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Chapter 18 > The Heart > Flashcards

The Heart Flashcards

1
Q

What is the pericardium?

A

A double walled sack around the heart

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2
Q

Parietal pericardium

A

Lines the internal surface of the fibrous pericardium

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3
Q

Visceral pericardium

A

Lines the surface of the heart

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4
Q

Homeostatic imbalance

Pericarditis

A

Inflammation of the pericardium, rough serous membrane, heart rubs against the pericardial sac. visceral and parietal pericardia stick together

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5
Q

Homeostatic imbalance

cardiac tamponade

A

Large amounts of inflammatory fluid compress the heart, limiting it’s pumping action (it must be drained)

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6
Q

Three layers of the heart wall

A

Epicardium- visceral layer of the pericardium

Myocardium- Cardiac muscle layer forming bulk of heart, fibrous skeleton of the heart

Endocardium- Endothelial layer of the inner myocardial surface

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7
Q

The way heart muscle is bundled allows it to function as a syncytium, what does that mean?

A

It “works together” as a single coordinated unit

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8
Q

What is the difference between the pulmonary circuit and the systemic circuit?

A

They going opposite direction one drop off oxygen, the other picks up the oxygen.

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9
Q

Coronary circulation

A

Functional blood supply to the heart muscle itself

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10
Q

Anastomoses

A

Also known as collateral routes, ensures blood delivery to the heart even if major vessels are obstructed

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11
Q

Homeostatic imbalance

angina pectoris

A

(Choked chest) thoracic pain caused by deficiency and blood delivery to myocardium

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12
Q

Homeostatic imbalance

myocardial infarction

A

A heart attack caused by lack of oxygen due to blockage of the coronary system, areas of cell death are repaired with scar tissue

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13
Q

Why is damaged cardiac muscle not replace?

A

Because muscle cells do not undergo mitosis because they are missing centrioles

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14
Q

Heart valves

A

Atrioventricular valves- Tricuspid, bicuspid(mitral)

semilunar valves: pulmonary and aortic

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15
Q

Heart valves function

A

They ensure unidirectional blood flow through the heart

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16
Q

Incompetent valve

A

Makes swishing sound, blood backflows or regurgitates through partially open valve

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17
Q

Stenotic valve

A

High-pitched sound or click because valvular opening is narrowed so bloodflow is restricted

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18
Q

Cardiac muscle

A

Striated, short, fat, branched and interconnected. connective tissue endomysium acts as tendon and insertion

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19
Q

Intercalated discs

A

Made of gap junctions and desmosomes. anchor cardiac cells together and allow free passage of ions

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20
Q

Autorhythmic cells

A

Create the action potential which travel through the gap junction to depolarize the contractile cells (slow sodium Fast calcium)

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21
Q

Contractile cells

A

Fast sodium slow calcium

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22
Q

What is the difference between autorhythmic cells and contractile cells

A

Autorhythmic set the pace uses calcium

Contractile cells like the rest of the heart use sodium to contract

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23
Q

Why must there be a 0.1 second delay between as SA and AV nodes

A

Because all heart chambers cannot squeeze at the same time

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24
Q

Sequence of electrical excitation to the heart

Intrinsic

A
  • SA node generates impulse
  • Atrial excitation begins
  • Impulse delayed at AV node
  • Impulse passes to heart apex
  • Ventricular excitation begins
  • Ventricular excitation complete
25
Q

Arrhythmias

A

Irregular heart rhythm

26
Q

Fibrillation

A

Rapid out of step contraction where control of heart rhythm is taken away by SA node fibrillating ventricles are useless pumps.
defibrillization is needed to shock heart and allow SA node to reestablish rhythm

27
Q

Ectopic focus

A

SA node is replaced by another pacemaker like AV node

28
Q

Junctional rhythm

A

Pace set by AV node usually 50 beats

29
Q

Extrasystole

A

Hyperexcitable region of the heart causes premature contractions, before SA node initiates regular contraction
premature ventricular contraction PVC are most problematic

30
Q

Heart block

A

Inability of ventricles to receive impulses from AV node. Total heart block-Ventricles forced to beat at own slow autorhythmic rate. To slow for adequate circulation

Total or partial heart block a pacemaker can recouple atria to ventricles

31
Q

Extrinsic innervation of the heart

A

Sympathetic nerve- speeds up (100)

parasympathetic nerve- vagus nerve tells it to slow down

32
Q

Why does parasympathetic nerve dominate control over the heart?

