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Mammalian Test Bank > Ch 18 - The Heart > Flashcards

Ch 18 - The Heart Flashcards

1
Q

Heart muscle

A

Myocardium

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2
Q

Serous layer covering the heart muscle

A

Epicardium

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3
Q

The outermost layer of the serous pericardium

A

Parietal layer

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4
Q

SA node

A

Pacemaker of the heart

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5
Q

Found in the interventricular septum

A

AV bundle

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6
Q

Network found in the ventricular myocardium

A

Purkinje fibers

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7
Q

The point in the conduction system of the heart where the impulse is delayed

A

AV node

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8
Q

Prevents backflow into the left ventricle

A

Aortic valve

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9
Q

Prevents backflow into the right atrium

A

Tricuspid valve

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10
Q

Prevents backflow into the left atrium

A

Bicuspid valve

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11
Q

Prevents backflow into the right ventricle

A

Pulmonary valves

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12
Q

AV valve with 2 flaps

A

Bicuspid valve

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13
Q

AV valve with 3 flaps

A

Tricuspid valve

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14
Q

True or false? The myocardium receives its blood supply from the coronary arteries.

A

True

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15
Q

True or false? Cardiac muscle has more mitochondria and depends less on a continual supply of oxygen than does skeletal muscle.

A

False

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16
Q

Endocardium

A

The inner lining of the heart

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17
Q

True or false? Proper function of the heart is dependent upon blood levels of ionic sodium

A

False

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18
Q

True or false? Congestive heart failure means that the pumping efficiency of the heart is depressed so that there is inadequate delivery of blood to body tissues

A

True

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19
Q

True or false? Tissues damaged by myocardial infarction (heart attack) are replaced by connective tissue

A

True

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20
Q

True or false? The left side of the heart pumps the same volume of blood as the right

A

True

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21
Q

True or false? Chronic release of excess thyroxine can cause a sustained increase in heart rate and a weakened heart

A

True

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22
Q

True or false? The mitral valve has chordae but the tricuspid valve does not

A

False

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23
Q

True or false? Trabeculae carneae are found in the ventricles and never the atria

A

True

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24
Q

True or false? The “lub” sounds of the heart are valuable in diagnosis because they provide information about the function of the heart’s pulmonary and aortic valves

A

False

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25
Q

True or false? Autonomic regulation of heart rate is via 2 reflex centers found in the pons

A

False

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26
Q

True or false? The dicrotic notch refers to the brief rise in pressure caused by the closure of the AV valves during ventricular systole

A

False

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27
Q

True or false? An ECG provides direct information about valve function

A

False

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28
Q

True or false? As pressure in the aorta rises due to atherosclerosis, more ventricular pressure is required to open the aortic valve

A

True

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29
Q

True or false? Proxysmal atrial tachycardia is characterized by bursts of atrial contractions with little pause between them

A

True

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30
Q

Normal heart sounds are caused by _______________.

A

Closure of the heart valves

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31
Q

Cardiac reserve can be improved by ______________________.

A

Regular exercise

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32
Q

Hemorrhage with a large loss of blood causes _______________________ due to change in cardiac output

A

A lowering of blood pressure

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33
Q

The left ventricular wall of the heart is thicker than the right wall in order to do what?

A

Pump blood with greater pressure

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34
Q

Damage to the __________ is referred to as heart block

A

AV node

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35
Q

The P wave of a normal electrocardiogram indicates what?

A

Atrial depolarization

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36
Q

Blood within the pulmonary veins returns to the ___________________

A

Left atrium

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37
Q

Small muscle masses attached to the chordae tendineae are the ________________________

A

Papillary muscles

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38
Q

The term for pain associated with deficient blood delivery to the heart that may be caused by the transient spasm of coronary arteries is ___________________________.

A

Angina pectoris

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39
Q

To auscultate the aortic valve, you would place your stethoscope __________________.

A

In the second intercostal space to the right of the sternum

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40
Q

The source of blood carried to capillaries in the myocardium would be the ________________________.

A

Coronary arteries

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41
Q

When the heart is beating at a rate of 75 times per minute, the duration of one cardiac cycle is _______ seconds.

A

0.8

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42
Q

Age, gender, and body temperature influence heart rate, while _______ does not

A

Skin color

43
Q

Atherosclerosis, decline in cardiac reserve, and fibrosis of cardiac muscle are all age-related changes affecting the heart, while ____________ does NOT.

A

Thinning of the valve flaps

44
Q

If cardiac muscle is deprived of its normal blood supply, damage would primarily result from ___________.

A

Decreased delivery of oxygen

45
Q

Cardiac muscle cells are like skeletal muscle cells in that they ________________.

A

Have I and A bands

46
Q

Cardiac output is about _________ L/min

A

5.25

47
Q

The pericardial cavity contains a lubricating fluid called ________________

A

Serous fluid

48
Q

If the length of the absolute refractory period in cardiac muscle cells was the same as it is for skeletal muscle cells _______________ might occur, which would stop the heart’s pumping action

A

Tetanic contractions

49
Q

Norepinephrine acts on the heart by ______________.

