Heart Flashcards

1
Q

What consists of the Circulatory system?

A

Heart, blood vessels, and blood.

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2
Q

What consists of the Cardiovascular system?

A

Heart, arteries, veins, and capillaries

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3
Q

What are the two major divisions of the Cardiovascular system?

A

Pulmonary circuit and Systemic circuit.

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4
Q

Describe the Pulmonary circuit

A

The right side of the heart carries blood to the lungs for gas exchange.

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5
Q

Describe systemic circuit

A

Left side of the heart supplies blood to all the organs of the body

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6
Q

What cavity encases the heart and is located in between the lungs ?

A

Mediastinum

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7
Q

What part of the heart is the base ?

A

The broad superior portion of the heart

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8
Q

What part of the heart is the apex?

A

The inferior end, tilts to the left, tapers to a point .

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9
Q

True or false the heart rests on your diaphragm

A

True

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10
Q

The left side of the heart pumps _____ blood to the ____and the right side of the heart pumps_____blood to the _____.

A

Oxygenated blood to the body, pumps deoxygenated blood to the lungs.

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11
Q

What are the two Atrioventricular valves ?

A

Tricuspid valve, Bicuspid valve( Mitral)

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12
Q

Tricuspid valve is in the ___ side of the heart and Bicuspid valve is in the ___ side of the heart

A

Tricuspid is in the right side, and Bicuspid is on the Left side.

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13
Q

What is another name for the Bicuspid valve?

A

Mitral valve

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14
Q

True or false both the Atrioventricular valves only allow blood to flow down.

A

True

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15
Q

The superior and inferior vena cava pump their deoxygentated blood where?

A

Right Atrium

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16
Q

During systole where does the blood from the right ventricle go ?

A

Pulmonary trunk, which leads to the lungs

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17
Q

Where does the blood from your left ventricle go during systole ?

A

Aorta, pumps blood to your body and organs

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18
Q

What two valves allow blood out of the heart ?

A

Pulmonary semilunar valve and aortic semilunar valve

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19
Q

What are the three shunts in the fetal circulation ?

A

Ducuts Arteriosus, Ductus venosus, Foramen ovale

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20
Q

After birth the Ducutus Arteriosus seals and becomes what?

A

Ligamentum Arteriosum, Bypasses blood flow from right atrium to descending aorta

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21
Q

After birth the Ductus Venosus seals and becomes what?

A

Ligamentum Venosum, Connects the umbilical vein(oxygenated blood) to the inferior vena cava (deoxygenated blood)

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22
Q

After birth the Formamen ovale seals and becomes what ?

A

Fossa Ovalis, shunts highly oxygenated blood from right atrium to left atrium

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23
Q

What two layers make up the pericardium ?

A

Fibrous and serious layer

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24
Q

What layers make up the serous membrane ?

A

Parietal, directly beneath the fibrous pericardium and visceral, attached directly to the heart

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25
Q

What is another name for the visceral part of the serous membrane?

A

Epicardium

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26
Q

Where is pericardial fluid found?

A

In between the parietal and visceral layer of the pericardium (inside the pericardial cavity)

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27
Q

What is the function of pericardial fluid ?

A

Prevents friction between the membranes of heart

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28
Q

Define cardiac tamponade

A

Compression of the heart due to fluid accumulation within the pericardium

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29
Q

Pericardiocentesis is what?

A

Drainage of the pericardial fluid from the pericardium

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30
Q

Describe the myocardium

A

Thick muscle layer, network of collagenous and elastic fibers

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31
Q

Describe the endocadium

A

Smooth inner lining

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32
Q

What are the 4 chambers of the heart ?

A

Right and Left Atrium and right and left Ventricle

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33
Q

What does the atrioventricular sulcus seperate?

A

Seperates the atria and ventricles

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34
Q

What does the anterior and posterior sulci seperate?

A

the grooves seperated ventricles

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35
Q

Define interatrial septum

A

Wall the seperates atria (plural for atrium)

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36
Q

Where are pectinate muscles and what is said to be their function?

A

Muscles found in the right atrium and both auricles, said to help increase power of contraction

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37
Q

What does the interventricular septum separate?

A

Ventricles

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38
Q

Describre Trabaculae Carneae

A

Internal ridges in both ventricles, prevent suction that would occur with a flat surfaced membrane

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39
Q

What cords connect AV valves to papillary muscles(on floor of ventricles)

A

Chordae tendineae

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40
Q

What is the purpoes of semilunar valves?

A

control flow into great arteries

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41
Q

True or false both the Mitral and tricuspid valves are connected to chordae tendineae

A

true

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42
Q

True or False Semilunar Valves-prevent backflow into the ventricles

A

true

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43
Q

What are the two different types of mechanical valve? Which valves do they replace?

