Lecture Exam 1

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104 Terms

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\*two major divisions of the circulatory system
pulmonary and systemic
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\*pulmonary circuit
* right side of the heart with deoxygenated blood
* carries blood to lungs for gas exchange and then back to heart
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\*systemic circuit
* left side of the heart with oxygenated blood
* supplies oxygenated blood to all tissues of the body and returns it to the heart
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what type of blood does the LEFT side of the heart hold?
fully oxygenated blood from the pulmonary veins
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what type of blood does the right side of the heart hold?
oxygen-poor blood from the superior and inferior vena cavae
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top of the heart:
base
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bottom of the heart:
apex
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hearts position in the body:
directly behind the sternum
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a double-walled sac that encloses the heart:
pericardium
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what does the pericardium allow the heart to do?
beat without fiction and anchor into place
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pericardial cavity:
* between the visceral and parietal pericardium
* its superficial fibrous layer of CT and a deep, thin serous layer
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visceral pericardium:
* a serous membrane covering the heart
* AKA epicardium
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term for painful inflammation of the membrane:
Pericarditis
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\*3 layers of the heart wall:
Epicardium

Endocardium

Myocardium
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\*epicardium
* serous membrane covering heart
* coronary blood vessels travel through this layer
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\*endocardium
* smooth inner lining of heart and blood vessels
* covers the valve surfaces and it continuous with endothelium of blood vessels
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\*myocardium
* layer of cardiac muscle proportional to work load
* 90%
* fibrous skeleton of the heart: framework of collagenous and elastic fibers
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four chambers of the heart:
right and left atrium, right and left ventricle
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\*on the surface above the atriums:
auricles
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wall that separates atria:
interatrial septum
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internal ridges of myocardium that are in the right atrium and both auricles:
pectinate muscles
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wall that separates ventricles:
interventricular septum
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internal ridges that are in both ventricles:
trabeculae carneae
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\*the foramen ovale in the fetus that gets filled when it grows:
fossa ovale
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separates the atria and ventricles on the outside of the heart:
antrioventricular sulcus
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divides the right ventricle from the left on the outside of the heart:
interventricular sulcus
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controls the blood flow between atria and ventricles
atrioventricular valves (AV)

* right AV - tricuspid
* left AV - mitral/ bicuspid
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\*cord that connects AV to papillary muscles on the floor of ventricles:
chordae tendineae

* prevents AV from flipping or bulging into atria when ventricles contract
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\*systole:
contraction
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\*diastole:
relaxation
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What controls the flow into great arteries?
semilunar valves
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What are the 2 types of semilunar valves?
pulmonary and aortic
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how do semilunar valves open and close?
because of blood flow and pressure
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Blood flow of deoxygenated blood:

1. blood enters the right atrium from superior/inferior vena cava
2. blood in right atrium flows through right AV valve into right ventricle
3. contraction of right ventricle forces pulmonary valve open
4. blood flows through pulmonary valve into pulmonary trunk
5. blood is distributed by right/left pulmonary arteries to the lungs, unload CO2 and load O2
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blood flow of oxygenated blood:

1. blood returns from lungs via pulmonary veins into left atrium
2. blood in left atrium flows through left AV valve into left ventricle
3. contraction of left ventricle forces aortic valve open
4. blood flows through aortic valve into ascending aorta
5. blood in aorta is distributed to every organ in body, unloading O2 and loading CO2
6. blood returns to right atrium via vena cava
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the coronary circulation relates to:
blood vessels on heart walls
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what percentage of blood pumped by the heart to the heart itself through the coronary circulation?
5% (250mL/min)
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what arteries branch off the ascending aorta?
left coronary (LCA) and right coronary (RCA) arteries
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what blood vessels supply blood to both ventricles and anterior 2/3 of the interventricular septum?
anterior interventricular branch (branches off of LCA)
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What passes around the left side of the heart in coronary sulcus?
circumflex branch - supplies left atrium and posterior wall of left ventricle (branches off of LCA)
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what branches off of the circumflex branch?
left marginal branch
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what blood vessel supplies the right atrium and sinoatrial node?
right coronary artery (RCA)
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what supplies lateral aspects of the right atrium and ventricle?
right marginal branch (branches off of RCA)
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what supplies the posterior walls of ventricles?
posterior interventricular branch (branches off of RCA)
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what disease in the constriction of the coronary arteries?
Coronary arteries disease (CAD)

* results in atherosclerosis
* starts when endothelium is damaged
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medical term for a heart attack:
myocardial infarction (MI)

* interruption of blood supply to the heart from a blood clot and can cause cell death within minutes
* 27% of US deaths
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what is it called when you have chest pains from partial obstruction of coronary blood flow?
angina pectoris

* pain is caused by ischemia (decrease of blood flow) or cardia muscle
* shift to anaerobic fermentation
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what does the venous drainage drain?
waste
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what vein drains coronary blood directly back into the heart chambers to drop off deoxygenated blood?
thebesian veins

* drop of to the right atrium by the coronary sinus
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3 coronary sinus inputs:

1. great cardiac vein
2. posterior interventricular vein
3. left marginal veins
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what veins travel alongside the anterior interventricular artery and collect blood for the anterior portion of the heart?
great cardiac vein
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what vein is found in the posterior sulcus and collects blood from the posterior portion of the heart?
posterior interventricular
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what is the large transverse vein in the coronary sulcus on the posterior side of the heart?
coronary sinus
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what are the striated, short, thick, branches cells with one central nucleus surrounded by light-stained mass of glycogen and myofibrils?
cardiocytes - all beat in unison
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what joins cardiocytes end to end with interdigitating folds, mechanical junctions, and electrical gap junctions?
intercalated discs
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what do cardiac muscles depend almost exclusively on the make ATP?
aerobic respiration

* rich in myoglobin and glycogen
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what cells make up the nerve-like conduction pathways through myocardium?
conductive and contractic cells
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conductive cells
send the signals
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contractic cells
receives the signal and contracts muscle
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the internal pace maker:
sinoatrial node (SA)

* modifies cardiocytes by initiating heartbeat and rate
* located in right atrium near base of superior vena cava
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process of the conduction system:

1. sinoatrial (SA) node fires
2. excitation (conductive cells) spreads through atrial myocardium
3. atrioventricular (AV) node fires
4. excitation spreads down AV bundle
5. Purkinje fibers distribute excitation through ventricular myocardium
6. hits cardiocyte in the ventricle and contracts
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what happens during steps 3 and 4?^\`
signals starts to slow down to allow ventricles to fill up
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what is the sinus rhythm?
normal heartbeat triggered by SA nodes (70-80bpm)
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what is the region of spontaneous firing other than the SA node?
ectopic focus caused by caffeine or stress
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if the SA node is damaged and heart rate is set by the AV node, what is the new stressed rhythm called?
nodal rhythm (40-50bpm)
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what is gradual depolarization called?
pacemaker potential
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what are the 3 phases to cardiocyte action potential?
depolarization, plateau, repolarization
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depolarization
* brief
* stimulus opens voltage-regulated Na+ gates, membrane depolarizes rapidly
* peaks at +30MV
* Na+ gate close quickly
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plateau phase
* sustains contractions for expulsion of blood from heart
* voltage-gated slow Ca2+ channels open admitting Ca2+ which triggers opening of Ca2+ channels on sarcoplasmic reticulum
* Ca2+ binds to troponin triggering contracton
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repolarization
* Ca2+ channels close
* K+ channels open
* rapid diffusion of K+ out of cell returns it to resting potential
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what happens during a P wave?
atrial depolarization = atrium contracts
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what happens during the QRS complex?
ventricular depolarization
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what happens during the ST segment?
ventricles contract
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what happens during the T wave?
ventricular repolarization and relaxation
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the opening and closing of valves are governed by ___
pressure changes
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what is any failure of a valve to prevent reflux?
valvular insufficiency
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What is it called when cusps are stiffened and the opening is constricted by scar tissue?
valvular stenosis

* result of rheumatic fever, autoimmune attack on the mitral and aortic valves and enlarged overworking heart
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when there is an insufficiency in which one or both mitral valve cusps bulge into atria during ventricular contraction?
mitral valve prolapse (may cause chess pain and shortness of breath)
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first heart sound is ____. What produces it?
lubb

* produced by closure of the AV valves
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second heart sound is ___. What produces it?
dupp

* produced by closure of semilunar valves
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ventricular filling
valves

* AV opening, semilunar closing

no sound

EDV achieved in each ventricle (130mL)
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isometric contraction
valves

* AV closed, semilunar opening

first heart sound
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ventricular ejection
valves

* AV closed, semilunar open

no sound

60mL of blood remaining = ESV
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isovolumetric relaxation
valves

* AV and semilunar closed

second heart sound

T wave ends and ventricles begin to expand
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EDV
end-disastolic volume

130mL
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ESV
end-systolic volume

= EDV - SV
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SV
stroke volume: amount of blood pumped per beat

SV=EDV-ESV
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what are the results from the failure of either ventricle to eject blood effectively called?
congestive heart failure (CHF)

* due to chronic hypertension, valvular insufficiency
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what is is called when blood backs up into the lungs causing pulmonary edema?
left ventricular failure

* symptoms: shortness of breath or sense of suffocation
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what is it called when blood backs up in the vena cava causing systemic or generalized edema?
right ventricular failure

* symptoms include: enlargment of liver, ascites, distention of jugular veins, swelling of fingers
* leads to heart failure
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what is the term for the amount of blood ejected by each ventricle in 1 minute?
cardiac output

= heart rate x SV

results in 4-6L/minute at rest
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what is the term for the difference between a person’s maximum and minimum cardiac output?
cardiac reserve

* increases with fitness; decreases with disease
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tachycardia
more than 100 beats/min
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bradycardia
less than 60 beats/min
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how does venous return affect SV and CO?
amount of blood coming back to the heart through veins will depends how much blood can be pumped
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how does exercise affect HR, SV, and CO
increase all 3
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the part of the intrinsic conduction system that initiates and sets the heart rate:
SA node
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a tracing of the electrical activity of the heart is:
ECG (electrocardiograph)
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atrial repolarization is hidden by ____ wave in a normal ECG
QRS
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the three variables of a stroke volume:
preload, contractility, afterload