Cardiovascular Anat/Phys

Question 1

pulmonary arteries carry ____ blood

Answer 1

deoxygenated blood
to the lungs from the R ventricle

Question 2

Pulmonary veins carry ____ blood

Answer 2

oxygenated blood
to the heart, entering the L atrium

Question 3

R coronary artery supplies:

Answer 3

R atrium, ventricle
L ventricle (most ppl)
AV node, SA node (60% ppl), Bundle of His

Question 4

infarct in R coronary a can impact:

Answer 4

R atrium/ventricle, conduction/timing of the heart leading to arrhythmias

Question 5

L coronary a supplies:

Answer 5

L main artery branches into LAD and circumflex
LAD: L ventricle, septum, apex
circumflex: lat/inf walls L ventricle, SA node (40%)

Question 6

infarct in L coronary a can impact:

Answer 6

conduction through bundle of his, resulting in arrhythmias, systemic circulation

Question 7

tissue layers of the heart include:

Answer 7

endocardium
myocardium
visceral/parietal pericardium (separated by serous pericardium)
deep to superficial

Question 8

what innervation influences myocardium?

Answer 8

vagus nerve
vasovagal syncope
PNS/SNS
cervical and thoracic sympathetic ganglion feed into sympathetic innervation of the heart

Question 9

function of the endocardium

Answer 9

create smooth surface for blood flow
support valve/tissue
house purkinje fibers

Question 10

AV valves

Answer 10

tricuspid and mitral/bicuspid

Question 11

semilunar valves

Answer 11

pulmonary and aortic

Question 12

What factors affect cardiac output?

Answer 12

CO = HR x SV

Question 13

stroke volume

Answer 13

blood volume ejected from the L ventricle per beat
normal is 55-100 mL

Question 14

What affects SV?

Answer 14

preload: stretch experienced by muscle tissue before contraction, “priming”
afterload: F L ventricle has to overcome to pump blood to systemic circulation
contractility: squeezing pressure

Question 15

ejection fraction

Answer 15

percentage of blood emptied from ventricle in systole
EF = SV/EDV
normal range 55% (60-70% ideal)

Question 16

rate pressure product

Answer 16

HR x SBP
myocardial oxygen demand or energy cost of the cardiac muscle

Question 17

neurohumeral influences on the heart include:

Answer 17

sympathetic/adrenergic
parasympathetic/cholinergic

Question 18

sympathetic/adrenergic influence on the heart

Answer 18

control from medulla and T1-T4 to SA node, AV, conduction
increase HR/contractility –> increased oxygen demand
vasodilation of coronary aa.

Question 19

parasympathetic/cholinergic

innervation, effects on heart

Answer 19

control from medulla through vagus nerve and cardiac plexus
to the SA and AV nodes
slow HR and contractility –> decreased oxygen demand
vasoconstricts coronary aa.

Question 20

baroreceptor influence on heart

Answer 20

in wall of aortic arch and carotid sinus
respond to changes in BP
Drop in BP detected is corrected by SNS stim
Increase in BP detected is corrected by PNS stim

Question 21

chemoreceptor influence on heart

Answer 21

in carotid body
detect changes in O2, CO2, pH
increased CO2/decreased O2/pH increase HR/RR
increased O2 decreases HR

Question 22

hyperkalemia

Answer 22

increased potassium
decreased HR, contractility, arrhythmias, changed EKG

Question 23

hypokalemia

+ effect(s)

Answer 23

decreased potassium
EKG changes

Question 24

hypercalcemia

Answer 24

increased Ca
increased HR, contractility
kidneys are affected
can lead to confusion and coma

Question 25

hypocalcemia

Answer 25

decreased Ca arrhythmia

Question 26

hypermagnesmia

Answer 26

increased mg Ca blocker, arrhythmias, cardiac arrest, hypotension, confusion, lethargy

Question 27

hypomagnesium

Answer 27

decreased Mg ventricular arrhythmias, coronary aa vasospasm

Question 28

Phases of cardiac cycle

Answer 28

1: filling ventricles, AV valves open, semilunar valves closed; SA node depolarizes then AV shortly after and starts ventricular contraction 2. isovolumetric contraction, pressure increasing but not yet high enough to open semilunar valves, AV close 3. ejection, semilunar valves open, SV 4. isovolumetric ventricular relaxation: semilunar valves close, as ventricle relaxes valves are closed and blood flows into atria

Question 29

segments of R Upper lobe

Answer 29

apical, anterior, superior, posterior

Question 30

segments of R middle lobe

Answer 30

medial, lateral

Question 31

segments of R lower lobe

Answer 31

anterior basal, lateral basal, posterior basal

Question 32

segments of L upper lobe

Answer 32

apical, anterior, posterior, superior, inferior

Question 33

segments of L lower lobe

Answer 33

anterior basal, posterior basal, lateral basal

Question 34

carina

Answer 34

ridge in the trachea right above the bifurcation into the L and R bronchi

Question 35

mediastinum | contents

Answer 35

middle of thoracic cavity heart great vessels thymus esophogus trachea connective tissue nerves

Question 36

Which clavicular line is used to palpate intercostal spaces for heart sounds?

Answer 36

midclavicular lines

Question 37

muscles of inspiration

Answer 37

external intercostals, diaphragm

Question 38

accessory muscles of inspiration

Answer 38

SCM, scalenes, pec minor

Question 39

muscles of expiration

Answer 39

mainly passive in normal breathing with elastic recoil active breathing uses: internal intercostals, abdominals, some QL

Question 40

what forces keep lungs inflated

Answer 40

inward pull with alveoli surface tension and outward pull with pleural cavity serous fluid surface tension

Question 41

pulmonary cycle

Answer 41

one inspiration and one expiration

Question 42

lung compliance

Answer 42

distensibility like blowing up a balloon, how much resistance

Question 43

conditions impacting breathing mechanics

Answer 43

scoliosis COPD pulmonary fibrosis premature babies TBI asthma

Question 44

brain structures controlling breathing

Answer 44

medulla, pons control peripheral chemoreceptors for COs mainly

Question 45

hypercapnia

Answer 45

increased CO2 in blood increase ventilation

Question 46

lung volumes

Answer 46

tidal volume inspiratory reserve: volume to be inhaled after normal breath expiratory reserve: volume to be exhaled after normal breath residual volume: leftover air inspiratory capacity: tidal + reserve functional residual: expiratory reserve and residual vital capacity: everything but residual

Question 47

surface anatomy landmark for aortic arch

Answer 47

3rd costochondral angle

Question 48

surface anatomy landmark for trachea

Answer 48

suprasternal notch

Question 49

surface anatomy landmark for thyroid

Answer 49

midway between thyroid cartilage and suprasternal notch

Question 50

pump handle mechanism

Answer 50

sternum and xiphoid process move sagitally forward and up with inhalation

Question 51

palpation of the neck

Answer 51

most superior bone felt is hyoid below is thyroid cartilage below is cricoid cartilage below are tracheal rings

Question 52

location of auscultation of heart sounds

Answer 52

aortic valve: R second costochondral space tricuspid: 4th space pulmonic valve: L space mitral valve: 5th space

Question 53

bucket handle mechanism

Answer 53

ribs upwardly rotate and elevate while inhaling