A&P - Heart

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Author:
tiffanydawnn
ID:
69928
Filename:
A&P - Heart
Updated:
2012-01-18 23:42:40
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Cardiovascular System Heart Blood Vessels
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Cardiovascular System, Heart, Blood, Blood Vessels
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  1. cardiovascular system
    • heart, blood, blood vessels
    • 2 circulatory patterns: pulmonic and systemic
  2. pulmonic circulation
    RV (DOB) -> lungs (exchange) -> LA (OB)
  3. systemic circulation
    LV (OB) -> body (exchange) -> RA (DOB)
  4. heart
    • located in mediastinum
    • behind sternum, between lungs
    • left of midline, tipped to front
    • 4 chambers
  5. base of the heart
    • superior
    • all blood vessels enter and exit
  6. apex of the heart
    inferior
  7. right atrium
    • upper right chamber
    • receives DOB from body
  8. right ventricle
    • lower right chamber
    • receives DOB from RA
    • pumps DOB to lungs
  9. left atrium
    • upper left chamber
    • receives OB from lungs
  10. left ventricle
    • lower left chamber
    • largest chamber, thickest wall
    • receives OB from LA
    • pumps OB to body
  11. auricles
    • on top of RA and LA
    • increases volume
  12. interventricular septum
    septum between the ventricles
  13. interatrial septum
    septum between the atria
  14. foramen ovale
    • hole in the IAS of a fetus
    • allows blood to move from R to L (fetal lungs immature)
  15. fossa ovalis
    closed foramen ovale
  16. atrial septum defect
    • foramen ovale fails to close after birth
    • must be surgically repaired
  17. SVC
    • superior vena cava
    • returns DOB to the RA from all regions above the heart
  18. IVC
    • inferior vena cava
    • returns DOB to the RA from all regions below the heart
  19. CS
    • coronary sinus
    • returns the DOB to the RA from the heart itself
  20. PT
    • pulmonary trunk
    • DOB from RV to lungs
    • splits into L & R pulmonary arteries
  21. PV
    • pulmonary veins (4 - 2R, 2L)
    • returns OB from the lungs to the LA
  22. aorta
    • OB from LV to body
    • largest BV in the body
  23. tricuspid
    • R atrioventricular valve
    • between RA/RV
  24. bicuspid
    • aka mitra or L atrioventricular
    • between LA/LV
  25. aortic semilunar valve
    entrance to aorta
  26. pulmonary semilunar valve
    entrance to pulmonary trunk
  27. chordae tendineae
    • heart strings that attach valves to papillary muscles
    • keep valves moving one way
    • maintain tension
  28. epicardium
    outer thin covering of the heart
  29. myocardium
    thick middle muscle layer of the heart
  30. endocardium
    • thin, shiny inner lining of the heart
    • lines all cavities and vessels that enter/exit the heart
  31. pericardial sac
    • thick CT bag
    • 2 layers: fibrous (outer) & serous (inner)
  32. conduction system
    • several masses of nerve tissue
    • controls rate, rhythm, force of HB
    • SA -> AV -> Bundle of His -> purkinje fibers
  33. SA node
    • sinoatrial node aka pacemaker of the heart
    • located in upper RA
    • receives impulses from ANS
    • sends impulses to LA and AV node
  34. AV node
    • atrioventricular node
    • located in lower RA
    • receives impulses from SA node
    • sends impulses down Bundle of His
  35. Bundle of His
    • runs transverse through IV septum
    • R and L branches
    • receives impulses from AV node
    • sends impulses to apex of heart
  36. purkinje fibers
    • terminal branch of conduction system
    • receives impulses from Bundle of His
    • sends impulses into ventricular myocardium
  37. EKG
    • graphical record of electrical activity of the ehart
    • 3 waves: P wave, QRS complex, T wave
  38. P wave
    • atrial depolarization
    • electricity moves through both atria
    • end of P wave - atria contract
  39. QRS complex
    • ventricular depolarization
    • electricity moves through both ventricles
    • end of QRS complex- ventricles contract
  40. T wave
    • ventricular repolarization
    • end of T wave - ventricles relax
  41. auscultation
    listening to heart sounds
  42. lubb
    • heart sound produced when AV valves close
    • longer, louder sound
  43. dup
    • heart sound produced when semilunars close
    • shorter, softer sound
  44. heart murmur
    abnormal heart sounds (swishing)
  45. cardiac cycle
    • all events associated with blood moving through the heart
    • 3 stages: ventricular filling, ventricular systole, isovolumetric relaxation
  46. ventricular filling
    • P-wave
    • overall pressure in the heart is low
    • blood enters atria, moves through to ventricles
    • passive filling (70%) due to gravity and weight of blood
    • both cuspids open, both semilunars closed
    • atria contract to empty remaining 30%
    • atria relax
  47. ventricular systole
    • pressure in ventricles rises
    • cuspids close
    • for 1/10 second, ventricles are completely closed chambers
    • pressure opens semilunars
    • ventricles contract to force blood into aorta and pulmonary trunk (called ventricular
