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PHRM2102 > Week 1: Cardiovascular System > Flashcards

Week 1: Cardiovascular System Flashcards

1
Q

T or F
The pulmonary vascular bed has less resistance than the systemic bed

A

T

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2
Q

Sympathetic neural activation of the heart will increase which of the following?
a. heart rate
b. PR interval
c. metabolic demands
d. coronary flow rate
e. cardiac contractility
f. sleep

A

a, c, d and e

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3
Q

What does “venous capacitance” mean?

A

The measure of a BLOOD VESSEL’’s ability to increase the volume of BLOOD it holds without a large increase in BLOOD PRESSURE.

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4
Q

T or F
Thrombophlebitis never causes oedema

A

F
Thrombophlebitis is inflammation of the veins and will cause swelling but might cause oedema, especially if long standing.

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5
Q

T or F
Lymphatic blockage favours oedema formation

A

T

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6
Q

T or F
Decreased plasma protein concentrations doesn’t increase the chances of oedema formation

A

F

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7
Q

T or F
Greatly increased capillary pore size increases the chances of oedema formation

A

T

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8
Q

What separates the two atrium in the heart?

A

interatrial septum

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9
Q

What separates the two ventricular in the heart?

A

interventricular septum

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10
Q

The right atrium and right ventricle are connected via what valve?

A

The tricuspid valve

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11
Q

The left atrium and left ventricle are connected via what valve?

A

The bicuspid valve

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12
Q

The bicuspid valve is also called…

A

the mitral valve

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13
Q

The leaflets of the hearts atrioventricular valves are connected to fibrous tissue called…

A

chordae tendinae.

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14
Q

What are chordae tendinae attached to?

A

papillary muscles

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15
Q

Contraction and relaxation of what muscles cause a hearts valves to open and close?

A

papillary muscles

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16
Q

Contraction and relaxation of what muscles cause a hearts valves to open and close?

A
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17
Q

T or F
Like the atriums and ventricles of the heart, the aorta and pulmonary trunk also have valves.

A

T

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18
Q

The pulmonary and aortic valves are also called…

A

semilunar valves

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19
Q

The characteristic “double up” sound of the heartbeat is produced during…

A

the closing of the heart valves.

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20
Q

T or F
The walls of the atrium are thicker than those of the ventricles.

A

F
They are thinner

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21
Q

Which ventricle pumps blood a greater distance at higher pressures?

A

the left ventricle

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22
Q

T or F
The walls of the left ventricle are comparatively thicker than those of the right ventricle.

A

T

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23
Q

What 4 sections/fibres of the heart are considered specialised cardiac tissue?

A
  1. Sino-atrial Node (SAN)
  2. Atrio-ventricular Node (AVN)
  3. Bundle of HIS
  4. Purkinje Fibres
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24
Q

T or F
All specialised cardiac tissue is auto-excitable

A

T

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25
Q

The wall of the heart is comprised of what three layers?

A

from inside out:

Endocardium
Myocardium
Epicardium

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26
Q

Which layer of the hearts walls contains cardiac myocytes?

A

The myocardium

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27
Q

A heart walls myocardium consists mainly of … cardiac muscle fibers arranged … around each heart chamber.

A

contractile
spirally

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28
Q

Which layer of the heart is continuous with the endothelial lining of the blood vessels?

A

endocardium

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29
Q

What is mesothelium?

A

the epithelium that lines the pleurae, peritoneum, and pericardium

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30
Q

Which layer of the heart walls can be described as a simple squamous mesothelium supported by a layer of loose connective tissue containing blood vessels and nerves.

A

the epicardium

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31
Q

What is the layer of loose fibrous tissue uniting the endocardium and myocardium called?

A

the subendocardial layer

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32
Q

What does the endocardium of the heart wall consist of?

A
  • the lining endothelium
  • the lining endotheliums supporting layer of fibroelastic connective tissue with scattered fibers of smooth muscle
  • the subendocardial layer
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33
Q

The subendocardial layer of the heart walls is specialsed for what?

A

impulse induction

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34
Q

The subendocardial layer of connective tissue in the ventricles surrounds … fibres of the heart’s impulse conducting network.

A

Purkinje

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35
Q

What specialised heart fibre am I?
I am modified cardiac muscle fibers joined by intercalated disks but specialised for impulse conduction rather than contraction. I contain glycogen but relatively few organelles and peripheral myofibrils.

A

Purkinje fibres

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36
Q

T or F
Purkinje fibers typically are paler staining than contractile muscle fibers.

A

T

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37
Q

T or F
The thickness of the myocardium varies between chambers.

