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112 Cards in this Set
- Front
- Back
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Mediastinum
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A tissue layer extending from the sternum to vertebral column and between the pleura
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Apex of Heart
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Pointed part of heart (at bottom)
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Base of Heart
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Broad portion of heart (at top)
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Anterior Border of Heart
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deep to the sternum and ribs
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Inferior Border of Heart
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Lies on the diaphragm and between the apex and the right border
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Right border of Heart
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faces right (between the base and inferior border)
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Left border of Heart
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Pulmonary Border
Faces left (between the base and apex) |
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Heart Wall - Pericardium
Fibrous |
outer layer
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Heart Wall - Pericardium
Serous |
Outer parietal layer
Inner visceral layer (a.k.a. epicardium) |
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Pericarditis
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inflammation of pericardium
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Pericardial cavity
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space between parietal serous and visceral serous pericardium
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Pericardial Fluid
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normal fluid in pericardial cavity
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Myocardium
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The middle muscular layer of the heart
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Endocardium
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The simple squamous endothelium (overlying a thin areolar tissue layer) covering lining the interior of the heart chambers. It covers the valve surfaces and is continuous with endothelium of blood vessels.
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Inflammations of Heart Wall
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Epicarditis, Pericarditis, Myocarditis, Endocarditis
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Cardiac Tamponade
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Heart compression due to fluid pressure buildup around the heart in the pericardial cavity (sac).
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External/Internal Structures of the Heart
Aorta |
Ascending, arch, decending, thoracic, abdominal. Large artery extends from L ventricle to lower abdominal cavity, gives rise to all other arteries of systemic circ.
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External/Internal Structures of the Heart
Pulmonary Trunk |
A vessel that arises from the right ventricle of the heart, extends upward, divides into R and L pulmonary arteries that convey unaerated blood to the lungs. When R ventricle contacts, blood inside it put under pressure and tricuspid valve between R atrium and ventricle closes. Only exit for blood from the right ventricle is then through the pulmonary trunk. The PULMONARY TRUNK is to R VENTRICLE what AORTA is to L ventricle -- the OUTLET VESSEL.
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External/Internal Structures of the Heart
Pulmonary Artery (R and L) |
One of the two vessels which are formed as terminal branches of the pulmonary trunk and convey unaerated blood to the lungs. The two pulmonary arteries differ in length and anatomy.
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External/Internal Structures of the Heart
Pulmonary Artery - Right |
The right pulmonary artery is the longer of the two. It passes transversely across the midline in the upper chest and passes below the aortic arch to enter the hilum of the right lung as part of its root.
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External/Internal Structures of the Heart
Pulmonary Artery - Left |
The left pulmonary artery is the shorter of the two terminal branches of the pulmonary trunk. It pierces the pericardium (the sac around the heart) and enters the hilum of the left lung.
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External/Internal Structures of the Heart
Pulmonary Veins (R and L) |
One of four vessels that carry aerated blood from the lungs to the left atrium of the heart. (The four are the right and left superior and inferior pulmonary veins). The pulmonary veins are the only veins that carry bright red oxygenated blood.
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Internal Structures of the Heart
Right Atrium |
receives deoxygenated blood from the SVC (Superior Vena Cava), IVC (Inferior Vena Cava), and Coronary Sinus (opening)
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Internal Structures of the Heart
Right Ventricle |
receives blood from the right atrium and sends it to the pulmonary trunk.
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Internal Structures of the Heart
Left Atrium |
(heart base) receives oxygenated blood from the lungs via the pulmonary veins
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Internal Structures of the Heart
Left Ventricle |
(apex) is thicker than the right ventricle because of the high systemic pressure and therefore, more work, than is needed to overcome the pulmonic pressure presented on the right side. Receives blood from the left atrium and sends it into the ascending aorta (-> body).
