Circulatory System
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| What are the coverings of the heart? | fibrous pericardium and the inner serous pericardium; the inner layer can also be divided into an outer parietal & inner visceral
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| What are the 3 layers of the heart? Which is the functional layer? | From outer to inner: epicardium, myocardium, endocardium; they myocardium is the functional muscle
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| Which layer of the heart includes the connective tissue of the valves? | endocardium
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| What component of the heart is considered the pacemaker? Why? | the SA node (sinoatrial node); it initiates the impulse
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| Trace the conduction pathway | SA node initiates impulse -> left atrium -> Bachmann's bundle -> AV node -> AV bundle -> left & right bundle branches -> left & right ventricles -> Purjinke fibers - > papillary muscles -> ventricular muscles
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| What is the fossa ovalis? | a remnant of the fetal foramen ovale; ASD is atrial septa defect - if it fails to close
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| What is systole and diastole? | systole is the contraction of the heart muscle; systolic pressure is the pressure of all the arteries when the heart is contracted; diastole is relaxation of the heart muscle; pressure of all arteries when heart is relaxed
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| What is normal blood pressure? Which number is on top? | 120 mm Hg systolic/80 mm Hg diastolic
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| Trace systemic circulation: | starts at left ventricle -> aorta -> rest of body -> IVC and SVC -> right atrium (this circulation excludes circulation through the heart & lungs)
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| Trace pulmonary circulation (aka pulmonary circuit): | starts at right ventricle -> pulmonary trunk - > lungs -> pulmonary veins -> left atrium
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| Trace coronary circulation: | starts in right & left coronary arteries (which come off the aorta as soon as it leaves the heart) -> cardiac vein -> coronary sinus -> right atrium
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| What are the cardiac arteries? | right coronary artery, left main coronary artery, left circumflex; left anterior descending
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| Where do all cardiac veins drain? | into the coronary sinus
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| Does the heart have blood capillaries? | No
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| What is an EKG? | electrocardiagram - sum of electrical activity of the heart - used for diagnosis of a whole range of problems
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| What are the components of an EKG? | P wave - atrial depolarization (contraction); QRS complex - ventricular depolarization; T wave - ventricular repolarization (relaxation)
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| Why isn't the atrial repolarization included in the EKG? | it is superimposed on the QRS complex
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| What does a normal EKG look like? | it has a sinus rhythm: P wave, followed by QRS complex, followed by a T wave
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| What's the normal heart rate? | between 60-100 beats/minutes; <60 bradycardia; >100 - tachycardia
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| What are the different types of blood vessels? | arteries, arterioles, capillaries, venules, veins
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| Where are capillaries located? What is their function? | They are located inside organs; they are the site of exchange of nutrients and waste
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| What type of nutrients are supplied by the capillaries? | glucose, amino acids, fatty acids & glycerol
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| What are the wastes removed by the capillaries? | urea, uric acid, ammonia
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| What gases are exchanged in the lungs? | O2 & CO2
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| What are the layers of the walls of blood vessels (from inner to outer)? | tunica intima, tunica media, tunica externa (adventitia)
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| What is the difference in layers between veins & arteries? | same layers, just thinner in veins
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| What is the space inside blood vessels called? | lumen
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| What is the purpose for valves in the veins? | there are valves at intervals to prevent blood from pooling in the lower extremities and to prevent backflow
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| Which blood vessel wall layer has its own blood supply and why? | the tunica adventitia (externa) has its own blood supply called vaso vasurum; it is necessary because this layer is too far away from the inside of the blood vessel
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| Where are the pressure points of the arteries? | where the pulse can be felt: temporal, facial, carotid, *brachial*, *radial*, femoral, popliteal, posterior tibial, dorsalis pedis
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| Which 3 arteries come off of the aortic arch? | BCS - brachiocephalic trunk, left common carotid, left subclavian artery
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| What does the brachiocephalic trunk give rise to? | right common carotid and right subclavian
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| What are the branches of the descending aorta? | thoracic aorta, becoming the abdominal aorta after the diaphragm;
1st branch off the abdominal aorta-celiac trunk; 2nd branch-superior mesentery artery (SMA); 3rd branch-renal artery; 4th branch-mesenteric artery
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| What happens to the abdominal aorta in the pelvic region? | it bifurcates into the right & left common iliac arteries; each of these bifurcates into an external and iliac artery; the external iliac artery becomes the femoral artery once it crosses the inguinal ligament
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| Where does the external iliac artery change into the femoral artery? | after it crosses the inguiunal ligament
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| What does azygos mean? | unpaired
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| Is the hemiazygos vein the the same as the azygos vein? | No - the hemiazygos is a variation that occurs in addition to the azygos
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| What are the 3 blood supplies to/from the liver? | supplied by the hepatic artery (branch of celiac artery); drained by hepatic vein into the IVC; the hepatic portal vein brings nutrients (glucose & amino acids) from the small intestine
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| Which vein is commonly used in heart bypass operations? | great saphenous vein
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| What does a chest exam consist of? | IPPA - inspection, palpation (point of maximal intensity), percussion (feel for empty spaces, fluid, solid material), auscultation (hearing)
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| Where is the point of maximal intensity (impulse)? | in the 5th intercostal space in the mid-clavicular line, between 5th and 6th ribs
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