Download KEY CHAPTER 15 OBJECTIVES: CARDIOVASCULAR SYSTEM 1

KEY CHAPTER 15 OBJECTIVES: CARDIOVASCULAR SYSTEM
1.
List the organs that compose the cardiovascular system and discuss the general
functions of this system.
ORGANS
FUNCTION
HEART
TO TRANSPORT BLOOD to and from organs and
tissues.
BLOOD VESSELS
To transport blood, rich in nutrients and oxygen, to
organs and tissues and carry away blood, with
wastes and carbon dioxide, from organs and
tissues, back to the heart.
2.
Describe the location, size, and orientation of the human heart.
The heart is located in the mediastinum, behind the sternum, with the apex slightly to
the left of center above the diaphragm.
3.
Define the term cardiology.
Cardiology is the study of the heart.
4. Describe the structure of the heart in terms of its coverings, wall layers, chambers,
valves, and blood vessels. Please label any of these structures present in the diagram
below.
Coverings
A FIBROUS PERICARDIUM = DENSE REGULAR CT;
B PARIETAL PERICARDIUM = SIMPLE SQUAMOUS ET/LOOSE
AREOLAR CT
Layers
C VISCERAL PERICARDIUM = SSET/LACT
A EPICARDIUM = SSET/LACT
B MYOCARDIUM = CARDIAC MUSCLE
Chambers
Valves
C ENDOCARDIUM = SSET/LACT
A ATRIA: RIGHT ATRIUM RECEIVES DEOXYGENATED BLOOD
FROM VEINS; LEFT ATRIUM RECEIVES OXYGENATED BLOOD
FROM LUNGS
B VENTRICLES: RIGHT VENTRICLE PUMPS BLOOD TO LUNGS;
LEFT VENTRICLE PUMPS BLOOD TO BODY (AORTA)
1a TRICUSPID LIES BETWEEN THE RIGHT ATRIUM AND RIGHT
VENTRICLES.
1b BICUSPID LIES BETWEEN THE LEFT ATRIUM AND LEFT
VENTRICLE
2a PULMONARY SEMILUNAR VALVE LIES WITHIN PULMONARY
TRUNK
2b AORTIC SEMILUNAR VALVE LIES WITHIN AORTA
Blood
vessels
associated
with
1a SUPERIOR VENA CAVA FROM UPPER LIMBS/HEAD EMPTIES
INTO RIGHT ATRIUM
1b INFERIOR VENA CAVA FROM TRUNK/LOWER LIMBS EMPTIES
INTO RIGHT ATRIUM
1c CORONARY SINUS FROM MYOCARDIUM EMPTIES INTO RIGHT
ATRIUM
1d PULMONARY VEINS FROM LUNGS EMPTIES INTI LEFT ATRIUM
2a
AORTA FROM LEFT VENTRICLE CARRIES BLOOD TO
ARTEIRIES/BODY PARTS
2b PULMONARY TRUNK FROM RIGHT VENTRICLE CARRIES
BLOOD TO LUNGS TO BE OXYGENATED
5.
Name the function of serous fluid around the heart. LUBRICATION
6.
Give another name for epicardium. VISCERAL PERICARDIUM
7.
Describe the structure and function of the interventricular septum and label it above.
THE IV SEPTUM IS COMPOSED OF THICK MYOCARDIUM ABD IT SEPARATES THE
LEFT AND RIGHT VENTRICLES
8.
Explain why the atria are passive chambers, while the ventricles are active.
ATRIA
VENTRICLES
THEY ARE PASSIVE, RECEIVING BLOOD THEY ARE ACTIVE, PUMPING BLOOD
FROM VEINS
INTO ARTERIES
9.
Name the function of heart valves. TO PREVENT BACKFLOW OF BLOOD
10.
Distinguish between AV and SL valves in terms of
close. Please label them above.
