BMD310 - Exam 4

closed
arteries, veins, capillaries

The cardiovascular system consists of the heart and a ----- system of blood vessels called -----, -----, -----.

arteries

Transport blood away from the heart.
Most carry OXYGENATED blood, except for the pulmonary ones.

veins

Transport blood back to the heart
Most carry DEOXYGENATED blood, except for the pulmonary ones.

circulatory

The cardiovascular system containing arteries, veins, and capillaries is also called the ------ system.

mediastinum
left

The heart is located deep to the sternum in the ----- of the thoracic cavity.
- superior to the diaphragm
- 2/3 of the heart is ---- of the midline.

base of heart

superior border of the heart
- formed by the atria (primarily the left atrium), ascending aorta, and pulmonary trunk

apex of the heart

inferior border of the heart
formed by the left ventricle
- PMI: point of maximal impulse

Point of maximal impulse (PMI)

the point where the apex of the heart touches the anterior chest wall and heart movements are most easily observed and palpated

- palpable left midclavicular line 5th intercostal space.

midclavicular line

imaginary vertical line bisecting the middle of the clavicle in each hemithorax

pericardium

restricts movement and stabilizes (gives support) the heart in the thoracic cavity from the surrounding organs
- the outer sac

fibrous
serous
parietal
visceral

In the pericardium, there is....
1. ----- pericardium: dense, inelastic irregular connective tissue (outer layer)
2. ----- pericardium: inner lining
a. ----- layer: fused to the fibrous pericardium
b. ----- layer: fused to the heart surface

Epicardium

visceral layer of the serous pericardium
- contains blood vessels, lymphatics, and nerves that supply the myocardium

myocardium

composed of cardiac muscle tissue
- striated involuntary muscle
- contraction generates the force necessary to pump blood

Endocardium

inner lining which makes the heart smooth
- composed of simple squamous epithelium cells and underlying layer of connective tissue
- lines the chambers of the heart and valves

endothelium

In the endocardium, there is the ----- which continuous epithelium that lines the blood vessels.

epicardium, myocardium, endocardium

The heart wall structure is formed by the -----, ------, and -----.

fibrous pericardium

serous pericardium (parietal layer)

serous pericardium (visceral layer)

epicardium

myocardium

muscular, middle layer of the heart

trabeculae of heart

endocardium

inner endothelial lining covering trabeculae

pericarditis

inflammation of the pericardium
- typically an infection of the heart
- layers can adhere to one another
- interferes with the heart contractions

pericardial effusion

collection of fluid within the pericardial cavity
- common causes are pericarditis, trauma (bleeding into the space), heart failure
- can lead to tamponade

tamponade (cardiac)

compression of the heart by fluid that restricts heartbeat

pericardiocentesis

drainage of fluid from the pericardial cavity; Is usually necessary to relieve cardiac tamponade

Atria
right
left
ventricles
right
left

Four chambers of the heart:
1. ----- : blood coming into the heart
- thin walled chambers located superiorly
- receives blood from the veins
a. -----: receives deoxygenated blood
b. -----: receives oxygenated blood
2. ------: blood is leaving the heart
- thicker walled chambers located inferiorly
- pumps blood into the arteries
a. -----: pumps deoxygenated blood to the lungs (through the pulmonary artery)
b. -----: pumps oxygenated blood to the body (through the aorta)

atria

ventricles of heart

auricle

increases in volume when atria are filling with blood

pectinate mm.

muscular ridges that line the auricle and anterior wall

crista terminalis

smooth ridge of tissue that extends from the SVC to the IVC

fossa ovalis

former location of the fetal foramen oval, which shunted blood from the right atrium to the left atrium during fetal development

Thebesian valve

valve of coronary sinus

Inferior Vena Cava (IVC)

returns blood from portions of the body below the heart

interarterial septum

separating wall or partition between the right and left atria

superior vena cava

A vein that is the second largest vein in the human body and returns blood to the right atrium of the heart from the upper half of the body.

moderator band

connects the base of the anterior papillary muscle to the inter ventricular septum

- septal marginal trabeculae

trabeculae carneae

large, smooth, irregular muscle ridges

chordae tendineae

prevent valve from everting and flapping into the atrium when the right ventricle is contracting

Papillary mm.

