Heart

Front 1

about ________of the heart lies on the left of the bodies midline.The pointed end of the heart is the ___________.

Back 1

2/3's,,,apex

Front 2

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.

Back 2

mediastinum

Front 3

The membrane that surrounds and protects the heart is the _________??

Back 3

pericardium

Front 4

The pericardium consists of two parts________and__________>

Back 4

fibrous and serous

Front 5

The fibrous pericardium is a tough _______,________irregular _________ tissue.

Back 5

inelastic,,dense,,connective

Front 6

The serous pericardium forms a double layer called ::outer_________::inner________

Back 6

parietal<<visceral

Front 7

the visceral layer is also called the______

Back 7

epicardium

Front 8

Because the pericardium cannot strech the buildup of fluid compresses the heart. this is known as_________-

Back 8

cardiac tamponade

Front 9

The inner most wall of the heart is called _______

Back 9

endocardium

Front 10

The heart has four chambers. The 2 superior chambers are called ________and the 2 others___________.

Back 10

atria,,,,ventricles

Front 11

On the the anterior surface of each atria is a pouchlike structure called_________.

Back 11

auricle

Front 12

The deep________ sulcus encircles most of the heart and marks the boundry between the atria and the ventricles.

Back 12

coronary

Front 13

The vertical sulcus of the heart is called___________

Back 13

anterior intreventricular sulcus

Front 14

The right atrium receives blood from _________,__________and the____________.

Back 14

inferior vena cava,superior vena cava, coronary sinus

Front 15

In the right atrium the anterior wall has__________(muscular ridges) and the posterior walls are ___________

Back 15

pectinate muscles, smooth

Front 16

Between the left and right atrium is a thin partition called____________with a depression in it called________

Back 16

interatrial septum, fossa ovalis

Front 17

Insid e the right ventricle is a series of ridges called__________

Back 17

trabeculae carneae

Front 18

The cusps of the tricuspid valve are connected to__________which in turn are connected to THe_______________>

Back 18

chordae tendineae, papillary muscles

Front 19

blood passes through the _____and goes to a large artery called the___________

Back 19

pulmonary valve,pulmonary trunk

Front 20

The left atrium reiceves blood from the ________thru 4 ___________.

Back 20

lungs, pulmonary veins

Front 21

blood passes thru right atrium to ventricle thr___________valve

Back 21

bicuspid(mitral)

Front 22

blood from the left ventricle passes thru __________into the largest artery of the body called_________

Back 22

aortic valve ,ascending aorta

Front 23

during fetal life the tempory blood vessel from pulmonary trunk to aorta is called____________< after birth turns to tendon called_______

Back 23

ductus arteriosis,ligamentum arteriosum

Front 24

The heart wall also contains dense connective tissue called______

Back 24

the fibrous skeleton of the heart

Front 25

vales open and close in response to ______.the bi and tricuspid valves are known as ___________

Back 25

pressure changes,atrioventricular(AV) valves

Front 26

The aortic and pulmonary valves are known as ________.Failure of a heart valve to close is__________to open _______

Back 26

semilunar (SL) valves, insuffiency or incompetence, stenosis

Front 27

when one or more valves of the mitral valve extend into the left atrium it is called _______

Back 27

mitral valve prolapse(MVP)

Front 28

rheumatic fever most often damages the _____valve.

Back 28

mitral

Front 29

The left side of the heart is the pump for the _______circulation and the right is for the __________circulation

Back 29

systemic, pulmonary

Front 30

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

Back 30

coronary sinus

Front 31

___________reestablishing blood flow to the heart may damage tissue further due to ______________

Back 31

reperfusion, free radicals

Front 32

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.

Back 32

desmosomes,gap junctions,Mitochondria

Front 33

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 _____..

Back 33

sarcoplasmic reticulum ,,,,Ca++

Front 34

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)

Back 34

autorhythmic fibers,pacemaker,,conduction system

Front 35

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)

Back 35

autorhythmic fibers,pacemaker,,conduction system

Front 36

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.

