PART ONE General Characteristics of the Cardiovascular System

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1 HUMAN ANATOMY & PHYSIOLOGY CARDIOVASCULAR SYSTEM Chapter 15 Notes OBJECTIVES HOLE S HA&P CHAPTER FIFTEEN 1. Discuss the functions of the organs of the cardiovascular system. 2. Distinguish between the various coverings of the heart and the layers that compose the wall of the heart. 3. Identify and locate the major parts of the heart and discuss the function of each part. 4. Trace the pathway of the blood through the heart and the vessels of coronary circulation. 5. Describe the cardiac cycle and explain how heart sounds are produced. 6. Identify the parts of a normal ECG pattern and discuss the significance of this pattern. 7. Explain control of the cardiac cycle. 8. Compare the structures and functions of the major types of blood vessels. 9. Describe how substances are exchanged between blood in capillaries and the tissue fluid surrounding body cells. 10. Explain how blood pressure is produced and controlled. 11. Describe the mechanisms that aid in returning venous blood to the heart. 12. Compare the pulmonary and systemic circuits of the cardiovascular system. 13. Identify and locate the major arteries. PART ONE General Characteristics of the Cardiovascular System Cardio Vascular CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 1

2 LOCATION OF THE HEART IN THE THORACIC CAVITY The heart is a cone-shaped organ approximately the size of a fist and is located within the mediastinum, or medial cavity, of the thorax. It is flanked laterally by the lungs, posteriorly by the vertebral column, and anteriorly by the sternum. Its more pointed apex extends slightly to the left and rests on the diaphragm, approximately at the level of the fifth intercostal space. Its broader base, from which the great vessels emerge, lies beneath the second rib and points toward the right shoulder. In situ, the right ventricle of the heart forms most of the anterior surface. 1. The drawing at the right shows the heart within the chest cavity. Color the following parts on the diagram. Pericardium-covered heart (A) Superior vena cava (B) Pulmonary trunk (C) Pulmonary artery (D) Pulmonary vein (E) Aortic arch (F) Thoracic aorta (G) Trachea (H) Esophagus (I) THE WALL OF THE HEART The heart is enclosed within a double walled fibrous sac called the pericardium. The thin visceral pericardium, or epicardium, which is closely applied to the heart muscle, reflects downward at the base of the heart to form its companion serous membrane, the outer, loosely applied parietal pericardium, which is attached at the heart apex to the diaphragm. Serous fluid produced by these membranes allows the heart to beat in a relatively frictionless environment. The serous parietal pericardium lines the loosely fitting superficial fibrous pericardium composed of dense connective tissue. Inflammation of the pericardium, pericarditis, causes painful adhesions between the serous pericardial layers. CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 2

3 These adhesions interfere with heart movements. The wall of the heart is composed primarily of cardiac muscle the myocardium which is reinforced internally by a dense fibrous connective tissue network. The endocardium is the thin, inner lining of the heart. It is composed of simple squamous epithelium and some connective tissue. The endocardium is continuous with the inner lining of the blood vessels. 2. The drawing at the right shows the wall of the heart and the pericardium. Color the following parts on the diagram. Endocardium (A) Myocardium (B) Visceral Pericardium (C) Pericardial cavity (D) Parietal pericardium (E) Fibrous pericardium (F) 3. What is the covering around the heart called? 4. What is the function of the fluid filled sac surrounding the heart? 5. Identify the layer of the heart wall (EPIcardium, MYOcardium, or ENDOcardium) described below. Outer layer Thick muscular layer Continuous with the inner lining of blood vessels Innermost layer Also called visceral pericardium Middle layer Composed of simple squamous epithelium & some connective tissue CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 3

