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Cardiovascular system Flashcards

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1
Q

Describe the pericardium layers of the heart

A
  1. FIBROUS - tough and inelastic connective tissue which attaches to diaphragm therefore preventing damage to the heart during deep exhalations also connects to outer layer of great vessels // 2.SEROUS -space and tissue between the fibrous tissue and the myocardium - consists of the parietal layer (fuses with fibrous) , visceral layer (continuous part of epicardium and pericardial cavity - space between parietal and visceral layers
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2
Q

Describe the chambers of the heart

A

Right atrium and right ventricle (deoxygenated blood )// Left atrium and left ventricle (oxygenated blood)

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3
Q

Describe the valves in the heart.

A

atrioventricular (separate atria and ventricles -> right side = bicuspid valve / left side = tricuspid valve (mitral)// semilunar - 3 semilunar cusps emerging at arteries , controlling blood flow from the ventricles

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4
Q

What are the great vessels?

A

RIGHT SIDE -> inferior and superior vena cava bring blood to right atria// pulmonary arteries take blood away from right ventricle /// LEFT SIDE -> Pulmonary veins bring blood into left atrium, aorta takes blood away from left ventricle

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5
Q

What is the systemic circulation?

A

BODY
left ventricle (oxygenated blood )-> aorta -> body/ skeletal muscles -> capillary bed at muscles (becomes deoxygenated) -> returns to heart via right atrium

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6
Q

What is the pulmonary system?

A

LUNGS
right ventricle (deoxygenated) -> pulmonary arteries -> capillary beds in alveoli (oxygenated) -> returns to left atrium (oxygenated )

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7
Q

What is the coronary circulation?

A

SURROUNDING THE HEART
originated just before semi-lunar valve, supplies the blood to the heart muscles

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8
Q

Describe components of the blood.

A

Plasma cells/ white blood cells/ platelets/ red blood cells

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9
Q

Where is the bicuspid and tricuspid valve?

A
  • both control flow from atria to ventricles
    TRICUSPID -> right atrioventricular //BICUSPID (mitral)-> Left atrioventricular valve // composed of valve cusps , chordae tendinea and papillary muscle
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10
Q

Where are the semilunar valves located and what is the structure?

A

located at the merging arteries leaving the ventricles// composed of 3 semilunar valves

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11
Q

When looking at a specimens heart what position of the heart are you looking at and what can you see?

A

anterior facing side of the heart, seeing mainly the right side (the left side is “hidden”)

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12
Q

What is the coronary sulcus?

A

the division between arteria and ventricles found in both the anterior and posterior

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13
Q

What are the anterior and posterior interventricular sulcus ?

A

anterior - marks division between ventricles in the anterior (front side ) where as posterior is the back division of the ventricles

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14
Q

Give the characteristics of erythrocytes.

A

RED BLOOD CELLS
no nucleus / haemoglobin protein/ / produced in bine marrow / transports oxygen

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15
Q

Give the characteristics of leukocytes.

A

WHITE BLOOD CELLS / protection and phagocytosis /

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16
Q

Give the characteristics of platelets.

A

cell fragments / involved in blood clot formation through fibrin production

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17
Q

What does haematopoiesis and haemorrhaging refer to ?

A

haemorrhaging = blood loss
haematopoiesis= blood production

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18
Q

What does anaemia and polycythaemia refer to?

A

ANEMIA = too little RBS / low iron
POLYCTHAEMIA = too many RBC making blood viscous

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19
Q

What is the main structural features of arteries and arterioles?

A

Different types of arteries: large elastic(wall thickness is 10% of vessel diameter ) and medium muscular (wall thickness is 25% of vessel diameter) // Mainly composed of externa / turnica media (contains elastic fibres and smooth muscle / / turnica intima (in contact with lumen)/// arterioles - mostly smooth muscles, less elastic fibres in tunica media (wall thickness is 50% of vessel diameter)

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20
Q

What is the main structural features of veins and venules?

A

composed of ;Endothelium tunica interna layer / connective tissue (containing elastic and collagenous tissue) / tunica media /tunica externa (adventitia) // structurally similar to arteries however have a larger lumen to carry a larger volume of blood// sit net to skeletal muscles to aid movement of blood // contain valves to promote blood flow/// VENULES are either post capillary or muscular both much smaller and consist of only tunica externa and endothelium.

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21
Q

What is the main structural features of capillaries?

A

smallest blood vessel, a single layer of endothelial cells and basal membrane / highly permeable for gaseous exchange // 3 types -> continuous / fenestrated (contains holes in endothelium cells for exchange)/ sinusoid (gaps within and between endothelium cells)

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22
Q

What is anastomoses?

A

The point where at least 2 blood vessels join and merge // allows communication between arterial branches

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23
Q

What dies the circle of Willis refer to?

