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A&P II Lecture > exam 4 heart > Flashcards

exam 4 heart Flashcards

1
Q

What does the cardiovascular system include?

A

heart, blood vessels, blood, & lymphatic system (not really)

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2
Q

What is the heart?

A

approximately 1 pound with the size/shape of a closed fist; located in thoracic cavity slightly left of the midline

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3
Q

What is the heart’s base?

A

superior part which is flat

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4
Q

What is the heart’s apex?

A

inferior part which is pointed; rests on the diaphragm & touches the chest wall at the 5th intercostal space

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5
Q

What happens to the heart when using CPR?

A

the heart muscle is manually contracted/squeezed between bodies of vertebrae & ribs + sternum

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6
Q

What layers protect the heart?

A

fibrous pericardium & serous pericardium (parietal/visceral)

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7
Q

What is the fibrous pericardium?

A

tough, dense, fibrous connective tissue; protects heart & holds it in place

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8
Q

What is the serous pericardium?

A

thin, soft, delicate serous membrane folded into parietal & visceral surfaces

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9
Q

What is the parietal pericardium?

A

deeper surface; fuses to the inside of the fibrous pericardium

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10
Q

What is the visceral pericardium?

A

also called epicardium; anchors directly to the heart wall; can also be categorized as a layer in the wall of the heart

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11
Q

What is the pericardial cavity?

A

space separating the parietal & visceral pericardium; filled with 15 mL of pericardial fluid which serves as a lubricant to reduce friction

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12
Q

What is the myocardium?

A

muscle layer made of cardiac muscle cells; each cell is branched & contains 1 central nucleus & they are interwoven to provide strength & prevent this layer from tearing

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13
Q

How are adjacent cardiac cells anchored?

A

by many desmosomes & specialized gap junctions called intercalated disks which act to hold cells together while allowing electrical impulses to pass from 1 cell to another to help coordinate contraction of the myocardium

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14
Q

How are cardiac muscle cells autorhythmic?

A

they can contract spontaneously without electrical impulses; when these cells touch each other they contract as a unit

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15
Q

What is a syncytium?

A

the units in which cardiac muscle cells are arranged; this arrangement allows the heart to contract with a slight twist to properly pump blood

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16
Q

When the heart is damaged, what chemicals could leak from the cardiac muscle cells?

A

troponin & creatine phosphokinase

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17
Q

What is troponin?

A

it can leak into the blood; elevated levels indicate heart damage (usually a heart attack)

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18
Q

What is creatine phosphokinase?

A

an enzyme that cardiac muscle cells use during their metabolism; it leaks into blood when cells are damaged

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19
Q

What is the endocardium?

A

deepest layer lining the inside of the heart; made of endothelium which is a type of epithelium where the cells are flat & scale-like (squamous)

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20
Q

Why is the formation of the cells in the endocardium important?

A

the cells are close together making this lining slick so that blood zips through

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21
Q

What tissue forms the heart valves?

A

the endocardium; it is continuous with the linings of blood vessels

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22
Q

What is endocarditis?

A

occurs when the lining is inflamed which can cause blood clots along the now roughened surface which can lead to pulmonary embolism in the lung or a stroke

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23
Q

What is c-reactive protein?

A

released into the blood by the liver due to some type of blood vessel inflammation (endocarditis); elevated levels of this protein can indicate any type of blood vessel inflammation

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24
Q

What are the 2 main routes of blood flow through the heart?

A

pulmonary & systemic circulation

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25
Q

What is pulmonary circulation?

A

deoxygenated blood is pumped to the lungs; right side of the heart

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26
Q

Through what 3 sources does blood enter the heart during pulmonary circulation?

A

superior vena cava, inferior vena cava, & coronary sinus opening

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27
Q

What is the superior vena cava?

A

drains blood from above heart level

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28
Q

What is the inferior vena cava?

A

drains blood from below heart level

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29
Q

What is the coronary sinus opening?

A

drains blood from the myocardium

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30
Q

Where does the blood go after it enters the heart?

A

fills the atria & auricles

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31
Q

How does blood travel to the right ventricle?

