Distinguish between the pulmonary and systemic circulatory system in terms of purpose, ventricles, arteries leaving these ventricles and whether or not these vessels are carrying oxygenated or deoxygenated blood.

Pulmonary: for the right ventricle that is receiving deoxygenated blood to pump the deoxygenated blood to the lungs and for the co2 to be blown off and for the oxygen to saturate the hemoglobin and the RBC’s.  The deoxygenated returns to the left side of the heart and the l ventricle will pump oxy blood out to all the capillaries and distribute o2 and pick up co2 and head back to right side of heart.

Systemic:

What is the importance in realizing that the two circulatory systems are serially connected in terms of cardiac output?

If the right ventri is pumping 5 liters of blood then the left has to be pumping 5 liters of blood.  If this is off, it can back up and cause systemic adema or pulmonary adema.

What are the two functions of the pericardium? The two layers of the pericardium? Two membranes of the parietal pericardium?

Prevent displacement of the heart during gravitational acceleration and deceleration;

Act as a physical barrier that protects the heart against infection and inflammation from the surrounding organs and tissues within the chest cavity.

2 layers of the pericardium:  visceral and parietal layers

2 layers of the parietal pericardium: serous layer and the fibrous pericardium.

The serous visceral layer secretes a fluid in the pericardium cavity and parietal layer dumps fluid in there and it accumulates in the pericardium layer and acts as a lubricant.  The lubricant allows the pumping o f the blood and you minimize friction between these two (parietal and visceral.)

-dependant of the pressure it has to pmp against. Around 4-6 in the right and left ventricles. Pulmonary: around 12 pressure; Arterial pressure in aorta= about 9.

Because they have to pump against the highest blood pressure

What is the composition of the endocardium?

Thin layer of endothelia cells and connective tissue beneath it.

What is the main component of the fibrocollagenous skeleton of the heart? What is the function of this component?

Central fibrous body, located at the level of the cardiac valves;

The downward extension of the fibrocollagenous tissue forms what? Is this a minor or major component of the interventricular septum? What is the other component?

-The ventricular ceptum

-Minor component

-Muscular ceptum

What is the importance in the fact that the fibrocollagenous skeleton of the heart separates the atrial syncytium from the ventricular syncytium in relationship to electrical impulses?

What are the the atrioventricular valves? Semilunar valves? Which are open and which are closed during the ventricular diastole? Isovolumic contraction? Ventricular Systole? Isovolumic relaxation?

Trucuspid and mitral valves

-Pulmonary valves and Aortic Valves

Diastoleà ventricles are relaxed mitral and tricuspid are open; aortic and pulmonic valves are closed.

Isovolumic contractionà all 4 are shut

Ventricular Systoleà ventricles pushing blood; mitral and tricuspid are closed; aortic and pulmonic valves are open.

Isovolumic relaxationà All four valves are closed.

Ventricular diastoleà pulmonic and aortic valves: closed; mitral and tricuspid valves: open

Taut

relaxed

What are the three veins entering the right atrium?

Superior venacave, inferior venacava, coronary sinus

The second sound of the heart is heard.

Isovolumic Ventricular relaxation (s2)

Diastasus

Rapid Ventricular Filling (6)

. Atrioventricular valves are open and semilunar valves are closed.

Diastasis/ Atrial Systole/ Rapid Ventricular Filling

Isovolumic ventricular systole

Stroke volume is pushed into the aorta

Ventricular injection

21. At the beginning of this phase, the first sound of the heart (S1) is heard.

Isovolumic ventricular systole (S1)

22. Atrioventricular valves and semilunar valves are closed and the pressure in the ventricles are falling.

Isovolumic Ventricular Relaxation

23. The first sound of the heart is caused by what? The second sound of the heart?

1^st: the shutting of the atrioventricular valves (Mitral and tricuspid valves)

2^nd: aortic valves shutting

24. “Topping off” ventricular filling

Atrial systole

25. At the beginning of this phase, the second (S2) sound of the heart is heard?

Isovolumic relaxation

27. Where is the secondary and tertiary pacemakers located? Which one represents junctional rhythm?

-Sa node is pacemaker of the heart

-AV node will take over the pacemaker of the heart when the SA node cant do it.  This is junctional rhythm.

28. When considering the electrocardiogram (ECG), What does the following represent: P wave, QRS complex, and T wave? What would abnormal ST segments suggest?

-P wave: Atrial contraction

-QRS: ventricular systole (contraction)

-T Wave: ventricular repolarization

29. To which areas of the heart does the right coronary artery distribute blood?

Anterior, lateral, posterior walls of the right ventricle and some of the intermuscular septum

30. What are the major branches of the left coronary artery? To which areas of the heart does the left coronary artery distribute blood?

-Left anterior descending artery and circumflex atery

-anterior descending= interventricular septum as well as anterior portion of the left ventricle.