AV VALVES
LOCATION
BETWEEN
ATRIA
AND
VENTRICLES
STRUCTURE
2 OR 3 CUSPS, ANCHORED
TO PAPILLARY MUSCLE
THROUGH
CHORDAE
TENDINEAE
WHEN CLOSED
WHEN
VENTRICLES
CONTRACT
11.
location, structure, and when they
SL VALVES
WITHIN MAJOR ARTERIES
3 CUSPS
WHEN VENTRICLES RELAX
Define/describe the terms chordae tendineae, papillary muscle, and trabeculae carneae,
and label each in the diagram above.
chordae tendineae
papillary muscle
trabeculae carneae
CORD-LIKE STRUCTURES THAT ANCHOR CUSPS OF AV VALVES
TO PAPILLARY MUSCLE
COLUMNS OF MUSCLE IN VENTRICLES THAT ANCHOR CUSPS
OF AV VALVES
CHARACTERISTIC “FLESHY BEANS” APPEARANCE OF INNR
VENTRICULAR WALL
12a.
VEIN
SVC
IVC
CS
PV
12b.
Name (and locate in the diagram above) the veins that deposit their blood into the atria
of the heart (which atria? deox- or oxygenated?).
OXYGENATED OR DEOXYNATED BLOOD?
WHICH ATRIA?
DEOX
RIGHT
DEOX
RIGHT
DEOX
RIGHT
OX
LEFT
Name (and locate in the diagram above) the arteries that take blood away from the
heart (from which ventricle? deox-or oxygenated blood?).
ARTERY
OXYGENATED OR DEOXYNATED BLOOD?
FROM
WHICH
VENTRICLE?
AORTA
OX
LEFT
PULMOMARY
DEOX
RIGHT
TRUNK
13. List the 13 steps of pulmonary circulation below. Then add each
step and its corresponding number, correctly to the diagram
illustrating pulmonary circulation on the next page.
1. RIGHT ATRIUM
2. TRICUSPID VALCE
3. RIGHT VENTRICLE
4. PULMONARY SEMILUNAR VALVE (PSLV)
5. PULMONARY TRUNK
6. PULMONARY ARTERIES
7. LUNG CAPILALLARIES
8. PULMONARY VEINS
9. LEFT ATRIUM
10. BICUSPID/MITRAL VALVE
11. LEFT VENTRICLE
12. AORTIC SEMILUNAR VALVE (ASLV)
13. AORTA
See diagram created in class and lab.
14.
Distinguish between pulmonary, coronary and systemic circulation, listing their steps.
CORONARY
PULMONARY
SYSTEMIC (6 general steps back to
(4 steps back to right atrium)
13 steps
the right atrium)
1. Right Atrium
17. Coronary
Sinus
2. Tricuspid Valve
23. Vena
Cavae
3. Right Ventricle
22. Veins
4. Pulmonary Semilunar Valve
16. Cardiac Veins
5. Pulmonary Trunk
21. Venules
6. Pulmonary Arteries
7. Lung Capillaries
15. Myocardial
Capillaries
8. Pulmonary Veins
20. Tissue
Capillaries
9. Left Atrium
19. Arterioles
14. Coronary
Arteries
10. Bicuspid (Mitral Valve)
11. Left Ventricle
18. Arteries
12. Aortic Semilunar Valve
13. Aorta
15.
16.
Track a drop of blood through the following circulations:
a.
pulmonary (heart to lungs and back to heart)
RIGHT ATRIUM (RA)
TRICUSPID
RIGHT VENTRICLE (RV)
PULMONARY SEMILUNAR VALVE (PSLV)
PULMONARY TRUNK (PT)
PULMONARY ARTERIES (PA)
LUNG CAPILALLARIES (CAPS)
PULMONARY VEINS (PV)
LEFT ATRIUM (LA)
BICUSPID/MITRAL
LEFT VENTRICLE
AORTIC SEMILUNAR VALVE (ASLV)
AORTA
b.
coronary (through myocardium)
AORTA
CORONARY ARTERIES
MYOCARDIAL CAPS
CARDIAC VEINS
CORONARY SINUS
RIGHT ATRIUM
c.
systemic (heart to body and back to the heart, in general).
AORTA
ARTERIES
ARTERIOLES
CAPILLARIES
VENULES
VEINS
RIGHT ATRIUM
Define the term anastomoses.
