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MCC Paramedic
Cardiovascular System
66
Anatomy
Undergraduate 2
09/18/2009

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Cards

Term

Location of the Heart

 

Describe the following locaions

  • Apex
  • Base
  • Anterior Surface
  • Pericardial Sac
Definition
  • Apex - bottom of the heart formed by  the tip of the left ventricle
  •  

  • Base - Top of the heart (approx at the level of the 2nd costal cartillages)
  •  

  • Anterior Surface - Consists primarily of R ventricle
  •  

  • Pericardial Sac - Sac surrounding the hear
  • Term
    How large is the heart?
    Definition

    Approx the size of a fist

     

    5" Long

    3 1/2" Wide

    2 1/2" Thick

    Term
    Name the 4 chambers of the heart
    Definition
    1. Right Atrium
    2. Right Ventricle
    3. Left Atrium
    4. Left Ventricle
    Term
    Which side of heart is low pressure and which side is high pressure?
    Definition

    Right side of the heart is low pressure pumping venous blood to the lungs.

     

    Left side fo the heart is high pressure pumping arterial blood to the systemic circulation

    Term
    What seperates the left and right atrium?
    Definition
    Interatrial septum
    Term

    What seperates the left and right ventricles?

     

    How much fluid can the ventricle hold?

    Definition

    Interventricular septum

     

    approx 150ml

    Term
    How much fluid does the ventricle eject?
    Definition
    Ventricles hold approx 150ml of blood when full but only ejects about half (70-80ml) with each contraction.
    Term
    What is End Diastole Volume (EDV)?
    Definition
    Amount of fluid filled in ventricles during diastole
    Term
    What is End Systolic Volume (ESV)?
    Definition
    Volume remaining in ventricles after contraction.
    Term
    What is stroke volume (SV)?
    Definition
    Amount of blood ejected with each stroke
    Term
    Name the three layers of the Heart
    Definition
    1. Endocardium
    2. Myocardium
    3. Epicardium
    Term
    Describe the endocardium
    Definition
    Innermost layer of the heart
    Term
    Describe the myocardium
    Definition

    Middle layer of hear

     

    Thick Muscular Layer

     

    Responsible for pumping action

    Term
    Describe the epicardium
    Definition

    Also called the visceral pericardium

     

    External layer of the hear

     

    Includes blood capillaries, lymph capillaries, nerve fibers and fat

     

    Smoothe and glistening

    Term
    Describe the Pericardium
    Definition
    • Double walled sac that encloses the heart
    • Fibrous parietal perietal pericardium - rough outer layer of the pericardial sac
    • Pericardial space contains approx 10ml of serous fluid
    Term

    Pericardial Sac

     

    Describe Pericarditis and Pericardial Tamponade

    Definition
    • Pericarditis - inflamation of the pericardium
    • Pericardial Tamponade - pericardial sac is filled with blood due to trauma
    Term
    Describe the four heart valves and locations
    Definition
    • Two sets of atrioventricular valves seperating the atria/ventricles
    • Two sets of semilunar valves prevent backflow from the aorta and pulmonary arteries
    Term
    Describe the 2 AV valves
    Definition
    • Tricuspid -
      • Lies between R Atrium and R Ventricle
      • Consists of 3 seperate leaflets
      • Larger in diameter and thinner than the mitral valve
    • Mitral (Bicuspid)
      • Lies between L Atrium and L Ventricle
      • Has only two cusps
    Term
    What are the cusps of the AV valves attatched to?
    Definition
    chordae tendineae (heart strings originating from papillary muscles)
    Term
    Describe Semilunar Valves
    Definition
    • Semilunar valves have three cusps shaped like half-moons
    • Do not have chords/papillary muscles.
    Term
    Describe Pulmonic Valve
    Definition
    Semilunar valve that prevents backflow of blood in to the right ventricle
    Term
    Describe the Aortic Valve
    Definition
    Semilunar valve that prevents backflow of blood in to the left ventricle
    Term
    Describe 1st and 2nd heart sounds
    Definition
    • S1- Closure of tricuspid and mitral valves
    • S2- Closure of pulmonic and aortic (semilunar) valves
    Term
    Describe blood flow through the heart:
    Definition
    1. R Atrium receives blood from the
      1. Superior Vena Cava
      2. Inferior Vena Cava
      3. Coronary Sinus
    2. Tricuspid Valve
    3. Right Ventricle
    4. Pulmonic Valve
    5. Pulmonary Arteries
    6. Lungs
    7. Left Atrium
    8. Mitral Valve
    9. Left Ventricle
    10. Aortic Valve
    11. Systemic Circulation
    Term

    Describe the following terms:

     

    Incompetence

     

    Regurgitation

    Definition
    • Incompetence - Valve does not close completely
    • Regurgitation - Blood leaking back because of open valve
    Term
    Describe Coronary Circulation
    Definition
    • Right (Posterior descending) and left (anterior descending) coronary arteries supply the heart with oxygenated blood.
    • Coronary veins drain myocardial blood into the right atrium via the coronary sinus
    Term
    Describe Angina Pectoris
    Definition
    • Angina Pectoris is associates with atherslerotic disease that produces a fixed obstruction of the coronary arteries.
    • Pain caused when the metabolic demands of the myocardium exceed the ability to deliver adequate blood flow
    Term
    Describe Varian Angina / Prinzmetal's Angina
    Definition

    Angina causes by spasming of the coronary arteries.

