path exam 5

what is the main function of the cardiovascular system

supply an adequate amount of blood to all tissues of the body

how does the heart get the blood to the tissues

by the rhythmic contractions of the heart

what is the heart rate controlled by

autonomic nervous system

what nerve slows the heart rate down

the vagus nerve

what does the vagus nerve release to slow the heart

acetylcholine

what system in the body increases the heart rate and increases the force of its contractions

the sympathetic nervous system

what does the sympathetic nervous system release in order to increase the heart rate

epinephrine

how many chambers are in the heart

4

what are the walls of the heart chambers called that are composed of striated muscle

myocardium

the myocardium is lined with a smooth delicate membrane called

endocardium

what are the four chambers of the heart

right atrium and right ventricle, and left atrium and ventricle

what separates the right and left sides of the heart

the septum

which are larger and thicker walled due to having a heavier pumping load

the ventricles

between each artium and its associated ventricle what is found

the atrioventricular valves (AV valves)

how many directions does the AV valves allow blood

one direction

the AV valves have flaps of endocardium anchored to the papillary muscle of the ventricles by cord like structures called what

chordae tendinae

what is the mitral valve

it is a bicuspid valve, found on the left side of the heart, it has two cusps

what is the tricuspid valve

it is found on the right side of the heart, it has three cusps

what valves separate the ventricles from the great vessels

semilunar valves

where is the pulmonary valve found

between the right ventricle and the pulmonary artery

where is the aortic valve found

between the left ventricle and the aorta

how is deoxygenated blood returned back to the heart

through the superior and inferior vena cava

where do the superior and inferior vena cava return the blood to in the heart

the right atrium

describe the way the blood flows through the whole heart

right atrium - tricuspid valve - right ventricle - pulmonary valve - pulmonary artery - lungs - pulmonary vein - left atrium - mitral valve - left ventricle - aortic valve - aorta

what is the general circulation of the body termed

systemic circulation

what is the circulation of blood through the lung termed

pulmonary circulation

is greater pressure needed for the pulmonary or systemic circulation

systemic

the wall of the ___ ventricle is quite larger than the other ventricle

left

what is the contraction phase called

systole

what is the relaxation phase called

diastole

what happens during diastole

the heart chambers relax and fill with blood

what stimulates the mechanical contraction of the heart

SA node (sinoatrial node)

what is the SA node also known as

the pacemaker of the heart

where is the SA node found

in the right atrial wall near the opening of the superior vena cava

describe the bundle of His

they terminate in purkinje fibers, and they can impulse throughout the muscle of both ventricles and stimulate them to contract almost simultaneously

what does the SA node posses

an intrinsic rhythm

what is an intrinsic rhythm

it causes the node to initiate impulses at regular intervals (60-70 bpm)

what generates impulses rhythmically but at a much slower rate than the SA nodes

ectopic pacemakers

what supplies the heart muscle with oxygenated arterial blood

the right and left coronary arteries

where does the deoxygenated blood from the myocardium go

in the coronary veins into the coronary sinus into the right atrium

what is the double membranous sac that surrounds the heart

pericardium

what does the pericardium have to protect the heart from friction and prevent it from moving easily during contractions

a well lubricated lining

what are the most common congenital cardiac lesions

left to right shunts

what do left to right shunts do

they permit the mixing of blood in the systemic and pulmonary circulations

what does the magnitude of the shunt depend on

the size of the defect and the differences in pressure on the two sides

what is the most common congenital cardiac lesion

atrial septal defect

what does atrial septal defect do

permits free communication between he two atria as a result of either lack of closure of the foramen ovale after birth or its improper closure during gestation

which atrial pressure is typically higher than the other

left atrium

what is the location of the atrial septal defect

communication between the atria

what does the atrial septal defect show radiographically

PA chest: enlargement of the right ventricle, right atrium, and the pulmonary outflow tract

what is the ventricle septal defect

a left to right shunt

what does the ventricle septal defect cause

increased pulmonary blood flow and increased pulmonary venous return which leads to diastolic overload and enlargement of the left ventricle and atrium

what is the location of the ventricular septal defect

communication between the ventricles

how does ventricular septal defect appear radiographically

PA chest: pulmonary trunk enlargement and no right ventricular enlargement

what is the patent ductus arteriosus

it serves to shunt blood from the pulmonary artery into the systemic circulation during intrauterine life

what is the vessel that extends from the bifurcation of the pulmonary artery to join the aorta just distal to the left subclavian artery