CONNECTIONS BETWEEN SMALL ARTERIES/ARTERIOLES THAT PROVIDE
ALTERNATE ROUTES FOR BLOOD TO FLOW
17.
Define the terms ischemia and hypoxia, and explain how they are related to the
pathologic conditions of angina pectoris and myocardial infarction.
ISCHEMIA
REDUCED BLOODFLOW TO A TISSUE
HYPOXIA
REDUCED OXYGEN TO A TISSUE
18.
19.
Discuss what causes reperfusion damage. OXYGEN FREE RADICALS
Name the term referring to all of the events associated with one heartbeat.
CARDIAC CYCLE
20.
Define the terms systole and diastole.
SYSTOLE
CONTRACTION
DIASTOLE
RELAXATION
21.
Name the two major divisions of the cardiac cycle, and compare them in terms of
direction of blood flow, whether valves are opening or closing, and relative pressure
within the chambers.
Phase
VENTRICULAR
CONTRACTION
(SYSTOLE)
ATRIAL
RELAXATION
(diastole)
VENTRICULAR
RELAXATION
(DIASTOLE)
ATRIAL
CONTRACTION
(systole)
Blood
flow
Blood is forced
from ventricles
into arteries.
Atria fill with
blood.
Ventricles fill with
blood.
Blood is forced
from atria into
ventricles.
Valves
SL open
AV closed
SL open
AV closed
AV open
SL closed
AV open
SL closed
Pressure
V high
A low but rises
as filling
continues
V low but rises as
filling continues
A high
22.
Discuss heart sounds in terms of what they represent, how they sound, how they are
detected and their significance.
HEART SOUND
WHICH VALVES CLOSING?
VENTRICULAR SYSTOLE OR DIASTOLE?
LUB
AV VALVES
SYSTOLE
DUP
SL VALVES
DIASTOLE
INCOMPLETE CLOSING OF CUSPS CAUSESBACKFLOW OF BLOOD; THIS IS HEARD BY
STETHOSCOPE AS A “WHOOSHING” SOUND = MURMUR
23.
Discuss the physiological stages of cardiac muscle contraction and trace how they
appear on graph plotting mV vs. time (i.e. ion channels opening causing what event?)
I DON'T HAVE THIS GRAPH IN A FORM TO INCLUDE HERE, BUT REMEMBER WE DID IT IN
CLASS ON THE WHITE BOARD. IT STARTS AT -90mV. SA Node fires, opening Na+ ion
channels causing rapid depolarization (up to +30mV); Na + channels close and calcium
channels open for a long plateau period (allowing for the contraction mechanism to
become activated; the Ca++ channels close and Potassium (K+) channels open causing
repolarization.
24.
Explain why the refractory period between cardiac muscle contractions is so long.
SO THE VENTRICLES CAN FILL WITH ADEQUATE VOLUME OF BLOOD PRIOR TO
CONTRACTION
25. Explain the significance of each component of the cardiac conduction system and trace
how the cardiac impulse travels through the myocardium.
CCS COMPONENT
LOCATION
SIGNIFICANCE
SENDS CARDIAC
IMPULSE TO ...
Sinoatrial Node
right uppermost
atrial wall
Pacemaker initiates
cardiac impulse 60100 times per
minute
Atrioventricular
Node
Atrioventricular
Node
interatrial septum
delay signal to allow
for ventricular filling
Atrioventricular
Bundle
Atrioventricular
Bundle
superior
interventricular
septum
only electrical
junction between
atria & ventricles
right and left bundle
branches
right and left bundle
branches
lateral
interventricular
septum
passes signals down
to apex
Purkinje fibers
Purkinje fibers
in papillary muscles
of ventricles
conduct impulse to
the mass of
ventricular
myocardium and
forces blood out
26.
Name the common term for the sinoatrial (SA) node. Pacemaker
N/A
27.
Trace a typical ECG and label each wave or complex and explain what event of the CCS
corresponds to each wave.
28.
