Unit 3 Flashcards
What are three main components of the cardiovascular system?
- Heart
- Vasculature (blood vessels)
- Blood
What are the six functions of the cardiovascular system?
- Transports nutrients, wastes, hormones, etc.
- Blood pressure regulation
- Water homeostasis
- Hemopoiesis (formation of blood)
- Immunity
- Blood clotting
In blood flow, what is the pulmonary circuit?
Pulmonary circuit sends blood to lungs for oxygenation.
In blood flow, what is the systemic circuit?
Systemic circuit sends oxygen rich blood to all other tissues of the body.
What are the four chambers of the heart?
Right and left atria; Right and left ventricles.
Which one of the heart’s two ventricles is thicker?
The left ventricle is 3-4 times thicker than the right ventricle because the left ventricle needs more power to pump to rest of body (right ventricle only pumps to lungs).
What are the chambers of the heart separated by?
Fibrous connective tissue that impulses cannot cross.
What do the heart valves do?
Direct the flow of blood through the heart.
What makes cardiac cells similar to skeletal muscle cells?
Both contain myofibrils, filaments, t-tubules, and sarcoplasmic reticulum.
What are gap junctions?
Interconnections found within intercalated discs. They aid in impulse transmission between contractile cells (quick spread or transmission of impulses from myocardial cell to myocardial cell).
The heart uses what process for ATP?
Aerobic respiration.
What are three types of specialized cardiac cells?
- Contractile cells (myocardial cells)
- Nodal cells
- Specialized conduction cells or fibers
What do contractile cells do?
They are responsible for the contraction of the chambers and the formation of pressure to move blood out of ventricles and into arteries.
99% of cardiac cells are contractile cells.
What do nodal cells do?
They are auto-rhythmic (myogenic) and generate their own action potentials or impulses. That’s why the heart can still beat outside of the body.
Two nodes include the sinoatrial (SA) node and the atrioventricular (AV) node.
What do specialized conduction cells or fibers do?
They’re fast action potential conducting systems. It’s a system for the rapid movement of the impulse between the chambers and also within the ventricles.
Ex: internodal pathways, Bundle of His (AV bundle), bundle branches, Purkinje fibers.
What node in the heart has the fastest firing rate?
Pacemaker (SA node).
Faster than AV node. It dictates the pace of the heart.
How does the pacemaker (SA node) propagate its impulse?
Impulses from the pacemaker located at the upper surface of the right atrium can spread out and stimulate other right atrial contractile cells and left atrial contractile cells by impulse propagation over gap junctions.
Pacemaker impulses CANNOT reach ventricles by gap junctions b/c of the non-conducting fibrous tissue that separates the chambers.
How do impulses spread from atria to ventricles?
Step 1: Impulses spread from SA node to AV node along the internodal pathways (where there is a 1/10 second delay at AV node).
Step 2: Impulses from AV node are sent to apex of ventricles by way of Bundle of His (AV bundle), bundle branches, and Purkinje fibers.
Step 3: Using gap junctions between cells alows for the excitation of the contractile cells of the ventricles.
Explain the three steps for electrical activity in NODAL or PACEMAKER cells?
Step 1: Gradual depolarization from increase Na+ and decrease K+ permeability at first, followed by opening of Ca2+ gates. (More Na, less K, and more Ca)
Step 2: Rapid opening of the Ca gates causes depolarization of the action potential b/c Ca flows into cell. (More Ca)
Step 3: Closing of Ca gates and opening of K gates cause repolarization. This causes K to flow out of cell. (Less Ca, more K)
How does the autonomic system influence the electrical activity in NODAL or PACEMAKER cells?
Sympathetic stimulation: speeds up depolarization (increase Na and Ca permeability).
Parasympathetic stimulation: slows down by hyperpolarizing cell (increase K) and slowing depolarization (decrease Ca).
Explain the three steps for electrical activity in CONTRACTILE cells?
Step 1: Depolarization caused by increase in Na permeability. (-90mV to +30mv)
Step 2: Plateau from decrease Na and increase Ca permeability.
Step 3: Repolarization from decrease Ca and increase K permeability.
What four things make contractile cells different from skeletal muscle cells?
- Ca ions play an important role.
- Depolarization is longer.
- Refractory period is longer.
