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Mid Semester Exam > Cardiovascular l > Flashcards

Cardiovascular l Flashcards

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1
Q

What is the heart?

A

A fibromuscular, hollow organ

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2
Q

How big is the heart? + how much does it weigh?

A

The size of the heart is approx. the size of a clenched fist relative to each individual. Average weight is 310g for male, and 225g for female

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3
Q

Where is the heart located?

A

In the inferior mediastinum (the region of the thoracic cavity between the lungs). Located one third to the right of the sternum, remaining two thirds to the left.

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4
Q

How is the heart orientated?

A

The apex of the heart is directed towards the left hip and rests on the diaphram, approx. at the fifth intercostal space. The bast of the heart (where great vessels emerge) points towards the right shoulder and lies beneath the 2nd rib.

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5
Q

Heart coverings - what is the pericardium + how many layers + sublayers does it consist of?

A

The pericardium is a double walled sac. It consists of two main layers: the fibrous pericardium and the serous pericardium. The serous pericardium contains an additional two sublayers: the parietal and visceral layer

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6
Q

What is the outermost layer of the pericardium called - what is its function?

A

The fibrous pericardium. This is a tough, loose fitting and inelastic sac around the heart. It protects the heart, anchors it to the chest cavity/to nearby structures like the diaphram, and prevents overfilling/expansion of the heart

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7
Q

What is the innermost layer of the pericardium ?

A

The serous pericardium. It is divided into two sublayers: the parietal layer, and the visceral layer (also called the epicardium).

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8
Q

What is the function of the outermost layer of the Serous Pericardium? (Parietal layer)…

A

The parietal layer lines the inner surface of the fibrous pericardium. It helps reduce friction by secreting serous pericardial fluid into the pericardial cavity.

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9
Q

What is the function of the innermost layer of the serous pericardium? (Visceral layer/epicardium)

A

The visceral layer covers the heart and reduces friction by secreting serous fluid.

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10
Q

Heart wall layers - how many layers are the heart walls made up of?

A

Three -
1. Outer epicardium (visceral pericardium)
2. Mycocardium
3. Endocardium

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11
Q

What is the myocardium + what is its function?

A

The myocardium is the middle layer of the heart wall. It consists of thick layers of cardiac muscle. This is the layer that ‘contracts’ to pump blood around the body. Electricity through this layer creates the ‘ECG’ wave.

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12
Q

What is the endocardium + what is its function?

A

The endocardium is the innermost layer of the heart wall. It lines the inner chambers of the heart + valves, and is a thin delicate layer made up of endothelial cells (which are smooth and prevent blood from clotting by reducing friction as blood flows through the heart). The lining is consistent with the vessels leaving and entering the heart.

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13
Q

What are the four chambers of the heart?

A

The left and right atria (atrium singular), the left and right ventricles.

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14
Q

What separates the left and right ventricles?

A

The septum (interventricular septum).

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15
Q

Structure - what is the purpose of valves in the heart?

A

Valves in the heart permit blood flow in one direction; preventing the backflow of blood through thee heart

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16
Q

How many valves are found in the heart - what are they named?

A

There are four valves found in the heart.
- Two are atrioventricular valves (found between the atria and ventricles). These are the left and right atrioventricular valves
- Two are semilunar valves. These are the pulmonary valve and the aortic valve

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17
Q

How are the two atrioventricular valves structured? What are they called?

A

Atrioventricular valves have pointed leaflets called cusps. The right atrioventricular valve has three cusps (and is called the tricuspid valve as a result). The left atrioventricular valve has two valves (and is called the bicuspid Valve as a result) NOTE for reference: the bicuspid valve is also called the mitral valve - derivative from double cusped hats worn by bishops called miters***

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18
Q

Where is the pulmonary valve located in the heart?

A

Where the trunk of the pulmonary artery joins to the right ventricle (it is a semilunar ‘half moon’ shape).

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19
Q

Where is the aortic valve located in the heart?

A

Where the aorta joins to the left ventricle (it is a semilunar ‘half moon’ shape).

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20
Q

Circulation - How many main circuits of circulation are there in the body?

