Exam 4 (Comprehensive)

ALL arteries carry blood away from the heart. All veins carry blood toward the heart

accept; artery = away, vein = to

Blood vessels are the medium for exchange between the 70 trillion cells in the body and it is the heart that makes the cardiovascular system efficient in this purpose.

Blood vessels are the transport for the medium between the 70 trillion cells in the body and it is the heart that makes the cardiovascular system efficient in this purpose.

Exchange vessels can be capillaries, arterioles, or venules.

Exchange vessels can be capillaries.

The pulmonary circuit is the vessels that carry blood to and from the lung and the pump for this circuit is the right side of the heart.

accept; definition of pulmonary circuit

inferior vena cava - large vessel that brings O2 poor blood from the thoracic region of the heart

inferior vena cava- large vessel that brings O2 poor blood from the below the diaphragm

left ventricle - is the pump for system circulation, which includes coronary circulation

accept; definition

right and left pulmonary arteries - carry oxygenated blood back to heart

right and left pulmonary veins - carry oxygenated blood back to heart

aortic semilunar valve- prevent backflow of blood into right ventricle

aortic semilunar valve- prevent backflow of blood into left ventricle

The fibrous pericardium is non-serous.

accept; definition

The visceral layer is also called the epicardium.

accept; definition

The myocardium is the connective tissue fibers of the heart skeleton.

The myocardium is the cardiac muscle cells that are tethered together to form the heart skeleton

The pericardial sac is made of tough dense connective tissue and the parietal layer of the pericardium (synthesis)

accept; definition

The aorta is the largest conducting artery and carries oxygenated blood back from the heart

accept; function of aorta

The tricuspid valve is the right atrioventricular valve

accept; definition

The mitral valve contracts to open and allow blood into left ventricle.

The mitral valve contracts to close and prevent back flow into left ventricle

The pulmonary veins (4-5) come from the lungs

accept; definition

Both AV valves have papillary muscles. The contraction of these muscles neither opens nor closes the valve.

accept; definition and function of papillary muscles

The left ventricle has walls that are circular. This increases contraction force of this chamber relative to the right ventricle.

accept; structure and function of left ventricle

Distributing vessels have larger amounts of smooth muscle for the purpose of propelling blood onward during contraction.

Conducting vessels have larger amounts of elastic tissue for the purpose of propelling blood onward during contraction.

At rest, veins function as blood reservoirs because of their large lumen compared to their thin walls.

accept; veins have larger lumen than arteries

Aortic stenosis causes the opening through the aortic semilunar valve to be smaller. this can cause ventricular hypertrophy because the heart must work harder to maintain cardiac output. (synthesis)

accept; heart conditions

Mitral valve prolapse is more prevalent in women, often due to heredity, and results in less oxygenated blood getting to the tissues. Symptoms include fatigue and shortness of breath, especially on exertion.

accept; heart conditions

The bicuspid and tricuspid valves are often replaced by mechanical valves. They are often replaced together because both are associated with the left ventricle and where out because of the pressure this chamber exerts.

The left AV and aortic semilunar valves are often replaced by mechanical valves. They are often replaced together because both are associated with the left ventricle and where out because of the pressure this chamber exerts.

Older people, in their 80s and above, have valve replacement more frequently than younger people because of damage done to their valves by a strep infection in childhood… at a time before ANY antibiotics were available.

accept; extra information on slides we covered but didn’t have

Atrial fibrillation/flutter, results in less blood getting back to the heart and thus, as a result, less blood to tissues.

accept; point to ponder

In a second-degree heart block, the SA node functions and produces P waves.

accept; point to ponder

Arteries that deliver blood to specific organs and arterioles are called “resistance vessels” and are active in vasoconstriction which controls blood flow to specific organs.

accept; definition

Vein have valves, which force blood toward the heart in the muscular pump.

Vein have valves, which prevent backflow, and force blood toward the heart with the muscular pump.

pulmonary trunk - large artery that carries deoxygenated blood toward both lungs. The same amount of blood flows through it as it does in the aorta, with each heartbeat.

accept; definition

capacitance vessels - all vessels in the venous part of circulation

accept; definition

coronary sinus - largest vein in the circulation for the heart (coronary circulation). It drains into the rt. atrium as does all the rest of the systemic circulation. 

accept; definition

microcirculation—term that describes all the capillaries in the body.

microcirculation—term that describes the capillary bed of an organ

Angina pectoris is most often caused by blood clots.

