The Cardiovascular System

Front 1

The _____ side of the heart receives oxygen-rich blood from body tissues and then pumps the blood to the ____ to pickup ___ and dispel ____

Back 1

1) Right

2) Lungs

3) Oxygen

4) Carbon Dioxide

Front 2

The blood vessels that carry blood to and from the lungs form the _____

Back 2

Pulmonary Circuit

Front 3

The ____ side of the heart receives oxygenated blood returning from the _____ and pumps this blood throughout the body to supply ____ and ____ to the body tissues.

Back 3

1) Left

2) Lungs

3) Oxygen

4) Nutrients

Front 4

The blood vessels that carry blood to and from all body tissues form the ____

Back 4

Systemic Circuit

Front 5

The heart has two receiving chambers called the right and left _____

Back 5

atrium

Front 6

The heart has two main pumping chambers the right and left _____ that pump blood around the two circuits.

Back 6

Ventricle

Front 7

The heart is about the size of a ____

Back 7

fist

Front 8

The heart is _____ shaped

Back 8

Cone

Front 9

Define Mediastinum

Back 9

The medial cavity of the thorax where the heart is enclosed.

Front 10

Approx. 2/3 of the heart's mass lies to the left of the _____.

Back 10

Midsternal line

Front 11

The ____ points toward the left hip

Back 11

apex

Front 12

Define Apical Impluse

Back 12

Heart beat that can be felt through the chest wall

Front 13

Define Pericardium

Back 13

The double-layered sac enclosing the heart and forming its superficial layer

Front 14

The pericardium has ____ and ___ layers

Back 14

fibrous and serous layers

Front 15

Define Fibrous Pericardium

Back 15

The loosely fitting superficial part of the pericardium

Front 16

3 jobs of the Fibrous Pericardium

Back 16

1) Protects the heart

2) Anchors it to surrounding structures

3) Prevent overfilling of the heart with blood

Front 17

Define Serous Pericardium

Back 17

A thin, slippery, two-layered serous membrane that forms a closed sac around the heart.

Front 18

Serous Pericardium is made of two layers the ____ and the ___

Back 18

1) Parietal

2) Visceral

Front 19

Parietal Layer

Back 19

Lines the internal surface of the fibrous pericardium

Front 20

____ attaches to the large arteries exiting the heart and then turns _____ and continues over the external heart surface as the ______

Back 20

1) Parital Layer

2) Inferiorly

3) Visceral Layer/Epicardium

Front 21

Define Pericardial Cavity

Back 21

A slit-like cavity between the parietal and visceral layers that contains a film of serous fluid.

Front 22

The serous membranes of the pericardial cavity allow

Back 22

Allow the two serous membranes to glide smoothly past one another, allowing the heart to work relatively friction-free

Front 23

Pericarditis

Back 23

Inflammation of the pericardium, roughens the serous membrane surfaces.

Front 24

Three layers of the heart wall

Back 24

1) Epicardium

2) Myocardium

3) Endocardium

Front 25

Myocardium is composed mainly of ___ and forms the ____ of the heart

Back 25

1) Cardiac msucle

2) Bulk

Front 26

The myocardium branching cardiac muscle cells are tethered to one another by connective tissues fibers called ___ that ____ all parts of the heart.

Back 26

1) Circular bundles

2) Link

Front 27

Define Cardiac Skeleton

Back 27

The dense connective tissue fibers that reinforce the myocardium internally and anchors the cardiac muscle fibers.

Front 28

Importance of the cardiac skeleton

Back 28

1) Without the support the vessels and valves might eventually stretch because of the continuous stress

2) Limits spread of action potentials to specific pathways in the heart because they are not electrically excitable

Front 29

Define Endocardium

Back 29

Glistening white sheet of endothelium resting on a thin connective tissue layer

Front 30

_____ is located on the inner myocardial surface and lines the heart chambers and covers the fibrous skeleton of the valves.

