart?

A
  1. SA node
  2. AV node
  3. AV bundle
  4. Right and left bundles
  5. Purkinje fibers
96
Q

What sets the intrinsic rhythm of the heart?

A

The cells of the SA node

97
Q

What type of fibers does the SA node contain?

A

Contains autorythmic fibers

98
Q

Where is the SA node located?

A

Located at the right atrial wall near the opening of the SVC

99
Q

What is the rate of the SA node? What about at rest?

A

-100 beats/minute
-At rest, 70-75 bpm

100
Q

What would happen if the SA node failed for any reason?

A

-The pacemaker function would shift to the AV node; which would cause bradycardia

101
Q

What does the AV node stand for?

A

Atrioventricular

102
Q

Where is the AV node located?

A

At the interatrial spetum, superior to the ventricles near the center of the heart

103
Q

What is the function of the AV node?

A

Slows down the speed of travel of the AP

104
Q

T/F

The AV node has fewer gap junctions and smaller diameter fibers

A

True

105
Q

Label 1-5

A
  1. SA node
  2. AV node
  3. AV bundle
  4. Right and left bundle branches
  5. Purkinje fibers
106
Q

What is the function of an ECG?

A

Monitors the electric currents generated by the heart

107
Q

What are the 3 deflection waves on an ECG graph and how long on average are each segments?

A
  1. P wave-.08 sec
  2. QRS wave-.08 sec
  3. T wave-.16 sec (slower)
108
Q

What does the P wave represent?

A
  1. The depolarization of both atria following contraction
109
Q

What is occuring physiologically during the P wave with the nerve impulse?

A

The impulse moves from the SA node through the atria

110
Q

What is the QRS complex representing?

A

Represents the depolarization of ventricles and the replarization of the atria

111
Q

Why is the repolarization of the atria not visualized on the graph in the opposite direction?

A

Because the depolarization of the ventricles and the repolarization of the atria are occuring at the same time

112
Q

What does the T-wave represent?

A

The replarization of ventricles

113
Q

How does the myocardium of ventricles repolarize?

A

In reverse order

114
Q

Label 1-5

(the boxes at the bottom are refering to the type of contraction)

A
  1. P interval
  2. S-T segment
  3. Q-T interval
  4. Atrial contraction
  5. Ventricular contraction
115
Q

What is occuring during the PR segment?

A

AV nodal delay

116
Q

What is occuring during the ST segment?

A

Time during which ventricles are contracting and emptying

117
Q

What is occuring during the TP interval?

A

Time during which ventricles are relazing and filling

118
Q

Label 1-3

A
  1. PR segment
  2. ST segment
  3. TP interval
119
Q

What is the average heart rate?

A

75 beats/min

120
Q

What is the average cardiac cycle?

A

0.8 sec

121
Q

The diastole/systole of both atria and ventricles is refered to as what?

A

The cardiac cycle

122
Q

How long does atrial systole last?

A

.1 seconds

123
Q

What is happening to the ventricles when the atria re in systole?

A

The ventriclese are diastole

124
Q

What is occuring with the atria when the ventricles are in systole?

A

The atria are in diastole

125
Q

How long does ventricular systole last?

A

.3 seconds

126
Q

How much of the ventricles are passively filled?

A

70% (105mL) are passively filled

127
Q

What vavles are opened and closed during atrial systole?

A

The AV valves are open, the SL valves are closed

128
Q

Which way, and how much does blood flow during atrial systole?

A

Blood flows from the atria to the ventricles
(25 mL)

129
Q

What does the firing of the SA node induce?

A

Atrial depolarization (P wave)

130
Q

How much blood do the ventricles contain at the end of diastole? What is this called?

A

130 mL
-This is called the EDV
(end diastolic volume)

131
Q

What vavles close during ventricular contraction? Why?

A

The AV valve closes due to increased pressure

132
Q

What is occuring with the valves during isovolumetric contraction?

A

All of the valves are closed

133
Q

When does ventricular ejection occur? What valve opens during this?

A

When the pressure inside the ventricle is greater than the artery
-The SL valves open

134
Q

What is the ESV?

A

-Whats left inside the ventricle during systole
-60 mL

135
Q

What valve closes during ventricular disastole?

A

The SL valves close

136
Q

When the AV valves open, and blood is passively flowing from the atria to the ventricles, what stage are the atria and ventricles in?

A

They are in diastole

137
Q

Which pressure is higher during ventricular diastole; the pressure in the ventricles, or the pressure in the atria?

