Chapter 13: Cardiovascular System (Study Guide & Study Questions)Intro:

Cardiovascular system is in control of transportation. Allows the body to move around substances that are vital for homeostasis.

Heart:location size and position (278)

2/3 of the mass of the heart is to the left of the midline of the body and 1/3 is to the right. the heart is a triangular organ shaped and is sized like a closed fist Apex or blunt point at the lower edge of the heart that lies on the diaphragm pointing

towards the left. Sounds of your apical beat are found on the Apex. (Left 5th intercostal space down at the

midclavicular line). Heart is positioned in the thoracic cavity between the sternum in front and thoracic

vertebrae in the back. Apex: Good place for CPR (Cardiopulmonary Resuscitation) rhythmic compression of the

heart in this way can maintain blood flow in cases of cardiac arrest combined with effective artificial respiration.

Functional Anatomy (279)Heart Chambers:

Heart chambers are hollow organs. Partition divides it into right and left sides. Heart contains four cavities (hollow chambers)

o Two upper chambers (Atria) o Two lower chambers (Ventricles)

Atria are smaller than ventricles. Atria walls are thin & less muscular. Atria have an earlike extension called an auricle. Atria are RECEIVING CHAMBERS. Blood enters the heart through veins that open to the atria. Ventricles are DISCHARGING CHAMBERS. Each heart chamber is named according to its location. Wall of each heart chamber is composed of cardiac muscle tissue: Myocardium. Interatrial Septum: Separates atrium. Interventricular Septum: Separates ventricles. Chambers of the heart are covered in smooth muscle tissue: Endocardium. Two pericardial layers glide over each other without friction when the heart beats because

these are serious membranes with moist slippery surfaces.

Inflammation of the endocardium: Endocarditis Thrombus: Clot Pericardium:

Inflammation of Pericardium: PericarditisHeart Action: (280)

Systole: Contraction of heart Diastole: Relaxation of heart

Heart Valves: (281)

Atrioventricular valves have 3 “flaps” Semilunar valves have 2 “flaps” Chordae tendineae are the stringlike structures that are attached to the “flaps” of the AV

valves. SL Valves are between each ventricular chamber and its large artery that carries blood

away from the heart when it contracts. Ventricles, like atria, contract together, so the two SL valves open and close at the same

time. Pulmonary SL valve is at the beginning of the pulmonary artery and allows blood going to

the lungs to flow out of the right ventricle during systole and prevents backflow during diastole.

Aortic SL valve is at the beginning of the aorta and allows blood flow out of the left ventricle up into the aorta but prevents backflow into this ventricle.

Heart Sounds: Lub Dup: Rhythmical and repetitive sounds of the heart. Lub: The first sound that you hear. Caused by the vibration and abrupt closure of the AV

valves as the ventricles contract. Closure of the AV valves prevent blood from backflowing into the atria during contraction of the ventricles.

First sound is longer in duration and has a lower pitch. The pause between the lub and dup sound is shorter than after the second sounds and lub

dup of systole. Dup: Second sound that you hear. Caused by the closing of both semilunar valves when

the ventricles relax (diastole). Stethoscope: Used to listen to heart sounds. Heart Murmurs: Abnormalities in the normal lub dup heart sounds.

Blood Flow Through The Heart:

Atrioventricular Valves:

Tricuspid Valve(Right Atrioventricular Valve)TRI BEFORE YOU BIBicuspid Valve(Left Atrioventricular Valves)

Semilunar Valves:

Pulmonary Semilunar Valve

Aortic Semilunar Valve

Blood Supply to Heart Muscle: Myocardium (heart muscle), must receive blood containing nutrients and oxygen to

function effectively. Coronary Circulation: Process of delivery of oxygen and nutrient rich arterial blood to

cardiac muscle tissue & the return of oxygen poor blood from this active tissue to the venous system.

(Page 281)-When the heart “beats”, first, the atria contract at the same time. This is ATRIAL SYSTOLE.

-After the ventricles fill with blood, they contract together also and this is called ventricular systole.

-The left and right side of the heart act as separate pumps.

Pulmonary Circulation: Flow of blood from the right ventricle to the lungs and back to the left atrium.

