Cardiovascular Health & Sodium Intake Quiz
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Questions and Answers

How does high sodium intake affect the heart's physiology?

High sodium intake triggers the kidneys to retain water, increasing blood volume and leading to hypertension.

What role does potassium play in cardiovascular health?

Potassium helps maintain normal blood pressure and supports muscle contraction, balancing sodium levels in the body.

Explain the mechanism by which high sodium contributes to left ventricular hypertrophy.

High sodium levels lead to increased blood volume and pressure, which cause strain on the heart, triggering left ventricular hypertrophy.

Describe the role of the renin-angiotensin-aldosterone system (RAAS) in blood pressure regulation.

<p>RAAS is triggered by increased pressure in the cardiovascular system and causes vasoconstriction and fluid retention, raising blood pressure.</p> Signup and view all the answers

What is the impact of high sodium intake on stroke risk?

<p>High sodium intake increases blood pressure and contributes to vascular remodeling, thereby increasing the risk of stroke.</p> Signup and view all the answers

How does fluid balance impact blood pressure?

<p>Fluid balance, influenced by sodium intake, affects blood volume, which is a direct contributor to blood pressure levels.</p> Signup and view all the answers

What physiological changes occur in the heart due to chronic high sodium consumption?

<p>Chronic high sodium consumption leads to increased blood volume, hypertension, and can cause structural changes like left ventricular hypertrophy.</p> Signup and view all the answers

What is meant by capillary exchange mechanisms within the cardiovascular system?

<p>Capillary exchange mechanisms refer to the processes by which nutrients, gases, and waste products are exchanged between blood and tissues.</p> Signup and view all the answers

What is the primary role of the sinoatrial (SA) node in the heart?

<p>The SA node generates impulses that initiate heartbeats, acting as the natural pacemaker of the heart.</p> Signup and view all the answers

Explain the relationship between stroke volume (SV) and end diastolic volume (EDV) and end systolic volume (ESV).

<p>Stroke volume is calculated as SV = EDV - ESV, representing the blood ejected from a ventricle with each heartbeat.</p> Signup and view all the answers

What are the main phases of the cardiac cycle?

<p>The main phases of the cardiac cycle are systole (contraction) and diastole (relaxation).</p> Signup and view all the answers

How does the smooth muscle in blood vessels contribute to blood pressure regulation?

<p>The smooth muscle contracts or relaxes to change the diameter of blood vessels, affecting total peripheral resistance and thus blood pressure.</p> Signup and view all the answers

What is the Frank-Starling law of the heart?

<p>The Frank-Starling law states that the stroke volume of the heart increases in response to increased venous return, due to increased muscle stretch.</p> Signup and view all the answers

Describe how action potentials are generated in cardiac muscle cells.

<p>Action potentials in cardiac muscle are generated through unstable resting potentials and depolarization primarily due to calcium influx.</p> Signup and view all the answers

What role does the atrioventricular (AV) node play in the heart's conduction system?

<p>The AV node delays the impulse from the atria before it passes to the ventricles, allowing for coordinated contractions.</p> Signup and view all the answers

What factors can adversely affect stroke volume?

<p>Adverse factors include decreased preload, increased afterload, acidosis, and calcium channel blockers.</p> Signup and view all the answers

What is cardiac output (CO) and how is it calculated?

<p>Cardiac output is the volume of blood pumped by each ventricle in one minute, calculated as CO = heart rate (HR) x stroke volume (SV).</p> Signup and view all the answers

How do sympathetic and parasympathetic divisions of the autonomic nervous system affect heart rate?

<p>The sympathetic nervous system increases heart rate, while the parasympathetic system decreases it.</p> Signup and view all the answers

What is the significance of the dicrotic notch in the aortic pressure waveform?

<p>The dicrotic notch represents a brief rise in aortic pressure due to the backflow of blood rebounding off the closed semilunar valves.</p> Signup and view all the answers

Define capillary exchange and its significance.

<p>Capillary exchange refers to the process of nutrients, gases, and waste products moving between blood and tissues across capillary walls.</p> Signup and view all the answers

How does preload affect cardiac output?

<p>Preload affects cardiac output by determining the degree of stretch of cardiac muscle cells before contraction, thus influencing stroke volume.</p> Signup and view all the answers

What physiological mechanisms are involved in the regulation of blood pressure?

<p>Blood pressure is regulated through cardiac output, vascular resistance, and blood volume, with contributions from neural and hormonal control mechanisms.</p> Signup and view all the answers

How does the heart develop in an embryo, and when does it start pumping?

<p>The simple 'tube heart' develops in the embryo and starts pumping by the fourth week.</p> Signup and view all the answers

What is the significance of fetal circulation in relation to the mother's blood supply?