4 HEART CHAMBERS & VALVES The heart is divided into four chambers; two superior atria and two inferior ventricles, each lined with a thin serous lining called the endocardium. The septum that divides the heart longitudinally is referred to as the interatrial or interventricular septum, depending on which chambers it separates. Functionally, the atria are receiving chambers and are relatively ineffective as pumps. Blood flows into the atria under low pressure from the veins of the body. The right atrium receives relatively oxygen-poor blood from the body via the superior and inferior vena cava. Four pulmonary veins deliver oxygen-rich blood from the lungs to the left atrium. The inferior thick walled ventricles, which form the bulk of the heart, are the discharging chambers. They force blood out of the heart into the large arteries that emerge form its base. The right ventricle pumps blood into the pulmonary trunk, which routes flood to the lungs to be oxygenated. The left ventricle discharges blood into the aorta, from which all systemic arteries of the body diverge to supply the body tissues. Four valves enforce a one way blood flow through the heart chambers. The atrioventricular (AV) valves, located between the atrial and ventricular chambers on each side, prevent backflow into the atria when the ventricles are contracting. The left atrioventricular valve, also called the mitral or bicuspid valve, consists of two cusps, or flaps, of endocardium. The right atrioventricular valve, the tricuspid valve, has three cusps. Tiny white collagenous cords called the chordae tendineae (literally, heart strings) anchor the cusps to the ventricular walls. The chordae tendineae originate from small bundles of cardiac muscle, called papillary muscles, project from the myocardial wall. When blood is flowing passively into the atria and then into the ventricles during diastole (the period of ventricular relaxation), the atrioventricular valve flaps hang limply in the ventricular chambers and then are carried passively toward the atria by the accumulating blood. When the ventricles contract (systole) and compress the blood in their chambers, the intraventricular blood pressure rises causing the valve flaps to be reflected superiorly, which closes the AV valves. The chordate tendineae, pulled taut by the contracting papillary muscles, anchor the flaps in a closed position preventing backflow into the atria during ventricular contraction. If unanchored, the flaps would blow upward into the atria rather like an umbrella being turned inside out by a strong wind. The second set of valves, the pulmonary and aortic semilunar valves, each composed of three pocket-like cusps, guards the bases of the two large arteries leaving the ventricular chambers. The valve cusps are forced open and flatten against the walls of the artery as the ventricles discharge their blood into the large arteries during systole. However, when the ventricles relax, blood flows backward toward the heart and the cusps fill with blood, closing the semilunar valves and preventing arterial blood form reentering the heart. CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 4

5 6. The drawing below shows the internal structures of the heart and the great vessels attached to the heart. Color the following parts on the diagram. 7. What is the function of the valves inside the heart? 8. Complete the following by filling in the blanks with the correct heart valve. The prevents backflow of blood from the right ventricle into the right atrium. The prevents back flow of blood from the left ventricle into the left atrium. The prevents back flow of blood from the aorta into the left ventricle. The prevents back flow of blood from the pulmonary trunk into the right ventricle. CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 5

6 9. Describe what happens during: a. Diastole. b. Systole. 10. Identify the parts on the following diagrams CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 6

7 11. Identify the parts on the following diagrams CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 7

8 12. Color the following parts on the diagram below. Deoxygenated blood (A) Capillary blood (B) Oxygenated blood (C) Systemic circulation (D) Pulmonary circulation (E) The heart functions as a double pump. The right side serves as the pulmonary circulation pump, shunting the carbon dioxide rich blood entering its chambers to the lungs to unload carbon dioxide and pick up oxygen, and then back to the left side of the heart. The function of this circuit is strictly to provide for gas exchange. The second circuit, which carries oxygen rich blood from the left heart through the body tissues and back to the right heart is called the systemic circulation. It supplies the functional blood supply to all body tissues. CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 8

9 13. Trace the path of blood through the heart by coloring the arrows on the diagram below. The shaded arrows show the path of deoxygenated blood. Use blue to color the shaded arrows. The other arrows show the path of oxygenated blood. Use red to color these arrows. 14. Identify the type of blood (Oxygenated or Deoxygenated) carried or pumped by each of the following structures. Use the drawing in the previous question for help. Aorta Inferior vena cava Left atrium Left ventricle Pulmonary trunk/arteries Pulmonary veins Right atrium Right ventricle Superior vena cava CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 9

