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cardiac anatomy
cardiac anatomy
106
Anatomy
Graduate
05/23/2012

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Cards

Term
at what rib level is the apex of the heart
Definition
5
Term
what is the degree of tilt of the heart from vertical
Definition
45 deg
Term
what is the degree of tilt of the heart from horizontal
Definition
45 deg
Term
does the left or right side of the heart face more anteriorly
Definition
left
Term
do all muscle fiber layers of the heart contract at the same time? Why or why not?
Definition
no, they contract within miliseconds of each other in order to squeeze the blood out of the heart
Term
what is a transmural heart attack
Definition
heart attack that goes all the way through the heart, cuts down on heart function
Term
if someone has a little heart attack, where did it occur (probably)
Definition
epicardium
Term
why are heart attacks that affect the endocardium dangerous
Definition
we have difficulty knowing how that part of the heart will react
Term
what is the SA node
Definition
bundle of nerve tissue that initiates heart depolarization/nerve conduction that spreads to other areas of the heart.
Term
where is the SA node
Definition
in the right atrium
Term
from the SA node in the right atrium, where do impulses go
Definition
across to the left atrium and also down to the AV node.
Term
what is the AV node
Definition
another specialized bundle of nerve tissue that's inherent in the muscle.
Term
what is the path of an electrical implulse once it goes from the SA node to the AV node?
Definition
once it goes through the AV node, it goes through the bundle of HIS and splits into the left bundle branch and the right bundle branch and the bundle branches curve around to the peripheral outer side of each ventricle on the left or right (these are purkinje fibers)
Term
what is the P wave
Definition
atria pushing blood into the ventricles. As the atria depolarize electrically, the muscle fibers are stimulated to contract, pushing blood from the atria to the ventricles.
Term
What is QRS
Definition
preparing for ventricular contraction. As the ventricles depolarize electrically, the muscle prepares to contract, there's a bit of back pressure, the leaflets open, and the ventria re able to squeeze out blood
Term
is ventricular fibrillation an electrical or mechanical probem with the heart
Definition
electrical
Term
is heart failure an electrical or mechanical problem with the heart
Definition
mechanical
Term
what dumps blood into the right atria
Definition
superior/inferior vena cava - from the body
Term
when does the SA node begin to work
Definition
when the right atria fills with blood
Term
what is the valve between the right atria and ventricles
Definition
tricuspid valve
Term
what is another term for the tricuspid valve
Definition
semilunar valve - double check this. I don't think it's right
Term
what valve does blood go through after being in the right ventricle
Definition
pulmonary valve
Term
where does blood go after going through pulmonary valve
Definition
pulmonary artery to lungs
Term
what does the pulmonary artery do
Definition
bifurcates to go to each lung
Term
what is anemia
Definition
low red blood cells; can't pick up and carry as much oxygen
Term
how does oxygenated blood get from lungs to heart
Definition
pulmonary vein
Term
what is the valve between the left atrium and ventricle
Definition
mitral, bicuspid valve
Term
what does the left ventricle do once it is depolarized
Definition
it contracts and pushes blood out through the aortic valve
Term
which 2 heart valves have the most problems
Definition
aortic, bicuspid
Term
why do the aortic and bicuspid valves have the most problems
Definition
they are underthe most stress because the left ventricle has to pump blood out through the aortic valve to get blood out through the whole body and the bicuspid valve has to stay closed while this happens
Term
what are the steps in the cardiac cycle
Definition
vena cava - Right atrium - tricuspid valve - right ventricle - pulmonary valve - pulmonary artery - lungs - pulmonary vein - left atrium - bicuspid valve - left ventricle - aortic valve - aorta - body - vena cava
Term
what are the 2 circuits of blood flow
Definition
systemic, pulmonary
Term
what is cardiac output
Definition
product of heart rate and stroke volume
Term
what things affect stroke volume
Definition
preload, afterload, contractility
Term
what is starling's curve
Definition
increasing preload leads to increased force up to a point.
Term
how does heart rate change as we age
Definition
decreases
Term
why does heart rate increase with activity
Definition
our muscles need more oxygen/nutrients
Term
what controls heart rate
Definition
autonomic nervous system, circulatoin catecholamines
Term
what is the autonomic nervous system
Definition
involuntary input to viscera
Term
how is heart rate affected with exercise if a patient is on a beta blocker
Definition
heart rate will not increase as much
Term
what are catecholamines
Definition
hormones that begin to circulate about 5 minutes after beginning exercise. they cause an increase in heart rate
Term
is the autonomic nervous system or the catecholamine system faster at increasing heart rate and why
Definition
autonomic nervous system because the body senses the need to increase heart rate to meet demand from exercise
Term
what is Starling's law
Definition
the amount of blood that we get into the heart influences the volume that is pushed out of the heart
Term
what is afterload
Definition
the blood that is pushed out of the heart; load against which the muscle contracts
Term
what is contractility
Definition
contractility of the heart muscle = muscle performance; change in stroke volume not attributed to preload or afterload
Term
what things affect contractility of the heart
Definition
valve issues, scar tissue where muscle doesn't work as well
Term
what is diastole
Definition
the time when the heart fills with blood after contraction
Term
what is systole
Definition
contraction
Term
what is the frank-starling law based on
Definition
amount of blood pumped into the heart
Term
what do we call the amount of blood pumped into the heart
Definition
end diastolic volume
Term
what does the end diastolic volume correspond to
Definition
end diastolic pressur
Term
what is the afterload
Definition
load against which the heart muscle contracts
Term
what does the afterload correspond to
Definition
end systolic pressure
Term
what is the end diastolic pressure
Definition
the force of contraction
Term
what things can obstruct the blood that the left ventricle is trying to push out of the heart through the aorta?