<p>Fetal circulation allows the fetus to receive oxygen and nutrients from the mother's blood while bypassing the non-functioning lungs.</p> Signup and view all the answers

Describe the difference in structure between veins and arteries.

<p>Arteries have thicker walls made of smooth muscle, while veins have larger lumens and thinner walls with valves to prevent backflow.</p> Signup and view all the answers

What role do capillaries play in the circulatory system?

<p>Capillaries are the exchange vessels where oxygen and nutrients leave the blood and carbon dioxide and waste products enter.</p> Signup and view all the answers

Explain how blood pressure is affected by the autonomic nervous system.

<p>The sympathetic division of the autonomic nervous system can increase blood pressure by causing vasoconstriction.</p> Signup and view all the answers

What happens to fetal blood circulation after birth?

<p>After birth, the foramen ovale closes, and the ductus arteriosus constricts, redirecting blood flow through the lungs.</p> Signup and view all the answers

What factors contribute to the regulation of stroke volume?

<p>Stroke volume is primarily regulated by the heart's contractility and by Starling's law, which states that increased stretch leads to stronger contractions.</p> Signup and view all the answers

What is capillary exchange and how does it occur?

<p>Capillary exchange refers to the movement of substances across capillary walls, primarily through diffusion based on concentration gradients.</p> Signup and view all the answers

How does blood pressure vary across the body and what are the normal ranges?

<p>Blood pressure decreases as distance from the heart increases, with a normal range of 140-110 mm Hg systolic and 80-75 mm Hg diastolic.</p> Signup and view all the answers

What mechanisms assist veins in the return of blood to the heart?

<p>Veins rely on the milking action of skeletal muscles and the presence of valves to prevent backflow of blood.</p> Signup and view all the answers

Define the terms systolic and diastolic blood pressure.

<p>Systolic blood pressure is the pressure during ventricular contraction, while diastolic blood pressure is the pressure when the ventricles relax.</p> Signup and view all the answers

What are fenestrated capillaries, and where are they commonly found?

<p>Fenestrated capillaries have pores that allow for increased permeability and are commonly found in areas requiring extensive exchange, like the kidneys and intestines.</p> Signup and view all the answers

How does exercise affect heart rate and cardiac output?

<p>Exercise increases heart rate and, consequently, cardiac output to meet the heightened oxygen and nutrient demands of the body.</p> Signup and view all the answers

Why do capillaries have walls that are only one cell layer thick?

<p>Capillaries have one-cell-thick walls to facilitate efficient diffusion of gases, nutrients, and wastes between blood and surrounding tissues.</p> Signup and view all the answers

Study Notes

Cardiovascular System (Heart)

  • The cardiovascular system is a closed system with the heart and blood vessels.
  • The heart pumps blood, and blood vessels allow blood to circulate throughout the body.
  • The function of the cardiovascular system is to deliver oxygen and nutrients, and to remove carbon dioxide and other waste products.

Heart Anatomy

  • Approximately the size of a fist.
  • Location: superior surface of diaphragm, left of midline, anterior to the vertebral column, and posterior to the sternum.
  • Coverings of the Heart:
    • Pericardium - a double-walled sac around the heart
      • Fibrous pericardium - superficial layer
      • Serous pericardium - deep layer with parietal (internal surface) and visceral (epicardium, surface of heart) layers.
    • Serous fluid fills the space between the layers of pericardium to allow for friction-free movement.

Heart Wall

  • Epicardium - external layer, visceral layer of serous pericardium
  • Myocardium - middle layer, mostly cardiac muscle
  • Endocardium - inner layer, endothelium

External Heart: Major Vessels (Anterior View)

  • Vessels returning blood to the heart include:
    • Superior and inferior venae cavae
    • Right and left pulmonary veins
  • Vessels conveying blood away from the heart include:
    • Pulmonary trunk (splits into right and left pulmonary arteries)
    • Ascending aorta (three branches):
      • Brachiocephalic
      • Left common carotid
      • Left subclavian arteries

External Heart: Vessels that Supply/Drain the Heart (Anterior View)

  • Arteries - right and left coronary (in atrioventricular groove), marginal, circumflex, and anterior interventricular arteries
  • Veins - small cardiac, anterior cardiac, and great cardiac veins

External Heart: Major Vessels (Posterior View)

  • Vessels returning blood to the heart include:
    • Right and left pulmonary veins
    • Superior and inferior venae cavae
  • Vessels conveying blood away from the heart include:
    • Aorta
    • Right and left pulmonary arteries

External Heart: Vessels that Supply/Drain the Heart (Posterior View)

  • Arteries - right coronary artery (in atrioventricular groove); posterior interventricular artery (in interventricular groove)
  • Veins - great cardiac vein, posterior vein to left ventricle, coronary sinus, and middle cardiac vein

Atria of the Heart

  • Receiving chambers of the heart
  • Each atrium has a protruding auricle.
  • Pectinate muscles mark atrial walls.
  • Blood enters the right atria from superior and inferior venae cavae and coronary sinus.
  • Blood enters left atria from pulmonary veins.

