Chapter 16 - Anatomy of the Heart

what are two kinds of shunts?

a left-to-right shunt a right-to-left shunt

in a mitral valve regurgitation/prolapse, what can be heard?

a murmur

atria depolarization (atria fires and contracts) a. P wave b. T wave c. QRS wave

a. P wave

- once the Bundle of His spreads out into this, the ventricles contract a. Purkinje fibers b. AV node c. Bundle of His d. SA node

a. Purkinje fibers

what valves lies at the entrance and exit of the ventricles? a. atrioventricular valves b. semilunar valves

a. atrioventricular valves

a life-threatening condition in which the heart cannot pump enough blood; must aspirate (suck out) serous fluid through inserting long needle into pericardial space a. cardiac tamponade b. pericardial effusion c. pericarditis

a. cardiac tamponade

which ventricle receives unoxygenated blood from the right atrium, to which it pumps blood through the pulmonary arteries to the lungs to be oxygenated? a. right ventricle b. upper ventricle c. left ventricle

a. right ventricle

in a left-to-right shunt, blood pumps from the left ventricle into the right ventricle, from the oxygenated side to the unoxygenated side. this blood is called ____

acyanotic

a semilunar valve located between the left ventricle and the aorta

aortic valve

the lower, pointed end of the heart that is located left of the sternal midline and at the 5th intercostal space

apex

when the SA node, pacemaker of the heart is not working, other parts can take over, but at a slower rate; an ____ pacemaker is needed

artificial

these are the upper chambers of the heart that receive the blood into the heart

atrias

refers to the ability of cardiac pacemaker cells two general their own electrical signal with no help from extrinsic nerves coming from the CNS

automaticity

- slows the cardiac impulse as it moves through this node to the Bundle of His - the slowing of this node is important bc it delays the two atria and two ventricles so that the atria can undergo systole while the ventricles undergo diastole (vice versa) a. Purkinje fibers b. AV node c. Bundle of His d. SA node

b. AV node

ventricular repolarization a. P wave b. T wave c. QRS wave

b. T wave

where is friction rub of a person suffering from pericarditis best heard with a stethoscope?

left sternal border, near apex of heart

what kind of shunt is when blood is diverted from the left heart to the right heart; specifically, there is a hole in the interventricular septum. this VSD causes the left ventricle to do two things: (1) it pumps blood into the aorta (2) it also pumps blood into the right ventricle through the hole in the septum

left-to-right shunt

what valve lies between the left atria and left ventricle?

mitral valve

allows blood to back up from the ventricle into the atria; a murmur can be heard

mitral valve regurgitation or mitral valve prolapse

complete blood flow blockage of the coronary artery which causes myocardial cells to die - "elephant sitting on my chest" - nausea and vomiting - diaphoresis (profuse sweating) - irreversible damage - fatigue - digestive issues such as heart burn and upset stomach - women and OA do not have typical s/s - known as "widow maker"

myocardial infarction

- middle layer of heart - the thickest layer containing cardiac muscle thats contracts and pumps blood through blood vessels - sliding of actin, myosin - arranged sarcomeres - intercalated discs to enable rapid transmission of impulses)

myocardium

the function of the pulmonary circuit is to pump blood through the lungs in order to pick up ____ and get rid of ____ O2 diffuses from the lungs into the blood for delivery to ____, whereas CO2 diffuses from the blood into the lungs for ____

oxygen CO2 tissues excretion

- middle layer of pericardium that attaches to the outer fibrous pericardium

parietal pericardium

a potential space between the visceral pericardium (epicardium) and parietal pericardium; this space has pericardial membranes that secrete 10-30 mL of serous fluid into this space which lubricates the surfaces of the membranes, allowing them to slide and slide without friction

pericardial cavity/space

the heart is supported by a sling like structure which attaches the heart to surrounding structures such as the diaphragm and its large blood vessels

pericardium

the area of the anterior chest wall overlying the heart and great vessels

precordium

this artery carries unoxygenated blood from the right ventricle to the lungs to be oxygenated

pulmonary artery

the path that blood follows from the right side of the heart to and through the lungs and back to the left side of the heart is what kind of circulation?

pulmonary circulation

this veins carry oxygenated blood to the left ventricle

pulmonary veins

a semilunar valve located between the right ventricle and pulmonary artery

pulmonic valve

pain that originates from one area and spreads to local surrounding areas through shared nerve pathways

referred pain

what parts of the heart does the coronary artery supply?

right side of heart, esp. the R ventricle SA node AV node

what kind shunt is when blood is diverted from the right heart to the left heart; it is illustrated by a child who has a VSD and a stenotic pulmonic semilunar valve ; pulmonary valve stenosis increases the pressure within the R ventricle; this elevated pressure pumps blood into the L ventricle via the VSD; the left ventricle now has unoxygenated blood

right-to-left shunt

a ____ is a passageway that diverts blood from its normal pathway

shunt

the path that blood follows from the left heart to all organs of the body and back to the right heart is what kind of circulation?

systemic circulation

abnormal cardiac rhythm with a rate greater than 100 beats per minute

tachydysrhythmia

what is another name for a left-to-right shunt?

