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184 Cards in this Set
- Front
- Back
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approx ____ of blood in body, you circulate entire blood supply every ____
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5L
minute |
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Cardiac output = ____ x ____
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heart rate
stroke volume |
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____ for an adult at rest is 5L per minute
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Cardiac output
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____ = amount of blood pumped out of the heart per beat/contraction
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Stroke volume
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Heart rate for an adult at rest approx ____ beats per minute
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50-80
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Stroke volume (typ measured in ml) ____ ml per beat
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60-80
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____ = HR x SV
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CO
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____ what is being pumped out of the left ventricle
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Stroke Volume
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Small fraction of heart cells are ____ or ____
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auto rhythmic
pacemaker cells |
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These pacemaker cells automatically generate an action potential at the rate of about ____ per minute
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100
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That means that at rest your heart is under control of the ____ nervous system, which dampens/decreases those action potentials
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parasympathetic
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Most of the heart cells are ____ cells, how forceful these cells contract influence the ____ . The stronger the contraction the higher the ____
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contractile
stroke volume stroke volume |
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The more cardiac exercise you do, the ____ your heart can ____ and the higher your average ____ can be.
(if you run across the room, your heartrate does not have to increase as much to get that high cardiac output needed) |
harder
contract stroke volume |
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If heart is going too ____, not enough time for the heart to fill up with blood and therefore stroke volume ____ and total ____ decreases
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fast
decreases cardiac output |
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Typically can increase cardiac output up to ____ per minute, which is a combination of stroke volume and heart rate
World class athlete up to ____ per minute which is still a combination of stroke volume and heart rate, but predominantly ____ |
25L
40L stroke volume |
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(____) ____ = volume of blood in the left ventricle at the end of relaxation (heart is filled and ready to contract)
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End-diastolic volume
EDV |
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Most of the time (if your heart is working properly) the higher your ____ the higher your stroke volume
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EDV
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Skeletal muscle pump and respiratory pump are two mechanisms that help increase ____
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EDV
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When standing have to work against ____ to get blood pumped back up to heart
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gravity
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____ - assessment of blood composition
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Hematocrit
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Most of blood is just ____
____ - what portion of blood is red blood cells Red blood cells are ____ carriers Females slightly lower ____ than males |
water
hematocrit oxygen hematocrit |
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____ - mostly water, but has proteins, hormones, glucose
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plasma
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other stuff in blood besides plasma and erythrocytes
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White blood cells small percentage
Platelets - cell fragments, help in clotting process |
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Red = ____
Blue = ____ |
oxygen full
oxygen poor |
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The heart sits in a fluid filled sac called a ____
Attached at the bottom to the ____ |
pericardium
diaphragm |
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____ is extremely dense and therefore tough connective tissue. Helps protect heart from any sort of puncture wound
(also have ____ protecting the heart) Do not want heart ____ against any other organs, can be painful |
pericardium
ribcage rubbing |
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The left side of the heart sits about ____
The left side of the heart is bigger, literally sits ____ |
2/3 off center
off center |
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____ - chambers through which blood flows from veins to ventricles. ____ contraction adds to ventricular filling but is not essential for it.
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Atria
Atrial |
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____ - chambers whose contractions produce the pressures that drive blood through the pulmonary and systemic vascular systems and back to the heart.
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Ventricles
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____ - low-resistance tubes conducting blood to the various organs with little loss in pressure. They also act as pressure reservoirs for maintaining blood flow during ventricular relaxation.
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Arteries
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____ - Major sites of resistance to flow; responsible for the pattern of blood flow distribution to the various organs; participate in the regulation of arterial blood pressure.
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Arterioles
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____ - Major sites of nutrient, metabolic end product, and fluid exchange between blood and tissues.
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Capillaries
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____ - site of nutrient, metabolic end product, and fluid exchange between blood and tissues.
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Venules
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____- low resistance conduits for blood flow back to the heart. Their capacity for blood is adjusted to facilitate this flow.
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Veins
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____ - liquid portion of the blood that contains dissolved nutrients, ions, wastes, gases and other substances. Its composition equilibrates with that of the interstitial fluid at the capillaries.
