Exam 2 Cardiovascular Flashcards
(174 cards)
1
Q
Location of heart
A
Mediastinum
Mid thorax, between lungs
2
Q
Pericardium and it’s layers
A
•a serous membrane
The two layers are as following
•Visceral: lines the organs
•parietal: lines the cavity
3
Q
Pericarditis
A
Inflammation in pericardium
4
Q
Chronic pericarditis
A
Increases pericarditis over time
(Gets worse and worse)
Treatment is removing excess fluid
5
Q
Layers of the heart
A
•Epicardium
•myocardium
(makes up muscle of heart walks)
•endocardium
•Myocarditis (inflammation of myocardium)
•Endocarditis (Inflammation of endocardium)
6
Q
Myocarditis and Endocarditis
A
Inflammation of myocardium
and inflammation of endocardium
7
Q
Four major chambers of the heart
A
Upper
•left atrium
•Right atrium
Lower
•left ventricle
• right ventricle
8
Q
Arteries take blood…
Veins take blood….
A
Away from the heart
Back to the heart
9
Q
Needed by body’s cells to make atp
A
Oxygen
10
Q
Bifurcation
A
When one vessel splits into two vessels
11
Q
Right atrium receives blood from…
A
- superior and inferior vena cava
* the coronary sinus
12
Q
The right ventricle…
A
Receives blood from the right atrium
Sends blood to the lungs
13
Q
Left atrium
A
Receives blood from the pulmonary veins
14
Q
Left ventricle
A
- Receives blood from left atrium
- sends blood all over the body
- thicker than the right ventricle
15
Q
Right and left Antrioventricular valves
A
- Tricuspid on right
- Bicuspid (Mitral) on left
* prevents back flow
16
Q
Heart valves
A
Valves open and close in response to pressure changes as the heart contracts and relaxes
17
Q
Right and left semilunar valves
A
- pulmonary valves
- aortic valves
* prevents back flow from the arteries into the ventricles
18
Q
Base
A
Top of heart
19
Q
Apex
A
Bottom of heart
20
Q
Heart Disorders
A
Mitral valve prolapse
Heart murmurs
Valvular stenosis
21
Q
Pulmonary capillaries
A
Blood loses CO2 and gains O2
22
Q
Systematic capillaries
A
Blood loses O2 and gains CO2
23
Q
Coronary arteries
A
Branches arise from the ascending aorta
Blood flow delivers oxygenated blood and nutrients to the myocardium
24
Q
Coronary veins
A
Branches converge at the lm coronary sinus
Removes carbon dioxide and wastes from the myocardium
25
Left coronary artery
Artery on left and right of heart
* circumflex artery- left atrium, left ventricle
* anterior interventrucular artery- interventricular septum
26
Right coronary artery
Marginal artery - right lateral heart walls
Posterior interventricular artery-R&L posterior ventricular walls
27
Cardiac veins
•return deoxygenated blood from myocardium
* great cardiac vein
* middle cardiac vein
* small cardiac vein
•empty kitchen not the Coronary Sinus
(Bag on back of heart)
28
Angina pectoris
•Chest pain
I
•insufficient blood flow/
Blockage of coronary artery
29
Infarct
Myocardial infarction- Heart attack
Death of Ischemic Cells
30
Cardiac Muscle
•Intercalated discs
(Gap junctions- electrically coupled)
(Desmosomes- prevent separation)
* Striated,
* branched cell
* 1-3 nuclei, many mitochondria
31
Intercalated discs
(Gap junctions- electrically coupled)
| Desmosomes- prevent separation
32
Autorhythmic fibers
* self excitable
| * autorhythmic
33
Cardiac muscle cells
Repeatedly generate action potentials
.....
