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CardioVascular slide 211
CVT Cardio
141
Biology
Not Applicable
07/24/2012

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Term
thrombus
Definition
clotting of blood in an unbroken vessel
Term
emobolus
Definition
clot, air,or fat transported by the blood stream
Term
hemocytoblasts
Definition
immature cells that are eventually capable of developing into mature blood cells
Term
tunica interna(endothelium internal
media middle
externa(adventia) external
Definition
Three layers of artery (tunics), inner diameter is lumen
Term
arteries are thicker and more muscular
Definition
compare walls of arteries to veins
Term
elasticity- expand for extra blood
contractility- recoil/thrust fwd
vasoconstriction- decrease lumen
vasodilation- increase lumen, decrease resistance and increase flow
Definition
define properties of arteries:
elasticity
contractility
vasoconstriction
vasodilation
Term
elastic- conducting arteries, aorta, subclavian, thin walled, more elastic than muscular
muscular- medium sized, brachial/radial, more muscle, greated ability to dilate/constrict
Definition
2 types of arteries. describe elastic and muscular
Term
arterioles. major regulator of BP and blood flow, smooth muscle contracts like rings
Definition
between arteries and capillaries, major function of these
Term
capillaries
Definition
connect arterioles to venules. near every cell in the body, more in highly active organs, muscles
Term
capillaries
Definition
type of blood vessel made of a single layer of squamous epithelial cells.
surrounding basement membrane gives support
Term
metarteriole
Definition
branch of arterioles, flow straight through to venules. Thoroughfare channel. no smooth muscle. allows sustained blood flow
Term
true capillary
Definition
rises from arterioles or metarterioles. indirect route from arteriole to venule. controlled by precapillary sphincters
Term
pre-capillary sphincters
Definition
these constrict to reduce bloodflow to the true capillaries
Term
post-capillary sphincters
Definition
regulates flow of blood OUT of the capillary bed
Term
metarteriole (thoroughfare channel)doesn't have sphincters, travels directly from arteriole to venule
Definition
how is blood flow maintained if capilary sphincters contracted?
Term
venules
Definition
formed by several capillaries joining together
Term
veins
Definition
composed of same layers as arteries. Externa is thickest. Has collagen and elastic fibers.
Term
slow and even
skeletal muscle
contains semilunar valves to prevent backflow
Definition
describe bloodflow in veins, what aids flow, internal object veins have that arteries don't
Term
L/R coronary arteries
sinus of valsalva
Definition
first 2 arteries coming off aorta. what is this area called?
Term
brachiocephalic(innominate artery), L. common carotid, L. subclavian
Definition
3 arteries coming off aortic arch
Term
external carotid- external scalp/face
internal carotid- right side of brain
Definition
common carotid splits into these. what do they supply
Term
Left Internal Mammary Artery. Subclavian.
Definition
LIMA means what? where does it branch from?
Term
Bronchial tubes, visceral pleurae, bronchial lymph nodes, esophagus
Definition
Bronchial arteries branch off Thoracic Aorta supplying 4 areas
Term
chest wall muscles, overlying subQ tissues, mammary glands, vertebral canal
Definition
Intercostal Arteries supply 4 areas
Term
common hepatic- liver, gallbladder,
stomach
L.Gastric artery- stomach, esophagus
Splenic artery- spleen, pancreas, tail of stomach, greater omentum
Definition
Celiac Trunk of Aorta=supply what?
Common hepatic
Left Gastric artery
Splenic artery
Term
adrenal glands
kidneys
Definition
arteries supply what? suprarenal arteries & renal arteries
Term
pancreas, small intestine, Ascending/transverse colon

transverse/descending/sigmoid colon, rectum
Definition
superior mesenteric arteries
inferior mesenteric arteries
Term
External to femoral
Internal- bladder, rectum, prostate, vagina/uterus, gluteal muscles, medial aspect of thighs
Definition
Internal/External arteries
Term
pa-femur
behind the knee
top of foot, medial side
Definition
profunda artery
popliteal artery location
dorsalis pedis location
Term
SVC
Definition
VEINS. formed by L/R subclavian veins. blood from superior portion of body to heart
Term
IVC
Definition
VEINS. returns blood from inferior portion of body to heart. Renal, Iliac, Femoral veins
Term
Internal/External Jugular, Axillary, Brachial, Median Cubital, Accessory Cephalic, Median Antebrachial, Cephalic
Definition
VEINS. drain into subclavian. IJ, EJ, Ax, B, MC, AC, MA, C veins
Term
Hepatic Portal Vein
Splenic Vein
Superior Mesenteric Vein
Definition
HEPATIC FLOW.Blood from digestive system organs enter into HPV by way of SV and SMV. Exits liver via the IVC. Blood supplied to liver via HA.