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Internal Structures of the Heart
Pulmonic (Right) and Aortic (Left) a.k.a. Similunar Valves |
R and L, located at entry of major blood vessels
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Internal Structures of the Heart
Tricuspid (R) & Mitral/Bicuspid (L) a.k.a. Atrioventricular (R and L AV) |
located between atria and ventricles
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Internal Structures of the Heart
Chordae Tendinae |
tendonlike cords connected to and prevent the valves from being pushed up into the atria on ventricular contraction.
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Internal Structures of the Heart
Papillary Muscles |
muscles attached to the ventricular wall and chordae tendinae to prevent the AV valves from everting (insufficiency) and causing blood flow regurgitation.
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External Structures of the Heart
Coronary Sinus |
return of venous blood supply of the heart that carries de-oxygenated blood with CO2 and waste to the right atrium
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External Structures of the Heart
Coronary Sulcus |
External Groove that separates the atria and ventricles
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Pathophysiology
Regurgitation / Insufficiency |
backflow of blood through any of the valves (heart vomits)
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Pathophysiology
Stenosis |
narrowing i.e. mitral valve stenosis, aortic valve stenosis, pulmonic valve stenosis.
Stenosis - narrowed. |
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Left Coronary Artery - LCA
Circumflex artery |
left atrium and left ventricle
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Left Coronary Artery - LCA
Anterior Interventricular Branch / Left anterior descending artery (LAD) |
left & right ventricles
anterior area of the interventricular septum atrioventricular bundles |
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Right Coronary Artery - RCA
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Right atrium and ventricle, SA & AV nodes
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Right Coronary Artery - RCA
Martinal artery |
Right VEntricle
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Right Coronary Artery - RCA
Posterior ventricular artery |
Right & Left Ventricles
posterior area of the interventricular septum |
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Anastomosis
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A natural communication, direct or indirect, between two blood vessels or other tubular structures.
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Heart Sounds
First Heart Sound (1st HS or S1) |
AV Valve closure after the start of ventricular stroke
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Heart Sounds
Second Heart Sound (2nd HS or S2) |
Semilulnar valve closure at the end of ventricular systole
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Heart Sounds
Components |
Mitral (S1)
Tricuspid (S1) Aortic (S2 or A2) Pulmonic (S2 or P2) |
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Auscultation of the heart
Aortic area |
2nd right intercostal space close to the sternum
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Auscultation of the heart
Pulmonic area |
2nd left intercostal space close to the sternum
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Auscultation of the heart
Tricuspid area |
5th left intercostal space close to the sternum
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Auscultation of the heart
Mitral (Apical) area |
5th left intercostal space just medial to the midclavicular line
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Auscultation of the heart
Erb's Point |
third left intercostal space close to the sternum where murmurs of both aortic and pulmonic origin may often be heard
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Phases
Systole |
Phase of heart/chamber contraction
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Phases
Diastole |
Phase of heart / chamber relaxation
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Automaticity
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self-excitation = spontaneous action potentials cause heart muscle contraction. The SA node consists of a cluster of cells that are situated in the upper part of the wall of the right atrium (the right upper chamber of the heart). The electrical impulses are generated there.
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Sinoatrial Node / SA Node / Sinus Node
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Pacemaker of the heart.
Consists of a cluster of cells that are situated in the upper part of the wall of the right atrium (the right upper chamber of the heart). The electrical impulses are generated there. Electrical signal generated by the SA node moves from cell to cell down through the heart until it reaches the AV node. |
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Heart Rate at Rest
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75 BPM
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Atrioventricular node / AV Node
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An electrical relay station between the atria (the upper) and the ventricles (the lower chambers of the heart). Electrical signals from the atria must pass through the AV node to reach the ventricles. AV Node receives its signal from the SA Node.
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Cardiac Conduction System
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system generates electrical impulses and conducts them throughout the muscle of the heart, stimulating the heart to contract and pump blood.
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Cardiac Conduction System Pathway
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SA node --> atria --> AV node ---(delay) --> AV Bundle / Bundle of His --> Bundle Branches (R&L) --> Purkinje fibers (conduction myofibers) --> heart contraction (ventricles)
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Cardiac Conduction System
Capture |
SA node gets to the slower excitatory AV node before it can self-excite and sets the pace. With this action, the SA node remains the dominant excitation throughout the heart.