34
SA node
| Sinoatrial
“Natural pacemaker of the heart”
* impulses in right atrium 75 times per minute
* initiate action potentials the most frequently
35
AV node
| Atrioventricular
* receives impulses
* Contains autorhythmic fibers
* ab node comes pacemaker at slower rate (50 bpm)
36
Signals from nervous system and hormones
modifies the heart rate and forces contraction
do not set the fundamental rhythm
37
Arrhythmias
Irregular heart rhythms
38
Fibrillation
Rapid irregular contractions
39
Heart block
-av node defect
* beat slower than atria
* implant pacemaker
40
Membrane potential
Measured by mV
Roughly -90 millivolts
41
Electrocardiogram (EKG)
measured in mV
```
Deflection waves
(P wave- depolarization of atria)
(QRS wave- depolarization of ventricles)
(AV node)
(Atrial repolarization obscured)
(T wave- repolarization of ventricles)
```
Measuring voltage over time
42
Depolarization
Sodium flows into cell
Potassium flows out
Facilitated by Sodium
Causes muscle contraction
43
Repolarization
Opening of potassium channels
Facilitated by Potassium
44
Plateau
Maintained depolarization
Due to calcium
Facilitated by Calcium
45
Systole
Contraction
46
Diastole
Relaxation
47
Cardiac cycle Events
•electrical events
(Depolarization and repolarization)
* pressure changes
* volume changes
* mechanical events
* heart sounds
48
Mechanical events
....
49
Atrial contraction / Atrial systole
Contraction
| Forces blood into ventricles
50
Isovolumetric contraction
.
51
Ventricular ejection
.
52
Stethoscope
Device allowing us to listen to heartbeat
53
Murmurs
Unusual heart sounds good
When blood goes somewhere it isn’t supposed to
54
Lub (S1)
First sound, longer, ab valves closing
55
Dup (s2)
Second sound, shorter, semilunar valves closing
56
Cardiac output (CO)
Volume of blood ejected from the ventricles into the aorta / pulmonary trunk every single minute
(Ml or L)
57
Stroke volume (SV)
Amount of blood pumped out of the ventricle every beat
(70ml/beat)
* 60% of blood chamber
* preload, contractility, and afterload
58
End diastolic volume
| Relaxed). (EDV
Amount of blood in ventricle during diastole
59
End systolic volume
| ESV
Amount of blood remaining in ventricle after systole
60
Preload
Amount of stretch put on ventricles
Cardiac muscles stretch just before contraction
61
Stretching muscle fibers
Increases force of contraction
62
Venous return
Blood going to heart
Connects two sides of heart
Most important factor in stroke volume
63
Contractility
Increase in contractility
Results in ejection or more blood from heart
Increases SV
64
Positive inotropic agents
Increase contractility
Sympathetic nervous system
Ca2+ (calcium)
Epinephrine
65
Negative inotropic agents
Decrease contractility
Calcium channel blockers
66
Afterload
Pressure ventricles must
overcome to eject blood
Increases ESV
Increased pressure
Amount of blood pressure found in aorta / pulmonary trunk
67
Hypertension
High blood pressure
Reduces ability of ventricle to eject blood
68
Autonomic nervous system
Sympathetic and Parasympathetic nerves
69
Sympathetic nerves
stimulate increased heart rate during stress
70
Parasympathetic nerves
Slow and steady heart rate after demand is over
71
Hormones that increase heart rate
Epinephrine
Thyroxine
72
Tachycardia
High Heart Rate >100 bpm
73
Bradycardia
Low heart Rate
<60 bpm
74
Heart rate
Faster in females
Fastest in fetus
Heat increases
Exercise decreased HR
Decreases with age
75
End diastolic volume
Stretches the heart
Increased preload
76
Positive inotropic agents
Increased sympathetic, catecholamines, or thyroid hormones in the blood
Increased calcium
Increase force of contraction of all levels of stretch
77
Decreased steroid blood pressure during diastole
Semilunar valves open sooner when blood pressure in aorta
pulmonary artery is lower
Increased stroke volume
78
Hypocalcemia
Low calcium blood levels
Depress heart activity
79
Hypercalcemia
High calcium blood levels
Increase heart activity
80
Hypernatremia
High sodium blood levels
Blocks calcium and contraction
81
Hyperkalemia
High potassium levels (k+)
Depolarization
82
Regular aerobic exercise
increase cardiac output
•decrease triglycerides
•
•
•
83
Transplant
Need donor with similar antigens
84
Intra-aortic balloon pump
Helps failing hearts
85
Heart ventricular assist devices
AIDS in pumping of ventricles
86
Coronary artery disease
Obstructed lumen
Atherosclerotic plaque
87
Congestive heart failure
Inadequate for tissue needs
Progressive Disease
High blood pressure
Coronary atherosclerosis (clogged vessels)
Myocardial infarction
Can result in pulmonary or systemic edema
88
Heart defects in babies
Coarctation of the aorta
Increase workload
Septal defects
Patient ductus arteriosus
Systemic blood with oxygenated pulmonary blood
89
Tetralogy of fallout
Multiple defects in babies
90
Hypertrophied
Enlarged
91
Atherosclerosis
Changes in walls of great arteries
lipid deposits
92
An increase stoke volume would cause...