Term
Internal Carotid Arteries
Vertebral Arteries
Basilar Artery
Definition
CEREBRAL FLOW. Brain is most metabolically active organ. Supplied by ICAs and VA joining to form BA.
Term
Circle of Willis
Definition
Formed by union of basilar artery(2 joined vertebral arteries) & 2 internal carotid arteries. Helps provide adequate circulation through its anastomoses
Term
Cardiac Output.
High to Low.
100mmHg
Definition
BLOOD PRESSURE. Generated by CO. Pressure gradient, flows from H to L pressure. Aorta pressure XXX mmHg.
Term
Viscosity
vessel Length
vessel Radius
Definition
3 factors causing bloodflow resistance. Depends on V,L,R
Term
Cardiac Output = Stroke Vol x Heart Rate

Blood Pressure = CO x Peripheral Resistance
Definition
CO = SV x HR
BP = CO x PR
Term
Directly
Directly
Inversely
Directly
Definition
Affect BP directly or indirectly?
Viscosity- resistance is X proportional
Vessel Length - X proportional
Vessel Radius - X proportional
Cardiac Output- X proportional
Term
Cardiac Output
Blood Volume
Peripheral Vascular Resistance
Definition
3 factors controlling BP?
CO - varies directly w BP
BV - directly w BP, 5 LITERS
PVR -arterioles, vasomotor center
Term
medulla, maintains vessel diameter

pressure receptors in carotid sinus and aortic arch, msg to medulla for BP
Definition
Vasomotor center? where/what
Baroreceptors? where/what
Term
in carotids and aorta
increases BP and respirations when CO2 drops. also sensitive to O2, H+
Definition
Chemoreceptors.
where?
Sensitive to what?
Term
Renin-angiotensin-aldosterone system
epi and norepi
Antidiuretic Hormone
Parathyroid Hormone
Definition
Hormonal regulation of BP.
RAAS
E and NE
ADH
PTH
Term
5%
Diffusion, Vesicular Transport, Bulk Flow
Definition
X% of capillary blood does bulk of material exchange with tissues.
3 ways exchage takes place. D/VT/BF
Term
Blood Hydrostatic Pressure
Interstitial Fluid Osmotic Pressre
Definition
bulk flow due to BHP & IFOP
Term
filtration through cap membranes dependent on difference between pressure from blood on membranes and osmotic pressure of the membranes. NET effect of these opposing pressures determines rate of flow
Definition
Starling's Law of the capillaries
Term
capillaries
outward, interstitial
Interstitial Fluid Osmotic Pressure
Definition
BLOOD HYDROSTATIC PRESSURE:
pressure within the _____
Attempts to force fluid ____into ____interstital place
Opposes IFO pressure
Term
interstitial
Blood Colloidal Osmotic Pressure
Zero
Definition
INTERSTITIAL FLUID HYDROSTATIC PRESSURE
pressure of the ____space
force fluid from interstitial space to capillaries
opposes BCO Pressure
Typical pressure is close to ___
difficult to measure
Term
Blood Hydrostatic pressure
Interstitial Fluid osmotic pressure
Definition
2 factors affecting Bulk Flow
Term
edema
Definition
Disruption between filtration and reabsorption can cause _____.
Term
small blood vessels have greater resistance.
Definition
Greater resistance to bloodflow? large or small blood vessels?