A

Older ball and cage replaces the Mitral (bicuspid valve)

modern tilting disk replaces the semilunar valves.

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44
Q

When ventricles relax pressure____ ,semilunar valves____, AV valves____, and blood flow from the atria to ventricles.

A

pressure drops, semilunar vavles close, and AV valves open.

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45
Q

When ventricles contract pressure ____, AV valves____, papillary muscles ____, semilunar valves ____, and blood flows into the arteries.

A

Pressure rises, AV valves close, papillary muscles contract, semi-lunar valves open.

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46
Q

What are the blood vessels on the actual heart for?

A

nourish cardiac muscle

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47
Q

What two arteries branch off of the aorta to supply and nourish the heart muscles ?

A

Right and left coronary arteries

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48
Q

True or false both the left and the right coronary arteries are under the left and right auricles ?

A

True

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49
Q

The left coronary artery branches off into the Anterior (descending) interventricular artery and the circumflex artery. What do they supply?

A

Anterior interventricular supplies the interventricular septum and the anterior walls of the ventricles.
The circumflex supplies the left atrium and posterior wall of the left ventricle.

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50
Q

True or False the circumflex artery passes around left side of heart in coronary sulcus,

A

True

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51
Q

The right coronary artery branches off into the marginal and posterior interventricular artery, what do they supply?

A

Marginal artery supplies the lateral right atrium and ventricle. The posterior interventricular artery supplies posterior walls of ventricles.

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52
Q

Define myocardial infarction

A

sudden death of heart tissue caused by interruption of blood flow.

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53
Q

How does Anastomoses defend against interruption (clogs) in blood vessels?

A

provides alternate blood pathways

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54
Q

True or false 98% of the time myocardial infarction happens due to arteriosclerosis “hardening of the arteries”.

A

True

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55
Q

What are the 9 risk factors of heart disease?

A

Hypercholesterolemia•Hypertension•Cigarette smoking•Obesity•Lack of exercise•Diabetes mellitus•Genetic predisposition•Male gender•Alcohol

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56
Q

Define angioplasty

A

endovascular (within the blood vessel) procedure to widen the walls of veins or arteries due to plaque

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57
Q

What are the two different procedures for an angioplasty ?

A

Balloon Angioplasty and stent with balloon angioplasty (stent stays inside the artery)

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58
Q

Define an aneurysm

A

is a permanent, localized dilatation of an artery

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59
Q

True or False Ruptured Abdominal Aortic Aneurysm (AAA) has a very high mortality rate

A

True, 80% are fatal

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60
Q

What causes an aneurysm ? How can it be treated?

A

Weakening of the artery wall, has the potential to cause a blowout. Surgical grafting to reinforce the artery wall

61
Q

Define collateral circulation

A

network of tiny blood vessels, and, under normal conditions, not open.

62
Q

When the heart muscles have used the oxygenated blood ___% drains into the right ventricle and ___% returns to the right atrium via the coronary sinus

A

20% and 80%

63
Q

The coronary sinus collects deoxygenated blood from what two veins and empties into the right atrium?

A

Great cardiac vein (ant. interventricular sulcus) and Middle cardiac vein (post. sulcus)

64
Q

True or False The sarcoplasmic reticulum T tubules are much larger than in skeletal muscle, admit more Ca2+from ECF during excitation

A

True

65
Q

What are the three distinct features of intercalated discs?

A
  1. Interdigitating folds 2. mechanical junctions 3.electrical junctions
66
Q

What is the purpose of interdigitating folds?

A

Increase surface area

67
Q

What is the purpose of mechanical junctions and what two structures aid in it?

A

tightly joined myocytes. Fascia adhearens (anchors actin to plasma membrane) Desmosomes (weblike junctions that prevent cells from pulling apart)

68
Q

What is the purpose of electrical junctions?

A

Gap junctions form channels allowing ions to flow directly into next cell

69
Q

True or False ? Cardiac muscle depends almost exclusively on aerobic respiration to make ATP

A

True

70
Q

Why is cardiac muscle rich in myoglobin and glycogen ?

A

myoglobin(source of stored oxygen) and glycogen(source of stored glucose)

71
Q

True or false the heart contains large mitochondria

A

True

72
Q

The heart uses which organic fuels?

A

Fatty acids, glucose, ketones, lactic acid, and amino acids

73
Q

True or False? The cardiac muscle is more vulnerable to oxygen deficiency than lack of fuel and is Fatigue resistant

A

True

74
Q

What are the two types cells in cardiac muscle?

A

Contractile cells and Autorhythmic (automatic) cells.