An increase of cardiac output (CO)
Co= SV • HR
93
This part of the conduction system causes ventricular myocardial cells to contract...
Purkinje Fibers
94
P wave
Atrial contraction
95
Tunica interna
| Tunica intima
Innermost layer of blood vessels
96
Tunica media
Middle layer of blood vessel
Has smooth muscle and elastic fibers
97
Tunica externa
Outermost layer of blood vessels
98
Arteries
Take blood away from the heart to the tissues
Walls of arteries are elastic
Absorbs pressure created by ventricles of the heart
Smooth muscle in the tunica media
Regulates blood flow
99
Capillary beds
Smallest substance exchange
Vessels connect arterioles and venules
Single layer of endothelium
Basement membrane
Exchange of nutrients
10-100/ bed
100
Veins
Return blood to heart
| Brings blood back in
101
Arterioles
Smallest arteries
feed blood into capillary beds
Thin
Construct and dilate to control flow of blood into tissues
102
Venules
Drain capillary beds, empty into vein
103
Muscular arteries
| Distributing arteries
Smooth muscle
fewer elastic tissue
Most of the body arteries
Distributes blood
104
Elastic arteries
| Conducting arteries
Aorta and major branches
More elastic fibers
Less smooth muscle
Withstands great pressure
105
Vascular shunt
Connects arterioles and venules
106
precapillary sphincter
Smooth muscle fibers
Surrounding capillary
Regulate blood flow
107
Metarteriole
Feeds capillary bed
108
Postcapillary Venule
drains capillary bed
109
Continuous Capillaries
Intercellular clefts (allows passage of fluids through vessels)
Small solutes
Skin and muscles
110
Fenestrated capillaries
Found in intestines, endocrine glands, kidneys
Has Oval pores with delicate membrane
111
Sinusoidal capillaries
Found in liver, bone barrow, lymphoid tissue
Usually fenestrated
112
Veins
Formed from venules
Thinner tunica interna and tunica media
Thicker tunica externa
Low pressure
Elastic tissue; less smooth muscle
Contain valves
Blood Reservior: 65%
Found in veins
113
Venous sinuses
Coronary sinus
114
Varicose veins
Overworked valves give way
Becomes twisted
Obesity and pregnancy exert pressure on lower vessels
———-
115
Arteries anastomoses
.joints- movement may hinder flow
Present in brain, heart, abdominal organs
116
Venous anastomoses
More abundant
117
Vascular anastomoses
Provides alternative route for blood flow
Arterial anastomoses
Venous anastomoses
118
Blood reservoirs
Largest portion of blood;
In Systemic veins and venules
Systemic veins and venules (blood reservoirs) 64%
119
Capillary exchange
Gas exchange
Diffusion- simple diffusion;
substances such as oxygen, carbon dioxide, glucose, amino acids
Transcytosis- large, lipid-insoluble molecules (Like insulin).