Systemic Circulation: Flow of blood from the left ventricle throughout the body and back to the right atrium.

Blood flows into the heart muscle through two small vessels: Coronary Arteries

During ventricular systole, the myocardium is contracting and putting pressure on the coronary arteries, so little blood can enter them.

During ventricular diastole, blood that backs up behind the aortic SL valve can flow easily into the coronary arteries.

Embolism : Obstruction of a blood vessel by foreign matter carried into the blood stream. (CLOT)

o With a clot, blood cannot pass through occluded vessels and cannot reach the heart to supply what is normally does.

o Cells will become damaged or die. MYCARDIAL INFARCTION : ‘heart attack’ is tissue death to the muscle of the heart.

o Common cause of death in middle and late adulthood.o Recovery is possible is the amount of tissue or muscle that was not damaged is able

to supply the needs of the rest of the heart. ANGINA PECTORIS : severe chest pain that is used as a warning sign when the heart

muscle isn’t getting enough oxygen. CORONARY BYPASS : common treatment for those who have had severely restricted

coronary artery blood flow. Veins are “harvested” from the rest of the body and are used to bypass partial blockages in coronary arteries.

ANGIOPLASTY : A device is inserted into a blood vessel to force open a channel for blood flow through a blocked artery.

After blood passes through the capillary beds in the myocardium, it flows into cardiac veins, which empty into coronary sinus and then into the right atrium.

Cardiac Cycle: Each complete heartbeat is called a cardiac cycle. Cardiac cycle includes contraction (systole) and relaxation (diastole) of atria and

ventricles. Each cycle takes about 0.8 seconds to complete if the heart is beating at an average rate of about 72 beats per minute.

Most of the atrial blood moves into the ventricles passively before the atria have a chance to contract.

There is a moment at the beginning of ventricular contraction where there is no change in volume. This occurs because it takes a moment for the ventricular pressure to overcome the force needed to open the SL valves.

There is another period of constant volume as the ventricles begin to relax, before the mitral valves open and blood gushes rapidly in from the atria.

Electrical Activity of the Heart:Conduction System:

Cardiac muscle fibers can contract rhythmically on their own. Cardiac muscle fibers must be coordinated by electrical signal impulses) if the heart is to

pump effectively. Rate of cardiac muscle’s rhythm can be sped up or slowed down by autonomic nerve

signals. The heart has its own built in conduction system for generating action potentials

spontaneously and coordinating contractions during the cardiac cycle. All cardiac muscle fibers in each region of the heart are electrically linked together. intercalated discs are connections that Electrically join muscle fibers into a single unit that

can conduct an impulse through the entire wall of the heart chamber without stopping.

Think, “I will be with a coroner if I do not have coronary circulation!”

Veins are the vehicles for blood to be sent to the heart.Arteries carry blood away from the

Both atrial walls will contract at about the same time because all of their fibers are electrically linked.

Both ventricular walls will contract at about the same time. 4 structures in bedded in the wall of the heart specialize in generating strong action

potentials & conduct them rapidly to certain regions of the heart wall. They make sure that the atria contract and then the ventricles contract in an efficient manner.

1. Sinoatrial node (SA node) (pacemaker) 2. Atrioventricular node (AV node) 3. (AV bundle)(bundle of his) 4. sub endocardial branches (Purkinje fibers)

Impulse conduction normally start as a spontaneous action potential in the hearts natural pacemaker, the SA node. It spreads in all directions through the atria.

Myocardial fibers are electrically linked together & normally match the activity of the fibers that make up the conduction system.

When impulses reach the AV node, it is triggered to relay its own impulse by way of the AV bundle and the sub endocardial branches to the ventricular myocardium, causing the ventricles to contract.

A ventricular beat follows each Adriel beat. Endocarditis or my cardio infarction can damage the hearts conduction system and disturb

its rhythmic beating. (This is called a heart block. Impulses are blocked from getting through to the ventricles, resulting in the ventricles reading at a much slower rate than normal.)

Treatment for a heart block can be implanting an artificial pacemaker in the heart. (electrical device that causes ventricular contractions at a rate fast enough to maintain an adequate circulation of blood).