A

by passing through the tricuspid valve; the right ventricle contracts from the apex upwards with a slight twisting motion

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32
Q

Where does blood flow when it exits the right ventricle?

A

into the pulmonary artery trunk which branches into the left & right pulmonary arteries that continue to the lungs

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33
Q

What is the pulmonary semilunar valve?

A

it snaps shut to prevent backflow of blood into the right ventricle (from PAT)

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34
Q

Why must some blood always remain in the ventricles?

A

to prevent the walls from collapsing

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35
Q

What is systemic circulation?

A

newly oxygenated blood from the lungs is pumped to all body systems; left side of heart

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36
Q

How does blood enter the heart during systemic circulation?

A

newly oxygenated blood in alveolar capillaries merges into 4 pulmonary veins

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37
Q

How does blood enter the left ventricle?

A

by going through the bicuspid valve; left ventricle contracts from apex upwards with a slight twisting motion to eject blood into the aorta

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38
Q

What is the aortic semilunar valve?

A

it snaps shut to prevent backflow from the aorta into the left ventricle

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39
Q

What are the 2 types of valves in the heart?

A

atrioventricular & semilunar valves

40
Q

What are atrioventricular valves?

A

the tri & bi cuspid valves; they separate the atria & ventricles

41
Q

What are atrioventricular valves made of?

A

soft flaps called cusps which grow out of the endocardium

42
Q

What are chordae tendinae?

A

“heart strings” that anchor the cusps into the ventricles; they attach to papillary muscles

43
Q

What are papillary muscles?

A

cone-shaped extensions from the ventricle wall to prevent the valve’s cusps from extending into the atria which prevents leakage of blood from ventricle into atrium

44
Q

What are semilunar valves?

A

rigid valves that pop open due to force of blood as its ejected from ventricles; prevents leakage from “great vessels” (PAT & aorta) into ventricles

45
Q

How is the “lub” heart sound heard?

A

from the closure of the tri & bi cuspid valves at the same time

46
Q

How is the “dup” heart sound heard?

A

from the closure of the semilunar valves at the same time

47
Q

What is a heart murmur?

A

when the heart sound is heard as a gurgle due to valve leakage

48
Q

What is the heart’s conduction system?

A

groups of neurons that coordinate the contraction of the heart

49
Q

What does the conduction system include?

A

SA node, AV node, AV bundle of His, bundle branches, & Purkinje fibers

50
Q

What is the sinoatrial (SA) node?

A

a lump of nervous tissue in the right atrial wall slightly inferior to the opening of the superior vena cava

51
Q

What does the SA node do?

A

sets basic heart rate at approximately 75 bpm which can be adjusted as needed; causes atria to contract at the same time

52
Q

What is the atrioventricular (AV) node?

A

a lump of nervous tissue in the interatrial septum near the tricuspid valve; sends impulses to AV bundle of His

53
Q

What is the atrioventricular (AV) bundle of His?

A

strand of nervous tissue in the superior part of interventricular septum; branches to form the bundle branches

54
Q

What are the bundle branches?

A

strands of nervous tissue in the inferior portion of the interventricular septum; branches into Purkinje fibers

55
Q

What are Purkinje fibers?

A

tiny branches that extend into lateral walls of the heart from apex upwards to ensure that contraction of the heart also occurs from apex upwards

56
Q

When does heart failure occur?

A

when blood is not adequately ejected into the “great vessels”; often due to issues with conduction system or death/weakness of a portion of the heart wall

57
Q

What are the 2 types of heart failure?

A

pulmonary & systemic

58
Q

What is pulmonary heart failure?

A

occurs when the right side doesn’t fully eject blood which causes blood to back up into the right atrium & inferior vena cava

59
Q

What happens as a result of pulmonary heart failure?

A

swelling of the extremities, especially feet, ankles, and legs; can cause serous fluid to leak from the skin (weeping heart failure)

60
Q

What is systemic heart failure?

A

occurs when the left side doesn’t fully eject blood which causes blood to back up into the left atrium & 4 pulmonary veins

61
Q

What happens as a result of systemic heart failure?

