Cardiopulm A&P

Question 1

what is the mediastinum?

Answer 1

space where the heart is located within the thoracic cavity

Question 2

what is the heart’s position?

Answer 2

apex located at 5th intercostal space under the sternum

Question 3

What is the innermost cardiac layer?

Answer 3

endocardium

Question 4

what is the “meat of the heart?”

Answer 4

myocardium, this muscle does all the work

Question 5

what is the outer layer of the heart?

Answer 5

visceral pericardium or epicardium - houses nerves here as well

Question 6

why are there two layers to the pericardium, and what are they?

Answer 6

Parietal pericardium and Fibrous pericardium – contains 10-20ml of serous fluid between to reduce fruction

Question 7

which layer is connected to the diaphragm?

Answer 7

fibrous pericardium

Question 8

when does perfusion of the heart occur?

Answer 8

during diastole as the valve closes and blood returns to coronary arteries

Question 9

What are the 5 main coronary arteries?

Answer 9

Left Main, Left Anterior Descending, Left Circumflex, Right Coronary Artery, Posterior Descending

Question 10

what does the left main artery supply?

Answer 10

left ventricle / atrium

Question 11

what does the left anterior descending artery supply?

Answer 11

front region of the left side of the heart // anterior 2/3 of septum and anterior portion of left ventricle // **provides 1/2 of aterial supply

Question 12

what does the left circumflex artery supply?

Answer 12

back and outer side of the heart’s left pumping chambers, including the left atrium and the posterior-lateral aspect of the left ventricle

Question 13

what does the right coronary artery supply?

Answer 13

right atrium, right ventricle, and the SA and AV nodes

Question 14

what does the posterior descending artery supply?

Answer 14

the posterior one-third of the interventricular septum

Question 15

what is the blood flow through the heart?

Answer 15

right atrium –> tricuspid valve –> right ventricle –> pulmonary semilunar valve –> pulmonary trunk –> pulmonary veins –> left atrium –> mitral valve –> left ventricle –> aortic semilunar valve –> aorta –> thru body –> sup/inf vena cava –> right atrium

Question 16

what is the atrial kick?

Answer 16

blood flows passively to the ventricle, when atria contacts it squeezes last 25% of blood from atria to ventricles

Question 17

does the atria or ventricles contract first?

Answer 17

atria by milliseconds

Question 18

what does the radial pulse measure?

Answer 18

left ventricular output to the body

Question 19

what is the pathway of electrical signals in the heart?

Answer 19

SA node generates signal –> signal spreads throughout atria –> signal gathers in AV node –> signal travels to Bundle of His –> signal passes through ventricles (continuations of Bundle of His) –> singal spreads to Perkinje fibers

Question 20

What is the P wave on an EKG?

Answer 20

Depolarization of atria - contraction

Question 21

What is the QRS complex on an EKG?

Answer 21

Perkinje depolarization of ventricles - contraction

Question 22

What is the T wave on an EKG?

Answer 22

system resets – repolarization

Question 23

what does the cardiac plexus contain?

Answer 23

both sympathetic and parasympathetic systems

Question 24

What role does the sympathetic nervous system play in the cardiac plexus?

Answer 24

increases HR and contractility, increases BP, reduced AV conduction time

Question 25

What role does the parasympathetic nervous system play in the cardiac plexus?

Answer 25

lowers sympathetic influence, vagus nerve acts to slow HR and decreases contractility

Question 26

what is the stroke volume?

Answer 26

volume/amount of blood ejected from ventricles with each contraction

Question 27

what is the cardiac output?

Answer 27

amount of blood ejected into aorta each minute // stroke volume x HR = CO (usually 5 L/min)

Question 28

what is the Ejection Fraction?

Answer 28

proportion of blood pumped from left ventricle at end of diastole // EF = SV/EDV (end diastolic volume) ((whatever filled ventricle at end of diastole)) // usually 55-75%

Question 29

What three factors influence stroke volume?

Answer 29

Preload, Afterload, and Contractility

Question 30

What is Preload?

Answer 30

amount of tension on the muscle before it contracts

Question 31

What is afterload?

Answer 31

load against which the muscle exerts its contraction

Question 32

what is contractility?

Answer 32

muscular performance

Question 33

what is Frank Starling's Law?

Answer 33

indicates that the increased filling pressure of the right heart results in increased cardiac output

Question 34

what is blood flow determined by?

Answer 34

pressure gradient & vasular resistance (vasodilation / constriction)

Question 35

What is laminar blood flow?

Answer 35

streamlined flow

Question 36

What is turbulent blood flow?

Answer 36

disorderly flow created by obstruction or bifurcation

Question 37

how do you measure arterial pressure?

Answer 37

CO x Total Peripheral Resistance

Question 38

What does a high arterial pressure indicate?

Answer 38

increased workload on the heart

Question 39

what is venous return?

Answer 39

return of blood to right atrium via superior and inferior vena cava

Question 40

Where is venous pressure the highest?

Answer 40

distally, lowest at junction of vena cava w/ atrium

Question 41

how does blood flow back to the heart from the feet?

Answer 41

muscles contract / helps push the blood up and valves stop it from going back down

Question 42

what are normal levels of sodium?

