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Anatomy and Physiology > Cardiovascular System > Flashcards

Cardiovascular System Flashcards

1
Q

What body cavity is the heart located in?

A

thoracic cavity

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2
Q

what are organs found in the thoracic cavity?

A

heart, lungs, trachea, esophagus

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3
Q

what organs are found in the superior mediastinum?

A

trachea and esophagus

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4
Q

what organ is found in the pleural cavity?

A

lungs

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5
Q

what organ is found in the pericardial mediastinum?

A

heart

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6
Q

where is the heart located in relation to the midsternal line?

A

2/3 on the left of midline

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7
Q

what is the name of the serous membrane that surrounds the heart?

A

pericardium

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8
Q

what are the two layers of the pericardium?

A

visceral and parietal pericardium

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9
Q

what is the space between the inner and outer pericardium called?

A

pericardial cavity

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10
Q

what is found in the pericardial cavity?

A

serous fluid

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11
Q

where does the systemic circuit carry blood?

A

out and back to body

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12
Q

where do systemic arteries carry blood?

A

away from the heart

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13
Q

where do systemic veins carry blood?

A

towards the heart

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14
Q

what is the function of the cardiac circuit (coronary circulation)

A

supply the heart itself with blood

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15
Q

where do cardiac arteries branch from?

A

base of aorta

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16
Q

where do cardiac veins bring blood to?

A

coronary sinus

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17
Q

where does the coronary sinus drain blood into?

A

right atrium

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18
Q

what is the function of the pulmonary circuit?

A

bring blood to and from the lungs

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19
Q

are pulmonary arteries bringing blood to or away from the lungs?

A

to the lungs

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20
Q

what is the state of blood in pulmonary arteries?

A

de-oxygenated

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21
Q

are pulmonary veins brining blood to or away from the lungs?

A

away from the lungs, back to the heart

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22
Q

what is the state of blood in pulmonary veins?

A

oxygenated

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23
Q

what is the function of capillary beds in body tissue?

A

sites of gas exchange

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24
Q

what are the three layers of the heart wall from outermost to inner?

A

epicardium, myocardium, endocardium

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25
Q

what is another name for the epicardium?

A

visceral pericardium

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26
Q

what is the muscular layer of the heart?

A

myocardium

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27
Q

what layer of the heart is the contracting layer and forms the atria and ventricles?

A

myocardium

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28
Q

what type of epithelium is the endocardium?

A

simple squamous

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29
Q

what does the endocardium do?

A

covers inner walls and heart valves

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30
Q

what is different about atrial and ventricular muscle contractions?

A

duration of contraction is longer, has a long absolute refractory period

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31
Q

what are pacemaker cells called?

A

auto rhythmic cells

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32
Q

what interconnects cardiac muscle cells (fibers)?

A

intercalated discs

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33
Q

what are three key components of intercalated discs?

A

gap junctions, desmosomes and fascia adherens

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34
Q

what is the function of desmosomes in intercalated discs?

A

hold fibers together and convey force of contraction

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35
Q

what is the function of gap junctions in intercalated discs?

A

propagate muscle action potentials between cells by allowing ions and chemical communication to pass

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36
Q

what is the function of fascia adherens in intercalated discs?

A

provides an anchor for myofibrillar proteins

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37
Q

what does cardiac muscle function as?

A

syncytium, heart muscle cells are interconnected

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38
Q

functional syncytium

A

cardiac cells are mechanically, electrically and chemically connected

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39
Q

does cardiac muscle tissue have triads?

A

no

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40
Q

what do intercalated discs allow?

A

action potential to move cell to cell

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41
Q

what does cardiac muscle rely on for getting Ca for muscle contraction? and why?

A

rely on extracellular Ca because SR in cardiac muscle lack large terminal cisternae

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42
Q

shape and size of t tubule in cardiac muscle?

A

short and broad and encircles the sarcomere at the Z-lines and not the zone of overlap

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43
Q

are mitochondria more abundant in cardiac or skeletal muscle?