Elasticity of arteries produce rebound sustained flow in diastole due to elasticity
Term
LAMINAR FLOW
Definition
Term for smooth, steady flow. All particles have same speed, but friction at vessel wall causes cells at wall to drag behind
Term
TURBULENT FLOW
results in bruit (vascular murmur)
Definition
Type of Flow:
Disparity in laminar flow
Several causes:
Narrowing: stenosis, plaque
Shunt: AV fistula
Dilation (aneurysm)
Increased metabolism or CO
Term
End-diastolic volume (preload)
Stroke Volume
Cardiac Output
Gravity
Tension Pneumothorax/Pericardial Tamponade
Definition
If venous return to the heart is hindered:
EDV (P)drops
S volume decreases
CO decreases
G (NUMBER 1 FACTOR)
Increased Chest Pressure: TP or PT
Term
Skeletal Muscle
Negative
Right
Blood Volume
Definition
Factors Promote Venous Return
Contraction of SM
N inspiratory pressure in chest
R Ventricular relaxation
BV
Term
Transport! O2, CO2, Nutrients & Electrolytes, Hormones, Heat, Waste Products
Definition
Primary function of blood is to?
Also regulates pH, body temperature.
Term
3
100.4
7.35 - 7.45
4-6 liters
8%
Definition
Blood Viscosity: ? x that of H2O
Temp: X degrees F
pH: 7.x - 7.x
volume x - x liters
X% of bodyweight
Term
straw colored, wo clotting factors is serum, plasma proteins formed in liver, 91.5% water
Definition
blood plasma facts
Term
ALBUMIN: osmotic pressure
GLOBULIN:transports lipids, immunity with gamma globulins
FIBRINOGEN: hemostasis
Definition
3 types of plasma proteins:
A
F
G
Term
hemopoiesis
Definition
TERM FOR PRODUCTION OF BLOOD CELLS
Term
erythrocytes rbc
leukocytes wbc
thrombocytes platelets
Definition
3 cells in blood
Term
straw colored, wo clotting factors is serum, plasma proteins formed in liver, 91.5% water
Definition
blood plasma facts
Term
ALBUMIN: osmotic pressure
GLOBULIN:transports lipids, immunity with gamma globulins
FIBRINOGEN: hemostasis
Definition
3 types of plasma proteins:
A
F
G
Term
hemopoiesis
Definition
TERM FOR PRODUCTION OF BLOOD CELLS
Term
erythrocytes rbc
leukocytes wbc
thrombocytes platelets
Definition
3 cells in blood
Term
straw colored, wo clotting factors is serum, plasma proteins formed in liver, 91.5% water
Definition
blood plasma facts
Term
ALBUMIN: osmotic pressure
GLOBULIN:transports lipids, immunity with gamma globulins
FIBRINOGEN: hemostasis
Definition
3 types of plasma proteins:
A
F
G
Term
hemopoiesis
Definition
TERM FOR PRODUCTION OF BLOOD CELLS
Term
erythrocytes rbc
leukocytes wbc
thrombocytes platelets
Definition
3 cells in blood
Term
straw colored, wo clotting factors is serum, plasma proteins formed in liver, 91.5% water
Definition
blood plasma facts
Term
ALBUMIN: osmotic pressure
GLOBULIN:transports lipids, immunity with gamma globulins
FIBRINOGEN: hemostasis
Definition
3 types of plasma proteins:
A
F
G
Term
hemopoiesis
Definition
TERM FOR PRODUCTION OF BLOOD CELLS
Term
erythrocytes rbc
leukocytes wbc
thrombocytes platelets
Definition
3 cells in blood
Term
99%
Erythropoiesis
hemoglobin
23%
Definition
RBCs. % of formed elements?
formation called E____
O2 carrying portion?
% of CO2 it carries?
Biconcave shape
live for 120 days
Term
hematocrit
M 42-52%
F 35-45%
Definition
% of RBC in blood
+ with IV fluids
+ with dehydration, polycythemia
Term
hemoglobin
M 14-16.5gm/dl
F 12-15 gm/dl
Definition
active carrying sites of O2 on RBC
each molecule can carry 4 O2 molecules
2 alpha 2 beta chains
Term
granular leukocytes: Neutrophil, Eosinophil, Basophil
agranular leukocytes: Lymphocytes, Monocytes
Definition
Leukocytes: Explain BEN LM.
Live months to years. 500-1000/ml
Term
pinkish, Lobed, Bacteria. 54-62%
Definition
Neutrophils: Fine P granules. L nucleus 2-5parts). Phagocytosis of SMALLER B.