Definition
plaque build-up, clots
Term
what does the aorta turn into inferiorly
Definition
abdominal aorta, then iliac arteries
Term
which arteries carry blood to the legs
Definition
iliac arteries
Term
how does atherosclerosis affect afterload
Definition
increases afterload by increasing the pressure/load against which the muscle contracts
Term
how would atherosclerosis in the iliac arteries or beyond affect afterload
Definition
increases afterload
Term
what is the result of increased afterload
Definition
slowness of the flow and increased pressure
Term
what does ESP stand for
Definition
end systolic pressure
Term
what is end systolic pressure
Definition
how much pressure is encountered by bloodflow that goes out of the heart
Term
how can we tell how far downstream from the heart atherosclerosis exists when there is pressure in the heart
Definition
vascular studies with tubes, doppler studies
Term
what does contractility indicate
Definition
muscle performance of the heart
Term
what 3 things influence stroke volume
Definition
preload, afterload, contractility
Term
what is preload
Definition
end-diastolic volume
Term
what controls contractility
Definition
autonomic system input
Term
what does stroke volume influence
Definition
cardiac output
Term
what is cardiac output a measure of
Definition
fitness
Term
if you have a big cardiac output with exercise, is that good or bad
Definition
good: the entire system is working well
Term
when does catecholamine stimulation occur
Definition
kicks in after 5 minutes of exercise
Term
what does catecholamine stimluation do
Definition
enhances contractility and heart rate
Term
what is heart failure
Definition
scar tissue in the heart. Unable to push a full contraction of the heart. Lousy contractility
Term
what tool can measure cardiac contractility
Definition
cardiac ultrasound, cardiac cath fed through femoral artery into the heart
Term
are nerves reconnected in heart transplants
Definition
no, only vessels
Term
if someone has a heart transplant, can their heart rate increase
Definition
yes, with catecholamine stimulation. Need to have a long warm-up period of 5-10 minutes to give time for catecholamines to increase heart rate before exercising a patient with a heart transplant
Term
how do beta blockers affect fatigue in exercise
Definition
if a patient is on a beta blocker, they will fatigue faster so your goals should be lower
Term
what is the age predicted max heart rate
Definition
220-age
Term
what is the aortic pump/kick?
Definition
the aorta has a little reservoir of blood so that when the artery contracts, it can contribute to total cardiac output via the stroke volume of the heart. This contraction is beneficial to patients with heart failure who have weak left ventricles.
Term
what is the average resting cardiac output in a man
Definition
5L/min
Term
how is the average resting cardiac output calculated for an untrained main
Definition
5L/min = 70bpm x 71ml
Term
how is the average resting cardiac output calculated for a trained man
Definition
5L/min = 50 bpm x 100ml
Term
why do trained people have a greater stroke volume than untrained people
Definition
the left ventricle is stronger so it can push out more blood
Term
what is the parasympathetic innervation to the heart
Definition
vagus, pre-ganglionic
Term
what is the sympathetic innervation to the heart
Definition
rami of sympathetic trunk
Term
what is the mixed nerve plexus of the heart
Definition
some sympathetic, some parasympathetic innervation in a nerve plexus for the heart
Term
where is the superior portion of the mixed nerve plexus located
Definition
below the aortic arch
Term
what are the 2 parts of the superior portion of the mixed nerve plexus
Definition
right coronary plexus, left anterior pulmonary plexus
Term
where is the deep portion of the mixed nerve plexus located
Definition
tracheal bifurcation
Term
what are the 2 parts of the deep portion of the mixed nerve plexus
Definition
left coronary plexus, right anterior pulmonary plexus
Term
how does sympathetic input change with exerise
Definition
sympathetic input increases
Term
what does increased sympathetic input from cardiac changes with exercise do
Definition
increase HR and strength of heart contraction
Term
how does the amount of circulating catecholamines change with exercise
Definition
increases
Term
what does increasing catecholamines do
Definition
increase heart rate and contraction
Term
do catecholamines have a greater impact on heart rate or on contraction?
Definition
heart rate
Term
what is the result of increased heart rate and contraction with exercise
Definition
increased cardiac output
Term
what things increase with exercise
Definition
cardiac output, heart rate, stroke volume
Term
will a more trained individual have a higher or lower heart rate at the same workload
Definition
lower
Term
how does sympathetic innervation affect the heart
Definition
excites it: increases HR
Term
how does parasympathetic innervation affect the haert
Definition
slows it down: decreases HR
Term
what can you do to decrease HR
Definition
vagal massage (done by physicians, not PTs)
Term
what does SVR stand for
Definition
systemic vascular resistance
Term
what things affect blood pressure
Definition
heart rate, stroke volume, blood volume, peripheral vascular resistance, blood viscosity
Term
what is the formula of blood pressure
Definition
cardiac output x systemic vascular resistance
Term
what affects systemic vascular resistance
Definition
viscosity, peripheral vascular resistance, blood volume
Term
what is polycythemia
Definition
overabundance of red blood cells, increases viscosity
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