A

cardiac muscle

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44
Q

what type of metabolism does cardiac muscle use?

A

aerobic

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45
Q

what type of metabolism does skeletal muscle use?

A

anaerobic

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46
Q

what has more myoglobin cardiac or skeletal muscle and why?

A

cardiac muscle because aerobic respiration

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47
Q

what substances are elevated in cardiac cells due to aerobic metabolism?

A

intracellular glycogen and lipid inclusions

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48
Q

what are the three branches of the aorta?

A

brachiocephalic artery, left common carotid and left subclavian

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49
Q

what are the four muscular chambers of the heart?

A

right atrium, right ventricle, left atrium, left ventricle

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50
Q

what is the right side of the heart called?

A

pulmonary pump

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51
Q

what is the left side of the heart called?

A

systemic pump

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52
Q

what does the right atrium do?

A

collects de-oxygenated blood from systemic circuit and coronary sinus

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53
Q

what does the right ventricle do?

A

pumps de-oxygenated blood to the pulmonary circuit via the pulmonary artery

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54
Q

what does the left atrium do?

A

collects oxygenated blood from the pulmonary circuit via the pulmonary veins

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55
Q

what does the left ventricle do?

A

pumps oxygenated blood to the systemic circuit

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56
Q

what structure separates the right and left ventricles?

A

interventricular septum

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57
Q

where does the superior vena cava receive blood from?

A

head, neck, upper limbs, and chest

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58
Q

where does the inferior vena cava receive blood from?

A

trunk, viscera, and lower limbs

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59
Q

before birth, what is the opening through the interatrial septum called?

A

foramen ovale

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60
Q

what does the foramen ovale become after birth?

A

fossa ovalis

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61
Q

what are raised bundles of cardiac muscle found in the ventricles called?

A

trabeculae carneae

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62
Q

where is the moderator band found and what is its function?

A

found in the right ventricle and is a muscular ridge that extends from the inter ventricular septum and connects to the anterior papillary muscle. It contains part of the conducting system and coordinates contractions of cardiac muscle cells.

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63
Q

true or false, both sides of the heart accept and pump equal amounts of blood?

A

true

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64
Q

function of atrioventricular valves?

A

prevent back flow of blood from ventricles to atria during systole?

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65
Q

what is the right AV valve called?

A

tricuspid valve

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66
Q

what is the left AV valve called?

A

bicuspid

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67
Q

chordae tendineae function?

A

connective tissue that anchor flaps to walls of ventricles to prevent AV valves from opening backwards

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68
Q

where do chordae tendineae originate?

A

papillary muscles

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69
Q

function of semi-lunar valves?

A

prevent back flow of blood from the aorta and pulmonary arteries into the ventricles during diastole

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70
Q

what are the two semi-lunar valves?

A

pulmonary and aortic semilunar valves

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71
Q

do semi-lunar valves have muscular support? what do they have instead?

A

no muscular support, have three cusps support like tripod

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72
Q

what does the pulmonary trunk divide into?

A

right and left pulmonary arteries

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73
Q

what does the ascending aorta turn into?

A

turns into aortic arch and then becomes descending aorta

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74
Q

systolic pressure

A

measures the peak pressure in arteries during contraction. The ventricles contract, ventricular pressure rises, AV valves close and semi-lunar valves open

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75
Q

diastolic pressure

A

measures the aortic pressure when the ventricles relax, AV valves open and semi-lunar valves close

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76
Q

normal blood pressure

A

< 120/80 mm Hg

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77
Q

elevated blood pressure

A

120-129/ <80 mm Hg

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78
Q

hypertension stage 1

A

130-139/ 80-89 mm Hg

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79
Q

hypertension stage 2

A

> = 140/ >= 90 mm Hg

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80
Q

hypertensive crisis

A

> 180/ >120

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81
Q

what’s larger left or right ventricle?

