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AP2 Exam 1 Flashcards

1
Q

Chemical gradient

A

concentration based

requires no energy

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2
Q

Electrical gradient

A

equalize the charge

requires energy due to active transport

think Na+/K+ pump and Ca2+ channels in regards to APs

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3
Q

Of the fluids in the body, ______/3 is intracellular fluid and ______/3 is extracellular. Most (80%) of ECF is ______ fluid.

A

2/3

1/3

interstitial

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4
Q

Base of the heart

A

Formed, mostly, by the LA and a small portion of RA

Consists of 4 pulm. veins and 2 pulm. arteries

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5
Q

Apex of the heart

A

formed by the inferolateral portion of the LV

*rests on diaphragm

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6
Q

Situs inversus totalis

A

most serious form of dextrocardia

general transposition of the thoracic and abdominal viscera including the heart vs. isolated dextrocardia

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7
Q

The pericardium consists of which layers?

A

Fibrous pericardial layer: attached to central tendon of diaphragm

Serous pericardial layer: consists of the parietal and visceral layers

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8
Q

The epicardium is synonymous with the ______ ______.

A

visceral pericardium

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9
Q

______ tissue protects the major coronary vessels.

A

Adipose

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10
Q

Blood vessels and lymphatics that supply the epicardium, myocardium and endocardium rest/start on the ______ and dive inward through the other layers.

A

Epicardium

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11
Q

Muscle fiber cells of the ______ are wrapped and bundled with sheaths. They are organized in bundles that swirl diagonally around the heart. This is what gives the heart a ______ like appearance as it contracts

A

Myocardium

Torque

*although striated, cardiac muscle is involuntary

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12
Q

Endocardium

A

smooth lining for chambers of the heart

covers the valves of the heart

continuous with the endothelial lining of the vessels

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13
Q

Endocarditis will often produces these two signs amongst the other typical signs of an illness.

A

Heart murmur: bacteria literally growing on heart valves creating turbulent noise

Irregular heart beat

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14
Q

Auricles of the heart

A

atrial appendages

pouch like structure that can increase the collecting and pumping capacity of the atria

can be diff. sizes in diff. indiv.: some indiv. can have floppy auricles where blood can collect and clot

has some muscle that allows for contraction at the same time as atrial contraction

have pectinate muscles within both atria

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15
Q

Coronary sulcus

A

“crown” aka atrioventricular sulcus

externally separates the atria from ventricles

can be seen on anterior and posterior surfaces, however:
it is not complete on the anterior surface because of the great vessels

the coronary sinus sits in the posterior portion of the coronary sulcus

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16
Q

Pectinate muscles

A

special feature of the ATRIA

special ridges of muscle found in the anterior portion of RA

also found in both auricles

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17
Q

Crista terminalis

A

dividing line in RA: smooth surface transition to pectinate muscles

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18
Q

The ______ receives blood from the coronary sinus.

A

RA

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19
Q

Right atrium (RA) posterior and anterior walls

A

smooth posterior wall

anterior wall is rough>pectinate muscles

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20
Q

Moderator band of the RV

A

particular bridge that carries a portion of the RBB (conduction system)

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21
Q

The ______ forms most of the base of the heart. It receives blood from the lungs via ______ pulmonary veins. Its posterior and anterior walls are both ______.

A

LA

4

smooth (pectinate muscles are only found in RA and both auricles)

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22
Q

The inferolateral portion of the ______ forms the apex of the heart.

A

LV

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23
Q

The ______ septum contains the electrical tract that sends a signal from the RA to the LA.