Outline the phases of the cardiac cycle in terms of what is happening in the ECG trace,
mechanical events (contraction or relaxation), atrial pressure, ventricular pressure,
ventricular volume, aortic volume and timing.
SEE #21ABOVE.
29.
Define the terms cardiac output (CO), heart rate (HR), and stroke volume (SV).
CO CO is the volume of blood pumped by each ventricle each minute;
the volume of blood that is circulating through the systemic (or
pulmonary) circuit per minute ;
5 liters/minute is normal adult.
HR # of heart beats/minute
SV SV is the volume of blood pumped by each ventricle with each contraction
(stroke)
30.
Discuss the factors that regulate heart rate.
HORMONAL FACTORS
31.
NEURAL FACTORS
Explain what is meant by the human cardiovascular system being a "closed system".
HEART – LUNGS – BODY – HEART. As long no vessel is damages, the blood stays
within this closed network
32.
Define the term hemodynamics. THE PHYSIOLOGY OF CIRCULATION
33.
Compare and contrast the 3 types of blood vessels in terms of the following:
a.
b.
c.
d.
direction of blood-flow (in terms of the heart),
wall structure (# of layers and components of those layers),
gas concentrations and
pressure.
Type of Blood
Vessel
Arteries
Veins
Capillaries
Function (i.e.
direction of blood
flow in terms of
heart)
carry blood away from
heart
carry blood toward
heart
exchange site for
gases, nutrients &
wastes between
blood and tissues
connect arterioles
and venules.
Wall structure
(layers and layer
components)
three tunics:
innermost = tunica intima
(endothelium plus
basement membrane)
middle = tunica media
(thick smooth muscle plus
elastic fibers)
outermost = tunica
adventitia (collagen and
elastic fibers)
same three tunics as
arteries but tunica
media is much
thinner equipped
with valves
only tunica intima
(single layer of
endothelium plus its
basement
membrane)
Concentration of
gases (oxygen and
carbon dioxide)
high in oxygen
low in carbon dioxide,
except pulmonary
arteries
high in carbon
dioxide low in
oxygen, except
pulmonary veins
Pressure of blood
carried
high
low therefore they
are equipped with
valves
34.
N/A
N/A
Describe how arterioles play a major role in regulating blood flow to capillaries.
THE VASOMOTOR CENTER CAN CAUSE VASOCONSTRICTION TO INCREASE BP
AND CAUSE VASODILATION TO DECREASE BP
35.
Discuss the major event that occurs at capillaries.
EXCHANGE OF OXYGEN AND NUTRIENTS IN BLOOD WITH CARBON DIOXIDE
AND WASTES IN TISSUE CELLS
36.
Compare and contrast continuous, fenestrated
structure and location.
structure
Continuous UNINTERRUPTED
RING
OF
capillaries
ENDOTHELIAL CELLS
Fenestrated HOLES
OR
PORES
IN
capillaries
ENDOTHELIAL
BASEMENT
MEMBRANES
Sinusoidal
OPEN
SPACES
BETWEEN
capillaries
ENDOTHELIAL CELLS
37.
and sinusoidal capillaries in terms of
Location
MOST ORGANS
KIDNEY GLOMERULI
INTESTINAL VILLI
LIVER AND SPLEEN
Define the terms blood flow and circulation time and give the value of the normal
circulation time in a resting adult.
Blood flow
CIRCULATION OF BLOOD THROUGH THE CLOSED CV SYSTEM
Circulation time
THE TIME IT TAKES FOR A DROP OF BLOOD TO PASS FROM
RIGHT VENTRICLE AND THEN BACK TO RIGHT VENTRICLE
38.
A.
Discuss the factors that affect cardiac output.
Autonomic Nervous System: See Fig 15.24, page 579.
Recall that cardiovascular center is located in medulla of brainstem.
1.
parasympathetic (normal) decreases cardioinhibitor reflex center
2.
sympathetic (stress) increases cardioacceleratory reflex center
B.
Chemicals
1.
hormones (i.e. epinephrine increases)
2.
ions
a.
calcium increases
b.
potassium and sodium decreases.
