79midterm

the heart is a __ organ

muscular

the size of an adult heart

sightly larger than fist

location

center of chest

which way is heart tilted

forward and left

top of the heart is called__, and below the _ rib

base, 2

bottom of the heart is called__, and below the _ rib

apex, 5

how much of the heart lays to the left of midline

2/3

what effect heart size (5)

age, weight, size, exercise, HD

inner layer heart

endocardium

middle layer of the heart

myocardium

the endocardium does what

reduces friction btw blood and walls

myocardium split into 2

sunendocardial, subepicardial

which of 2 types of myocardium is one the inside

subendocardium

what is the outer sac of heart called

pericardium

what does pericardium do

protects heart

2 types of pericardium

fibrous pericardium, serous pericardium

fibrous pericardium is where, does what

on outside, anchors heart

serous pericardium 2 types

parietal layer, visceral layer

parietal layer where

lines serous pericardium

serous layer where

lines myocardium

the visceral layer of the pericardium is also know as the

epicardium

RA ___ blood

receives

thickness of chamber walls is related to

pressure needed to eject blood

2 types of septa

interatrial, interventricular

2 types of AV valves

tricuspid - R, mitral - L

what attaches to the papillary muscles of heart

chordae tendinae

first heart sound S1 is

AV closure

2 types semilunar valvues

pulmonic-R, aortic - L

semilunar valves are shaped like

leaflets

second sound of heart S2 is

SL closure

systemic circuit what size circuit, what side heart

lg, left

pulmonary circuit what size circuit, what side of heart

sm, right

name heart conduction

SA -internodal conduction tracts - Bachmann bundle - AV - bundle of his - bundle branches - perkinje fibers

main 2 coronary heart vessels

LMCA, RMCA

LMCA splits into 2

LAD, LCx

LAD supplies

anterior 2/3 IVS, anterios LV, lateral LV, BB

LCx supplies

LA, Lateral LV, Posterior LV, Inferior LV (10), posterior 1/3 IVS (10), SA(45), AV (10)

RMCA supplies

RA, RV, inferior LV (90), posterior 1/3 IVS (90), , SA (55), AV (90)

widow maker is blockage of what artery

LAD

mother of all window makers is blockage in what artery

LMCA

collateral circulation occurs

if artery is blocked

collateral circulation can only provide __ % normal blood flow

25

name 3 parties come of ascending aorta

brachiocephalic artery, left common carotid artery, left subclavian artery

ANS spit into 2

sympathetic, parasympathetic

sympathetic “__”, what center

fight or flight, cardioaccelerator

sympathetic: vaso__ , __HR at SA node, __ conductivity through AV node, __ force contraction

constricts, inc.

parasympathetic “__”, what center

rest and digest, cardioinhibitor

para sympathetic: vaso__ , __HR at SA node, __ conductivity through AV node, __ force contraction

dilates, dec

properties of cardiac cells

automaticity, excitability conductivity, contractility

automaticity is

spontaneous depolarize

contractility is

shorten when stimulated

conductivity

conduct impulses

excitability

ability respond impulse

myocardial cells have __ discs, which contain __, which permit

intercalated, gap junctions, rapid conduction

T/F myocardial cells have semipermeable membranes?

T

T/F myocardial cells contain myofibrils?

T

characteristics of myocarial cells

excitability contractility, conductivity

characteristics of pacemaker cells

automaticity, conductivity, excitability

T/F pacemaker cells have more gap junctions than myocarial cells

T (6x)

T/F pacemaker cells have myofibrils

F

order of blood vessels

arteries, arterioles, capillaries, venues, veins

layers of blood vessels ( in to out)

lumen, tunica interna (intima), tunica media, tunica externa (adventitia)

BP is highest where

arteries

T/F BP decreases as it flows through circulatory system

T

pulse pressure

SBP - DBP

MAP definition

driving pressure

MAP (short)

Q * PR

MAP (long)

DBP + 1/3(SBP - DBP)

Q equation

Q = SV * HR

4 determinant of MAP

Blood volume, Q, PR, blood distribution

BP regulation at rest. (short term) what NS

sympathetic, parasympathetic

what do baroreceptors sense, where live, response?

blood pressure, carotid bodies, parasympathetic if high BP

what do chemoreceptors sense, where live, response?

chemicals (o2/co2/pH), heart, need o2 then sympathetic

Short term control of Bp at rest 3 types neurotransmitter and hormones

norepinephrine, epinephrine, ADH

long term control of BP at rest

renin-angiotensin-aldosterone system

short term Bp control: norepinephrine

vasoconstrictor at A1 and A2 receptors, inc HR and contractility at B1 receptors

short term Bp control: epinephrine

vasoconstrictor at A1 and A2 receptors, inc HR and contractility at B1 receptors, vasodilator B2 receptors (lungs)

another name for ADH

vasopressin

short term BP control: vasopressin

acts of kidneys to promote re-absorption, vasoconstrictor

ADH make you pee more/less

less

pathways of RAA system

kidneys secrete renin - renin acts on angiotensinoge to convert to angiotensin 1- angiotensin of acts with ACE enzyme and converts angiotensin 2

angiotensin 2 functions:

vasoconstrits, Na reabsorption, release aldosterone and vasopressin, stimulates thirst, SAS release norepinephrine

aldosterone does what

inc NA and fluid retention

What stimulate RAA system

low BV, BP, Na

normal BP

<120 AND <80

ELEVATED BP

120-129 and <80

HTN 1 BP

130-139 or 80-89

HTN 2 BP

>140 or >90

% adults in US with hypertension

47%

HTN affects __ of worldwide population

1/3

risk double every __ increase in BP over __

20/10, 115/75

T/F hypertension is the most common cause of CVD-related deaths

T

how does HTN lead to CVD

damages endothelial lining of vessels

HTN inc __, which does what

after-load, cardiac hypertrophy, LV cannot maintain workload, pulmonary edema, congestive heart failure

treatment of: elevated BP/ stage 1 HTN + <10% ASCVD risk

non pharmacological

treatment of: stage 1 HTN + >10% ascvd risk

non pharmacological and antihypertensive drug

treatment of: HTN stage 2

non pharmacological + 2 antihypertensive drugs

non pharmacological interventions for HTN (6)

weight loss, diet, reduce NA, increase K, activity, moderation of alcohol

pharmacological interventions do what

lower BP, reduce risk

5 classes of drugs to prevent CVD

diuretics, ACE inhibitors, Angiotensin receptor blockers, calcium channel blockers, beta blockers