Stabilize the tricuspid valve to help prevent regurgitation of blood back into the right atrium during systole
- contract, pull on cords, and hold valve closed

tricuspid valve

interventircular septum

pulmonary semilunar valve

mitral valve

valve between the left atrium and the left ventricle; bicuspid valve

pulmonary arteries

carry deoxygenated blood out of the right ventricle and into the lungs

semilunar valves

passive valves- NO muscles to hold them closed

aortic semilunar valve

atrioventricular valves

active valves- papillary muscles contract to hold valves closed

tricuspid valve

valve between the right atrium and the right ventricle

ventricular diastole

ventricles relax and fill with blood passing through the tricuspid and bicuspid valves
- the pulmonary and aortic valves are closed to prevent regurgitation of blood into the ventricles.

Ventricular Systole

ventricles contract and force blood past the pulmonary and aortic valves
- papillary muscles and tension of chordae tendineae keep the tricuspid and bicuspid valves

aortic

sternal margin of R 2nd intercostal

number 1

pulmonary

sternal margin of L 2nd intercostal

Right AV valve (tricuspid)

sternal margin of L 5th intercostal

Left AV Valve (bicuspid)

midclavicular line of L 5th intercostal

heart murmur

an abnormal sound produced by turbulent blood flow
- first indication of heart valve problems

valvular insufficiency

cardiac valve leakage because valve cusps do not close properly
- leads to regurgitation of blood back through the valve
- caused by inflammation or disease

valvular stenosis

incomplete opening of valves because of partial fusion of valve cusps
- leads to resistance of flow of blood - decreasing chamber output
- chamber undergoes hypertrophy and dilates - both conditions that may have dangerous consequences
- primary cause - Rheumatic heart disease; which typically follows a streptococcus infection of the throat

pulmonary circulation

transports deoxygenated blood form the right side of the heart to the lungs

systemic circulation

transports oxygenated blood from the left side of the heart to the body

Right Atrium receives deoxygenated blood from the systemic circulation and the heart• Three major vessels: (1) superior and (2) inferior venae cavae, and (3) coronary sinus

Step 1 of blood circulation through the heart:

Deoxygenated blood is pumped through the Tricuspid Valve to get to the Right Ventricle

Step 2 of blood circulation through the heart:

Then, deoxygenated blood is pumped through the Pulmonary Semilunar Valve and the Pulmonary Arteries to get to the Lungs

Step 3 of blood circulation through the heart:

Left Atrium receives oxygenated blood from the lungs through the Pulmonary Veins

Step 4 of blood circulation through the heart:

Oxygenated blood is pumped through the Bicuspid Valve to get to the Left Ventricle

Step 5 of blood circulation through the heart:

Then, oxygenated blood is pumped through the Aortic Semilunar Valve and the Aorta to get to the Body

Step 6 of blood circulation through the heart:

right coronary artery

artery vascularizing the right side of the heart

right marginal artery

serves the myocardium of the lateral right side of the heart

left coronary artery

supplies blood to the left ventricle, left atrium, and interventricular septum

circumflex artery

supplies the left atrium and the posterior walls of the left ventricle

anterior interventricular artery

Also called the left anterior descending artery

posterior interventricular artery

runs to the heart apex and supplies the posterior ventricular walls

sulcus
sulci

In the coronary arteries, the coronary ---- and interventricular ---- mark the boundaries of the four heart chambers.

coronary sulcus

groove between the atria and ventricles that extends to the circumference of the heart
- left and right coronary arteries
- left circumflex artery

interventricular sulcus

groove between the ventricles that extends inferiorly from the coronary sulcus toward the apex
- anterior interventricular artery (LAD)
- posterior interventricular artery

myocardial infarction

commonly referred to as a heart attack
- an area of myocardium that has undergone necrosis, due to the obstructed blood flow
- potentially lethal condition resulting from sudden and complete occlusion of a coronary artery

ischemia
hypoxia
infarct

myocardial infarction:
1. -----: reduced blood flow
2. -----: reduced oxygen
3. -----: death of tissue due to lack of blood supply