A

Ring shaped-network of arteries located at the base of the brain connecting major vessels which supply the brain // ensure there is continuous blood flow even if one main artery is blocked

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24
Q

What are the different stages of the cardiac cycle?

A

1.VENTICULAR FILLING- 0.5 seconds// diastole// driven by venous pressure // ventricle walls expand // when ventricular pressure exceeds atrial AV valves shut and /// 2. ISOVOLUMETRIC CONTRACTION- 0.05 secs / AV and semilunar valves are shut/ pressure in ventricles climb rapidly// 3.EJECTION-0.3 seconds// ventricular pressure > arterial pressure // semilunar valves open/// 4.ISOMETRIC RELAXTATION -0.8 secs / semilunar and AV valves shut, atria and ventricles fill with blood

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25
Explain nervous control of the cardiac cycle
1.SA node causes Atrial systole// 2. AV node delays impulse // 3. impulse travels down buddle of his to purkinji fibres crating ventricular systole at depolarisation systole occurs// at repolarisation diastole occurs
26
How are pressure gradients maintained within the cardiac cycle?
The opening and closing of the Atrioventricular and semilunar valves
27
How do pressure gradients drive the flow through the CV system?
creating a force that pushes blood from areas of high pressure (like the arteries) to areas of low pressure (like the vein
28
How does the ANS control heart rate?
Controlled by SA node, sympathetic and parasympathetic nerves in the ANS can influence the rate of depolarisation caused by the SA node
29
What is starling's law?
the strength of a heart's contraction increases as the amount of blood in the heart increases// stroke volume increases as more blood enters the heart// the greater volume of blood = greater stretch of muscle fibres = greater contractile energy
30
What is atherosclerosis ? What are the main vessels which are commonly effected?
An inflammatory disease here cholesterol enters vessel walls narrowing lumen size and reducing elasticity// occurring mainly in the coronary, aortic arch and abdominal arch
31
How much blood is in our body?
5L / 8.8 pints
32
Define cardiac output
volume of blood ejected by 1 ventricle per minute
33
What is the equation we can use to calculate cardiac output?
stroke volume X heart rate
34
What is stroke volume ?
How much blood (ml ) ejected from the left ventricle per contraction
35
What is the average SV and HR of n individual at rest?
SV = 70ml // HR=70bpm
36
What influences the SV node?
the ANS controls the rate of depolarisation caused by the SA node // ANS cannot turn SA node on or off //
37
What is tachycardia? What is bradycardia? How do they come about?
TACHYCARDIA- increased HR , due to increased sympathetic nerve activity// BRADYCARDIA = slowed heart rate, due to parasympathetic nerve activity
38
How does the parasympathetic nerve slow down the SA node?
hyperpolarises membrane through the release if acetylcholine, meaning the time it takes for depolarisation to occur takes longer therefore SA node response is slower.
39
What is the difference between arteries and arterioles ?
Arteries are larger blood vessels that carry oxygen-rich blood away from the heart, while arterioles are smaller arteries that branch off from arteries and carry blood to tissues and organs
40
What is a varicose vein?
A disease of the vein // 1. vein walls loose their elasticity// 2. veins weakening and dilate// 3.Viens swell(varicose) // 4. blood collects in veins causing further dilation
41
What is hemodynamic ?
how the blood flows through blood vessels
42
What are some pressures of interest?
CVP = central venous pressure // MAP = mean arterial pressure //
43
What is the peripheral control of the hemodynamic function?
Change in blood vessel diameter, influencing blood pressure therefor hanging blood flow// happens via autonomic and metabolic pathways
44
What is fainting a consequence of?
Blood pooling at the feet-> the central venous pressure drops -> the elastic fibres in vessels shorten creating diastole -> Stroke volume drops -> arterial pressure drops -> blood pools at feet
45
What does autoregulation of blood pressure refer to?
Baroreceptor reflex -> baroreceptors in aortic arch and carotid arch detects pressure change -> info sent to brainstem-> altering HR, SV and blood vessel diameter -> changing blood pressure
46
What is the blood pressure value at hypotension and hypertension?
hypotension= <90mmHg hypertension=>140mmHg
47
What is typical arterial blood pressure level?
85-100mmHg
48
What occurs as a result of hypertension?
vascular remodelling 1. arterial wall thickens 2. reducing lumen size 3. positive feedback occurs -> the tightened blood pressure leads the arterial wall to thicken again...
49
What equation can be used to calculate blood flow?
Blood flow = (pressure at start of vessel- pressure at end of vessel ) / resistance
50
What blood vessels are involved in maintaining resistance?
Arterioles determine 60%-> because of their small diameter and thick layer of smooth muscle