75
Q

True or false Autorhythmic cells do not have a stable resting membrane potential

A

True

76
Q

Describe an action potential”pacemaker potential” for Auto-rhythmic cells.

A

The cell is depolarized by a SLOW inward diffusion of calcium and potassium channels, thereby opening FAST calcium channels, repolarization with outward diffusion of potassium.

77
Q

True or false the SA node does not have a stable membrane potential

A

true

78
Q

Describe Pacemaker potential

A

gradual depolarization from -60 mV, slow influx of Na+

79
Q

What is the threshold for a pacemaker potential?

A

-40 mV, after fast calcium channels open

80
Q

After a pacemaker potential, the depolarizing phase goes up to what voltage before the potassium channels open?

A

0 mV

81
Q

What is happening from 0 mV to -60 mV for an auto-rhythmic cell?

A

The cell is repolarizing due to potassium channels closing.

82
Q

Each depolarization of the SA node creates one ____

A

Heartbeat

83
Q

Unlike the pacemaker potential how do the contractile cells depolarize?

A

They depolarize by a rapid, FAST inward diffusion of sodium

84
Q

How does a contractile cell repolarize?

A

A slow outward diffusion of potassium

85
Q

In a contractile cell what creates the plateau phase at the beginning of repolarization ?

A

outward diffusion of potassium is offset by slow inward diffusion of calcium. (they are cross cancelling keeping the voltage at a steady charge)

86
Q

What causes the plateau phase to end and for the cell to drop down to resting potential (repolarize)?

A

The calcium channels close and the membrane potential quickly reaches the ‘resting’ potential

87
Q

What is the stable resting potential for myocytes in the myocardium?

A

-90mv, stable resting potential

88
Q

True or false depolarization for myocytes is very brief?

A

True

89
Q

For a myocyte, resting potential is ___mv and the peak of action potential is___

A

resting potential is -90 mV, Peak of action potential caused +30 mV.

90
Q

For myocytes, how is the contraction sustained (plateau) ?

A

Slow Ca+2 channels open and the Ca+2 binds to fast Ca+2 channels on SR and increase Ca+2 into the cytosol resulting in contraction (contraction held because the Ca+2 is positive and is preventing the voltage from dropping down and re-polarizing the cell)

91
Q

Explain Repolarization of a myocyte

A

Ca+2 channels close, K+channels open, K+ runs out of the cell quickly dropping the voltage and returning to resting potential (-90 mV)

92
Q

Does the action potential on a myocyte use negative or positive feedback ?

A

positive because stimulus opens Na+gates, (Na+in) depolarizes to threshold, rapidly opens more Na+gates in a positive feedback cycle.

93
Q

Define refractory period

A

membrane is refractory to further stimulation until the contraction is over.

94
Q

True or false most of the muscle cells in the heart are contractile cells .

A

True

95
Q

The atrioventricular (AV) bundle is also called?

A

Bundle of His

96
Q

The bundle of his splits off into left and right branches that turn into what fibers ?

A

purkinje fibers

97
Q

True or false the heart can survive with just the purkinje fibers working?

A

False , the only beat 20-40 beats per min , doesn’t allow enough blood flow to brain, you clot, and die.

98
Q

What does myogenic mean?

A

heartbeat originates within heart muscle , not nerve impulse

99
Q

Autorhythmic -depolarize_____regularly

A

spontaneously

100
Q

What insulates the atria from the ventricles?

A

fibrous skeleton

101
Q

What is the “normal “ ratio for a heartbeat? how is this monitored in the heart?

A

70-80 bpm they are monitored by a combination the SA and AV node.

102
Q

Define Arrhythmia

A

abnormal cardiac rhythm

103
Q

What two main things can cause Arrhythmia ?

A

bundle branch block and total heart block (damage to AV node )

104
Q

Define 1st degree heart block

A

Electrical impulses are slowed , but they all successfully reach the ventricles. (rarely any symptoms )

105
Q

Define 2nd degree type 1 heart block (Mobitz or Wenckebach AV block)

A

Electrical impulses are delayed longer with each heartbeat until a heartbeat is skipped entirely (may cause dizziness)

106
Q

Define 2nd degree type 2 heart block

A

Some of the electrical impulses are unable to reach the ventricles (interference below the Av node, artificial pacemaker recommended)

107
Q

Define bradycardia

A

Slow heartbeat

108
Q

Define 3rd degree heart block

A

None of the electrical impulses can reach the ventricles leaving the ventricles to try and contract on their own via purkinje fibers , the heartbeat will be very slow and is a medical emergency because it can lead to cardiac arrest (heart stopping)

109
Q

The AV node delays the SA node by 100 msec allowing the ventricles to do what?

A

To fill

110
Q

True or false Papillary muscles get signal first and contract to stabilize AV valves

A

true they contract before the actual myocardium.

