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Cardiovascular system > The Heart - L2 > Flashcards

The Heart - L2 Flashcards

1
Q

Location of heart - what is it contained within?

A

Contained within medianstinum

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2
Q

What is heart enclosed by?

A

Pericardium

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3
Q

Location of heart in body?

A

2/3 offset left of midline of sternum

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4
Q

Approx g size of heart

A

250-300g

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5
Q

What is the pericardium?

A

It attaches the heart to surrounding tissue, it is a tough double layered membranous sac
Protective function

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6
Q

Pericardium made up a double layered membranous sac that is made up of?

A

1 visceral layer - attached to heart surface
1 parietal layer - outer pericardial layer

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7
Q

What does the fluid between layers of pericardium do?

A

Lubricating fluid between layers reduces friction during movement of heart surface with contraction

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8
Q

Heart surface - what is it made up of? Hint should be 8 broad

A
  1. Aorta
  2. superior vena cava
  3. right atrium
  4. right ventricle
  5. pulmonary artery
  6. coronary artery and vein
  7. left ventricle
  8. Auricle of left atrium - Pouch like projection from main body of left atrium.
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9
Q

Cardiac output - left/right side?

A

cardiac output is on both sides of the heart, but when talking about it typically talking about left side - the systemic component

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10
Q

Anatomy of heart

A

See diagram slide 4 lecture 2

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11
Q
  1. 2 Atria?
  2. 2 Ventricles?
  3. Left side?
  4. Right side?
A
  1. Priming pumps for ventricles
  2. Expulsion pump to eject blood into circulation
  3. Systemic circuit
  4. Pulmonary circuit
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12
Q

REMEMBER HEART IS MIRROR IMAGE I.E. LEFT IS ACC RIGHT AND RIGHT IS ACC LEFT

A

Heart is mirror image

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13
Q

Superior vena cava?

A

Returns blood from head, upper limbs

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14
Q

Right pulmonary veins?

A

Return blood from right lung

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15
Q

Inferior vena cava?

A

Returns blood from trunk, legs

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16
Q

Right and left pulmonary arteries go to?

A

To the lungs

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17
Q

Left pulmonary veins return?

A

Return blood from left lung

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18
Q

Is the heart an open/closed system, and what to valves respond to?

A

The heart is a closed pressure system and the valves respond to stimulus to open and close

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19
Q

What does the fibrous skeleton of the valves do?

A

dense connecting tissue keeps heart valves in place
they don’t conduct inputs in terms of ECG point of view

key role in maintaining blood flow in unidirectional
pressure controlled valves

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20
Q
  1. What happens when the pressure gradient is greater infront of the valve?
  2. What happens when the pressure gradient is greater behind the valve?
A
  1. When the pressure gradient greater infront of valve it CLOSES - one way valve it does not open in opposite direction
  2. When the pressure gradient is greater behind valve it OPENS
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21
Q

When there is more blood in the ventricles than in the atria do the valves open/close?
What is 1 structural reason why this happens, i.e. prevention of eversion of AV valves?

A

When there is more blood in ventricles then in atria it causes valves to CLOSE
The Chordae Tendineae is one reason why: it is attached to the myocardial muscle and they pull AV valves down to make sure they don’t flip back up - so they keep it going in a 1 way valve with unidirectional blood

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22
Q

What unique structure do aortic and pulmonary valve have to prevent back flow of blood once it is released from the ventricles?

A

The aortic and pulmonary valve have shallow indentations and unique structure of these valves helps to structurally prevent back flow of blood once the blood is released from ventricles

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23
Q

Explain this prevention of eversion of the semilunar valves, this leakproof seam in terms of different pressures in ventricles and blood vessels:

A

When ventricular pressure is greater then blood vessels, the blood vessels OPEN

When pressure drops, the blood is sucked back down towards valve but the cusp like openings fill with blood and it pops them back into place and seals it shut - leak proof seal and prevents back flow CLOSE

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24
Q

Heart muscle:

A

Myocardium - thick layer
bundles of myofibrils: spiral shape - ringing pumping action of heart = very densely packaged with mitochondria as lot of energy needed in heart

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25
Q

Endocardium?

