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126 Cards in this Set

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about ________of the heart lies on the left of the bodies midline.The pointed end of the heart is the ___________.
2/3's,,,apex
The heart rests on the diaphragm near the midline of the cavity.It lies in the ________,a mass of tissue that extends from the sternum to the vertebrel column.
mediastinum
The membrane that surrounds and protects the heart is the _________??
pericardium
The pericardium consists of two parts________and__________>
fibrous and serous
The fibrous pericardium is a tough _______,________irregular _________ tissue.
inelastic,,dense,,connective
The serous pericardium forms a double layer called ::outer_________::inner________
parietal<<visceral
the visceral layer is also called the______
epicardium
Because the pericardium cannot strech the buildup of fluid compresses the heart. this is known as_________-
cardiac tamponade
The inner most wall of the heart is called _______
endocardium
The heart has four chambers. The 2 superior chambers are called ________and the 2 others___________.
atria,,,,ventricles
On the the anterior surface of each atria is a pouchlike structure called_________.
auricle
The deep________ sulcus encircles most of the heart and marks the boundry between the atria and the ventricles.
coronary
The vertical sulcus of the heart is called___________
anterior intreventricular sulcus
The right atrium receives blood from _________,__________and the____________.
inferior vena cava,superior vena cava, coronary sinus
In the right atrium the anterior wall has__________(muscular ridges) and the posterior walls are ___________
pectinate muscles, smooth
Between the left and right atrium is a thin partition called____________with a depression in it called________
interatrial septum, fossa ovalis
Insid e the right ventricle is a series of ridges called__________
trabeculae carneae
The cusps of the tricuspid valve are connected to__________which in turn are connected to THe_______________>
chordae tendineae, papillary muscles
blood passes through the _____and goes to a large artery called the___________
pulmonary valve,pulmonary trunk
The left atrium reiceves blood from the ________thru 4 ___________.
lungs, pulmonary veins
blood passes thru right atrium to ventricle thr___________valve
bicuspid(mitral)
blood from the left ventricle passes thru __________into the largest artery of the body called_________
aortic valve ,ascending aorta
during fetal life the tempory blood vessel from pulmonary trunk to aorta is called____________< after birth turns to tendon called_______
ductus arteriosis,ligamentum arteriosum
The heart wall also contains dense connective tissue called______
the fibrous skeleton of the heart
vales open and close in response to ______.the bi and tricuspid valves are known as ___________
pressure changes,atrioventricular(AV) valves
The aortic and pulmonary valves are known as ________.Failure of a heart valve to close is__________to open _______
semilunar (SL) valves, insuffiency or incompetence, stenosis
when one or more valves of the mitral valve extend into the left atrium it is called _______
mitral valve prolapse(MVP)
rheumatic fever most often damages the _____valve.
mitral
The left side of the heart is the pump for the _______circulation and the right is for the __________circulation
systemic, pulmonary
The deoxygenated blood then drains to vascular sinus on the posterior of the heart called________from the great cardiac vein and the middle cardiac vein
coronary sinus
___________reestablishing blood flow to the heart may damage tissue further due to ______________
reperfusion, free radicals
The intercalated discs of contain _________, which hold the fibers together and__________, which allow muscle action potentials to conduct from one muscle to another...__________are larger and more numerouse in cardiac fiber.
desmosomes,gap junctions,Mitochondria
The transverse tubules of cardiac muscle are wider but less abundant(located at the Z disc and the________of the cardiac muscle is smaller than of skeletal muscles as a result the cardiac muscle has a somewhat smaller reserve of _____..
sarcoplasmic reticulum ,,,,Ca++
The heart has a specialized network of electrical fibers called______.these fibers are automatic generated. They act as the ______and they form the ______, a network of specialized fibers that provide apath for each cycle of the heart.Coordinated chambers(effective)
autorhythmic fibers,pacemaker,,conduction system
The heart has a specialized network of electrical fibers called______.these fibers are automatic generated. They act as the ______and they form the ______, a network of specialized fibers that provide a path for each cycle of the heart.Coordinated chambers(effective)
autorhythmic fibers,pacemaker,,conduction system
Normal cardiac Impulse production begins in the ________,located in the right atrial wall,inferior to the opening to the ______.Sa node cells do not have a stable resting potential. Rather they _______ to threshhold spontaneously.