-Cercumflex= lateral and posterior wall of left ventricle.

31. The major coronary vessels addressed in questions 29 and 30 are distributing arteries that branch into smaller arteries that dive into the myocardium and 50 become microvascular resistance vessels. When would the flow in these resistance vessels be the greatest—in systole or diastole?

Diastole and least during systole

32. What determines whether the left or right coronary artery is the dominant artery?

Which one flows into or forms the posterior descending artery.

33. Which is the neurotransmitter released by pre-ganglionic parasympathetic nerves? Sympathetic nerves?

Acetylcholine

34. Which is the receptor on the postganglionic nerve of the parasympathetic NS? Sympathetic NS?

Nicotinic

35. Which is the neurotransmitter of the postganglionic parasympathetic NS? Sympathetic NS.

Acetylcholine

Norepinephrine

36. Which is the receptor on the heart that is stimulated by the Vagal nerve? Sympatheitc nerve?

Muscarinic

Beta 1

37. Increase or decrease in innervation/stimulation of the heart by the sympathetic NS has what affect on the heart in terms of heart rate and contractility? By the vagal nerve?

-If you increase sympathetic innervations you increase heart rate and contractility.

-Decrease: decrease heart rate and deacrease contractility

-Increase parasympathetic or vagal tone you decrease heartrate and not physiological effect on contractility.

-Decrease: increase heart rate and no effect on contractility.

38. Explain the component(s) of preload; afterload; cardiac output.

Preload: volume of blood entering the ventricle during diastole, controlled by venous return, otal blood volume, respiration, and gravity.

Afterload: Resistance the left ventricle must overcome to pump blood into the aorta.

Cardiac Output: multiply the heart rate by the stroke volume and it’s expresses in L/minute so if the answer is 10, 450 mL/Min, the final answer would be 10.5 L/min.

39. Given a HR of 110 and a SV of 95, what is the cardiac output?

10,450 ml/min= 10.4 L/min

40. What is the relationship between pre-load and the Frank-Starling law of the heart? Length of cardiac muscle sarcomeres?

If you increase preload, you stretch out the biocardium and you will automatically on the next beat increase stroke volume bc as you stretch the heart, you increase the amount of myosin heads in contact with actin and you increase the strength and you increase the amount of calcium.

41. Where is the tunica intima located and what is it composed of? Tunica media? Tunica adventitia? Where are the elastic lamina located?

-Muscle cells right in the wall of the blood vessel;  thin layer of endothelial cells that make up the wall.  Above that is the Internal elastic media then tunica media made up of smooth muscle, then you have the tunica media then the external elastic lamina, and then finally the tunica adventitia made of of connective tissue.

42. Give examples of elastic arteries? What is the predominant anatomical characteristic of elastic arteries? Explain how this characteristic is necessary for these vessels to carry out their functional role (include in this answer an explanation of their functional role.

Elastic ateries:  Aorta, innominant, iliac, subclavian,

Made up mostly of elastic fibers

The elastictissues in their walls provide the resilience to smooth out the pressure wave.

43. What is the vasovasorum, where is it found, and what is it’s function?

Blood vessels in the tunica adventitia

Provide the blood system for the blood vessels.

44. Anatomically, what is the main difference between elastic and muscular arteries?

All the elastic fibers have moved out of the tunica media into the internal and external elastic lamina and the rest is smooth muscle.

45. Are elastic arteries innervated by the autonomic NS? Muscular arteries?

They are but they don’t have the same consequence.  The wall of the elastic arteries is very sturdy. 

The autonomic nervous system does not play a part in decreasing the radius of the elastic arteries.  Whereas the muscular arteries their lumin is greatly controlled by sympathetic ns.

46. Explain the relationship between postganglionic sympathetic nerves, norepinephrine, alpha-1 and alpha-2 receptors, and the diameter of muscular arteries.

Postganglionic nerves will run along the blood vessels (systemic) they will release norepinephrine, will stimulate alpha 1 and alpha 2 and will cause contraction.  If there is no innervation, there is normal vasculature.  If you pull that sympathetic innervations and don’t release norepinephrine, you can cause vasodilation.  The majr role played by sns is to cause vasoconstriction.

47. Describe the components of the wall of a medium size artery and what happens to those components as the arterioles get smaller and become a small arteriole.

Internal elastic lamina

Tunica Media (smooth muscle)

External elastic lamina

Tunica adventitia (Connective tissue)

Media is composed of one or two layers of smooth muscle cells.  As the arterioles get smaller, the continuous layers of smooth muscle become progressively discontinuous.

48. What is the formula in determining the resistance to blood flow in a vessel and explain each of the components. What component of this formula explains why arterioles offer considerable resistance to blood flow? What important function does this play? 51

R= (n*L)/r^4

N= Viscosity biggest controller is hematocrit

L = length of blood vessel

R=Radius of the blood vessel to the 4^th power.