A

left

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82
Q

what has thicker and more powerful muscles, left of right ventricle?

A

left

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83
Q

does the left ventricle have a moderator band?

A

no

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84
Q

what shape is the right ventricle and what shape is the left?

A

right ventricle is pouch-shaped and the left ventricle is round

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85
Q

what are the thee types of veins?

A

large, medium sized, and venule

86
Q

what are the three types of arteries?

A

elastic, muscular, arteriole

87
Q

what are the three layers of typical blood vessels?

A

tunica externa, tunica media, tunica intima

88
Q

what is the tunica externa usually made out of?

A

elastic fibers and connective tissue

89
Q

what is the tunica media usually made out of?

A

smooth muscular layer with elastic fibers

90
Q

what is the tunica intima usually made out of?

A

basement membrane with a endothelium layer made out of simple squamous epithelia

91
Q

what is the conducting artery?

A

elastic artery

92
Q

what is the distribution artery?

A

muscular artery

93
Q

what are the three types of capillaries?

A

continuous, fenestrated, sinusoid

94
Q

general appearance difference between arteries and veins?

A

arteries are usually round with thick walls, veins are usually flattened or collapsed with thin walls

95
Q

difference in tunica intima between veins and arteries?

A

tunica intima of arteries are rippled due to vessel constriction, tunica intima of veins are often smooth

96
Q

difference in tunica media of veins and arteries?

A

arteries have thick tunica media dominated by smooth muscle cells and elastic fibers. veins have thin tunica media dominated by smooth muscles cells and collagen fibers

97
Q

what differentiates elastic arteries?

A

high compliance, walls expand in response to pressure to accommodate surge of blood

98
Q

what differentiates muscular arteries?

A

larger tunica media, more smooth muscle

99
Q

continuous capillaries characteristics?

A

formed by endothelial cells, surrounded by basement membrane, no tunica media or tunica externa

100
Q

fenestrated capillaries characteristics?

A

endothelial layer has pores (fenestrations), no tunica media or externa

101
Q

where are fenestrated capillaries found?

A

kidneys, choroid plexus of ventricles in the brain and in endocrine glands

102
Q

sinusoid capillaries characteristics?

A

incomplete or absent basement membrane and large fenestrations, allow proteins to pass

103
Q

where are sinusoid capillaries found?

A

liver, new RBC, spleen, anterior pituitary and PTH glands

104
Q

what happens if the papillary muscles are damaged?

A

cusps of AV valves don’t close properly

105
Q

what happens if semi-lunar valves are damaged

A

valve replacement

106
Q

when the ventricles are contracting the:

A

AV valves are closed and the semi-lunar valves are open

107
Q

when the ventricles are relaxed the:

A

AV valves are open and the semi-lunar valves are closed. the chordae tendineae are loose and the papillary muscles are relaxed

108
Q

damage to which 2 valves is most detrimental to the cardiac system?

A

bicuspid and aortic valves

109
Q

Aortic and pulmonary valvuloplasty

A

catheter inserted through vein in neck and implants inflating balloon which crushes plaque in valve cusps

110
Q

annuloplasty rings

A

annulus rings that are placed around the natural annulus at the base of a heart valve. Used to reshape and strengthen the natural valve annulus

111
Q

posterior leaflet repair

A

portion of leaflet removed and repaired and annuloplasty ring is added to stabilize and strengthen the repaired valve

112
Q

mechanical valve replacement?

A

a long-lasting valve made of durable materials

113
Q

tissue valve replacement?

A

a valve made up of human or animal donor tissue

114
Q

ross procedure

A

borrowing your healthy pulmonary valve and moving it into the position of the damaged valve

115
Q

TAVI/TAVR procedure

A

transcatheter aortic valve replacement

116
Q

why do veins have valves?

A

to prevent reverse blood flow (venous reflex)

117
Q

varicose veins

A

twisted or enlarged veins that lead to pooling or back flow of blood in veins

118
Q

what causes varicose veins?

