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Cardiovascular, Pulmonary, and Hepatic Physiology > Anatomy of the Heart > Flashcards

Anatomy of the Heart Flashcards

1
Q

where is the heart located?

A

in the mediastinumbetween the sternum. vertebrae, and lungs

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2
Q

give the range of the weight of the heart in dogs

A

between 0.5-16 oz

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3
Q

give the weight range of the heart in horses

A

between 8-10lbs

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4
Q

where does about 2/3 of the mass of the heart lie?

A

on the left side of the midline of the body

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5
Q

describe the apex of the heart (location)

A
  1. bottom pointy part
  2. directed anteriorly, inferiorly, and to the left
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6
Q

describe the base of the heart

A
  1. basal part
  2. directed posteriorly, supreriorly, and to the right
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7
Q

what is the pericardium?

A

the sac of tissue (membrane) that protects the heart and holds it in place

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8
Q

how many parts does the pericardium have? list and describe location

A
  1. fibrous (most superficial)
  2. serous (innermost)
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9
Q

describe the fibrous portion of the pericardium (4; 3 are functions)

A
  1. outer, thicker layer made of tough, inelastic connective tissue
  2. prevents overstretching of the heart
  3. provides protection
  4. anchors heart to the mediastinum
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10
Q

describe the serous portion of the pericardium (2)

A
  1. more delicate, inner membrane layer
  2. has two parts that form a double layer around the heart: parietal and visceral
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11
Q

describe the visceral part of the serous portion of the pericardium; give an alternative name

A

adheres tightly to the surface of the heart; also called epicardium

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12
Q

what is found between the visceral and parietal layers of the serous portion of the percardium? what is its function?

A

pericardial fluid; reduces friction as the heart moves

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13
Q

what is pericarditis, generally?

A

inflammation of the pericardium

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14
Q

what are the 2 main types of pericarditis?

A
  1. acute
  2. chronic
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15
Q

describe acute pericarditis (how common, possible link, symptoms, duration, how treated)

A
  1. the most common type
  2. sudden onset with no known cause usually
  3. sometimes linked to viral infection
  4. chest pain that may extend to left shoulder and arm
  5. lasts about 1 week
  6. treat to reduce inflammation and pain
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16
Q

what are the 2 types of chronic pericarditis?

A
  1. effusive
  2. constrictive
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17
Q

escribe chronic pericarditis (generally, not the types yet)

A
  1. gradual onset, long lasting
  2. can be life threatening if great fluid accumulation
  3. most causes are unknown but sometimes related to cancer or TB
  4. treat by draining excess fluid through needle passed into pericardial cavity
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18
Q

describe effusive chronic pericarditis

A

more common, fluid-filling or accumulation

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19
Q

describe constrictive chronic pericarditis

A

fibrous scar tissue forms around the heart, meaning the heart can’t fill properly and leads to heart failure

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20
Q

how does fluid accumulation in chronic pericarditis lead to badness?

A

it compresses the heart, resulting in cardiac tamponade

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21
Q

list the 3 layers of the heart wall, from outer to innermost

A
  1. epicardium/ visceral serous pericardium
  2. myocardium
  3. endocardium
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22
Q

describe the epicardium of the heart wall

A

outermost, thin, transparent layer of the heart wall. also called visceral layer of serous pericardium

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23
Q

describe the myocardium of the heart wall (4)

A
  1. made of cardiac muscle tissue
  2. makes up the bulk of the heart
  3. responsible for the pumping action
  4. cardiac muscle fibers swirl diagonally around the heart in bundles
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24
Q

describe the endocardium of the heart wall (4)

A
  1. thin layer of endothelium overlying a thin layer of connective tissue
  2. privides smooth lining for chambers of the heart
  3. covers valves of the heart
  4. continuous with endothelial lining of large blood vessels attached to the heart
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25
Q

what is myocarditis?

A

inflammation of the myocardium

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26
Q

how is myocarditis usually caused?

