Circulation and Cardiac Physiology
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Questions and Answers

What is the primary role of the right side of the heart in circulation?

The right side of the heart receives deoxygenated blood from the body and pumps it to the lungs for oxygenation.

Describe how blood becomes oxygen-rich.

Blood becomes oxygen-rich after it travels through the lungs, where it unloads carbon dioxide and picks up oxygen.

What is the difference in workload between the right and left ventricles?

The right ventricle has a short, low-pressure workload while the left ventricle has a long pathway with high pressure and more resistance.

What is the primary function of the coronary arteries?

<p>The coronary arteries supply the heart muscle (myocardium) with blood, delivering necessary nutrients and oxygen.</p> Signup and view all the answers

Explain why coronary blood flow is ineffective during ventricular contraction.

<p>During ventricular contraction, the myocardium compresses the coronary arteries, restricting blood flow to the heart muscle.</p> Signup and view all the answers

What is the significance of the Na+ and K+ concentration in myocardial cells at rest?

<p>At rest, myocardial cells have a high concentration of K+ inside and a low concentration of Na+, which is vital for maintaining the resting membrane potential.</p> Signup and view all the answers

Describe the two main circuits of blood circulation in the heart.

<p>The pulmonary circuit carries deoxygenated blood to the lungs, while the systemic circuit distributes oxygen-rich blood to the body.</p> Signup and view all the answers

How do cardiac action potentials contribute to heart function?

<p>Cardiac action potentials facilitate the electrical impulses that trigger myocardial contractions and the cardiac cycle.</p> Signup and view all the answers

What role does K+ movement play in the resting membrane potential of ventricular cells?

<p>The movement of K+ out of the cell contributes to a loss of positive charge, maintaining a negative resting membrane potential of -80 to -90 mV.</p> Signup and view all the answers

What occurs when the membrane potential of a myocardial cell reaches the threshold value?

<p>When the membrane potential reaches the threshold, an action potential is generated, leading to depolarization.</p> Signup and view all the answers

What are the normal serum potassium (K+) levels?

<p>The normal serum potassium level ranges from 3.5 to 5.0 mEq/L.</p> Signup and view all the answers

List two components of the cardiac cycle.

<p>The two components of the cardiac cycle are diastole and systole.</p> Signup and view all the answers

What is cardiac output and how is it calculated?

<p>Cardiac output is the amount of blood ejected from the ventricle in one minute, calculated as CO = SV x HR.</p> Signup and view all the answers

Define preload in the context of stroke volume determination.

<p>Preload is the amount of blood delivered to the heart chamber, which depends on venous return.</p> Signup and view all the answers

What are the functions of the electrical conduction system in the heart?

<p>The electrical conduction system generates and conducts impulses rapidly, coordinating heartbeats.</p> Signup and view all the answers

What happens during early repolarization of a myocardial cell?

<p>Early repolarization involves a phase where the membrane potential begins to return towards the resting state after depolarization.</p> Signup and view all the answers

What is the significance of maintaining electrolyte balance in cardiac function?

<p>Maintaining electrolyte balance is crucial for proper cardiac depolarization and function.</p> Signup and view all the answers

Explain the process of late rapid repolarization in cardiac cells.

<p>Late rapid repolarization is the phase where the membrane potential sharply decreases, allowing the cell to return to its resting state.</p> Signup and view all the answers

What are the primary components of the circulatory system?

<p>The primary components are the heart, blood vessels, and blood.</p> Signup and view all the answers

Differentiate between the right and left ventricles in terms of blood type they receive.

<p>The right ventricle receives deoxygenated blood, while the left ventricle receives oxygenated blood.</p> Signup and view all the answers

What is the function of the pericardium?

<p>The pericardium fixes the heart to the thoracic cavity and holds serous fluid to prevent friction.</p> Signup and view all the answers

Name the valves present in the heart.

<p>The valves are the pulmonic valve, aortic valve, mitral valve, and tricuspid valve.</p> Signup and view all the answers

Describe the flow of deoxygenated blood through the right side of the heart.