A

Causing threshold to be reached more quickly

50
Q

If the vagal nerves to the heart were cut, the result would be that ___________

A

The heart rate would increase by about 25 beats per minute

51
Q

Foramen ovale connects the two atria in the ____________________

A

Fetal heart

52
Q

The stroke volume for a normal resting heart is _________ mL/beat

A

70

53
Q

Which vessel of the heart receives blood during right ventricular systole?

A

Pulmonary trunk

54
Q

Blood ejected from the ventricles enters ____________ during ventricular systole

A

Both the aorta and pulmonary trunk

55
Q

AV node, bundle of His, and SA node are part of the conduction system of the heart, while the _____ is NOT

A

AV valve

56
Q

The tricuspid valve is closed when __________

A

the ventricle is in systole

57
Q

When viewing a dissected heart, it is easy to visually discern the right and left ventricles by ____________

A

Noticing the thickness of the ventricle walls

58
Q

The AV valves are supported by ___________ so that they do not blow back up into the atria during ventricular contraction

A

Chordae tendineae

59
Q

The _____________ as applied to cardiac muscle means that the entire heart contracts as a unit or it does not contract at all

A

All-or-none law

60
Q

The ___________ is the layer of the heart that actually contracts

A

Myocardium

61
Q

Compared to skeletal muscle, cardiac muscle has ________________ that allow it to act as a functional syncytium

A

Gap junctions

62
Q

Cardiac muscle has sarcomeres with _________

A

A bands and I bands

63
Q

The deflection waves in an ECG tracing include the _____________, which indicates ventricular repolarization

A

T wave

64
Q

During the period of ventricular filling, blood flows passively through the atria and the _____________

A

Open AV valves

65
Q

The effect of endurance-type athletic training may be to lower the resting heart rate. This phenomenon is caused by _____________ of the heart muscle

A

Hypertrophy

66
Q

The second heart sound is heard during the ___________ phase of the cardiac cycle

A

Isovolumetric relaxation

67
Q

The time of the day most hazardous for heart attacks is ________________

A

Morning

68
Q

If a significant amount of connective tissue were to develop connecting the visceral and parietal pericardial layers together, the likely consequence would be __________

A

Interference with normal mechanical cardiac activity

69
Q

If we were able to artificially alter the membrane permeability of pacemaker cells so that sodium influx is more rapid, ________ and heart rate would increase

A

Threshold is reached more quickly

70
Q

A ___________ increases end diastolic volume, stroke volume, and force of contraction

A

Slow heart rate

71
Q

During contraction of heart muscle cells, some calcium enters the cell from the _______________ and triggers the release of larger amounts of calcium from ____________

A

Extracellular space; Intracellular stores

72
Q

The short period during ventricular systole when the ventricles are completely
closed chambers

A

Isovolumetric contraction

73
Q

Heart failure due to a relatively mild blow to the chest

A

Commotio cordis

74
Q

Negative chronotropic factors are factors that ______ heart rate

A

Decrease

75
Q

The enlarged coronary vessel outside the heart that empties blood into the right atrium is the __________

A

Coronary sinus

76
Q

In the fetal heart there is a ________ that allows blood to flow from the right atrium directly to the left atrium.

A

Foramen ovale

77
Q

The ________ cells of the heart do not maintain stable resting membrane potentials; therefore, they continually depolarize.

A

Autorhythmic

78
Q

Specialized conductive cells of the ventricles are called ________

A

Purkinje fibers

79
Q

The ECG T wave interval represents ________

A

Ventricular repolarization

80
Q

Cardiac output equals __________________

A

Heart rate * stroke volume

81
Q

The ________ of the serous pericardium membrane covers the heart.

A

Visceral layer

82
Q

The ________ valve of the heart has 3 valves with chordae tendineae.

A

Tricuspid

83
Q

The ________ and ________ valves of the heart have no chordae tendineae attached

A

Aortic; pulmonary

84
Q

Contraction of the muscle

A

Systole

85
Q

Relaxation of the muscle

A

Diastole

86
Q

The contraction
and relaxation of the ________ are normally described with the terms systole and
diastol

A

Ventricles

87
Q

Pulmonary circuit pump

A

Right atrium to right ventricle to pulmonary arteries to lungs

88
Q

Systemic circuit pump

A

Pulmonary veins to left atrium to left ventricle to aorta to body tissues to venae cavae

89
Q

2 important functions of the cardiac conduction system

A

To initiate and distribute impulses throughout the heart

90
Q

Why is oxygen so much more critical to the heart muscle than to skeletal muscles?

A

Cardiac muscle cells are highly dependent on oxygen and aerobic respiration, opposed to skeletal muscle cells. When forced to switch to anaerobic respiration, lactic
acid and rising H+ levels impair heart function.

91
Q

What is the functional importance of the intercalated discs of cardiac muscle?

A

Intercalated disks contain anchoring desmosomes that prevent cell separation, and gap junctions that allow ions to travel from cell to cell

92
Q

What is the

functional importance of the fibrous skeleton of the heart?