A

Parasympathetic controls because it maintains the heart rate

33
Q

Cardiac output problem

A

CO= HR x SV

The amount of blood pumped by each ventricle in one minute

34
Q

Stroke volume problem

A

SV= EDV - ESV

Stroke volume = end-diastolic volume - end-systolic volume
EDV is The amount of blood collected in a ventricle during diastole
ESV Is the amount of blood remaining in a ventricle after contraction

35
Q

Stroke volume

preload

A

The amount the ventricles are stretched by contained blood

36
Q

Stroke volume

Contractility

A

Cardiac cell contractile force due to factors other than EDV

37
Q

Stroke volume

afterload

A

Back pressure exerted by blood in the large arteries leaving the heart

38
Q

Frank-starling law

A

Preload is a critical factor in controlling stroke volume, cardiac muscle exhibits a length tension relationship. at rest, cardiac muscle cells are shorter than optimal length

39
Q

Factors influencing stroke volume

positive inotropic agents

Negative inotropic agent

A

Positive- increase and contractility
Ex increased sympathetic stimuli, catecholeamines, calcium

Negative- Decrease in contractility
Ex acidosis, calcium channel blockers, extracellular vitamin K

40
Q

Positive chronotropic factors

A

Increased heart rate

example tachycardia

41
Q

Negative chronotropic factors

A

Decrease heart rate

example bradycardia

42
Q

ANS vagal tone

A

Slowing heart rate PNS dominates the autonomic stimulation

43
Q

Bainbridge reflex

A

Sympathetic reflexes initiated by increase blood in atria (increase venous return)

Stimulation of SA node
stimulate Baroreceptors in atria causing increased SNS stimulation

44
Q

Hypocalcemia

A

Depresses heart rate

45
Q

Hypercalcemia

A

Prolongs plateau phase and leads to spasms that do not allow heart to rest

46
Q

Hypokalemia

A

Makes heart beat feebly and arrhythmically

47
Q

Hyperkalemia

A

Interferes with depolarization by lowering action potential and may lead to heart block and cardiac arrest

48
Q

Fetal heart structure

Foramen ovale

A

Connects the two atria

At birth becomes the fossa ovalus

49
Q

Fetal heart structure

Ductus arteriosus

A

Connect pulmonary trunk and the aorta

After birth becomes ligamentum arteriosum

50
Q

Why does the fetus heart structures have the foramen ovale and the ductus arteriosus?

A

To bypass the lungs before they are born

51
Q

If you have a junctional rhythm what is absent on an ECG?

A

The P wave

52
Q

If you have a partial heart block what is seen on an ECG?

A

More P waves than QRS waves

53
Q

Fibrillation looks like what on an ECG?

A

Chaotic waves

54
Q

P wave corresponds to ____ of a SA node; T wave corresponds to ___ ___

A

Depolarization, ventricular repolarization

55
Q

Aortic valves sounds are heard where?

A

Second intercoastal space at right sternal margin

56
Q

Pulmonary valve sounds are heard where?

A

Second intercostal space at left sternal margin

57
Q

Where are bicuspid valve sounds heard

A

Over heart apex in fifth intercostal space in line with the middle of the clavicle

58
Q

Where are tricuspid valves sounds heard?

A

Right sternal margin of the fifth intercostal space variation include over sternum or over left sternal margin in 5th intercostal space

Chapter 18 (1 decks)

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