ductus arteriosus

what is the location of patent ductus arteriosus

vascular connection between pulmonary artery and aorta

what is the radiographic appearance of the patent ductus arteriosus

PA chest: enlargement of the left atrium, left ventricle, and pulmonary arteries with an increase in pulmonary vascularity

what are all the left to right shunts

atrial septal defect, ventricular septal defect, and patent ductus arteriosus

what can all the left to right shunt be complicated by

Eisenmenger syndrome - the development of pulmonary hypertension

what is eisenmenger syndrome caused by

increased vascular resistance within the pulmonary arteries related to chronic increased blood flow through pulmonary circulation

what is the most common cause of cyanotic congenital heart disease

tetralogy of fallot

what are the four abnormalities found with tetralogy of fallot

1. high ventricle septal defect

2. pulmonary stenosis

3. overriding of the aortic orifice above the ventricle defect

4. right ventricle hypertrophy

in tetralogy of fallot what does the ventricle septal defect and overriding of the aorta produce

right to left shunting of the unoxygenated venous blood into the left ventricle and systemic circulation that causes the degree of cyanosis to increase

what is the radiographic appearance of the tetralogy of fallot

PA chest: enlarged right ventricle causes upward and lateral displacement of the heart apex

Echocardiography-demonstrates the four abnormalities of the disease

MRI-demonstrates the morphologic conditions:

Spin-echo scans to identify abnormalities Cine to demonstrate flow void in pulmonary stenosis

what is coarctation of the aorta

narrowing or constriction of the aorta

where does coarctation of the aorta typically occur

just beyond the branching of the blood vessels to the head and arms

since coarctation of the aorta causes increased blood pressure in the arms and head what does this mean for the lower body

decreased pressure

what does the coarctation of the aorta commonly cause in children

hypertension

What is the location of the Coarctation of the

aorta

Constriction of the aorta at the distal arch

What is the imaging appearance of the Coarctation of the aorta

PA chest-rib notching, figure-3

what is coronary artery disease

narrowing of the lumen of the coronary arteries that causes the deposition of fatty material in the inner arterial wall (atherosclerosis)

What is the location of Coronary artery disease

Blood vessels supplying the heart

What is the imaging appearance of Coronary artery

disease

PA chest-vessel calcifications

what can lead to myocardial infraction

the cutting off of a coronary artery to an area of myocardium that leads to tissue death

what can myocardial infraction lead to

congestive heart failure

what is congestive heart failure

the inability of the heart to propel blood at a rate and volume sufficient to provide an adequate supply to the tissue

what can cause congestive heart failure

intrinsic cardiac abnormality, hypertension, and any obstructive process

What is the location of Congestive heart failure

Insufficient cardiac output

What is the imaging appearance of Congestive heart failure

PA chest-C/T ratio >50%

what is pulmonary edema

an abnormal accumulation of fluid in the extravascular pulmonary tissue

what is the most common cause of pulmonary edema

an elevation of the pulmonary venous pressure

What is the location of Pulmonary edema

Extravascular fluid in the lungs

What is the imaging appearance of Pulmonary edema

PA chest-vascular markings not sharp; severe edema produces a butterfly pattern

what is hypertension

a high blood pressure

what can hypertension lead to

congenital heart failure and stroke

What is the location for Hypertension

Increased pressure in the systemic vascular system

What is the imaging appearance of Hypertension

PA chest-vascular markings not sharp; severe edema produces a butterfly pattern

what is blood pressure

a function of the cardiac output and total peripheral resistance

how is blood pressure measured

systolic / diastolic

what measures systolic

the highest pressure in the peripheral arteries when the left ventricle contracts

what measures diastolic

the pressure in the peripheral arteries when the left ventricle is relaxing and filling with blood from the left atrium

what is considered a high blood pressure

140 mmHg/ 90 mmHg

what is the rule of thumb when it comes to blood pressure

a person is allowed an additional 10 mmHg in systolic pressure each decade after 40

how is the benign form of essential hypertension characterized

by a gradual onset and a prolonged course often of many years

how is the much less common malignant form of hypertension characterized

an elevated blood pressure that is an abrupt onset that runs a rapid course that often leads to renal failure or cerebral hemorrhage

what is hypertensive heart disease

a long-standing high blood pressure that causes narrowing of systemic blood vessels an increased resistance to blood flow

What is the location of Hypertensive heart disease

Left ventricular enlargement

What is the imaging appearance of Hypertensive heart disease

PA chest-enlarged left ventricle, inferior displacement of cardiac apex, aortic tortuosity

what is an aneurism

a localized dilation of an artery that most commonly involves the aorta, especially its abdominal area