10 15. Identify the heart chambers represented by the numbers in the drawing from the previous question Use the word list below to complete the following. Aorta Inferior vena cava (IVC) Left atrium Left ventricle Pulmonary arteries Pulmonary veins Right atrium Right ventricle Superior vena cava (SVC) The and carry blood into the right atrium. The pumps blood into the right ventricle. The pumps blood into the pulmonary trunk. The carry blood to the lungs. The carry blood to the left atrium. The pumps blood into the left ventricle. The pumps blood into the aorta. The carries blood to the body. 17. What is an Auricle? 18. Strong, fibrous strings that attach to the cusps of the tricuspid valve are called: CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 10

11 15.4 BLOOD VESSELS Closed circuit PART TWO Misc. Arteries Arterioles Capillaries Venules CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 11

12 Veins 19. Trace a drop of blood through the body and heart! a. Aortic Valve b. Arteries c. Arterioles d. Bicuspid valve e. Capillaries f. Left Atrium g. Left Ventricle h. Lung i. Pulmonary Trunk (arteries) j. Pulmonary Valve k. Pulmonary Veins l. Right Atrium m. Right Ventricle n. Tricuspid Valve o. Veins p. Vena Cavas q. Venules CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 12

13 BLOOD SUPPLY TO THE HEART ITSELF It is a muscle and all muscles need a blood supply! Coronary Arteries Thrombus or Embolus Myocardial Infarction (MI) RETURN OF VENOUS BLOOD TO THE HEART A SMALL PRESSURE GRADIENT DRIVES BLOOD TOWARD THE HEART Blood flows from regions where its mechanical energy is high to regions where it is low. When we are in a recumbent position, most of this energy is in the form of pressure. As blood passes through the narrow arterioles and capillaries, the pressure falls substantially. In many venules, blood pressure is around 15 mm Hg. In the atria, the average pressure is close to 0 mm Hg. It follows that there is a small but definite pressure gradient available to force blood back to the heart. The fact that this small gradient (approximately 15 mm Hg) is sufficient to drive large volumes of blood demonstrates the low resistance of the venous pathway. Even veins that appear to be collapsed have a low resistance because the apparent creases in the vessel are never really flat; they always leave some space that can be easily traversed by circulating blood. CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 13

14 1. The diagram below shows the pressure gradient discussed in the above paragraph. Color the following diagram. Use Blue for A, Red for C, and Purple for D. 2. What happens to the pressure as blood moves from the arteries into the capillaries? 3. What happens to the pressure as blood moves form through the capillaries and into the veins? 4. Explain how the small pressure gradient between aids in the return of blood to the heart. MUSCLE CONTRACTION PUSHES VENOUS BLOOD In addition to pressure gradients, there are other mechanisms that aid venous return of blood to the heart. These include pumping actions of noncardiac muscles as well as movements of the heart itself, and they depend on the valves in the veins, which point in the direction of the heart. This orientation ensures a forward flow toward the heart: blood flowing forward forces the valves open; backflow snaps them shut. The picture below shows this action in a vein lodged between two skeletal muscles. When the muscles are relaxed, blood flows forward because of the pressure gradient described above, and the vein fills with blood. The contracting muscles squeeze on the vein and force blood in all directions. Blood flowing backward closes the bottom valve, but forward-flowing blood keeps the upper valve open so that blood spurts in the forward direction. When the muscle relaxes, there is no longer any external force pushing on the venous walls: the pressure gradient from below (farthest from the heart) forces blood flow in the forward direction, opening the lower valve and reestablishing the initial condition. CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 14

15 Thus, each time the muscle contracts and relaxes a spurt of venous blood is sent toward the heart. This action is called the muscle pump. A good illustration of the importance of the muscle pump in exercise is provided when a runner remains motionless just after finishing a strenuous race. His cardiac output is still high and his capillaries and small blood vessels are still dilated in response to the exercise. Without the muscle pump the veins are quickly drained, venous return to the heart decreases, and the cardiac output may falter sufficiently to compromise the blood supply to the brain. Fainting can be avoided if the runner continues mild exercise for a few minutes. 5. What causes the valves in the veins to open? 6. What causes the valves in the veins to close? 7. Describe how the muscle pump works. 8. A runner who remains motionless after completing a strenuous race may faint. Why? 9. Color the following parts on the diagram below. CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 15