<p>Deoxygenated blood enters the right atrium from the superior and inferior vena cava, moves to the right ventricle, and is pumped to the pulmonary circulation.</p> Signup and view all the answers

How does the left atrium receive blood, and what happens to that blood?

<p>The left atrium receives oxygenated blood from the pulmonary veins and sends it to the left ventricle.</p> Signup and view all the answers

What is the role of the vascular system?

<p>The vascular system transports blood throughout the body, consisting of systemic and pulmonary circulation.</p> Signup and view all the answers

What do arteries do in the circulatory system?

<p>Arteries carry blood away from the heart.</p> Signup and view all the answers

What type of blood does the pulmonary artery carry, and where does it go?

<p>The pulmonary artery carries deoxygenated blood to the lungs for oxygenation.</p> Signup and view all the answers

What differentiates veins from arteries anatomically?

<p>Veins have thinner walls and larger lumens compared to arteries, which have thicker walls and smaller lumens.</p> Signup and view all the answers

What are the primary effects of volatile anesthetic agents on the heart?

<p>They cause coronary vasodilation and reduce myocardial metabolic requirements.</p> Signup and view all the answers

Define pericarditis and its potential complications.

<p>Pericarditis is the inflammation of the pericardium, which can lead to pericardial effusion and cardiac tamponade.</p> Signup and view all the answers

What is the difference between stenotic and regurgitant valvular heart disease?

<p>Stenotic disease restricts forward blood flow, while regurgitant disease allows backward blood flow.</p> Signup and view all the answers

What is myocarditis, and what does it represent?

<p>Myocarditis is the inflammation of the myocardium, often indicating an underlying infection or inflammatory condition.</p> Signup and view all the answers

How does infective endocarditis affect the heart?

<p>Infective endocarditis involves infective organisms invading the endothelial lining, resulting in vegetation on the heart valves.</p> Signup and view all the answers

What are the major factors affecting cardiac stroke volume?

<p>Preload, afterload, contractility, wall motion abnormalities, and valvular dysfunction.</p> Signup and view all the answers

Describe Frank Starling's Law in relation to cardiac function.

<p>Frank Starling's Law states that the strength of heart contractions is proportional to the volume of blood filling the heart (preload) before contraction.</p> Signup and view all the answers

How does the sympathetic nervous system affect heart function?

<p>It increases heart rate, conduction speed, and contractility in the ventricles.</p> Signup and view all the answers

What role do baroreceptors play in blood pressure regulation?

<p>Baroreceptors sense changes in blood pressure and help regulate it by providing feedback to the autonomic nervous system.</p> Signup and view all the answers

Explain the intermediate control of arterial blood pressure.

<p>Intermediate control involves the activation of the renin-angiotensin-aldosterone system and vasopressin secretion, leading to increased vascular resistance.</p> Signup and view all the answers

What is the formula for estimating Mean Arterial Pressure (MAP)?

<p>MAP can be estimated by the formula: MAP = Diastolic pressure + (Pulse pressure / 3) or MAP = (2 × Diastolic pressure + Systolic pressure) / 3.</p> Signup and view all the answers

What is the long-term control mechanism for blood pressure?

<p>The long-term control mechanism involves the kidneys altering sodium and water balance to restore blood pressure to normal levels.</p> Signup and view all the answers

How does afterload affect cardiac stroke volume?

<p>Afterload is the resistance the heart must overcome to eject blood, and increased afterload decreases stroke volume.</p> Signup and view all the answers

What impact does contractility have on cardiac output?

<p>Increased contractility enhances cardiac output by improving the heart's ability to pump blood effectively.</p> Signup and view all the answers

How do the sympathetic and parasympathetic nervous systems work together to regulate heart rate?

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

Study Notes

Circulation through Heart

  • Blood flow through pulmonary circuit is from the right side of the heart through the lungs and back to the left side of the heart.
  • Blood flow through systemic circuit is from the left side of the heart through the body and back to the right side of the heart.
  • Systemic circuit has higher pressure than pulmonary circuit.

