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Fundamentals of Anatomy & Physiology > The Heart > Flashcards

The Heart Flashcards

1
Q

Function of cardiovascular system

A

To distribute oxygen and nutrients to the cells of the body, and to take away carbon dioxide and other wastes

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2
Q

Pulmonary circuit

A

Carries blood to and from the gas exchange surfaces of the lungs

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3
Q

Systemic circuit

A

Transports blood to and from the rest of the body

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4
Q

Flow of the pulmonary circuit

A

Carries oxygen-poor blood from the right ventricle, through the pulmonary arteries, to the lungs
Carries oxygen-rich blood back through the pulmonary veins to the left atrium

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5
Q

Flow of the systemic circuit

A

Carries oxygen-rich blood from the left ventricle, through the systemic arteries
Carries oxygen-poor blood through systemic veins back to the right atrium

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6
Q

Arteries

A

Carry blood away from the heart

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7
Q

Veins

A

Return blood to the heart

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8
Q

Great vessels

A

Largest veins and arteries in the body

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9
Q

Capillaries

A

Interconnect smallest arteries and smallest veins

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10
Q

Why do capillaries have thin walls?

A

To allow gas exchange and exchange of wastes between blood and surrounding tissues

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11
Q

Right atrium

A

Receives blood from systemic circuit and passes it to the right ventricle

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12
Q

Right ventricle

A

Receives blood from right atrium and passes it to pulmonary circuit

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13
Q

Left atrium

A

Receives blood from pulmonary circuit and passes it into the left ventricle

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14
Q

Left ventricle

A

Receives blood from left atrium and passes it into systemic circuit

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15
Q

Which chambers contract first?

A

Atria

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16
Q

Where is the heart located?

A

In the thoracic cavity near the anterior chest wall, directly posterior to the sternum

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17
Q

Where are the great vessels connected to?

A

The superior end of the heart at its base

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18
Q

In a midsagittal section, where does the base lie?

A

Slightly to the left of the midline

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19
Q

Does the heart sit in the anterior or posterior portion of the mediastinum?

A

Anterior

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20
Q

What does the mediastinum contain?

A

Great vessels, thymus, oesophagus, and trachea

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21
Q

Apex

A

Pointed tip of the heart

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22
Q

Endocardium

A
  • Covers inner surface of heart (inc. heart valves)
  • Simple squamous epithelium continuous with endothelial lining of blood vessels
  • Underlying areolar tissue
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23
Q

Myocardium

A
  • Middle layer

- Spiral bundles of cardiac muscle cells

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24
Q

Pericardium

A

Fibrous pericardium (dense network of collagen fibres that stabilise the position of the heart and vessels within the mediastinum) and serous pericardium

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25
Q

Serous pericardium

A
  • Parietal layer

- Visceral layer (epicardium) - covers surface of heart

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26
Q

What separates the parietal and visceral layer of the serous pericardium?

A

Potential, fluid-filled pericardial cavity

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27
Q

Functions of the cardiac skeleton

A
  • Anchors muscle fibres
  • Supports the great vessels and heart valves
  • Limits the spread of action potentials
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28
Q

How much pericardial fluid does the pericardial cavity normally contain?

A

15-50mL

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29
Q

What secretes pericardial fluid?

A

Pericardial membranes

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30
Q

Function of pericardial fluid

A

Acts as lubricant, reducing fiction between the opposing visceral and parietal surface as the heart beats

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31
Q

Pericarditis

A

Condition produced by pathogens that causes inflamed pericardial surfaces to rub against one another

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32
Q

Cardiac tamponade

A

Fluid collection in the pericardial cavity caused by increased production of pericardial fluid as a result of inflammation or traumatic injuries e.g. stab wounds

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33
Q

Auricle

A

The atriums ability to deflate and become a lumpy, wrinkled flap when not filled with blood

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34
Q

Coronary sulcus

A

A deep groove that marks the border between the atria and the ventricles

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35
Q

Inteventricular sulcus

A
  • Shallow depressions that mark the boundary between the left and right ventricles
  • Posterior and anterior
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36
Q

Name a characteristic of the coronary and inteventricular sulci

A

Substantial amounts of fat and arteries and veins that carry blood to and from the cardiac muscle

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37
Q

Visceral layer of serous pericardium (epicardium)

A

Consists of an:

  • Exposed mesothelium
  • Underlying layer of areolar connective tissue
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38
Q

Parietal layer of serous pericardium

A

Consists of an:

  • Outer dense, fibrous layer
  • Areolar layer
  • Inner mesothelium
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39
Q

What are the arteries and ventricles made of?