A

T

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38
Q

T or F
The thickness of the myocardium is NOT directly proportional to the work the chamber has to perform to pump blood.

A

F

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39
Q

What is the thickest layer of the heart walls?

A

The myocardium

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40
Q

T or F
The atria, serve as receiving chambers and perform little pumping action.

A

T

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41
Q

T or F
The blood flow through atria is passive.

A

T

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42
Q

When the ventricles contract, they must generate enough pressure to force open the … and push the blood into the …

A

semilunar valves
circulatory trees (systemic and pulmonary)

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43
Q

Under normal resting conditions, between heart beats, the pressure in the pulmonary artery is approximately … mmHg and pressure in the aorta is approximately … mmHg.

A

8
80

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44
Q

It is estimated that the left ventricular wall is … times thicker/thinner compared to the right ventricular wall.

A

3
thicker

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45
Q

What am I?
I am a cell type that covers and protects most of the internal organs of the body as well as adipose and connective tissue.

A

mesothelium

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46
Q

The aorta, the pulmonary trunk, the superior vena cava, and inferior vena cava of the heart are collectively referred to as…

A

great vessels

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47
Q

The S1 heart sound is caused by the closure of what valves?

A

The tricuspid and mitral valve

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48
Q

A split S1 sound is best heard in which auscultation area?

A

The tricuspid

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49
Q

T or F
In a typical heart the tricuspid and mitral valve will close simultaneously

A

T
Thus creating the S1 sound. A split S1 sound indicates that the tricuspid and mitral valves aren’t closing simultaneously.

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50
Q

T or F
A split S1 is medically concerning.

A

F
A split S1 is usually a normal finding that can be found in approximately 40%-70% of the population.

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51
Q

What does a right bundle branch block (RBBB) cause?

A

An RBBB causes the electrical impulse to reach the left ventricle before the right ventricle and makes the mitral and tricuspid valve close at different times. A split S1 is heard in RBBBs.

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52
Q

Match the term to the definition:

a. Cardiac output
b. Stroke volume
c. Heart rate

  1. The number of heart beats per minute
  2. The amount of blood pumped out of each ventricle/minute
  3. The volume of blood ejected per beat
A

a2
b3
c1

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53
Q

Diastole and systole are abbreviated as…

A

EDV and ESV

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54
Q

T or F
Stroke volume can only be changed by changes in EDV or ESV.

A

T

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55
Q

T or F
The phase of cardiac cycle during which the ventricles contract is called diastole

A

F
systole

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56
Q

Ventricle muscles
relaxing is called …

A

diastole

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57
Q

T or F
During systole, the blood is pumped out of the heart, and during diastole the heart is filled with blood.

A

T

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58
Q

What is meant when myocardium is said to be a “functional syncytium”?

A

That means the cells are not isolated from each other, and whenever one cell is excited, it leads to excitation spreading to all cardiac muscle cells.

59
Q

T or F
Contrary to the cardiac muscle, the skeletal muscle cells show autorhythmicity.

A

F
vice versa

60
Q

Excitation of the heart normally starts from the … node

A

sino-atrial (SA)

61
Q

T or F
As we move down the conduction pathway
from the sinoatrial node to the AV node, the rate of firing increases

A

F
decreases

62
Q

The normal firing rate of the heart is … to … beats per minute.

A

70 to 80

63
Q

Frank Starling’s law states what?

A

that stroke volume of the left ventricle will increase
as the left ventricular volume increases. (This is due to myocardial stretch causing a more forceful systolic contraction.)

64
Q

When a person stands up,
the cardiac output of that person falls, why?

A

because of a fall in central venous pressure.

65
Q

The sympathetic nervous system exercises control over the heart via … fibres. Whilst the parasympathetic nervous system exercises control via … fibres.

A

adrenergic
cholinergic

66
Q

T or F
While the parasympathetic nervous system reduces the force of atrial contraction,
it does not affect the ventricles.

A

T

67
Q

… arteries are the only arteries in the body that carry deoxygenated blood.

A

Pulmonary

68
Q

Increased tissue metabolic rate leads to … dilation and increased tissue …

A

arteriolar
blood flow

69
Q

Which neural fibers provide the most important means of reflex
control of vascular resistance and organ blood flow?

A

sympathetic nerve fibers

70
Q

AV valves close/open when atrial pressures are higher than ventricular pressures.

A

open

71
Q

The heart is an efficient and durable pump that on average beats … times per day and ejects over … litres of blood per day.

A

100,000
7000

72
Q

Blood vessels, measuring … Km in length when joined end-to-end, act as pipes that are connected to the heart allowing a constant flow of blood to all parts of the body.