  48. ejection)
  49. isovolumetric relaxation
    • ventricles rekax
    • pressure in ventricles drops
    • semilunars close
    • ventricles again closed chambers
  50. heart rate
    • normal 75 bpm
    • affected by age (decreases with age), gender (increased in women), exercise, body temp,
  51. chemicals, ANS
  52. tachycardia
    HR > 100
  53. bradycardia
    HR < 60
  54. cardiac output
    • total volume of blood pumped out of each ventricle per minute
    • formula: CO = HR x SV
  55. stroke volume
    • amount of blood pumped out of each ventricle per beat
    • 3 factors that affect SV: preload, contractility, afterload
  56. cardiac reserve
    • ability to push cardiac output far above normal
    • seen during exercise, emergency, and stress
  57. preload
    amount of stretch on cardiac fibers just before contraction
  58. Frank-Starling Law of the Heart
    • the greater the strecth, the stronger the contraction
    • explains why R & L ventricles eject the same volume despite size differences
  59. contractility
    • strength of contraction of individual cardiac fibers
    • controlled by positive and negative inotropic agents
  60. positive inotropes
    • increase strength of contraction
    • ex: epinephrine, norepinephrine, digitalis
  61. negative inotropes
    • decrease strength of contraction
    • ex: anesthesia
  62. afterload
    amount of pressure needed in both ventricles to open semilunars
  63. blood pressure
    • the force exerted on vessel walls by contained blood
    • affected by:
    • -blood volume (^ vol ^ BP)
    • -cardiac output (^ output ^ BP)
    • -peripheral resistance (^ resistance ^ BP)
    • -diameter of vessel (small diameter ^ BP)
  64. peripheral resistance
    friction encountered by blood as it moves through vessel walls
  65. HIGHEST BP
    in aorta and pulmonary trunk just after ventricles contract
  66. LOWEST BO
    in SVC, IVC, CS, pulonary veins before blood enters atria
  67. ZERO BP
    in atria just before contraction
  68. pulse pressure
    • difference between systolic and diastolic
    • working pressure of the blood that moves through the vessels
  69. hypertension
    systolic > 140
  70. hypotension
    systolic < 100
  71. essential hypertension
    BP 220/120 or greater
  72. thrombus
    stationary internal blood clot
  73. embolus
    thrombus that dislodges and moves
  74. aneurysm
    thin spot in the wall of a vessel that causes it to bulge and possible rupture
  75. blood vessels
    3 major groups: arteries, veins, capillaries
  76. arteries
    • carry blood (usually OB) away from the heart
    • larger of the vessels
    • empty into arterioles
  77. veins
    • carry blood (usually DOB) to the heart
    • supplied by venules
    • less elastic than arteries
    • lower BP than arteries
    • have valves to prevent backflow
  78. capillaries
    • connect arteries and veins
    • made of endothelium (simple squamous ET)
    • called microcirculation
    • allows for passage of O2, CO2, nutrients, waste between blood and tissues
  79. tunica interna/intima
    • inner layer of arteries and veins
    • simple squamous
  80. tunica media
    • middle, thickest layer of arteries and veins
    • smooth muscle w/elastic fibers
  81. tunica externa/adventitia
    • strongest, outer layer of arteries and veins
    • collagen w/elastic fibers
  82. anastamosis
    • life sustaining structures are supplied by a network of several arteries
    • provides alternate ways for structures to receive blood
    • ex: circle of willis in the brain
  83. trunk arteries
    • ascending aorta
    • --R & L coronary
    • arch of aorta
    • --brachiocephalic
    • ----R common corotid
    • ----R subclavian
    • --L subclavian
    • --L common corotid
    • abdominal descending
    • --renal arteries
    • --R & L common iliac
    • PIC
  84. trunk veins
    • ----R & L subclavian
    • --brachiocephalic
    • --internal/external jugulars
    • SVC
    • ----R & L coronary veins
    • --coronary sinus
    • RA
    • --R & L common iliac
    • IVC
    • PIC
  85. blood
    • liquid connective tissue
    • carries O2, nutrients, hormones to tissues
    • carries waste to lungs, kidneys, sweat glands
    • 38.0C, 100.4F
    • 55% plasma, 45% formed elements
    • pH 7.35 - 7.45
    • 3 functions:
    • --transportation
    • --regulation (pH, temp, water content)
    • --protection (antibodies, clotting)
  86. plamsa
    • thin, watery, yellowish liquid
    • 92% H20, 8% solute (protein, hormones, vitamins, nutrients, electrolytes)
    • 3 groups of proteins: albumin, globulins, fibrinogen
  87. albumins
    • 54% of plasma proteins
    • maintains blood volume, water balance, amount of water entering cells, carrier molecules for facilitated diffusion
  88. globulins
    • 38% of plasma proteins
    • produce antibodies
  89. fibrinogen
    • 7% of plasma proteins
    • clotting
  90. hematopoiesis
    • formation of blood or blood cells
    • in embryo: cells formed in liver, spleen, thymus, lymph nodes, bone marrow, and yolk sac
    • after birth: cells formed in red bone marrow (proximal epiphysis of humerus & femur, flat bones (sternum, ribs), cranial bones, vertebra, and pelvis)
