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Where are the location openings of the coronary arteries?
The root of the aorta, just above the aortic valve.
Describe the event that happens during ventriclue systole.
Opening of the semilunar valves.
What is meant by 'Preload' work of the heart?
The amount of blood that must be pumped before systole (each heart beat).
Describe Pulse Pressure.
The term referring to any of the events related to the flow of blood pressure that occurs from the beginning of the heart beat to the beginning of the next. The difference between the systolic and diastolic pressure.
What (if any) type of medication might be given for elevated pulse pressure?
Angiotensin-converting enzyme inhibitor (ACE inhibitor)
Describe the Cardiac Cycle.
Rhythmic pumping of heart that is broken into two parts, systole (ventricle contraction) and diastole (ventricle relaxation).
What causes the closing of the AV valves?
The AV valvse close by the tightening of the chordae tendineae.
What muscle(s) cause tension to better hold the AV valve?
The chordae tendineae are attached to papillary muscles.
What is subvalvular apparatice?
Both the papillary muscles at the chordae tendineae.
What is the arterial system?
Canals that carry blood from the heart to the organs.
Where is the greatest pulse pressure in the arterial system?
Aorta
In healthy adults, hwo many normal heart sounds are typically described?
Two normal heart sounds.
What are normal heart sounds?
Described as a lub and dub, that occur with each heart beat.
What causes the the first heart sound and any others that exist?
The closing of the AV valves and semilunar valves respectively.
Describe the isovolumetric contraction period of the cardiac cycle.
The interval between the closing of the AV valves and the opening of the semilunar valves (aortic and pumonary valves). Ventricle pressure rises rapidly without a chance in ventricular volune. Ventricular volume does not change because all valves are closed during this phase.
What greek words does the term tachycardia come from?
tachys (rapid) and kardia (of the heart)
In rapid tachycardia, why does the cardiac output fall?
Reduction in TIME for diastolic filling.
What factors have the largest effect on the amount of blood flow?
Diameter, Radius, etc (how WIDE).
What disease(s) might decrease blood flow?
Hypertension, atherosclerosis.
What is atherosclerosis?
Clogged and hardened arteris that narrow and become clogged with plaque.
How does atheroscerosis exert its effects?
Narrowing of the vessel lummen (ischemia), disruption of the endothelial lining, inflamation of the athersclerstic plaque.
How does the sympathetic nervous system regulate blood pressure?
Increased heart rate, contraction strengthens perverso resistance and release of epinepherine.
What is hypertension?
Chronic medical condition in which blood pressure is elevated.
What are the factors that predispose someone to the development of hypertension?
Obesity, alcohol consumption, high sodium intake
What are some symptoms of high blood pressure?
May have no signs or symptoms, may have dull heahaches, dizziness, nose bleeds.
The CENTRAL circulation contains blood that is in what?
The CENTRAL circulation contains blood that is in what? Heart, lungs, and pulmonary circulation
What primarily controls autoregulation of blood flow in microcirculation?
Metabolic need of tissue.
What is microcirulation?
The flow of blood through fine vessels (arteriole, capillaries and venules)
Describe the renin-angiotensin-aldosterone mechanism.
Renin converts Angioteninogen into Angiotension 1 Angiotension 1 is converted to Angiotension 2 Angiotension 2 constricts blood vessels and increases blood pressure.
Build up of Hydrogen ions, Potassium ions, and NITRIC OXIDE in local tissues promote what?
Vasodilation (widening of the diamter of blood vessel in order to decrease the resistance to blood flow).
What is an embolus?
Something that travels through the blood stream lodges in blood vessel and blocks it.
What are causes of embolus?
Piece of torn clot.
What is atherosclerosis?
A condition in which fatty material collects along the walls of ther arteries, thickens, hardens and blocks arteries.
What are the major risk factors of atherosclerosis?
Hypertension, smoking, blood cholesterol levels.
How does cigarette smoking and hypertension enhance atherosclerosis?
Disrupting endothelial layer of ateries.
Give examples of medical condition that can induce secondary hyperlipoprteinemia?
Diabetes, mellitus, and obesity.
Long term regulation of blood pressure depends on the function of what?
Kidney/ salt-water levels.
Where are the majority of the receptors that bind and remove LDL to carry cholesterol from circulation?
Liver.
What lifestyle factors increase the risk of atherosclerosis by producing a decrease in HDL?
Cigarette smoking.
What conditions can contribute to the development of venous thrombosis?
Immobility, older age, pregnancy, smoking, obesity.
Where does deep venous thrombosis (DVT) generally occur?
Deep veins of the leg or pelvic veins.
What are the two factors that predispose to the development of varicose veins?
Obesity and long-term standing.
Described varicose veins.