SA node, superior vena cava,depolarize
The spontanous depolarization is a ________,Each action potential from the sa node propagates throughout both atria via __________in the intercalated discs
pacemaker potential,gap junctions
The action potential then reaches the _______located in the septum between the two atria,anterior to the coronary sinus opening.Then the action potentialenters the _____________.This bundle is the onlu site where the action potentials can conduct to the ventricles.Elsewhere insulated)
Atrioventricular node(AV),,,,atrioventricular(AV) bundle,bundle of hiss,,,,,
Then the action potential enters both the left and right ________.The _________extend through through the interventricular septum toward the ______of the heart.
bundle branches,bundle branches, apex ```
finally the large diameter __________rapidly conduct from the apex upward toward the remainder or the ventricular myocardium
Purkinje fibers
Nerve impulses from the autonomic nervous system(ANS) and blood borne hormones like___________ modify the timing and strenth of the heart but not the esablished_________.
epinephrine, rhythm,(SA Node normal pacemaker at 100 times per minute)
ACETYcholine released by the parasumpathetic division of the ANS slows the SA node pacing to about_______ action potentials per minute ..
75
If the Sa node is damaged the AV node can take over but the rate of spontaneoous depolarization is about________ per minute, IF both nodes screw up then the bundles or the Purkinje fibers will take over at_________ beats per min.Normal rythym can be restored by a ____________.
40 to 60 beats ,20 to 35 ,pacemaker
When a site other than the SA node becomes the pacemaker it is called an _________
ectopic pacemaker
The working atrial and ventricular fibers are called ____________.These _______fibers depolarize at -_______mV.
contractile fibers,-90mV(let Na+ in)
the second phase of action potential in a contractile fiber is the ________, aperiod of maintained depolarization in part to the slower Ca++ channels, At the same time permeability to K+ decreases due to channels closing.
plateau
depolarization of a muscle fiber is ____ due to this Plateau
briefer
repolarization occurs when the ________channels open and let ______ out restoreing the negative resting potential(-90mV)
voltage-gated K+ channels, K+
The electrical activity (action Potential) leads to the mechanical response (contraction) after a short delay. As Ca++ concentration rises inside a contractile fiber,Ca++ binds to the regulatory protein_______which allows ____and ______ filaments to begin sliding past one another.(contraction)
troponin,,actin ,myosin
________ for example increases contraction force by enhancing the Ca++ flow into the cytosol
Epinephrine
________ for example increases contraction force by enhancing the Ca++ flow into the cytosol
Epinephrine
the time period during which a second action potential cannot be triggered is _________.As a result contraction cannot begin until relaxation is well underway . 'for this reason_________ cannot occur in cardiac muscle as it can in skeletal.
refractory period, tetanus
the oxygen is released from _______inside the cardiac fibers.AT rest the atp in heart comes from ______and ________.during exercise the heart uses ____________ from skeletel muscles.
myoglobin, fatty acid, glucose,lactic acid
like skeletel muscle the heart also produces atp from creatine phosphate.One sign that a heart attack ___________has occurred is the presence of ______________ in the blood.Injured or dying muscle release ___________.
myocardial infarction,creatine kinase,creatine kinase
an ecg or ekg can determine if _________,___________,and___________
if the conducting pathway is abnormal,if the heart is enlarged, if certain areas of the heart are damaged
In a typical Lead II record (right arm to left leg) three clearly recognizable waves appear with each beat. The first called the _______ is a small upward deflection on the ekg.The _______ represents atrial depolarization.
P wave
The second wave called the ________begins as a _____ deflection continues as alarge upright triangular wave and ends as a downward wave. this second wave is____________.
QRS complex, downward, rapid ventricular depolarization
The third wave is a ______shaped upward deflection called a ___________.It indicates ____________
dome, T wave,ventricular repolarization
larger P waves indicate________:an enlarged Q wave may indicate_________and an enlarged R wave generally indicates__________.When the heart is receiving insuffient O2(coronary artery disease)the _______is flatter than normal
enlarged atrium, myocardial infarction, enlarged ventricles ,T wave
analysis of EKG involves measuring time spans between waves called____ or _____
intervals segments
About _________sec. after the onset of The ____wave,The action potential has propagated through the bundle branches ,Purkinje fibers,and the entire ______________.Depolarization progresses down the septum,_________from the apex and outward(endocardial surface),producing the _________complex>
.2 sec,,,P,,,,ventricular myocardium,,,,,,upward,,QRS complex
At the same time the depolarization of the contractile fibers is going on __________repolarization is ocurring.Because the QRS complex is going on ;the EKg does not pick up the __________repolarization.
atrial,,,atrial
The __________begins shortly after the QRS complex and continues during the ___________ segment.Repolarization of the ventricular contractile fibers begins at the apex and spreads thru myocardium this is called the _____ wave in the EKG.