A

swelling of the alveolar capillaries which causes difficulty breathing

62
Q

What is an electrocardiogram (EKG)?

A

graphical representation of impulses/electricity from the conduction system

63
Q

What is the P wave on an EKG?

A

where depolarization of the atria occurs

64
Q

What is the QRS complex on an EKG?

A

shows the repolarization of atria & the depolarization of ventricles

65
Q

What is the T wave on an EKG?

A

where the repolarization of ventricles occurs

66
Q

What happens at the place between the P wave & QRS complex?

A

depolarization of atria is completed

67
Q

What happens at the place between the QRS complex & the T wave?

A

depolarization of ventricles is completed

68
Q

What is cardiac output (CO)?

A

the amount of blood ejected by each ventricle per minute; typically 5250 mL/min or 5.25 L/min

69
Q

How is CO calculated?

A

heart rate • stroke volume

70
Q

What is stroke volume?

A

the volume of blood ejected with each heartbeat; contraction force

71
Q

What is cardiac output influenced by?

A

intrinsic & extrinsic factors

72
Q

What are intrinsic factors?

A

changing of heart rate or stroke volume

73
Q

What are extrinsic factors?

A

events that somehow alter the intrinsic factors

74
Q

How is sympathetic stimulation an extrinsic factor?

A

it increases heart rate & contraction force through cardiac nerves in the sympathetic division supplying the heart

75
Q

How could sympathetic stimulation occur?

A

through fear, exercise, fever, excitement, most pain, etc.

76
Q

What is epinephrine?

A

hormone from the adrenal glands that is released in severe sympathetic stimulation; its presence greatly increases cardiac output

77
Q

How do high blood calcium levels affect cardiac output?

A

causes an increase in CO because it increases cross bridge formation in the cardiac muscle

78
Q

How is parasympathetic stimulation an extrinsic factor?

A

it returns an elevated cardiac output to normal through cranial nerve X = vagus nerve

79
Q

How does the vagus nerve affect cardiac output?

A

in severe abdominopelvic pain (kidney stones, appendicitis, etc.), the pain travels to the brain through the sensory part of vagus nerve & sends impulses back through vagus nerve to the heart causing a decrease in heart rate & stroke volume

80
Q

How could the decrease in CO due to the vagus nerve be harmful?

A

can lead to a cardiac output that causes insufficient blood going to the brain causing someone to pass out

81
Q

How do cold/freezing temperatures affect CO?

A

cause a decrease in cardiac output as body tries (unsuccessfully) to divert blood to our “vital” organs

82
Q

How do high blood potassium levels affect CO?

A

alter the waves of depolarization in heart’s conduction system which decreases cardiac output

83
Q

How does depression/grief affect CO?

A

decreases cardiac output

84
Q

How does acidic blood pH affect CO?

A

acidic blood pH occurs if the brain’s respiratory centers do not respond to this acidity (because of the presence of drugs like opioids); this pH decreases cardiac output which can lead to death

85
Q

What are baroreceptors?

A

masses of neurons found within the wall of the aortic arch & the wall of the common carotid arteries at the point where they branch into external & internal carotids

86
Q

Why is it important that the great vessels can stretch & recoil?

A

large volumes of blood enter these vessels as ventricles contract, so they must be able to withstand the force

87
Q

What do baroreceptors do?

A

monitor changes in blood pressure in the arteries they are located in, sending that information to the centers in the brain’s medulla which regulate cardiac output accordingly

88
Q

How is pressure in the blood vessels expressed?

A

systole & diastole; these phases are monitored when blood pressure is taken

89
Q

What is systole?

A

phase of contraction of atria & ventricles

90
Q

What is atrial systole?

A

atria contract

91
Q

What is ventricular systole?

A

ventricles contract

92
Q

What is diastole?

A

phase of relaxation of atria or ventricles

93
Q

What is atrial diastole?

A

atria relax & fill with blood

94
Q

What is ventricular diastole?

A

ventricles relax & fill with blood

95
Q

What is normal blood pressure?

A

120/80

A&P II Lecture (9 decks)

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