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BY409 - Lecture 18

Terms in this set (16)

1) What are the two major heart sounds?

2) What are these sounds caused by for each sound? Where do they coincide on the EKG?
1) Lub and Dub

2.a) Lub - Closing of the tricuspid and mitral valve
- Coincides with the latter part of the QRS complex
2.b) Dub - Closing of the aortic and pulmonary valve
- Coincide with the latter part of the T wave
1) What is another name of abnormal heart sounds? What are they?

2.a) What is a "stenotic valve" ?
2.b) What is the sound produced by a stenotic valve? Why?

3.a) What is an insufficient valve?
3b.) What is the sound produced by an insufficient valve? Why?
1) Murmurs, valve does not completely open or shut

2.a) A stiff heart valve that does not completely open
2.b) Whistling sound, due to turbulent flow of blood through the valve

3.a) Does not completely shut
3.b) Swishing sound, due to the blood leaking backwards through closed valve
1) How do we determine the type of murmur and where it's located?

2.a) Lub-Whistle-Dub : What is it?

2.b) lub-dub-whistle : What is it?

2.c) lub-swish-dub : What is it?

2.d) lub-dub-swish : What is it?
1) Time and sound of a murmur indicates if murmur is caused by AV or semilunar valves

2.a) Whistle sound so stenotic valve and semilunar valve would be open between the lub and the dub so it would be stenotic semilunar valve

2.b) Whistle sound so stenotic valve and the AV valve would be open after the dub sound, so it would be stenotic AV valve

3.c) Swish sound so insufficient valve and the sound comes from leakiness of the AV valve not closing completely, so it would be insufficient AV valve

3.d) Swish sound so insufficient valve, and the sound comes from the leakiness of the semilunar valve not closing completely, so it would be insufficient semilunar valve
1) What is the major cause of heart attacks and strokes?

2) What is atherosclerosis?

3) What does the inflammation of the arterial walls lead too?

4) What happens to the smooth muscle cells around the lipid rich core?
1) Atherosclerosis

2) Plague form in arterial wall due to inflammation of arterial wall

3)Accumulation of cholesterol, which accumulates under endothelium of arteries [form lipid rich core]

4) Begin to divide and enlarge and become benign smooth muscle tumor cells
1) What is Angina Pectoris caused by?

2) What is angina pectoris?

3) Where is pain in angina pectoris normally felt?

4) What can angina pectoris be treated with?

5) What does nitroglycerine produce and where?
1) Atherosclerosis

2) Reduced blood flow in coronary arteries that result in chest pain

3) Under upper sternum

4) Nitroglycerin and Ca++ channel blockers [verapamil]

5) Produces nitric oxide in smooth muscle in artery walls resulting in vasodilation
1) What is a heart attack normally caused by? Is it the most common death in the US?

2) What is acute myocardial infarction?

3) What is a heart attack caused by?

4) What are the two types of clots?

5) What can a lack of blood flow cause?
1) Atherosclerosis, yes =[so don't get it]

2) A heart attack

3) Blockage of coronary arteries is typically caused by a clot that was initiated by an atherosclerotic plague

4.a) Roughness of the plague can initiate a blood clot that blocks a coronary vessel
4.b) Clot could also be produced somewhere else, break off, travel some distance and block a coronary vessel
- Called thromboembolism

5) Damage myocardium which can lead to fibrillation or cardiac arrest
1) What is a stroke caused by?

2) What is a stroke?
1) Atherosclerosis

2) A thromboembolism in the brain, which causes a lack or decreased blood flow to a part of the brain
1) What is aortic-coronary bypass surgery?

2) What is normally used for the bypass?
1) A blood vessel is grafted from the aorta to the area which has reduced blood flow

2) A vein or artery removed from partient
1) What is coronary angioplasty? What does it allow?

2) What can be inserted to prevent artery from collapsing after angioplasty?

3) What can be combined to be used in carotid arteries?
1) A catheter is inserted in blocked coronary and small balloon is inflated to stretch artery and erode the plague
- Increase blood flow 3 to 4 fold

2) Stents and angioplasty
1) What is cardiac output (CO)?

2) What are the two items that CO is dependent on?

3) What is Normal CO at rest?

4) How much increase in CO can go up by in exercise? As well as liters per minute, and why?

5) What is cardiac reserve?
1) Volume of blood pumped by each ventricle per minute

2.a) Heart rate
- Approximately 72 bpm
2.b) Stroke volume
- Is the amount of blood pumped each time the ventricle contracts
- Normally about 70 mL at resting heart rate

3) Approximately 5 liters per minute

4.a) 4 to 5 fold increase in CO
4.b) 20 to 25 liters per minute
4.c) Due to increased heart rate and stroke volume

5) The difference between resting CO and maximum CO
1) What is stroke volume?

2) What can stroke volume increase due too?
1) It is variable and increases with heart rate to a maximum of about 110 mL

2.a) Increased contraction strength due to sympathetic stimulation
- Increase amount of blood ejected from the ventricle
- Not all blood is ejected from the ventricles [So amount remaining varies with heart rate]

2.b) Increased filling of the ventricles
- More blood is returned to the heart with increasing heart rate
- Increased filling with stretch muscles closer to optimal length
1) What is resting heart rate?

2) What does heart rate increase with?

3) What can maximal heart rate be calculated by?
1) Approximately 72 bpm

2) Exercise, anxiety, etc

3) Approximately 220 minus your age
1) Where are most blood cells produced?

2) What is the bone marrow?
1) In bone marrow by stem cells

2) Largest organ in body, one of the most active tissue (mitotically active), and contains pluripotent uncommitted stem cells (give rise to all blood cells)
1) What are type of white blood cells?

2) How many WBC are there per microliter (uL)?

3) How many WBC are there during infection?

4) What do WBC play a role in?
1) Neutrophils, eosinophils, basophils, monocytes, lymphocytes

2) 4000 to 11000, which are less than 1% of all blood cells

3) Levels can increase to 25,000 per microliter

4) The immune system
1) How many erythrocytes are there per microliter (uL)?

2)How much of the blood do erythrocytes represent?

3) How long do erythrocytes survive for?

4) Explain the structure of the erythrocytes, and they are just big enough to fit through what?

5) What are erythrocytes specialized for?

6) In mammals what do erythrocytes lack?

7) What are erythrocytes capable of that other cells are not?
1) 5 million per microliter

2) 99%

3) 120 days

4) biconcave in shape, 8 microns by 2 microns, and just big enough to fit through capillaries in a single file line

5) Containing hemoglobin for carrying oxygen [4 iron containing heme groups]

6) Lack ribosomes, nucleus, and organelles, so they can oxygen

7) Anaerobic respiration
1) What is erythropoietin (EPO)?

2) What do erythropoietin stimulates?

3) What is EPO used to treat patient with?

4) What is EPO used illegally for?
1) A hormone produced by kidneys in response to decreased oxygen delivery to kidneys

2) Stimulate stem cells in bone marrow to produce RBCs
- RBCs are continually produced to replace old RBCs

3) Anemia

4) Performance enhancing drug by some endurance athletes
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