A

usually a complication of viral infection, rheumatic fever, or exposure to radiation

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27
Q

describe the symptoms of myocarditis

A

often no symptoms but if any will be
1. fever
2. fatigue
3. vague chest pain
4. irregulaar heart beat
5. joint pain
6. breathlessness

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28
Q

describe severity and longevity of myocarditis

A

usually mild with recovery within 2 weeks

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29
Q

what can a severe case of mycarditis result in?

A

cardiac failure

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30
Q

what is endocarditis? what does it usually involve and what is it typically cuased by?

A

inflammation of the endocardium; usually involves the heart valves and caused by bacteria

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31
Q

what are the symptoms of endocarditis?

A
  1. fever
  2. heart murmur
  3. irregular heart beat
  4. fatigue
  5. loss of appetite
  6. night sweats
  7. chills
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32
Q

how is endocarditis usually treated?

A

intravenous antibiotics

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33
Q

give 3 risk factors that would make one more susceptible to endocarditis

A
  1. congenital heart issues
  2. dental procedures
  3. heart surgery
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34
Q

what are auricles? (3)

A
  1. the anterior surface of each atrium
  2. wirnkled, puch-like structures
  3. slightly increase capacity of atrium so it can hold greater volume of blood
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35
Q

what are sulci? (2)

A
  1. grooves in the heart
  2. contain coronary blood vessels and fat
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36
Q

what is the deep coronary sulcus?

A

encircles most of the heart and marks boundary between superior atria and inferior ventricles

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37
Q

what 3 sources does the right atrium receive blood from?

A
  1. superior vena cava
  2. inferior vena cava
  3. coronary sinus
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38
Q

what is the tricuspid valve? what is it also called? what is its function

A

also called the right atrioventricular (AV) valve; has three cusps and allows blood to pass from the right atrium to the right ventricle

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39
Q

what is the right AV valve/tricuspid valve composed of?

A

dense connective tissue covered by endocardium

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40
Q

what does the right ventricle form?

A

most of the anterior surface of the heart

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41
Q

give 3 structures that the right ventricle contains

A
  1. trabeculae carneae
  2. chordae tendineae
  3. intraventricular septum
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42
Q

what are trabeculae carneae? provide function

A

a series of ridges formed by raised bundles of cardiac muscle fibers that convey part of the conduction system of the heart

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43
Q

what are chordae tendineae?

A

tendon-like chords connected to the cusps of the tricuspid valve that are also connected to the conec shaped trabeculae carnea called papillary muscles

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44
Q

how is the right ventricle separated from the left ventricle?

A

by the interventricular septum

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45
Q

where does blood flow from the right ventricle?

A

through the pulmonary valve into the pulmonary trunk, which divides into R and L pulmonary arteries

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46
Q

what forms most of the base of the heart?

A

the left ventricle

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47
Q

where does the left atrium receive blood from and through what?

A

the lungs through 4 pulmonary valves

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48
Q

what does blood have to pass through to enter the left ventricle from the lungs? what is this also called?

A

the bicuspid valve/mitral valve/left AV valve; has two cusps

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49
Q

what forms the apex of the heart?

A

the left ventricle

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50
Q

name 2 structures that the left ventricle contains

A
  1. trabeculae carneae
  2. chordae tendineae
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51
Q

what is the function of the trabeculae carneae and chordae tendineae in the left and right ventricles?

A

to prevent backflow into the atria

52
Q

where doesgo when the left ventricle contracts?

A

through the aortic valve into the ascending aorta, and some of the blood flows into the coronary arteries that branch from the ascending aorta, while the remainder of the blood passes into the aortic arch and into the descending aorta then to the body

53
Q

what is the reason for the variation of myocardial thickness of each chamber?

A

they all perform different functions, so need different muscle thickness

54
Q

why are the atria relatively thin-walled of myocardium?

A

the only have to deliver blood to adjacent ventricles

55
Q

why do the ventricles have thicker myocardium?