A

interatrial septum

Bachmann’s bundle

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24
Q

Interventricular septum

A

mostly left ventricular myocardium

only normal pathway for electricity to get from the atria into the ventricles

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25
The ______ \_\_\_\_\_\_ acts as an electrical insulator between the atria and ventricles.
Fibrous skeleton
26
Remnant of the ductus arteriosus
Ligamentum arteriosum \*helps stabilize between the aortic arch and pulmonary trunk
27
Incomplete closure of heart valves is:
insufficiency
28
As ______ contract, a small amount of blood does flow back into great veins. As the ______ contract, they compress, and nearly collapses the venous entry points.
atria atria
29
LCA (left main coronary artery) divides into:
LAD aka anterior interventricular branch LCA aka circumflex
30
RCA (right main coronary artery) divides into:
Marginal aka acute marginal branch posterior descending artery aka posterior interventricular artery
31
LCA (left main coronary artery) supplies:
most of anterior LA
32
LAD supplies:
anterior 2/3 septum bundle branches bulk of LV small portion of RV aka anterior interventricular branch
33
Left circumflex artery supplies:
high lateral wall of LV posterior wall of LV rest of LA SA node (25% of people)
34
RCA to include its branches supplies:
RA RV (marginal mostly supplies) posterior 1/3 septum (posterior descending supplies) SA node (75% people) AV apex portion of LV
35
Marginal branch of RCA supplies:
most of RV
36
Coronary circulation picture
\*Most heart anatomy receives blood from more than one artery; collateral circulation via anastomoses
37
Posterior descending artery of RCA supplies:
posterior inferior wall of LV part of posterior interventricular septum aka posterior interventricular artery
38
Great cardiac vein drains:
portion of both ventricles and LA
39
Middle cardiac vein drains:
posterior aspect of both ventricles
40
Small cardiac vein drains:
portion of RV and RA
41
Posterior cardiac vein drains:
posterior LV
42
Anterior cardiac veins drain:
superior portion of RV opens directly into RA does NOT drain into the coronary sinus vs. all other cardiac veins drain into coronary sinus
43
Coronary circulation picture
\*all veins drain into the coronary sinus EXCEPT for the anterior cardiac veins
44
Aortic arch gives rise to these three arteries (in order from R to L)
Brachiocephalic artery Left common carotid artery Left subclavian artery
45
Brachiocephalic artery divides into:
Right subclavian artery Right common carotid artery
46
How many pulmonary veins do we have?
Four two from R and two from L
47
Electrical vs. Chemical potential
charge vs. concentration \*these are in constant battle \*results in CONSTANT state of electrolytes moving across cell membrane
48
Voltage
the measure of potential energy generated by separated charges in a cell this is known as MEMBRANE POTENTIAL (measured in mV)
49
Influx
movement of ions into a cell
50
Efflux
movement of ions out of a cell
51
Because cardiac conductive cells are autorhythmic, there is no ______ period.
rest
52
Bachmann's bundle
comes off the anterior internodal pathway through interatrial septum to depolarize the LA
53
The change in ______ at various locations through the conduction system allows for synchronous contractions throughout the heart.
velocity \*SA 0.01-0.02 m/s \*AV 1m/s \*Purkinje fibers 2 m/s
54
Phase 0
Depolarization rapid influx of Na+ and Ca2+ +10mV
55
Phase 1
Cell is a peak positive charge Rapid Ca2+ and Na+ influx slows then shuts off completely K+ channels open allowing outflow of K+ leading to slight/brief repolarization Brief repolarization Voltage gated slow Ca2+ channels open\>\>\>leads into phase 2 (plateau)
56
Phase 2
Plateau Slow influx of Ca2+ balanced with efflux of K+ **Ca2+ reaches saturation level need to initiate contraction\>\>muscle contraction occurs in this phase**
57
Phase 3
Repolarization Completion of contraction occurs at the beginning of this stage Voltage gated K+ channels open allowing rapid *mass* efflux of K+ (not leakage channels)
58
Phase 4
Resting membrane potential -90mV reached once the rapid efflux of K+ is complete the cells is ready to accept another AP
59
Types of ion channels in cell membrane
Leakage Voltage gated Mechanically gated (change in temp. or pressure) Ligand gated
60
Cardiac cell picture
shorter and less circular than skeletal muscle usually 1 central nucleus but may have 2 gap junctions allow entire myocardium of atria or ventricles to contract as a single unit
61
Intercalated disc
ends of cardiac myocytes\>\>connected to another myocyte contains: desmosome gap junction
62
Mitochondria in cardiac tissue are much ______ and more \_\_\_\_\_\_.
larger numerous \*25% cardiac vs. 2% in skeletal muscles
63
Action potential graph of **conductive** cells
Conductive cells contain a series of sodium ion channels that allow a normal and slow influx of sodium ions that causes the membrane potential to rise slowly from an initial value of −60 mV up to about –40 mV. The resulting movement of sodium ions creates spontaneous depolarization (or prepotential depolarization). At this point, calcium ion channels open and Ca2+ enters the cell, further depolarizing it at a more rapid rate until it reaches a value of approximately +15 mV. At this point, the calcium ion channels close and K+ channels open, allowing outflux of K+ and resulting in repolarization. When the membrane potential reaches approximately −60 mV, the K+ channels close and Na+ channels open, and the prepotential phase begins again.
