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Review: Exam II

Review: Exam II. Cardiovascular Anatomy and Physiology PED 205. Exam Format:. Chapters : 12-13 Multiple Choice: 30 Identification: Intrinsic Conduction System, Blood flow through heart, Blood Vessel Cross Section Short Answer: 5 Select One Essay Question. Cardiac Anatomy:.

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Review: Exam II

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  1. Review: Exam II Cardiovascular Anatomy and Physiology PED 205

  2. Exam Format: • Chapters: 12-13 • Multiple Choice: 30 • Identification: • Intrinsic Conduction System, Blood flow through heart, Blood Vessel Cross Section • Short Answer: 5 • Select One Essay Question

  3. Cardiac Anatomy: • Pericardium: Visceral / Parietal • Epicardium: Also visceral pericardium • Myocardium: Cardiac muscle layer • Endocardium: Connective Tissue Heart Valves + Epithelium

  4. Chambers and Valves: • R. Atrium Tricuspid Valve • R. Ventricle Pulmonary Valve • Pulmonary Artery Lungs • Pulmonary Vein L. Atrium • L. Atrium Mitral (Bicuspid) V. • L. Ventricle Aortic Valve • Aorta

  5. Coronary Arteries: • Left Coronary Artery: • Origin: Left side of AORTA • Supplies: Anterior/Left Heart • Right Coronary Artery: • Origin: Rt. Side of AORTA • Supplies: Right Heart

  6. Coronary Artery Disease: CAD • Narrowed Coronary arteries • Thrombus: Clot forms • Myocardial Infarction • Angina Pectoris • Coronary Bypass CAB), angioplasty, stents are treatments for CAD

  7. Intrinsic Conduction System: • SA Node: 90-100 bpm • AV Node: Slows the message down • AV Bundles: (also His): • L./R. Bundle Branches: • Purkinje Fibers:

  8. Cardiac Muscle Cells: • Striated, Branched, Intercalated Discs • Slower Action Potential than nerve or skeletal muscle cells • Voltage Gated Ca++ Channels!

  9. Electrocardiogram: ECG P: Atrial Depolarization/contraction QRS: Ventricular Depol/Contraction T: Ventricular Repolarization

  10. Cardiac Cycle: • Ventricular Diastole: • Ventricles relax, fill • Pulmonary/Aortic Valves close • Second Heart Sound: “Dupp” • Ventricular Systole: • Ventricles Contract – eject blood • Tri/Bicuspid valves close • First Heart Sound: “Lubb”

  11. Cardiac Output: HR X SV • CO = HR X SV • “Emergencies” • SNS Autonomic NS • Increase HR/SV = Increase CO • “Relaxing”: • PSNS Autonomic NS • Decrease HR = Decrease CO

  12. Baroreceptors: Pressure Emergencies • Increase CO = Increase Systolic BP • Emergency 1: Decreased Press • Increase SNS: Increased HR X SV = Increased CO • Problem 2: Increased Press • Decrease SNS: Decrease HR = Decreased CO

  13. Chemoreceptors: Metabolism Emergencies • Emergency 1: Increased Metabolic Rate: • Increased CO2, H+ (decreased pH) • Increased SNS …CO • Problem 2: Decreased Metabolic Rate: What’s the Problem? • Decreased CO2/ H+ (increased pH) • Decreased SNS …CO

  14. Intrinsic Regulation of the Heart: Starling’s Law • Increased Venous Return • Increased cardiac muscle stretch • Increase contraction force • Increased SV = Increased CO • Occurs without SNS/PSNS involvement • Exercise….

  15. Blood Vessels And Circulation

  16. Arteries and Veins • Elastic, Muscular and Arterioles • Capillaries: Exchange/Diffusion/ Osmosis • Venules, Veins

  17. Three Tunics: • Tunica Adventitia (Externa): Fibrous connective tissue • Tunica Media: Smooth Muscle and elastic connective tissue • Tunica Intima: Endothelium (forms the valves in veins

  18. Arterial Blood Pressure • Cardiac Output: Systolic blood pressure • Vascular Resistance: Diastolic Pressure • Vessel Diameter • Blood Viscosity • Vessel Length

  19. Pressure and Resistance • Increased Resistance = Increased Pressure • Increased Resistance = Increased Work of the Heart • Measurement: 120/80 mm Hg

  20. Vasoconstriction: • Decreases Vessel Diameter • Increases Resistance • Increases Diastolic BP • Increases Work of Heart • Increases SBP later • SNS, Cold, Hemorrhage etc cause vasoconstriction to “rescue” vital organs

  21. Vasodilation: • Increases Vessel Diameter • Decreases Resistance • Decreases Diastolic Pressure • PSNS, Heat, Local Exercise Demand cause vasodilation to perfuse skin, muscles for special situations

  22. Arteriosclerosis • Limits Vasodilation • Increases Resistance • Increases Pressure • Risk Factors: • Obesity, Cholesterol, Inactivity, Smoking, Aging, Heredity

  23. Systolic and Diastolic BP: • Systolic: Ventricular Systole • Greatest Arterial Pressure • Reflects CO and heart’s contribution to BP • Diastolic: Ventricular Diastole • Lowest Arterial Pressure • Reflects the resistance of the vessels to CO

  24. Essay Choices: • Exercise and the Heart/Vessels • Chronic Hypoxic Vasoconstriction of the Pulmonary Arteries • The effect of Nitroglycerin on peripheral resistance, work of the heart, BP

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