- No tetanus.
Electrical stimulation of cardiac muscle is similar to skeletal muscle except for these five factors:
- Action potential is longer around 200 milliseconds, with a longer refractory period in cardiac muscle.
- There is no tetanus in heart due to muscle relaxation during refractory period.
- Impulse on contractile cell is generated from its excited neighboring cell by using gap junctions.
- Action potential opens Ca channels on the sarcolemma so there is an influx of Ca into the cell from the ECF.
- Influx of Ca into ICF activates release of Ca from sarcoplasmic reticulum. This is a chemically activated gate in cardiac muscle and NOT votage activated gate as in skeletal muscle.
What is an electrocardiogram (ECG)?
A way to measure electrical currents of the heart by placing electrodes on the body’s surface.
What are P-waves, QRS complexes, and T-waves of an ECG strip?
P-wave: atrial depolarization
QRS complex: ventricular depolarization
T-wave: ventricular repolarization
What are the three standard limb leads?
Lead I: right arm, left arm
Lead II: right arm, left leg
Lead III: left arm, left leg
What are the three augmented vector leads?
aVR (right arm)
aVL (left arm)
aVF (left foot)
What are the six chest leads?
V1 - V6
What is the heart’s main function?
To receive blood from the veins and to create enough pressure to pump blood out the arteries to the body’s system.
What does systole mean?
Contraction (receives blood).
What does diastole mean?
Relaxation (gives blood).
What three major things happen during the cardiac cycle?
- Pressure changes (force behind blood flow) in the atria, ventricles, and arteries (aorta).
- Ventricular volume changes (amt of blood the ventricles receive and pump).
- Valve actions fill and empty the heart and to direct flow of blood.
What happens during Phase 1A (Ventricular Filling) during the cardiac cycle?
Atrial diastole and Ventricular diastole.
- Ventricles receive blood from atria via gravity and pressure before atria contracts. At rest, 80% of blood is in ventricles before atria contracts.
- Pressure in ventricle at this time is 0-5mm Hg.
- Atrial pressure > ventricular pressure, so AV valves are OPEN.
- Aortic pressure > ventricular pressure, so semilunar valves are CLOSED.
What happens during Phase 1B (Ventricular Filling w/ Atrial Systole) of the cardiac cycle?
Atrial systole and Ventricular diastole.
- P-wave causes atria to contract.
- Atria contracts and deliver 20% more blood into ventricles
- Maximum volume of blood in each ventricle is 135 mL (EDV)
- Pressure and valves similar to Phase 1A b/c we’re still filling
What happens during Phase 2 (Isovolumetric Contraction) of the cardiac cycle?
Ventricular systole and Atrial diastole.
- QRS complex causes contraction in ventricles.
- Ventricular depolarization activates systolic phase, which starts to rapidly build up ventricular pressure from 0mm Hg to 80mm Hg. Ventricular pressure > Atrial pressure, so AV valves are CLOSED.
- AV valves closing produces S1 or Lub sound.
- Aortic pressure > Ventricular pressure, so semilunar valves are still CLOSED.
What happens during Phase 3 (Ventricular Ejection) of the cardiac cycle?
Ventricular systole.
- Ventricular pressures increases. Ventricular pressure > aortic pressure, so semilunar valves OPEN above 80mm Hg.
- Ejection of blood occurs when semilunar valve opens and continues as long as ventricular pressure > arterial pressure.
- Ventricular contraction does not eject all the blood and the amt remaining is 65 mL (ESV).
What happens during Phase 4 (Isovolumetric Relaxation) of the cardiac cycle?
Ventricular diastole.
- After systole, heart returns to diastolic phase and ventricular pressure < aortic pressure, so semilunar valves CLOSE and make S2 or Dub sound.
- Ventricular pressure still > atrial pressure, so AV valves are CLOSED.
What are heart murmurs?
Turbulence in blood flow within OR outside the heart.
What is normal cardiac output at rest?
5000 mL (5 Liters) per minute.
How does cardiac output change depending on different physiological states?
Cardiac output depends on body’s oxygen requirement. During exercise, cardiac output can increase to 15-20 L/min or 30-40 L/min in well-trained athletes.
What is cardiac output?
Cardiac output = heart rate x stroke volume.
