A&PII Chapter 20 Test 3 UPDATED

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A&PII Chapter 20 Test 3 UPDATED
2010-10-02 18:53:26

Chapter 20 The Heart A&PII, from notes
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  1. What is the heart and what is it responsible for?
    The heart is a muscular pump. It is responsible for the circulation of the blood
  2. At what rate does the heart pump blood?
    About a gallon of blood per minute
  3. How many times a day does the heart beat?
    Slightly over 100,000 times per day
  4. How does the heart lie?
    Obliquely (45 degree angle)
  5. Where does the heart lie?
    within the mediastinum (the space between the lungs)
  6. The heart extends from the ________to the ____________ ______________.
    sternum to the vertebral column
  7. Where is the apex of the heart?
    The apex is at the bottom of the heart.
  8. The apex is the pointed end of the heart. It is directed....
    anteriorly, inferiorly, and to the left
  9. Where is the base of the heart?
    At the top of the heart
  10. Where do the great vessels enter and leave the heart?
    at the base
  11. What vessels can be seen on the external surface of the heart?
    the coronary arteries
  12. What vessels nourish the heart muscle itself?
    the coronary arteries
  13. What veins follow the coronary arteries and how are they named?
    • the coronary veins
    • they are named according to the corresponding arteries
  14. What is the double layered sac called that contains the heart?
    the pericardium
  15. What is the tough outer layer of the pericardium?
    the fibrous pericardium
  16. What is the inner layer of the pericardium?
    serous (parietal) pericardium
  17. What fluid does the serous pericardium secrete and what is the function of this fluid?
    • pericardial fluid
    • it acts as a lubricant to reduce friction as the heart beats
  18. Inflammation within the space between the heart and the pericardium is called...
  19. What is the condition called if bleeding occurs within the space between the pericardium and the heart and the heart is compressed?
    cardiac tamponade
  20. How many layers is the heart wall divided into?
  21. what are the 3 layers of the heart wall?
    • epicardium
    • myocardium
    • endocardium
  22. What is the outer layer of the heart wall called?
  23. What is the epicardium made out of and what is capable of producing?
    The epicardium is very thin transparent layer of serous tissue. It can produce serous fluid.
  24. What is the inflammation of the epicardium?
  25. middle layer of the heart wall
  26. fibers myocardium made up of?

    What does the myocardium do?
    • thick bundles of muscle fibers
    • cause the heart to contract
  27. inflammation of the myocardium
  28. thin inner lining of the heart wall?
  29. endocardium is composed of?
    simple squamous epithelium
  30. endocardium is continuous with?
    the endothelium (inner lining) of the blood vessels
  31. inflammation of the endocardium
  32. How many circulatory routes does the heart have? What are those routes?
    • 2
    • pulmonic
    • systemic
  33. How is the heart divided in order to deliver blood via its 2 routes (pulmonic and systemic)?
    it is separated into right and left halves
  34. A low-pressure system involving the right half of the heart
    pulmonic circulation
  35. The right half of the heart pumps blood where?
    to the lungs
  36. What color is deoxygenated blood?
    dark red
  37. Vascular illustrations depict deoxygenated blood as...
  38. The right half of the heart pumps blood to the _________ for ___________.
    • lungs
    • oxygenation
  39. What is systemic circulation?
    A high-pressure system involving the left half of the heart that pumps oxygenated blood throughout the body (except the lungs).
  40. What color is blood in the left side of the heart? why is it that color?
    bright red, because it is oxygenated
  41. what color is oxygenated blood?
    bright red
  42. Vascular illustrations depict oxygenated blood as...
  43. How many chamber is the heart divided into?
  44. What are the upper chambers of the heart called?
  45. what are the lower chambers of the heart called?
  46. Where is gas exchanged?
    the tissues of the lungs
  47. What might cause cardiac tamponade?
  48. What causes myocarditis?
    usually a viral infection, rheumatic fever, or exposure to radiation, chemicals, or medications
  49. What usually causes endocarditis?
    bacterial infection (dirty needles)
  50. What does the latin word atrium mean?
  51. What chamber received the deoxygenated systemic blood?
    Right atrium
  52. Returning blood enters the right atrium through what structures?
    • superior vena cava
    • inferior vena cava
    • coronary sinus
  53. What helps to increase the volume of the atriums?
  54. What does auricle mean in Latin?
  55. What type of blood enters the left atrium?
    oxygenated pulmonic blood (from the lungs)
  56. Where does the blood come from that enters the left atrium?
    the lungs
  57. How may openings enter into the left atrium?
  58. Blood enters the left atrium through what vessels?
    the 4 pulmonary veins
  59. What is the origin of the 4 pulmonary veins?
    the lungs
  60. What structure separates the 2 atria of the heart?
    interatrial septum
  61. Depression found on the 2 surfaces of the interatrial septum?
    fossa ovalis
  62. What did the fossa ovalis originate from?
    foramen ovale
  63. What is the foramen ovale and what does it become?
    embryonic opening in the interatrial septum between the 2 atria which closes at birth