As the radius gets smaller and smaller, the flow of pressure is going to decrease.

Prevents transudation of fluid across capillary wall.

49. Where are pre capillary sphincters located, what are they composed of, and

what is their function?

Near the junction between the terminal (smallest) arterioles.

Consist of a few smooth muscle cells arranged circularly.

Control the amount if blood that is going to enter the capillary system.

50. What are the two mechanisms that control the radius of the arterioles and the pre capillary sphincters and, therefore, the amount of blood entering a capillary network..

1) the level of sympathetic innervation,

2) the tissue activity in which the capillary bed is located.

51. Where are pericytes located and what is their function?

May be found in association with the endothelium of certain continuous capillaries.  Can give rise to smooth muscle cells during vessel growth.

Also play a crucial role in the formation and functionality of the selective permeability space between the circulatory system and the central nervous system.

52. In terms of characteristics of the endothelium, differentiate between continuous, fenestrated, and discontinuous capillaries.

Continuous: There are seams between cells and no fenestrations.  The outer wall is continous.

Fenestrated: The endothelial cells are pierced by pores, which extend through its full thickness and provide channels across the capillary wall. (Line the liver)

Discontinuous: larger, more irregularly shaped.  Usually wide gaps present between the endothelial cells that permit leakage of material into and out of these vessels.

53. Compare blood pressure in the veins to that in the arteries.

Systemic is high blood pressure.  Pulmonary is low. 

54. How many layers make up the walls of veins? Which layer forms the valves? How do veins differ from arteries?

Same 3 layers as arteries, the elastic lamina and tunica media are thinner.

Endothelial lining

In a vein, the tunica media Is much thinner.  Veins do not have large musculature associated with them because they act mainly as a reservoir for blood, and have more expansion properties than contractile ones.

55. At rest, why is the majority of blood contain within the venous system? What controls venomotor tone? How does venomotor tone differ from vasoconstriction on the arterial side?

-Venous blood flow occurs along relatively small pressure gradients and even small variations in resistance and vessel radius affect the return flow (see diagram on next page). The effect of gravity retards venous return. When upright, as the veins are distensible and due to the hydrostatic pressure of a column of blood in the veins below the level of the heart, blood tends to collect or pool in the feet and legs.

-Your veins are also innervated by postganglionic sympathetic nerves and also stimulate the smooth muscles around the veins and the alpha 1 and alpha 2 receptors during sympathetic innervations. 

-Differs in that Veins have an increase in rigidity during sympathetic innervations.

56. Explain why venous pooling does not mean stagnation.

Because it simply means that the veins accommodate a greater volume of blood.

57. How does arterial blood pressure depend on venous return (ie., remember, blood pressure is directly affected by cardiac output)?

Because how much comes back will determine how much goes out.

58. What affect does bed rest have on venomotor tone?

It makes it low due to the lack of exercise.

59. What characteristic of the veins of the lower legs and arms assists the skeletal muscle pump in returning blood toward the heart?

Changes in the venomotor tone, altering the capacity of venous system, the skeletal muscle pump and the respiratory pump.

60. When Dr. P. was in the Army he spent many hours at parade rest. Why did I slowly rock back and forth on my feet and push up and down on my toes during these wonderfully productive hours?

To keep the blood flowing and to keep it from pooling in the lower extremeties so he wouldn’t pass out.

61. What are the two ways that the respiratory pump returns blood to the heart.

With each inspiration, the pressure is lowered with the thorax and hence also within the right atrium of the heart; this increases the pressure gradient and aids blood flow back to the heart.

62. What are the components that control blood pressure? What component is controlled by the radius of blood vessels? Heart rate? Stroke volume?

Resistance to flow: the total resistance to blood flow in the arteries of the body, especially in the small arteries and arterioles— total peripheral resistance.

Cardiac output: how much blood is being put into the body by the heart.

63. Dr. P. has his blood pressure measured every Sunday and it usually is 125/75. What is my mean arterial pressure? How does this compare to the “average” blood pressure of persons the same age as Dr. P. (I’m 62 as of 2008). Why do you think such a difference exists?

97 mmHg

*64. Where are the baroreceptors located? A drop in blood pressure has what reflexive affect on the cardiovascular center in the medulla? How does this increase blood pressure (recall the answer to question #62).  

-Carotid sinus (at the bifurcation of external and internal carotids) & in the aortic arch.

-A decrease in arterial pressure (mean, pulse or both) results in decreased baroreceptor firing from the aortic arch and carotid sinus.  The "cardiovascular center" within the medulla responds by increasing sympathetic outflow and decreasing parasympathetic (vagal) outflow.

66. Where is atrial natriuretic factor (ANF) produced, stored, and released?

Atrial myocytes.