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Learning outcomes for this module as of Fall 2019:
Please note: Those headings with associated teaching tips are underlined, clickable links. However, while this identifies which topics have associated teaching tips, the actual list of teaching tips you click through to include all teaching tips for this module, not only the ones for one particular topic in this module.
Topic from HAPS Guidelines (in bold font)
Learning Outcomes (indented, regular font)[1]
1. General functions of the cardiovascular system
1. Describe the major functions of each component of the cardiovascular system (i.e., blood, heart, blood vessels).
1. Describe the general composition of blood (e.g., plasma, formed elements).
2. Describe the composition of blood plasma.
3. List the major types of plasma proteins, their functions, and sites of production.
4. Compare and contrast the morphological features and general functions of the formed elements (i.e., erythrocytes, leukocytes, platelets).
5. List the five types of leukocytes in order of their relative prevalence in normal blood, and describe their major functions.
6. Describe the structure and function of hemoglobin, including its breakdown products.
7. Define hematocrit and state the normal ranges for adult males and females.
8. *State the normal ranges for erythrocyte counts in adult males and females, total leukocyte count, and platelet count.
3. Hematopoiesis (hemopoiesis)[2]
1. Describe the locations of hematopoiesis (hemopoiesis) and the significance of the hematopoietic stem cell (HSC or hemocytoblast).
2. Explain the basic process of erythropoiesis, the significance of the reticulocyte, and regulation through erythropoietin (EPO).
3. Explain the basic process of leukopoiesis.
4. Explain the basic process of thrombopoiesis.
4. Hemostasis
1. Describe the vascular phase of hemostasis, including the role of endothelial cells.
2. Describe the role of platelets in hemostasis and the steps involved in the formation of the platelet plug.
3. Describe the basic steps of coagulation resulting in the formation of the insoluble fibrin clot.
4. Differentiate among the intrinsic (contact activation), extrinsic (cell injury), and common pathways of the coagulation cascade.
5. Explain how the positive feedback loops in the platelet and coagulation phases promote hemostasis.
6. Explain the role of vitamin K in blood clotting.
7. Describe the process of fibrinolysis, including the roles of plasminogen, tissue plasminogen activator, and plasmin.
1. Explain the role of surface antigens on erythrocytes in determining blood groups.
2. List the type of antigen and the type of antibodies present in each ABO blood type.
3. Describe how the presence or absence of Rh antigen results in blood being classified as positive or negative.
4. Describe the development and clinical significance of anti-Rh antibodies.
5. Predict which blood types are compatible and what happens when the incorrect ABO or Rh blood type is transfused.
6. Gross and microscopic anatomy of the heart
1. Describe the position of the heart in the thoracic cavity.
2. Identify and describe the location, structure, and function of the fibrous pericardium, parietal and visceral layers of the serous pericardium, serous fluid, and the pericardial cavity.
3. Explain the structural and functional differences between atria and ventricles.
4. On the external surface of the heart identify the 4 chambers, the coronary (atrioventricular) sulcus, anterior interventricular sulcus, posterior interventricular sulcus, apex and base.
5. Identify and describe the structure and function of the primary internal structures of the heart, including chambers, septa, valves, papillary muscles, chordae tendineae, fibrous skeleton, and venous and arterial openings.
6. Describe the blood flow to and from the heart wall, including the location of the openings for the left and right coronary arteries, left coronary artery and its major branches, right coronary artery and its major branches, cardiac veins, and coronary sinus.
7. Describe the structure and functions of each layer of the heart wall (i.e., epicardium, myocardium, endocardium).
8. Describe the microscopic anatomy of the myocardium, including the location and function of the intercalated discs.
7. Physiology of cardiac muscle contraction
1. List the phases of contractile and autorhythmic cardiac muscle action potentials and explain the ion movements that occur in each phase.
2. Contrast the initiation of action potentials in cardiac autorhythmic cells, in cardiac contractile cells, and in skeletal muscle cells.