Swollen, twisted, and sometimes painful veins that hvae filled with an abnormal collection of blood.
What parameters of circulation are related to the arterial blood pressure?
Cardiac output and peripheral vascular resistance.
General action of ADH anti diuretic hormone.
Increases the absorption of water and sodium in the kidneys (more so of water). Water and sodium can go into circulation and increase blood pressure.
What helps reduce water retention and decease vascular volume in individuals with hypertension?
Limiting the amount of salt (NaCI)
Where are the effects of hypertension on the heart largely manifested?
Left ventricular hypertrophy (enlargement).
What does the diastolic blood pressure represent?
Pressure maintained by the peripheral blood vessels.
What does the systolic blood pressure represent?
The blood pressure when the heart is contracting.
What does the systolic component of blood pressure directly reflect?
Maximum arterial pressure during contraction of the left ventricle of the heart.
What is pregnancy induced hypertension related to?
Toxic mediators. From impaired placenta perfusion that alter vessels endothelial cells.
What is another term for pregnancy induced hypertension?
Toxemia or Preclampsia.
What are the symptoms of toxemia?
High blood pressure (greater then 140/90 mm Hg or increase in one or both pressures), protien in urine, edema (swelling).
Explain isolated systolic hypertension in the elderly.
Aorta gets increasingly regid.
Describe ACE-inhibitors?
Angiotensin converting enzymes. Decreases conversion angiotensin 1 to angiotensin 2.
In addition to hypertension, what else might ACE inhibitors be used to treat?
Scleroderma and Migraines.
What medication is frequently used to reduce the risk of coronary thrombosis (blood clot) in the absence of angina?
Antiplatlets, such as Plavix.
Describe variant (Prinzmental's) angina (chest pain).
Caused from coronary vessel spasm.
What is myocardial infarction?
Heart Attack.
What are the signs and symptoms of myocardial infarction?
Crushing chest pain, feeling of nausea and indigestion.
What is the most recommended treatment to reduce chest pain for myocardial infarction?
Nitroglycerin.
What is the cause for the high frequency of myocardial infarction from 6:00 am to noon?
Catecholamine sensitivity of coronary vessels higher - more vasoconstricting action.
Most common complication of early myocardial infarction?
Dyshythmias.
What role does myoglobin play in myocardial infarction?
Enzyme test used to determine if there is elevated levels. Levels elevate during first 2-3 hours of heart attack.
Explain why anginal pain does not develop in a number of people with advanced coronary atherosclerosis?
Pain tolerance, sedentary lifestyle, adequate collateral circulation.
Describe the cardiac conduction system.
Specialized myocardial cells that can create and conduct impulses.
What is hypovolemic shock?
An emergency condition in which sever blood and fluid loss makes the heart unable to pump enough blood to the body. It can cause many organs in the body to stop working.
What are the causes of hypovolemic shock?
Excessive loss of body fluid (includes vomiting)
What is the reason for the appearance of pale, cool, and clammy skin that is found in an individual with shock?
Blood is shunted away from skin to vital organs.
What compensatory mechanisms come into play if heart failure occurs?
Hypertrophy, sympathetic stimuation, rennin-angiotensin-aldosterone mechanism.
Describe ECG graph paper.
Eletrocardiograph runs at a paper speed of 25mm/s. One small block of ECG paper translates into 0.04 s. Five small blocks make up 1 large block, which translates into 0.20 s.
What is an ECG and what represents the ventricular depolarization on the ECG?
Electrocardiogram. Records the electrical activity of the heart. QRS Wave.
Most common initial manifestations of dilated cardiomyopathis are related to?
Heart Failure.
Describe what happens during the 'T' wave of the cardiac cycle.
Ventricular re-polarization.
Describe what happens during the 'P' wave of the cardiac cycle.
Artial depolarization (stimulation).
Describe what happens during the 'QRS' wave of the cardiac cycle.
complex-ventricular depolarization (stimulation).
Sympathetic stimulation causes what effects on the heart?
Increases in rate and strength of cardiac contraction.
What is the SA node?
Sinoartrial.
What is the function of the SA node?
Pacemaker of the heart. Generates impulses faster than other cardic cells.
Describe congestive heart failure.
Inability to meet the needs of the body's demand for blood.
What comes FIRST in the order of impulse conduction in the heart?
SA Node.
What comes SECOND in the order of impulse conduction in the heart?
AV Node.
What comes THIRD in the order of impulse conduction in the heart?
Bundle of HIS.
What comes FOURTH in the order of impulse conduction in the heart?
Purkinje system.
What is the modern explanation of the mechanism of the cardiac cell contraction?
A crossbridge that is formed between myosin and actin.
What are LDL and HDL?
Lipoprotiens.
Which carries cholesterol to the liver for removal? LDL or HDL?
HDL.

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