Bulk flow- passive process; higher pressure to lower pressure
120
Filtration in reabsorption
Filtration- from blood capillaries into interstitial fluid;
•blood hydrostatic pressure and interstitial fluid osmotic pressure promotes filtration
Reabsorption-
•interstitial fluid hydrostatic pressure and blood colloid osmotic pressure promotes reabsorption
121
Venous blood return
Steady pressure
* respiratory pump-
* muscular pump-
122
Maintaining blood pressure
- Short term
| - long term
123
Systemic blood pressure
BP of vessels- force exerted on vessel wall by blood (mm Hg)
- resistance to flow
- pressure gradient keeps blood moving from high to low
124
Blood pressure
Systolic and Diastolic blood pressure
Higher the BP the higher the blood flow
Aorta-highest pressure
Venacava- lowest pressure
Determined by CO, blood volume, resistance,
125
Arterial blood pressure
Systolic pressure- 120 mm Hg
Diastolic pressure- 70-80 mm Hg; ventricles relax
Capillary blood pressure- enters at 40 mm Hg; exits at 20 mm Hg
126
Monitoring arterial blood pressure
Pulse pressure= Systolic- diastolic
-indicates elasticity of arteries
Mean Arterial Pressure (MAP)= diastolic + (pulse pressure/3)
-average pressure; propels blood to tissues
127
Measuring blood pressure
Listen for Korotkoff sounds
Sphygmomanometer- BP cuff
First sound- indicates systolic pressure
Diastolic pressure 70-80 mm Hg
128
Pulse
Alternating expansion and recoiling of elastic arteries
Changes occur during activity, posture changes, and emotional pressure
129
Maintaining blood pressure
Regulated by cardiac output, peripheral resistance, and blood volume
Short term regulation: neural and hormonal
Long term: renal
Peripheral resistance- amount of friction the blood encounters in the blood vessels
130
Total Peripheral Resistance (TPR)
Factors of resistance
Opposition to blood flow is due to friction
Higher resistance leads to lower flow
* blood viscosity- thickness of fluid; plasma proteins
* vessel length- usually constant; obesity-409 miles/2.2lb of fat
* vessel diameter- vasoconstriction
131
Vessel diameter
Decrease diameter increase resistance
Vasoconstriction- can change frequently
132
Vessel length
.
133
Blood viscosity
.
134
Short term bp controls
•Neural control-
Vasomoter center- changes in diameter
Vasomotor tone- construction
Baroreceptors- mechanoreceptors- become stretched/ pressure sensitive
Etc.etc...
•Hormonal control-
135
Primary hypertension
Factors:
Diet
Obesity
Age
Stress
Smoked
136
Secondary hypertension
Excessive renin secretion
137
Pharmaceutical hypertension treatment
Ace inhibitors
Diuretics
Beta blockers (beta 1 receptor)
Vasodilators
Calcium channel blockers
(All decrease blood volume)
138
Shock
Hypovolemic
139
Responses to shock
Renin-angiotensin-aldosterone system
Secretion of antidiuretic hormone
Release of local Vasodilators
140
Responses to hypovolemic shock
(Low volume shock)
Baroreceptors in carotid sinus and arch of aorta
141
Symptoms of shock
Tachycardia
Weak, rapid pulse
Hypotension
Altered mental status
Thirst
Decreased urine output
142
Special circulatory routes
Coronary circulation
Hepatic portal circulation
143
Aging in the cv system
Loss of compliance of aorta
Increased systolic blood pressure
Decline in max heart rate
Loss of cardiac muscular strength
144
Filtration
Promoted by blood hydrostatic pressure and Interstitial fluid osmotic pressure
145
Reabsorption
Promoted by Interstitial fluid
| hydrostatic pressure and blood colloid osmotic pressure
146
Cardiac output
Venous return (SV)
Neural and hormonal control (HR)
Enhanced CO increases MAP
147
Peripheral resistance
Amount of friction the blood encounters in the blood vessels
148