Angina pectoris is most often caused by atherosclerosis and ischemia

A myocardial infarction can be treated with nitroglycerine.

Angina pectoris can be treated with nitroglycerine.

Because of the large amount of heart tissue that receives blood from this vessel, atherosclerosis that blocks the left coronary artery will cause a lot of ischemia and thus a lot of chest pain and the most heart damage. 

accept; definition of atherosclerosis

Coronary artery disease causes half the deaths in the western world. Half of people will die within 1 hr. of the onset of an myocardial infarction. Many people live but then must live with a damaged heart because myocardial tissue does no “functionally regenerate.”  (Does little regeneration and mostly fibrosis) (synthesis).

accept; definition

Venous valves can become “incompetent” (not functional). This can cause “varicose veins.”

accept; definition

Blockage in the distil part of the left anterior descending artery affects the left ventricle, near the apex

accept; point to ponder

Autorhythmic cells are 1% of the cardiac cells.

accept; definition

The bundle branch is made up of autorhythmic cells but too slow for pacing the heart to support life. (evaluation)

accept; definition

The primary factors that begin the process of atherosclerosis are a diet high in fat and a sedentary lifestyle.

The primary factors that begin the process of atherosclerosis are tissue damage to tunica intima.

The first sign of atheroma development is macrophages engorged with LDLs, forming a fatty streak.

accept; from atherosclerosis reading

Arteriosclerosis involves complicated plaques with calcium salts in the lesions. 

accept; from atherosclerosis reading

A significant part of the action of cholesterol-lowering drugs called statins is their anti-inflammatory activity.

accept; from atherosclerosis reading

The intrinsic cardiac conduction system is made up of the cardiac cells that do not contract.

accept; definition

All cardiac muscle cells are autorhythmic. And can initiate and distribute electrical impulses.

Only 1% cardiac muscle cells are autorhythmic. And can initiate and distribute electrical impulses.

Autorhythmic cells have unstable resting potentials because of slow Na⁺ movement into the cells.

accept; definition

The opening of voltage gated Ca⁺⁺ channels cause depolarization at threshold for cardiac cells

accept; definition

The SA node is called the pacemaker because it sends out pacemaker potentials to effectors.

The SA node is called the pacemaker because it has pacemaker potentials

Sinus rhythm under the influence of vagal tone is ~75 beats/min.

accept; sinus rhythm + vagal tone = 75 bpm

The heart exhibits “organ unit contraction” (true statement) because depolarization spreads between cardiac cells through gap junctions.  This contrasts with skeletal muscle which exhibits “motor unit contraction.” evaluation

accept; from notes

The AV bundles passes the electrical signal to the bundle branches of the conduction system.

accept; definition

Purkinje fibers - conduction cells that begin near the heart apex that carry the electrical impulse to papillary muscle first and before it goes to ventricular contractile cells. 

accept; definition

positive chronotropic factors—Factors that make the duration of the events of the ECG longer.

positive chronotropic factors—factors that increase the heart rate

heart murmur - a heart defect determined by an abnormal ECG

heart arrhythmia - a heart defect determined by an abnormal ECG

cardioaccelatory center - area in the medulla oblongata that sends sympathetic signals through T₁-T₅ spinal nerves to the heart

accept; definition

The heart continuously receives both parasympathetic and sympathetic innervation, but only sympathetic signals change the strength of heart contraction.

accept; definition

An increase in body temperature will cause the release of norepinephrine at the SA and AV nodes to increase heart rate.

accept; medullar oblongata signals for norepinephrine release for sympathetic response

Parasympathetic nerves always release acetylcholine, which decreases heart rate but not the strength of contraction.

accept; definition

Epinephrine, from the adrenal medulla, increases heart rate.  There are no hormones that are negative chronotropic factors.

accept; acetylcholine is a neurotransmitter

The P wave is due to atrial depolarization which causes atrial contraction.

accept; definition

Frequent QRS complexes, which are seen in an ECG of ventricular tachycardia, means the ventricles will be pumping less blood to the body. 

accept; point to ponder

It is not an arrhythmia if the duration of electrical events on an ECG are altered but the sequence is normal.

It is an arrhythmia if the duration of electrical events on an ECG are altered but the sequence is normal.

The T wave is a recording of the relaxation of the conduction system in the ventricular septum and the ventricular walls. 

The T wave is a recording of the repolarization of the ventricles.

Cardioaccelatory center - area in the cerebrum that gives us an awareness of increasing heart rate.