Back 36

SA node, superior vena cava,depolarize

Front 37

The spontanous depolarization is a ________,Each action potential from the sa node propagates throughout both atria via __________in the intercalated discs

Back 37

pacemaker potential,gap junctions

Front 38

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)

Back 38

Atrioventricular node(AV),,,,atrioventricular(AV) bundle,bundle of hiss,,,,,

Front 39

Then the action potential enters both the left and right ________.The _________extend through through the interventricular septum toward the ______of the heart.

Back 39

bundle branches,bundle branches, apex ```

Front 40

finally the large diameter __________rapidly conduct from the apex upward toward the remainder or the ventricular myocardium

Back 40

Purkinje fibers

Front 41

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_________.

Back 41

epinephrine, rhythm,(SA Node normal pacemaker at 100 times per minute)

Front 42

ACETYcholine released by the parasumpathetic division of the ANS slows the SA node pacing to about_______ action potentials per minute ..

Back 42

75

Front 43

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 ____________.

Back 43

40 to 60 beats ,20 to 35 ,pacemaker

Front 44

When a site other than the SA node becomes the pacemaker it is called an _________

Back 44

ectopic pacemaker

Front 45

The working atrial and ventricular fibers are called ____________.These _______fibers depolarize at -_______mV.

Back 45

contractile fibers,-90mV(let Na+ in)

Front 46

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.

Back 46

plateau

Front 47

depolarization of a muscle fiber is ____ due to this Plateau

Back 47

briefer

Front 48

repolarization occurs when the ________channels open and let ______ out restoreing the negative resting potential(-90mV)

Back 48

voltage-gated K+ channels, K+

Front 49

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)

Back 49

troponin,,actin ,myosin

Front 50

________ for example increases contraction force by enhancing the Ca++ flow into the cytosol

Back 50

Epinephrine

Front 51

________ for example increases contraction force by enhancing the Ca++ flow into the cytosol

Back 51

Epinephrine

Front 52

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.

Back 52

refractory period, tetanus

Front 53

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.

Back 53

myoglobin, fatty acid, glucose,lactic acid

Front 54

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 ___________.

Back 54

myocardial infarction,creatine kinase,creatine kinase

Front 55

an ecg or ekg can determine if _________,___________,and___________

Back 55

if the conducting pathway is abnormal,if the heart is enlarged, if certain areas of the heart are damaged

Front 56

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.

Back 56

P wave

Front 57

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____________.

Back 57

QRS complex, downward, rapid ventricular depolarization

Front 58

The third wave is a ______shaped upward deflection called a ___________.It indicates ____________

Back 58

dome, T wave,ventricular repolarization

Front 59

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

Back 59

enlarged atrium, myocardial infarction, enlarged ventricles ,T wave

Front 60

analysis of EKG involves measuring time spans between waves called____ or _____

Back 60

intervals segments

Front 61

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>

Back 61

.2 sec,,,P,,,,ventricular myocardium,,,,,,upward,,QRS complex

Front 62

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.

Back 62

atrial,,,atrial

Front 63

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.

Back 63

Ventricular systole(contraction),,,S-T segment,,,,T wave

Front 64

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>

Back 64

relax(ventricular diastole),,,0.6 sec,relaxed,,0.8sec (these figures are for a heart beating at 75 beats per min))

Hint 64

`

Front 65

the pressures given in the picture in the book(681)apply to the left side :pressures on the right side are considerably ______________.

Back 65

lower

Front 66

During ________,which lasts about0.1 sec.,,the atria are contracting.at the same time the ___________are relaxed>

Back 66

atrial systole,,,,ventricles

Front 67

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).

Back 67

25mL,,,105mL,,ventricular,,130ml

Front 68

The _________ marks the onset of ventricular depolarization.full blood volume in the ventricles is called______.