A

the have to pump blood a greater distance

56
Q

compare and contract the R and L ventricles (4)

A
  1. they are two separate pumps
  2. they simultaneously eject EQUAL quantities of blood
  3. the right ventricle has a smaller workload
  4. the left ventricle pumps blood a much greater distance
57
Q

why does the right ventricle have a smaller workload than the left ventricle?

A

it only pumps blood to the lungs at lower pressure and it only has to overcome a small resistance to blood flow

58
Q

describe the resistance and pressure the left ventricle must overcome to pump blood

A

much greater resistance against much higher pressure to deliver blood to the rest of the body

59
Q

what is the stabilizing factor for the heart valves?

A

the fibrous skeleton of the heart

60
Q

what is the fibrous skeleton of the heart made of?

A

dense connective tissue forming 4 rings that surround the valves of the heart, fuse with one another, and merge with the interventricular septum

61
Q

what is the role of the fibrous skeleton of the heart? (3)

A
  1. prevents overstretching of valves as blood passes through them
  2. serves as a point of insertion for bundles of cardiac muscle fibers
  3. acts as an electrical insulator between atria and ventricles
62
Q

where are the atrioventricular valves located?

A

between the atria and the ventricles

63
Q

give the two atrioventricular valves and what side they’re on

A

tricuspid on the right, biscupid on the left

64
Q

when the AV valves are open, where do the pointed ends of the cusps project?

A

into the ventricle

65
Q

describe the chordae tendineae and papillary muscles when the ventricles are relaxed and what happens to blood in this state

A

papillary muscles: relaxed
chordae tendineae: slack
blood moves from high pressure in atria to lower pressure in ventricles

66
Q

describe the chordae tendineae and papillary muscles when the ventricles are contracting and what happens to blood in this state

A

papillary muscles: contract and pull on chordae tendineae as the pressure of the blood drives the cusps of AV valves upward so the edges meet and close the opening

67
Q

what could happen if the AV valve or chordae tendineae are damaged?

A

blood may regurgitate into atria when ventricles contract

68
Q

in what direction do the cusps of the AV valves fall?

A

in the direction of blood flow

69
Q

what is the overall purpose of the AV valves, chordae tendineae, and papillary muscles?

A

to prevent leakage

70
Q

what state are the ventricles in when the AV valves are closed?

A

ventricles contracting when AV valves are closed

71
Q

what are the 2 semilunar valves? what are they made up of?

A

aortic and pulmonary; made up of 3 crescent moon shaped cusps

72
Q

what is the function of the semilunar valves?

A

allow ejection of blood from heart into arteries and prevent backflow of blood into ventricles

73
Q

where do the borders of the cusps of the semilunar valves project?

A

into the lumen of their arteries

74
Q

what happens to the pressure in the ventricles when they contract?

A

the pressure in the chamber of the ventricle increases

75
Q

when do the semilunar valves open? what does this result in?

A

when pressure in the ventricle exceeds the pressure in the arteries; blood is ejected into the pulmonary trunk and aorta

76
Q

what happens when the ventricles relax and what does this result in?

A

blood starts to flow back to the heart, filling the valve cusps, which causes the semilunar valves to close tightly

77
Q

give the 4 major differences between the semilunar and AV valves

A
  1. high pressure in arteries at the end of systole causes SL valves to snap to closed position in contrast to the softer closure of AV valves
  2. because of the smaller openings, the velocity of blood ejection through the aortic and pulmonary claves is much greater than through the much larger AV valves
  3. because of the rapid closure and rapid ejection, the edges of the aortic and pulmonary valves are subjected to much greater mechanical stress than AV valves (more likely to get roughed up)
  4. AV valves are supported by the chordae tendineae, the SL valves are not
78
Q

what are the heart sounds heard on auscultation and what do they indicate?

A

lubb (AV valve closure and turbulence) dupp (SL valve closure and turbulence)

79
Q

which of the heart sounds is quicker and why?

A

the dupp is quicker because the SL valves close quicker and have more blood turbulence

80
Q

are there any valves giarding the junctions between the right atrium/vena cavae or left atrium/pulmonary veins? why or why not?

