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 CO 2, 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