A

vein wall weakness, history of blood clots, absence of vein valves, family history of varicose veins

119
Q

how does muscle contraction help move venous blood?

A

skeletal muscle contraction compresses the blood and increases the pressure in that area. This forces blood closer to the heart where venous pressure is lower.

120
Q

what three factors influence resistance of blood?

A

blood viscosity, total blood vessel length, blood vessel diameter

121
Q

how does blood viscosity impact resistance?

A

as viscosity increases, resistance increases and flow decreases

122
Q

what is viscosity affected by?

A

plasma proteins, formed elements and temperature

123
Q

how does total blood vessel length impact resistance?

A

the longer the vessel, the greater the resistance and lower the flow

124
Q

how does blood vessel diameter impact resistance?

A

increased diameter means less blood touching the vessel wall so less resistance as diameter increases

125
Q

what equation describes the non-linear effect of blood vessel diameter on resistance?

A

Resistance = 1/r^4

126
Q

what electrically insulates the atria from the ventricles?

A

the cardiac skeleton

127
Q

what type of tissue is the cardiac skeleton consist of? and why?

A

dense connective tissue because it is not electrically excitable and prevents transmission of current between the chambers of the heart

128
Q

how many bands of connective tissue are there? where are they located? and why?

A

4 bands of dense connective tissue that encircle the heart valves. Located around the base of the aorta, both AV valves and the pulmonary trunk. Provides a point of attachment for valve leaflets and the myocardium - electrically insulate the atrial cells from the ventricular cells

129
Q

where is the AV node found?

A

at the center of the cardiac skeleton?

130
Q

what is important about the location of the AV node?

A

the AV node proposes the action potential through the atrioventricular conducting system. This results in a delay in depolarization as the action potential is propagated through the AV bundle to the apex of the heart so the ventricles contract after the atria

131
Q

what are the two types of cells that make up the electrical and mechanical system?

A

autorhythmic and contractile cells

132
Q

order of electrical and mechanical events

A

electrical event precede mechanical events

133
Q

what percent of cardiac cells are autorhythmic cells?

A

1%

134
Q

what is the function of autorhythmic cells?

A

control heart beat and spontaneously produce action potentials

135
Q

what causes the unstable resting potential of authorhythmic cells?

A

slow inflow of Na+ without compensating for outflow of K+

136
Q

what allows autorhythmic cells to continuously depolarize and drift up to AP threshold?

A

If channels (funny channels)

137
Q

how are autorhythmic cells connected to contractile cells?

A

gap junctions

138
Q

where are autorythmic cells found in the conducting system?

A

SA node (cardiac pacemaker), AV node, internodal pathways: bundle of his, right and left bundle branch, and purkinje fibers

139
Q

what is the only place where AP conducts from atria to the ventricles?

A

AV bundle or bundle of His

140
Q

How fast does the sinoatrial (SA) node fire?

A

75-100 AP/min

141
Q

how fast does the atrioventricular (AV) node fire?

A

50 impulses/min

142
Q

how fast do the right and left bundle branch fire?

A

20-40 impulses/min

143
Q

describe how action potentials in autorhythmic cells are propagated?

A

If channels spontaneously depolarize the cell to threshold as Na+ inflow exceeds K efflux. Voltage gated Ca channels open and Ca/Na flow into the cell from the ECF, depolarizing the cell. At peak, K+ channels open and K+ flows out of the cell to depolarize the cell back to resting membrane potential

144
Q

what is the resting membrane potential of cardiac contractile cells?

A

-90 mV

145
Q

what is the threshold for contractile cell depolarization?

A

-75 mV

146
Q

what happens after contractile cells reach threshold?

A

rapid depolarization as Na+ channels open and Na moves into the cells

147
Q

at what voltage do Na+ channels close? and what happens after?

A

at +30 mV, Na+ channels close and Na is pumped out of the cell

148
Q

what causes the plateau in the action potential after NA is pumped out of the cell?