    it forms the fossa ovalis
  64. Where does the right ventricle receive blood from?
    from the right atrium
  65. what separates the right ventricle from the right atrium?
    tricuspid valve (right atrioventricular (AV) valve
  66. another name for the tricuspid valve?
    right atrioventricular (AV) valve
  67. What is the structure of the tricuspid valve?
    3 downward opening flaps or cusps
  68. What is the meaning of cusp?
  69. What type of valve does blood pass through when it leaves the right ventricle?
    3 cusped semilunar valve
  70. the name of the valve in the pulmonary trunk that blood passes through when it leaves the right ventricle on the way to the lungs?
    pulmonic semilunar valve
  71. How many cusps does the pulmonic semilunar valve have?
  72. What does semilunar mean?
    half moon
  73. Where does the blood go when it passes through the semilunar valve of the right ventricle?
    into the pulmonary trunk (pulmonary artery) then to the lungs
  74. what is another name for the pulmonary trunk?
    pulmonary artery
  75. Is the blood in the pulmonary trunk oxygenated or deoxygenated?
  76. What is the next major structure(s) that the blood would enter after leaving the pulmonary trunk?
    the lungs
  77. Where does the blood come from that enters the left atrium?
    from the lungs
  78. What valve separates the left atrium from the from the left ventricle?
    bicuspid or mitral valve (left atrioventricular (AV) valve)
  79. The left ventricle receives oxygenated blood from the...
    left atrium
  80. What are 2 other names for the bicuspid valve?
    mitral valve or left atrioventricular (AV)valve
  81. Through what type of valve does blood leave the left ventricle ?
    3 cusped semilunar valve of the aorta
  82. What separates the 2 ventricles of the heart from each other?
    interventricular septum
  83. What is the interventricular septum?
    A thick muscular wall that separates the 2 ventricles of the heart from each other
  84. What 2 chambers of the heart contain oxygenated blood?
    the left atrium and the left ventricle
  85. What attaches both the tricuspid and the bicuspid valves underneath?
    papillary muscles and chordae tendineae
  86. What are the tough fibers that attach the tricuspid and bicuspid valves underneath?
    chordae tendineae
  87. What are the muscles that attach the tricuspid and bicuspid valves underneath?
    papillary muscles
  88. What do the chordae tendineae and papillary muscles prevent?
    prolapsing of the tricuspid and bicuspid valves, which prevents reflux of blood back into the atrium
  89. What does prolapse mean?
    collapsing backward
  90. If the mitral valve prolapses what does it cause?
    reflux of blood back into the atrium
  91. What are the primary heart sounds? What produces them?

    the closing of the heart valves
  92. What is the first heart sound (S1)? What does it result from?

    the near-simultaneous closing of the tricuspid and mitral valves
  93. What is the second heart sound (S2)? What does it result from?