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Cardiac Conduction System
Refractory Period |
- Recovery after heart contraction
- longer than the contraction period - tetani of the heart cannot occur because of delayed contraction - delay ensures that the atria have a chance to fully contract before the ventricles are stimulated |
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Define Electrocardiogram (ECG / EKG)
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recording of heart electrical changes
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Electrocardiogram (ECG / EKG)
P Wave |
Indicates atrial depolarization
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Electrocardiogram (ECG / EKG)
QRS Wave |
Indicates ventricular depolarization.
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Electrocardiogram (ECG / EKG)
T Wave |
Indicates ventricular repolarization
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Cardiac Output (CO)
Formula |
Heart Rate (beats/min) x Stroke Volume (mL/beat) = Cardiac Output in mL/min
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Cardiac Output (CO)
Heart Rate |
number of beats per minute. Average person resting heart rate of 70 BMP
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Cardiac Output (CO)
Stroke Volume |
volume of blood, in mililiters (mL) pumped out of the heart with each beat.
Average resting stoke volume is 70 ml/beat. |
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What would increasing either heart rate or stroke volume do?
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It would increase the Cardiac Output
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What would the cardiac out put for an average person at rest be?
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An average person has a resting heart rate of 70 beats/minute and a resting stroke volume of 70 mL/beat. The cardiac output for this person at rest is:
Cardiac Output = 70 (beats/min) X 70 (mL/beat) = 4900 mL/minute. |
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What is the total volume of blood in the circulatory system of an average person?
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5 litres, or about 5000 mL
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How much of the volume of blood within the circulatory system is pumped by the heart each minute at rest?
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All 5 litres , or 5,000 mL of it.
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How much can cardiac output increase during vigorous exercise
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It can increase up to 7 fold, at 35 litres per minute.
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Which ventricle is responsible for the circulation of the blood through the body? What is the cardiac output for this?
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Left ventricle.
70 ml. x 7.5 bpm = 5.2 litres. |
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What is the average heart rate of a normal person?
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Between 60 and 100. Average 75 BPM.
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Heart Rate
SA Node |
90 - 100
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Tachycardia
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Fast heart rate, over 100 BPM
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Bradycardia
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Slow heart rate, less than 60 BPM
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What aspects of the nervous system regulates heart beat?
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The Sympathetic and Parasympathetic nervous system
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Heart Beat Regulation
Sympathetic Nervous system |
-Post ganglion fibers (short): accelerator nerve and NE (Norepinepherine)
-Adrenal Medulla: Epi (Epinephrine) and NE (Norepinephrine) |
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Heart Beat Regulation
ParaSympathetic Nervous system Pathway |
Vagus N. (X) predominate nervous system
1. Parasympathetic nervous system via vagus (Cr. X)-->acetylcholine (Ach)-->A decrease of SA & AV node-->decrease in heart rate and contraction. Heart rate decreased by blockage/reduced sympathetic flow to the heart |
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Heart Beat Regulation
Sympathetic Nervous system Pathway |
Sympathetic nervous system -->NE-->A&V-->increase HR & contraction
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Chronotropic
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Chronology is time, so it relates to BPM. Affecting the rate or timing of a physiologic process, such as heart rate.
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Inotropic
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Refers to contractility, or force of contraction. (An inotropic heart drug is one that affects the force with which the heart muscle contracts.)
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Stroke Volume
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the volume of blood ejected from the ventricles at each contraction (Think V for Volume and Ventricles)
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Stroke Volume Regulation
Preload |
The degree of stretching in the heart (ventricular) muscle before it contracts
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Stroke Volume Regulation
Preload - Frank Starling Law |
increase diastolic filling-->increase systolic contraction
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Stroke Volume Regulation
Contractility |
The force of the contraction
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Stroke Volume Regulation
Afterload |
The pressure required to eject the blood from the ventricles
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Baroreceptors
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blood pressure receptors. Located in aortic arch, internal carotid arteries, right atrium.