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Plasma
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____ - includes erythrocytes that function mainly in gas transport, leukocytes that function in immune defenses, and platelets (cell fragments) for blood clotting
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Cells
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CVD = ____
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cardiovascular disease
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The higher your resting blood pressure the higher your risk for developing ____
____ can be caused by narrow blood vessels ____ is increased risk to blood vessels, and decreased oxygen delivery |
cardiovascular disease
high bp high bp |
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____ = good cholesterol, we use cholesterol in our body plasma membranes and steroid hormone formation
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HDL
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LDL = ____, if LDL is ____ it can injure endothelial cells. As LDLs float in blood stream and become ____, arteries have _____ for LDL, and bind the LDL which is conducive to ____ formation
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bad cholesterol
oxidized oxidized receptors plaque |
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____ can increase the tendency of ____ to form
Intrude on the ____, decrease the bloodflow More vulnerable to dislodging/breaking Bigger the plaque, the higher the pressure and the more liable to ____ and start a blood clot inside the blood vessel |
bad cholesterol
clots lumen dislodge |
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Form a clot and stop the bleeding and the platelet plug will send in stronger connective tissue
Called ____, the ____ will hold that blood vessel together until the endothelial tissue can ____ (need ____ to dissolve) does not behave the same was as blood vessel does dilate/constrict |
fibrin
fibrin repair fibrin |
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Two mechanisms for triggering the clotting pathway- ____
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the intrinsic and extrinsic pathway
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____ - is a protein (chemical signal) that triggers platelets to migrate toward the damaged vessel/area
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Thrombin
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____
Activated when we actually cut ourselves, blood seeping out of our body (vessel damage that leads to blood leaving the body) More important pathway, activates more quickly/quicker to respond Fewer enzomatic steps Literally plugs that blood vessel so cannot bleed out |
Extrinsic
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____
Blood vessel damage, but not losing blood to the environment, but may be losing it to body cavities (internal bleeding) Takes a little longer because there are more enzomatic steps to get to the thrombin |
Intrinsic
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____ are drawn to the damaged area by chemical signal, and form the ____ a temporary fix to the blood vessel
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platelets
platelet plug |
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____ -
The +, means have a D antigen The -, means no antigen (70 percent of Americans ____ the D antigen) |
RH factor or D antigen
have |
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+ can ____, but - cant ____ +
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receive
receive |
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____
Problem can be with 2nd baby, antibodies developed after first baby, 2nd baby, antibodies cross over to babies blood and attack it Injection of ____ - inhibits developments of antibodies |
mothers with no D antigen
rhogam |
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____ - lots of glycoproteins/self signature proteins
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RBC (erythrocytes)
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A blood has ____, has _____ for B antigens
Will fight off type ____ or type ____ blood. |
A antigens
antibodies B or AB |
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Type ____ is the universal Acceptor
Type ____ is the universal Donor |
AB
O |
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RBC - lots of glycoproteins/self signature proteins
One of the ____ (one of many) we use for typing Named for the self ____ antigen they have |
antigens
surface |
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!do not need to know different kids of leukocytes
Just ____, ____ or ____ |
RBC
WBC platelets |
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____ - no true nuclei, no mechanism for repairing themselves
More efficient oxygen carriers, more room for hemoglobin ____ - do have nuclei much laster longer |
RBC
WBC |
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Red blood cells have a approx. ____ lifespan
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120 day
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Regulation of red blood cells-
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Kidneys have chemoreceptors oof amount of oxygen they receive
As the amout decreases they produce erythropoietin (EPO) Target tissue is in the bone marrow Increase red blood cell production and will increase oxygen delivery Negative feedback mechanism and stop producing epo |
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Narrowed blood vessels, decrease significantly blood flow to the ____. ____ are the arteries specifically oxygenated the heart itself. If they get blocked etc with ____, like a traffic jam
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heart
coronary arteries plaques |
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Put in a ____ that will flatten out the plaque against the arterial wall
Temporary fix, ____ Or ____, rerouting the blood flow, think of accident bypassing the area of blockage |
tube/stent
5-10 years bypass |
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____ useful, decrease blood volume therefore less EDV
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Diuretics
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____ - increase ventricular contractility and help manage EDV
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Cardiac inotropic drugs
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____ - heart failure/congestive heart failure
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Old people
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Heart is ____, not beating as strongly, starts getting a larger and larger ____, but cant handle it, not beating strong enough, starts to enlarge and build up fluid basically due to ____ if no other infections
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old
EDV enlarge aging |
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____ leads to increased fluid retention, leading to increased blood volume and _____; however, the failing heart is less able to handle a large ____.