    the near-simultaneous closing of the pulmonary and aortic semilunar valves
  94. Listening to heart sounds with a stethoscope is...
  95. What causes the primary heart sounds?
    closing of the heart valves
  96. Are the closure sounds for each valve best auscultated directly over the valves?
    no, the best locations for ausculation are slightly different from the actual valve locations
  97. an extra heart sound that consists of a flow noise heard before or after the primary heart sounds
    heart murmur
  98. Are all murmurs bad?
  99. What are murmurs caused by?
    turbulent blood flow around valves due to abnormal anatomy or increased blood volume
  100. What is the blood supply to the heart itself called?
    coronary circulation
  101. How many arteries are in the coronary circulation system?
  102. What are the 5 main arteries of the coronary circulation system?
    • left coronary artery
    • right coronary artery
    • anterior descending (interventricular)artery
    • circumflex artery
    • posterior descending (interventricular) artery
  103. What does coronary mean?
  104. What 2 arteries initially lead into the coronary circulation system?
    • left coronary artery
    • right coronary artery
  105. What does the coronary circulation system do?
    supplies blood to the heart
  106. Where do the left and right coronary arteries originate?
    the aortic arch
  107. What does the left coronary artery bifurcate into?
    • anterior descending (interventricular) artery
    • circumflex artery
  108. anterior descending artery also known as...
    anterior interventricular artery
  109. bifurcate
    to split
  110. what branches of the right coronary artery?
    posterior descending artery
  111. another name for the posterior descending artery
    posterior interventricular artery
  112. The coronary veins carry deoxygenated blood into what large vein?
    coronary sinus
  113. where does the coronary sinus empty?
    right atrium
  114. nerve center that innervates the heart
    cardiovascular center of the autonomic nervous system
  115. What nervous system is the cardiovascular system part of?
  116. What influence does the cardiovascular center have over the heart?
    it can slow or speed up the rate of contractions
  117. where is the cardiovascular center located?
    brain stem
  118. sympathetic nervous system can...
    increase heart rate
  119. parasympathetic nervous system can...
    decrease heart rate
  120. what hormone acts with sympathetic nervous system to increase heart rate?
  121. what cranial nerve is involved in the heart parasympathetic distribution?
    Vagus nerve (CNX)
  122. kind of system that cause the heart to contract?
  123. what does intrinsic imply?
    that it's situated within or belongs solely to the body part on which it acts
  124. specialized muscle tissues that initiate and conduct electrical impulses in the the heart
    Purkinje fibers
  125. Purkinje center that signals the contraction of the atria?
    sinoatrial node (SA node)
  126. Where is the SA node located? What does it do?
    upper wall of right atrium

    initiates both atria to contract for each heart beat
  127. What is the SA node also referred to?
    the pacemaker
  128. How many times per minute do the atria contract?
  129. What center signals the ventricles to contract?
    atrioventricular node (AV node)
  130. AV node is located...
    in the floor of the right atrium
  131. What simulates the AV node to contract?
    SA node impulse
  132. After the AV node receives the pacemaker (SA node) impulse it...
    delays it a fraction of a second, then excites the ventricles to contract
  133. where does the impulse go from the AV node?
    it enters the atrioventricular (AV) bundle (Bundle of His)
  134. What is the atrioventricular (AV) bundle also known as?
    bundle of His
  135. AV bundle (bundle of His) bifurcates to form...
    • right bundle branch
    • left bundle branch
  136. the right bundle branch goes to...
    the right ventricle
  137. the left bundle branch goes to...
    the left ventricle
  138. Where does excitation of the ventricular walls begin and how does it travel?
    begins at the apex of the heart and radiates upward towards the base
  139. What mechanical device is used to regulate heart beats when there is a problem with the Purkinje system?
    artificial pacemaker
  140. What function do intercalated discs perform?
    rapid conduction of impulses within the heart
  141. What monitors blood pressure at points throughout the body?
  142. How do baroreceptors work?
    If blood pressure drops, nerve impulses are sent to increase the heart pumping action