Electrocardiogram: the hearts conduction system generates tiny electrical currents that spread through

surrounding tissues and eventually to the surface of the body. o These electrical signals can be picked up from the body surface and transformed

into visible tracings by an instrument called electrocardiograph. Electrocardiograph: a graphic record of the heart’s electrical activity obtained using the

electrical cardiograph apparatus. (ECG or EKG). A normal ECG tracing has three very characteristic deflections or waves: P-wave, QRS

complex & T-waveo (these deflections represent the electrical activity that regulates the contraction or

relaxation of the atria or ventricles)

Depolarization: describes the electrical Activity that triggers contraction of the heart muscle.

Repolarization: begins just before the relaxation phase of cardiac muscle activity. ECG deflections begin before myocardial contractions, not during these contractions. Depolarizations trigger contractions and a trigger always comes before the event that is

triggered. Damage to cardiac muscle tissue that is caused by an MI or disease affecting the hearts

condition system, results in distinctive changes in the ECG. ECG tracings are extremely valuable and diagnosis and treatment of heart disease.

Cardiac output:definition of cardiac output:

Cardiac output (CO): volume of blood pumped by one ventricle per minute; it averages about 5 L in a normal resting adult.

Cardiac output is determined by the heart rate (HR)and stroke volume (SV) heart rate refers to the number of heartbeats cardiac cycles per minute. Stroke volume refers to the volume of blood ejected from the ventricles during each beat. HR is determined mostly by the natural rhythm of the heart created by the hearts on

conduction system. Abnormally decreased CO can result in fatigue or with a significant drop in CO, even

death.Heart rate:

Autonomic nervous system may alter the hearts rhythm to increase or decrease HR. Neurons of the sympathetic cardiac nerve release the neurotransmitter nor epinephrine,

which causes the SA node to increase its usual pace and thereby increase HR. Parasympathetic division of the ANS slows down HR. Neurons of the Vegas nerve or (cranial nerve X) release acetylcholine to decrease the

pace of the SA node. The balance between antagonistic influence of sympathetic and parasympathetic signals

to the heart can be shifted by a variety of factors.  o When blood CO2 levels rise during exercise, there is a reflective rise in HR. This is

an attempt by the body to restore homeostasis of blood gases.

o A sudden drop in blood pressure triggers a reflective increase in HR as the body attempts to restore normal blood flow out of the heart.

o Stress can also cause a sudden increase in HR so that skeletal muscles will be ready to resist or avoid the stressor. Various dysrhythmias may affect HR by disrupting the normal rhythm of the heart.

Stroke volume: The volume of blood ejected by the ventricles is determined by the volume of blood

returned to the heart by the veins, or venous return. Generally, the higher the venous return, the higher the SV. Venous return can change when the volume of blood changes, as in dehydration or blood

loss due to hemorrhage. Various hormones can influence total blood volume and affect SV. Movement of skeletal muscles, including breathing, influence pressure on veins which

increases venous blood flow and increases the rate of venous return. The strength of myocardial contraction also helps determine SV. Ion imbalances can affect muscle fiber function and impair contraction. This would

decrease SV. Valve disorders, coronary artery blockage, or MI, decrease SV and may decrease cardiac

output.blood vessels:Types:

Arterial blood is pumped from the heart through a series of large distribution vessels: arteries.

Largest artery: aorta. Arteries subdivide and blood flows into vessels that become progressively smaller arteries

until finally it enters tiny arterials that control blood flow into microscopic exchange vessels called capillaries.

In Capillary beds, The exchange of nutrients and respiratory gases occurs between the blood and tissue fluid around the cells.

Blood exits from the capillary beds and then enters the small venules, which join with other venules and increase in size becoming veins.