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heart failure
greater stroke volume EDV |
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____ or more commonly ____, reduce contractility strength reduce blood pressure
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Beta-adrenergic
beta blockers |
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____ - inhibit enzyme producing angiotension II, I am inhibiting vasoconstriction and therefore lowering blood pressure
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ACE inhibitors
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____ - these drugs increase urinary excretion of sodium and water. They tend to decrease cardiac output with little or no change in total peripheral resistance.
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Diuretics
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____ - These drugs reduce the entry of calcium into vascular smooth muscle cells, causing them to contract less strongly and lowering total peripheral resistance. (lower BP)
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Calcium channel blockers
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____ - First it inhibits previous hormones, Aldosterone, angitension
It vasodialates or increases volume without increasing pressure Also acts as a mild diuretic, promotes urine output (get rid of some of the volume) |
ANP
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____ or sometimes called ____ (hormone released by cells in the left atrial wall)
Inside the left atrium (high pressure side of the heart) there are stretch receptors that are activated By increased volume, stretches that wall alittle bit |
ANP
ANH |
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____ in the kidney that monitor blood flow, respond to a decreased blood pressure which is a decreased blood volume they release an enzyme ____
Triggers the conversion of ____ (inactive) to ____ (active) Angiotension acts directly (prev slide) And also acts to stimulate adrenal cortex to release ____ |
Baroreceptors
renin angiotensinogen angiotensin aldosterone |
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Aldosterone is sluggish!, process is that if ___ , ___or___ occurs then angiotensin II a protein hormone is produced
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salt deficit
low blood volume low BP |
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____ is a vasoconstrictor, will decrease the diameter of all of my blood vessels, will increase blood pressure (faster response, will be able to continue to oxygenate my brain, until blood volume can be increased)
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Angiotensin II
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Remember rule wherever sodium goes, ____
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water follows!
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_____ is an agonist with adh, will help conserve water
Steroid hormone Rember sluggish, secreted by the adrenal cortex Stimulated by low blood volume, same trigger as adh, or low sodium! _____ will trigger the kidneys to release more sodium and the water will follow it, so reabsorb it ____ also promotes potassium secretion (out of body) If released chronically lead to lots of salt-water imbalances |
aldosterone
aldosterone aldosterone |
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____ -
Is a steroid hormone secreted by adrenal cortex Helps maintain blood volume & pressure through reabsorption & retention of salt and water Release stimulated by salt deprivation, low blood volume and pressure |
Aldosterone
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____, released to conserve blood volume, conserve water
Anti/Opposite of diuretic |
Adh - antidiuretic hormone
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Dehydrated or high salt intake, will increase ____ - due to either more salt or less water in blood (high amounts of ____)
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blood osmolality
solute |
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____ respond to a change in solute concentration
If they determine blood osmolality is increased they will send a signal to post pituitary to release ____ |
osmoreceptors
ADH |
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____ - increases water retention or water reabsorbtion in the kidney
____ - sends a signal thirsty!, hopefully drink water and help with blood volume |
ADH
Hypothalmus |
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The ____ an organ clears waste products out of our system. regulates blood volume, drink too much fluid, more urine, dehydrated less urine
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kidney
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____, often just use the term blood pressure
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Map = mean arterial pressure
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Say we have a hemorrhage or lost blood
Low blood volume due to blood loss, low bp One of the things to do is increase fluid absorption from the ____, shut down ____ no urine output |
interstitial fluid
kidneys |
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If they detect a ____, one thing can do is ____, will increase volume loss
Hopefully lowering blood volume can ____ Can also detect ____, same mechanism - trigger ____ to increase output |
higher BP
increase urine output lower BP increased blood volume kidneys |
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Baroreceptors - ____
One place is monitoring pressure right as blood is leaving the heart - ____ Also have ____ - blood going to the brain |
pressure sensor
aortic arch baroreceptor carotic baroreceptors |
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Lose blood volume out of our body-
Loose blood volume, in turn lose blood pressure Everything decreases w/ less ____ The biggest problem is lose enough ____ to the point that there is not enough for the ____, so little to no blood delivery to ____ and ____ |
blood volume
volume heart to pump heart brain |
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____ helps maintain interstitial fluid balance, and it will help fight off infection (at the ____ they are going to store white blood cells which can attack foreign particles)
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lymph system
lymph nodes |