A

160,000

73
Q

T or F
The kidney receives more blood flow than its metabolic requirements mainly due to its excretory functions.

A

T

74
Q

There are multiple variables that regulate the blood vessels which are critical to maintain their function. The most important ones are …, … and …

A

blood flow, blood pressure, and vessel resistance.

75
Q

The heart starts beating at about … weeks in utero.

A

five

76
Q

T or F
When we are resting blood flow to the skin is reduced.

A

T

77
Q

The cardiovascular system includes what two separate circulatory sets?

A

pulmonary circulation and systemic circulation.

78
Q

T or F
The right side of the heart is responsible for systemic circulation,
whereas the left side is responsible for pulmonary circulation.

A

F
vice versa

79
Q

Normal pulmonary artery systolic pressure at rest is about … to … mmHg.

A

18 to 25

80
Q

The low pressure in the pulmonary circuit is due to …., resulting in lower resistance.

A

the large cross-sectional area of the pulmonary circulation

81
Q

The normal systolic pressure in systemic circulation is about …mmHg.

A

120

82
Q

The high pressure in the systolic circuit is to overcome the …., in particular the arterioles.

A

resistance of systemic blood vessels

83
Q

The septum that separates the right from the left atrium is known as the …, and the septum that separates the right from the left ventricle is known as …

A

interatrial septum
interventricular septum

84
Q

T or F
Morphologically, the interatrial septum is very important because it holds the bundle of His and the right and left bundle branches.

A

F
the interventricular septum

85
Q

The systemic circulation
is complemented by which two accessory systems?

A

The portal and azygos systems.

86
Q

T or F
The blood within the azygos system is very low in oxygen, but very high in nutrition.

A

F
the portal system

87
Q

Both the portal and azygos systems eventually drain into the … system.

A

caval

88
Q

The … system helps drain venous blood from intercostal spaces and the posterior abdominal wall.

A

azygos

89
Q

When the right side of the heart fails blood starts to pool in what locations?

A

The primary site would be the right atrium. Once the right atrium has reached capacity, the blood will start to pool in the superior and inferior vena cava.

90
Q

What side of a patients heart is failing when there is jugular venous pressure?

A

The right side

91
Q

Pooling of blood in the inferior vena cava results in a pulsatile …

A

liver.

92
Q

T or F
Peripheral pooling results in oedema.

A

T

93
Q

Heart failure in the left side of the heart results in a pooling of blood in the left atrium. Once the left atrium has reached its capacity, blood will start to pool in the …

A

pulmonary circuit

94
Q

The coughing up of blood stained mucus indicates heart failure in which side of the heart?

A

left

95
Q

Difficulty breathing, especially when lying down indicates heart failure in which side of the heart?

A

left

96
Q

The percentage of blood that the heart can carry is
usually measured by a unit called …

A

ejection fraction.

97
Q

Normal left ventricular ejection fraction
is about … to …%.

A

50 to 60%

98
Q

What does HFREF stand for?

A

heart failure with reduced ejection fraction

99
Q

When heart failure with reduced ejection fraction occurs the heart is pumping only …% of its blood into the systemic circulation.

A

40

100
Q

T or F
In systolic heart failure, the hearts ejection fraction may be reserved.

A

F
In diastolic heart failure

101
Q

T or F
Clinically, left heart failure eventuality leads to right heart failure.

A

T

102
Q

T or F
The hearts valves are bidirectional

A

F
unidirectional

103
Q

T or F
In the vascular system,
only veins have valves

A

T

104
Q

Under normal conditions, average pressure in systemic arteries is approximately … mmHg whereas the average pressure in systemic veins approaches … mmHg.

A

100
0

105
Q

Briefly describe Poiseuille’s Law.

A

Blood flows through a vessel within an organ only because of the pressure difference that exists between the blood in the arteries supplying the organ and the veins draining it

106
Q

T or F
The sarcoplasmic reticulum of cardiac myocytes stores many calcium ions

A

F
They store few

107
Q

T or F
Cardiac myocytes have few mitochondria

A

F
They have plentiful

108
Q

T or F
The myocardium is comprised only of myocytes

A

F
Although myocytes make up 70% of the myocardium

109
Q

… is used as a biomarker
for myocardial infarction.

A

Troponin

110
Q

Within the cardiac myocytes, the fibres can be divided into … and … fibres

A

slow and fast

111
Q

Within the SA node and AV node, the fast fibres can be converted into slow fibres by the effects of ….

A

hypoxia or certain toxins that block sodium channels.

112
Q

T or F
The normal atrial and ventricular myocardial cells as well as specialised conducting tissue in the heart are all fast fibres.