The large veins are called sinuses. Superior vena cava and inferior vena cava are sinuses. Arteries carry blood away from the heart and toward capillaries. Veins carry blood toward the heart and away from capillaries. Capillaries carry blood from the tiny arterials into tiny venules. The aorta carry blood out of the left ventricle of the heart, and the vena cava returns

blood to the right atrium after the blood has circulated through the body.Structure:

Three coats or layers are found in both arteries and veins.o Outer layer : (tunica externa) “coat” or “outside”. Made of connective tissue fibers

which reinforce the wall of the vessel so that it will not burst under pressure. Connective fibers also connect to the extracellular matrix of surrounding tissues to help hold the vessel in place.

o Middle layer : (Tunica media) “middle coat”. This muscle layer is much thicker in arteries than veins. Thicker muscle layer in the artery wall is able to resist great pressures generated by ventricular systole. In arteries the tunica media plays role in

maintaining blood pressure controlling blood distribution

o This is a smooth muscle so it is controlled by the NS. It is also sometimes includes a thin layer of elastic fibers tissue. Smooth muscle cells that in circle the arterial walls may contract or relax to regulate how much blood flow will be into a capillary bed.

o Inner layer: (tunica intima) or “inner most coat”. lines arteries and veins.

A single layer of squamous epithelium cells called endothelium that lines the inner surface of the entire cardiovascular system.

The tunica intima sometimes includes a thin layer of elastic fibers tissue. Tunica intima is equipped with pockets that act as one-way valves. Prevent the Backflow of blood due to gravity, muscle contractions, and other

forces and keeps blood flowing in one direction back to the heart. These venous valves also allow veins to act as supplemental pumps that help

maintain venous return of blood to the heart. stretching walking and other activities helped improve blood circulation and

prevent formation of thrombi in the veins. When a surgeon cuts into the body only arteries arterials veins and venules

can be seen. Capillaries cannot be seen because they are microscopic.

Capillaries are extremely thin with only one layer of flat endothelial cells that compose the capillary membrane.

Capillary wall is composed of only one layer, the tunica intima. Substances such as glucose, oxygen, CO2, Hormones and waste can quickly pass through it on their way to or from cells.

Functions: Together, arteries capillaries and veins all conduct blood around the body circulatory

routes.Arteries and arterioles:

Arteries and arterioles distribute blood from the heart to capillaries in all parts of the body. Constricting or dilating, arterials help maintain arterial blood pressure in a normal level.

Arterial pressure is a major force in keeping blood flowing.Capillary exchange:

Capillaries function as exchange vessels, carrying out a central function of the cardiovascular system glucose and oxygen move out of the blood and capillaries into IF and then into cells.

Carbon dioxide and other substances move in the opposite direction, to the capillary blood from the cells.

Fluid is also exchanged between capillary blood and IF. Two opposing forces influence capillary exchange: osmosis and filtration.

o Osmosis is the passive movement of water when some solids cannot cross the membrane.

o Filtration is passive movement of fluid resulting from a hydrostatic pressure gradient.

Capillary exchanges forces vary, depending on location.

1. At the arterial end of a capillary, the outward driving force of BP, is larger than the inwardly directed force of osmosis. Fluid moves out of the vessel. 2. At the venous end of a capillary,

the inward driving force of osmosis is greater than the outwardly directed force of hydrostatic pressure. Fluid enters the vessel.3. About 90% of the fluid leaving

the capillary at the arterial end is recovered by the blood before it leaves the venous end. The remaining 10% is recovered by the venous blood eventually, by way of lymphatic vessels.

At the arterial end of a capillary, the outwardly directed forces are dominant and tend to move fluids from blood to tissue.

At the Venous end of a capillary, the inwardly directed forces are greater and tend to move fluids from tissue to blood.

Excess fluid tissue not moved to the blood are collected by the lymphatic system to be eventually return to Venus blood.

Factors that affect osmotic pressure (like a plasma albumin levels) or hydrostatic pressure (like blood pressure) drive filtration can disrupt capillary exchange that might result in dehydration or overhydration of tissues.

Veins and Venules: Venules and veins collect blood from capillaries and return it to the heart. Larger veins also serve as blood reservoirs because they carry blood under lower pressure

than arteries. They can expand to hold a larger volume of blood or constrict to hold a much smaller amount.

External pressure can turn veins, which have one-way valves, into pumps that help return blood to the heart.