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Where are Atrial Natriuretic Peptides (ANP)found?
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•Found throughout the heart but mainly in the right atrium
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What is the stimulus which releases Atrial Natriuretic Peptides (ANP)?
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Stretch is the stimulus which releases ANP (two peptides are released).
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What else besides stretch releases ANP (Atrial Natriuretic Peptides)
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Secreted in response to Salt Intake (the natri means sodium, NA+)
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What does Atrial Natriuretic Peptides (ANP) do?
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ANP increases Na+ loss (natriuresis) and water loss by the kidney due to, in part, to increase in glomerular filtration rate.
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What is the physiological importance of ANP or Atrial Natriuretic Peptides?
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Not known due to impossibility of indentification or production of specific human deficiency. However, it increases in weightlessness, while renin, aldosterone, and ADH secretion decreases. Thus, along with other hormones, it might have to do with normal regulation of ECF (extracellular fluid) osmolarity and volume.
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Chemoreceptors
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Carotid bodies and aortic bodies. Carotid artery wall cells sensitive to changes in the O2 and CO2 content of the blood (or cerebrospinal fluid). Primarily the CO2.
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Which cranial nerve monitors carotid body and sinus?
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Glossopharyngeal (IX)
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Pathophysiology
Cardiomegaly |
enlarged heart
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Pathophysiology
Left Ventricular Hypertrophy |
Increase in the size of the left ventricle myocardial wall (overall) due to increase in resistance/pressure.
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Pathophysiology
Coronary Artery Disease (CAD) |
Reduced blodflow to the heart due to narrowed coronary arteries.
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Pathophysiology
Ischemia and Angina Pectoris |
Reduced O2 supply to the heart muscle cells.
Causes chest pain from ischemia of the myocardium. |
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Pathophysiology
Myocardial Infarction (MI) |
A localized necrotic (dead) tissue due to interrupted or inadequate blood O2 supply. Also known as a “heart attack”. (ie blood clot)
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Pathophysiology
Congestive Heart Failure (CHF) |
Failure of the heart to pump efficiently with resulting increase in end diastolic volume. Leads to HF if not treated.
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Pathophysiology
LHF |
Inadequate pumping of the left side of the heart-->pulmonary edema (which, in turn, causes RHF)
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Pathophysiology
RHF |
Caused by LHF, this inadequate pumping of the right side of the heart, in turn, causes peripheral edema (hands and feet).
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Pathophysiology
Cor Pulmonale |
Enlarged right ventricle due to hypertension of the pulmonic region which extends into the pulmonic trunk with increase pressure.
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Pathophysiology
Arrhythmia & dysrhythmia |
Irregular Heart Rhythm (i.e. heart block, AV Block)
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Pathophysiology
Atrial Flutter |
Atrial rhythm averages b/w 240-360 beats/minute as well as AV block (irregular).
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Pathophysiology
Atrial Fibrilation |
“uncoordinated” contractions causing an irregular fast heart beat with loss of pumping action.
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Pathophysiology
Ventricular Fibrilation |
dysfunctional contractions --> ineffective --> circulatory failure --> death
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Heart Defects
Patent Ductus Arteriosus (PDA) |
by-pass at aorta & pulmonary trunk remains open after birth.
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Heart Defects
Atrio Septal Defect (ASD) |
Defect with an opening between the atria.
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Heart Defects
Ventricular Septal Defect (VSD) |
Defect with opening between the ventricles
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Heart Defects
Tetralogy of Fallot - 4 defects |
Overriding Aorta
Pulmonaty Stenosis Right Ventricular Hypertrophy Ventricular Septal Defect (VSD) |
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Coronary Artery Bypass
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Grafting....bypass around a blocked region of the coronary artery. They often use the Great Saphneous Vein of the leg for this
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