A

no valves because any loss where blood comes into the atria is insignificant and as atrial muscles contract, they compress and nearly collapse the venous entry points (most backflow minimized)

81
Q

what are the 2 types of heart valve disorders? describe generally

A
  1. stenosis: narrowing of heart valve opening that restricts blood flow
  2. insufficiency or incompetence: failure of valve to close completely
82
Q

what is mitral stenosis?

A

scar formation or congenital defect causes narrowing of mitral valve

83
Q

what is mitral insufficiency?

A

backflow of blood from L ventricle to L atrium

84
Q

what can mitral valve insufficiency be caused by?

A

mitral valve prolapse (MVP)

85
Q

what is mitral valve prolapse (MVP)? also give prevalence

A
  1. one or both cusps of the mitral valve protrude into L atrium during ventricular contraction
  2. one of the most common valve disorders (30% of population!!)
  3. more common in women
86
Q

what is aortic stenosis? who affected more and why?

A
  1. when the aortic valve is narrowed
  2. takes time (decades) to develop so often see elderly affected more
87
Q

when is aortic stenosis often noticed and why?

A

during exercise (will pass out)

88
Q

what is the most common valvular disorder in the western world?

A

aortic stenosis

89
Q

what are 3 common causes of aortic stenosis?

A
  1. rheumatic fever
  2. calcium imbalance
  3. endocarditis
90
Q

what is rheumatic fever?

A

an autoimmune disease that often results from strep or scarlet fever that targets that aortic and mitral valves

91
Q

what are the 2 closed circuits in which the heart pumps blood? describe how related

A
  1. systemic
  2. pulmonary
    the output of one becomes the input of the other
92
Q

what is the left side of the heart a pump for?

A

systemic circulation

93
Q

describe systemic circulation involving the left side of the heart (9)

A
  1. left atrium receives O2 rich blood from pulmonary circulation (lungs)
    2.passes through left AV valve into left ventricle
  2. left ventricle ejects blood into the aorta
  3. blood enters progressively smaller systemic arteries then goes to organs (not lungs)
  4. exchange of nutrients and gases occur across thin-walled capillaries
  5. blood unloads O2 and picks up CO2
  6. blood flows through one capillary and enters systemic venule
  7. venues carry deO2 blood away from tissues and merge to form larger systemic veins
  8. blood flows back to R atrium
94
Q

what is the right side of the heart a pump for?

A

pulmonary circulation

95
Q

describe pulmonary circulation invovling the right side of the heart

A
  1. right atrium receives deO2 blood coming from systemic circulation
  2. blood pases through right AV valve into R ventricle, which ejects blood into the pulmonary trunk
  3. the pulmonary trunk brances into pulmonary arteries and carries blood to the lungs
  4. blood unload CO2 in pulmonary capillaries (whihc is exhaled)
  5. O2 is inhaled and oxygenated blood flows into pulmonary veins, returning to L atrium
96
Q

what is coronary circulation?

A

the myocardium’s network of blood vessels

97
Q

what do R and L coronary arteries branch from and form?

A

the ascending aorta to encircle the heart

98
Q

describe blood flow in coronary circulation whule the heart is contracting and why

A

low blood flow because coronary arteries are squeezed shut

99
Q

describe what happens in the coronary arteries when the heart is relaxed and why

A

high pressure in the aorta proels blood through coronary arteries and into capillaries, then to into coronary veins

100
Q

how are all areas of the myocardium supplied with blood?

A

R and L coronary arteries branch from the ascending aorta then branch further to supply

101
Q

what are anastomoses? (3) what do they do?

A
  1. connections where 2 or more arteries supply the same region of tissue
  2. end-to-end union of blood vessels (lymphatic vessels or nerves)
  3. provide alternate routes for blood to reach an organ or tissue
102
Q

what happens in the coronary veins after blood passes through the coronary arteries and flows into capillaries?