Cardioaccelatory center - area in the medulla oblongata that gives us an awareness of increasing heart rate.

Positive chronotropic factors - conditions such as emotional trauma and increased body temperature 

accept; definition

Vagal tone - the inherent rate of the SA node pacemaker

vagal tone- parasympathetic dominant influence at rest with vagus nerve (lowering to 75 from 100 with SA node pacemaker)

Sinus rhythm - the ECG from the reference man

Sinus rhythm - the inherent rate of SA node pacemaker influence

The cardiac cycle is all events associated with blood flow through the heart  during one heartbeat. 

accept; definition

The cardiac cycles mechanical events always follow the electrical events of the heart. 

accept; electrical → mechanical

Pressure changes directly determine heart sounds

Blood backflowing and bouncing off closed valves changes directly determine heart sounds

In the cardiac cycle, volume changes produce pressure changes, which determine valve action.

In the cardiac cycle, volume changes and valve action determine blood flow

The P wave occurs in the middle of mid to late ventricular diastole.  This electrical event causes the atria to contract and eject about 20% of the blood in the ventricle

accept; definition + chart

In ventricular systole, semilunar valves are closed in the beginning and then open in the ventricular ejection phase. 

accept; definition

Early ventricular diastole is the same as isovolumetric relaxation. 

accept; definition

In isovolumetric contraction, ventricular pressure is rising at the same time that blood pressure is falling.  (evaluation)

accept; look at the chart

The first heart sound occurs simultaneously with the initiation of the QRS complex.  It is the sound of the A-V valves closing.

The first heart sound occurs simultaneously with the initiation of the QRS complex.  It is the sound of the backflow of blood against AV valves.

Both semilunar and A-V valves are closed for all of isovolumetric contraction and isovolumetric relaxation.

accept; definition

The dicrotic notch is a momentary surge in systemic arteriole blood pressure as blood bounces off the closed semilunar valves.  It is concurrent with the second heart sound.

accept; definition + chart

The cardiac cycle does not include a short pause at the end of ventricular diastole.

The cardiac cycle includes a short pause at the end of ventricular diastole.

blood pressure - average pressure of all arteries and veins

blood pressure—average pressure of the aorta and arteries

heart murmur - abnormal heart sound usually due to a problem with heart valves.  It is detected with a stethoscope.

accept; definition

pulse pressure - pressure in aorta when blood is first ejected from the ventricle

pulse pressure - the difference in systolic and diastolic pressure

systolic pressure - highest mean arteriole pressure (MAP), occurs at the end of ventricular contraction

systolic pressure—highest pressure that occurs at the end of ventricular relaxation

Cardiac output is ~ 40 ml/beat for a male and is calculated by multiplying cardiac output by venous return

Cardiac output is ~ 5.25L/minute for a male and is calculated by multiplying heart rate by stroke volume

Diastolic blood pressure occurs during ventricular contraction. 

accept; at very end of ventricular contraction, we get lowest diastolic pressure

Blood pressure changes little during normal duration of exercise (true statement).  There can be up to 7x increase in cardiac output in a well-trained endurance athlete during exercise.  This means that your arterioles dilate dramatically to compensate (evaluation). 

accept; application

The difference between resting and maximal cardiac output is called cardiac reserve.

accept; definition

The main factor affecting stroke volume is the contractility of the heart muscle.

The main factor affecting stroke volume is the preload.

Increasing venous return increases preload → end diastolic volume(EDV) is increased which increases stroke volume.

accept; look at flow chart

ESV is the blood left in both ventricles (the amount should be the same in each) after contraction.

accept; definition

Afterload is defined as the force of contraction changed by extrinsic factors.

Afterload is defined as the blood left in ventricles after contraction

Gaining 10 pounds increases your blood pressure because vessel length increases peripheral resistance.

accept; definition

Excessive sweating leads to a decreased blood pressure because of lower blood volume, lower venous return, lower stroke volume, lower cardiac output. 

accept; look at flow chart

Systemic blood pressure is homeostatically regulated in the body by receptors in the heart and effectors in the carotid sinuses.

Systemic blood pressure is homeostatically regulated in the body by receptors in the carotid sinuses.

Blood pressure is calculated as cardiac out x peripheral resistance. When you are nervous (like during this exam) blood pressure increases because increases both heart rate and stroke volume increase (the 2 factors for cardiac output) and norepinephrine produces constriction of smooth muscle in artery walls, the main factor affecting peripheral resistance.  So, both sides of the blood pressure equation increase!

accept; look at flow chart