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Lymphatic a system of ____
Helps flush out toxins Blood capillaries also site of fluid exchange with the lymph capillaries Groups of lymph ____, in addition to series of lymph ____ |
vessels
nodes vessels |
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Always a slight disruption between ____ and ____ in the capillaries
____ will pick up the extra, but they return that fluid at the veins For circ system a ____ for maintaining blood volume |
filtration
absorption lymphatic vessels catchall |
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Increasing venous return -
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Increases EDV
Increases stroke volume Increases cardiac output/oxygen delivery |
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Veins have several "tricks"
Have to travel against ____ to get back to heart ____ - can help squeeze veins to help propel the blood back toward the heart Veins have ____, one way swinging doors, a pressure mechanism to push them open and swing shut when the pressure below is less, to prevent ____ |
gravity
skeletal muscles one way valves backflow |
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As we age these venous valves weaken (need to prop up grandmas feet)
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Decreases oxygen delivery
Net filtration pressure decreases Interstitial fluid increases |
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At any given time more of your blood volume is tied up in your veins
Since it Is a lower pressure system, need larger ____, ____ |
volume
approx 60% |
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____ - is the pressure in the capillary, water pressure pushing out
____ - is all the solutes in the capillary, drawing fluid in ____ -water pressure outside (interstitial fluid) pushing toward capillary ____ - acting osmotic ally pulling fluid toward the interstitial fluid |
Pc
∏c Pif ∏if |
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Positive = ____
Neg = ____ P is for ____ ∏ is for ____ |
arterial
venous plasma protein |
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____ - is the movement of fluid and solutes out of the blood (in this chapter)
____ - move something (fluid or solutes) back into the blood ____ - moving fluid or solutes out of my body |
filtration
absorption secretion |
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Net filtration pressure = ____
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Pc + ∏if - Pif - ∏c
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1st rule -
2nd rule- |
net filtration pressure is positive at the arterial end of a capillary (want to push things out of the blood to the tissues)
net filtration pressure is negative at the venous end of a capillary (fluid and solute are being absorbed into the blood) |
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In a healthy person, the protein levels should remain constant no matter where you are along the capillary
Also interstitial fluid should remain constant So the only thing that changes is the hydrostatic pressure in the capillary |
net filtration pressure
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Make a point of the ____ surface area is so tremendous - basically every cell in our body will have direct access to a capillary, every cell needs ____ and ____ (oxygen, co2, glucose) so have tremendous surface area and is a ____ system, and no muscle cell in capillaries
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capillary
nourishment waste disposal low pressure |
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If fast/high pressure would not have time for transfer and would burst those very thin ____ walls
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capillary
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____ -Oxygen rich blood vessel, see oxygen and co2 traveling down their ____. Other main molecule is ____, our main energy source
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capillary system
concentration gradients glucose |
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As the blood vessels get larger and larger, larger ____ blood vessels are going to be larger in ____, but also have a higher pressure, so have ____ so have ability to change pressure
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oxygen rich
diameter smooth muscle |
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As blood vessels get larger and larger on the ____ side they increase in ____ too, but are carrying blood at a lower ____ (think lazy river) so not have the same thick ____ layer
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oxygen poor
diameter pressure muscle |
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What affects blood pressure?
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Plaques narrowing diameter of artery, affect BP negatively
(anytime you narrow the diameter of an artery you are increasing BP, like putting thumb over portion of your water hose) |
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Capillary site of gas exchange, at tissues oxygen will diffuse down ____ and co2 across its ____
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gas exchange
concentration gradient concentration gradient |
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How it is being measure the "old fashioned way"
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Basically squeeze the arm hard, basically squeezing shut that main artery down that forearm
Increased pressure, no sound literally closed off blood flow, slowly release pressure Top number is when they first hear sounds, pressure is released just enough to start hearing sounds rushing through Keep on releasing pressure, until pressure is completely off - wait to hear nice blood flow (no traffic jam sounds) |
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BP standard -
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120/80 standard but a wide range of normal
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One exception! In ____ - heart is beating so
fast that there is no filling time between beats, so cardiac output actually decreases |
ventricular fibrillation
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___: norepinephrine delivery from sympathetic neurons, and epinephrine delivery from adrenal medulla (reduce parasympathetic).