C.
Age (decreases)
D.
Sex
1.
females increased
2.
males decreased.
E.
Temperature
F.
Emotion
G.
Disease
39.
Define the term blood pressure, name the type of blood vessels where blood pressure is
significant, and name the normal (average) value in a resting adult.
BP IS THE FORCE THE BLOOD EXERTS AGAINST THE INNER WALLS OF THE
BLOOD VESSELS(ARTERIES)
40.
Define the term blood resistance and discuss the three major factors that determine it.
FRICTION BETWEEN BLOOD AND THE WALLS OF BLOOD VESSELS PRODUCES A
FORCE CALLED PERIPHERAL RESISTANCE, WHICH DECREASES BLOODFLOW =
INCREASED BP
41.
Explain the processes by which materials are exchanged through a capillary.
Gases, nutrients, and wastes are exchanged between blood in capillaries and tissues
in three ways:
1.
diffusion
a.
most common
b.
substances include oxygen, CO2, glucose, & hormones,
c.
Lipid-soluble substances pass directly through endothelial cell
membrane
d.
Water-soluble substances must pass through fenestrations or gaps
between endothelial cells.
2.
vesicular transport (endo/exocytosis)
3.
bulk flow (filtration and absorption).
a.
filtration
hydrostatic (blood) pressure pushes small solutes and fluid out of
capillary
colloid osmotic pressure (osmosis) draws fluid back into capillary
net affect is fluid loss at the beginning of capillary bed but most is
regained by the end of the capillary bed
fluid not regained enters lymphatic vessels (next chapter)
a special situation occurs in the kidney (Chapter 20)
42.
Locate the neural cardiovascular center on a mid-sagittal diagram of the brain, explain
where impulses sent to it are first detected, and explain where its outgoing impulses are
directed and what happens when they get there.
VASOMOTOR CENTER
CARDIAC CENTER
Medulla
Medulla
Peripheral arterioles to constrict (decrease SA and AV to speed up or slow down.
bp) or dilate (increase bp).
43.
List the hormones involved in regulation of blood pressure and blood flow.
HORMONES THAT INCREASE BLOOD HORMONES THAT INCREASE BLOOD
PRESSURE
PRESSURE
Epinephrine
ANP
Norepinephrine
Histamine
Aldosterone
Antidiuretic Hormone
Angiotensin II
44.
Define the terms tachycardia and bradycardia.
Tachycardia = heart rate above 100 bpm
Bradycardia = heart rate below 60bpm
45.
Distinguish between the pulmonary and systemic circuits (circulatory routes).
pulmonary circuit Heart – lungs - heart
systemic circuit
Heart – body – heart
46.
Track a drop of blood through the following:
a.
from the right fingers to the left ear
VENOUS CIRCULATION
1. RIGHT FINGER (DIGITAL
CAPILLARIES
2. right digital vein
PULMONARY CIRCULATION
ARTERIAL CIRCULATION
(SEE EARLIER TRACING)
10
23 LEFT COMMON
CAROTID ARTERY
11
24 LEFT EXTERNAL CAROTID
ARTERY
3. right venous palmar
arches
12
4. right radial or ulnar vein
13
5. right brachial vein
14
6. right axillary vein
15
7. right subclavian vein
16
8. right brachiocephalic
vein
17
9. superior vena cava
18
19
20
21
22
25. LEFT EAR CAPILLARIES
b.
from the stomach to the left fingers
VENOUS CIRCULATION
1. STOMACH (GASTRIC)
CAPILLARIES
2. GASTRIC VEIN
PULMONARY CIRCULATION
ARTERIAL CIRCULATION
(SEE EARLIER)
7
20. LEFT SUBCLAVIAN
ARTERY
8
21. LEFT AXILLARY ARTERY
3. HEPATIC PORTAL VEIN
9
22. LEFT BRACHIAL ARTERY
4. LIVER SINUSOIDS
10
23. EITHER LEFT RADIAL OR
ULNAR ARTERY
5. HEPATIC VEIN
11
24. LEFT ARTERIAL
PALMAR ARCHES
6. INFERIOR VENA CAVA
12
25. LEFT DIGITAL ARTERY
13
26 Left finger (digital)
capillaries
14
15
16
17
18
19
c.