    they monitor the stretching of major arteries and veins caused by the pressure of the blood flowing through them
  143. If the blood pressure drops the heart rate will...
  144. what baroreceptor is activated when suddenly arising form a prone sleeping position?
    carotid sinus
  145. mechanical device used to measure the electrical activity of the cardiac conduction system
  146. record of electrical changes that occur during each cardiac cycle
    electrocardiogram (ECG or EKG)
  147. 3 waves represented in EKGs
    • P wave
    • QRS wave
    • T wave
  148. What does the P wave on an EKG represent?
    Spread impulse from the SA node over the atria (known as depolarization)
  149. What is the term that describes P wave activity?
  150. Electrical charge in the cardiac conduction system during depolarization?
  151. QRS wave on EKG represents...
    spread of the impulse from the AV Node through the ventricles
  152. what term describes QRS wave activity?
  153. What does T wave represent on an EKG?
    ventricular repolarization
  154. What happens during ventricular repolarization?
    muscles of the ventricles return to their resting state (relaxation)
  155. Why is atrial repolarization not seen on an EKG?
    it is masked by the QRS sequence
  156. What other than the waves are important in interpreting an EKG?
    • intervals between peaks
    • amplitudes and widths of waves
    • regularity or rhythms of wave sequences
  157. a graphic outline of functioning heart structures compiled from ultrasound vibrations that are echoed into a receiving monitor
  158. what is used to obtain the outlines of the heart in a echocardiogram?
  159. in a normal cardiac cycle what happens?
    • the 2 atria contact almost simultaneously while the two ventricles are relaxed
    • then the ventricles contract while the atria relax
  160. contraction phase of the ventricles
  161. stroke pressure of systole
    • 120mm of mercury in left ventricle
    • 20mm in the right ventricle
  162. ventricular relaxation phase
  163. diastolic (resting) pressure
    • 80mm of mercury in left ventricle
    • 10mm in right ventricle
  164. the amount of blood ejected by the left venricle
    • stroke volume
    • about 70ml
  165. amount of blood remaining in the left ventricle after systole
    • end systolic volume
    • 60ml
  166. Why are the walls of the atria relatively weak?
    their only function is to receive blood from the great veins and pump it into the ventricles
  167. Why is the left ventricular myocardium thicker than the right?
    because of the greater stroke pressure needed to drive blood throughout the body
  168. anatomical flaws in the heart structures that are present from birth
    congenital heart defects
  169. term used for babies born with congenital heart defects
    blue babies
  170. why are blue babies described as blue?
    cyanosis (blue discoloration of the skin and mucus membranes) caused by the mixing of oxygenated blood with de-oxygenated blood in babies with congenital heart defects
  171. name 5 types of congenital heart defects
    • coarctation of the aorta
    • patent ductus arteriosus
    • interatrial septal defect
    • interventricular septal defect
    • Tetralogy of Fallot
  172. a portion of the aorta is narrowed which reduces blood flow of systemic blood and causes hypertrophy of the left ventricle
    congenital heart defect - coarctation of the aorta
  173. ductus arteriosus (fetal blood vessel between the aortic arch and pulmonary trunk) doesn't close at birth to form the ligamentum arteriosum
    Patent ductus arteriosus - congenital defect
  174. ligamentum arteriosum
    the remnant of the ductus arteriosus (fetal blood vessel between aortic arch and pulmonary trunk) which closes at birth
  175. mixture of atrial blood caused by a failure of the foramen ovale to close at birth
    interatrial septal defect
  176. what is the most common congenital heart defect?
    interatrial septal defect
  177. a mixture of the blood between the two ventricles as a result of an opening in the interventricular septum
    interventricular septal defect - congenital heart defect
  178. a combination of 4 heart defects common in Down Syndrome children
    Tetralogy of Fallot
  179. What 4 defects does Tetralogy of Fallot include?
    • stenosed pulmonary semilunar valve
    • interventricular septal defect
    • enlarged right ventricle
    • an aorta emerges from both ventricles
  180. What does blockage of the coronary arteries cause?
    ischemia (decreased blood flow) to the heart muscles
  181. What does ischemia caused by partial blockage of the coronary arteries result in?
    angina pectoris
  182. What is angina pectoris?
    • chest pain
    • ischemia caused by partial blockage of the coronary arteries
  183. Complete blockage of coronary arteries leads to...
    myocardial infaction
  184. partial blockage of the coronary arteries causes...
    angina pectoris
  185. myocardial infarction results in...
    tissue death
  186. Americans who will have had a myocardial infarction (MI) by the age of 60
    1 in 5
  187. Risk factors for MI
    • Tobacco
    • Obesity
    • lack of regular exercise
    • overuse of alcohol
    • high BP
    • gender (males vs females)
    • genetics
    • high blood cholesterol
    • age - risk increases with age
    • stress
  188. Heart condition often associated with old age
    congestive heart failure
  189. Chronic condition where heart becomes inefficient and weak, blood doesn't circulate well
    congestive heart failure
  190. sign of congestive heart failure
    peripheral edema, especially in ankles
  191. objectives of medical treatment for congestive heart failure (CHF)
    what treatments are used?
    • increase the contractile ability of the myocardium, digitalis
    • remove fluid from the body, lasix (diuretic)
  192. arteries take blood
    away from the heart
  193. veins take blood
    to the heart
  194. what are the only veins that carry oxygenated blood?
    pulmonary veins
  195. what are the only arteries that carry deoxygenated blood?
    pulmonary arteries