Back 30

Endocardium

Front 31

_____ is continuous with the endothelial linings of the bod vessels leaving and entering the heart.

Back 31

Endocardium

Front 32

The heart has four chambers. Two superior ____ and two inferior ____

Back 32

1) Atria

2) Ventricles

Front 33

Define Interatrial Septum

Back 33

The internal partition that divides the heart longitudinally where it separates the atria

Front 34

Define Interventricular Septum

Back 34

The internal partition that divides the heart longitudinally where it separates the ventricles.

Front 35

Define Pectinate muscles

Back 35

Parallel ridges in the walls of the atria of the heart that are shaped like teeth of a comb

Front 36

Right atrium is made of two parts

Back 36

1) Pectinate Muscles - anterior portion

2) Smooth-walled posterior part

Front 37

Left atrium is mostly _____. The _____ muscles are found only in the auricles

Back 37

1) Smooth

2) Pectinate

Front 38

The atria are relatively small, thin-walled chambers because

Back 38

they need to contract only minimally to push blood "down" to the ventricles

Front 39

Blood enters the right atrium through these 3 veins

Back 39

1) Superior Vena Cava

2) Inferior Vena Cava

3) Coronary Sinus

Front 40

Function of Superior Vena Cava

Back 40

Returns blood from body regions superior to the diaphragm

Front 41

Function of the Inferior Vena Cava

Back 41

returns blood from body area below the diaphragm

Front 42

Function of Coronary Sinus

Back 42

collects blood draining from myocardium

Front 43

Four _____ veins enter the left atrium which transport blood from the ____ back to the heart.

Back 43

1) Pulmonary Veins

2) Lungs

Front 44

The _____ makes up most of the heart's anterior surface.

Back 44

Right ventricle

Front 45

Papillary Muscles

Back 45

play a role in valve function and project into the ventricular cavity

Front 46

The ventricles are the ___ of the heart

Back 46

pumps

Front 47

When the ventricles contract they

Back 47

propel blood out of the heart into the circulatory system.

Front 48

Pulmonary Trunk

Back 48

Vessel leaving the right ventricle that routes the blood to the lungs where gas exchange occurs

Front 49

Aorta

Back 49

Vessel leaving the left ventricle and is the largest artery in the body

Front 50

Blood flows in one direction

Back 50

from atria to ventricles and out the great arteries leaving the superior aspect of the heart

Front 51

4 valves that enforce blood flow direction

Back 51

1) Atrioventricular Valves (AV) - tricuspid valve and mitral valve(or bicuspid)

2) Semilunar Valves (SV) - aortic and pulmonary

Front 52

Define chordae tendineae

Back 52

Tiny white collagen cords attached to each of the AV valve flaps which anchor the cusps to the papillary muscles protruding from the ventricular walls.

Front 53

When the heart is relaxed the AV valves _____ into the _____ below and blood flows into atria, through ____ and into ventricles

Back 53

1) Hang limply

2) Ventricle chambers

3) AV valves

Front 54

When the ventricles contract the flap edges ____ and ____ the AV valve

Back 54

1) Meet

2) Close

Front 55

The ____ and ___ serve to anchor the AV valve flaps in their closed position

Back 55

1) Chordae Tendineae

2) Papillary muscles

Front 56

The ___ and ____ guard the bases of the large arteries issuing from the ventricles (the aorta and pulmonary trunk) and prevent ____ into the associated ventricles.

Back 56

1) Aortic valve

2) Pulmonary valve (Semilunar,SL)

Front 57

The ____ circuit , ____served by the ____ ventricle, is a short, low-pressure circulation.

Back 57

1) Pulmonary

2) Right

Front 58

The ____ circuit, served by the ____ ventricle, takes a long pathway through the entire body and encounters ____.

Back 58

1) Systemic

2) Left

3) Resistance to blood flow

Front 59

The anatomy of left ventricle that shows the difference in workload

Back 59

Left ventricle walls are three times thicker than those of the right ventricle and its cavity is nearly circular.

