Overview and Heart Anatomy Flashcards


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1

T/F: 52% of men with heart attacks die within a year, making men more likely to die than women of a hear attack.

False

2

List the 5 critical points that should be considered when discussing the heart

  1. Contractions must be synchronized
  2. Valves must open completely (not stenotic)
  3. Valves must not leak (not insufficient/regurgitant)
  4. Myocardial muscle cells must provide enough force to move blood
  5. Ventricles must be able to fill during diastole
3

What three essential mechanisms are required for cells to maintain homeostasis?

  1. Sufficient blood flow in capillaries
  2. Diffusion b/w capillaries and interstitial fluid must be small
  3. Arterial blood must have correct parameters
4

What are some functions of the CV system?

  • Exchange of fluids, gases, electrolytes, large molecules
  • Heat exchange
5

Blood flow w/in the lungs involving O2 and CO2 gas exchange b/w the blood and alveoli is part of __________ circulation

Pulmonary

6

Blood flow involving all the blood vessels in the body except for the lungs is part of __________ circulation

Systemic

7

T/F: the CV system may be viewed anatomically as two pumps

False

8

Which functional pump is considered low pressure (Pulmonary / systemic)?

Pulmonary

9

Which functional pump is considered high pressure (Pulmonary / systemic)?

Systemic

10

T/F: The pulmonary and systemic circuits are arranged in-series

True

11

What is the CO for a resting adult?

5-6 L/min

12

At what stage in the circulation does the heart receive its blood supply?

Immediately when blood is projected out of the aorta

13

Darcy's Law Equation:

F = (PA - PV) /R

14

The phase of ventricular relaxation and filling is known as:

Diastole

15

The phase of ventricular contraction is known as:

Systole

16

The ventricular wall tension (force) at the end of diastole is known as:

Preload

17

Clinically, ________ is the stretch on the ventricular fibers just before contraction, often approximated by the end-diastole volume (EDV) or end-diastole pressure (EDP)

Preload

18

The ventricular wall tension (force) during contraction is known as:

Afterload

19

Clinically, _________ is the force that must be overcome for the ventricles to eject its contents. Often approximated by the systolic ventricular (or arterial) P.

Afterload

20

Property of heart muscle that accounts for changes in the strength of contraction, independent of the preload and afterload.

Contractility

21

________ reflects chemical/hormonal influences on the force of contraction

Contractility

22

CO =

SV*HR

23

SV =

EDV - ESV

24

What factors affect SV?

EDV and ESV

25

What factors affect CO?

SV and HR

26

T/F: The Frank-Starline mechanism correlates an increase in venous return and ventricular preload and a decrease in SV

False

27

What can be used clinically to define preload rather than calculating the wall stress?

LVEDP or LVEDV

28

EF =

SV/EDV

29

What does the ejection fraction (EF) represent?

Fraction of the blood pumped out of the ventricle

30

T/F: In the normal heart, the EF >0.55 (55%)

True

31

Chronotropy

Heart rate

32

Dromotropy

Conduction velocity

33

Inotropy

Contractility

34

Lusitropy

Relaxation

35

How does NE affect chronotropy, dromotropy, and inotropy of the heart?

Positively (increases)

36

How does ACh affect chronotropy, dromotropy, and inotropy of the heart?

Negatively (decreases)

37

NE is released from the ___________ system

Sympathetic

38

ACh is released from the ________

Vagus nerve

39

Which receptors does NE act on?

β2, β1, α1

40

Which receptors does ACh act on?

M2

41

How does the body respond if there is a drop in arterial P (AP)?

  • ANS = Quick Cardiac stimulation and Vascular constriction
  • Kidneys = slowly increase blood volume
42

Reduces blood volume in response to atrial distension, found in heart failure (HF)

Atrial Natriuretic Peptide (ANP)

43

T/F: ANP is a counter-regulatory system to the renin-aldosterone system

True

44

Where is the heart positioned?

Thoracic cavity (aka Mediastinum)

45

Describe what structures are located around the heart

  • Lungs (R and L of heart)
  • Sternum (anterior to heart)
  • Spine (posterior to heart)
  • Diaphragm (inferior to heart)
46

Where does the apex of the heart point?

Inferiorly, anteriorly, and to the left

47

Where is the Long axis of the heart located?

Distance from LV to the root of the aorta

48

Superior border is comprised of:

RA and LA

49

Left border is comprised of:

LV and some LA

50

Inferior border is comprised of:

RV and some LV

51

Right border is comprised of:

RA

52

Protective border of the heart:

Pericardium

53

Role of the Pericardium:

  1. Protection
  2. Anchoring
  3. Viscous fluid reduces frictional forces
  4. Constrains the amount of blood filling
54

The cell bodies for the preganglionic vagal efferents innervating the heart are found in which region of the brain?

