1. Cardiovascular Review 1
Cardiovascular Review 1. Which of the 4 tissue types would line and cover the heart? 2. The covering from #1 would be a part of what type of membrane? What is the specific name of this membrane? 3. What do we call the portion of the membrane that adheres to the surface of the heart? 4. Of what would the myocardium be composed? 5. If the heart is controlled by the autonomic nervous system, what are the 2 neurons called that this system uses? 6. What nerve does the parasympathetic use to get to the heart? Ganglion? NT? Receptors? 7. To increase the heart rate what ganglion does the sympathetic use to deliver impulses? NT? Receptors?

2. Midsternal line 2nd rib Sternum Diaphragm Point of maximal intensity
(PMI)
(a)
660

3. Mediastinum Superior Aorta vena cava Parietal pleura (cut) Pulmonary
trunk
Left lung
Pericardium
(cut)
Apex of
heart
Diaphragm
(c)
660

4. Figure 18.2 The pericardial layers and layers of the heart wall.
Pulmonary
trunk
Fibrous pericardium
Parietal layer of
serous pericardium
Pericardium
Pericardial cavity (serous
fluid)
Myocardium
Epicardium
(visceral layer
of serous
pericardium)
Heart
wall
Myocardium
Endocardium
Heart chamber
Simple Squamous
(Endothelium)
661

5. Cardiac
muscle
bundles
Motor Unit 1
Motor Unit 2
661

6. Left To Body ventricle To Lungs Right ventricle Interventricular
septum
670

7. Figure 18.2 The pericardial layers and layers of the heart wall.
Anchors
Pulmonary
trunk
Fibrous pericardium
Parietal layer of
serous pericardium
Pericardium
Pericardial cavity
Myocardium
Epicardium
(visceral layer
of serous
pericardium)
Heart
wall
Myocardium
Endocardium
Heart chamber
Pericarditis
661

8. (right atrioventricular) valve
Pulmonary valve
Aortic valve
Area of cutaway
Mitral valve
Tricuspid valve
Myocardium
Tricuspid
(right atrioventricular)
valve
-separates the 2 motor units
-separates them electrically
-supports heart valves
Mitral
(left atrioventricular)
valve
Aortic valve
Pulmonary
valve
Fibrous
skeleton
(a)
Annulus Fibrosus
Anterior
666

9. Aorta
Left pulmonary
artery
Superior vena cava
Right pulmonary
artery
Left atrium
Left pulmonary
veins
Pulmonary trunk
Right atrium
Mitral (bicuspid)
valve
Right pulmonary
veins
Fossa ovalis
Aortic valve
Semilunar
Valves
Pectinate muscles
Pulmonary valve
Tricuspid valve
Left ventricle
Right ventricle
Papillary muscle
Chordae tendineae
Interventricular
septum
Trabeculae carneae
Epicardium
Inferior vena cava
Myocardium
Endocardium
(e) Frontal section
Interatrial Septum
665

10. 667 Blood returning to the heart fills atria, putting Direction of
pressure against
atrioventricular valves;
atrioventricular valves are
forced open. 1
Direction of
blood flow
Atrium
Cusp of
atrioventricular
valve (open)
As ventricles fill,
atrioventricular valve flaps
hang limply into ventricles. 2
Chordae
tendineae
Atria contract, forcing
additional blood into ventricles. 3
Papillary
muscle
Ventricle
(a) AV valves open; atrial pressure greater than ventricular pressure
Atrium
Ventricles contract, forcing
blood against atrioventricular
valve cusps. 1
Cusps of
atrioventricular
valve (closed)
Atrioventricular valves
close. 2
Blood in
ventricle
Papillary muscles
contract and chordae
tendineae tighten,
preventing valve flaps
from everting into atria. 3
(b) AV valves closed; atrial pressure less than ventricular pressure
667

11. 668 Aorta Pulmonary trunk As ventricles contract and intraventricular
pressure rises,
blood is pushed up
against semilunar
valves, forcing them
open.
(a) Semilunar valves open
As ventricles relax
and intraventricular
pressure falls, blood
flows back from
arteries, filling the
cusps of semilunar
valves and forcing
them to close.
(b) Semilunar valves closed
668

12. Clicker Question: Which of the following is the correct sequence for blood to pass through part of the heart? A. Right atrium-> mitral valve-> right ventricle-> pulmonary semilunar valve B. Right atrium-> tricuspid valve -> right ventricle-> aortic semilunar valve C. Left atrium-> mitral valve-> left ventricle-> aortic semilunar valve D. Left atrium-> tricuspid valve-> left ventricle-> aortic semilunar valve

13. (a) The major coronary arteries
Aorta
Pulmonary
trunk
Superior
vena cava
Left atrium
Anastomosis
(junction of
vessels)
Left
coronary
artery
In Left atrioventricular sulcus
Right
atrium
Circumflex
artery
Right
coronary
artery
In Right atrioventricular sulcus
Left
ventricle
Right
ventricle
Anterior
interventricular
artery
Right
marginal
artery
Posterior
interventricular
artery
In Anterior Interventricular Sulcus
In Posterior Interventricular Sulcus
(a) The major coronary arteries
670

14. (b) The major cardiac veins
Superior
vena cava
Great
cardiac
vein
Anterior
cardiac
veins
Coronary
sinus
Small cardiac vein
Middle cardiac vein
(b) The major cardiac veins
670