16 10. Examine the cross section of an artery and vein at the right. Which letter represents the artery? How do you know this is an artery? Which letter represents the vein? How do you know this is the vein? 11. Use the key below to identify the blood vessel being described. A. Arteries B. Arterioles C. Capillaries D. Venules E. Veins Efferent blood vessels Carry blood away from Walls consist of 3 layers Walls 1 cell layer thick Have valves Branch to form arterioles Converge to form veins Provide large surface area for exchange of materials Afferent blood vessels Carry blood to the heart heart Have the thickest walls Walls consist of only endothelium Branch to form capillaries Converge to form venules Smallest, most numerous b.v.s Site of diffusion 12.What factors are involved in the movement of blood to the heart? 13.What is the role of valves in the veins? 14.Explain what goes wrong when varicose veins appear on legs. 15.How can you tell by simple observation whether bleeding is arterial or venous? CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 16

17 16. Match the artery with the correct letter from the diagram. Abdominal aorta Aorta Brachiocephalic Left axillary artery Left common carotid artery Left common iliac artery Left external iliac artery Left subclavian artery Right axillary artery Right common carotid artery Right common iliac artery Right external iliac artery Right subclavian artery Thoracic aorta 17. Match the vein with the correct letter from the diagram. Brachiocephalic vein Inferior vena cava Left common iliac vein Left external iliac vein Left subclavian vein Right common iliac vein Right external iliac vein Right external jugular vein Right subclavian vein Superior vena cava CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 17

18 18. Match the artery or vein with the correct letter from the diagram. Abdominal aorta Aorta Common carotid artery Common iliac artery Common iliac vein External iliac artery External iliac vein External jugular vein Inferior vena cava Subclavian artery Subclavian vein Superior vena cava Thoracic aorta CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 18

19 15.3 HEART ACTIONS PART THREE Cardiac Cycle Systole Diastole CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 19

20 THE FIVE PERIODS OF THE CARDIAC CYCLE ATRIAL CONTRACTION Atrial contraction is signaled by the P wave of the ECG. As atrial pressure rises, blood is thrust into the ventricles through the open AV valves. These valves are open (as they have been throughout the diastole) because pressure in the atrium is higher than pressure in the quiescent ventricle. Blood enters the ventricle but cannot leave because the aortic valves are closed (pressure in the aorta is greater than the pressure in the ventricle). Note that the resulting volume increase on the ventricular volume curve appears as a small bump. The atrium serves as a booster pump, but its contribution to ventricular filling is small; most of the ventricular filling occurred earlier, when both atrium and ventricle were at rest. When the heart rate goes up, as in exercise, there is less time between beats for filling, and the atrial contribution becomes more significant. ISOVOLUMETRIC VENTRICULAR CONTRACTION Now the impulse invades the ventricles (QRS in the ECG), and, after a short delay, they begin to contract. This is the beginning of systole. Ventricular pressure builds up steeply and quickly exceeds atrial pressure. The AV valves snap shut, producing the first heart sound Lupp or Lub. Following closure of the AV valves, ventricular pressure continues to rise steeply until it exceeds aortic pressure. Pressure rises rapidly because both sets of heart valves are closed. The heart continues to contract, but there is no place for the blood to go to relieve the ascending pressure. (Contraction of the heart during this period is similar to an isometric contraction in skeletal muscle.) During this period, the ventricular volume cannot change note the flat horizontal trace on the ventricular volume curve. The constant ventricular volume is the reason for naming this period isovolumetric ventricular contraction. VENTRICULAR EJECTION As soon as the ventricular pressure exceeds aortic pressure, the aortic valves are thrust open, and blood is ejected into the aorta. Pressure in the aorta begins to rise because blood is entering from the ventricles faster than it can leave through the smaller arteries. Prior to this time, pressure in the aorta had been falling because the aortic valves were closed; blood continued to leave the aorta through smaller arteries, but none could enter from the ventricle. Blood entering the ventricles is reflected in the ventricular volume curve, which drops precipitously as soon as ejection begins. Soon afterward, the contractile force of the ventricle wanes; the ventricular pressure ascent slows and begins to reverse while the initial rapid change in ventricular volume begins to level off. As the ventricles begin to repolarize (T wave of the ECG) and relax, the ventricular pressure curve crosses the aortic curve and goes below it. Shortly thereafter, the aortic valve snaps shut, producing a sharp Dup sound (the second heart sound) and bringing the ventricular ejection period, as well as the period of systole, to an end. It also produces a bump notch on the aortic pressure curve. The aortic valve closure is not simultaneous with the crossover of the ventricular and aortic pressure curves because the blood flowing through the valves has an appreciable momentum (mass X velocity) in the direction of forward flow. Applying a force (pressure difference) in the opposite direction requires a small amount of time to stop or reverse the motion. (Imagine trying to stop a rolling automobile with a hand push in the opposite direction.) Notice that not all of the blood contained within the ventricle is ejected with each beat. The residual blood is almost equal to the amount ejected. CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 20