51
What are some intrinsic control of blood flow?
Myogenic response / endothelial secretions/ vasoactive metabolites and temperature /// MYGOENIC RESPONSE -> myocytes depolarize when they become stretched, an increase in arterial pressure -> increase in vascular tones = constriction of vessels to prevent too much blood flow.
52
How do endothelial secretions affect blood flow?
Shear stress(the amount of frictional force of blood on the bessle walls ) is detected if it is : HIGH - nitric oxide is released= vasodilating// LOW blood pressure = epithelin- 1 is released = vasoconstriction
53
What is Raynaud's syndrome?
Spasms of the small arteries which supply extremities with blood, in responce to coldness and stress
54
What are some vasomotor hormones and the effect they have on blood vessel?
Adrenaline -> constriction and dilation // vasopressin (ADH)->constriction// Angiotensin -> constriction // Atrial natriuretic peptide (ANS)-> dilation// insulin -> dilation
55
What are some risk factors of hypertension?
Smoking/ Obesity/ diet/ exercise / genetics / secondary hypertension
56
What are some secondary issues from hypertension?
Atherosclerosis / stroke/ myocardial infraction / heart failure / renal failure / retinopathy
57
What is Dr pages theory ?
Explains high blood pressure (hypertension) is a multifactorial disease impacted by: genetics / environemnt/ hormones/ anatomy / adaptions/ neurones / endocrine system...
58
Give some examples of drugs which can be used to lower blood pressure ?
BETA - BLOCKERS (block sympathetic nervous system on heart ) // ALPHA - BLOCKERS (reduces sympathetic nerves effects on blood vessels )// DIURETICS (reduce blood volume ) // ACE (inhibits angiotensin receptors ) // CA2+ CHANNEL BLOCKERS (vasodilates arterioles through relaxing smooth muscles )
59
What drug for hypertension did sir James black introduce?
DCI - dischloroisoperanaline // BETA -BLOCKERS - both block he affect of adrenaline on the heart therefore reducing heart rate // act as competitive reversible antagonists
60
What is angina?
issues with coronary blood vessels, heart is starved of oxygen due to a build up of metabolites including co2 , lactate and potassium ions
61
What are the 3 main types of angina ?
STABLE - predictable attacks , myocardial oxygen is not met , associated with atherosclerosis // UNSTABLE - unpredictable attacks due to platelet adhesion on ruptured atherosclerosis plaques// VARIANT - unpredictable attacks due to coronary artery vasospasms
62
What is an occlusion?
An occlusion is a partial or complete blockage of an artery or vein. // reduce or stop blood flow to vital organs like the brain, heart, or extremities. // may be life-threatening and lead to a stroke or heart attack.
63
What are some treatments for angina?
aim = reduce oxygen demand VASODILATING DRUGS - dilating arteries reduces afterload (force of L ventricle reducing oxygen demand ) // dilating veins (reduces pre-load ) // NITRATES - vasodilators, mimic the endothelium which produce nitrate oxygen // IVABRADINE (blocks sodium current through altering the K+/Na+ channel preventing activity of the NA+/CA2+ channel) *Ca2+ is involved in contraction-> reduced calcium reduces HR reducing blood pressure and oxygen demand
64
What are some causes of heart failure ?
Haemodynamic overload (excess pressure and excess volume ) // neurohormonal overload // tissue damage // genetics *heart failure = heart cannot pump enough blood around the body to meet oxygen demand
65
What are the main symptoms of heart failure ?
LEFT VENTRICLE FAILIURE -> fatigue and oedema/// RIGHT VENTRICULAR FAILURE -> venous distention / oedema and cyanosis (blue lips)
66
What are some treatments of heart failure?
aim = reduce preload and afterload DIURETICS (excretes nitrates reducing blood fluid volume )// ACE INHIBTORS (prevents the activity of ACE enzyme which is involved in vessel contraction) // POSITIVE INOTROPES e.g. digoxin ( increase the force of the heart muscle contractions)
67
What is meant by pre-load and after-load of the heart?
PRE-LOAD = amount of blood filling the heart chambers just before contraction, essentially the "stretch" on the heart muscle before it pumps// AFTER-LOAD= e resistance the heart must overcome to eject that blood, meaning the pressure against which the heart needs to pump to push blood out into the circulatory system;
68
Give some drugs used to treat atherosclerosis
CHYLOMICROS-> transport TGs to liver, muscles and adipose tissues // VLDL-> tale TGs from liver to adipose tissue// LDL -> cholesterol reservoir // HDL-> absorb cholesterols released from dying cells
69
What is hyperlipoproteinemia?
accumulation of lipids within the body // statins - compete and prevent cholesterol biosynthesis
70
What is rheumatic heart disease?
heart muscle and valve damage due to rheumatic fever (fever following a bacterial infection)
71
What is DVT (Pulmonary embolism)?
Blood clots in veins which can move to heart and lungs.
72
What is congenital heart disease?
Malfunctions of heart structure from birth