Ventricles of the Heart

  • Discharging chambers of the heart.
  • Papillary muscles and trabeculae carneae muscles mark ventricular walls.
  • Right ventricle pumps blood into the pulmonary trunk.
  • Left ventricle pumps blood into the aorta.

Heart Function to Circulate Human Blood

  • The heart's function is to circulate blood by pumping it throughout the body.

Myocardial Thickness and Function

  • Thickness of myocardium varies according to the function of the chamber.
  • Atria are thin-walled, delivering blood to adjacent ventricles.
  • Ventricle walls are thicker and stronger; the left ventricle wall is the thickest to supply systemic circulation.

Myocardial Physiology: Autorhythmic Cells (Pacemaker Cells)

  • Smaller than contractile cells
  • Don't contain many myofibrils.
  • No organized sarcomere structure.
  • Unstable membrane potentials called pacemaker potentials.
  • Use calcium influx (rather than sodium) for rising phase of the action potential.
  • Characteristics of pacemaker cells:
    • Unstable membrane potential - "bottoms out" at -60 mV,"drifts upward" to -40 mV, forming a pacemaker potential.
    • Myogenic - the upward drift allows the membrane to reach threshold potential (-40 mV) by itself. This is due to:
      • Slow leakage of K+ out & faster leakage of Na+ in
      • Ca2+ channels open as membrane approaches threshold
      • Slow K+ channels open as membrane depolarizes, causing efflux of K+ and repolarization of membrane
    • Altering Activity of Pacemaker Cells (Sympathetic activity):
    • NE and E increase I₁ channel activity
    • Altering Activity of Pacemaker Cells (Parasympathetic activity)
      • ACh binds to muscarinic receptors & decreases Ca2+/increases K+ permeability = hyperpolarizing the membrane
    • Longer time to threshold = slower rate of action potentials

Myocardial Physiology: Contractile Cells

  • Special aspects
    • Intercalated discs - Highly convoluted and interdigitated junctions, Joint adjacent cells with Desmosomes & fascia adherens, Allow for synticial activity—with gap junctions
    • Less sarcoplasmic reticulum
      • Also Ca2+ influxes from ECF reducing storage need
    • Larger t-tubules
    • Myocardial branching
    • More mitochondria than skeletal muscle
  • The action potential of a contractile cell
    • Ca2+ plays major role.
    • Action potential duration is longer than a typical neuronal action potential; plateau phase due to Ca2+ entry
    • Phases of the Contractile Action Potential; resting membrane potential @-90 mV, depolarization, temporary repolarization, plateau phase, repolarization
  • Plateau phase prevents summation due to elongated refractory period. No summation capacity= no tetanus.

Cardiac Cycle

  • Sequence of events as blood enters the atria, leaves the ventricles and starts over again.
  • Crucial aspects include electrical conduction pathways, synchronization, and rate regulation.
  • Phases: Rest, atrial systole, isovolumetric ventricular contraction, ventricular ejection, isovolumetric ventricular relaxation, back to atrial & ventricular diastole, which is the blood flow through the heart.
  • The electrical system gives rise to electrical changes which are transmitted through body fluids allowing us to record the ECG, a recording of electrical activity that maps to the cardiac cycle.

Cardiac Output (CO) and Reserve

  • Cardiac Output is the amount of blood pumped by each ventricle in one minute (CO is the product of heart rate (HR) and stroke volume (SV)).
    • HR is the number of heart beats per minute
    • SV is the amount of blood pumped by the ventricles with each beat
  • Cardiac reserve is the difference between resting and maximal CO.

Regulation of Stroke Volume

  • SV=end diastolic volume (EDV)- end systolic volume (ESV) - EDV = amount of blood collected in a ventricle during diastole - ESV = amount of blood remaining in a ventricle after contraction -Factors affecting stroke volume include Preload, Contractility, and Afterload

Regulation of Heart Rate

  • Positive chronotropic factors increase heart rate, for instance, caffeine.
  • Negative chronotropic factors decrease heart rate, for instance, sedatives.
  • Autonomic nervous system regulates heart rate via control of sympathetic and parasympathetic activation.
  • Parasympathetic nervous system (PNS) stimulation is mediated by acetylcholine and opposes the SNS and lowers heart rate and causing vagal tone.
  • Sympathetic nervous system (SNS) stimulation is activated by stress, anxiety, excitement, or exercise. (If vagus nerve is cut, the heart would lose its tone, increasing heart rate by 25 beats per minute) .
  • Atrial (Bainbridge) reflex - a sympathetic reflex initiated by increased blood in the atria. It causes stimulation of the SA node and stimulates baroreceptors in the atria, causing increased SNS stimulation.
  • Chemical regulation: Hormones epinephrine and thyroxine increase heart rate. Intra- and extracellular ion concentrations must be maintained for normal heart function.

