Cardiovascular System and Heart Anatomy

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1
What are the two major divisions of the cardiovascular system?
The pulmonary circuit and the systemic circuit.
2
What does the pulmonary circuit do?
Carries blood between the heart and lungs for gas exchange.
3
What does the systemic circuit do?
Carries blood between the heart and the rest of the body.
4
What does the right side of the heart pump?
Deoxygenated blood to the lungs.
5
What does the left side of the heart pump?
Oxygenated blood to the body.
6
Which arteries carry deoxygenated blood?
Pulmonary arteries.
7
Which veins carry oxygenated blood?
Pulmonary veins.
8
What is the pathway of blood through the heart?
Vena cava, right atrium, tricuspid valve, right ventricle, pulmonary valve, pulmonary arteries, lungs, pulmonary veins, left atrium, mitral valve, left ventricle, aortic valve, aorta.
9
What is the function of the atria?
Receive blood returning to the heart.
10
What is the function of the ventricles?
Pump blood out of the heart.
11
What is the function of the tricuspid valve?
Prevents backflow from the right ventricle into the right atrium.
12
What is the function of the bicuspid or mitral valve?
Prevents backflow from the left ventricle into the left atrium.
13
What do the pulmonary and aortic valves prevent?
Backflow from the arteries into the ventricles.
14
What do the chordae tendineae do?
Anchor the AV valves and prevent them from prolapsing.
15
What do the papillary muscles do?
Tighten the chordae tendineae during ventricular contraction.
16
What is the pericardium?
The protective sac surrounding the heart.
17
What are intercalated disks?
Connections between cardiac muscle cells that help them contract together.
18
What do gap junctions in intercalated disks allow?
Electrical signals to pass between cardiac muscle cells.
19
What are the two major types of cardiac muscle cells?
Autorhythmic cells and contractile cells.
20
What is the function of autorhythmic cells?
Generate action potentials that initiate the heartbeat.
21
What is the function of contractile cardiac cells?
Generate force to pump blood.
22
How are cardiac contractile cells different from pacemaker cells?
Contractile cells have organized sarcomeres and generate force; pacemaker cells generate electrical signals.
23
What are the characteristics of cardiac muscle cells?
They are striated, branched, usually have one nucleus, connect through intercalated disks, and contain many mitochondria.
24
What is the sinoatrial (SA) node?
The heart's primary pacemaker.
25
What is the atrioventricular (AV) node?
The structure that delays and relays electrical signals to the ventricles.
26
What is the purpose of AV node delay?
Allows the atria to finish contracting before the ventricles contract.
27
What is the pathway of electrical conduction through the heart?
SA node, atria, AV node, bundle of His, bundle branches, Purkinje fibers, ventricles.
28
What is the normal pacemaker rate of the SA node?
About 60–100 beats per minute.
29
What is the intrinsic pacemaker rate of the AV node?
About 40–60 beats per minute.
30
What is the intrinsic pacemaker rate of Purkinje fibers?
About 20–40 beats per minute.
31
What happens when the SA node fires?
The electrical signal spreads through the atria and reaches the AV node.
32
What is an electrocardiogram (ECG or EKG)?
A recording of the heart's electrical activity.
33
What does the P wave represent?
Atrial depolarization.
34
What happens mechanically after the P wave?
The atria contract.
35
What does the QRS complex represent?
Ventricular depolarization.
36
What happens mechanically after the QRS complex?
The ventricles contract.
37
What does the T wave represent?
Ventricular repolarization.
38
What happens mechanically after the T wave?
The ventricles relax.
39
What does the PR interval represent?
The time for electrical activity to travel from the atria through the AV node toward the ventricles.
40
What does the ST segment represent?
The period when the ventricles are depolarized.
41
How can heart rate be estimated from an ECG?
Count the number of QRS complexes per minute or use the time between successive R waves.
42
What is systole?
The contraction phase of the heart.
43
What is diastole?
The relaxation and filling phase of the heart.
44
What is the cardiac cycle?
The sequence of contraction and relaxation during one heartbeat.
45
What are the five phases of the cardiac cycle?
Late diastole, atrial systole, isovolumetric ventricular contraction, ventricular ejection, and isovolumetric ventricular relaxation.
46
What happens during late diastole?
The atria and ventricles are relaxed and the ventricles passively fill with blood.
47
What happens during atrial systole?
The atria contract and push remaining blood into the ventricles.
48
What happens during isovolumetric ventricular contraction?
The ventricles contract while all valves are closed, increasing pressure without changing volume.
49
What happens during ventricular ejection?
The semilunar valves open and blood leaves the ventricles.
50
What happens during isovolumetric ventricular relaxation?
The ventricles relax while all valves are closed, decreasing pressure without changing volume.
51
What causes the first heart sound, S1 or "lub"?
Closure of the AV valves.
52
What causes the second heart sound, S2 or "dub"?
Closure of the semilunar valves.
53
What is end-diastolic volume (EDV)?
The amount of blood in a ventricle at the end of filling.
54
What is end-systolic volume (ESV)?
The amount of blood remaining in a ventricle after contraction.
55
What is stroke volume?
The amount of blood pumped out by one ventricle per beat.
56
What is the formula for stroke volume?
SV = EDV - ESV
57
What is cardiac output?
The volume of blood pumped by one ventricle per minute.
58
What is the formula for cardiac output?
CO = HR * SV
59
What happens to cardiac output when heart rate increases and stroke volume stays constant?
Cardiac output increases.
60
What happens to cardiac output when stroke volume increases and heart rate stays constant?
Cardiac output increases.