Ventricular systole(contraction),,,S-T segment,,,,T wave
shortly after the T wave begins ,the ventricles start to _____(________).By ______of a second ventricular repolarization (from beginning of P wave)is complete and ventricular fibers are_________.At______sec the P wave appears again>
relax(ventricular diastole),,,0.6 sec,relaxed,,0.8sec (these figures are for a heart beating at 75 beats per min))
`
the pressures given in the picture in the book(681)apply to the left side :pressures on the right side are considerably ______________.
lower
During ________,which lasts about0.1 sec.,,the atria are contracting.at the same time the ___________are relaxed>
atrial systole,,,,ventricles
atrial systole contributes a final ______mL of blood to the volume already in each ventricle _________.the end of the atrial systole is also the end of the__________diastole. thus each ventricle contains about ____ of blood at the end of its relaxaation period______(diastole).
25mL,,,105mL,,ventricular,,130ml
The _________ marks the onset of ventricular depolarization.full blood volume in the ventricles is called______.
QRS complex,end-diastolic volume(EDV)
Ventricular systole::
during ____________, which lasts about .3 sec.,the ventricles are contracting.At the same time the _______ are relaxed ;termed(_________)
ventricular systole,atria ,,atrial diastole
when both the semilunar and the AV valves are closed ,cardiac muscles fibers are exerting force but not shortening(can't shorten because of closed valves)and volume remains the same .This is called_______.
isovolumetric contraction
When left ven. pressure surpases aortic pressureand right ven. pressure rises above the pulmonary trunk pressure both ________valves open.This period is called _______________
semilunar, ventricular ejection
the ventricles ejects about _______mL of blood and left in ven is about _______mL.this left in ven. blood called____________.the volume ejected per beat is called_____________.
70 ,,,60,,,,end systolic volume,ESV,,Stroke volume
the _______wave marks the onset of ventricular repolarization.
T wave
during the relaxation period 0.4sec. both atria and ventricles are relaxed.as the heart beats faster the relaxation period gets ________and _______whereas the _________of the__________and ___________shorten only slightly.
shorter,,durations, atrial s ystole,ventricular systole
rebound of blood off the closed semilunar in the aorta produces the ________ on the aorta pressure curve.
dicrotic wave
_______ is the act of listening to the sounds in the body.
auscultation
The first sound the ________ is longer and louder than the second sound It is caused by blood turbulance associated with the closure of the _________valves.
lubb,,atrioventricular (AV)
the second sound the _______which is ____ and not as loud as the first.is caused by blood turbulance associated with the closure of the __________valves.
dupp,,,shorter ,,,sl
a________is an abnormal sound (rushing clicking gurguling)most often indicating valve disorder
heart murmur
__________ is the volume of blood ejected from each ventricle per minute
cardiac output
Cardiac output =______________*__________
stroke volume (70mL)* HR
Typical cardiac output per minute is equal to the __________volume of the person>__________is the difference between a persons maximum volume Per min.(cardiac output)and cardiac output at rest.
total,,,cardiac reserve,,,((average is 4 or 5 times)
three factors regulate stroke volume and insure that left and right volume are =1._________2.__________3.__________
preload, contractility, afterload
_________ is the degree of stretch on heart before contraction.the more the heart fills with blood during diastole the greater the force of systole.This is known as___________
Preload....Frank-Starlings law of the heart
Two factors determine the EDV1________2__________( the volume of blood returning to right ventricle.
1. the duration of ven. diastole 2. venous return
at rapid heart rates (160 BPM) stroke volume usually ________due to short filling times.(making preload smaller)
declines
The _____________equalizes the left and right ven.
Frank-Starling law of the heart
The second factor that influences stroke volume is myocardial_______,which is the strenth of contraction at any given preload.Substances that increase contractility are__________;decrease__________.
contractility,positive inotropic agents ,,negative inotropic agents
hormones such as _____,____and _________;and___________are positive inotropic agents
epinephrine,norep.,digitalis,stimulation of ANS (Sympathetic division),
Negative inotropic agents would be ______,________,______,and_________
inhibition of the sympathetic division of ANS ,anoxia,acidosis,anesthetics(halothane),increased levels of K=
___________ are drugs that have a negetive inotropic effect by reducing Calcium inflow.
calcium channel blockers
the pressure that must be overcome before a semilunar valve can open is termed the __________
afterload
conditions that can increase afterload are _________and _________.
hypertension, atherosclerosis
When the heart is a failing pump it is called ____________.These can result from__________,__________,_________,_______and __________
congestive heart failure,,,coronary artery disease,congenital defects, long term high blood pressure,myocardial infarctions and,valve disorders.
If too much blood stays in the ventricles increased preload leads to increased force of contraction,but as the preload increase further the heart is __________and it_________less forcefully,the result is a potentially lethal__________feedback loop.
stretched and contracts,positive
If the left ven. fails first blood backs up in________and causes _________fluid accumulation in _______that can suffocate a person.
lungs, pulmonary edema,lungs
if the right ven. fails; first blood backs up in the systemic veins.(The kidneys cause an increase in blood volume,)the result is called_________and is most noticeable in the feet and ankles.
peripheral endema
the most important factors that contribute to the regulation of the heart rate are __________and________,and __________from the ____________.