64
What are the 2 types of cardiac cells?
*Conductive*: **specialized cardiac muscle cells** relatively non-contractile initiates APs\>\>**no rest period because they are autorhythmic** self-excitable *Contractile*: requires an AP from conductive cells **resting period**
65
The AP from SA node propagates through which 3 internodal pathways in RA?
anterior internodal: bachmann's bundle comes off this pathway\>\>sends signal to LA through interatrial septum middle internodal posterior internodal
66
Only site where APs propagate from the atria to the ventricles
atrioventricular bundle (aka bundle of His)
67
Q wave on EKG
true beginning of ventricular depolarization if present, represents rapid, early septal depolarization not seen in every lead permanent Q wave can be indicative of previous MI
68
Flat portions of EKG represent:
muscle contractions \*there is some overlap such as when the superior aspect of the septum and ventricles start to contract while electricity is still making its way throughout the rest of the ventricles
69
Contraction of the ventricles begins during the QRS and finishes during the:
ST segment \*ventricles start to relax as the T wave begins
70
Heart sounds come from:
Blood rebounding off of valve leaflets (causes them to close) NOT a “door shutting sound” smooth flowing blood is silent
71
S1 indicates the start of:
ventricular systole \*closure of the AV valves
72
S2 indicates the start of:
ventricular diastole \*closure of semilunar valves \*split S2: sometimes the aortic closes before the pulmonic valve causing split S2 sounds; can usually hear this when a person inhales
73
S3 sound:
occurs during early diastole ventricular gallop: blood rapidly filling of the ventricles (sounds louder with decreased ventricular distensibility) under 40y/o can be normal
74
S4
occurs late ventricular diastole (atrial contraction) hitting non-compliant ventricular walls\>\>stiffness
75
S4
coincides with atrial contraction (late ventricular diastole) aka atrial gallop hitting non-compliant ventricular walls as atrial contract\>\>ventricular stiffness
76
Although the L and R sides of the heart have different pressures, they still expel the same ______ of ______ with each beat.
volume blood
77
End of atrial systole equals:
end of ventricular diastole \*130mL
78
End Diastolic Volume
end of atrial systole=end of ventricular diastole 130mL of blood in ventricle affected by two factors: lengths of ventricular diastole (shorter=less preload) and venous return (less return=less preload)
79
Isovolumetric contractions
0.05 second when both the AV and SL valves are closed ventricles are beginning to contract and ventricular pressure is rising to the point that the SL valves can open no blood movement
80
Aortic valve opens at ______ mm Hg
80 ## Footnote **left side/systemic afterload**
81
Pulmonic valve opens at ______ mm Hg
20 ## Footnote **right side/pulmonary afterload**
82
End systolic volume
volume of blood remaining in the ventricle at end of systole
83
SV equals:
EDV-ESV **Resting stroke volume is 50-60% of EDV** Ejection Fraction (EF): anything greater than 50% is considered normal (estimated via US/echocardiogram)
84
Isovolumetric relaxation
period of time where all 4 valves are closed
85
Typical resting adult male averages a SV of \_\_\_\_\_\_mL/beat.
70mL \*typical blood volume of adult male is 5L
86
The entire ______ volume flows through the pulmonary and systemic circulation each minute.
blood volume \*~5L in adult male
87
Cardiac reserve
max CO - resting CO \*average person has a cardiac reserve of 4-5x the resting CO
88
3 factors that affect SV:
Preload Contractility Afterload
89
Frank starling law (principle)
the more the heart fills with blood during diastole, the greater the force of the contraction
90
Calcium: positive vs. negative inotropy
Increase in Ca2+ influx during APs, *increases HR* and strengthens contractions (catecholamines, digitalis)\>\> **positive inotropy** Reduced Ca2+ influx during APs, reduces strength of contractions (CCBs, anesthetics)\>\> **negative inotropy**
91
High extracellular K+, ______ HR and contractility.
decreases \*prevents complete repolarization
92
Blood vessel walls separate the ______ \_\_\_\_\_\_ from blood plasma.
interstitial fluid
93
The open end of the fibrous pericardium is attached to what?
The great vessels
94
The epicardium is synonymous with:
Visceral layer of the serous pericardium
95
Fibrous skeleton
Electrical insulator between the atria and the ventricles Structural support Anchors the myocardium Prevents valves from being overly distended
96
The weight/volume of ______ in the atria is what forces the AV valves open
blood
97
Autonomic regulation of the heart
cardiovascular center is located in the medulla oblongata receives input from: sensory receptors, limbic system, cerebral cortex, and afferent nerve fibers from ventricles proprioceptors (body position and movement), chemoreceptors (pH, blood chemistry), and baroreceptors (blood pressure) [aortic arch and carotid arteries]
98
Sympathetic vs. parasympathetic innervation of heart
SNS: efferent cardiac accelerator nerves from thoracic spinal cord to SA and AV node (increases Ca2+ entry) PNS: L/R efferent vagal nerve to SA and AV node; afferent fibers send feedback to CV center in medulla
99
Adult females have slightly ______ resting HR.
higher
100
Fever and HR Exercise and CO
fever can increase HR after exercise training, maximum CO increases

AP2 (4 decks)

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