Week 4 Test Review-Homework

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Platt College, Aurora *

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Medicine

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Dec 6, 2023

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1. Where is the heart located? (what are the boundaries) Lies in the mediastinum, behind the body of the sternum between the points of attachment of ribs two through six 2. What is the apex of the heart? What direction does it typically point? Note: when viewing a chest X-Ray, that is important to know and look for the heart shadow and its orientation.) Apex lies on the diaphragm, pointing to the left 3. What is the function of the CV / cardiovascular system? Transportation (blood, oxygen, hormones), heart, valves, tubes 4. Be able to identify parts to the heart (anatomy) in a whole heart, a cross section of the heart (as a recommendation, and going the extra mile, on a separate sheet of paper, you should draw out a picture of the heart (trace it) and label parts as listed below Also, for the following, know the function of these heart parts too 5. veins a. Superior vena cava- the large vein that drains blood from the head, neck, and upper limbs into the right atrium of the heart b. Inferior vena cava- largest vein of the abdomen. It carries blood from the lower limb, pelvis, kidneys, and posterior abdominal wall. It passes through the diaphragm and enters the right atrium of the heart 6. Pulmonary vein (left and right)- both are one of four veins returning relatively oxygenated blood to the atrium 7. Arteries- high pressure vessel carrying blood away from the heart. Arteries have a thick middle layer of elastic tissue and smooth muscle (called the tunica media) a. Ascending aorta- the semilunar valve at the beginning of the aorta. It prevents regurgitation of aortic blood to the left ventricle during ventricle diastole b. Aortic arch- the most superior part of the aorta. It gives rise to brachiocephalic artery (trunk), left common carotid artery, and left subclavian artery 8. Descending aorta- the part of aorta distal to the arch. Supplies the posterior chest wall, spinal cord, abdomen, pelvis, and lower limbs. It divides at the level of lumbar vertebra 4 into two common iliac arteries 9. Pulmonary arteries (right and left)- branches of the pulmonary artery that supplies relatively deoxygenated blood to the left lung 10. Other a. Pulmonary trunk- main pulmonary artery b. Arteries are usually oxygenated i. What is the exception to this rule as it pertains to the heart “tubes” (I sometimes like to call blood vessels tubes)? Pulmonary artery 11. Veins are usually de-oxygenated What is the exception to this rule as it pertains to the heart “tubes”? Pulmonary vein 12. Right and left atrium a. Right atrium- the heart chamber that receives systemic venous blood from the superior and inferior vena cava and the veins draining blood from the heart itself. Most blood from the heart itself enters the right atrium through the opening of the coronary sinus
b. Left atrium- the chamber that receives relatively oxygenated blood from the four pulmonary veins and pumps this to the left ventricle 13. Right and left ventricle a. Left Ventricle- the heart chamber that develops the highest pressure (120 mm Hg) and therefore has the thickest muscle wall. Its interior cavity (lumen) is conical in shape and pumps blood to the ascending aorta b. Right Ventricle- The heart chamber that pumps blood into the pulmonary circulation. It has a thinner wall than the left ventricle because it develops lower pressures (25 mm Hg) 14. Circumflex artery- supplies the left atrium and ventricle 15. Left coronary artery, right coronary artery- travel within the coronary sulcus of the heart to supply the heart wall 16. Great cardiac vein - runs alongside the anterior interventricular artery 17. Anterior cardiac vein- group of parallel coronary veins that course over the anterior surface of the right ventricle 18. Small cardiac vein- travels close to the right marginal artery 19. Apex of the heart- inferior conical end 20. Base of the heart - atrium 21. Auricles- (the external ear) The anterior part of each atrium is wrinkled, flaplike extension so they call it the auricles because it resembles the ear 22. Branches off the aortic arch (in order of blood flow) a. Brachiocephalic artery- brachiocephalic artery or trunk is the first branch of the aortic arch. It gives off the right subclavian and right common carotid arteries b. Let common carotid- the artery that supplies the left head and neck c. Left subclavian- the branch of the arch of the aorta that supplies the left upper limb Inside the heart d. Mitral valve aka left atrioventricular valve aka left A/V valve, aka bicuspid valve- two cusp valve between the left atrium and left ventricle. It also called the bicuspid valve and is open during ventricle diastole e. Tricuspid valve aka right atrioventricular valve aka right A/V valve- three cusp valve located between the right