Routes of Circulation: Blood flows through vessels that are arranged in a complete circuit or circular

pattern. Route of circulation is a particular set of circular pathways, such as from the heart

to the lungs and back, or from the heart to a particular organ and back.Systemic and Pulmonary Routes of Circulation: (Page 291 & Figure 13-18)

Hepatic Portal Circulation:

Fetal Circulation:

She does not want us to know anything about this for the test, but in case it is brought up, she did say to know what the umbilical cord and placenta were.

Know that the umbilical cord can be used for an IV solution for the baby.Hemodynamics:

Hemodynamics is the set of processes that influence the flow of blood. The main force that drives the continuous flow of blood through its circulatory

routes is BP.Defining Blood Pressure:

Blood pressure is the push of blood as it flows through the cardio system. BP exists in all blood vessels but is highest in the arteries and lowest in the veins. (Figure 13-21 shows the BP pressure gradients in blood flow). The BP gradient is the difference between 2 blood pressures. The BP gradient for the entire systemic circulation is the difference between the

average or mean BP in the aorta and the BP at the termination of the venae cavae where they join the right atrium of the heart.

The mean BP in the aorta is 10 mm Hg. The pressure at the at the termination of the VC is 0. With these typical normal figures, the systemic BP gradient is 100 mm Hg (100-0) High BP is hypertension (HTN). HTN is bad because if BP becomes too high, it may cause a rupture oof one or

more blood vessels. (the brain would be a stroke). Chronic HTN can also increase the load on the heart, causing abnormal thickening

of the myocardium. Could lead to heart failure. Low BP can be dangerous too. If arterial pressure falls low enough, then blood will

not be able to flow through, or perfuse, the vital organs of the body.

Circulation of blood and life would cease. Massive hemorrhage drastically reduces BP and can result in death.

Factors That Influence BP: Blood volume Strength of each heart contraction Heart rate Thickness of blood (viscosity)

Blood Volume: The direct cause of BP in the volume of blood in the vessels. The larger the volume of blood is in the arteries, the more pressure the blood

exerts on the walls of the arteries, or the higher the arterial BP will be. Less blood there is in the arteries, the lower the BP tends to be. Hemorrhage demonstrates this relationship between blood volume and blood

pressure. Hemorrhage is a pronounced loss of blood, and this decrease in volume of blood

causes BP to drop. Major sign of hemorrhage is a rapidly falling BP. Diuretics: drugs that promote water loss by increasing urine output. These are

used to treat HTN. As water is lost from the body, BV decreases, and BP decreases to a lower level.

Volume of blood in arteries is determines by how much blood the heart pumps into the arteries and how much blood the arterioles drain out of them.

Diameter of the arterioles plays an important role in determining how much blood drains out of arteries into arterioles.

Strength of Heart Contractions: Strength and rate of HB affect cardiac output and BP. Each time the left ventricle contracts, it squeezes a certain volume of blood (Stroke

volume) into the aorta and into other arteries. The stronger each contraction is, the more blood it pumps into the aorta and

arteries. The weaker the contraction is, the less blood it pumps. Strength of a heartbeat affects BP: stronger increases and weaker decreases.

Heart Rate: The rate of a heartbeat may also affect arterial BP. When the heart beats faster, more blood enters the aorta, so the arterial volume &

BP would increase. o This is true, only if the stroke volume does not decrease sharply when the

heart rate increases. Often, when the heart beats very fast, each contraction of the left ventricle takes place so rapidly that is has little time to fill with blood and therefore squeezes out much less blood than usual in the aorta.

An increase in the rate of HB increases BP. A decrease in the rate decreases BP. Whether a change in the HR produces a similar change in BP depends on whether

the stroke volume also changes and by how much.Blood Viscosity:

Viscosity: thickness If blood becomes less viscous than normal, BP decreases. If a person suffers a hemorrhage, fluid moves into the blood from the IF and this

dilutes the blood. After hemorrhage, transfer of whole blood or plasma is preferred to infusion of

saline solution. Saline solution is not a viscous liquid and it cannot keep BP at a normal level.

Polycythemia can occur when oxygen levels in the air decrease and the body attempts to increase its ability to attract oxygen to the blood, (this happens in working at high altitudes).