A

Myocardium

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40
Q

Atrial myocardium

A

Contains muscle bundles that wrap around the atria and form figure eights that encircle the great vessels

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41
Q

What wraps around the ventricles?

A

Superficial ventricular muscles and deeper muscle layers spiral around and between the ventricles toward the apex in a figure eight pattern

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42
Q

What is each cardiac muscle cell wrapped in?

A

A strong but elastic sheath

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43
Q

What connects adjacent cardiac muscle cells?

A

Fibrous cross-links called struts

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44
Q

What separates the superficial and deep muscle layers?

A

Interwoven sheets of struts

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45
Q

Functions of the connective tissue fibres

A
  1. Provide physical support for the cardiac muscle fibres, blood vessels, and nerves of the myocardium
  2. Help distribute forces of contraction
  3. Add strength and prevent overexpansion of the heart
  4. Provide elasticity that helps return heart to its original size and shape after a contraction
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46
Q

Cardiac skeleton

A

Four dense bands of tough elastic tissue that encircle the heart valves and bases of the pulmonary trunk and aorta

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47
Q

Interatrial septum

A

Separates atria

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48
Q

Interventricular septum

A

Separates ventricles

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49
Q

Is the interatrial or interventricular septum thicker?

A

Interventricular septum

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50
Q

Atrioventricular (AV) valves

A
  • Tricuspid and mitral
  • Folds of fibrous tissue that extend into the openings between the atria and ventricles
  • Permit blood flow only in one direction: atria to ventricles
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51
Q

Semilunar valves

A
  • Pulmonary and aortic
  • Between ventricles and their great vessels
  • Ensures blood flow through the vessels
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52
Q

Superior vena cava

A
  • Opens into the posterior and superior portions of the right atrium
  • Delivers blood to right atrium from head, neck, upper limbs and chest
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53
Q

Inferior vena cava

A
  • Opens into the posterior and inferior portion of the right atrium
  • Carries blood to the right atrium from the rest of the trunk, the viscera, and the lower limbs
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54
Q

Are there valves between the venae cavae and the right atrium?

A

No

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55
Q

Foramen ovale

A
  • From 5th week of embryonic development to birth
  • Penetrates the interatrial septum and connects the two atria of the fetal heart
  • Permits blood flow from right atrium to left atrium while lungs are developing
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56
Q

Fossa ovalis

A

A small, shallow depression that remains after the foramen ovale closes up

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57
Q

What is the surface of the posterior walls of the right atrium and the interatrial septum like?

A

Smooth

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58
Q

What is on the the surface of the anterior atrial wall and the inner surface of the auricle?

A

Prominent muscular ridges called pectinate muscles

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59
Q

Tricuspid valve

A

Contain three fibrous flaps called cusps

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60
Q

Chordae tendineae

A

Connective tissue fibres that attach to the free edge of each cusp in the tricuspid valve

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61
Q

Papillary muscles

A
  • Conical muscular projections that arise from the inner surface of the right ventricle
  • Chordae tednineae originate at the papillary muscles
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62
Q

What is on the surface of the ventricles?

A

Muscular ridges called trabeculae carnae

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63
Q

Moderator band

A

Muscular ridge that extends horizontally from the inferior portion of the interventricular septum and connects to the anterior papillary muscle

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64
Q

Conus arteriosus

A

Cone-shaped pouch that ends at the pulmonary valve

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65
Q

Pulmonary valve

A

Contains three semilunar cups of thick connective tissue

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66
Q

Pulmonary trunk

A

Receives blood from right ventricle and passes it on to left pulmonary arteries and the right pulmonary arteries

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67
Q

What forms the four pulmonary veins?

A

Small veins that unite

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68
Q

Where does the posterior wall of the left atrium receive blood from?

A

Two left and two right pulmonary veins

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69
Q

Is there a valve between the pulmonary veins and the left atrium?

A

No, but there’s an auricle

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70
Q

What guards the entrance to the left ventricle?

A

Mitral valve

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71
Q

How many cusps does the mitral valve have?

