The Cardiovascular System-The Heart

Chapter 15

Objective 1 Describe the location of the heart and

the structure and functions of the pericardium.

Figure 15.1

Question 1 Your heart is found in the thoracic

cavity with 2/3 of its mass lying to the left of the body’s midline.

Question 2 The apex of the heart is formed by

the left ventricle and it rests on the diaphragm.

Question 3 The major blood vessels enter and

exit from the base of the heart.

Figure 15.2, Question 4 Explain cardiac tamponade.

Because the pericardium cannot stretch, fluid builds up and compresses the heart

Objective 2 Describe the layers of the heart wall

and the chambers of the heart

Question 5 Name the three layers of the heart

wall. Epicardium (external) Myocardium (middle) Endocardium (inner)

Question 6 Name the four chambers of the heart

Left atrium Right atrium Left ventricle Right ventricle

Question 7 Figure 15.3

Objective 4 Describe the structure and functions

of the valves of the heart.

Question 8 The atrioventricular (AV) valves on

the right side are also known as the tricuspid valve.

Question 9 What is the purpose of the chordae

tendineae? To prevent the valves from pushing up

into the atria.

Figure 15.4 Question 10- The AV valves on the left

side are known as the bicuspid or mitral valve.

Question 11 Define valvular heart disease.

Any condition in which one or more of the heart valves operate improperly.

Question 12 What happens if regurgitation

continues? This leads to congestive heart failure The heart can no longer pump enough to

supply the oxygen demands of the body

Objective 5, Figure 15.5 Explain how blood flows through the

heart.

Objective 6 Describe the clinical importance of

the blood supply of the heart.

Question 13 Name the two coronary arteries and

the name of the one vein. Left and right coronary arteries The vein is the coronary sinus

Question 14. Define the following: Ischemia Angina pectoris Myocardial infarction infarction

Ischemia- local anemia due to obstruction of blood vessels.

Angina Pectoris- ischemia of the myocardium, this causes chest pain.

Myocardial infarction- a heart attack. Infarction- Death of an area of tissue

because of interrupted blood supply. (A blood clot in the coronary arteries could cause this)

Objective 7 Explain how each heartbeat is

initiated and maintained.

Question 15, Figure 15.6, p. 359 List the five steps for the conduction

system of the heart SA Node Action potential AV Node AV Bundle Right and left bundle to branches Purkinje fibers

Question 16 List five triggers of ectopic activity

(ectopic pacemaker). Caffeine Nicotine Electrolyte imbalances Hypoxia Toxic reactions to drugs

Objective 8 Describe the meaning and diagnostic

value of an electrocardiogram, ECG.

Objective 9 Describe the phases of the cardiac

cycle.

Question 17 Define

Systole-contraction (PQRS) Diastole- phase of relaxation (T wave)

Question 18 List the three stages of the cardiac

cycle. Atrial systole Ventricular systole Relaxation period

P wave- atria depolarize, atria contract

QRS Complex- ventricles depolarize, ventricles contract

T wave-ventricles repolarize

Question 19 What causes heart sounds? Explain

lubb and dupp. Turbulence in blood flow created by

closure of the valves causes heart sounds.

Lubb- AV valves close, ventricles contract

Dupp- seimlunar valves close

Question 21 Explain mitral stenosis and mitral

valve prolapse (MVP). Mitral stenosis- narrowing of the mitral

valve by scar formation or congenital defect.

MVP- a portion of the mitral valve is pushed too far and the cusps do not close properly. About 10% of healthy people have this.

Objective 10 Define cardiac output, explain how it

is calculated and describe how it is regulated.

Question 22 How do you calculate cardiac output?

Stroke volume X beats per minute

Question 23 What is normal stroke volume for a

resting adult? 70 mL

Question 24 What is the normal heart rate in beats

per minute? 75 bpm 5.25L/min

Question 25 Name the three factors that regulate

stroke volume and ensure that the left and right ventricles pump equal volumes of blood. The degree of stretch in the heart before

it contracts. The forcefulness of individual ventricular

muscle fibers. The pressure required to eject blood

from the ventricles.