Resistance to Blood Flow: Peripheral Resistance (PR) is affected by many factors, including the vasomotor

mechanism (vessel muscle contraction/relaxation).Fluctuations in Arterial Blood Pressure:

BP varies within normal range. Normal systemic arterial BP is below 120/80 at rest.

Central Venous Pressure: Venus BP within right atrium, the “low end” of the pressure gradient that drives

blood flow. Venous return of blood to the heart, depends on at least 5 mechanisms:1. A strongly beating heart2. An adequate arterial BP3. Valves in the veins4. Pumping action of skeletal muscles as they contract5. Changing pressures in the chest cavity caused by breathing.

Pulse: Pulse is the alternate expansion and recoil of the blood vessel wall. Nine major pulse points that are named after the arteries over which they are felt:

o 3 pulses on the side of the head and the neck: Superficial temporal artery: in front of the ear. Common carotid artery: in the neck along the front edge of the

sternocleidomastoid muscle. Facial artery at the lower margin of the mandible at a point below the

corner of the mouth. o 3 pulses on the upper limbs:

Axillary Artery: in the armpit. Brachial Artery: At the bend of the elbow along the inner or medial

margin of the biceps brachii muscle. Radial Artery: At the wrist

o Radial pulse is the most commonly accessed.o 4 pulses in the lower extremities:

Femoral Artery: in the groin Popliteal Artery: Behind and just proximal to the knee Posterior Tibial Artery: Just behind the medial malleolus 9inner bump of

the ankle). Dorsal Pedis Artery: On the front surface of the foot, just below the

bend of the ankle joint.

Things that were discussed deeper in class:o Sinoatrial Node/SA Node/Pacemaker: 60-100 BPMo Atrioventricular Node/AV Node: 40-60 BPMo AV Bundle/Bundle of HIS: 30-40 BPMo Subendocardial Branches/Purkinje Fibers: 15-40 BPMo (Bradycardia: below 60)o (Tachycardia: Above 100)o People who have heart attacks before 50 have a lot less collateral

circulation.

Quick Checks: Chapter 13 (Cardiovascular System)(Page 284)

1. What are the functions of the atria and ventricles of the heart?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________2. What coverings does the heart have? What is the heart’s lining called?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________3. What are systole and diastole of the heart?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________4. What are the two major “circulations” of the body?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________5. What are the auricles of the heart?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

(Page 286)1. What structure is the natural “pacemaker” of the heart?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________2. What information is in an electrocardiogram?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________3. What is a heart block?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

(Page 287)1. What are the two main factors that affect cardiac output?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________2. If a person’s heart rate increases, what may happen to the cardiac output?

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________3. If a person bleeds excessively, what effect would that have on cardiac output?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

(Page 291)1. What are the two main types of blood vessels in the body? How are they different?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________2. Can you describe the 3 major layers of a large blood vessel?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________3. What are capillaries? What is their role in the body?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

(Page 296)1. How do systemic and pulmonary circulations differ?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________2. What is the hepatic portal circulation?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________3. How is fetal circulation different from circulation after birth?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

(Page 300)1. How does the blood pressure gradient explain blood flow?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________2. Name four factors that influence blood pressure.______________________________________________________________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________3. Does a person’s blood pressure stay the same all the time?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________4. Where are the places in your body that you can likely feel your pulse? ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

CHAPTER 13 PRACTICE TEST1. ____________________________ are thicker chambers of the heart, which are sometimes called the discharging chambers

2. The ____________________________ are the thinner chambers of the heart, which are sometimes called the receiving chambers

of the heart

3. Cardiac muscle tissue is called _____________________________________________

4. The ventricles of the heart are separated into right and left sides by the ____________________________

5. The thin layer of tissue lining the interior of the heart chambers is called the ____________________________

6. Another term for the visceral pericardium is the ____________________________

7. Contraction of the heart is called ____________________________

8. Relaxation of the heart is called ____________________________

9. The heart valve located between the right atrium and right ventricle is called the ____________________________ valve

10. The term ____________________________ refers to the volume of the blood ejected from the ventricle during each beat

11. The ____________________________ is the pacemaker of the heart and causes the contraction of the atria

12. The ____________________________ are extensions of the atrioventricular fibers and cause the contraction of the ventricles