A

3 (Pulmonary, Systemic, and Coronary circuits)

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21
Q

What cardiac phase does the pulmonary circuit occur in?

A

Diastole (passive cardiac relaxation)

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22
Q

What is the pathway of the flow of blood through the pulmonary circuit?

A

In the pulmonary circuit, deoxygenated blood is returned to the right side of the heart via the SVC and IVC. The pathway is as follows:
- right atrium (from returned systemic circulation oxygen poor blood through tricuspid valve into:)
- right ventricle (through pulmonary valve to get to:)
- pulmonary artery
- lungs (to pick up oxygen)
pulmonary veins to get oxygenated blood back to the left atrium

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23
Q

What is the pathway of the flow of blood through the systemic circuit?

A

In the systemic circuit, oxygenated blood is returned to the left side of the heart via the pulmonary veins. The pathway is as follows:
- Left atrium from pulmonary circulation (through the bicuspid Valve into:)
- Left ventricle
- Aorta (to be moved around the body + diffuse into cells from capillaries)
- travels back via veins to right atrium via SVC and IVC

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24
Q

What cardiac phase does the systemic circuit occur in?

A

Systole (active cardiac contraction)

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25
What does the coronary circuit do?
Consists of blood vessels that supply the oxygenated blood to the heart muscle (coronary arteries) and return deoxygenated blood to circulation (coronary veins)
26
Where do coronary arteries originate and extend?
Coronary arteries originate at the base of the aorta, and extend over the epicardial surface of the heart.
27
What is the flow of blood through the coronary circuit?
Oxygenated blood leaves the left ventricle → It enters the aorta → Blood flows into the left and right coronary arteries (branches off the aorta + extend over epicardial surface of the heart) → These arteries deliver oxygenated blood to the heart muscle (myocardium) → After the heart muscle uses the oxygen, the deoxygenated blood flows into cardiac veins → Cardiac veins drain into the coronary sinus → The coronary sinus empties deoxygenated blood into the right atrium of the heart.
28
What are the two main coronary arteries?
The left and right coronary arteries
29
Where do the coronary arteries originate?
At the base of the aorta (they branch off from the aorta)
30
Where are the coronary arteries extended to?
The epicardial surface of the heart
31
What phase of the cardiac cycle are coronary arteries supplied with blood?
Diastole (passive relaxation of the heart)
32
How are the coronary arteries filled with blood during diastole?
The Aortic valve closes, blood flows down the coronary arteries to perfuse the myocardium
33
What do the coronary veins do?
Drain the heart/myocardium
34
Where do the coronary veins deliver blood to?
The right atrium via the coronary sinus (an enlarged vessel on the posterior surface of the heart).
35
36
What are the two main coronary arteries?
The left and right coronary arteries
37
When are the coronary arteries supplied with blood?
During diastole: The aortic valve closes, and blood flows down the coronary arteries to perfuse the myocardium
38
What do coronary arteries do?
Supply oxygenated blood to the heart
39
What do coronary veins do?
Return deoxygenated blood back to circulation
40
What is a circulation circuit that is part of the systemic circuit?
Coronary circulation
41
Physiology - Energy Requirements: Why do cardiac muscle cells contain larger amounts of mitochondria than other body cells?
To enable higher production of ATP for usage by the heart
42
Where does the heart derive energy from in aerobic metabolism?
60% from FFA (free fatty acids) and Triglycerides 35% from CHO (carbohydrates) 5% amino acids
43
What happens if a small part of the heart is deprived of oxygen for too long?
A myocardial infarction (heart attack) will occur
44
What is aerobic metabolism necessary for in the heart?
Supporting the metabolic function of the heart
45
Physiology - Energy Requirements: What is myoglobin?
A pigment found within the heart that contains a haem group (an oxygen binding site)
46
What is a haem group?
An oxygen binding site (crucial prosthetic group found in proteins like haemoglobin and myoglobin, consisting of an iron atom held within a porphyrin ring, essential for oxygen binding and transport). - *myglobin has a higher affinity for oxygen than haemoglobin so it grabs oxygen easily*
47
Physiology - Energy Requirements: What does myoglobin do?