Front 60

The anatomy of right ventricle that shows the difference in workload

Back 60

The cavity is flattened into a crescent shape that partially encloses the left ventricle

Front 61

The wrapping of the right ventricle around the left ventricle allows the left ventricle to ____

Back 61

produce more pressure and be a more powerful pump.

Front 62

____ volumes of blood are pumped through the pulmonary and systemic circuits

Back 62

Equal

Front 63

The heart is two _______

Back 63

side-by-side pumps

Front 64

Define Coronary Circulation

Back 64

The functional blood supply of the heart and shortest circulation in the body

Front 65

Both the left and right coronary arteries arise from the base of the ____ and _____ the heart in the _____

Back 65

1) Aorta

2) encircle the heart

3) Coronary sulcus

Front 66

The ____ coronary artery runs toward the left side of the heart and then divides into two major brnaches

Back 66

Left

Front 67

The Left coronary artery divides into these two major branches

Back 67

1) Anterior interventricular artery

2) Circumflex artery

Front 68

Anterior interventricular artery supplies blood to _____ and ____

Back 68

1) interventricular septum

2) anterior walls of both ventricles

Front 69

Circumflex artery supplies ____ and ___ with blood

Back 69

1) Left atrium

2) Posterior walls of left ventricle

Front 70

Right coronary artery two branches

Back 70

1) Right marginal artery

2) Posterior interventricular artery

Front 71

The branches of the ___ coronary artery supply the ___ and nearly all of the ____

Back 71

1) Right

2) Right atrium

3) right ventricle

Front 72

Coronary arterial supply ____ and there are many _____ among the coronary arterial branches

Back 72

1) varies

2) anastomoses (junctions)

Front 73

These fusing networks provide _____ for blood delivery to the heart muscle

Back 73

additional routes

Front 74

Angina pectoris

Back 74

Thoracic pain caused by a fleeting deficiency in blood delivery to the myocardium

May result from stress-induced spasms of the coronary arteries or from increased physical demands on the heart

The myocardial cells are weakened by temp lack of oxygen but do not die

Front 75

Myocardial infarction

Back 75

Commonly called heart attack

Cells do die

Caused by prolonged coronary blockage

Area of cell death is repaired with noncontractile scar tissue

Front 76

Physical attributes of cardiac cells

Back 76

striated, short, fat, branched, and interconnected.

Front 77

The intracellular spaces of cardiac muscle are filled with ____ that connects to the ____ which gives cardiac muscle ____

Back 77

1) loose connective matrix (endomysium)

2) fibrous skeleton

3) something to exert force against

Front 78

Intercalated discs

Back 78

junctions between cells that anchor cardiac cells to one another

Front 79

Intercalated discs contain ___ and ___

Back 79

1) desmosomes

2) gap junctions

Front 80

Function of desmosomes

Back 80

prevent adjacent cells from separating during contraction

Front 81

Function of gap junctions

Back 81

allow ions to pas and electrically couple adjacent cells - transmitting current across the entire heart

Front 82

Because ____ electrically couple cardiac cells, the ____ behaves as a _____, a single coordinated unit

Back 82

1) Gap junctions

2) myocardium

3) functional synctium

Front 83

____ account for 25 - 35% of the volume of cardiac cells. This makes cardiac cels high resistant to ___

Back 83

1) Mitochondria

2) Fatigue

Front 84

_____ are wider and fewer in cardiac muscle cells than in skeletal

Back 84

T tubles

Front 85

____ is simpler in cardiac muscle cells than skeletal

Back 85

Sarcoplasmic reticulum

Front 86

Define intercalated discs

Back 86

Junctions where plasma membranes of adjacent cardiac cells interlock

Front 87

Intercalated discs contain ___ and ___

Back 87

1) Desmosomes

2) Gap Junctions

Front 88

Desmosomes prevent ______

Back 88

adjacent cells from separating during contraction

Front 89

Gap Junctions allow ____

Back 89

ions to pass from cell to cell, transmitting current across entire heart

Front 90

Define Functional Syncytium

Back 90

When cells act as a single unit, such as when the myocardium of the heart works all together