A

T

113
Q

T or F
Skeletal muscle action potentials are very rapid,
whereas cardiac muscle action potentials are spread over a considerable time.

A

T
This spread of action potential is primarily due to calcium ions.

114
Q

…. are a component of the cardiac conducting system exhibiting the longest plateau phases
of any cardiac tissue.

A

Purkinje fibres

115
Q

Sympathomimetic drugs not only increase the …,
but also increase the ….,
which helps increase the slope of phase four depolarisation.

A

heart rate
slow inward calcium current

116
Q

The sympathetic nervous system causes a marked positive/negative inotropic effect due to an/a increase/decrease in the flux of calcium,
whereas parasympathetic nervous system causes
a positive/negative inotropic effect
by increasing/reducing the flux of calcium.

A

positive
an increase
negative
reducing

117
Q

Small changes in … concentration can have a devastating effect on the heart.

A

potassium

118
Q

Match the terms to the definitions:
a. Bathmotropy
b. Lusitropy
c. Inotropy
d. Dromotrophy
e. Chronotropy.

  1. contractility
  2. rate
  3. conduction at the AV node
  4. excitability
  5. relaxation
A

a4, b5, c1, d3, e2

119
Q

Activation of the cardiac parasympathetic nerve activity will have a positive/negative chronotropic effect on the heart.

A

negative

120
Q

Why would increased arterial pressure cause a reduction in stroke volume?

A

because it takes more force to overcome the resistance of the peripheral vasculature.

121
Q

T or F
it is possible for a person
to have a heart attack yet a very normal ECG.

A

T

122
Q

What does the P wave on an ECG represent?

A

atrial depolarisation

123
Q

What does the Q wave on an ECG represent?

A

depolarisation of the interventricular septum.

124
Q

What does the QRS wave on an ECG represent?

A

ventricular depolarisation.

125
Q

What does the T wave on an ECG represent?

A

ventricular repolarisation.

126
Q

In some ECGs, an additional positive
deflection may be noticed immediately after the T wave. This is known as the … wave and it is thought to represent the … of …

A

U
repolarisation
Purkinje fibres

127
Q

On a standard EKG paper, or ECG paper, the speed is … millimeters per second.

A

25

128
Q

T or F
The baroreceptor reflex is slow

A

F
it is a very fast reflex and occurs within minutes
after a change has occurred in the cardiovascular system.

129
Q

T or F
Blood pressure is directly proportional to blood volume

A

T

130
Q

What 3 things are responsible for the viscosity of the blood?

A

The composition of plasma
The total number of cells in the blood
The resistance of the cells to deformation and temperature

131
Q

What 3 types of capillaries are present within the body?

A

continuous, sinusoidal, and fenestrated.

132
Q

T or F
Capillaries are “naked” tubes of endothelium i.e. they are not surrounded by a layer of smooth muscle

A

T

133
Q

What is the most abundant capillary type in the body?

A

continuous capillaries

134
Q

T or F
Blood flow that bypasses the capillaries, as it passes from the arterial to the venous side of the circulation via metarterioles, has been termed nutritional flow, or shunting.

A

F
non-nutritional flow

135
Q

Diffusion across a capillary wall is governed by … law.

A

Fick’s

136
Q

What does Fick’s law state?

A

This law states that for adequate diffusion to occur concentration gradient of the solute and distance of diffusion play important roles.

137
Q

T or F
Plasma proteins can generally cross the capillary wall

A

F

138
Q

The only effective oncotic agent in capillaries is …

A

protein

139
Q

capillary oncotic pressure, favours/opposes filtration out of the capillaries and is dependent on the … concentration in the blood.

A

opposes
protein

140
Q

capillary hydrostatic pressure, favours/opposes movement out of the capillaries and is dependent on both … and ….

A

favours
arterial
venous blood pressures

141
Q

Treatment for oedema includes…

A

medication, reducing intake of salt, wearing compression stockings, and keeping legs raised.

142
Q

Common drug classes used to treat oedema include…

A

corticosteroids, loop diuretics, thiazide diuretics, potassium-sparing/thiazide diuretic combinations, thiazide-like diuretics, carbonic anhydrase inhibitors, and potassium-sparing diuretics.

143
Q

What medications can cause oedema?

A

Pramipexole, clonidine, trazadone, MAO-inhibitors, NSAID’s, calcium channel blockers, beta-blockers, corticosteroids, gabapentin, pregabalin, pioglitazone, rosiglitazone and insulin.

144
Q

Stimulation of the … nerve reduces heart rate.

A

vagus

PHRM2102 (9 decks)

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