A

The pressure in the atria

138
Q

Label 1-4

A
  1. Pulmonary valve (open)
  2. Bicuspid valve (closed)
  3. Aortic valve (open)
  4. Tricuspid valve (closed)
139
Q

Label 1-6

A
  1. Pulmonary valve (closed)
  2. Left coronary artery
  3. Bicuspid valve (open)
  4. Right coronary artery
  5. Aortic valve (closed)
  6. Tricuspid valve (open)
140
Q

Label 1-11

A
  1. Pulmonary trunk
  2. Pulmonary valve
  3. Pectinate muscle of left atrium
  4. Left coronary artery
  5. Bicuspid valve
  6. Ascending aorta
  7. Right coronary artery
  8. Pectinate muscle of right atrium
  9. Aortic valve
  10. Tricuspid valve
  11. Coronary sinus
141
Q

What are the 3 factors that affect stroke volume?

A
  1. Preload
  2. Contractility
  3. Afterload
142
Q

What is preload?

A

The degree of stretch on the heart before it contracts

143
Q

What is contractility?

A

The forcefulness of contraction

144
Q

What is the afterload?

A

The pressure tha must be exceeded before ejection of blood from the ventricles can occur

145
Q

What happens when the right ventricle starts systole?

A
  1. Tricsupid valve closes
  2. Pulmonary valve doesnt open until isometric volume occurs
146
Q

What is the function of stroke volume?

A

Ensures that the left and right ventricles pump the same amount of blood

147
Q

What is the law that describes how preload works?

A

The frank-starlings law

148
Q

What is the relationship between preload and EDV?

A

Preload is proportional to the EDV

149
Q

T/F?

Greater stretch or preload leads to a greater contraction?

A

True

150
Q

What is the main function fo the preload?

A

To keep the 2 ventricles in balance

151
Q

What are the 2 factors that EDV is affected by?

A
  1. Duration of ventricular diastole (filling time)
  2. Venous return
152
Q

What catagory of drugs increases contractility?

A

Adrenergic drugs

153
Q

What decreases contractility of the heart?

A
  1. Calcium channel blockers
  2. Anoxia
  3. Acidosis
154
Q

What increases the contractility of the heart?

A
  1. Increased Ca+ levels
  2. Adrenergic drugs
  3. Sypmathetic division
  4. Epinephrine and norepinephrine
155
Q

What is the afterload pressure in the vessel after the right ventricle?

A

20mmHg

156
Q

What is the afterload pressure in the vessel right after the left ventricle?

A

80mmHg

157
Q

Will an increasing afterload cause an increase, or decrease in stroke volume?

A

It will cause a decrease in stroke volume

158
Q

What can an increased afterload be caused by?

A
  1. Hypertension
  2. Atherosclerosis
159
Q

What is atherosclerosis?

A

High blood pressure caused by build up of plaque

160
Q

What has a direct affect on cardiac output?

A

Changes in either SV or HR

161
Q

T/F

Anything that affects the stroke volume or heart rate will have an affect on the cardiac output.

A

True

162
Q

How do you measure the actual stroke volume?

A

Catheterization

163
Q

What are some factors that may modify heart rate?

A
  1. Chemical influences
  2. Neural influences
  3. Age
  4. Gender
  5. Physical fitness
  6. Body temp

(only name 3)

164
Q

What centers do the medulla oblongata contain?

A
  1. Respiratory center
  2. Cardiovascular center
165
Q

What is the function of chemoreceptors?

A

They detect chemical changes

166
Q

What is the function of baroreceptors?

A

Measuring the stretch or pressure on the vessel; sending the information back to the medulla oblongata

167
Q

What happens if the SA and the AV node fails?

A

The heart rate slows down, and the individual will need a pacemaker

168
Q

What are the 2 systems of the ANS?

A
  1. Sympathetic
  2. Parasympathetic
169
Q

What are the four things that play a large role in nervous control of heart rate?

A
  1. The medulla oblongata
  2. The ANS
  3. Chemoreceptors
  4. Baroreceptors
170
Q

What is the first part of the internal carotid artery?

A

The carotid sinus

171
Q

What 3 things control the chemical regulation of heart rate?

A
  1. Epinephrine and norepinephrine
  2. Exercise, stree and excitment
  3. Adrenal glands
172
Q

T/F

Exercise, stress and excitement stimulates the release of more hormones, which in turn decreases the heart rate and strength of contraction.

A

False; Exercise, stress and excitement stimulates the release of more hormones, which in turn increases the heart rate and strength of contraction.