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To increase HR, increase
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____ - end-diastolic volume, norepinephrine delivery from sympathetic neurons, and epinephrine delivery from the adrenal medulla.
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To increase SV, increase
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If heart is conditioned by ___,
The heart rate can drop, so ____ Increases, more filling more stroke volume More ____ delivery |
regular exercise
filling time oxygen |
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The more time the heart spends in relaxation, the more filling time it has, so it will have an increased ____, increased ____ will have increased ____
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EDV
EDV stroke volume |
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To further increase oxygen delivery to tissue, can increase stroke volume,
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Increase delivery of epinephrine and Norepinephrine
If you exercise/condition heart muscle it will contract more forcefully and that will increase stroke volume Can temporarily have actin and myosin in heart muscle align optimally, to increase contractilaly strength |
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Mechanisms for speeding or slowing heart rate for bodies needs
Speeding up heart for - Mechanisms - decrease parasympathetic and increase sympathetic Increase epinephrine, from the adrenal gland, act like norepinephrine Acts to increase heart rate |
Exercise
Fever Change positions, lying down and then quickly stand up |
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Mechanisms for speeding or slowing heart rate for bodies needs
Mechanisms - ___ - Acts to increase heart rate |
decrease parasympathetic and increase sympathetic
Increase epinephrine, from the adrenal gland, act like norepinephrine |
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Piece of cardiac cycle, to get a sense of what is going on with pressure over time
We mentioned 4 components in the cardiac cycle already ____ during relaxation ____ with contraction ____ = all 4 valves are closed and blood volume does not change in any of the chambers |
ventricular filling
ejection isovolumetric |
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Pieces of cardiac cycle -
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Ventricular Filling
Isovolumetric ventricular contraction Ventricular ejection Isovolumetric ventricular relaxation |
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Another way to calc stroke volume - ____
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SV = EDV-ESV
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____, largest volume the left ventricle sees
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EDV
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____ - amount of blood ejected with each contraction
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Stroke Volume
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____ - Lowest amount of blood volume ventricles see
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ESV (End systolic volume)
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Prolonged refractory period = ____
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cannot get tetanus
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____ is the primary pacemaker, but do have backup ____
Have backup cells if it gets damaged |
SA node
pacemaker potential |
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Action potential traveling-
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SA node
AV nod Down Bundle Branches Purkinje fibers - now contraction occurs At Rest |
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The ____, the _____ occurs prior to the muscle contraction
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action potential
electrical stimulation |
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____ - measures the electrical activity of the heart
Not what waves measure electrically - but also whats happening in the heart in the intervals between the waves |
ecg/ekg
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The valves between chambers are connected to the ventricles by the ____ in the figure - (____) help keep the valves opening and closing at regular intervals
Can get ____ and ____ over time (burping into atria) |
white tendons (chordae tendineae)
damaged stretch out |
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Left side of the heart is on right side of the paper, looking down on the paper, left side is ____, left side is ____
and has a more muscular appearance ____ - high pressure ____- low pressure ____ has to blast that blood all over the body ____ just has to send that blood gently next door to the longs |
Oxygen rich
bigger LS RS Left side Right side |
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Typically arteries are oxygen rich and veins oxygen poor
2 exceptions - |
pulmonary veins
pulmonary arteries |
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____ - coming to heart from the lungs so they are oxygen rich
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pulmonary veins
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____ - are going to the lung from the heart so they are oxygen poor
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pulmonary arteries
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Heart is composed of 3 main layers -
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endocardium
myocardium epicardium |
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Innermost (blood facing) ____ layer - basically and endothelium, easily sloughed off and replaced
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endocaridum
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Middle layer (muscle layer) ____, contractile part of the heart
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myocardium
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Outer layer, ____ - connected to the pericardium, a strong connective tissue to protect the heart
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epicardium
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bicuspid or ____ valve
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mitral
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____ - narrowing, congenital or heart attack
Blood backing up to left ventricle Left ventricle enlargement Decrease stroke volume, blood cant squeeze out |
Aortic stenosis
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____ - damaged valve, possibly heart attack
Leads to blood burping back down into the left ventricle |
Aortic insufficiency
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Aortic stenosis and insufficiency -
Issues with the ____ side of the heart Problem with the ____, valve between ____ and the aorta |
left
aortic semilunar valve left ventricle |
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____ - blood pops back up to left atria
Decrease stroke volume a little bit Decrease the pressure that left ventricle can build up, decrease force you can send blood on through to the aorta |
Mitral insufficiency
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____ - often hereditary (born with it)