21 ISOVOLUMETRIC VENTRICULAR RELAXATION Now, as in isovolumetric contraction, both valves are closed, and blood cannot enter or leave the ventricles. This time, however, the ventricular muscles relax; it is the beginning of diastole. Pressure falls precipitously, but ventricular volume does not change. Soon the ventricular pressure falls below atrial pressure, the AV valves open, and isovolumetric relaxation ends. VENTRICULAR FILLING In this period, atrial pressure is higher than ventricular pressure because blood continues to flow into the atrium from the pulmonary veins. Blood flows through the open AV valve from atrium to ventricle. Ventricle filling continues throughout diastole, not just when the atrium contracts. The ventricular volume curve during diastole shows that early ventricular filling is not prominent and that contraction of the atrium contributes only a minor portion to the ventricular contents. Toward the end of this period, atrial contraction ensues, and this period, as well as diastole, ends with closure of the AV valves. DIRECTIONS FOR COLORING THE DIAGRAM ON NEXT PAGE 1. Pick colors for each item listed in the key below. Use red for Blood (F). o Left atrium (A) o AV valve (B) o Left ventricle (C) o Aortic valve (D) o Aorta (E) o Blood (F) use red 2. Using the key in #1: a. Color the titles for 1 5 and all the labeled structures in each heart diagram. Color the heart sounds and the sound bars surrounding the relevant valve. b. Color the pressure graph and refer to the relevant period in the cardiac cycle shown at the top. c. Color the volume graph and refer to the relevant period in the cardiac cycle shown at the top. 3. Pick a color, one not used in the key, to color the ECG graph. 4. Pick a color, one not used in the key, to color the bottom numbers representing the time intervals. CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 21

22 CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 22

23 CARDIAC CONDUCTION SYSTEM SA Node Atrial Syncytium Junctional Fibers AV Node AV Bundle Bundle Branches Purkinje Fibers Ventricular Syncytium CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 23

24 HEART SOUNDS Lub Dup ELECTROCARDIOGRAPHY (ECG/ EKG) General Description P Q R S T Heart Rate CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 24

25 15.5 BLOOD PRESSURE Arteriole Blood Pressure Factors affecting arterial blood pressure Heart Action Blood Volume Peripheral Resistance Viscosity Control of Blood Pressure p BP = CO x PR (recall: CO = SV x HR) & (SV = EDV-ESV) Mechanical Frank -Starling law of the heart: Increased stretch (preload) = increased strength of contraction Neural Increased sympathetic innervation increases the force of contraction which increases the percentage of EDV pumped out in a single beat. Chemical Epinephrine increases heart rate. Carbon Dioxide, Oxygen, H+ ions, Nitric Oxide, Angiotensin, Bradykinin Fear, anger, physical exercise, rise in external temperature CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 25