13. The ECG tracing that occurs when the ventricles depolarize is called the ____________________________

14. The ECG tracing that occurs when the atria depolarize is called the ____________________________

15. The ____________________________ are the blood vessels that carry blood back to the heart

16. The ____________________________ are the blood vessels that carry blood vessels away from the heart

17. The ____________________________ are the microscopic blood vessels in which substances are exchanged between the blood

and tissues

18. The innermost layer of tissue in the artery is called the ____________________________

19. The outermost layer of tissue in an artery is called the ____________________________

20. Systemic circulation involves the moving of blood throughout the body; ____________________________ involves moving blood

from the heart to the lungs and back

21. The two structures in the developing fetus that allow most of the blood to bypass the lungs are the

____________________________ and the _________________________

22. The strength of the heart contraction and blood volume are two factors that influence blood pressure. Two other factors that

influence blood pressure are ____________________________ and ____________________________

23. The venous blood pressure within the right atrium is called the ____________________________

24. A device used to measure blood pressure in clinical and home health-care situations is called a ____________________________

25. Place the following structures in their proper order in blood flow through the heart by putting a 1 in front of the first structure through which the blood would pass and ending with a 10 in front of the last structure through which the blood would pass

___ left atrium___ tricuspid valve (right atrioventricular valve)___ right ventricle___ pulmonary vein___ aortic semilunar valve___ mitral valve (left atrioventricular valve)___ left ventricle___ pulmonary artery___ right atrium___ pulmonary semilunar valve

Match:a. Pericardiumb. Severe chest pain c. Thrombusd. Pulmonarye. Heart blockf. Ventricles g. Systemich. Coronary arteriesi. Systolej. Depolarization k. Atria l. Apexm. Epicardium

___ covering of heart___ receiving chambers ___ circulation from left ventricle throughout body ___ blood clot___ semilunar valve___ discharging chambers___ supplies oxygen to heart muscle___ angina pectoris___ slow heart rate caused by blocking impulses___ contraction of the heart___ electrical activity associated with ECG___ blunt-pointed lower edge of heart___ Visceral pericardium

1. Cardiac output is the volume of blood pumped by one atrium (per minute or per second).2. The (sympathetic or parasympathetic) system of the ANS decreases the heart rate3. The (higher or lower) the venous return, the higher the stroke volume.4. The strength of myocardial (contraction or relaxation) helps determine stroke volume5. The average cardiac output in a normal, resting adult (5 or &) liters

Match:a. Structure unique to fetal circulation b. Carry blood to the heart

c. Carry blood into venulesd. Carry blood away from the hearte. Largest veinf. Largest artery g. Outermost layer of arteries and veins

___ arteries___ veins___ capillaries___ tunica externa___ ductus venosus___ superior vena cava___ aorta

6. The aorta carries blood out of the:a. Right atriumb. Left atriumc. Right ventricled. Left ventriclee. None of the above

7. The superior vena cava returns blood to the:a. Left atriumb. Left ventriclec. Right atriumd. Right ventriclee. None of the above

8. Which one of the following vessel’s walls are made up entirely of endothelial cells?a. Vein b. Capillaryc. Arteryd. Venulee. Arteriole

9. The _________ is made up smooth musclea. Tunica mediab. Tunica adventitiac. Tunica intimad. Endotheliume. Myocardium

10. The ________ function as exchange vesselsa. Venulesb. Capillariesc. Arteriesd. Arteriolese. Veins

11. Blood returns from the lungs during pulmonary circulation via the:a. Pulmonary arteryb. Pulmonary veinsc. Aortad. Inferior vena cava

12. The hepatic portal circulation serves the body by:a. Removing excess glucose and storing it in the liver as glycogenb. Detoxifying bloodc. Removing various poisonous substances present in the bloodd. All of the above

13. The structure used to bypass the liver in fetal circulation is the:a. Foramen ovaleb. Ductus venosusc. Ductus arteriosus d. Umbilical vein