Answer 42

134-145 mmdl/L

Question 43

what are normal levels of potassium?

Answer 43

3.5 - 5.0 mmdl/L

Question 44

what is the major muscle of inspiration?

Answer 44

diaphragm

Question 45

what are the accessory INspiratory muscles?

Answer 45

SCM, scalenes, upper traps, pec major/minor, serratus anterior, rhomboids, lats

Question 46

what does the diaphragm look like at rest?

Answer 46

jellyfish, visceral organs help maintain its position

Question 47

how far down does the diaphragm descend at rest and during exercise?

Answer 47

descends down to an inch at rest, with exercise diaphragm drops 4"

Question 48

when a patient is bent over and stabilizing their arms on knees or a surface, what muscle is aiding in breathing out?

Answer 48

pec major, serratus

Question 49

when coaches instruct athletes to raise their arms above their head after exercising, what type of breathing are they encouraging: diaphragmatic or accessory?

Answer 49

diaphragmatic // not a good option and wouldn't use for cardiopulm patients

Question 50

when the diaphragm flattens/contracts, which direction does it go?

Answer 50

anterior/posterior + head/toe, all directions, circumferential expansion of thoracic cage

Question 51

what layer surrounds the lungs?

Answer 51

pleural layer - parietal and visceral and also contains fluid to allow sliding during expansion

Question 52

how far down does the pleural layer extend past the lung tissue and why?

Answer 52

2 ribs lower than the lungs to allow protected room for expansion

Question 53

at rest, where do the lungs sit? how far down do they go when you inhale?

Answer 53

at rib 5-6, expand to about rib 8

Question 54

what is the hilus of the lungs?

Answer 54

point where nerves, vessels, and primary bronchi enter parenchyma of lungs

Question 55

what is the root of the lungs?

Answer 55

primary bronchus, pulmonary artery/veins, bronchial arteries and veins, pulmonary nerve plexus, lymph vessels

Question 56

how many lobes does the R/L lobe have?

Answer 56

R - 3, L - 2. L is smaller because of the heart

Question 57

what is the purpose of the upper respiratory tract?

Answer 57

filtration and warms/adds moisture to the air

Question 58

what is the purpose of the lower respiratory tract?

Answer 58

some pathways are for just for air to travel through, some are for gas exchange

Question 59

what are the 3 lobar branches of the right lung?

Answer 59

upper, middle, lower

Question 60

what are the 2 lobar branches of the left lung?

Answer 60

upper/lingula, lower

Question 61

what are the 3 segments of the right upper lobe?

Answer 61

apical, anterior, posterior

Question 62

what are the 2 segments of the right middle lobe?

Answer 62

medial, lateral

Question 63

what are the 5 segments of the right lower lobe?

Answer 63

superior, medial, anterior, lateral, and posterior

Question 64

what are the 4 segments of the left upper lobe?

Answer 64

Anterior, apicoposterior, inferior, and superior lingular

Question 65

what are the 4 segments of the left lower lobe?

Answer 65

Lateral, anteromedial, superior, and posterior

Question 66

what is involved in the removal of inhaled particulare matter?

Answer 66

mucociliary escalator

Question 67

what is the functional unit of the lungs?

Answer 67

respiratory bronchioles, alveolar ducts, alveoli // sit for exchange of O2 and CO2

Question 68

how thick are the alveoli?

Answer 68

1 cell layer thick , surrounded by capillary beds to allow blood/gas exchange

Question 69

what do the alveoli produce?

Answer 69

surfactant - decreases affinity to collapse // decreases surface tension

Question 70

what is the parenchyma?

Answer 70

"meat of the lung," does the work and this is what you hear during lung sounds. alveoli, alveolar ducts, small pulm. blood vessels

Question 71

what is the interstitium?

Answer 71

space of thin layer of connective tissue between alveoli and alveolar capillaries to keep them next to each other

Question 72

what input does the parasympathetic system do to the lungs?

Answer 72

vagus nerve --> bronchial constriction, dilation of pulmonary artery smooth muscle, increased mucous secretion

Question 73

what input does the sympathetic system do to the lungs?

Answer 73

bronchial relaxation, constriction of arterial smooth muscle, decreased mucous secretion

Question 74

what is ventilation?

Answer 74

movement of gases

Question 75

what is respiration?

Answer 75

diffusion of gases

Question 76

what are the mechanics of ventilation?

Answer 76

change in pressure gradient to allow for airflow --> we create a negative pressure in relation to atmospheric air pressure when we breathe in so air can come in

Question 77

what is happening during quiet breathing / how is air moved? (expiration)

Answer 77

expiration results from passive recoil of the lungs

Question 78

what muscles are actively working during expiration?

Answer 78

abdominal muscles, rectus abdominis, ext. obliques, int. obliques, transversus abdominis

Question 79

what is normal atmospheric pressure?

Answer 79

760 mmHg

Question 80

what is tidal volume?

Answer 80

the amount of air that moves in/out in one breath cycle

Question 81

what is compliance?

Answer 81

ability to expand

Question 82

what is elasticity?

Answer 82

tendency of structure to recoil // passive (think: quiet breathing during expiration)

Question 83

what is surface tension?

Answer 83

resistance to expansion -- surfactant decreases this