Question 26 Explain congestive heart failure

(CHF). The heart is a failing pump. More and more blood is left in the

ventricles at the end of each cycle. The heart stretches.

Question 27 Name the four causes of CHF.

Coronary artery disease Long term high blood pressure Myocardial infarctions Valve disorders

Omit Question 28.

Question 29 Explain how hormones and ions

regulate the heart rate. Epinephrine and norepinephrine enhance

the heart’s pumping effectiveness, increase heart rate and contraction force.

Thyroid hormones increase heart rate High K+ or Na+ decrease the heart rate

and contraction force.

Objective 11 Explain the relationship between

exercise and the heart.

Question 31 To benefit the heart aerobic exercise

must be for at least 20 minutes. How many times a week? 3-5

Question 32 What does sustained exercise do to

benefit the cardiovascular system? Increases the oxygen demand

Question 33A A. Explain coronary artery disease.

Atherosclerotic plaques in the coronary arteries reduce the blood flow to the myocardium.

Question 33B What are the risk factors?

High cholesterol High blood pressure Smoking Obesity Diabetes Type A Personality Sedentary lifestyle

Question 33C What are the treatment options?

Moderate exercise Reduce fat in the diet Drugs: nitroglycerine, beta blockers,

cholesterol lowering, clot dissolving Surgical and nonsurgical procedures to

increase blood supply to the heart

Question 34 Define atherosclerosis and its causes.

Large to medium-sized lesions High LDL levels Prolonged high blood pressure Carbon monoxide in cigarette smoke Cytomegalovirus (Herpes virus) Diabetes mellitus

Question 35 Explain the following congenital

defects. Patent ductus arteriosus Interventricular septal defect Valvular stenosis Tetralogy of Fallot

Question 35 Patent ductus arteriosus- the ductus

arteriosus between the aorta and pulmonary trunk remains open.

Interventricular septal defect- incomplete closure of the interventricular septum

Question 35 Valvular stenosis- narrowing of one of

the valves Tetralogy of Fallot- there are four

defects Interventricular septum defect An aorta from both ventricles instead of

just the left Narrowed pulmonary semilunar valve Enlarged right ventricle

Question 36 Define arrhythmia and name eight

causes Arrhythmia- an irregularity in heart

rhythm

Eight causes Caffeine Nicotine Alcohol Anxiety Drugs Hyperthyroidism Potassium deficiency Heart disease

Question 37 One serious arrhythmia is called heart

block (AV block)

Question 38 Define the following:a. Atrial flutter- rapid atrial contractions,

atrial rhythm averages 240-360 bpm.b. Atrial fibrillation- an uncoordinated

contraction of atrial muscles. They quiver individually instead of contract together.

Question 38c. Ventricular fibrillation- haphazard,

asynchronous ventricular muscle contractions. Circulatory failure and death occur.

Match the followingJ. 39. Sudden cardiac death- the

unexpected cessation of circulation and breathing due to heart disease.

A. 40. Cardiac angiography- A cardiac catheter is used to inject a radiopaque dye, clot dissolving drugs or tissue plasminogen activator (t-PA)

E. 41. Cor pulmonale (CP)- Right ventricular hypertrophy caused by hypertension (high blood pressure).

G. 42. Incompetent valve- any valve that does not close properly and permits backflow of blood.

D. 43. Cardiomegaly- Heart enlargement

B. 44. Cardiac arrest- A clinical term meaning cessation of an effective heartbeat. The heart may be completely stopped or in ventricular fibrillation.

I. 45. Paroxysmal tachycardia- A period of rapid heartbeats that begins and ends suddenly.

C. 46. Cardiac catheterization- 1. Procedure to visualize the heart’s

coronary arteries, chambers, valves and great vessels.

2. The flow of blood and oxygen can be measured

F. 47. Cardiac resuscitation- The artificial establishment of normal or near normal respiration and circulation. Follow the ABC’s. Airway, Breathing and Circulation.

H. 48. Palpitation- A fluttering of the heart or abnormal rate or rhythm of the heart.