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 ALL ORGANS AND TISSUES |
|
BLOOD VESSELS |
|
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.
|
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 B PARIETAL PERICARDIUM = SIMPLE
SQUAMOUS ET/LOOSE C
VISCERAL PERICARDIUM = SSET/LACT |
|
Layers |
A
EPICARDIUM = SSET/LACT B
MYOCARDIUM = CARDIAC MUSCLE C
ENDOCARDIUM = SSET/LACT |
|
Chambers |
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) |
|
Valves |
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
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 FROM VEINS |
THEY
ARE ACTIVE, PUMPING BLOOD INTO ARTERIES |
9. Name the function of heart valves. TO
PREVENT BACKFLOW OF BLOOD
10. Distinguish between AV and SL valves in
terms of location, structure, and when they close. Please label them above.
|
|
AV VALVES |
SL VALVES |
|
LOCATION |
BETWEEN ATRIA AND VENTRICLES |
WITHIN MAJOR ARTERIES |
|
STRUCTURE |
2 OR 3 CUSPS, ANCHORED TO PAPILLARY
MUSCLE THROUGH CHORDAE TENDINEAE |
3 CUSPS |
|
WHEN CLOSED |
WHEN VENTRICLES CONTRACT |
WHEN VENTRICLES RELAX |
11. Define/describe the terms chordae tendineae,
papillary muscle, and trabeculae carneae, and label each in the diagram above.
|
chordae tendineae |
CORD-LIKE STRUCTURES THAT ANCHOR CUSPS
OF AV VALVES TO PAPILLARY MUSCLE |
|
papillary
muscle |
COLUMNS OF MUSCLE IN VENTRICLES THAT
ANCHOR CUSPS OF AV VALVES |
|
trabeculae
carneae |
CHARACTERISTIC “FLESHY BEANS”
APPEARANCE OF INNR VENTRICULAR WALL |
12. Name (and locate in the diagram above)
the veins that deposit their blood into the atria of the heart (which atria? deox-
or oxygenated?).
|
VEIN |
OXYGENATED OR DEOXYNATED BLOOD? |
WHICH ATRIA? |
|
SVC |
DEOX |
RIGHT |
|
IVC |
DEOX |
RIGHT |
|
CS |
DEOX |
RIGHT |
|
PV |
OX |
LEFT |
13. 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 TRUNK |
DEOX |
RIGHT |
14. Distinguish between pulmonary, coronary
and systemic circulation.
|
PULMONARY |
CORONARY |
SYSTEMIC |
|
HEART TO LUNGS BACK TO HEART |
TO AND FROM MYOCARDIUM |
TO AND FROM ALL BODY PARTS |
15. 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 |
16. 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. Discuss what causes reperfusion damage. OXYGEN FREE RADICALS
19. 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 60-100 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 |
N/A |
26. Name the common term for the sinoatrial (SA) node. Pacemaker
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 |
NEURAL FACTORS |
31. 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. direction
of blood-flow (in terms of the heart),
b. wall
structure (# of layers and components of those layers),
c. gas
concentrations and
d. 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 |
N/A |
|
Pressure of blood carried |
high |
low
therefore they are equipped with valves |
N/A |
34. 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 and sinusoidal capillaries in terms of structure and location.
|
|
structure |
Location |
|
Continuous capillaries |
UNINTERRUPTED RING OF ENDOTHELIAL CELLS |
MOST ORGANS |
|
Fenestrated capillaries |
HOLES OR PORES IN ENDOTHELIAL BASEMENT
MEMBRANES |
KIDNEY GLOMERULI INTESTINAL VILLI |
|
Sinusoidal capillaries |
OPEN SPACES BETWEEN ENDOTHELIAL CELLS |
LIVER AND SPLEEN |
37. 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. Discuss the factors that affect cardiac
output.
A. 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 |
|
|
Medulla |
Medulla |
|
Peripheral
arterioles to constrict (decrease bp) or dilate
(increase bp). |
SA
and AV to speed up or slow down. |
43. List the hormones involved in regulation
of blood pressure and blood flow.
|
HORMONES THAT INCREASE BLOOD PRESSURE |
HORMONES THAT INCREASE BLOOD 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 |
PULMONARY CIRCULATION (SEE EARLIER TRACING) |
ARTERIAL CIRCULATION |
|
1. RIGHT FINGER (DIGITAL CAPILLARIES |
10 |
23 LEFT COMMON CAROTID ARTERY |
|
2. right digital vein |
11 |
24 LEFT EXTERNAL CAROTID ARTERY |
|
3. right venous palmar arches |
12 |
25. LEFT EAR CAPILLARIES |
|
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 |
|
b. from
the stomach to the left fingers
|
VENOUS CIRCULATION |
PULMONARY CIRCULATION (SEE EARLIER) |
ARTERIAL CIRCULATION |
|
1. STOMACH (GASTRIC) CAPILLARIES |
7 |
20. LEFT SUBCLAVIAN ARTERY |
|
2. GASTRIC VEIN |
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 |
PULMONARY CIRCULATION (SEE PREVIOUS) |
ARTERIAL CIRCULATION |
|
1. right knee capillaries (popliteal) |
7 |
20. LEFT RENAL ARTERY |
|
2. RIGHT POPLITEAL VEIN |
8 |
21. left renal capillaries |
|
3. RIGHT FEMORAL VEIN |
9 |
|
|
4. RIGHT EXTERNAL ILIAC VEIN |
10 |
|
|
5. RIGHT COMMON ILIAC VEIN |
11 |
|
|
6. INFERIOR VENA CAVA |
12 |
|
|
|
13 |
|
|
|
14 |
|
|
|
15 |
|
|
|
16 |
|
|
|
17 |
|
|
|
18 |
|
|
|
19 |
|
d. from
the right kidney to the right side of the brain.
|
VENOUS CIRCULATION |
PULMONARY CIRCULATION |
ARTERIAL CIRCULATION |
|
1. right renal capillaries |
4 |
17. BRACHIOCEPHALIC ARTERY |
|
2. RIGHT RENAL VEIN |
5 |
18. RIGHT COMMON CAROTID ARTERY |
|
3. INFERIOR VENA CAVA |
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 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).