A

Two

72
Q

Where does the mitral valve permit blood flow to?

A

From the left atrium into the left ventricle

73
Q

What does the right ventricle have that the left ventricle doesn’t?

A

Moderator band

74
Q

Aortic valve

A

Receives blood from the left ventricle and passes it to the ascending aorta

75
Q

Aortic sinuses

A

Saclike expansions of the base of the ascending aorta that prevent individual cusps of the aortic valve from sticking to the wall of the aorta

76
Q

Ascending aorta

A

Receives blood from the aortic valve and passes it to the aortic arch

77
Q

Aortic arch

A

Receives blood from the ascending aorta and passes it to the descending aorta

78
Q

Ligamentum arteriosum

A

A fibrous band that attaches the pulmonary trunk to the aortic arch

79
Q

Which ventricle is larger?

A

The left ventricle

80
Q

Why is the left ventricle larger?

A

It has thicker walls that allow it to push blood through the systemic circuit

81
Q

Descending aorta

A

Receives blood from aortic arch

82
Q

Function of the atria

A

To collect blood that is returning to the heart and convey it to the ventricles

83
Q

What happens when the left ventricle contracts?

A

It shortens and narrows and bulges into the right ventricular cavity

84
Q

Interaction between AV valves, chordae tendinae and papillary muscles

A

Ventricles = relaxed: chordae tendineae are loose, AV valves offer no resistance as blood flows from A to V

Ventricles = contracted: blood moving back towards atria swings the cusps together, papillary muscles tense chordae tendineae which stops cusps swinging into the atria

85
Q

Regurgitation

A

Backflow of blood into the atria caused by cut chordae tendineae or damaged papillary muscles

86
Q

3 types of valve faults

A
  1. Stenotic valve (doesn’t open)
  2. Regurgitant valve (doesn’t close)
  3. Prolapsed valve (flops backwards)
87
Q

Heart murmurs

A

Fault valves heard through stethoscope

88
Q

Why do semilunar valves not need muscular braces?

A

Because the arterial walls do not contract and so the cusps are stable

89
Q

What prevents the individual cusps of the aortic valve from sticking to the walls of the aorta?

A

Aortic sinuses

90
Q

Valvular heart disease (VHD)

A

When valve function deteriorates to the point at which the heart cannot maintain adequate circulatory flow

91
Q

Carditis

A

Inflammation of the heart

92
Q

Rheumatic fever

A

Inflammatory autoimmune response to an infection by streptococcal bacteria, occurring most often in children and causing carditis

93
Q

Coronary circulation

A

Supplies blood to muscle tissue of the heart

94
Q

Where do the left and right coronary arteries originate?

A

At the base of the ascending aorta, at the aortic sinuses

95
Q

Elastic rebound

A

Recoil of the aortic walls when the left ventricle relaxes, blood no longer flows into the aorta and pressure declines

96
Q

Marginal arteries

A

Arteries that arise from right coronary artery and that extend across the surface of the right ventricle

97
Q

Posterior interventricular artery

A

Supplies blood to the interventricular septum and adjacent portions of the ventricles

98
Q

Right coronary artery

A

Supplies blood to:

  1. Right atrium
  2. Portions of ventricles
  3. Portions of electrical conducting system of heart
99
Q

Left coronary artery

A

Supplies blood to:

  1. Left atrium
  2. Left ventricle
  3. Interventricular septum
100
Q

Circumflex artery

A

Arises from left coronary artery and curves to the left around the coronary sulcus

101
Q

Anterior interventricular artery

A

Arises from left coronary artery and swings around the pulmonary trunk, and rungs along the surface within the anterior interventricular sulcus

102
Q

Arterial anastomes

A

Interconnections between arteries

103
Q

Coronary artery disease (CAD)

A

Areas of partial or complete blockage of coronary circulation

104
Q

Coronary ischemia

A

Reduced circulatory supply usually as a result from CAD

105
Q

Cause of CAD

A

Formation of fatty deposit (atherosclerotic plaque) in the wall of a coronary vessel which narrows the passageway and reduces blood flow

106
Q

Angina pectoris

A

First symptom of CAD - chest pain spasm

107
Q

Myocardial infarction

A

Heart attack, when part of the coronary circulation becomes blocked, and cardiac muscle cells die from lack of oxygen

108
Q

Infarct

A

Nonfunctional area created from death of affected tissues during myocardial infarction

109
Q

Coronary thrombosis

A

When a vessel already narrowed by plaque formation becomes blocked by a sudden spasm in the smooth muscles of the vascular wall

110
Q

Enzymes released during heart attack

A

Cardiac toponin T, cardiac troponin I, and CK-MB (form of creatine phosphate)

111
Q

Great cardiac vein

A

Drains blood from region supplied by anterior interventricular artery

112
Q

Where do cardiac veins return blood to?