A

slow Ca+ channels open and Ca moves into the cell

149
Q

how and when does repolarization occur in contractile cells?

A

slow Ca channels begin closing, slow potassium channel begin opening. K+ moves out of the cell and the cell repolarizes to resting membrane potential

150
Q

what do slow Ca channel cause?

A

long absolute refractory period where contractile cells cannot be stimulated to contract again

151
Q

what does long absolute refractory period prevent? and what does it allow?

A

tetany. allows ventricles to fill

152
Q

where does Ca+ enter from?

A

ECF and SR

153
Q

how does Ca+ leave the cell

A

pumped out by Na/Ca ATPase

154
Q

relative refractory period

A

Na channels closed but can open if stronger stimulus is received

155
Q

calcium-induced calcium release

A

calcium enters the cardiomyoctye via L-type calcium channels. Calcium activates ryanodine receptors on the SR to further increase calcium availability. As contraction ends, intracellular calcium returns to the SR via SERCA calcium channel pump

156
Q

p-wave

A

SA node fires and atria depolarize

157
Q

PQ or PR segment

A

time between the beginning of the P wave to the beginning of the QRS complex, interval between the beginning of the electrical excitation of the atria and the beginning of excitation of the ventricles. conduction of signal through AV node

158
Q

QRS complex

A

ventricles depolarize and atria depolarize. atrial repolarization masked by ventricular depolarization. ventricles contract

159
Q

T wave

A

ventricular repolarization

160
Q

ST interval

A

interval between ventricular depolarization and repolarization

161
Q

QRS duration

A

duration of ventricular muscle depolarization

162
Q

QT interval

A

duration of contraction of the ventricle from ventricular depolarization and repolarization

163
Q

R-R represents what?

A

one heart beat

164
Q

bradycardia

A

slow heart beat <60 bpm

165
Q

tachycardia

A

fast heart beat >100 bpm

166
Q

what does a long PR interval reflect?

A

damage to the conducting pathway of AV node

167
Q

what does a large QRS complex reflect?

A

enlarged heart

168
Q

what causes a long QT interval?

A

electrolyte disturbances, medications, coronary ischemia, conduction problems, myocardial damage

169
Q

what impacts the size of the T wave?

A

things that influence ventricular repolarization including starvation, low cardiac energy reserves, abnormal ion concentrations, coronary ischemia

170
Q

what are the two phases within any one chamber?

A

systole = contraction
diastole = relaxation

171
Q

how does blood pressure change during systole and diastole?

A

rises during systole, falls during diastole

172
Q

what are the 8 steps of the cardiac cycle?

A
  1. atrial contraction begins
  2. atria eject blood into ventricles
  3. atrial systole ends; AV valves close
  4. isovolumetric ventricular contraction
  5. ventricular ejection occurs
  6. semi-lunar valves close
  7. isovolumetric relaxation occurs
  8. AV valves open and ventricles fill passively
173
Q

end-diastolic volume?

A

volume of blood before contraction

174
Q

end-systolic volume?

A

volume of blood after contraction

175
Q

stroke volume?

A

the amount of blood pumped by one ventricle during contraction (SV = EDV - ESV)

176
Q

ejection fraction

A

the percentage of EDV represented by SV

177
Q

cardiac output

A

volume of blood pumped through circulatory system in 1 minute

178
Q

what is the equation relating cardiac output to heart rate and stroke volume?

A

CO = HR (beats/min) x SV (mL/beat)

179
Q

What is the name of the principal that describes how the greater the heart is stretched during filling, there greater the force of contraction and the greater amount of blood pumped into the aorta?

A

Frank Starling Principle

180
Q

how does the sympathetic nervous system affect the heart?

A

increases contractibility to muscle which makes the heart a stronger pump and increases the volume of blood pumped and the force of contraction

181
Q

what does the SNS do to peripheral vessels?

A

contracts

182
Q

What does the SNS do to cardiac output?