61
What is ejection fraction?
The percentage of end-diastolic volume ejected during contraction.
62
What is the formula for ejection fraction?
EF = (SV / EDV) *100
63
What is preload?
The stretch of ventricular muscle before contraction, related to end-diastolic filling.
64
What is afterload?
The pressure or resistance the ventricles must overcome to eject blood.
65
What is contractility or inotropy?
The ability of cardiac muscle to generate force at a given muscle length.
66
What is a positive inotrope?
A substance that increases cardiac contractility.
67
What is a negative inotrope?
A substance that decreases cardiac contractility.
68
What are examples of positive inotropes?
Epinephrine, norepinephrine, and digitalis.
69
What determines the strength of cardiac muscle contraction?
The amount of calcium bound to troponin and the number of active cross-bridges.
70
How does increased calcium availability affect cardiac contraction?
It increases the force of contraction.
71
What is the Frank-Starling law?
Increased ventricular filling stretches cardiac muscle and produces a stronger contraction.
72
How is stroke volume related to EDV?
Stroke volume generally increases as EDV increases.
73
How does increased venous return affect stroke volume?
It increases EDV and usually increases stroke volume.
74
What are three mechanisms that increase venous return?
Venoconstriction, the skeletal muscle pump, and the respiratory pump.
75
What does the skeletal muscle pump do?
Contracting skeletal muscles squeeze veins and help return blood to the heart.
76
What does the respiratory pump do?
Pressure changes during breathing help move venous blood toward the heart.
77
How does sympathetic stimulation affect heart rate?
Increases heart rate.
78
How does parasympathetic stimulation affect heart rate?
Decreases heart rate.
79
Which autonomic division normally dominates resting heart rate?
Parasympathetic activity.
80
How does sympathetic stimulation affect contractility?
Increases ventricular contractility.
81
How does parasympathetic stimulation affect cardiac contractility?
It has its strongest effect on heart rate and has little direct effect on ventricular contractility.
82
How does sympathetic stimulation affect pacemaker cells?
Increases sodium and calcium permeability, speeding pacemaker depolarization.
83
How does parasympathetic stimulation affect pacemaker cells?
Increases potassium permeability and decreases calcium permeability, slowing pacemaker depolarization.
84
What receptor does sympathetic stimulation use on cardiac pacemaker cells?
Beta-1 adrenergic receptors.
85
What is tonic control of heart rate?
The ongoing autonomic influence that adjusts heart rate; resting heart rate is normally dominated by parasympathetic activity.
86
What are the four phases of the cardiac contractile-cell action potential?
Rapid depolarization, initial repolarization, plateau, and repolarization.
87
What causes rapid depolarization in a cardiac contractile cell?
Rapid sodium influx.
88
What causes initial repolarization in a cardiac contractile cell?
Sodium channels close and potassium begins leaving the cell.
89
What causes the plateau phase of the cardiac contractile action potential?
Calcium influx balanced by potassium leaving the cell.
90
Why is the cardiac action potential plateau important?
It creates a long refractory period and prevents sustained tetanic contraction.
91
What causes repolarization in a cardiac contractile cell?
Calcium channels close and potassium leaves the cell.
92
How does a pacemaker action potential differ from a contractile-cell action potential?
Pacemaker cells spontaneously depolarize and do not have the same stable resting potential or plateau.
93
What causes spontaneous depolarization in pacemaker cells?
Slow inward positive current, including funny sodium current and calcium entry.
94
What causes depolarization in pacemaker cells?
Calcium influx.
95
What causes repolarization in pacemaker cells?
Potassium efflux.
96
What does the NCX antiporter do?
Exchanges sodium and calcium across the cell membrane.
97
Does the NCX antiporter directly use ATP?
No, it uses the sodium gradient maintained by the sodium-potassium pump.
98
What is the function of phospholamban in cardiac muscle?
It regulates calcium storage in the sarcoplasmic reticulum.
99
How do catecholamines increase cardiac contractility?
They increase calcium availability and calcium storage in cardiac muscle.
100
What is the cardiovascular system's pressure reservoir?
The arterial system.
101
What is the cardiovascular system's volume reservoir?
The venous system.
102
What is the main function of arteries?
Carry blood away from the heart and maintain pressure.
103
What is the main function of arterioles?
Regulate resistance and distribute blood to tissues.
104
What is the main function of capillaries?
Allow exchange of gases, nutrients, and wastes.
105
What is the main function of venules?
Collect blood from capillaries.
106
What is the main function of veins?
Return blood to the heart and act as a blood-volume reservoir.
107
What is the aorta?
The large artery carrying blood from the left ventricle to the systemic circulation.
108
What is the vena cava?
The large veins that return systemic blood to the right atrium.
109
Which blood vessels have the greatest smooth muscle control over diameter?
Arterioles.
110
Which blood vessels contain abundant elastic tissue?
Large arteries.
111
Which blood vessels have very thin walls for exchange?
Capillaries.
112
What is endothelium?
The thin layer of cells lining blood vessels.
113
What is angiogenesis?
The formation of new blood vessels.
114
What is blood flow?
The volume of blood moving through a vessel or circulation per unit time.
115
What causes blood to flow?
A pressure gradient.
116
What happens when there is no pressure gradient?
There is no net blood flow.
117
Does blood flow depend on absolute pressure or pressure difference?
Pressure difference.
118
What is the relationship between pressure gradient and flow?
Greater pressure difference produces greater flow if resistance stays constant.
119
What is the relationship between resistance and flow?
Greater resistance decreases flow if the pressure gradient stays constant.
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