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01
Gross and Cellular Structure of the Heart
45
Pharmacology
Undergraduate 1
11/30/2016

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Term
What type of muscle is cardiac muscle and how does this affect it's appearance?
Definition
A specialised form of striated muscle which makes it appear 'stripey' in appearance which reflects the sarcomeric organisation.
Term
What are the functions of the heart?
Definition
1. supply oxygenated blood containing nutrients (e.g. glucose) to the major organs.
2. remove waste products formed during metabolism (e.g. via the lungs).
Term
Where is the heart located?
Definition
behind the sternum, situated at an angle.
behind the ribcage and extends from the 2nd rib to the 5th rib.
Term
How big is the heart?
Definition
12-14cm long (size of an adult male's clenched fist)
weighs about 250-350g
Term
How is the CV system divided?
Definition
3 parallel circuits:
1. Pulmonary circuit
2. Coronary circuit
3. Systemic circuit
Term
What constitutes the pulmonary circulation?
Definition
1. deoxygenated blood is pumped by the RV to the lungs via the pulmonary artery
2. Gas exchange occurs in the lungs; CO2 is expelled and O2 is taken up by the blood.
3. Re-oxygenated blood returns to the LA of the heart via the pulmonary vein
Term
What makes the pulmonary artery and veins different to the others in the body?
Definition
The pulmonary artery is the only artery in the body to carry deoxygenated blood and likewise for the vein.
Term
How is oxygenated blood supplied to the heart?
Definition
via the left and right coronary arteries, of which the left is slightly larger. These arteries branch directly from the base of the aorta, just above the semilunar valve.
Term
What does the right coronary artery split into?
Definition
the marginal artery (which serves the right ventricular wall)
and then continues round the posterior aspect of the heart
Term
What does the left coronary artery split into?
Definition
It emerges behind the pulmonary trunk and splits into the anterior interventricular artery (supplied the elft ventricular wall) and the circumflex artery (which anastomoses with the right coronary artery).
Term
How is venous blood drained from the heart?
Definition
into the coronary sinus, which in turn drains into the RA. From there the blood will go to the lungs for re-oxygenation via the pulmonary circuit.
Term
Describe the systemic circulation
Definition
LV pumps blood into the aorta which branches into smaller arteries.
Term
How are the head and neck supported?
Definition
- the aortic arch which splits into the vertebral and right common carotid artery
- the left common carotid artery
Term
How are the upper chest and arms supported?
Definition
- the right subclavian artery (from brachiocephalic trunk)
- the left subclavian artery (from aortic arch)
Term
What do the subclavian arteries become?
Definition
axillary arteries which split into the brachial artery at the elbow.
the brachial artery splits into the radial and ulnar arteries.
Term
How is the digestive tract supported?
Definition
stomach via the gastric artery
S&L intestines via the superior and inferior mesenteric arteries
Term
How are the pelvis and legs supported?
Definition
the descending aorta splits into the common iliac arteries just superior to the pelvis

the common iliac artery splits into the internal and external arteries and supplies the pelvis and legs respectively

the legs are also supplied by the femoral arteries which are from the common iliac arteries.
Term
Describe blood flow through the heart
Definition
1. blood returns from the body via the superior and inferior vena cavae
2. right atrium
3. right ventricle
4. pulmonary arteries
5. left and right lungs
6. pulmonary veins
7. left atrium
8. left ventricle
9. blood the flows through coronary and systemic circulations via the aorta.
Term
What is the heart enclosed in?
Definition
a double walled sac called the pericardium which is both fibrous and indistensible
Term
Describe the outer layer of the pericardium
Definition
Fibrous pericardium
protects the heart and anchors it to adjacent structures like the diaphragm and the great vessels to stop it moving in the cavity, and to also stop it overfilling with blood
Term
Describe the inner layer of the pericardium
Definition
Serous pericardium
extends to cover the epicardial surface of the muscular wall of the heart
Term
Describe the pericardial cavity
Definition
filled with a fluid to lubricate the membranes so they can glide over each other during the twisting of the heart when it contracts
Term
What is pericarditis?
Definition
inflammation of the pericardial membrane - causes sharp chest pain left of centre - exacerbated by deep breathing and coughing
Term
How is pericarditis diagnosed?
Definition
using a stethoscope as you can hear the two membranes rubbing against each other
Term
What is cardiac tamponade?
Definition
severe pericarditis that limits the extent of ventricle filling.
life threatening if the fluid is not drained quickly.
Term
Where are valves located?
Definition
between the atria, ventricles and great vessels on each side of the heart
Term
Describe the Right AV valve
Definition
3 cusps and is called the tricuspid valve
Term
Describe the left AV valve
Definition
two cusps and is called the bicuspid or mitral valve
Term
Describe the valves located at the entrance of ventricular outflow tracts
Definition
3 cusps (semilunar valves)
very delicate
guard the pulmonary artery and aorta entrances
Term
How do the valves work?
Definition
1. when pressure is greater behind the valve, it opens
2. when pressure is greater in front of the valve, it closes and do not open in the opposite direction, they are one way.
Term
What is the role of the papillary muscles?
Definition
When the ventricles contract, pressure is higher in the ventricle than the atrium so the valve is forced shut. The papillary muscle contract and pull on the chordae tendinae to prevent the flaps from everting into the atrium.
Term
How do ventricle muscle cells differ to skeletal muscle cells?
Definition
They are much smaller (120micrometers long and approx 30micrometers wide).
Term
What are cardiac muscle cells rich in and why?
Definition
Glycogen and myoglobin and contain a large number of mitochondria (about 30% of ventricular muscle cell volume is occupied by mitochondria).

This reflects the high energy demand of the tissue.
Term
How are adjacent ventricular muscle cells joined together?
Definition
individual cells are bound together to form layers of heart muscle.
attachments are made via intercalated discs which creates the lattice.
Term
What are the roles of intercalated discs?
Definition
1. firmly bind adjacent cells together; mechanical coupling.
2. they allow electrical coupling between adjacent cells.
Term
What are desmosomes?
Definition
structures specialised for cell-to-cell adhesion
Term
Describe the nexus/gap junction
Definition
area of close contact membranes, where regular arrays of proteins called connexins are found. These forms large channels which allow passage of ions and other small molecules between one cell and another.
Term
Define functional syncytium
Definition
the result of electrical coupling means the heart behaves electrically as a single cell.
Term
List the 5 other cell types within the heart
Definition
1. fibroblasts
2. endothelial cells
3. smooth muscle cells
4. conduction cells
5. cardiomyocytes
Term
What is the function of fibroblasts?
Definition
contribute to the ECM providing mechanical support
Term
What is the function of endothelial cells?
Definition
contribute to the lining of blood vessels
Term
What is the function of SMC?
Definition
in coronary veins and arteries
Term
What is the function of conduction cells?
Definition
generation and passing of electrical impulses
Term
What is the function of cardiomyocytes?
Definition
form the contractile apparatus of the atria and ventricles
Term
What principle do cardiac cells obey?
Definition
the all or nothing principle
if you electrically excite a part of it you electrically excite all of it
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