111
Q

Ventricular systole begins at ____ and progresses up

A

Apex

112
Q

What is a Electrocardiogram (ECG) and what does it do?

A

recording of all action potentials detected in the heart in the order that it contracts through electrodes on the arms, legs, and chest.

113
Q

What does the P wave mean in a ECG?

A

SA node fires causes atrial depolarization—> atrial systole

114
Q

What is the QRS complex in a ECG?

A

Atrial re-polarization and diastole , AV node fires causing ventricular depolarization , and ventricular systole occurs

115
Q

What does the T wave mean in a ECG ?

A

ventricular re-polarization

116
Q

What is Auscultation ?

A

listening to sound made by the body

117
Q

Describe the first sound (S1) of the heart?

A

The AV valves are closing “lubb” creating a louder and longer sound

118
Q

Describe the seconds sound(S2) of the heart ?

A

The semilunar valves are closing “dupp” creating a softer and sharper sound

119
Q

In people less than 30 S3 is ____ heard

A

rarely , occurs when the rush of blood into the filling ventricle is suddenly halted, resulting in a vibration of the ventricle and surrounding structures.

120
Q

In the Quiescent period of the cardiac cycle what 3 things are occurring?

A

all chambers are relaxed, AV valves are open, and blood is flowing into the ventricles.

121
Q

Define EDV

A

end diastolic volume , blood in ventricles at the end of diastole (130 ml)

122
Q

What does Isovolumetric mean ?

A

no change in volume

123
Q

Define SV

A

stroke volume, amount ejected into arteries from ventricles

124
Q

Define ESV

A

End-systolic volume, amount left in the heart after systole

125
Q

How do you find the the ejection fraction ?

A

SV/EDV = %

126
Q

True or false both ventricles must eject the same amount of blood

A

True

127
Q

What happens when the right ventricular output exceeds the left ventricular output?

A

pressure backs up , fluid accumulates in pulmonary tissue , and leads to left ventricular output.

128
Q

What happens when the left ventricular output exceeds right ventricular output?

A

pressure backs up, fluid accumulates in systemic tissue, and leads to congestive heart failure of right ventricle

129
Q

Define Cardiac output ?

A

CO is amount ejected by each ventricle in one min. CO=HRxSV

130
Q

Define cardiac reserve?

A

difference between maximum and resting CO

131
Q

True or false as the HR increases the time spent in diastole is reduced but the time in systole remains fairly constant.

A

True this results in less time for ventricular filling

132
Q

Define Tachycardia

A

abnormally rapid heart rate

133
Q

True or false Infants and elderly have higher beats per minute than average.

A

True

134
Q

True or false Positive chronotropic agents raise HR and negative chronotropic agents lower HR

A

True

135
Q

The cardioacceleratory center stimulates what 3 things in the heart during sympathetics?

A

SA node, AV node, and myocardium. (HR can also go up with nor-epinephrine)

136
Q

The Cardioinhibitory center stimulates the vagus nerve that in turn stimulates what?

A

right vagus nerve stimulates SA node and left vagus nerve stimulates AV node. ACH binds and opens K+ channels , hyper polarizing and inhibiting potentials.

137
Q

Define vagal tone

A

background firing rate holds HR to sinus rhythm of 70 to 80 bpm

138
Q

True or flase Hypercapnia(high levels of CO2) and acidosis(high levels of acid in blood) stimulates cardiac center to ↑HR.

A

true

139
Q

True or false caffeine , hormones, and nicotine raise BP?

A

true

140
Q

Rapid rise of K+ makes myocardium unusually _____, and Slow rise of k+ makes myocardium ____ excitable than normal.

A

Excitable, leads to systolic arrest.

Less Excitable leads to arrest in diastole.

141
Q

Define hypercalcemia

A

reduces the heart-rate and strengthens contraction strength

142
Q

Define hypocalcemia

A

increases the heartrate and weakens contraction

143
Q

Define preload

A

Amount of tension in ventricular myocardium before it contracts

144
Q

Define Frank-Starling law of heart

A

ventricles eject as much blood as they receive, more they are stretched (↑preload)the harder they contract

145
Q

Frank-Starling law of heart is based on what knowledge ?

A

The arrangement of the myofilaments generate maximal contraction , the more they stretch the stronger the contraction

146
Q

Define contractility

A

Contraction force for a given preload

147
Q

what influence is one that modifies the contractile state of the myocardium independent of Frank-Starling mechanism?

A

Inotropic influences states that the heart can contracts harder without expanding (franks law needs to expand) by increasing the amount of calcium available.

148
Q

Define afterload

A

pressure that the heart must generate to move blood into the aorta