A
  1. blood delivers O2 and nutrients to heart muscle
  2. blood collects CO2 and waste
  3. then moves into coronary veins
103
Q

where does most deoxygenated blood drain into from the coronary veins?

A

into the large vascular sinus (coronary sinus) in the coronary sulcus

104
Q

what happens to the deoxygenated blood in the coronary sinus?

A

empties into the R atrium

105
Q

what is reperfusion?

A

reestablishment of blood flow after blockage of the coronary artery deprives myocardium of O2

106
Q

how can reperfusion damage myocardial tissue further? (3)

A
  1. formation of oxygen free radicals from reintroduced O2
  2. these unstable and highly reactive molecules cause chain reactions that lead to cellular damage/death
  3. during myocardial reperfusion, a burst of oxygen-derived free radicals overwhelms normal cellulaar defenses
  4. they can oxidize lipids, leading to membrane dysfunction and also alter nucleic or other proteins
107
Q

how are sources of ROS elicited by early reperfusion?

A
  1. variations within the mitochondrial electron chain
  2. disruption of normal metabolism
108
Q

what are superoxide dismutase and catalase?

A

enzymes that convert free radicals to less reactive substances (the body’s protection from ROS)

109
Q

what are 2 methods to lessen reperfusion issues?

A
  1. ischemic post conditioning: rapid, intermittent introduction of blood flow
  2. antioxidant treatment
110
Q

what is myocardial ischemia?

A

partial obstruction of blood flow in coronary arteries

111
Q

what is caused by myocardial ischemia? (2)

A
  1. hypoxia (reduced O2 supply)
  2. may weaken cells without killing them
112
Q

what is angina pectoris (5)

A
  1. strangled chest
  2. severe pain that usually accompanies myocardial ischemia
  3. tightness or squeezing sensation
  4. pain often to the neck, chin, and down the left arm
  5. may indicate impending heart attack! (Act fast!)
113
Q

what is myocardial infarction?

A

a heart attack; complete obstruction to blood flow in coronary artery

114
Q

what does infarction mean?

A

death of tissue because of interrupted blood supply

115
Q

what happens as a result of myocardial infarction always (2)

A
  1. heart tissue distal to the obstruction dies and is replaced by non-contractile scar tissue
  2. heart loses some of its strength
116
Q

what can happen as a result of myocardial infarction depending on size and location of infarcted area? (2)

A
  1. may be disruption of conduction system
  2. may cause sudden death by triggering ventricle fibrillation
117
Q

give 3 treatments for mycoardial infarction

A
  1. clost dissolving (thrombolytic) agent and heparin
  2. coronary angioplasty (trying to open vessel)
  3. coronary artery bypass grafting
118
Q

contrast cardiac muscle to skeletal muscle

A

shorter in length and hella branched

119
Q

describe the inercalatede discs of cardiac muscle

A

irregular trasnverse thickenings of sarcolemma

120
Q

what are sarcolemma

A

cell membranes that separate individual cardiac muscles from on another

121
Q

what do intercalated discs do

A

connect the ends of cardiac muscle fibers

122
Q

what do intercalated discs contain, what do they do? (2)

A
  1. desmosomes that hold the fibers together
  2. gap junctions that allow rapid diffusion of ions (action potentials) to travel easily from one cardiac msucle cell to the next
123
Q

describe the concept of syncytium

A

when one heart muscle cell contracts, the rest of the cells in the area also contract; allows for coordinated contraction

124
Q

conpare cardiac muscle cell mitochondria to skeletal muscle cell mitochondria

A

cardiac cells have more mitochondria

125
Q

compare cardiac and skeletal msucle fibers

A
  1. same arrangement of actin and myosin
  2. same bands, zones, and Z disks
126
Q

contrast tranverse tubules in cardiac muscle versus skeletal muscle cells

A

wider transverse tubules in cardiac but less abundant; smaller sarcoplasmic reticulum because smaller intracellular reserve of Ca2+

Cardiovascular, Pulmonary, and Hepatic Physiology (12 decks)

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