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36 Cards in this Set

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Normal blood flow through the hearts
Left: Oxygenated blood arrives from the pulmonary circulation via pulmonary vein→enters LA→mitral valve→LV→aortic valve→systemic circulation.
Right: Deoxygenated blood arrives from the systemic circulation→enters the RA→tricuspid valve→RV→pulmonic valve→pulmonary artery→lungs to pick up oxygen.
Heart valves
RA→tricuspid valve→RV
RV→pulmonic valve→pulmonary artery
LA→mitral valve→LA
LV→aortic valve→systemic circulation.
Major vessels that supply the heart
Left Main (LM)
Left Anterior Descending (LAD)
Right Coronary Artery (RCA)
Right Posterior Descending (PDA)
Circumflex (Circ) (around back)
**note arteries originate from Aorta
Veins: Coronary Sinus
Main coronary arteries and where they are: Left Main (LM), Right Coronary Artery (RCA), Circumflex (Circ) (around back)
?
During which does blood fill the coronary arteries?
Diastole
Receptors: B1, B2, alpha
??
Normal blood flow through the hearts
Left: Oxygenated blood arrives from the pulmonary circulation via pulmonary vein→enters LA→mitral valve→LV→aortic valve→systemic circulation.
Right: Deoxygenated blood arrives from the systemic circulation→enters the RA→tricuspid valve→RV→pulmonic valve→pulmonary artery→lungs to pick up oxygen.
Heart valves
RA→tricuspid valve→RV
RV→pulmonic valve→pulmonary artery
LA→mitral valve→LA
LV→aortic valve→systemic circulation.
Major vessels that supply the heart
Left Main (LM)
Left Anterior Descending (LAD)
Right Coronary Artery (RCA)
Right Posterior Descending (PDA)
Circumflex (Circ) (around back)
**note arteries originate from Aorta
Veins: Coronary Sinus
Main coronary arteries and where they are: Left Main (LM), Right Coronary Artery (RCA), Circumflex (Circ) (around back)
?
During which does blood fill the coronary arteries?
Diastole
Receptors: B1, B2, alpha
??
influx of which electrolytes allows cardiac myocytes to contract?
Na+, Ca++, while K+ efflux
Where is the SA and AV node located?
the sinoatrial node (SA node), located in the right atrium.
the atrioventricular node (AV node), located in a bundle of tissues on the border between the right atrium and the right ventricle,
Under normal conditions, the heart rate is under PSNS or SNS control?
Under resting conditions, HR under PSNS control
What is a normal cardiac output (CO)?
blood pumped out/minute
‐normal is 5‐6 L/min
CO = HR x SV
The heart rate is simply the number of heart beats per minute. The stroke volume is the volume of blood, in milliliters (mL), pumped out of the heart with each beat. Increasing either heart rate or stroke volume increases cardiac output.
What is a normal ejection fraction (EF)?
Ejection fraction, or EF, is the proportion, fraction, or percentage of blood pumped out of your heart with each beat. A normal heart pumps out a little more than half the heart's volume of blood with each beat — a normal EF is 55 percent or higher.
CO= ________x________
CO = HR x SV
Normally, pressure is higher in which side of the heart?
Left ventricle
Controllable vs. uncontrollable risk factors: what’s the difference?
??
3 systems that transport blood
??
Artery vs. Vein: what is the structural difference, and what do they carry?
Arteries as resistance vessels
 Ability to vary lumen diameter
 ANS stim
 Inflammatory mediators
 Vasodilation = decreased systemic resistance = dec BP
 Vasoconstriction = inc systemic resistance = inc BP
 3 layers:
 Tunica intima
 Tunica media
 Tunica adventitia
Veins
 Capacitance vessels
 Decreased elastic tissue relative to arteries
 Same layers at arteries, less elastic tissue
 Act as a blood reservoir
 At rest 60% of the blood supply can be in the veins
 Liver and spleen as blood reservoir
 Veins and one-way valves
 Skeletal muscle contraction
What is lymphedema?
Lymphedema: normal flow of lymph is blocked or altered
Clinical presentation of lymphedema
Lymph collects in the interstitium: inflammation, hypertrophy of subQ adipose tissue,
fibrotic changes over time, congestion with thick, brown skin color
Blood Pressure: What is Autoregulation?
Autoregulation of the blood pressure refers to increasing and decreasing the blood pressure to meet the needs of the body without voluntary intervention or awareness.
What are the 4 mechanisms that can alter BP?
ANS input
 Balance between SNS and PSNS systems
 Baroreceptors (pressure receptor)
 aortic arch (where aorta leave heart)
 internal carotids (in the neck)
 Stimulated when the walls of the arteries are stretched by an
increased BP, Impulses from the baroreceptors inhibit the vasomotor
center in the brain, this leads to a vasodilation in the
periphery, and a drop in CO
 With decreased BP, the CNS activates a vasoconstrictor response
 Chemoreceptors
 decreased pH, increased PaCO2 or decreased PaO2 will stimulate the PSNS to decreased HR
and dromotropy, which will preserve myocardial function in
the face of hypoxia
 RAA and renal function
BP = ___________x_____________
BP = CO x PVR( total peripheral resistance)
Risk factors for CHD
Age. Simply getting older increases your risk
Sex. Men are at greater risk. However, the risk for women increases after menopause.
Family history.
Smoking. Nicotine constricts your blood vessels, and carbon monoxide can damage their inner lining, making them more susceptible to atherosclerosis.
High blood pressure. Uncontrolled high blood pressure can result in hardening and thickening of your arteries, narrowing the channel through which blood can flow.
High blood cholesterol levels. High levels of cholesterol in your blood can increase the risk of formation of plaques and atherosclerosis. High cholesterol can be caused by a high level of low-density lipoprotein (LDL), known as "bad" cholesterol. A low level of high-density lipoprotein (HDL), known as "good" cholesterol, also can promote atherosclerosis.
Diabetes. Both conditions share similar risk factors, such as obesity and high blood pressure.
Obesity.
Physical inactivity.
High stress.
Ischemia creates a context for injury via 3 mechanisms: what is the triad?
Ischemia creates a context for injury via
 Oxygen free radicals
 Excitatory amino acids
 Inflammation
Which intracellular electrolyte accumulates in the face of ischemia?
Ca++ Overload
HDL vs. LDL cholesterol
LDL = low density lipoproteins “bad cholesterol”
 Carries cholesterol to the cells
 Deposited in walls to become PLAQUE
 HDL = high density lipoproteins “good cholesterol”
 Picks up excess, unused cholesterol from the cells and
brings it back to the liver for processing
 Then taken out of body
What is the significance of foam cells in atherosclerosis?
Macrophages engulf lipidbecome FOAM
cells
“Foam cells” form fatty streaks… the first sign of problems
As the vessel lumen narrows: understand the of platelets, clotting cascade, thrombus risk
As the plaque grows and luminal diameter is decreased,
platelets cluster on the arterial wall and recruit more platelets,
such that a blockage can result and compromise blood flow
 Plaque ulceration
 Definitely recruits platelets
 Release of vasoactive amines which activate the coagulation cascade
 This can cause a thrombus to form (=blood clot which can narrow
the luminal diameter, but worse still can break off to form a floating
embolus)
Who is at greatest risk for a silent MI?
Risk factors
 HTN, DM, smoking, increased LDL, decreased HDL, genetic predisposition
What causes endothelial injury that leads to atherosclerosis?
?
Cardiac myocytes are able to store how much ATP?
How long can they withstand hypoxic conditions?
?