Transfers oxygen from the blood to the heart muscle cells, and stores reserve oxygen for aerobic metabolic function in the muscle cell
48
Physiology - Energy Requirements: What does anaerobic metabolism provide?
Additional energy during brief periods of oxygen deprivation
49
What is the equation for anaerobic and aerobic respiration?
Anaerobic: glucose → lactic acid + energy Aerobic: Glucose + oxygen → carbon dioxide + water (+ energy)
50
NOTE***
**Lactate accounts for the anaerobic component of cardiac metabolism. Lactate can be recycled by the heart and provides additional support during nutrient deprivation.
51
How much ATP is produced from a single glucose molecule during aerobic/anaerobic respiration?
- Aerobic: 38ATP - Anaerobic: 2-3ATP
52
Physiology: Conduction System **What is the difference between the heart's conduction system and intrinsic conduction system?
The heart’s conduction system is the anatomical pathway of electrical signals that control the heartbeat (e.g SA/AV nodes, purkinje fibres etc) The intrinsic conduction system refers to the heart’s ability to generate its own electrical impulses and maintain rhythm without needing outside signals (e.g., nerves).
53
What is a cardiac action potential?
A transmission of electrical impuluse
54
How is cardiac action potential created?
Via pacemaker cells found in the SA node. Pacemaker cells have an unstable membrane potential, which allows them to gradually depolarize until they reach a threshold and trigger an action potential (electrical impulse). Na⁺ and Ca²⁺ enter pacemaker cells because they're higher in concentration outside the cell in extracellular fluid, and are attracted to the inside’s negative charge. This movement happens through special ion channels in pacemaker cells, and triggers the heart’s electrical activity.
55
What does the transmission of electrical impulse (action potential) achieve within the heart?
Allows cells to contract synchronously and coordinate the heart
56
What is a polarised cell?
A cell that is negatively charged at rest (e.g pacemaker cells)
57
What causes depolarisation of the heart
When there is an influx of Ca2+ and Na+ ions to the pacemaker cells (due to diffusion*?) they become less negatively charged, and reach a threshold where the action potential is fired (the SA node fires) -QRS interval
58
What does the QRS interval measure on an ECG?
The depolarisation of the ventricles: the time it takes for the electrical signal to spread through the heart's ventricles (lower chambers).
59
What is repolarisation?
The process whereby a cells membrane returns to its resting negative state after a period of depolarisation (contraction in terms of the heart), and K+ channels open (while Na+ channels close), leading to an outflow of K+ from the cell and this faciliates the return to a negative resting state). T wave
60
What does the T wave on an ECG measure?
The repolarisation of the heart's ventricles after contraction
61
Where is the SA node located?
On the posterior surface of the right atrium of the heart, near the SVC
62
What does SA node stand for?
Sinoatrial node
63
What does AV node stand for?
Atrioventricular node
64
What is referred to as the pacemaker of the heart?
The SA node
65
What is the intrinsic depolarisation rate of the SA node?
60-100 times per minute
66
What is the intrinisic depolarisation rate of the AV node cells?
40-60 times per minute
67
Where is the AV node located?
On the right posterior surface of the interatrial septum
68
What seperates the atria and ventricles?
Non-conductive tissue, allowing a delay
69
What does the delay of the AV node achieve?
Optimal filling time of the ventricles for more efficient pumping of blood (as atria have time to fully contract and empty blood to ventricles before ventricles contract). The delay also ensures that ventricles do not respond to rapid atrial depolarisation rates
70
What is the role of the bundle of His?
To conduct the electrical depolarisation from the AV node to the ventricles
71
What is the intrinsic rate of the bundle of His?
15-40 times per minute.
72
Where is electrical impulse sent after the bundle of His?
To bundle branches in the upper interventricular septum. This then spreads into the purkinje fibres, which cause the ventricle muscle tissue to contract.
73
What is the role of the purkinje fibres?
To carry electrical depolarisation into the ventricles. They carry this from the left and right bundle branches to the ventricles' myocardium causing the contraction of the muscle tissue in the ventricles.
74
Where are purkinje fibres found/spread?
Throughout the entire muscle of the ventricle walls

Mid Semester Exam (11 decks)

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