Back 68

QRS complex,end-diastolic volume(EDV)

Front 69

Ventricular systole::
during ____________, which lasts about .3 sec.,the ventricles are contracting.At the same time the _______ are relaxed ;termed(_________)

Back 69

ventricular systole,atria ,,atrial diastole

Front 70

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_______.

Back 70

isovolumetric contraction

Front 71

When left ven. pressure surpases aortic pressureand right ven. pressure rises above the pulmonary trunk pressure both ________valves open.This period is called _______________

Back 71

semilunar, ventricular ejection

Front 72

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_____________.

Back 72

70 ,,,60,,,,end systolic volume,ESV,,Stroke volume

Front 73

the _______wave marks the onset of ventricular repolarization.

Back 73

T wave

Front 74

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.

Back 74

shorter,,durations, atrial s ystole,ventricular systole

Front 75

rebound of blood off the closed semilunar in the aorta produces the ________ on the aorta pressure curve.

Back 75

dicrotic wave

Front 76

_______ is the act of listening to the sounds in the body.

Back 76

auscultation

Front 77

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.

Back 77

lubb,,atrioventricular (AV)

Front 78

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.

Back 78

dupp,,,shorter ,,,sl

Front 79

a________is an abnormal sound (rushing clicking gurguling)most often indicating valve disorder

Back 79

heart murmur

Front 80

__________ is the volume of blood ejected from each ventricle per minute

Back 80

cardiac output

Front 81

Cardiac output =______________*__________

Back 81

stroke volume (70mL)* HR

Front 82

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.

Back 82

total,,,cardiac reserve,,,((average is 4 or 5 times)

Front 83

three factors regulate stroke volume and insure that left and right volume are =1._________2.__________3.__________

Back 83

preload, contractility, afterload

Front 84

_________ 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___________

Back 84

Preload....Frank-Starlings law of the heart

Front 85

Two factors determine the EDV1________2__________( the volume of blood returning to right ventricle.

Back 85

1. the duration of ven. diastole 2. venous return

Front 86

at rapid heart rates (160 BPM) stroke volume usually ________due to short filling times.(making preload smaller)

Back 86

declines

Front 87

The _____________equalizes the left and right ven.

Back 87

Frank-Starling law of the heart

Front 88

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__________.

Back 88

contractility,positive inotropic agents ,,negative inotropic agents

Front 89

hormones such as _____,____and _________;and___________are positive inotropic agents

Back 89

epinephrine,norep.,digitalis,stimulation of ANS (Sympathetic division),

Front 90

Negative inotropic agents would be ______,________,______,and_________

Back 90

inhibition of the sympathetic division of ANS ,anoxia,acidosis,anesthetics(halothane),increased levels of K=

Front 91

___________ are drugs that have a negetive inotropic effect by reducing Calcium inflow.

Back 91

calcium channel blockers

Front 92

the pressure that must be overcome before a semilunar valve can open is termed the __________

Back 92

afterload

Front 93

conditions that can increase afterload are _________and _________.

Back 93

hypertension, atherosclerosis

Front 94

When the heart is a failing pump it is called ____________.These can result from__________,__________,_________,_______and __________

Back 94

congestive heart failure,,,coronary artery disease,congenital defects, long term high blood pressure,myocardial infarctions and,valve disorders.

Front 95

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.

Back 95

stretched and contracts,positive

Front 96

If the left ven. fails first blood backs up in________and causes _________fluid accumulation in _______that can suffocate a person.

Back 96

lungs, pulmonary edema,lungs

Front 97

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.

Back 97

peripheral endema

Front 98

the most important factors that contribute to the regulation of the heart rate are __________and________,and __________from the ____________.

Back 98

ANS,epinephrine and norepinephrine,adrenal medulla

Front 99

the ________ in the __________increases or decreases the frequency of nerve impulsesin both the__________and the ______ branches of the ___________.