A

The fibrous skeleton is connective

tissue that reinforces the myocardium internally

93
Q

The slowing the heart rate below 60 beats per minute

A

Bradycardia

94
Q

Why is fibrosis of the cardiac muscle serious?

A

As the heart muscle stiffens it is unable to fill the atria as it once did, therefore less blood
is pumped. Further, as the muscle stiffens it takes more energy to expel the bolus of
blood from the heart which will eventually weaken the heart

95
Q

Would an ECG with an inverted QRS wave be of concern to the doctor?

A

Not normally. What has probably happened is the technician has reversed the polarity on the leads causing the inverted wave

96
Q

A 14-year-old girl undergoing a physical examination prior to being admitted to summer
camp was found to have a loud heart diastolic murmur at the second intercostal space to the
left side of the sternum. Explain the reason for the loud heart murmur associated with this girlʹs condition.

A

The heart murmur is due to incomplete closing of the pulmonary valve

97
Q

A man enters the hospital complaining of chest pain. His history includes smoking, a stressful job, a diet heavy in saturated fats, lack of exercise, and high blood pressure. Although he is not suffering from a heart attack, his doctor explains to him that a heart attack is quite possible.
What did the chest pain indicate? Why is this man a prime candidate for a heart attack?

A

His symptoms indicate angina pectoris, possibly due to either atherosclerosis or
stress-induced spasms of the coronary arteries. If the arteries are occluded
(atherosclerosis), the heart muscle could be deprived of blood, and therefore oxygen. A
heart attack could occur if the coronary vessels experience further (or progressive)
occlusion.

98
Q

An older woman complains of shortness of breath and intermittent fainting spells. Her doctor runs various tests and finds that the AV node is not functioning properly. What is the suggested treatment?

A

The suggested treatment is surgery to implant an artificial pacemaker.

99
Q

An angiocardiogram was performed on an infant and it was found that he had a patent ductus arteriosus. Discuss the location and function of the ductus arteriosus in the fetus and relate it to the reason for the boyʹs breathlessness.

A

The ductus arteriosus is a shunt between the pulmonary trunk and the aorta in the
fetus, which normally closes at birth. Pathology is due to the mixing of oxygenated and
deoxygenated blood because the connection between the aorta and the pulmonary
trunk remains slightly open

100
Q

A patient takes a nitroglycerin tablet sublingual for chest pain. Nitroglycerin acts directly on
smooth muscle, producing relaxation and vessel dilation. How would this relieve chest pain?

A

Angina pectoris is thoracic pain caused by a fleeting deficiency in blood delivery to the myocardium, with resulting decreased oxygen being delivered to the cells. Because
nitroglycerin acts as a vasodilator, blood flow is increased, promoting the delivery of oxygen to the cells.

101
Q

A patient was admitted to the hospital with chest pains. On admission, his pulse was 110 and blood pressure was 96/64. According to his history, his normal pulse rate is usually between 80 and 88 and his blood pressure runs from 120/70 - 130/80. Explain why these changes in BP and HR occur

A

Increased heart rate (measured by taking his pulse) without maintaining his normal blood pressure is suggestive of reduced stroke volume. Both a drop in blood volume and a weakened heart could cause this, but the chest pains suggest heart damage.
Failure of compensating mechanisms to maintain blood pressure suggest a serious decline in cardiac output.

102
Q

A 55-year-old male was admitted to the hospital with heart failure. He complains of
increasing shortness of breath on exertion and needing to sleep on three pillows at night. On physical assessment, the nurse determines that his ankles and feet are very swollen. Which of these symptoms reflect left-sided heart failure and which reflect right-sided heart failure?

A

Because the heart is a double pump, each side can initially fail independently of the
other. If the left side fails, pulmonary congestion occurs. The right side of the heart continues to propel blood to the lungs, but the left side does not adequately eject the returning blood into the systemic circulation. Thus, blood vessels in the lungs become engorged with blood, pressure within them increases, and fluid leaks from the circulation into the lung tissue, causing pulmonary edema.

If the right side of the heart fails, peripheral congestion occurs. Blood stagnates within
body organs, and pooled fluids in the tissue spaces impair the ability of body cells to
obtain adequate nutrients and oxygen and to rid themselves of wastes. Edema is most
noticeable in the extremities (feet, ankles, and fingers).

103
Q

Asystole is the total absence of ventricular electrical activity. Explain why defibrillation would
not be effective in this situation.

A

Defibrillation is accomplished by electrically shocking the heart which interrupts its
chaotic twitching by depolarizing the entire myocardium. In this case, the ventricles are at a total standstill and defibrillation would not be effective.

104
Q

A patient is prescribed a calcium channel blocker to prevent angina (chest pain), by decreasing the demand for oxygen. Explain why.

A

By preventing the influx of calcium ions into myocardial and vascular smooth muscle cells, calcium channel blockers inhibit the intracellular release of additional stores of calcium ions. A drug that inhibits the release of intracellular calcium ions decreases the force of myocardial contractility, thereby decreasing the oxygen demand.

Mammalian Test Bank (3 decks)

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