atrium and right ventricle. It is also called the atrioventricular valve f. Pulmonary semilunar valve aka pulmonary valve- the semilunar valve at the outflow from the right ventricle. It prevents regurgitation of blood from the pulmonary truck into right ventricle during diastole g. Aortic semilunar valve aka aortic valve - semilunar valve at the beginning of the aorta. It prevents regurgitation of aortic blood into the left ventricle during ventricular diastole h. Interventricular septum- forms a thick wall between the right and left ventricles i. Chordae tendineae- fibrous bands (“heartstrings”) which anchor the edges of atrioventricular valve leaflets to the apices of papillary muscles j. Myocardium- middle layer of the heart wall consisting of cardiac muscle k. Right and left atrium- superior chambers l. Right and left ventricles —inferior chambers
m. Papillary muscles- small muscular projection that anchors the chordae tendineae and hence atrioventricular valve leaflets to the heart wall. The papillary muscles contract during ventricle systole to keep the valve leaflets closed n. Purkinje fibers- larger than other cardiac muscle cells. Extremely rapid consistent with the large size of cells and spends immediately throughout the ventricular myocardium In other words, be able to identify these parts (listed above) in a whole heart and or in a dissected heart (cross section usually in the coronal plane) 23. Know the layers of the heart (what are they, 4 layers) a. Pericardium (surrounds the heart) b. Epicardium (part of the serious fluid for heart lubrication) c. Myocardium (thick cardiac mm) d. Endocardium (helps blood flow smoothly) 24. What is the name of the fluid around the heart? Serous fluid / Pericardial effusion 25. What layers of the heart does this fluid lay between? a. Serous pericardium b. Pericardial cavity 26. What is the function of the atria? responsible for receiving the blood and fill the ventricles 27. What is the function of the ventricles? Are responsible for discharging the blood and their walls are thicker 28. What layer of the heart is the thickest? Myocardium 29. What is the bundle of Hiss? What is its aka? Atrioventricular bund is a continuation of the specialized tissue of the AV node and serves to transmit the electrical impulse from the AV node to the Purkinje of the ventricles 30. On power point slide #12 shows blood flow through the heart 31. If you were an RBC, what order of heart parts would you come to from beginning to end 32. In other words, be able to write out every part in the heart, in order, the blood would flow through beginning to end. 1. Superior Vena Cava 2. Inferior Vena Cava 3. Right Atrium 4. Tricuspid Valve 5. Right Ventricle 6. Pulmonary Valve 7. Pulmonary Artery (to the lungs) 8. Pulmonary Vein 9. Left Atrium 10. Mitral Valve
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11. Left Ventricle 12. Aortic Valve 33. Hint … as blood is entering the heart from the body, it would start with the superior and inferior vena cava ----à flow into the ___________ then __________ and so on (space provided to draw your diagram) more questions after this page too 34. What is the S/A node? Called the pacemaker of the heart. Sends out an electrical impulse. 35. What is the A/V node? Electrical conduction system of the heart that coordinates the top of the heart. It electrically connects the atria to the ventricles 36. Draw a normal EKG pattern (showing the P (QRS) T points on the graph 37. What does the P wave represent? SA node will depolarize (contracts the atria) 38. What does the QRS complex represent Where the ventricles depolarize (are squeezing) 39. What does the T wave represent? Ventricles must repolarize and they do slowly (producing the T wave) 40. What does depolarization of the heart mean orderly passage of electrical current sequentially through the heart muscle, changing it, cell by cell, from the resting polarized state to the depolarized state until the entire heart is depolarized. 41. What does repolarization of the heart mean Ventricular repolarization is a complex electrical phenomenon which represents a crucial stage in electrical cardiac activity. 42. What is the mV of the threshold of the EKG? 0.025 mV or 5% 43. What is the systolic sound / what does that mean / indicate? First sound; believed to be caused primarily by the contraction of the ventricles and vibrations of the closing AV waves 44. What is the diastolic sound “____ “? Short, sharp sound, though to be caused by the vibrations of the closing of SL valves 45. What is S/D what does the numerator represent Systolic sound: first sound; believed to be caused primarily by the contraction of the ventricles and vibrations of the closing AV valves When the heart contacts (ventricles are squeezing, ejecting blood) 46. What does the denominator represent? Diastolic sound: short, sharp sound; thought to be caused by vibrations of the closing of SL valves Heart relaxes (ventricles are relaxing, filling with blood) 47. What is normal average heart rate?