Have to do with valve not closing correctly, flaps overlapping a little bit, or not meeting etc Same problem as mitral insufficiency (blood back to left atria) (really just a congenital mitral insufficiency) Often don’t know you have it Sometimes a skipped beat.. Often don’t do anything unless really irregular heart beat |
Mitral valve prolapse
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Can do ____ of heart to see if valves functioning appropriately
Can do ____ to look at it... |
sonograms
ecg |
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Or ____, where valve is slightly narrow (congenital means born with it) heart attack, scar tissue builds up
Like a traffic accident, blood starts backing up right above the narrow spot - left atrium Left atrial enlargement Left ventricle gets less blood, so stroke volume decreases |
left AV stenosis
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____ - spontaneously depolarize at approximately 100 per minute
At rest heart is under control of parasympathetic (because want to slow it down a bit) |
Pacemaker cells
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____ - how it travels through the heart (sequence)
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Cardiac action potential
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Right atrial wall - ____ - group of pacemaker cells
1st structure for action potential generation in the heart |
sinoatrial node, SA node
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Want heart muscle to contract as a unit and want contraction to contract starting at the ____
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bottom
(think squeezing toothpaste from the bottom) |
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Differences between cardiac and other skeletal action potential etc!
Addition of ____ increase the refractory period which means cannot get a sustained contraction (no tetanus) Similarities - sodium enters, depolarizes Potassium channels are slower causes repolarizes |
voltage gated calcium channels
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____ - atria is sending far too many action potentials, and often not synchronous, meaning the atria is not contracting as a unit- messing with the regularity of the heart rate and preventing the
Ventricles from filling up appropriately |
Atrial fibrillation
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How it is being measure the "old fashioned way"
Basically squeeze the arm hard, basically squeezing shut that ____ down that forearm Increased pressure, no sound literally closed off ____, slowly release pressure Top number is when they first ____, pressure is released just enough to start hearing sounds rushing through Keep on releasing pressure, until pressure is ____ - wait to hear nice blood flow (no traffic jam sounds) |
main artery
blood flow hear sounds completely off |
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In a healthy person, the ____ should remain constant no matter where you are along the capillary
Also ____ should remain constant So the only thing that changes is the ____ in the capillary |
protein levels
interstitial fluid hydrostatic pressure |
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To increase ____, increase - end-diastolic volume, ____ delivery from sympathetic neurons, and ____ delivery from the adrenal medulla.
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SV
norepinephrine epinephrine |
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Heart sounds (lub dub) - what you hear are the ____
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valves closing,
slamming shut |
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1st lub is the ____ slamming shut
2nd lub is the ____ valve close |
av valve
semilunar |
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Brief moment where all ____ are closed
(blue vertical band on chart above) Any pressure changes that occur at the point ____ Ventricular contraction 1st and and relaxation 2nd |
4 valves
Are isovolumetric (blood volume does not change) |
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_____ -
Semilunar valve - between the aorta and ventricle (responds to pressure) Once bp in the left ventricle increases above the pressure in the aorta it will open the aortic semilunar valve (once pressure in ventricle is above pressure in the aorta it will fling open valve and blood will surge into aorta - Once pressure drops below aortic pressure the valve slams shut Creates a dichotic notch - that slight bump |
Aortic pressure
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Pressure as it relates to ventricular volume and the ecg
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Atrial depolarization occurs and this triggers atrial contraction - blood will enter the ventricle, ventricular depolarization which corresponds to tremendous increase in ventricular pressure
Ventricle relaxation triggers decrease in ventricular pressure Expect volume to be highest at the end of relaxation (right before contraction) Ventricles have relaxed and are filled with blood QRS wave will signal/trigger contraction which will increase pressure and force blood out of the left ventricle (blood volume in left ventricle plummets) At the end of the contraction - get the drop in pressure, the relaxation, get the systolic volume - amount of blood left in ventricles after relaxation |
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____ means relaxation
BP 120/80 means, pressure vessels are putting out ____ = 120 ____ = 80 |
Diastole
Systole Diastole |
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____ means contraction
(atrial or ventricle contraction) ____ occurs as a unit - right and left atria or right and left ventricle |
Systole
Contraction |
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____ - ventricles contracting too fast - not efficient at all, very low oxygen, asynchrony of contraction
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Ventricle fibrillation
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____ = depolarization of the muscle cells in the atria
Atria depolarization - assume this leads to atrial contraction (this happens somewhere in the PQ interval) |
P wave
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___ - spike
Ventricular depolarization Trigger ventricular contraction |
QRS complex/wave
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____ - ventricular repolarization
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T wave
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Approx ____ seconds from ____ wave to ____ wave (at rest - no exercise)
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.8
p wave p wave |
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____ is being hidden/masked under the QRS
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Atrial repolarization
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Approx ___ seconds for the QT interval - if longer think about ____ or ____
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.4
blockage miscommunication |
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At hookup to ecg - looking for ____
Sometimes looking at the intervals. |
nice even pattern
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The interval between the ____ and the ____ should be less than ____ seconds.