Front 91

The ability to ___ and ___ is intrinsic

Back 91

1) Depolarize

2) Contract

Front 92

Define Intrinsic Cardiac Conduction System

Back 92

A network of non-contractile (autorhythmic) cells that initiate and distribute impulses to coordinate the depolarization and contraction of the heart

Front 93

Autorhythmic cells nickname

Back 93

Pacemaker cells

Front 94

____ cells have unstable resting potentials due to ____.

Back 94

1) Autorhythmic

2) Open slow Na channels

Front 95

Define pacemaker potentials

Back 95

Spontaneously changing membrane potentials

Front 96

Pacemaker potentials initiate the ____

Back 96

action potentials that spread throughout the heart to trigger its contractions

Front 97

3 parts of action potential in pacemaker cells

Back 97

1) Pacemaker potential

2) Depolarization

3) Repolarization

Front 98

Steps of action potential in pacemaker cells

Back 98

1) At threshold Ca channels open

2) Explosive Ca entry produces rising phase of action potential

3) Repolarization results from inactivation of Ca channels and opening of K channels

Front 99

Autorhythmic cells are found in these 5 places

Back 99

1) Sinoatrial (SA) node

2) Atrioventricular (AV) node

3) Atrioventricular Bundle

4) Right and Left bundle branches

5) Subendocardial Conducting Network

Front 100

Define Sinoatrial (SA) node

Back 100

Crecent-shaped node located in the right atrial wall, just inferior to the superior vena cava

Front 101

SA node generates impulses ___ times per minute

Back 101

75

Front 102

The ___ node sets the pace for the heart as a whole because ___

Back 102

1) SA node

2) no other region of the conduction system has a faster depolarization rate

Front 103

The ____ is the heart's pacemaker

Back 103

SA node

Front 104

Define Sinus rhythm

Back 104

Normal rhythm of the heart determined by SA node impulses

Front 105

Define Atrioventricular (AV) node

Back 105

Located inferior portion of the interatrial septum above the tricuspid valve

Front 106

From the SA node the depolarization spreads via ____ throughout the ____ to the _____

Back 106

1) gap junctions

2) atria

3) Atrioventricular (AV) node

Front 107

The AV node delays impulse approx. ___

Back 107

.1 sec

Front 108

The delay of the AV node allows ___________

Back 108

the atria to respond and complete their contraction before the ventricles contract

Front 109

The AV node has ____ and ____ that cause the delay

Back 109

1) smaller diameter fibers

2) fewer gap junctions

Front 110

Define Atrioventricular Bundle (Bundle of His)

Back 110

Located in the superior part of the interventricular septum

Front 111

Though the atria and ventricles abut they are ____

Back 111

not connected by gap junctions

Front 112

The AV bundle is the only ____

Back 112

electrical connection between atria and ventricle

Front 113

The AV bundle splits into ___ and ___, which course toward _____

Back 113

1) Left Bundle Branch

2) Right Bundle Branch

3) Apex of heart

Front 114

Define Subendocardial Conducting Network

Back 114

Long strands of barrel-shaped cells, also called Purkinje fibers, that complete the pathway to the apex

Front 115

Without SA input the AV node would depolarize about ____

Back 115

50 times per minute

Front 116

Without AV node input the AV bundle and Purkinje fibers only depolarize about

Back 116

30 times per minute

Front 117

Defects in the intrinsic conduction system may result in (3)

Back 117

1) Arrhythmia - irregular heart beat

2) Uncoordinated atrial and ventricular contractions

3) Fibrillation - rapid, irregular contractions that make pumps useless

Front 118

Defective SA node may result in (2)

Back 118

1) Ectopic Focus - abnormal pacemaker takes over

2) If AV node takes over there will be a junctional rhythm (40 - 60 bpm)

