Module #1 - Heart: Anatomy and Function Flashcards by Suzanne Zick

What are the 3 circulation systems of the cardiovascular system?

Pulmonary Circulation

Systemic Circulation

Coronary Circulation

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Where is the pulmonary circulation supplied from?

Right side of the heart

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Describe Blood flow in the pulmonary circulation (start w/ heart)?

R side of heart –> pulmonary trunk

Pulmonary trunk –> R/L Pulmonary arteries

Pulmonary arteries –> Capillaries surrounding alveoli

Capillaries –> pulmonary veins

Pulmonary veins –> L side of the heart

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What is the function of pulmonary circulation?

Deliver blood to lungs for gas exchange

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What is the pressure of the pulmonary circulation system compared to systemic pressure?

“Low pressure”

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How does the volume of blood pumped per heart beat through the pulmonary circulation compared to systemic circulation?

Same amount of volume

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Describe blood flow in the systemic circulation?

L side of the heart –> aorta

Aorta –> major blood vessels of body

Major blood vessels –> capillaries w/in each organ of the body

Capillaries –> venous system

Inferior/superior vena cava –> R side of the heart

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What is the function of systemic circulation?

Deliver blood to every region of the body for gas exchange

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How does the pressure of the systemic circulation compare to the pulmonary system?

High pressure

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What is the function of coronary circulation?

Blood supply to the heart itself

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Describe blood flow in the coronary circulation

L side of the heart –> aorta

Aorta –> R/L coronary arteries

R/L Coronaries –> Regional arterial branches

Arterial branches –> Coronary capillaries

Coronary capillaries –> Coronary veins

Coronary veins –> Coronary sinus

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What are collateral arteries of the coronary circulation?

Anastomoses –> connections between r/l pathways or 2 branches of R or L coronary artery

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What is arteriogenesis?

Collateral growth

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When does arteriogenesis occur?

In response to coronary artery obstruction

remodeling allows for new/alternative blood flow pathways to supply myocardium

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Describe blood flow through the 4 chambers of the heart

Right atrium –> Tricuspid valve (right AV valve)

Tricuspid valve –> Right ventricle

Right ventricle –> Right semilunar valve (pulmonary semilunar valve)

Lungs –> Left atrium

Left atrium –> Mitral valve (left AV valve)

Mitral valve –> Left ventricle

Left ventricle –> Left semilunar (aortic semilunar valve)

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Where does the right atrium get its blood and what kind of blood does it get?

“Low oxygenated blood” from SVC, IVC, Coronary sinus (via coronary gens)

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What does the tricuspid valve (right av valve) do?

Regulate blood flow from R atria –> R ventricle

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Where does the right ventricle receive its blood and what kind of blood does it receive?

“Low oxygenated” from the R atrium

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What is the shape of the right ventricle, and why is it shaped that way?

Triangularly shaped

Functions as “bellow” –> allows pumping of large volume into “low pressure” pulmonary circulation

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What does the right semilunar valve do?

Regulate blood flow from right vent rile to pulmonary trunk

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Where does the left atrium get its blood from and what kind of blood is it?

“Oxygenated blood” from 4 pulmonary veins (2 from right; 2 from left)

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What does the mitral valve (left av valve) do?

Regulated blood flow between left atrium and left ventricle

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Where does the left ventricle get its blood and what kind of blood is it?

“Oxygenated blood” from the left atrium

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What is the shape of the left ventricle and why is it shaped like that?

“Bullet shaped” –> allows forceful pumping of blood into “high pressure” circulation

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What does the left semilunar valve (aortic semilunar valve) do?

Regulates blood flow between left ventricle and aorta

Which phase is systole?

Contraction phase

What happens during systole?

Blood ejected from R/L ventricles into circulation

Which phase is diastole?

Relaxation phase

What happens during diastole?

Blood fills R/L ventricles

Describe what happens during systole during the cardiac cycle

Isovolumetric contraction **first sound Ventricular ejection

Describe what happens during diastole during the cardiac cycle

Isovolumetric relaxation **second sound Ventricular filling Atrial systole

Describe the mechanical events during the cardiac cycle

Atrial kick (atrial systole) Isovolumetric ventricular contraction Ventricular ejection Isovolumetric Relaxation Ventricular Filling

What happens during Atrial kick?