If its taking longer something is blocking that flow of information, something is increasing the communication time between the ____ and those bundled branches (____ etc) |
p
QRS .2 seconds SA node scar tissue |
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Heart Valves -
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Right (tricuspid) AV valve
Pulmonary Semilunar Valve Left (bicuspid) AV valve Aortic Semilunar valve |
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Pulmonary Vein back to the heart -
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Superior Vena Cava - on top, blood flow "down" to the right atrium
Inferior Vena Cava - on bottom, blood flow "up" to the right atrium |
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(EPIC)
Blood entering the right atrium,... |
blood goes through the right atrio ventricular valve (av) often called the tricuspid valve
Right ventricle Pulmonary semilunar valve, Pulmonary artery which branches right and left to lungs Lung capillaries - gas exchange will occur, oxygen poor blood will give up carbon dioxide and pick up oxygen Oxygen rich blood will eventually now get to pulmonary veins Left atrium Bicuspid AV valve Left ventricle Aortic semilunar valve Out to the aorta (main oxygen rich blood vessel) Branch into several main arteries and send oxygen rich blood to the body Branch finer and finer, systemic capillaries, oxygen exchange - dropping off oxygen and picking up carbon dioxide Bigger and bigger veins Finely superior and inferior vena cava that dump into the right ventricle |
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Blood from from Left Ventricle to Right Atria -
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Aorta
Arteries Arterioles Capillaries Venuoles Veins Vena Cavae |
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Blood from Right Atrium to Aorta-
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Right (tricuspid) AV valve
Right ventricle Pulmonary Semilunar valve Pulmonary artery Capillaries of lungs Pulmonary vein Left Atrium Left (bicuspid) AV valve Left Ventricle Aortic Semilunar valve |
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Backup pacemaker potential in the
AV node & bundle of His (if the SA node is damaged etc) But! They are slower AV node = ___ minute (vs 100 for SA) Bundle of his = ___ per minute |
50
30 |
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Issues w/ backup pacemaker -
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1st problem - lose parasympathetic
control - only have sympathetic 2nd with bundle of his as the ap You lose atrial contraction ability Which lowers stroke volume |
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Mitral =
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think mighty!, left strong side of the heart, the bicuspid valve into the left ventricle
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Whats happening ionically-
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Sodium will enter the muscle cell and depolarize it
Sodium channels are very quick Do not want to sustain a contraction! (bad lose blood flow) 3rd ion - voltage gated calcium channels Allows calcium to enter the cell - down its concentration gradient This prolongs the depolarization event - This extends the refractory period, which means I cannot! Have another action potential stimulating before a certain amount of time Potassium channels are opening slowly, potassium will exit or leave the cell slowly and this will repolarize the cell back down to resting and will not get the sustained contraction as before |
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QRS complex/wave - spike
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Ventricular depolarization
Trigger ventricular contraction |
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T wave -
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ventricular repolarization
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atrial repolarization -
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is being hidden/masked under the QRS
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P wave -
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depolarization of the muscle cells in the atria
Atria depolarization - assume this leads to atrial contraction |
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QRS wave will signal/trigger -
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contraction (left ventricle)
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