from the right knee to the left kidney
VENOUS CIRCULATION
1. right knee capillaries
(popliteal)
2. RIGHT POPLITEAL VEIN
PULMONARY CIRCULATION
ARTERIAL CIRCULATION
(SEE PREVIOUS)
7
20. LEFT RENAL ARTERY
8
3. RIGHT FEMORAL VEIN
9
4. RIGHT EXTERNAL ILIAC
VEIN
10
5. RIGHT COMMON ILIAC
VEIN
11
6. INFERIOR VENA CAVA
12
21. left renal capillaries
13
14
15
16
17
18
19
d.
from the right kidney to the right side of the brain.
VENOUS CIRCULATION
1. right renal capillaries
2. RIGHT RENAL VEIN
3. INFERIOR VENA CAVA
PULMONARY CIRCULATION
ARTERIAL CIRCULATION
4
17. BRACHIOCEPHALIC
ARTERY
5
18. RIGHT COMMON
CAROTID ARTERY
6
19. RIGHT INTERNAL
CAROTID ARTERY
7
20. right brain capillaries
8
9
10
11
12
13
14
15
16
47.
Name the branches of the ascending aorta, aortic arch, thoracic aorta, and abdominal
aorta, and denote what body region they supply with blood.
Ascending aorta
A. RIGHT CORONARY ARTERY
B LEFT CORONARY ARTERY
Aortic Arch
A BRACHIOCEPHALIC ARTERY
B LEFT COMMON CAROTID ARTERY
C LEFT SUBCLAVIAN ARTERY
Thoracic Aorta
A PHRENIC ARTERY
B ESOPHAGEAL ARTERY
C INTERCOSTAL ARTERIES
D BRONCHIAL ARTERIES
Abdominal Aorta
A INFERIOR PHRENIC ARTERY
B CELIAC ARTERY (TRUNK)
C SUPERIOR MESENTERIC ARTERY
D SUPRARENAL ARTERIES
E RENAL ARTERIES
F GONADAL ARTERIES
G INFERIOR MESENTERIC ARTERIES
Common Iliac Arteries
EXTERNAL ILIAC ARTERY
INTERNAL ILIAC ARTERY
48. Explain what happens to the aorta at the brim of the pelvis.
It branches into an external and internal branch.
49. Although the venous circuit is essentially parallel to the arterial circuit, list the
differences between the two.
a.
jugular veins (head) See Fig 15.53, page 612.
o
external jugular vein (face and scalp)
o
internal jugular vein (brain).
b.
median cubital vein (venipuncture site): Fig 15.54, pg 612.
c.
Note that there are 2 brachiocephalic veins. The union of the
subclavian and jugular veins on each side forms them.
See Fig 15.55, page 613.
d.
Superior Vena Cava (formed by the union of the left and right
brachiocephalic veins = head and upper limbs).
f.
coronary sinus (cardiac veins)
o
cardiac veins (caps of myocardium).
g.
hepatic vein (drains hepatic portal system):See Fig 15.56, page
614.
o
hepatic portal vein (drains gastric, mesenteric and splenic
veins)
1.
gastric vein (stomach)
2.
mesenteric veins (intestines)
3.
splenic vein (spleen)
*
These veins do not drain directly into the inferior
vena cava. Instead, the blood drained from these
abdominal organs travels to the liver via the portal
vein. Recall the hepatic portal system discussed
during digestion.
h.
great saphenous vein = the longest vein in the body. Extends
from the medial ankle to the external iliac vein.
See Fig 15.58, page 616.
j.
Inferior Vena Cava (drains veins from abdominal & lower limbs).
50.
51.
Name the longest vein in the body and the venipuncture site.
Longest vein/blood vessel
Venipuncture site
median cubital vein
great saphenous vein
Discuss hypertension.
High blood pressure puts undo stress on major arteries, can lead to strokes
and/or MIs and………………..