Coronary Circulation

  • Coronary arteries are the shortest circulation in the body.
  • Coronary arteries supply the heart muscle with blood.
  • Coronary arteries are located at the base of the aorta.
  • Coronary arteries are blocked by the aortic valve when the heart is contracting.

Cardiac Physiology

  • Myocardial membrane is permeable to Potassium (K+) but not Sodium (Na+) at rest.
  • Action potential is caused when the membrane potential becomes less negative and reaches a threshold value.
  • Electrolytes play a key role in cardiac function.

Electrical Conduction System

  • The heart has a specialized electrical conduction system composed of:
    • Sinoatrial (SA) node
    • Atrioventricular (AV) node
    • Bundle of His
    • Right and Left Bundle Branches
    • Purkinje Fibers

Mechanical function of the heart

  • The Cardiac Cycle has two components:
    • Diastole: Filling of the chamber
    • Systole: Contraction of the chamber and ejection of blood

Cardiac Output

  • Cardiac Output (CO) = Stroke Volume (SV) x Heart Rate (HR)
  • Stroke Volume: Amount of blood ejected from the ventricle in one contraction
  • Heart Rate: Number of cardiac cycles in one minute

Determination of Stroke Volume

  • Preload: Amount of blood delivered to the chamber.
  • Contractility: Efficiency and strength of contraction.
  • Afterload: Resistance to forward blood flow by the vessel walls.

Major Factors affecting Cardiac Stroke Volume

  • Preload
  • Afterload
  • Contractility
  • Wall motion abnormalities
  • Valvular dysfunction

Autonomic Nervous System

  • Sympathetic Nervous System: Increases heart rate, conduction, and contractility.
  • Parasympathetic Nervous System: Decreases heart rate and conduction times.

Arterial Blood Pressure

  • Mean Arterial Pressure (MAP) is proportional to the product of Systemic Vascular Resistance (SVR) × Cardiac Output (CO).
  • MAP can be estimated by: Diastolic pressure + Pulse pressure / 3 or 2 × Diastolic pressure + Systolic pressure / 3.

Control of Arterial Blood Pressure

  • Immediate Control: Autonomic nervous system controls blood pressure minute by minute using baroreceptors.
  • Intermediate Control: Activation of the renin-angiotensin aldosterone system and arginine vasopressin (AVP) secretion are stimulated by sustained decrease in blood pressure. Both angiotensin II and AVP increase vasoconstriction.
  • Long-term Control: Kidney alters sodium and water balance to restore blood pressure to normal.

Effects of Anesthetic Agents

  • Volatile anesthetic agents can cause coronary vasodilation, reducing myocardial metabolic requirements.
  • Volatile agents are beneficial in experimental myocardial ischemia and infarction.

Pathophysiology - Pericardial, Myocardial and Endocardial Disease

  • Pericarditis: Inflammation of the pericardium.
  • Effusion: Excess fluid/blood/pus in the pericardial sac.
  • Tamponade: Compression of the heart due to pericardial effusion.
  • Myocarditis: Inflammation of the myocardium.
  • Cardiomyopathies: Dilatation, hypertrophy or non-compliance of the myocardium.
  • Infective Endocarditis: Infective organisms invade the endothelium of the heart, affecting valves and causing vegetations.

Pathophysiology - Valvular Heart Disease

  • Stenosis: Valve cannot open fully restricting forward blood flow, increasing afterload leading to hypertrophy.
  • Regurgitation (Insufficiency, Incompetence): Valve cannot close fully, permitting backward blood flow, increasing volume load leading to chamber dilation.
  • Rheumatic Heart Disease: Inflamation and scarring of the valves.
  • Infective Endocarditis: Infective organisms invade the heart valves causing vegetations.

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Description

Explore the mechanisms of blood flow through the heart, including the pulmonary and systemic circuits. Understand the coronary circulation and the electrical conduction system that governs cardiac function. This quiz will test your knowledge on key concepts related to heart physiology.

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