Range: %-% of WBC
Term
Reddish, Bi-lobed. Allergic Reactions. Histamine. Parasitic. Inflammation. 1-3%
Definition
Eosinophils: Coarsh R granules. B nucleus. Combat AR (fights H). P infections, Controls I. %-% of WBC
Term
Blue. Bi-lobed. Histamine, Anticoagulants, Heparin. 1%
Definition
Basophil: Deep B stained granules. B nucleus. Releases H, A, H. Less than % of WBC.
Term
nucleus, cytoplasm, lymphatics, B & T cells, 25-33%
Definition
Lymphocyte: agranulocyte. Smaller cell with relatively larger N. Thin layer of C. Can move in/out of L. Immunity (2 cell types) %-% WBC
Term
3-9
Definition
Monocytes. L cells in blood, Varied nuclei shape. Phagocytosis of LARGER bacteria. %-% WBC
Term
10, Fraction, 250-400, clotting
Definition
Platelets: X day life span. Oval. Just a F of a cell. X-X level in blood. Contains chemicals for C.
Term
Megakaryocytes, platelets
Definition
M are giant cells with edges that break off to form P.
Term
Hemostasis
Vascular Spasm
Platelet Plug Formation
Coagulation
Definition
Stoppage of bleeding is H. 3 mechanisms:
VS
PPF
C
Term
Intrinsic, Extrinsic
Definition
2 clotting pathways: I & E.
Term
Extrinsic. Vessel Trauma. Platelets.
Collagen, platelet factors, attract, aggragate
Definition
E pathway: due to VT, activation of P. Exposed C binds/activates platelets. PF are released. Factors A more platelets. Platelets A into platelet plug.
Term
thromboplastin Factor
catalyzes, Ca++, thrombin
fibrin monomers, Ca++
FM, fibrin, fibrin stablizing factors, activated platelets
Definition
Tissue TF converts to prothrombin VII. prothrombin C with C, making T. Thrombin converted to F M by C.
FM to F threads by FSF from AP
Stable FT trap AP, RBC, WBC
Term
F=Factor, kinogen, Ca++
Ca++, Prothrombinase
Prothrombinase, prothrombin, Ca++
Prothrombin, Thrombin, Ca++
Definition
INTRINSIC pathway, due to blood trauma. FXII and K produce FXI. FXI to FX by C.
FX,FV,FVIII catalyze with C to make P
P to P by C
P to T by C. rest of pathway same as extrinsic
Term
Fibrinolysis.
Plasminogen
Definition
F= prevents clots from growing to large
When a clot is formed, an inactive plasma enzymed (P) is incorporated into the clot
Term
Plasmin. Fibrinolysin.
Thrombin, Activated FactorXII
Tissue Plaminogen Activator
Definition
Blood and tissues contain substances that can turn plasminOGEN into active form P. Also called F.
3 examples of substances: T, AFXII, tPa
Term
fibrin
Definition
Plasmin can digest F threads and inactivate several clotting factors
Term
Mediastinum
Definition
M = Mass of tissue between lungs. Extends betwen sternum and spine
Term
apex
Definition
A = pointed, inferior end of heart formed by tip of the left ventricle
Term
Thebesian valve
Coronary sulcus
myocardium
endocardium
pericardium
epicardium
Definition
TV = valve of the coronary sinus
CS = separates atrium from ventricles
externally
M = middle, muscular layer of heart
E = lines inside of heart,
valves/tendons connect to it
P = loose-fitting membrane covering
heart
E = outer layer of heart
Term
chronotropy
inotropy
Definition
C = affecting heart rate
I = altering force of contractions
Term
Left, 60
Definition
HEART: 2/3 lies to X of midline, heart lies at X degrees in chest down/fwd/left
Term
Anterior, Posterior, Diaphragmatic
Definition
Heart Surfaces: A/P/D
Term
5-50ml, pericardial fluid
Visceral= continuous w epicardial layer
Parietal= outer layer, fibrous sac
Definition
Pericardium: tough, fibrous sac
contains x to x ml of PF
2 layers: V & P
Term
Friction, Anchor, Inflammation, OverExpansion
Definition
Pericardium Functions:
Reduce F, helps A the heart in chest, protects against I, helps resist acute OE with volume changes
Term
Thin Walled, Weak
Atrial Septum, Foramen Ovale
Definition
Atrial walls: TW with W contractions
AS open during fetal life FO
Term
Right Atrium, IVC, SVC, Coronary Sinus
Pulmonary veins
Definition
RA receives blood from IVC, SVC, CS
LA receives blood from 4 PV
Term
interatrial, Atria, Endocardial
interventricular, Ventricles, 95,5.