173
Q

Define arteries:

A

They carry blood away from the heart

174
Q

Define veins:

A

They carry blood to the heart

175
Q

What is the function of the capillaries?

A

They exchange vessels

176
Q

What are the 2 systems of circulation?

A
  1. Pulmonary
  2. Systemic circulation
177
Q

How are circuits in pulmonary and systemic circulation arranged?

A

They are arranged in series

178
Q

What does starlings law ensure when it comes to circuits?

A

It ensures that the same volume of blood flows into each circuit

179
Q

T/F

The output of one circuit becomes the input of the other

A

True

180
Q

What is the pump of the pulmonary system?

A

The right side of the heart

181
Q

T/F

Deoxygenated blood from the body is pumped out the pulmonary trunk to the pulmonary arteries.

A

True

182
Q

How is oxygenated blood returned to the left atrium?

A

Via the four pulmonary veins

183
Q

What is the pump of the sytemic circulation system?

A

The left side of the heart is the pump

184
Q

Where is oxygenated blood pumped in the systemic circulation system?

A

Pumped to the entire body

185
Q

Where is deoxygenated blood pumped in sytemic circulation?

A

It is returned to the right atrium

186
Q

What is the pathway of blood srarting at the right atrium?

A
  1. Right atrium
  2. Tricuspid valve
  3. Right ventricle
  4. Pulmonary valve
  5. Pulmonary trunk and pulmonary arteries
  6. In pulmonary capp
  7. Pulmonary veins
  8. Left atrium
  9. Bicuspid valve
  10. Left ventricle
  11. Aortic valve
  12. Aorta and systemic arteries
  13. Systemic cappillaries
  14. SVC, IVC or coronary sinus
187
Q

T/F

In systemic cappillaries, blood gains O2, and looses CO2

A

False; in cappilaries, blood looses O2 and gains CO2

188
Q

T/F

The right atrium does not have to contract for the blood to go into the right ventricle because of passive blood flow into the right ventricle

A

True

189
Q

What are the 2 coronary arteries?

A
  1. Right coronary artery
  2. Left coronary artery
190
Q

What is the function of coronary circulation?

A

To supply blood to the muscles of the heart

191
Q

What does sinus mean?

A

A localized area that is swollen

192
Q

When the heart contracts, does blood flow in the coronary arteries?

A

No

193
Q

When does blood flow in the coronary arteries? Why?

A

Blood flows in the coronary arteries when the heart relaxes since high blood pressure in the aorta propels it along

194
Q

Does blood flow in the coronary arteries when the ventricles contract?

A

No

195
Q

What is the first artery to come off the ascending aorta?

A

The coronary arteries

196
Q

What are the 2 sections of the left coronary artery?

A
  1. The circumflex branch
  2. The Left anterior descending branch
197
Q

What sulcus does the LAD branch make up?

A

The anterior interventricular sulcus

198
Q

What sulcus does the posterior descending artery make up?

A

The posterior interventricular sulcus

199
Q

What sulcus does the circumflex branch make up?

A

Makes up the coronary sulcus

200
Q

What sulcus does the marginal branch make up?

A

The coronary sulcus

201
Q

What is the function of the LAD branch?

A

Supplies oxygenated blood to the walls of both ventricles

202
Q

What is the function of the circumflex branch?

A

Supplies oxygenated blood to the walls of the left ventricle and atrium

203
Q

What is the function of the PDA branch?

A

Supplies oxygenated blood to the walls of both ventricles

204
Q

What is the function of the barginal branch?

A

Supplies oxygenated blood to the wall of the right ventricle

205
Q

What are the 2 parts of the right coronary artery?

A
  1. Posterior interventricular branch/ PDA
  2. Marginal branch
206
Q

What is an anastomoses?

A

Many arterial collateral routes that provide protection by having built in extra circulation of vessels that go to the same area

207
Q

Where does all venous blood enter?

A

The coronary sinus

208
Q

Where does the venous blood go to after entering the coronary sinus?

A

The right atrium

209
Q

What is stroke volume?

A

Amount of blood pumped out of the heart each beat

210
Q

How do you calculate the SV?

A

SV = EDV (End Diastolic Vol) – ESV (End Systolic Vol)

211
Q

What is the cardiac output?

A

The amount of blood pumped out by each side of the heart in 1 min

212
Q

How do you calculate cardiac output?

A

CO = HR(bpm) x SV(mL/b)

213
Q

What is being demonstrated here?

A

Dextrocardia

214
Q

What pathology is being shown here?

A

Cardiomegaly

Anatomy and Physiology 2 (12 decks)

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