A

increase it

183
Q

What are the 5 electrical steps of the conducting system?

A
  1. SA node activity and atrial activation begins
  2. stimulus spreads across the atrial surfaces and reaches the AV node
  3. 100-msec delay at AV node while atrial contraction begins
  4. impulse travels within the AV bundle and the bundle branches to the Purkinje fibers and via the moderator band to the papillary muscles of the right ventricle
  5. the impulse is distributed by Purkinje fibers and relayed through the ventricles. Atrial contraction is completed and ventricular contraction begins
184
Q

what are 5 risk factors for a heart attack?

A

age, obesity, high-stress job, hypertension, family history

185
Q

what is the difference between cardiac arrest and a heart attack?

A

cardiac arrest is an electrical problem. It occurs when the heart malfunctions and stops beating unexpectedly. a heart attack is a circulation problem that occurs when blood flow to the heart is blocked

186
Q

describe the parasympathetic stimulation of heart rate

A

releases Ach which activates cholinergic receptors that influence K and Ca channels in the pacemaker cells. The cel hyperpolarizes and decreases the rate of spontaneous depolarization. Heart rate slows

187
Q

describe the sympathetic stimulation of heart rate

A

releases NE, which increases ion flow through If and Ca channels and depolarizes the cell to accelerate the rate of spontaneous depolarization. Heart rate increases

188
Q

what are three circulating biomarkers that might be used to diagnose myocardial infarction?

A

myoglobin, creatine kinase, cardiac troponin

189
Q

what are the three proteins of troponin complex and which are unique to cardiac tissue?

A

Troponin T, Troponin I, Troponin C. T & I are unique to cardiac tissue

190
Q

when is myoglobin released?

A

when muscle tissue is damaged

191
Q

is myoglobin specific to MI?

A

no, skeletal muscle also contains myoglobin so it is non-specific for MI

192
Q

what form of creatine kinase is specific to myocardial cells?

A

MB type

193
Q

what does cardiac troponin I bind to?

A

actin

194
Q

what does cardiac troponin T bind to?

A

tropomyosin

195
Q

where does lipid begin to deposit in atherosclerosis?

A

between the intima and media

196
Q

what does a healthy artery endothelial wall resist?

A

attachment of WBC

197
Q

what starts the formation of a thrombus?

A

irritation of wall causes which then express adhesion molecules to capture leukocytes, differential into macrophage and ingest lipid that becomes foam cell

198
Q

what happens after foam cells are formed?

A

migration of smooth muscle cells make more extracellular matrix

199
Q

how does a thrombus form?

A

fibrous cap of plague ruptures, platelets rush in and cause blood coagulation which triggers the development of a thrombus

200
Q

what is the danger of a thrombus?

A

impairs blood flow

201
Q

what part of the fibrous cap is most vulnerable to rupture?

A

shoulders of the cap

202
Q

when does Acute coronary syndrome happen?

A

when atherosclerotic plagues become unstable and cause partial or total occlusion of a coronary artery

203
Q

true or false, people often have abrupt change from stable ischemic heart disease or asymptomatic heart disease to ACS?

A

true

204
Q

true or false, many of the ACS occur in individuals that do not have significant occlusion of the vessel?

A

true

205
Q

what is stemi on a ECG?

A

ST elevation

206
Q

what ECG represents muscle ischemia?

A

NSTEMI T wave inversion

207
Q

two categories of ACS

A

NSTE-ACS which is non-st elevation myocardial infarction have incomplete to transient obstruction of blood flow in a coronary artery
STEMI- ST segment elevation myocardial infarction have an occlusive thrombus

208
Q

what is the preferred immediate treatment for STEMI?

A

PCI - percutaneous coronary interventions

209
Q

what does PCI do?

A

opens and stabilizes the artery lumen

210
Q

why has mortality decreased for ACS?

A

stabilize with aspirin, heparin and nitroglycerin, thrombolysis (clot busters), PCI

Anatomy and Physiology (7 decks)

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