3. Explain the significance of the plateau phase in the action potential of a cardiac contractile cell.
4. Compare and contrast the molecular events of cardiac muscle contraction/relaxation and skeletal muscle contraction/relaxation.
5. Compare and contrast the role of autonomic innervation in the depolarization of cardiac pacemaker cells, ventricular contractile cells, and skeletal muscle cells.
6. Compare the refractory periods of cardiac contractile muscle and skeletal muscles.
7. Explain the role of calcium in determining the force of myocardial contraction (contractility).
8. Blood flow through the heart
1. Trace the path of blood through the right and left sides of the heart, including its passage through the heart valves, and indicate whether the blood is oxygen-rich or oxygen-poor.
9. Electrical conduction system of the heart and the electrocardiogram
1. List the parts of the electrical conduction system of the heart in the correct sequence for one contraction and explain how the electrical conduction system functions.
2. Explain why the SA node normally paces the heart.
3. Explain how the cardiac conduction system produces coordinated heart chamber contractions.
4. Name the waveforms in a normal electrocardiogram (ECG or EKG) and explain the electrical events represented by each waveform.
1. Define cardiac cycle, systole, and diastole.
2. Describe the phases of the cardiac cycle including ventricular filling, isovolumic (isovolumetric)[3] contraction, ventricular ejection, and isovolumic (isovolumetric) relaxation.
3. Relate the electrical events represented on an electrocardiogram (ECG or EKG) to the normal mechanical events of the cardiac cycle.
4. Explain how atrial systole is related to ventricular filling.
5. Relate the opening and closing of specific heart valves in each phase of the cardiac cycle to pressure changes in the heart chambers and the great vessels (i.e., blood vessels entering and leaving the heart).
6. Relate the heart sounds to the events of the cardiac cycle.
7. Define systolic and diastolic blood pressure and interpret a graph of aortic pressure versus time during the cardiac cycle.
8. Compare and contrast pressure and volume changes of the left and right ventricles during one cardiac cycle.
9. Given the heart rate, calculate the length of one cardiac cycle.
11. Regulation of cardiac output (CO), stroke volume (SV), and heart rate (HR)
1. Define cardiac output (CO) and state its units of measurement.
2. Calculate cardiac output, given stroke volume and heart rate.
3. Predict how changes in heart rate (HR) and/or stroke volume (SV) will affect cardiac output (CO).
4. Describe the concepts of ejection fraction and cardiac reserve.
5. Define end diastolic volume (EDV) and end systolic volume (ESV), and calculate stroke volume (SV) given values for EDV and ESV.
6. Define venous return, preload, and afterload, and explain the factors that affect them.
7. Explain how venous return, preload, and afterload each affect end diastolic volume (EDV), end systolic volume (ESV), and stroke volume (SV).
8. State the Frank-Starling Law of the heart and explain its significance.
9. Explain the influence of positive and negative inotropic agents on stroke volume (SV).
10. Describe the influence of positive and negative chronotropic agents on HR.
11. Explain the relationship between changes in HR and changes in filling time and EDV.
12. Describe the role of the autonomic nervous system in the regulation of cardiac output.
12. Anatomy and functional roles of the different types of blood vessels
1. Define the terms artery, capillary, and vein.
2. List the three tunics associated with most blood vessels and describe the composition of each tunic.
3. Compare and contrast tunic thickness, composition, and lumen diameter among arteries, capillaries, and veins.
4. Identify and describe the structure and function of specific types of blood vessels (i.e., elastic [conducting] arteries, muscular [distributing] arteries, arterioles, capillaries, venules, veins).
5. Define vasoconstriction and vasodilation.
6. List types of capillaries, state where in the body each type is located, and correlate their anatomical structures with their functions.