73
What is the aim of Morris studies ?
to understand the relationship between physical activity and disease
74
What did Paffenbergs work find?
Increasing activity reduces blood pressure and weight
75
What are some direct and indirect impacts of physical activity on cardiovascular health?
DIRECT - physical activity improves endothelial functioning enhancing vasodilation and vasomotor function in blood vessels // INDIRECTLY -> physical activity contributes to weight loss, glycaemic control, improved blood pressure , lipid profile and insulin sensitivity
76
What are some risk factors of hypertension?
smoking/ obesity / diet / exercise / genetics / secondary hypertension
77
What is angina?
A lack of blood flow through coronary vessels- creating myocardial ischemia , often resulting in chest pain
78
What are some risk factors of heart failure ?
obesity (excess volume ) / neurohormonal overload // tissue damage// genetical determination
79
What calculation can be used to find blood pressure?
total peripheral resistance X Cardiac output
80
What does Dr pages mosaic theory explain?
High blood pressure is a multifactorial disease meaning it is hard to find a direct cause
81
What drugs can be used to lower blood pressure ?
Beta - blockers -> heart beats more slowly with less forceful contraction o// DIURETIC -> reduces blood volume // Ca2+ chennl blocker -> prevents vasodilation
82
What is the function of ACE inhibitors?
A drug which converts angiotensin I to the active angiotensin II , lowering blood pressure via reducing vasocontraction
83
What are the 3types of angina ?
STABLE - predictable attacks (myocardium 0xygen is not met ) // UNSATBLE - unpredictable attacks , platelet adhesion affects coronary artery // VARIANT ADHESION- unpredictable attacks due to coronary artery vasospam
84
What drugs can be used to combat angina?
NITRATES - increases vein diameter/ e.g. GTN /amyl nitrrite / // IVABRADINE - Blocks sodium which is involved in the SA depolarisation
85
What is the brain bridge reflex?
heart rate increases in response to increased blood volume to reduce venous return
86
What are some symptoms of heart failure?
- Left ventricle failure (creates fatigue and oedema)// Right ventricular failure (venous distension/ oedema and cyanosis )
87
What ae some treatments of heart failure ?
- Aim = reduce preload /afterload or make the heart work harder (positive inotropes)// USED diuretics (excretes NA_ reducing blood fluid volume ) // ACE inhibitors - lowers blood pressure through indirectly reducing Na+= excretion) // OTHER TREATMENTS = vasodilators (nitrates) / low doses of beta-blockers // positive inotropes
88
How is calcium involved in heart contractions?
It acts as a primary signal triggering muscle fibre to contract // calcium triggers the opening of the sodium calcium channel thus affecting the potassium channel which is involved in action potential altering the resting state of muscles
89
What are some treatments of atherosclerosis ?
introducing different lipoproteins : CHYLOMICRONS - carry TF from muscles to adipose tissue/ transports TGs from intestine to liver // VLDL - Carry newly synthesised TGs from liver to adipose tissue //LDL - cholesterol revivor (cholesterol is removed from blood via endocytosis)// HDL - absorbs cholesterol which is released by dying cells and transports it to the liver LIVER = organ which breaks down cholesterol and lipids
90
What occurs when the body is in a state of HYPERLIPORPOTEINAEMIA ?
liver can no longer break down cholesterol, blood pressure increases
91
What is the function of statins ?
A competitive inhibitor of the rate -limiting step of cholesterol biosynthesis therefore reduces cholesterol levels
92
What are the divisions of the aorta?
BRACHROCEPTATIC (right side of the body) // LEFT COMMON CAROTIOD (left neck) // LEFT SUBCLARIAN (left arms + side)
93
What makes up what % of the blood ?
55% = plasma // 45% = RBS // 1% = WBC + PLATLETS
94
What is the P section of an ECG showing ?
Atrial depolarisation, AV valves are open, atria contract and blood enters ventricles
95
What is the QRS complex of an ECG showing ?
Ventricular depolarisation and contraction AV valve is shut and semi-Luna is open
96
What is the T section of an ECG showing ?
ventricular repolarisation , ventricles relax and and heart is a diastole
97
What ae the peripheral controls of blood flow?
METABOLIC - o2 and c02 content // MYOGENIC - vasular tones (increase = constriction/ decrease = dilation ) // ENDOTHELIAL SECREATIONS - endoithelim -1 = constriction // Nitric oxide = dilation // SYMPATHETIC NERVE = releases noepipherine constricting vessles // HORMONES
98
What does anabolism , metabolism and catabolism refer to ?
ANABOLISM - construction METABOLISM - construction+ destrcuction CATABOLISM- destruction *of molecules
99
What is the difference between autonomic and metabolic processess?
AUTONOMIC = nervous system is controlling bodily functions// METABOLIC = chemical processes within the body

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