A

endocardium - inner endothelial layer of heart

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26
Q

Where does the heart receive most of its blood supply through?

A

The coronary circulation during diastole: relaxation stage

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27
Q

What is coronary blood flow adjusted in response to?

A

Coronary blood flow is adjusted in response
to changes in the heart’s O2 requirements

28
Q

What comes back into heart is what is available to leave heart - venous return is very important

Does the heart get nourished during contraction/relaxation and when do the other organs get nourished is it during contraction/relaxation?

A

The rest of organs get nourished when it contracts and heart gets nourished when it is relaxed

29
Q

coronary arteries structure - what does it look like it?
What is the coronary artery?

A

It is a crowning structure
It is a separate circulation itself that keeps parallel organ functioning to allow functioning of all the other organs in the body

30
Q

What are these intercalated discs in cardiac muscle?

A

Cardiac muscle fibers branch and are interconnected by these intercalated discs

Intercalated discs are the connecting point between 1 myocyte and the next to allow muscle fibres to all be connected

31
Q

Cardiac muscle - activity is controlled by the?

A

ANS: Sympathetic and parasympathetic

32
Q

What does the ANS control of cardiac muscle?

A

Control of rate and contractile strength

33
Q

What are intercalated discs made up of and what do these structures do?

A

Made up of (1.) Desmosome which holds the muscle fibre in place and allows monocyte to be structurally sound and (2.) Gap junction which allows electrical transmission, a.p. to be transmitted from one myocyte to the next within the myocyte

34
Q

What is a muscle cell? Where is it attached, what connects it and what is it made up of? -

A

Muscle cell is a mycoyte that is attached end to end and the structure that connects them is intercalated discs which are made up of gap junctions and desmosomes

35
Q

The myocardium is made up of 2 different types of muscle cells? What do these cells do?

A

Contractile cells - most of them: 99% of cardiac muscle cells and they do the mechanical work of pumping
Auto rhythmic cells: 1% of cardiac cells- they initiate and conduct the action potentials responsible for
contraction of working cells => they don’t need external neural input they work off their own accord

36
Q

Heart automatic or not?

A

Automaticity: the heart contracts rhythmically as a result of action potentials that it generates by itself

37
Q

Contractile cells of cardaic muscle?

A

The heart initially contracts itself rhythmically but to sustain it it needs electrical neural input from these contractile cells to do the mechanical work of pumping

38
Q

Specialised pacemaker areas?

A

Sino-atrial node (SA) - right atrium
AtrioVentricular (AV)- Right atrium above
Bundle of his - either side of septum
Purkinje fibres - left and right of myocardium itself

39
Q

ANS - Autonomic nervous system- what is it and what is it made up of?

A

It is an involuntary branch of Peripheral Nervous System with parasympathetic and sympathetic branches which often have opposing effects

40
Q

What is the ANS the central output to?

A

Parasympathetic NS (vagus nerve)
Sympathetic NS via rostral ventrolateral medulla
Sympathetic chain

41
Q

Properties of an effective heart: Should be 7

A
  1. Regular contractions at appropriate rate for metabolism
  2. Guaranteed time for ventricular filling after atrial & ventricular contractions
  3. Contraction duration long enough for physical movement of fluid
  4. Contractile strength sufficient to generate appropriate pressures
  5. Ventricular pressure directed towards exit valves
  6. Coordination of left & right, and atrial & ventricular contractions
  7. Matched volumes of emptying & filling

=> They are all to ensure cardiac output

42
Q

How are all these properties of an affective heart achieved?

A

All achieved by the electrical and mechanical properties of the heart and cardiac muscle

43
Q

What is cardiac adaptation to physical training in athletes dependent on?

A

Cardiac adaptation to physical training in
athletes is a cycle dependent on the types of training, the duration of training, and the intensity.

44
Q

What does isotonic stress lead to and give and example?