Front 119

Defective AV node may result in

Back 119

1) Partial or total heartblock

2) Few or no impulses from SA node reach the ventricles

Front 120

Heartblock

Back 120

Total heart block is when no impulses get through to the ventricles and they beat at their intrinsic rhythm which is too slow for circulation

Front 121

Heartbeat is modified by the ____

Back 121

Autonomic Nervous System

Front 122

The _____ increases the rate and force of heartbeat

Back 122

Sympathetic Nervous System

Front 123

The _____ slows the heart

Back 123

Parasympathetic Nervous System

Front 124

The cardiac centers are located in the ____

Back 124

medulla oblongata

Front 125

The cardioacceleratory center innervates the _____, _______, _____, and _____ through ______

Back 125

1) SA node

2) AV node

3) Heart muscle

4) Coronary arteries

5) sympathetic neurons

Front 126

Cardioinhibitary center inhibits ____ and ___ through _____ in the _____

Back 126

1) SA node

2) AV node

3) Parasympathetic fibers

4) Vagus Nerves

Front 127

Define electrocardiogram

Back 127

a composite of all the action potentials generated by nodal and contractile cells at a given time

Front 128

An EKG does not _____

Back 128

provide information on valve function

Front 129

Name 3 types of waves

Back 129

1) P wave - depolarization of SA node

2) QRS complex - Ventricular depolarization

3) T wave - ventricular repolarization

Front 130

Order of sequence of excitement

Back 130

1) SA node generates impulse

2) Impulse delays at AV node

3) AV bundle connects atria and ventricles

4) Bundle branches impulses through interventricular septum toward apex

5) Subendocardial Conducting Network (Purkinje fibers) depolarizes the contractile cells of both ventricles

Front 131

Name for the two sounds associated with closing of heart valves

Back 131

Lub-Dub

Front 132

First sounds of heart occurs when

Back 132

AV valves close and signifies the beginning of systole

Front 133

Second heart sounds occurs when

Back 133

SL valves close at the beginning of ventricular diastole

Front 134

Define heart murmur

Back 134

abnormal heart sounds most often indicative of valve problems

Front 135

3 phases of cardiac cycle

Back 135

1) Ventricular Filling

2) Ventricular Systole

3) Isovolumetric relaxtion

Front 136

Define systole

Back 136

periods of contraction

Front 137

Define diastole

Back 137

periods of relaxation

Front 138

Define cardiac cycle

Back 138

includes all events associated with blood flow through the heart during one complete heartbeat - atrial systole and diastole followed by ventricular systole and diastole

Front 139

Describe events of Ventricular filling

Back 139

1) Atria is in mid-to-late diastole

2) AV valves are open and blood is filling ventricles

3) AV flaps begin to float to closed position

4) Atria contracts following P wave

5) Ventricles are in last part of diastole and have EDV

Front 140

____% of blood passively flows into the ventricles, the other ___ % comes from ____

Back 140

1) 80%

2) 20%

3) Atrial systole

Front 141

Define End Diastolic Volume (EDV)

Back 141

When ventricle has maximum amount of blood volume it will contain

Front 142

Describe events of Ventricular Systole

Back 142

1) Atria relax and ventricles beging to contract

2) Ventricle pressure rises closing AV valves

3) Ventricular pressure continues to rise opening SL valves

4) Blood rushes into aorta and pulmonary trunk

Front 143

Define Isovolumetric Contraction Phase

Back 143

The split-second period hen the ventricles are completely closed chambers and the blood volume remains constant as ventricle contract

Front 144

Describe events of Isovolumetric relaxation

Back 144

1)Ventricles relax

2) Backflow of blood in aorta and pulmonary trunk closes SL valves and causes dicrotic notch

Front 145

Isovolumetric relaxation occurs during

Back 145

early ventricle diastole

Front 146

Define dicrotic notch

Back 146

rise in aortic pressure

Front 147

Define End systolic volume (ESV)

Back 147

volume of blood remaining in each ventricle after contraction and ejection

Front 148

Cardiac Output (CO) =

Back 148

Heart Rate (HR) + Stroke Volume (SV)