What are three extrinsic controls (outside heart) for heart rate?
- Increase sympathetic firing to pacemaker (SA node).
- Decrease parasympathetic firing to pacemaker.
- Epinephrine on pacemaker.
Stroke volume is influenced by what three factors?
- Ventricular contractility
- End diastolic volume or preload
- Mean arterial pressure or afterload
What is ventricular contractility and how does it influence stroke volume?
Extrinsic control b/c it’s controlled by nerves and hormones.
Sympathetic stimulation (epinephrine) to the contractile cells increases strength of contractility, thus increasing stroke volume.
Parasympathetic doesn’t do anything for ventricular contractility. There’s NO dual innervation.
This causes more Ca to enter cells and more to be released from sarcoplasmic reticulum. More Ca binding to troponin and more cross-bridges available for muscle contraction.
So epi and norepi cause more of these Ca gates to open, so there’s more strength.
What is the end diastolic volume and how does it influence stroke volume?
Intrinsic control.
Increase in EDV (preload… loading heart w/ blood before contraction) will increase SV.
Length-Tension relationship.
More cross-bridge overlap.
An increase in cardiac muscle distension from more blood increases force of contraction.
Venous return: more venous return, more SV.
Length of diastole: longer filling time, more blood in heart, more SV.
What is the mean arterial pressure (afterload) and how does it influence stroke volume?
Decrease in MAP, increase in SV.
Vasodilation of arterioles decreases mean arterial pressure. So heart doesn’t have to work too hard to get blood in.
Increase in compliance in arteries, decreases in MAP, so increase in SV.
Arteriosclerosis (hardening of arteries), means less compliance so heart works harder to get blood out.
What is bradycardia?
Heart rate < 60 per min.
Decrease in heart rate, decrease cardiac output.
What is tachycardia?
Heart rate > 100 per min.
What is a flutter?
Heart rate 200-300 per min.
Disadvantage is that with an increased heart rate, filling time decreases, thus decreases SV and cardiac output.
What is fibrillation?
An uncoordinated contraction of the heart causes a quivering of muscle, thus no pumping.
What are heart blocks?
Impulses from SA node are slwoed or completely blocked from reaching AV node.
What is a myocardial infarction?
Heart attack.
Starts w/ decrease in blood supply to muscle, called tissue ISCHEMIA. This causes decrease in oxygen supply to muscle that shifts metabolism from aerobic to anaerobic.
Damage is reversible within 30-45 min. Afterwards tissue necrosis occurs followed by a replacement w/ connective tissue.
What three things can cause myocardial infarction?
- Vascular spasms
- Emboli from heart chambers or from veins
- Atherosclerosis
What are eight predisposing factors for a myocardial infarction?
- Family history
- Diabetes
- Weight
- Gender
- Smoking
- Nutrition
- Lack of exercise
- Stress
What are five treatments for myocardial infarction?
- Coronary bypass
- Angioplasty
- Stents
- Atherectomy
- Drugs
What is a coronary bypass?
Arteries or veins from elsewhere in the patient’s body are grafted to the coronary arteries to bypass atherosclerotic narrowings and improve the blood supply to the myocardium (heart muscle).
What is angioplasty?
Mechanically widening narrowed or obstructed arteries. An empty and collapsed balloon on a guide wire, known as a balloon catheter, is passed into the narrowed locations and then inflated to a fixed size. The balloon forces expansion of the inner white blood cell/clot plaque deposits and the surrounding muscular wall, opening up the blood vessel for improved flow, and the balloon is then deflated and withdrawn.
What are stents?
A mesh ‘tube’ inserted into a natural passage/conduit in the body to prevent or counteract a disease-induced, localized flow constriction.
What is an atherectomy?
Surgical method of removing the plaque burden within the vessel.
What are vessels?
Vessels contain an inner single layer of cells called the endothelium surrounding by blood vessel walls consisting of smooth muscle and elastic connective tissue.
What is the relationship between the total surface area and diameter of vessels?
Inverse relationship. Total surface area increases as vessel diameter increases.
What is the relationship between the blood velocity and diameter of vessels?
Direct relationship. Blood velocity decreases as vessel diameter decreases.
Which blood vessels have the slowest blood flow?
Capillaries.
Which blood vessels have the fastest blood flow?
Arteries.