VSD (ventricular septal defect)

T/F: ischemia is not reversible

F; it is reversible

list the 4 chambers of the heart

R atrium L atrium R ventricle L ventricle

the first heart sound, "lubb" is called ____, which is caused by the closure of the ____ ____ at the beginning of ventricular contraction; best heard over the ____

S1 AV valves apex

the second heart sound, "dupp" is called ____, which is caused by the closure of the ____ ____ at the beginning of ventricular relaxation; best heard at the ____ of the heart

S2 semilunar valves base

list the pathway of the conduction system of the heart

SA node AV node Bundle of His Purkinje fibers

when the heart rhythm is disturbed

dysrhythmia

- innermost layer of heart - lines the valves of heart - continuous with blood vessels that enter and leave the heart - smooth and shiny surface allows blood to flow over it easily

endocardium

three layers of the heart from inner to outer

endocardium myocardium epicardium

dead myocardial cells leak ____ into the blood, causing plasma elevations of cardiac enzymes such as CPK, AST, LDH, and a regulator protein called ___

enzymes troponin

- thin outermost layer of heart - helps form the pericardium

epicardium

three layers of the epicardium from inner to outer (include any alternatives)

epicardium (visceral pericardium) parietal pericardium fibrous pericardium

- innermost layer of pericardium that folds back and forms the parietal pericardium

epicardium or visceral pericardium

- outermost layer of pericardium that anchors the heart to its surrounding structures

fibrous pericardium

what kind of pressure gradient does blood flow in the heart?

high pressure to low pressure

what separates the two atria? what separates the two ventricles?

interatrial septum interventricular septum

diminished blood flow and oxygen deprivation = chest pain = heart attack =

ischemia angina myocardial infarction

characteristics of coronary blood flow: 1. flow can increase up to ____ to ____ times during exertion 2. when is flow at its greatest in the coronary artery? 3. coronary arteries can form ____

1. 4 to 5 2. during myocardial relaxation 3. anastomoses

the left coronary artery branches into what two arteries that nourish the left side of the heart? what parts of the heart is nourished by them?

1. left anterior descending artery (LAD) 2. circumflex artery left side of heart, esp. the L ventricle septum

what two drugs are used to relieve angina?

1. nitroglycerin 2. beta-adrenergic blockers

when a surgeon bypasses the obstructions in the coronary vessels with a donor blood vessel, such as the saphenous vein in the leg, what is this called?

CABG

occlusion of what artery is called the "widow maker"?

LAD - left anterior descending artery

plasma elevations of CPK, AST, LDH and troponin are indicative of

MI

during ischemia, or oxygen deprivation in the heart, chest pain arises and radiates where? a. down the left leg and to the left foot b. down the left shoulder and to the left arm into the fingers c. down the right shoulder and to the right arm into the fingers

b. down the left shoulder and to the left arm into the fingers

when the inflamed pericardial membranes secrete excess fluid, which can compress the heart externally, making it difficult for it to relax and fill with blood a. cardiac tamponade b. pericardial effusion c. pericarditis

b. pericardial effusion

a thin-walled cavity that received unoxygenated blood from the sup/inf vena cavas a. left ventricle b. right atrium c. left atrium

b. right atrium

what valves control the outflow of blood from the right/left ventricles and are therefore exiting valves? a. atrioventricular valves b. semilunar valves

b. semilunar valves

the upper, flat portion of the heart located at the 2nd rib

base

where is the heart specifically located?

between 2nd and 5th intercostal space

- fibers of fibrous CT that serves as a partition b/t the two atria and two ventricles; splits into right and left; they get down, turn upward and spread out, permeating the muscle a. Purkinje fibers b. AV node c. Bundle of His d. SA node

c. Bundle of His

ventricular depolarization (filling) a. P wave b. T wave c. QRS wave

c. QRS wave

a thin-walled cavity that receives oxygenated blood from the lungs through four pulmonary veins a. right ventricle b. right atrium c. left ventricle

c. left ventricle

inflammation of the pericardial membranes characterized by pain and a sound called friction rub; friction rub is similar to the sound of scratchy sandpaper and is best heard when the stethoscope is placed over the left sternal border, near the apex of the heart a. cardiac tamponade b. pericardial effusion c. pericarditis

c. pericarditis

the heart is a double pump that acts as one; the pumps are the right and left heart; the right is colored blue because it contains not enough oxygen and more ____ meanwhile the left is red because it contains ____ rich blood

carbon dioxide oxygen

this system is located within the walls and septum of the heart; it is the conduction system that provides stimulus (cardiac impulse) for muscle contraction and coordinates pumping activity of the atria and ventricles

cardiac conduction system

the cusps are attached to the ventricular walls by ____ ____, which are tough fibrous bands of tissue

chordae tendineae

S1 sound of heart is during ventricular ____ S2 sound of heart is during ventricular ____

contraction relaxation

what arteries arise from the base of the aorta nourishes and oxygenates the myocardium?

coronary arteries

CABG

coronary artery bypass graph

the coronary veins carry the blood to the ___ ___ which empties the blood into the right atrium

coronary sinus

in a right-to-left shunt, blood pumps from the R ventricle into the L ventricle, from the unoxygenated side to the oxygenated side; this blood is called ____ and is pumped into the systemic circulation and the child appears blue

cyanotic

- pacemaker of the heart (sets the rate at which the heart beats/contracts and relaxes) - depolarizes two atrias - this is where the electrical signal originates - fires 60-100 times per minute (72 avg.) - called the P wave a. Purkinje fibers b. AV node c. Bundle of His d. SA node

d. SA node

what does nitroglycerin and beta-adrenergic blockers do to blood vessels in order to relieve angina?

dilate blood vessels to decrease work of heart

what valve lies between the right atrium and right ventricle?

tricuspid valve

list the 4 great vessels of the heart

vena cava (sup/inf) pulmonary artery pulmonary veins aorta

these are the lower chambers of the heart that pump blood out of the heart

ventricles

thickness of the myocardium reflects the amt. of work performed by the myocardium. if a ventricle is forced to overwork, it will eventually enlarge. what is this condition called?

ventricular hypertrophy

the heart sounds "lubb dupp lupp dupp" are made by what?

vibrations caused by closure of the valves

where is the "potential space" or pericardial cavity located between?

visceral pericardium (epicardium) and parietal pericardium