Definition
SEPTUMS. IA septum between 2 A. Made of E tissue.
Iv septum between 2 V. Made of % muscle, % fibrous.
Term
atrioventricular.
atria, ventricles
Circumflex, Coronary sinus
AV, IV
Definition
Coronary Sulcus: or AV sulcus. Externally separates __from___.
Encircles the heart.
Houses the C artery and CS.
Crux is where ____sulcus & ___sulcus meet
Term
LV, RV
LAD runs down anterior, PDCA down posterior. Great Cardiac Vein
Definition
Ventricular Sulcus: Separates externally the ___ from ___
2 coronary arteries and a vein run over it
Term
Chordea Tendineae (connected to papillary muscles)
prolapsing
Definition
CT = 80% collagen, 20% elastin/endothelial cells
Prevents P of the AV valves leaflets
Term
3
Pressure Differentials
Definition
IMPORTANT: # of leaflets/cusps on SL valves. Valves open/close due to PD in valves/vessels
Term
Left Anterior Descending. Circumflex Artery. IV Sulcus. Septal Perforators.
AV sulcus. Obtuse Marginal arteries
Definition
LEFT CORONARY ARTERY: branches into XXX & XX. LAD runs down X branching into X. Circumflex runs around X branching into X for posterior heart
Term
sinus of Valsalva. AV. Crux. Conus, SA, PDCA
Definition
RCA. Starts at right SofV, travels around XXsulcus to the X
Branches into 1st, 2nd arteries, XX branch, XXXX arteries
Term
Not apply
Definition
Ventricles receive blood from branches of L/R coronary arteries. Atria, in contrast, get blood only from a small branch of corresponding artery
Term
Septal Perforators. Diagonal Arteries.
lateral aspects of myocardium and posteromedial papillary muscle.
Definition
branches of LAD. XX supply blood to ANTERIOR ASPECT of IV septum. Circumflex branches into X. they supply 2 areas.
Term
Dominant side also supplies inferior aspect of the IVS and posterior LV. Posterior IVS and Post. LV supplied by RCA & L. circumflex arteries.
Definition
Coronary Dominance: 85% R side, can tell by which artery covers posterior IV sulcus and supplies crux
Term
SA Node, Intra-Atrial Tracts, AV Junction, Bundle of His, R/L Bundle Branches, Purkinje System
Definition
Conduction system:
XX node, IAT, XXjunction, XofX,
X and X bundles branches, X system
Term
60-80
40-60
Myocardium, 20
Definition
SA Node: X bpm
AV Node: X bpm
Purkinje fibers: terminal projections into M, X bpm
Term
0.1 sec
AV
Ventricular Systole
R
Definition
1st Heart Sound:S1 "lub"
Occurs X seconds into cardiac cycle
Represents closure of X valves
Onset of X X
Fall on X wave
Term
SL
T
Ventricular Diastole
Definition
2nd Heart Sound: S2 "dub"
closure of X valves
falls on X wave
start of VD
Term
Diastolic, Ventricles
Heart Failure, Ventricular Incompetence
Ventricular Gallop
Definition
3rd Heart Sound: S3
D sound made by rapid filling of V
Sign of HF or VI
occurs before X wave just after S2
X X rhythm
Term
Systolic, ventricle
Definition
4th Heart Sound: S4
PreX sound from strong contraction of atria against a stiffened X
just after "P" wave before S1
Term
A 2nd ic space sternal border S2
P 2nd ic space sternal border S2
T 4th ic space sternal border S1
M 5th ic space midclavicular S1,S3,S4
Definition
Best for heart sound?
All
Physicians
Take
Money
Term
Thrill, bruit
faint. louder, stronger towards 6.
Definition
Murmurs: sustained noise throughout Systole, Diastole, or both.
May be linked to a X, a PALPABLE vibration from turbulent flow. If whooshing sound HEARD within vessel, called a X. Murmurs graded 1-6 with 1 being X?
Term
Stenotic
regurgitant
Definition
Narrows valves not opening properly are X, valves failing to close properly are X.