Atria contract --> force additional blood into ventricles AV valves = open Semilunar valves = closed

What happens during isovolumetric ventricular contraction?

Ventricles begin to contract --> AV snap shut (1st sound) Ventricular pressure increases --> semilunar valves = shut All valves = shut

What happens during ventricular ejection?

Ventricular pressure exceeds vascular pressure forcing semilunar valves open Blood ejects from ventricles AV valves = close Semilunar valves --> push open

What happens during isovolumetric relaxation (beginning of diastole)?

Ventricular pressure falls below atrial pressure --> semilunar valves snap shut = 2nd heart sound All valves = shut @ End of this phase, venous blood returns to heart --> arterial pressures increase --> semilunar valves open = start of next phase

What happens during ventricular filling?

Ventricles passively fill w/ blood AV valves = open Semilunar valves = closed

What is the total time of the cardiac cycle (assuming there is a resting heart rate of 70 bpm)?

0.8 sec/beat ** systolic = 0.3 sec/beat; diastolic = 0.5 sec/beat

What is the total time of the cardiac cycle (assuming there is an exercising heart rate of 180 bpm)?

0.33 sec/beat **systolic = 0.2 sec/beat; diastolic = 0.13 sec/beat

Based on the total time of the cardiac cycle in a resting/exercising heart, what is the increase in HR due to?

Dramatic shortening of the diastolic phase of the cardiac cycle **ie less time to fil/less time for coronary circulation to occur

What is the first heart sound that is heard and what is causing this sound?

S1 = lub AV valves snap shut during the beginning of ventricular systole

What is the second heart sound that is heard and what is causing this sound?

S2 = dub Semilunar valves snap shut @ transition between ventricular systole and early diastole

What is the third heart sound?

S3 Heart in kids/young adults Vibration of ventricular walls from rush of blood into ventricles during rapid filling

What is splitting of second heart sound?

Delayed interval between aortic/pulmonary semilunar valves --> reduplication of sound (physiological splitting)

When do you heart splitting of the second heart sound?

Common during inspiration --> right pulmonary valve delayed Hear in various pathologies

What is a heart mumur?

Abnormal sounds heart over heart

What causes a heart murmur?

Turbulent blood flow Classic cardiac mumurs = valve dz

What happens in stenosis that would cause a heart murmur?

Opening of valve is narrowed

What happens during regurgitation/insufficiency that would cause a heart murmur?

Valve mechanically incompetent --> back flow

What is a bruit?

Abnormal sounds heart throughout vascular system?

What causes a bruit?

Turbulent blood flow

What is resting heart rate (RHR)?

Normal = 70 bpm

What is maximum heart rate (MHR) and how would you figure it out?

Estimate of maximum heart rate 220 - age = MHR 208 - (0.7 x age) = MHR

What is the traditional method for calculating target heart rate (THR)?

MHR x chosen %

What is the Karvonen formula that is used to calculate the heart rate reserve method?

[(MHR – RHR)] x chosen % + RHR

What is the average resting stroke volume?

70 mL

What is the average stroke volume in elite athletes?

90 - 100 mL

What is the maximum SV during exercise in elite athletes?

150 - 200 mL

How do you calculate cardiac output?

CO = SV x HR

What is the average CO @ rest?

5 L/min

What is the maximum CO during exercise?

20 - 30 L/min

What is the ejection fraction (EF)?

% of the blood that is ejected from the ventricle **proportion of the blood pumped out of the left ventricle w/ each beat

How do you calculate the ejection fraction (EF)

EF = SV / EDV (end diastolic volume)

What is the normal left ventricular EF (LVEF) @ rest?

55 - 68%

What is the normal right ventricular EF (RVEF) @ rest?

slightly less than LVEF

What are the clinical base line for EF?

Normal = 50 (or 55) - 70% Below Normal = 40 - 50% Diagnostic/increased risk of arrhythmia = < 35 - 40%

What happens to EF during exercise?

Increase 5 - 15% above resting value