1. The anterior IV (LAD) branch of the LCA (40-50%)
2. The RCA (30-40%)
3. The circumflex branch of the LCA (15-20%)

What are the 3 most common sites of coronary artery occlusion?

sinoatrial node (SA node)

pacemaker of the heart

atrioventricular (AV) node

a node of specialized heart muscle located in the septal wall of the right atrium; receives impulses from the sinoatrial node and transmits them to the atrioventricular bundle

AV bundle (bundle of His)

fibers in the heart that relay a nerve impulse from the AV node to the ventricles

Purkinje fibers

fibers in the ventricles that transmit impulses to the right and left ventricles, causing them to contract

- in myocardium and under endocardium

plasma (55%) and formed elements (45%)

A sample of whole blood is made up of ----- and -----.

plasma proteins and water

Plasma consists of ---- and -----.

platelets, white blood cells, and red blood cells (99.9%)

formed elements consists of -----, ------, and -----.

platelets

fragments of megakaryocytes critical for clotting
- not cells themselves

leukocytes

white blood cells; defense against infection
- neutrophils, eosinophils, basophils, lymphocytes, monocytes

erythrocytes

red blood cells
- deliver oxygen and remove carbon dioxide

temperature
albumins
globulins
clotting factors

Plasma is the liquid fraction of the blood.
1. water: more than 90% of plasma by volume
- helps blood function as ----- buffer (absorbs heat)
2. plasma proteins:
-----: too large to leave the bloodstream; regulate osmolarity and function as carrier molecules
-----: also function as carrier proteins
-----: play an essential role in blood clotting
These are water soluble hormones

Buffy coat
erythrocytes

formed elements include cells and their fragments
1. ----- -----: leukocytes and thrombocytes (white blood cells)
2. ------ : red blood cells

function

Erythrocyte structure complements -----.

biconcave
anucleate

In erythrocytes:
------ shape allows red blood cells to bend, fold, and stack to prevent blockage in tiny blood vessels
- this also increases surface area for gas exchange
-------: non-mitotic, carry very little DNA, unable to synthesize proteins (lack a nucleus)
- prone to apoptosis

erythropoiesis

----- is the process of red blood cell formation

adults
red bone marrow
reticulocyte
myeloid
4
spleen

In erythropoiesis,
- you are not making many RBC's as ------
- The first step begins at ------ and the last step ends with the -----.
The ---- stem cell can become either a red or white blood cell.
RBC's last for about --- months and are then broken down by the -----

bone marrow transplant

- Treatment option for blood borne cancers (in combination with chemotherapy, immunosuppressive therapy)
- Bone marrow is obtained from an anesthetized donor through the iliac crest
- Donor is typically the individual themselves (autograft) or close relative (allograft)
- Replenishes blood cells to avoid permanent myoablation

EPO

The regulation of erythropoiesis is kept by the hormone ------, which signals the production of Red Blood Cells

maturation
blood doping
anemia

In EPO,
- Hypoxia and testosterone both signal EPO release
• EPO drives erythrocyte -----
• "----- ------": artificially inducing polycythemia by taking testosterone, EPO or highly-packed RBC suspensions
• -------: blood disorders characterized by the body's failure to supply tissues with adequate O2

Hemoglobin

----- reversibly binds to blood gases within erythrocytes.

oxyhemoglobin
deoxyhemoglobin

In a hemoglobin molecule,
• Globular, tetrameric protein formed from 2 alpha and 2 beta chains (adult) or 2 alpha and 2 gamma chains (fetus)
• Each chain contains a heme group that binds oxygen using iron
• ------- = bound to O2
• ------- = no O2 bound
• Binding sites for O2 are cooperative