60-100 BPM 48. What are things that can change or influence heart rate? Temperature Anxiety, fear, and anger Grief Emotions Exercise Increased blood temperature or stimulation of skin heat receptors Decreased blood temperature or stimulation of skin cold receptors 49. What is K These effects the electrical potential of the cell membrane 50. What is Ca The SR of the cardiac mm has less CA than does SK mm 51. Are these important to the heart? If so, why? They provide information about the functioning of the valves of the heart 52. Define blood viscosity The thickness of blood as a fluid 53. What is vasomotor mechanism mean (as it pertains to the arteries) Muscles in the walls of arteriole may constrict (vasoconstriction) or dilate (vasodilation) thus changing the diameter of the arteriole 54. What would happen to the heart pump (the pressure of the heart) if the tubes in your body experienced vasoconstriction? Blood vessels constrict 55. What is peripheral resistance? Resistance of the arteries to blood flow. As the arteries constrict, the resistance increases and as they dilate, resistance decreases. 56. What would happen to the heart (the pressure of the heart) if the blood vessels were in vasodilation? Small changes in blood vessel diameter cause large changes in resistance, making the vasomotor mechanism ideal for regulating blood pressure and blood flow 57. What does auscultation mean? Listening to the heart contract and relax 58. What instrument do we use for this? stethoscope 59. What is the cardiac cycle? The complete beat of a heart which both the atria and ventricles contact then relax. Takes about .8 seconds 60. What tools are used to check a person's blood pressure? Blood pressure cuff (sphygmomanometer) 61. What is the Lub sound of the heart First part of the sounds Occurs during the ventricle contraction During this time, the A-V valves (tricuspid and bicuspid valves) are closing because you do not want to allow blood into atria's
62. What is the dub sound of the heart? Occurs during ventricle relaxation (filling with blood) so the AV valves have to open (so blood can spill into ventricles) And b/c the cusps and the lunars are always opposite of each other When the pulmonary and aortic valves are closing (do not want blood to back flow into the ventricles) 63. What is happening to ventricles if the AV valves are open? What does this mean the ventricles are doing if the AV valves are open? Blood flows into the ventricles 64. What is happening to the atria if the AV valves are open? Atria depolarization 65. What is happening to the atria if the AV valves are closed? The first heart sound 66. What is happening to the semilunar valves if the AV valves are open? The Semi Lunar valves are shut, and blood is forced into the ventricles. 67. What is happening to the semilunar valves if the AV valves are closed? The semilunar valves open, forcing blood into the aorta and pulmonary artery 68. What are the ventricles doing of the semilunar valves are closed? They are relaxing 69. What are the ventricles doing if the semilunar valves are open? They are contracting 70. What are the atria doing if the semilunar valves are open? The atria relax and blood enters them 71. What are the atria doing of the semilunar valves are closed? The atria contract to eject blood to the ventricles 72. If the AV valves are open, the semilunar valves are closed 73. If the AV valves are closed, the semilunar valves are Open 74. The S1 heart sound is produced when AV VALVES squeezes 75. The S2 heart sound is produces when VENTRICLES relaxes 76. If the ventricles are contracting, the atria are relaxing 77. If the atria are contracting the ventricles are relaxing 78. If the ventricles are relaxing, the atria are contracting 79. If the atria are relaxing the ventricles are Contracting 80. What chambers “squeezing” to feel the pulse (at the carotid artery or radial artery) The atria and ventricles 81. What is a murmur? Where blood backflows through a valve 82. How many grades are there in a murmur?