26 Questions 1. Match the description with the correct conduction system component. Use the key provided to indicate your answers. A. SA node B. AV node C. AV bundle & branches D. Purkinje fibers Sinoatrial node Located in the right atrium inferior to the entrance of the sup. vena cava Atrioventricular node Located in the lower atrial septum at the junction of atria and ventricles Located within the interventricular septum Located within the walls of the ventricles Pacemaker Provides the stimulus for contraction Sets the rate of depolarization for heart as whole Delays conduction of the impulse 2. Listed below are the events that cause the heart to contract. Put the steps in the correct order. Depolarization of the SA node Impulse passes along the Purkinje fibers Impulse spreads throughout the atria AV node receives impulse Impulse passes through the AV bundle AV node delays conduction of the impulse for approximately 0.1 sec. Atria contract Impulse passes through the bundle branches Ventricles contract 3. Identify the ECG wave (P, QRS, or T) described in each of the following: Atrial depolarization Depolarization wave travels from the SA node to the AV node Depolarization travels along AV bundle, bundle branches, Purkinje fibers Ventricular depolarization Ventricular repolarization Causes atria to contract Causes ventricles to contract Atria empty Ventricles empty CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 26

27 Atria fill 4. Match the ECG component and event with the correct letter from the diagram at the right. Ventricles fill T wave P wave QRS complex Depolarization of ventricles Repolarization of ventricles Depolarization of atria Causes contraction of atria Causes contraction of ventricles Ventricles empty Ventricles fill Atria empty Atria fill 5. How is the pressure on in the right side of the heart different from the pressure in the left side of the heart? Why does this difference exist? 6. The opening and closing of the valves results from the changes in pressure within the heart. Match the event with the correct cause. A. AV valves close B. AV valves open C. Semilunar valves open D. Semilunar valves close Pressure inside the ventricles is higher than the pressure inside the atria Pressure inside the larger arteries is higher than the pressure inside the ventricles Pressure inside the large arteries is lower than the pressure inside the ventricles Pressure inside the ventricles is lower than the pressure inside the atria CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 27

28 7. Identify the period of the cardiac cycle during which each of the following events occur. Use the key below to indicate your answers. 1. Atrial contraction 2. Isovolumetric ventricular contraction 3. Ventricular ejection 4. Isovolumetric ventricular relaxation 5. Ventricular filling Signaled by the P wave of the ECG Atria contract forcing blood into the ventricles Signaled by the QRS complex of the ECG Ventricles begin to contract Systole begins Pressure inside the ventricles increases until the pressure in the ventricles exceeds the pressure inside the atria Pressure inside the ventricles is lower than the pressure inside the aorta AV valves close Lupp (Lub) heart sound produced Ventricular volume cannot change Pressure inside ventricles exceeds pressure inside the aorta Semilunar valves (aortic) open Contraction of the ventricles forces blood out of the ventricles into the aorta Volume in the ventricles decreases Semilunar valves snap shut Dup heart sound produced Ventricles relax Diastole begins Pressure in the ventricles decreases AV valves open Pressure in the atria is higher than the pressure in the ventricles Blood flows from the atria into the ventricles Ventricular volume increases CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 28

29 8. Indicate if each of the following events occurs during Systole or Diastole. Ventricles contract and empty Ventricles relax and fill Atria contract and empty Atria relax and fill AV valves close Semilunar valves close 9. What would happen if the length of the quiescent (ventricular relaxation) period decreased? 10. Identify the heart sound (Lub or Dup) described in each of the following. First heart sound Second heart sound Longer, louder sound Shorter, sharper sound Associated with closure of the AV valves Associated with closure of the semilunar valves 11. Define cardiac output. 12. What two factors determine cardiac output? CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 29

30 13. Complete the following equation by filling in the missing parts. 14. What is the average heart rate for an adult at rest? 15. What does bpm represent? 16. Define stroke volume. 17. What is the average stroke volume for an adult at rest? 18. Explain the three primary factors regulating Stroke Volume. (p ) Mechanical: Neural: Chemical: 19. An increase in venous blood returning to the heart will heart rate. 20. In general, more blood entering the ventricles causes an in ventricular contraction resulting in an in cardiac output. 21. Stimulation of parasympathetic neurons causes the release of which heart rate. 22. Stimulation of sympathetic neurons causes the release of and which heart rate. CARDIOVASCULAR SYSTEM HA&P Notes Chapter 15 page 30

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