Term
Arterial septal defect
Ventricular septal defect
patent ductus arteriosus
Definition
INTRA-CARDIAC SHUNT:
ASD
VSD
PDA
Term
stenosis
regurgitation
Definition
Systolic murmurs.
SL open. murmurs here due to:
AV closed. murmurs here due to:
Term
regurgitation
stenosis
Definition
Diastolic murmrus.
SL closed. murmurs here from:
AV open. murmurs here from:
Term
Reduced Diastolic Filling: also referred to as DIASTASIS. A & V pressure slowly(+) w slow filling of ventricles. Coronary blood flow is OPTIMAL. This Subphase occurs during T-P interval
Definition
Rapid Diastolic filling(70%) is passive. AV open, blood rushes in. A & V pressure (-) until V less than A. occurs during EKG T-P interval. "V" wave of the atrial tracing.
Term
ISOVOLUMETRIC Contraction. Contraction (+) pressure in ventricle, BUT no change in volume, ALL valves are closed. V pressure must exceed A pressure to open SL valves. 2/3 of O2 use, after QRS, "c" on atrial tracing
Definition
Atrial Systole or Atrial Kick. 15-30% of diastolic ventricular filling. Lost in disrhythmias AF/Afib. Occurs after P wave, "a" wave of atrial tracing
Term
Atrial Tissue. SA shortest, AV longest
Ventricular Tissue. Bundle Branches shortest, Ventricular muscle longest.
Definition
Refractory Periods
Term
HR, age, electrolytes, medications
Definition
Can change ST segment
Term
Athlete, AMI,
Conduction system fibrosis(sick sinus syndrome)
Meds: opiates, BB, CBB, Dig, Organophosphates, sleep, vagal stim
Increased ICP, hypothermia, hypothyroidism
Definition
Causes for Sinus Brady
Term
Atropine: 0.5mg q3-5min to max of 0.04mg/kg (3mg MAX)
Transcutaneous Pacing
Dopamine, start 5mcg/kg/min infusion
Epinephrine 2-10mcg/min
Definition
Tx for SYMPTOMATIC BRADYCARDIA
Term
stress, hypovolemia, hypoxia
exercise, anemia, fever, toxins
MI, ischemia, HF, Hyperthyroidism, Inflammatory heart disease
Definition
Sinus Tachy causes
Term
Identify and Tx cause:
IV fluid replacement, O2, antipyretics
analgesic, blood transfusion
beta blockers
Definition
Sinus Tachy Tx
Term
normal variation by changing sym and parasym stim during breathing.
older patient with sick sinus syndrome
Digitalis Toxicity
Definition
Sinus Arrhythmia causes
Term
Usually none. Symptoms would usually come from underlying brady rate.
Tx accordingly.
Definition
Sinus Arrhythmia Tx
Term
Fibrodegenerative changes(sick sinus syndrome)
Ischemia of SA Node from RCA ischemia
Vagal Stimulation
Inflammatory Heart Disease
Electrolyte imbalance(sinus arrest)
Mg or K
Digitalis toxicity
Definition
Sinus Pause/Arrest causes
Term
Infrequent/asymptomatic...no Tx.
Stop causative medications
Atropine 0.5mg q3-5min or epinephrine infusion
Pacemaker possible for pauses over 2.5sec
Definition
Sinus Pause/Arrest Tx
Term
100-130
usually irregular
3 or more morphologies
varies with P wave morph
normal
normal
Definition
Multifocal Atrial Tachycardia MAT
Rate
Rhythm
P wave
PRI
QRS
P:QRS
Term
3 different P wave morphs
Pacemaker in SA, atria, or AV sites
Often mistaken for A-fib
Definition
MAT notes
Term
Sympathetic
Electrolytes
Digitalis
usual 3: ischemia, inflammation, dilating diseases
Definition
MAT causes
Term
Tx underlying disease, usually lung disease and hypoxemia
End drugs like beta agonists, methylxanthines
Avoid B2 blockers in lung disease
Mg or K could help even if levels are normal
Verapamil usually choice(5-10mg,IV, repeated until 20mg)
Not a reentrant beat so digoxin/cardioversion not effective
Definition
MAT Tx
Term
Any cardiac arrest characterized by organized electrical activity on the EKG monitor without a pulse
Definition
PEA
nots
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