Front 149

Define Cardiac Output (CO)

Back 149

The volume of blood pumped by each ventricle in one minute

Front 150

Heart Rate (HR) =

Back 150

number of beats per minute

Front 151

Define Stroke Volume (SV)

Back 151

volume of blood pumped out by a ventricle with each beat

Front 152

Stroke Volume (SV) =

Back 152

EDV (amount of blood collected in a ventricle during diastole) - ESV (the volume of blood remaining in a ventricle after it has contracted)

Front 153

Three main factors affecting Stroke Volume (SV)

Back 153

1) Preload

2) Contractility

3) Afterload

Front 154

Define preload

Back 154

Degree of stretch of cardiac muscle cells before they contract

Front 155

In a normal heart the higher the preload the ____ the stroke volume

Back 155

higher

Front 156

Define Frank- Starling law of heart

Back 156

The higher the preload the higher the stroke volume

Front 157

Cardiac muscle exhibits a _____ relationship

Back 157

length-tension

Front 158

At rest, cardiac muscle cells are ___ than optimal length

Back 158

shorter

Front 159

Slow heartbeat and exercise increase ____

Back 159

venous return

Front 160

Define venous return

Back 160

The amount of blood returning to the heart and distending its ventricles

Front 161

Define contractility

Back 161

Contractile strength at a given muscle length

Front 162

Contractility is independent of

Back 162

muscle stretch and EDV

Front 163

Define Positive inotropic agents

Back 163

Factors that increase heart rate

Front 164

Define Negative inotropic agents

Back 164

Factors that decrease heart rate

Front 165

Examples of positive inotropic agents affecting contractility

Back 165

1) Increased CA influx due to sympathetic nervous system

2) Hormones (thyroxine, glucagon, and epinephrine)

Front 166

Examples of negative inotropic agents contractility

Back 166

1) Acidosis

2) Increased extracellular K

3) Calcium channel blockers

Front 167

Define afterload

Back 167

Pressure that must be overcome for ventricles to eject blood

Front 168

_____ increases afterload, resulting in increased ___ and reduced ____

Back 168

1) Hypertension

2) ESV

3) SV

Front 169

Define Positive chronotropic factors

Back 169

Factors that increase heart rate

Front 170

Define negative chronotropic factors

Back 170

Factors that decrease heart rate

Front 171

The ____ exerts the most important extrinsic controls affecting heart rate

Back 171

ANS

Front 172

_____ is activated by emotional or physical stressors which causes release of ___, which causes ____

Back 172

1) Sympathetic Nervous System

2) Norepinephrine

3) increase heart rate

Front 173

___ opposes effects of sympathetic nervous system and effectively ___

Back 173

1) Parasympathetic nervous system

2) reduces heart rate

Front 174

The heart at rest exhibits ___ because ___

Back 174

1) vagal tone

2) dominant influence is inhibitory

Front 175

Define Atrial (bainbridge) reflex

Back 175

An autonomic reflex initiated by increased venous return and increased atrial filling

Front 176

Stretching the ___ increases heart rate stimulating the _____ and ____, which activates the ____

Back 176

1) Atrial walls

2) SA node

3) Atrial stretch receptors

4) sympathetic relexes

Front 177

Hormones that affect heart rate

Back 177

1) Epinephrine - enhances heart rate and contractility

2) Thyroxine increases heart rate and effects of norepinephrine and epinephrine

Front 178

___ must be maintained for normal heart function

Back 178

Intra and extracellular ion concentrations

Front 179

Define Tachycardia

Back 179

Abnormally fast heart rate >100 bpm

Front 180

Define Bradycardia and affects

Back 180

1) Heart rate slower than 60 bpm

2) Inadequate blood circulation

3) Desired for endurance training

Front 181

Define Congestive Heart failure

Back 181

Progressive condition where the CO is so low that blood circulation is inadequate to meet tissue needs