A

Coronary sinus which opens into the right atrium

113
Q

Posterior vein of left ventricle

A

Drains area served by circumflex artery

114
Q

Middle cardiac vein

A

Drains area supplied by posterior interventricular artery

115
Q

Small cardiac vein

A

Receives blood from posterior surfaces of right atrium and ventricle

116
Q

Anterior cardiac veins

A

Drain the anterior surface of the right ventricle and empty directly into the right atrium

117
Q

Audtorhythmicity

A

The hearts property of contracting on its own

118
Q

Conducting system

A

The cells that initiate and distribute stimulus to contract

119
Q

Two types of specialised cardiac muscle cells of conducting system

A
  1. Pacemaker cells - essential to heart rate

2. Conducting cells - interconnect SA and AV nodes and distribute contractile stimulus throughout myocardium

120
Q

Where are pacemaker cells found?

A

Sinoatrial (SA) node in atrium and atrioventricular (AV) node

121
Q

Where are conducting cells found?

A

Internodal pathways in atrial walls
Atrioventricular (AV) bundle
Bundle branches - run between ventricles
Purkinje fibres

122
Q

Special characteristic of pacemaker cells of SA and AV nodes

A

No stable membrane resting potential (instead, pacemaker potential)

123
Q

What causes pacemaker potential?

A

Slow inflow of Na+ without a compensating outflow of K+

124
Q

Where is spontaneous depolarisation fastest?

A

In cells in the SA node

125
Q

Pacemaker potential

A

Gradual depolarisation of pacemaker cells

126
Q

Sinus rhythm

A

Heart rhythm

127
Q

What establishes the sinus rhythm

A

The SA nodes reaching threshold first

128
Q

Why is the maximum normal heart rate 230 bpm?

A

Because even if the SA node generates impulses at a faster rate, the ventricles will still only contract at 230 bpm

129
Q

Impulse conduction - 0

A

SA node activity and trial activation begin

130
Q

Impulse conduction - 50msec

A

Stimulus spreads across the atrial surfaces and reaches AV node

P wave

131
Q

Impulse conduction - 150msec

A

Three is a 100msec delay at the AV node. Atrial contraction begins

P-R interval

132
Q

Impulse conduction - 175msec

A

The impulse travels along the interventricular septum within the AV bundle and the bundle branches to the Purkinje fibres, and, by the moderator band, to the papillary muscles of the right ventricle

Q wave

133
Q

Impulse conduction - 225msec

A

The impulse is distributed by Purkinje fibres and relayed throughout ventricular myocardium. Atrial contraction is completed and ventricular contraction begins

QRS complex

134
Q

Why does the pacemaker cell stimulus affect only the atria?

A

Because the cardiac skeleton isolates the atrial myocardium from the ventricular myocardium

135
Q

Why does the pacemaker impulse slow as it leaves internodal pathway and enters the AV node?

A

Because the nodal cells are smaller in diameter than the conducting cells and the interconnections between pacemaker cells are less efficient than those between conducting cells

136
Q

What would happen if the atria and ventricles contracted at the same time?

A

The contraction of the powerful ventricles would close the AV valves and prevent blood flow from the atria to ventricles

137
Q

Where is the only normal electrical connection between the atria and the ventricles?

A

The connection between the AV node and the AV bundle

138
Q

Which bundle branch is bigger?

A

The left bundle branch, as it supplies the massive left ventricle

139
Q

Bradychardia

A

Heart rate is slower than normal

140
Q

Tachycardia

A

Heart rate is father than normal

141
Q

Ectopic pacemaker

A

Their activity partially or completely bypasses the conducting system, disrupting the timing of the ventricular contraction

142
Q

Electrocardiogram

A

Monitors the electrical events of the conducting system

143
Q

Which components are important for in making a diagnosis with ECG?

