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AP2 > AP2 Exam 1 > Flashcards

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
Q

The ______ ______ acts as an electrical insulator between the atria and ventricles.

A

Fibrous skeleton

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26
Q

Remnant of the ductus arteriosus

A

Ligamentum arteriosum

*helps stabilize between the aortic arch and pulmonary trunk

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27
Q

Incomplete closure of heart valves is:

A

insufficiency

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28
Q

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.

A

atria

atria

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29
Q

LCA (left main coronary artery) divides into:

A

LAD aka anterior interventricular branch

LCA aka circumflex

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30
Q

RCA (right main coronary artery) divides into:

A

Marginal aka acute marginal branch

posterior descending artery aka posterior interventricular artery

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31
Q

LCA (left main coronary artery) supplies:

A

most of anterior LA

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32
Q

LAD supplies:

A

anterior 2/3 septum

bundle branches

bulk of LV

small portion of RV

aka anterior interventricular branch

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33
Q

Left circumflex artery supplies:

A

high lateral wall of LV

posterior wall of LV

rest of LA

SA node (25% of people)

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34
Q

RCA to include its branches supplies:

A

RA

RV (marginal mostly supplies)

posterior 1/3 septum (posterior descending supplies)

SA node (75% people)

AV

apex portion of LV

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35
Q

Marginal branch of RCA supplies:

A

most of RV

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36
Q

Coronary circulation picture

A

*Most heart anatomy receives blood from more than one artery; collateral circulation via anastomoses

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37
Q

Posterior descending artery of RCA supplies:

A

posterior inferior wall of LV

part of posterior interventricular septum

aka posterior interventricular artery

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38
Q

Great cardiac vein drains:

A

portion of both ventricles and LA

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39
Q

Middle cardiac vein drains:

A

posterior aspect of both ventricles

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40
Q

Small cardiac vein drains:

A

portion of RV and RA

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41
Q

Posterior cardiac vein drains:

A

posterior LV

42
Q

Anterior cardiac veins drain:

A

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
Q

Coronary circulation picture

A

*all veins drain into the coronary sinus EXCEPT for the anterior cardiac veins

44
Q

Aortic arch gives rise to these three arteries (in order from R to L)

A

Brachiocephalic artery

Left common carotid artery

Left subclavian artery

45
Q

Brachiocephalic artery divides into:

A

Right subclavian artery

Right common carotid artery

46
Q

How many pulmonary veins do we have?

A

Four

two from R and two from L

47
Q

Electrical vs. Chemical potential

A

charge vs. concentration

*these are in constant battle

*results in CONSTANT state of electrolytes moving across cell membrane

48
Q

Voltage

A

the measure of potential energy generated by separated charges

in a cell this is known as MEMBRANE POTENTIAL (measured in mV)

49
Q

Influx

A

movement of ions into a cell

50
Q

Efflux

A

movement of ions out of a cell

51
Q

Because cardiac conductive cells are autorhythmic, there is no ______ period.

A

rest

52
Q

Bachmann’s bundle

A

comes off the anterior internodal pathway through interatrial septum to depolarize the LA

53
Q

The change in ______ at various locations through the conduction system allows for synchronous contractions throughout the heart.

A

velocity

*SA 0.01-0.02 m/s

*AV 1m/s

*Purkinje fibers 2 m/s

54
Q

Phase 0

A

Depolarization

rapid influx of Na+ and Ca2+

+10mV

55
Q

Phase 1

A

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
Q

Phase 2

A

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
Q

Phase 3

A

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
Q

Phase 4

A

Resting membrane potential

-90mV

reached once the rapid efflux of K+ is complete

the cells is ready to accept another AP

59
Q

Types of ion channels in cell membrane

A

Leakage

Voltage gated

Mechanically gated (change in temp. or pressure)

Ligand gated

60
Q

Cardiac cell picture

A

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
Q

Intercalated disc

A

ends of cardiac myocytes>>connected to another myocyte

contains:
desmosome
gap junction

62
Q

Mitochondria in cardiac tissue are much ______ and more ______.

A

larger

numerous

*25% cardiac vs. 2% in skeletal muscles

63
Q

Action potential graph of conductive cells

A

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
Q

What are the 2 types of cardiac cells?

A

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
Q

The AP from SA node propagates through which 3 internodal pathways in RA?

A

anterior internodal: bachmann’s bundle comes off this pathway>>sends signal to LA through interatrial septum

middle internodal

posterior internodal

66
Q

Only site where APs propagate from the atria to the ventricles

A

atrioventricular bundle (aka bundle of His)

67
Q

Q wave on EKG

A

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
Q

Flat portions of EKG represent:

A

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
Q

Contraction of the ventricles begins during the QRS and finishes during the:

A

ST segment

*ventricles start to relax as the T wave begins

70
Q

Heart sounds come from:

A

Blood rebounding off of valve leaflets (causes them to close)

NOT a “door shutting sound”

smooth flowing blood is silent

71
Q

S1 indicates the start of:

A

ventricular systole

*closure of the AV valves

72
Q

S2 indicates the start of:

A

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
Q

S3 sound:

A

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
Q

S4

A

occurs late ventricular diastole (atrial contraction)

hitting non-compliant ventricular walls>>stiffness

75
Q

S4

A

coincides with atrial contraction (late ventricular diastole)

aka atrial gallop

hitting non-compliant ventricular walls as atrial contract>>ventricular stiffness

76
Q

Although the L and R sides of the heart have different pressures, they still expel the same ______ of ______ with each beat.

A

volume

blood

77
Q

End of atrial systole equals:

A

end of ventricular diastole

*130mL

78
Q

End Diastolic Volume

A

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
Q

Isovolumetric contractions

A

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
Q

Aortic valve opens at ______ mm Hg

A

80

left side/systemic afterload

81
Q

Pulmonic valve opens at ______ mm Hg

A

20

right side/pulmonary afterload

82
Q

End systolic volume

A

volume of blood remaining in the ventricle at end of systole

83
Q

SV equals:

A

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
Q

Isovolumetric relaxation

A

period of time where all 4 valves are closed

85
Q

Typical resting adult male averages a SV of ______mL/beat.

A

70mL

*typical blood volume of adult male is 5L

86
Q

The entire ______ volume flows through the pulmonary and systemic circulation each minute.

A

blood volume

*~5L in adult male

87
Q

Cardiac reserve

A

max CO - resting CO

*average person has a cardiac reserve of 4-5x the resting CO

88
Q

3 factors that affect SV:

A

Preload

Contractility

Afterload

89
Q

Frank starling law (principle)

A

the more the heart fills with blood during diastole, the greater the force of the contraction

90
Q

Calcium: positive vs. negative inotropy

A

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
Q

High extracellular K+, ______ HR and contractility.

A

decreases

*prevents complete repolarization

92
Q

Blood vessel walls separate the ______ ______ from blood plasma.

A

interstitial fluid

93
Q

The open end of the fibrous pericardium is attached to what?

A

The great vessels

94
Q

The epicardium is synonymous with:

A

Visceral layer of the serous pericardium

95
Q

Fibrous skeleton

A

Electrical insulator between the atria and the ventricles

Structural support

Anchors the myocardium

Prevents valves from being overly distended

96
Q

The weight/volume of ______ in the atria is what forces the AV valves open

A

blood

97
Q

Autonomic regulation of the heart

A

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
Q

Sympathetic vs. parasympathetic innervation of heart

A

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
Q

Adult females have slightly ______ resting HR.

A

higher

100
Q

Fever and HR

Exercise and CO

A

fever can increase HR

after exercise training, maximum CO increases

AP2 (4 decks)

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