     

    Usually occurs during rest or minimal activity and most often at night

    Term
    Describe Unstable Angina
    Definition
    • Results from athersclerotic plaque disruption. Because of its propensity to lead to infarction it is sometimes referred to as preinfarction angina
    Term
    Describe Myocardial Infarction
    Definition
    • (Heart Attack) ischemic death of myocardial tissue
    • MI usually results from rupture or fissuring of atherosclerotic plaque.

     

    Term
    What type of blood test can be performed to identify the presence of an MI?
    Definition
    Cardiac Enzyme test
    Term

    What are the intrisic rates of the following:

     

    SA Node

    AV Node

    Purkinje Fibers

    Definition
    • SA Node - 60-80 bpm
    • AV Node - 40-60 bpm
    • Purkinje Fibers - 15-40 bpm
    Term
    Describe Depolarization and Repolarization of the heart
    Definition
    • Depolarization is the electrical activity that triggers the contraction of the heart muscle
    • Repolarization is the electrical activity that "resets" the muscle and prepares it for the next contraction
    Term

    Basic ECG

    Describe the following:

    • P wave
    • QRS complex
    • PQ segment
    • PR interval
    • ST segment
    • ST interval
    • QT interval
    Definition
  • P wave - depolarization (contraction) of atria
  • QRS complex - depolarization of ventricles
  • PQ segment - time when impulse travels through the AV node, bundle of his, and bundle branches
  • PR interval - onset of P wave to middle of QRS
  • ST segment - end of QRS to onset of T wave
  • ST interval - end of QRS to end of T wave
  • QT interval - onset of QRS to end of T wave
  • Term

    Describe the following Cardiac Parameters:

    • Systole
    • Diastole
    • Stroke Volume (SV)
    • Heart Rate (HR)
    • Cardiac Output (CO)
    • Venous Return (VR)
    • End Diastolic Volume (EDV)
    • End Systolic Volume (ESV)
    Definition
    • Systole - Period of contraction / emptying
    • Diastole - Period of rest / filling
    • Stroke Volume (SV) - quantity of blood pumped out of either ventricle per beat (rest 70ml/beat max 120ml/beat)
    • Heart Rate (HR) - #times heart beats /min (72-230)
    • Cardiac Output (CO) - Quantity of blood pumped be either ventricle per min - HRxSV=CO
    • Venous Return (VR) - Quantity of blood returned to heart/min  - VR=CO
    • End Diastolic Volume (EDV) - Quantity of blood remaining in ventricle at end of V diastole (approx 130ml)
    • End Systolic Volume (ESV) - Quantity of blood remaining in ventricle at end of V systole
    Term
    Describe the effects of the Autonomic Nervous System on the Heart
    Definition
    • Heart Rate
    • Conductivity
    • Contractility
    Term
    What are the two nerves that stimulate the heart?
    Definition

    The Right and Left Vagus Nerves. The Vagus Nerve innervates the heart at the SA and AV nodes.

     

     

    Term
    Name 3 things that can increase stroke volume
    Definition

    Preload

     

    Sympathetic Nervous System

     

    Afterload

    Term
    What does "positive chronotropic effect" on the heart mean?
    Definition
    Increased heart rate
    Term
    What does "positive inotropic effect" mean?
    Definition

    A positive inotropic effect is an increas in contractility

     

    allows for an increase in SV with a constant preload through a more powerfull contraction and greater ejection of blood.

    Term
    Describe heterometric regulation
    Definition
    The more the ventricles are filled during diastole the more they will eject during systole
    Term
    What is "homometric regulation"?
    Definition
    An increase in contractility resulting in more complete ejection of blood
    Term
    Describe "Afterload"
    Definition

    Afterload is the back pressure exerted on the aortic and pulmonic semi lunar valves.

     

    The heart must overcome this pressure in order for circulation to take place.