A

Isotonic stress such as bicycling (the
green pathway) leads to volume load and
chamber dilation.

45
Q

What does isometric stress lead to and give an example?

A

Isometric stress, such as weightlifting (the
yellow pathway) leads to pressure load
and chamber hypertrophy

46
Q

What does rest do to cardiac structure after CVS adaptation in athletes?

A

Rest quickly reverses the training changes in both cardiac structure and ECG.

47
Q

Hypertrophy:

A

increase and growth of muscle cells normally via exercise
-> Can be physiological due to long endurance training, and pregnancy
-> Can be pathological via hypertension, high afterload, infarction, diabetes

48
Q

Pathological hypertrophy - hypertension and high after-load what does heart look like?

A

Concentric remodelling and Fibrotic lesions

49
Q

Pathological hypertrophy - Infarction what does heart look like?

A

Eccentric dilation, Impaired EF, Fibrotic lesions

50
Q

What is after-load?

A

After-load is a measure of the force resisting the ejection of blood by the heart thus increased/high after-load causes decrease in heart’s stroke volume and an increase in end-systolic volume this affects CO

51
Q

Pathological hypertrophy - diabetes what does heart look like?

A

Fatty and fibrotic lesions, increased ventricular mass and diastolic dysfunction

52
Q

Physiological hypertrophy via exercise and pregnancy what does the heart look like?

A

Eccentric muscular remodelling, enhanced function and improved metabolism

53
Q

What is infarction?

A

Infarction is tissue death/necrosis due to inadequate blood supply to affected area

54
Q

Resistance/aerobically fit - good for heart?

A

resistance training - need to coincide with VSC training so you don’t develop issues
aerobically fit: very good for the heart

55
Q

Infarction damage to heart?

A

If heart muscle cannot contract as it does not have enough O2, blood still returned back to heart, heart tissue is dead, reduced muscle capacity, and reduced O2 ability within the coronary artery, pooling blood within left ventricle that causes increased diameter in it but don’t have the contractility to actually do anything with it

56
Q

Damage issues to heart via diabetes?

A

diabetes damages mitochondria - lack of O2 tissue
issue with utilising glucose - heart muscle sometimes instead of using that so they use fatty acids fo the heart and the fats infiltrate the heart and develop heart and so you have a non-contractile structure - fatty tissue - no contractile strength so cannot eject cardiac output that we want to

57
Q

Main function of the valves?

A

Keep blood flowing in right direction
Prevent back flow of blood

58
Q

Pulmonary arteries bring…?

A

Pulmonary arteries bring deoxygenated blood to lungs

59
Q

Where is the aortic valve located? What happens here and what happens when ventricles contract and when pressure is greater within the valves?

A

The aortic valve is located at junction of ventricles where they’re ejecting blood and when ventricles contract they exceed that of the valves and when pressure is greater within the valves rather then the ventricles it causes the valve to close

60
Q

When the pressure is greater within valves compared to the ventricles, do the valves open or close?

A

When the pressure is greater within the valves rather then the ventricles it causes the valve to CLOSE

61
Q

Is there valves between the atria and veins? why/why not?

A

There are NO VALVES between the atria and
veins, because back flow here not a significant problem

62
Q

Where are semilunar valves located?

A

Semilunar valves between the ventricles and major arteries: Aortic and pulmonary valves

63
Q

What is the structure of the fibrous skeleton of the valves and what is the function?

A

Four interconnecting rings of dense connective tissue of the heart surround and support the four heart valves

64
Q

These 1 way valves have structural features that make them unique, but what controls them?

A

When pressure changes

65
Q
  1. What does ANS innervate
  2. What does parasympathetic NS innervate
  3. What does sympathetic NS innervate
  4. What system is needed to slow down ventricles?
A
  1. Innervates myocardium
  2. Parasympathetic NS innervates via vagus nerve only innervates AV and SA node
  3. Sympathetic SA, AV and ventricular myocardium
  4. Para doesn’t have a big role to slow down ventricles need more sympathetic drive to be slowed down etc

Cardiovascular system (13 decks)

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