Blood Vessels (Vascular System)

  • Taking blood to the tissues and back to the heart through the arteries, arterioles, capillaries, venules, and veins.
  • Three layers (tunics) make up blood vessels include tunic intima (endothelium), tunic media (smooth muscle), and tunic externa (mostly fibrous connective tissue).
  • Differences between blood vessel types:
    • Walls of arteries are thicker and their smooth muscle helps move blood.
    • Lumens of veins are larger because their walls are thinner.
    • Larger veins have valves to prevent backflow.
    • Skeletal muscle pushes blood in the veins back to the heart.
    • Walls of capillaries are only one cell layer thick to support exchange between blood and tissue..

Capillary Beds

  • Consist of two types of vessels:
    • Vascular shunt- directly connects the arteriole to a venule
    • True capillaries - exchange vessels
    • Oxygen and nutrients cross to cells, and carbon dioxide and metabolic waste products go into the blood.
  • Diffusion at Capillary Beds
    • Subtances are exchanged, such as oxygen and nutrients, via concentration gradients.
    • Diffusion occurs across plasma membranes and through intercellular clefts (gaps), and through pores (fenestrations), in some capillaries.

Major Arteries and Veins (Systemic Circulation)

  • Figures are available in the document provided

Arterial Supply of the Brain (Circle of Willis)

  • Figures and details are available in the provided document.

Hepatic Portal Circulation

  • Figures and details are available in the provided document.

Circulation to the Fetus

  • Figures and details are available in the provided document.

Pulse

  • Pressure wave of blood in arteries; monitored at pressure points where the pulse is easily palpated using a stethoscope.

Blood Pressure

  • Measurements by health professionals are made on the pressure in large arteries;
    • Systolic = pressure at the peak of ventricular contraction
    • Diastolic = pressure when ventricles relax

Measuring Arterial Blood Pressure

  • Measurement procedures and steps are available in the provided document.

Effects of Factors on Blood Pressure

  • Neural factors - Autonomic nervous system adjustments (sympathetic division)
  • Renal factors - Regulation by altering blood volume & Renin - hormonal control
  • Temperature - Heat has a vasodilation effect and cold has a vasoconstricting effect; chemicals include various substances that increase/decrease blood pressure; diet is a significant factor.

Variations in Blood Pressure

  • Human normal range is variable, from 140-110 mmHg systolic and 80-75 mmHg diastolic
  • Hypotension = low systolic (below 110 mmHg) and often associated with illness
  • Hypertension = High systolic (above 140 mmHg) and can be dangerous if chronic

Congestive Heart Failure (CHF)

  • Caused by coronary artery disease, hypertension, MI, valve disorders, and congenital defects
    • Left side heart failure: less effective pump; more blood in ventricle, blood back up in lungs, as pulmonary edema, suffocation and lack of oxygen to the tissues.
    • Right side heart failure: fluid builds up in tissues as peripheral edema.

Heart Disease

  • Various conditions including coronary artery disease, persistent high blood pressure, multiple myocardial infarctions, and dilated cardiomyopathy.

Developmental Aspects of the Heart

  • A simple tube heart develops in the embryo; pumps by the fourth week.
  • Heart becomes a four-chambered organ by end of seven weeks.
  • Limited structural changes after seventh week.
  • Fetus contains special structures bypassing pulmonary circulation to supply oxygen and nutrients to the fetus, such as the Foramen Ovale, and the Ductus Arteriousus. - Developmental abnormalities (congenital heart defects) can occur if the structures fail to fully develop as expected during fetal growth. Includes examples of ventricular septal defect, coarctation of the aorta, and tetralogy of fallot.
  • Sclerosis and thickening of valve flaps.
  • Decline in cardiac reserve
  • Fibrosis of cardiac muscle
  • Atherosclerosis

Clinical Problems

  • MI (myocardial infarction)= death of heart muscle tissue due to lack of O2 resulting in scar tissue formation.
  • Blood clot: Use clot-dissolving drugs, such as streptokinase or t-PA and heparin. Balloon angioplasty
  • Angina pectoris - heart pain from ischemia (lack of blood flow and oxygen) to the cardiac muscle.

Coronary Artery Disease

  • Heart muscle receiving insufficient blood supply due to narrowing of coronary vessels, or atherosclerotic blockage.
  • Treatment includes drugs, bypass graft, angioplasty, and stent.

Artificial Heart

  • Heart valve or complete heart replacement may be needed if the heart does not function adequately or when major heart disease or damage is present. Procedures to replace valves, or even the entire heart may be done to correct the problems.

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