    Term
    Describe Symptoms of Decreased Cardiac Output
    Definition
    • Cold, Clammy skin
    • Color changes in skin/mucous membranes
    • Dyspnea
    • Orthopnea
    • Crackes
    • Changes in mental status
    • Changes in blood pressure
    • Dysrhythmias
    • JVD
    • Fatigue
    • Restlessness
    Term
    Name the 3 parts of a typical artery
    Definition
    • Tunica Intima (innercoat) Endothelial cells (simple squamous)
    • Tunica Media (middle layer) smoothe muscle
    • Tunica Adventitia (outercoat) collagen and elastic fibers.
    Term
    Describe the 3 types of arteries
    Definition
    • Conducting arteries - Large elastic arteries (Aorta)
    • Distributing arteries - small to medium sized arteries (Muscle tissue)
    • Arterioles (smallest arteries)
    Term
    Describe the anatomical differences between arteries and veins
    Definition
    • Both have a Tunica Intima, Tunica Media, and Tunica Adventitia
    • Veins are thinner than arteries (not as much pressure and not as much muscle)
    • Veins have venous valves (semilunars) to prevent the backflow of blood.
    Term
    Describe the Pulmonary Circulation Process
    Definition
    • Blood from the right ventricle is pumped in to the pulmonary trunk
    • Blood is distributed to the right and left pulmonary arteries and transported to the lungs
    • After the exchange of O2 and CO2 two pulmonary veins exit each lung and enter the left atrium
    Term
    Describe the Systemic Circulation Process
    Definition
    • Blood enters the heart from the pulmonary veins into the left atrium
    • The left atrium sends the blood to the left ventricle
    • The left ventricle pumps blood out through the aorta
    Term
    Describe the Hepatic Portal System
    Definition
    • Veins from the spleen, pancreas, stomach, gall bladder, and intestines send blood to the Hepatic Portal Vein
    • This vein emties in to the liver
    • Blood from the liver drains into the hepatic veins which drain into the inferior vena cava.
    • (The liver is the first organ to see anything you digest
    Term
    What are the functions of the Hepatic Portal System?
    Definition
    • Maximizes the uptake of glucose and conversion of glucose to glycogen
    • Maximizes the detoxification properties of the liver.
    Term
    Describe "Mean Arterial Pressure"
    Definition

    Mean Arterial Pressure (MAP) is the actual pressure that propels blood to tissue.

     

    This is calculated by 2/3 (Diastolic Pressure) + 1/3 (Systolic Pressure)

    Term
    What do Baroreceptors do?
    Definition
    Baroreceptors measure pressure in the carotid  arteries and aorta. They send a message to the brainstem if a change is needed
    Term
    What is Lymph?
    Definition
    Lymph is a fluid that is created in the interstitial spaces of a tissue and is carried away by a lymphatic vessel back to normal circulation
    Term
    Describe the Lymphatic Vessels
    Definition
    • Lymphatic Capillaries
    • Lymphatic Venules and Veins
    • Lymphatic Ducts (Right Lymphatic Duct and Thoracic Lymphatic Duct)
    Term
    Describe the areas drained by the Right Lymphatic Duct and the Thoracic Lymphatic Duct
    Definition
    • Right Lymphatic Duct drains the upper right (quadrant) of the body
    • The Thoracic Duct drains the rest of the body
    Term
    What are Lymph Nodes?
    Definition
    Lymph nodes are beads or swellings along a lymphatic vessel. These are Filters
    Term
    What part of the body are Lymph Nodes most extensive?
    Definition
    • Breasts
    • neck
    • abdomen
    • thorax
    • pelvis
    • groin
    Term

    Thymus

     

    Describe the location and function of the Thymus

    Definition

    The thymus is located in the Mediastinum

     

    Produces WBCs especially T-Lymphocytes

    Term
    List the 3 types of Tonsils and their location
    Definition

    Tonsils are clusters of WBCs

    • Pharyngeal (adenoid) - back of throat
    • Palatine - posterior lateral side of mouth
    • Lingual - back of tounge
    Term
    Describe the location and function of the spleen
    Definition

    The spleen is located in the LUQ

     

    • Filtration of bacteria
    • Destruction of dead or deteriorating RBCs
    • Recycling of Iron
    Term
    Name a few methods of general protection to the body as far as immunity
    Definition
    • Skin
    • Mucus
    • Tears
    • INFLAMATION (Most important)
    Term
    What does inflamation do?
    Definition

    Causes:

    • Redness
    • Swelling
    • Pain
    • Heat
    • Diminished Function of the Tissue
    • ***Attracts WBCs
    Term
    Name the three types of Phagocytes
    Definition
    • Neutrophils
    • Monocytes
    • Macrophages
    Term

    Describe the following:

     

    B-Lymphocyte

    T-Lymphocyte

    Definition

    B-Lymphocyte- produces antibodies and acts as an immune memory cell

     

    T-Lymphocytes act as a recognition for foreign bodies and calling on phagocytes

     

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