Back 99

cardiovascular center ,medulla oblongata,sympathetic and parasympathetic,ANS

Front 100

heart rates may climb in preporation for anticipated events from the _______to the ___________ in the medulla

Back 100

Limbic cardiovascular center

Front 101

the sensory receptors that provide input to the heartrate are__________<__________and_________.

Back 101

propriocepters(position of limbs),chemorecptors(chemical changes(CO)),baroreceptors(monitor stretching in arteries)

Front 102

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.

Back 102

cardiac accelerator nerves, norepinephrine,beta-1

Front 103

Norepinephrine release has 2 results 1. _______and _______ node fibers speed depolarization,2.enhances _______entry thereby increasing contractility.

Back 103

SA ,AV,Ca++

Front 104

Subtracting one ______from _______ provides a good estimate of ones maximum heartrate

Back 104

age from 220

Front 105

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.

Back 105

vagus (X)nerves,sa node, av node and atrial myocardium,acetylcholine

Front 106

At rest __________stimulation predominates and slows the __________of the SA node.

Back 106

parasympathetic,autorhymic rate

Front 107

one sign of hyperthyroidism is __________,an elevated resting heart rate.

Back 107

tachycardia(thyroid hormones elevate heartrate)as well as e and Nore from the medulla.

Front 108

Elevated blood levels of K+andNa+_______heartrate. And a moderate increase in _______level speeds up heart rate.

Back 108

decreases,Ca++

Front 109

A resting heartrate under 60 BPM's is called _____???._________in body temp ________heart rate._________is a term of decreasing heartrate by lowering body temp

Back 109

bradycardia,Increase, Increases,Hypothermia

Front 110

help for failing hearts is given with____,____,and________

Back 110

heart transplants,cardiac assist devices,artificial hearts

Front 111

contractions of the primitive heart begin by the end of the _________.

Back 111

third week

Front 112

Risk factors for CAD( coronary artery disease) are_____,_____,______,_____,______

Back 112

high cholesteral,high blood pressure,smoking,obesity,diabetes mellitus,type A personality, and nonexercise

Front 113

__________is hardening of the arteries,one form is _________characterized by formations of lesions called _____________

Back 113

arteriosclerosis,atherosclerosis,atheriosclerosis plaques

Front 114

atherosclerosiss caused by high _____ levels,__________,____________,_________and high blood glucose from ___________.

Back 114

LDL,,cytomegalovirus,high blood pressure,co(cigarettes),diabetes mellitus

Front 115

A _________may dislodge from a clot formation and cause a __________

Back 115

thrombosis,embolus

Front 116

______ is an invasive process used to look at the hearts coronary arteries,chambers,valves,and great vessels

Back 116

Cardiac catherization

Front 117

___________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____________

Back 117

cardio angiography,streptokinase,t-PA

Front 118

_______________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.

Back 118

Coronary artery bypass grafting,bypass

Front 119

____ _____ ____ ______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

Back 119

percutaneous translumenal coronary angioplasty,stent

Front 120

_______is a severe pain in chest that normally accompanies ____________

Back 120

angina pectoris, myocardial ishemia(partial obstruction to the coronary arteries)

Front 121

besides killing heart tissue a _________ may disrupt the conduction system and cause________.

Back 121

infarction, ventricular fibrillation,

Front 122

in some babies the _____________may remain open and the aortic blood gets pushed into the lower pressure pulmonary trunk causeing overwork of both ven.

Back 122

dutus arteriosis_(condition called- Patent ductus arteriosus)

Hint 122

ductus arteriosus

Front 123

the normal rhythm of heart by SA node is called_____________. an abnormal rhythm is called ______or_______

Back 123

normal sinus rhythm, arrhythmia or dysrhythmia

Front 124

_________ is a serious arrhymia which conduction is slowed or blocked. with complete AV block the contractions will be less than_________BPM.

Back 124

heart block,40

Front 125

___________ 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.

Back 125

ventricular fibrillation, defibrillation

Front 126

_________is heart enlargement

Back 126

cardiomegaly