ANS,epinephrine and norepinephrine,adrenal medulla
the ________ in the __________increases or decreases the frequency of nerve impulsesin both the__________and the ______ branches of the ___________.
cardiovascular center ,medulla oblongata,sympathetic and parasympathetic,ANS
heart rates may climb in preporation for anticipated events from the _______to the ___________ in the medulla
Limbic cardiovascular center
the sensory receptors that provide input to the heartrate are__________<__________and_________.
propriocepters(position of limbs),chemorecptors(chemical changes(CO)),baroreceptors(monitor stretching in arteries)
From the thoracic region of the spinal chord sympathetic__________extend out to the SA node<AV node and most portions of the myocardium.Impulses from these nerves trigger the release of __________,which binds to _______ receptors on the heart.
cardiac accelerator nerves, norepinephrine,beta-1
Norepinephrine release has 2 results 1. _______and _______ node fibers speed depolarization,2.enhances _______entry thereby increasing contractility.
SA ,AV,Ca++
Subtracting one ______from _______ provides a good estimate of ones maximum heartrate
age from 220
Parasympathetic nerve impulses reach the heart via the right and left ________.These axons terminate in the ________,________andthe__________.They release___________,which decreases the heart rate by slowing depolarization.
vagus (X)nerves,sa node, av node and atrial myocardium,acetylcholine
At rest __________stimulation predominates and slows the __________of the SA node.
parasympathetic,autorhymic rate
one sign of hyperthyroidism is __________,an elevated resting heart rate.
tachycardia(thyroid hormones elevate heartrate)as well as e and Nore from the medulla.
Elevated blood levels of K+andNa+_______heartrate. And a moderate increase in _______level speeds up heart rate.
decreases,Ca++
A resting heartrate under 60 BPM's is called _____???._________in body temp ________heart rate._________is a term of decreasing heartrate by lowering body temp
bradycardia,Increase, Increases,Hypothermia
help for failing hearts is given with____,____,and________
heart transplants,cardiac assist devices,artificial hearts
contractions of the primitive heart begin by the end of the _________.
third week
Risk factors for CAD( coronary artery disease) are_____,_____,______,_____,______
high cholesteral,high blood pressure,smoking,obesity,diabetes mellitus,type A personality, and nonexercise
__________is hardening of the arteries,one form is _________characterized by formations of lesions called _____________
arteriosclerosis,atherosclerosis,atheriosclerosis plaques
atherosclerosiss caused by high _____ levels,__________,____________,_________and high blood glucose from ___________.
LDL,,cytomegalovirus,high blood pressure,co(cigarettes),diabetes mellitus
A _________may dislodge from a clot formation and cause a __________
thrombosis,embolus
______ is an invasive process used to look at the hearts coronary arteries,chambers,valves,and great vessels
Cardiac catherization
___________is another invasive procedure in which a cardiac catheter is used to inject radiopaque contrast medium,for visualization of heart .Or for injecting clot dissolving drugs_______or____________
cardio angiography,streptokinase,t-PA
_______________is a surgical procedure in which a blood vessel from another part of the body is grafted to a coronary artery to___________ an area of blockage.
Coronary artery bypass grafting,bypass
____ _____ ____ ______is the term for a tube that is inserted into the artery of an arm or leg and then gently guide to a coronary artery where a _________smashes the plaques against the wall.this usually fails then a______is needed
percutaneous translumenal coronary angioplasty,stent
_______is a severe pain in chest that normally accompanies ____________
angina pectoris, myocardial ishemia(partial obstruction to the coronary arteries)
besides killing heart tissue a _________ may disrupt the conduction system and cause________.
infarction, ventricular fibrillation,
in some babies the _____________may remain open and the aortic blood gets pushed into the lower pressure pulmonary trunk causeing overwork of both ven.
dutus arteriosis_(condition called- Patent ductus arteriosus)
ductus arteriosus
the normal rhythm of heart by SA node is called_____________. an abnormal rhythm is called ______or_______
normal sinus rhythm, arrhythmia or dysrhythmia
_________ is a serious arrhymia which conduction is slowed or blocked. with complete AV block the contractions will be less than_________BPM.
heart block,40
___________ is the most deadly arrhythmia in which contractions in the ven. are completely asynchronous. A procedure known as ____________ in which a strong brief electrical current is supplied to stop it.
ventricular fibrillation, defibrillation
_________is heart enlargement
cardiomegaly