  1. Cortex
  2. Hypothalamus
  3. Medulla
  4. Nucleus tractus solitarius

C

55

Norepinepherine released by sympathetic nerves:

  1. Binds preferentially to β2-adrenoceptors on cardiac myocytes
  2. Constricts blood vessels by binding to α1-adrenoeptors
  3. Inhibits its own release by binding to prejunctional β2-adrenoceptors
  4. Decreases renin release in the kidneys

B

56

Stimulating efferent fibers of the right vagus nerve

  1. Decreases systemic vascular resistance
  2. Increases atrial inotropy
  3. Increases HR
  4. Releases ACh, which binds to M2 receptors

D

57

The CV system

  1. Aides in the transfer of heat energy from organs deep w/in the body to the outside environment
  2. Comprises pulmonary and systemic circulations that are in parallel w/ each other
  3. Transports CO2 from the lungs to tissues w/in organs
  4. Transports O2 from individual cells to the lungs

A

58

Which of the following statements concerning the heart is true?

  1. CO is the product of ventricular SV and HR
  2. The right and left ventricles are in parallel
  3. The right ventricle generates higher P than the left ventricle
  4. The right ventricle receives blood from the pulmonary veins

A

59

A patient complains of becoming "light headed" when he is standing upright. BP measurements reveal a significant fall in AP upon standing. Which of the following is a likely explanation of this patient's condition?

  1. Excessive activation of baroreceptor negative feedback mechanisms
  2. Excessive fluid retention by the kidneys
  3. Increased HR
  4. Reduced CO

D

60

Simple squamous epithelium that lines the inner chambers of the heart as well as the valve and is indistinguishable from the lining of the blood vessels

Endocardium

61

Composed of cardiac myocytes that form the contractile layer for the ejection of blood.

Myocardium

62

The ____________ are the contractile units of muscle w/ specific arrangements of the ptns (myosin, actin, and troponin)

Sarcomeres

63

They myocardium is divided into the ____________ and ______________ areas

Subendocardial; subepicardial

64

The serous membrane on the outside of the middle layer of the heart.

Epicardium

65

The epicardium consists of _____________ cells that overlay connective tissues

Epithelial

66

The epicardium is synonymous with:

Visceral pericardium

67

What is the fibrous skeleton and its role in the heart?

Help keep tissue in place

68

There is a 3D topology of the endocardial surface, which is interlaced with _____________

Trabeculae carneae

69

Describe the appearance of the endocardium

Smooth w/ sponge-like appearance

70

List the partitioning structures of the heart:

  • Interatrial septum
  • Interventricular septum
71

RA pressure range:

2-8 mm Hg

72

Approximately 10% of the blood in the normal heart at rest is delivered via ___________ aka _________

Atrial contraction; atrial kick

73

During exertion, as much as ______% is delivered via atrial contaction

40%

74

RV pressure range:

2-8 mm Hg

75

RV pressure increases to __________ during contraction

15-30 mm Hg

76

LA pressure ranges:

2-10 mm Hg

77

T/F: the LV wall is approximately 2 times thicker than the RV

False

78

T/F: During diastole, the LV is spheroid shaped, but during systole, it is cone-shaped

False

79

LV pressure range (filling phase)

3-12 mm Hg

80

LV pressure range (Contraction)

100-140 mm Hg

81

T/F: Due to P differences, the interventricular septum is pushed to the right

True

82

In the fetal heart, this is the area where there was once an opening called the foramen ovale

Fossa ovalis

83

Hole in the heart

Atrial septal defect (ASD)

84

Flap-like opening b/w RA and LA caused when the foramen ovale does not close properly

Patent Foramen Ovale (PFO)

85

Approximately _____% of people have a PFO

25%

86

Cause of Afib

Disorganized electrical conduction pathways in the atria = less efficient pumping of atria

87

Afib causes blood to stagnate which can lead to clots. Where do the majority of these clots form?

Left atrial appendage (left auricle)

88

Treatment options for Afib

  • Blood thinners
  • Ablation
  • Surgical procedures and implantable devices
89

Common cardiomyopathies:

  • Dilated
  • Hypertrophic
  • Restrictive
90

Outflow obstruction in HCM can lead to _______

Mitral regurgitation

91

Function of heart valves:

Give unidirectional flow of blood w/o backflow

92

List the inlet valves

Atrioventricular valves (Tricuspid and Mitral (biscuspid)

93

List the outlet valves

Semulunar valves (Pulmonic and Aortic)

94

Which valves have 2 flaps

Mitral

95

Which valves have 3 flaps

  • Aortic
  • Pulmonic
  • Tricuspid
96

Obstruction of valve leading to decrease in forward blood flow:

Stenosis

97

Leaky valve leading to backflow of blood

Insufficiency

98

What happens during aortic stenosis?

  • Elevated LV P
  • Secondary ventricular hypertrophy
  • Murmur (systolic)
99

Which heart sound is the result of the mitral and tricuspid valves closing at the beginning of systole?

First sound (S1 "lub")

100

Which heart sound is the result of the aortic and pulmonic valves closing at the beginning of diastole?

Second sound (S2 "dub")

101

During expiration there is one sound, but may be audibly distinct during inspiration (physiologic splitting). Why does this happen?

  • When you breathe in, more blood fills in R side of heart, pushing blood into pulmonary artery
  • Pulmonary artery is more flexible = expands more = takes longer to get extra blood through