15. Aorta
Above armpits
Left pulmonary
artery
Superior vena cava
Right pulmonary
artery
Left atrium
Left pulmonary
veins
Pulmonary trunk
Right atrium
Mitral (bicuspid)
valve
Right pulmonary
veins
Fossa ovalis
Aortic valve
Pectinate muscles
Pulmonary valve
Tricuspid valve
Left ventricle
Right ventricle
Papillary muscle
Chordae tendineae
Interventricular
septum
Trabeculae carneae
Epicardium
Inferior vena cava
Myocardium
Below armpits
Endocardium
“Lub” “Dub”
Systole & Diastole
Veins = towards heart
Arteries = away from heart
(e) Frontal section
665

16. Blood flow through Coronary Vessels
Aortic blood pressure
Intramural blood pressure

17. (a) Anatomy of the intrinsic conduction system showing the
Autorhythmic Cells
Superior vena cava
Contractile Cells 1%
Right atrium
100 BPM
Atria Contract
The sinoatrial (SA)
node (pacemaker)
generates impulses. 1
Intercalated Discs
Internodal pathway
The impulses
pause (0.1 s) at the
atrioventricular
(AV) node. 2
Gatekeep-er
40 BPM
Left atrium
The atrioventricular
(AV) bundle (Bundle of His)
connects the atria
to the ventricles. 3
Purkinje
fibers
The bundle branches
conduct the impulses
through the
interventricular septum. 4
Inter-
ventricular
septum
The Purkinje fibers
depolarize the contractile
cells of both ventricles. 5
(a) Anatomy of the intrinsic conduction system showing the
sequence of electrical excitation
675

18. Sarcomeres 672 Nucleus Intercalated discs Cardiac muscle cell
Gap junctions
Desmosomes
(a)
Cardiac muscle cell
Mitochondrion
Nucleus
Intercalated
disc
Mitochondrion
T tubule
Sarcoplasmic
reticulum
Z disc
Nucleus
Sarcolemma
(b)
I band
A band
I band
Sarcomeres
672

19. Autorhythmic and Contractile Cell Depolarizations

20. Dorsal motor nucleus of vagus
The vagus nerve
(parasympathetic)
decreases heart rate.
Cardioinhibitory center
Para.
Medulla oblongata
Cardiac Center
Cardio-
acceleratory
Center
Symp.
Sympathetic trunk ganglion
Thoracic spinal cord
Sympathetic trunk
Sympathetic cardiac
nerves increase heart rate
and force of contraction.
Vagus
-ACH to Muscarinic
-K+ ion channels open
-SA, AV
Cardiac
-NE to Beta
-Ca+2 ion channels open
-SA, AV & Myocardium
AV node
SA node
Parasympathetic fibers
At rest vagus dominates = Vagal tone
Sympathetic fibers
Interneurons
677

22. Brain
Sensory nerve fiber in cranial nerve IX
(pharyngeal branch of glossopharyngeal)
External carotid artery
Internal carotid artery
Carotid body
Common carotid artery
Cranial nerve X (vagus nerve)
Sensory nerve fiber in
cranial nerve X
Aortic bodies in aortic arch
Aorta
Heart
837

24. Factors that Increase HR Increased Carbon Dioxide Decreased Blood Pressure Bainbridge Reflex Adrenaline Hypercalcemia Factors that Decrease HR Decreased Carbon Dioxide Increased Blood Pressure Hyperkalemia Hypernatremia Hypocalcemia

25. Approximately 70ml from each ventricle App 70 BPM
CO2
Ions
Bainbridge
Exercise (by
skeletal muscle and
respiratory pumps;
see Chapter 19)
Heart rate
(allows more
time for
ventricular
filling)
Bloodborne
epinephrine,
thyroxine,
excess Ca2+
Exercise,
fright, anxiety
Venous
return
Sympathetic
activity
Parasympathetic
activity
Contractility
EDV
(preload)
ESV
Starling’s Law
CO=HR x SV
EDV-ESV
Stroke
volume
Heart
rate
Approximately 70ml from each ventricle
App 70 BPM
Cardiac
output
ml/min
Increased CO= Increased BP
Initial stimulus
Physiological response
Result
Blood loss?
682

26. Clicker Question Select the correct statement about cardiac output. A
Clicker Question Select the correct statement about cardiac output. A. A slow heart rate increases end diastolic volume, stroke volume and force of contraction. B. Decreased venous return will result in increased end diastolic volume. C. If a semilunar valve were partially obstructed, the end systolic volume in the affected ventricle would be decreased. D. Stroke volume increases if end diastolic volume decreases.

27. Depolarization & Atrial Rep.
QRS complex
Sinoatrial
node
Ventricular
Depolarization & Atrial Rep.
Ventricular
repolarization
Atrial
depolarization
Atrioventricular
node
S-T
Segment
P-Q
Interval
Q-T
Interval
677

28. SA node 678 Slide 1 SA node R R T P P T Q S
Depolarization
Repolarization R
SA node R P T Q P T S 1
Atrial depolarization, initiated by the SA node, causes the P wave. Q S 4
Ventricular depolarization is complete.
AV node R R P T P T Q S 2 Q
With atrial depolarization complete, the impulse is delayed at the AV node. S 5
Ventricular repolarization begins at apex, causing the T wave. R R P T P T Q S Q 3 S
Ventricular depolarization begins at apex, causing the QRS complex. Atrial repolarization occurs.
Ventricular repolarization is complete. 6
678

29. Arrhythmias Heart Block Bradycardia Tachycardia Fibrillation Myocardial Infarction

30. Treatments Remove tissue Beta blockers (High blood pressure) Calcium Channel blockers (High blood pressure) Digitalis (Slows rate and strengthens contractions; heart failure) Pacemaker