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6 grades 83. What is the least murmur grade? Grade 1 84. What is the worst murmur grade? Grade 6 85. What is endocarditis? Where the valvular cusps can change shape because of inflammation and bacteria 86. What causes endocarditis? murmur 87. Why would the heart change its pressure? Inflammation or bacteria 88. Baroreceptors are? Where are they found in the body? Monitor blood pressure as it pertains to pressure changes Found in the walls of the internal carotids and aorta This sensory information goes to the centers in the medulla oblongata 89. Chemoreceptors are? Where are they found in the body? Effect of pH, carbon dioxide, oxygen Receptors that measure pH and carbon dioxide levels found in hypothalamus Chemoreceptors monitoring oxygen levels are found in aorta and internal carotids 90. What nerve is responsible for the baroreceptor and chemoreceptor communication between the body and the brain? Vagus nerve 91. What is cardiac output? Amount of blood pumped by the heart in one minute 92. What is Fick’s formula and write your own explanation of it Stroke volume x Heart rate 93. What is the ANS? During physical or emotional stress, the SNS stimulates the SA and AV nodes 94. What is the SNS? What happens to the body and the heart if you are in this “mode”? T1 and L3 95. What is the PNS? What happens to the body and the heart if you are in this “mode”? Cranial sacral – nerves innervate everything in your body 96. What neurotransmitter is released at the post synaptic ganglion (nerve) that puts you in SNS? acetylcholine 97. What neurotransmitter is released at the post synaptic ganglion (nerve) that puts you in PNS? norepinephrine 98. What happens to the myocardium with chronic exercise? Exercise thickens the myocardium and increases the supply of blood vessels in skeletal muscle tissue 99. What is atherosclerosis? Blockage or weaking of critical arteries 100. What is arteriosclerosis? Thickening and hardening of the walls of the arteries, occurring typically in old age 101. What is an MI?
Myocardial infarction (heart attack) 102. What is considered hypertension (the blood pressure value) above 120 and 80 103. What is normal BP? 120/80 104. What is ischemia? Lack of adequate blood supply 105. What is angina pectoris? Chest pain 106. What is a fibrillation? Rapid uncoordinated shuddering of cardiac mm Considered major cause of death because heart does not pump adequately 107. What is tachycardia? Rapid heartbeat (above 100 bpm) 108. What Is bradycardia? Slow heartbeat (below 60 bpm) 109. What happens if a person’s blood pressure is way too low? Can cause dizziness, weakness, fainting spells and risk of injury from falls. Can deprive the body of enough oxygen to carry out its function, leading to damage of heart and brain 110. About how many quarts of blood (on average) does the heart pump blood through the body in single day? 2,000 gallons of blood per day 111. What does EKG stand for? Electrocardiogram or electrocardiograph a. What is the “American” abbreviation of EKG? ECG 112. What part of your nervous system functions / operates the heart? Peripheral nervous system is responsible for regulating involuntary body functions such as heartbeat, blood flow, breathing and digestion 113. What is the pacemaker of the heart? The natural pacemaker – the sinus node – produces electrical impulses to stimulate your heart to beat. If the impulses are disrupted, you may need an artificial pacemaker 114. What is the neuro part of the heart that the electrical synapses on? Hint: giving the heart its rhythm Sinus node 115. How does and EKG machine know to graph a wave? Electrodes are connected to an ECG machine by lead wines. The electrical activity of the heart is then measured, interpreted, and printed out