14. The foramen ovale serves the fetal circulation by:a. Connecting to the aorta and the pulmonary arteryb. Shunting blood from the right atrium directly into the left atriumc. Bypassing the liverd. Bypassing the lungs

15. The structure used to connect the aorta and pulmonary artery in fetal circulation is the:a. Ductus arteriosusb. Ductus venosusc. Aortad. Foramen ovale

16. Which of the following is NOT an arterya. Femoralb. Poplitealc. Coronaryd. Inferior vena cava

17. Which of the following has valves to assist the blood flow?a. Veinsb. Arteriesc. Capillariesd. Arterioles

18. Heart sounds are most easily heard by placing a stethoscope:a. Directly over the apex of the heartb. Over the space between the first and second ribsc. Over the upper portion of the mediastinumd. None of the above

19. The valve located between the right atrium and ventricle is the:a. Bicuspidb. Aortic semilunar vlavec. Tricuspidd. Pulmonary semilunar vlave

20. Blood rich oxygen returns from the lungs and enters the left atrium of the heart through the:a. Aortab. Pulmonary veinsc. Superior vena cavad. Pulmonary artery

21. Heart block is often successfully treated by:a. Implanting an artificial pacemakerb. Coronary bypass surgeryc. Angioplastyd. None of the above

22. The outermost layer of the arteries and veins is the:a. Tunica externab. Tunica mediac. Tunica intimad. Endothelium

23. An electrocardiogram (ECG):

a. Is a graphic record of the hearts electrical activity b. Records damage to cardiac muscle tissue that affects the hearts conduction systemc. Has three deflections know as the P wave, the QRS complex, and the T waved. All of the above

24. The blood pressure gradient is:a. The pressure against the arties during contractionb. The pressure against the arteries at restc. Vitally involved in keeping the blood flowingd. The artery expanding and then recoiling alternately

25. The structure(s) unique to fetal circulation is the:a. Ductus venosusb. Ductus arteriosusc. Foramen ovaled. All of the above

26. Stroke volume refers to the:a. Volume of the blood pumped by one ventricle per minuteb. Flow of blood into the cardiac veinsc. Volume of blood ejected from the ventricles during each beatd. Flow of blood into the coronary sinus

27. A structural feature NOT present in arteries and unique to veins is:a. Tunica intima b. Tunica media c. One-way valvesd. Tunica adventitia

28. Match

a. Right atriumb. AV bundlesc. Discharging chambersd. Radial arterye. Ventricles relaxedf. Receiving chambersg. Lining of heart h. Vein i. Artery

___ atria ___ endocardium___ pericardium___ superior vena cava___ aorta___ bundle of His___ ventricles ___ central venous pressure___ pulse ___ diastole

1.2.3.4.5.6.7.8.

9.10.11.12.

Notes from Class:Where the heart is located, size, position

The circulation of the blood through the heart

Atria – receiving chambers

Ventricles- discharging chambers

Know where the apex is- at the bottom, you can listen to the apex of the heart

4 valves- bicuspid(3 names) try before we buy, (tricuspid on right bicuspid left side)

4 layers-

4 chambers-

4 conduction

1 vein in the entire body that carries oxygenated blood – LEFT PULMONARY VEIN(carries blood from lung to

heart)

Veins are low in oxygen normally

Lub – closure of AV valves (bicuspid & tricuspid valves)

Know where your valves are, chambers are, and how the blood flows through the heart

Something about one drop of blood

Heart attack is due to decrease of oxygen

What is the thickest chamber of our heart? Left ventricle (bc it is the last chamber of the heart before the

oxygenated blood before it goes back into systemic circulation, it pumps harder)

Most heart attascks occur in left ventricle

Collertal circulation

Cardiac cycle is about 72 bpm

Conduction- SA node (pacemaker) (primary pacer) (60-100 bpm in SA node)

Normal heartbeat = 60-100

Below 60= brachycardia

Above 100: tachycardia

AV node takes over for SV node if something happenes, normal is 40-60

Av bundle of his 30-40

Purkinje fibers 15-40

Artiers have higher pressure

Aorta- largest artery in the body comes off heart

What does the liver do