Blood volume
Regulated by the kidneys
149
Control mechanisms of BP
Short term: neural and hormonal
Long term: renal
150
Blood viscosity
Thickness of a fluid
Increased viscosity (more resistance)
Usually constant
Ratio of rbcs to plasma and plasma proteins
151
Vessel length
The longer the vessel the more resistance
Usually constant
Obesity- 400miles/2.2lb of fat
152
Vessel diameter
Decrease diameter increase resistance
Vasoconstriction (can change frequently)
153
BP controls
Vasomotor center
Baroreceptors
Chemoreceptors
Higher brain centers
154
Vasomotor center
Oversees changes in diameter
Vasomotor tone- construction of arterioles
155
Baroreceptors
Carotid sinus reflex- protects blood supply to brain
Aortic reflex- maintains BP or systemic circuit
Inhibits vasomotor center causing arterioles & veins to vasodilate
Heart Rate and contraction force reduced
156
Chemoreceptors
Respond to change in: oxygen, carbon dioxide
Located in aortic arch
Increase CO and Vasoconstriction
Return of blood to heart & lungs
157
Higher brain centers
Hypothalamus
-mediated fight or flight response
-mediates blood flow during exercise or body temp changes
Cerebral cortex can modify sympathetic system
158
Vasoconstrictors
| Hormonal Controls
1. Adrenal medulla hormones
- NE and epinephrine vasoconstriction
2. Angiotensin ||
- stimulates release of aldosterone and ADH
- vasoconstriction up
3. ADH
- vasoconstriction up
159
Vasodilators Hormonal Controls
1. ) Ateual natriuretic peptide (ANP)
- hormone produced by atria
- vasoconstriction down
OTHER CHEMICALS
1. ) Inflammatory chemicals
- histamine
- vasoconstriction down (redness)
2. )Alcohol
- ADH release
- Vasoconstriction down (flushed appearance)
160
Renal regulation
Direct renal mechanism
Kidneys alter BP through blood volume
If BP is high, or BV high fluid filters out of the blood faster, produce more urine
If BP is low, or BV is low, kidney has time to return water to blood, less urine produced.
161
Renin-angiotensin mechanism
Drop in blood pressure
| Drop in fluid volume
162
Angiotensin ||
Activation is caused by Renin
Angiotensin || causes
- release of aldosterone
- release of ADH
- stimulates thirst center
- vasoconstrictor
163
Decreased bp and bv
Leads to either
1.) endocrine mechanism
A. ADH
2.)Neural mechanism
A.Baroreceptors, chemoreceptors stimulated
B.general sympathetic activation
C. Cardiovascular centers stimulated
164
Autoregulation
The ability of a tissue to automatically adjust its own blood flow
165
Orthodontic Hypotension
Temporary low BP
Seen in elderly due to aged SNS
Reduced blood flow to brain
166
Chronic hypotension
Low blood viscosity
167
Hypertension
High BP
Normal during fever, physical exertion, and emotional stress
168
Chronic hypertension
Progressive disease
Major cause of heart failure, renal failure, and stroke
Heart works harder against greater resistance, myocardium enlarges,
Causes small tears in blood vessel walls
169
Homeostatic imbalances
Normal:
- less than 120 systolic
- less than 80 diatomic
Prehypertension:
- 120-139 systolic
- 80-89 diastolic
Stage 1 hypertension:
- 140-159 systolic
- 90-99 diastolic
Stage 2 hypertension:
- 160+ systolic
- 100+ diastolic
170
Primary hypertension
90% of hypertensive population
No underlying cause
Factors:
- diet
- obesity
- age
- stress
- smoking
171
Secondary hypertension
10% of hypertension population
Causes:
- excessive renin secretion
- arteriosclerosis
172
Treating hypertension
Loose weight
Limit alcohol consumption
Exercise
Reduce intake of sodium
don’t smoke
Manage stress
173
Hypertension medication
Diuretics
ACE inhibitors
Beta blocks
Vasodilators
Calcium channel blockers
174
SV x HR =CO
Cardiac output