  91. pleuripotent hematopoeitic stem cells
    • cells that make all blood cells
    • --myeloid stems
    • -----RBCs
    • -----WBCs (neutro, eosino, baso, monocytes)
    • -----thrombocytes
    • --lymphoid stems
    • -----lymphocytes
    • ---------plasma cells
    • ------------B&T cells
  92. RBCs
    • no nucleus - ejected before reticulocyte stage
    • live 120 days - broken down in liver or spleen
    • 2 million produced per second
    • surrounded by selectively permeable membrane that enclose cytoplasm and hemoglobin
  93. RBC counts
    • female: 4.8 million/mm3
    • male: 5.4 million/mm3
  94. hemoglobin
    • made of heme (iron) + globin (protein)
    • O2 binds to iron, CO2 binds to protein
    • takes up most space inside RBC (1/3 of weight)
    • when RBC destroyed in liver, Hgb breaks down into hemosiderin, bilirubin, globin
  95. hemosiderin
    • iron pigment that remains in the liver
    • stored and eventually used to make new Hgb
  96. bilirubin
    • waste product
    • moves from blood into bile
  97. globin
    protein metabolized in the liver
  98. erythropoiesis
    • production of RBCs
    • controlled by erythropoietin
  99. renal erythropoietic factor
    • enzyme produced and released by the kidneys that causes the production of more erythropoietin
    • triggered by excessive blood loss
  100. WBCs
    • fight infection
    • all have nucleus
    • live a few days to several months
    • can leave circulatory system and move to sites of infection
    • 2 classes: granular and agranular
  101. WBC count
    5,000 - 10,000/mm3
  102. leukocytosis
    WBC > 10,000
  103. leukopenia
    WBC < 5,000
  104. granular WBCs
    • small grains in cytoplasm
    • 3 types: neutrophils, eosinophils, basophils
  105. neutrophils
    • nucleus has 2-6 lobes
    • first WBC to reach site of infection
    • phagocytes
  106. eosinophils
    • nucleus has 2 lobes
    • fights parasites and worms
  107. basophils
    • irregular shaped nucleus
    • involved in allergic reactions
    • produce 3 chemicals that aid in allergic response: histamine, heparin, seratonin
  108. agranular WBCs
    • do not have grains in cytoplasm
    • 2 types: monocytes and lymphocytes
  109. monocytes
    • major phagocytes of the body
    • more will arrive to site of infection than neutrophils
    • turn into macrophages on the way to site of infection
  110. macrophages
    • most active phagocytes in the body
    • nucleus is kidney shaped
    • 2 types: fixed and wandering
  111. lymphocytes
    become B cells and T cells
  112. B cells
    become plasmal cells that make antibodies to kill bacteria
  113. T cells
    make cells that attack and kill viruses
  114. diapedesis
    WBC slides out of vessel wall
  115. chemotaxis
    WBC moves to site of infection
  116. thrombocytes
    • plug damaged vessels and secrete chemicals needed for clotting
    • made from megakaryocytes that shed pieces of cytoplasm, which becomes enclosed by a cell membrane
    • no nucleus
    • oval or disk shaped
    • production controlled by thrombopoietin
    • live 5-9 days - destroyed by liver and spleen
  117. platelet count
    250,000 - 400,000/mm3
  118. reticulocyte count
    measurement of speed of RBC formation
  119. talquist
    test for anemia
  120. hematocrit
    • # of RBCs/total blood volume
    • male: 42-54%
    • female: 37-47%
  121. differential WBC
    • # of each type of WBC per 100
    • neutrophils - 60 - 70
    • basophils - 0.5 - 1
    • eosinophils - 2-4
    • monocytes - 8-10
    • lymphocytes - 20-25
  122. hemostasis
    • stoppage of bleeding
    • posiive feedback loop that occurs when blood vessel is injured
    • 3 steps: vascular spasm, platelet plug formation, clotting
  123. vascular spasm
    • as blood escapes, it activates stretch receptors in vessel wall
    • vessel contracts rapidly to temporarily reduce blood loss
    • spasm most effecient if injury is cause by dull, blunt object (more receptors stimulated)
  124. platelet plug formation
    • in a normal vessel, wall and platelets have "+" charge
    • in an injured vessel, "-" charged collagen in tunica adventita is exposed
    • "-" collagen attracts "+" platelets to site
    • platelets swell, stick to each other and the collagen, and then blow up
    • granules inside platelets release more "-" chemicals to attract more "+" platelets
  125. degranulation of the platelet
    positive feedback loop that plugs injury
  126. clotting
    • a process that involves 20+ clotting factors
    • 2 pathways: intrinsic, extrinsic
  127. clotting factors
    a large group of chemicals that are ALL necessary for proper and efficient clotting
  128. intrinsic clotting
    • occurs inside blood vessels
    • more complex than extrinsic
  129. extrinsic
    • occurs outside blood vessel
    • faster than intrinsic
  130. common clotting pathway
    both pathways merge
  131. clotting factors
    • prothrominase - relased when platelet degranulates
    • prothrombin
    • vitamin k
    • thrombin
    • calcium
    • fibrinogen
    • fibrin

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