A

P wave and QRS complex

144
Q

Q-T inerval

A

The time required for the ventricles to undergo a single cycle of depolarisation and repolarisation (measured from the end of the P-R interval)

145
Q

Arrhythmia

A

Irregularity in the normal rhythm or force of the heartbeat

146
Q

Cardiac contractile cells

A

Form the bulk of the atrial and ventricular walls

147
Q

Where do the Purkinje fibres pass the stimulus on to?

A

Cardiac contractile cells

148
Q

What connects cardiac contractile cells to each other?

A

Intercalated discs

149
Q

Key differences between cardiac contractile cells and skeletal muscle fibres

A
  1. Cardiac - smaller
  2. Cardiac - 1 nucleus
  3. Cardiac - branching interconnections between cells
  4. Cardiac - intercalated discs
150
Q

How are the interlocking membranes of adjacent cells held together at intercalated discs?

A

By desmosomes and linked by gap junctions

151
Q

Action potentital in cardiac contractile cells

A
  1. Rapid depolarisation: causes NA+ entry, ends with closure of voltage-gated fast sodium channels
  2. The Plateau: causes Ca2+ entry, ends with closure of slow calcium channels
  3. Repolaraisation: causes K+ loss, ends with closure of slow potassium channels
152
Q

Refractory period

A

Period of time after an action potential when a cardiac contractile cell won’t respond to a second stimulus

153
Q

Absolute refractory period

A
  • The membrane cannot respons at all because the sodium ion channels are either already open or closed and inactivated
  • Includes plateau and initial period of repolarisation
154
Q

Relative refractory period

A

Voltage gated sodium ion channels are closed but can open so the membrane will respond to a stronger than normal stimulus

155
Q

Cardiac cycle

A

Period between the start of one heart beat and the beginning of the next

156
Q

Systole

A

The chamber contracts and pushes blood into an adjacent chamber of into an arterial trunk

157
Q

Diastole

A

The chamber fills with blood and prepares for the next cardiac cycle

158
Q

Phases of the cardiac cycle

A
  1. Atrial systole
  2. Atrial diastole
  3. Ventricular systole
  4. Ventricular diastole
159
Q

Atrial systole

A
  1. Atrial contraction begins - already 70% filled

2. Atria ejects blood into the ventricles through open right and left AV valves - remaining 30%

160
Q

Why can’t blood flow into the atria from the veins during atrial systole?

A

Because atrial pressure exceeds venous pressure

161
Q

Ventricular systole

A
  1. AV valves close
  2. Ventricles contracting but no blood flow occurs as the pressure isn’t high enough to force open semilunar valves
  3. Ventricular ejection: semilunar valves are pushed open and blood flows into pulmonary or aortic trunk
  4. Semilunar valve closes and blood flows into relaxed atria
  5. AV valves open and passive ventricular filling occurs
162
Q

Isovolumetric contraction

A

All the heart valves are closed, the volumes of the ventricles do not change and the ventricular pressure is rising

163
Q

Heart failure

A

When damage to one or both ventricles can leave the heart unable to pump enough blood through peripheral tissues and organs

164
Q

Cardiac output (CO)

A

Amount of blood pumped by the left ventricle in 1 minute

165
Q

Heart rate (HR)

A

Number of heart beats per minute

166
Q

Stroke volume (SV)

A

Amount of blood pumped our of a ventricle during each contraction

EDV - ESV

167
Q

CO calculation

A

HR X SV

168
Q

Cardioacceleratory center

A

In the medulla oblongata activates sympathetic neurons which speeds up heart rate and reduces ESV

169
Q

Cardioinhibitory centre

A

Controls parasympathetic neurons that slow the heart rate and increases ESV

170
Q

Bainbridge reflex

A

Accelerates heart rate when the walls of the right atrium are stretched

171
Q

Venous return

A

Amount of blood retuning to heart through veins

172
Q

Filling time

A

Duration of ventricular diastole

173
Q

Preload

A

Degree of stretching in ventricular muscle cells during ventricular diastole

174
Q

Afterload

A

Amount of tensions that the contracting ventricle must produce to force open the semilunar valve and eject blood

175
Q

Frank-Straling principle

A

The greater the EDV, the more powerful the succeeding contraction

176
Q

Cardiac reserve

A

Difference between resting and maximal cardiac outputs

Fundamentals of Anatomy & Physiology (25 decks)

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