7. Describe the functional significance of the venous reservoir.
8. Define anastomosis and explain its functional significance (e.g., cerebral arterial circle [Circle of Willis]).
13. Systemic and pulmonary circuits (circulations)
1. Describe the systemic and pulmonary circuits (circulations) and explain the functional significance of each.
2. Identify the major arteries and veins of the pulmonary circuit.
3. Identify the major arteries and veins of the systemic circuit.
4. Define a portal system.
5. Describe the structure and functional significance of the hepatic portal system.
14. Fetal (prenatal) versus postnatal circulation
1. Describe the role of the placenta, umbilical vessels, ductus venosus, foramen ovale, and ductus arteriosus in fetal circulation.
2. Trace the pathway of blood flow from the placenta, through the fetal heart and body, and back to the placenta.
3. Describe the changes in major fetal cardiovascular structures (i.e., umbilical vessels, ductus venosus, ductus arteriosus, foramen ovale) that typically occur beginning at birth, and the ultimate postnatal remnants (fates) of these structures.
1. Define blood flow, blood pressure, and peripheral resistance.
2. State and interpret the equation that relates fluid flow to pressure and resistance.
3. Describe the role of arterioles in regulating tissue blood flow and systemic arterial blood pressure.
4. List the local, hormonal and neural factors that affect peripheral resistance and explain the importance of each.
5. Interpret relevant graphs to explain the relationships between vessel diameter, cross-sectional area, blood pressure, and blood velocity.
6. Using a graph of pressures within the systemic circuit, interpret the pressure changes that occur in the arteries, capillaries, and veins.
7. Given values for systolic and diastolic blood pressure, calculate pulse pressure (PP) and mean arterial pressure (MAP).
8. State the equation relating mean arterial pressure (MAP) to cardiac output (CO) and total peripheral resistance (TPR).
9. Predict and describe how mean arterial pressure (MAP) would be affected by changes in total peripheral resistance (TPR) or by changes in cardiac output (CO) or any of its components - heart rate (HR), stroke volume (SV) or preload.
10. Explain the mechanisms of capillary exchange of gases, nutrients, and wastes.
11. Describe the forces that create capillary filtration and reabsorption.
12. Explain how changes in net filtration pressure (NFP) can result in edema and how a functional lymphatic system normally prevents edema.
13. Describe how muscular compression and the respiratory pump aid venous return.
14. Explain how local control mechanisms and myogenic autoregulation influences blood flow to tissues.
15. Explain the role of the precapillary sphincter in autoregulation.
16. List some chemicals that cause either vasodilation or vasoconstriction and explain the circumstances in which they are likely to be active.[4]
17. Explain the steps of the baroreceptor reflex and describe how this reflex maintains blood pressure homeostasis when blood pressure changes.
18. Explain the role of the autonomic nervous system in regulation of blood pressure and volume.
16. Application of homeostatic mechanisms
1. Provide specific examples to demonstrate how the cardiovascular system maintains blood pressure homeostasis in the body.
17. Predictions related to disruption of homeostasis
1. Given a factor or situation (e.g., left ventricular failure), predict the changes that could occur in the cardiovascular system and the consequences of those changes (i.e., given a cause, state a possible effect).
2. *Given a disruption in the structure or function of the cardiovascular system (e.g., pulmonary edema), predict the possible factors or situations that might have created that disruption (i.e., given an effect, predict possible causes).
[1] An asterisk (*) preceding a learning outcome designates it as an optional, advanced learning outcome. The HAPS A&P Comprehensive Exam does not address these optional learning outcomes.
[2] Hematology and medical books define hematopoiesis as the production/formation of all blood cells beginning in the embryo, and hemopoiesis as the formation of new cellular components of blood in myeloid and lymphoid tissue. Therefore, hematopoiesis is inclusive of hemopoiesis, (but not vice versa).
[3] The more appropriate term is isovolumic (and not isovolumetric) because the volume within the ventricles remains constant, while the length of the cardiac muscle fibers change. We have included isovolumetric in parentheses because many people use that term, but we strongly suggest people switch to the accurate term.
[4] Some chemicals that cause vasoconstriction or vasodilation, such as natriuretic peptides and those created by the renin-angiotensin system, will be included in the Fluid/Electrolyte Module (Module Q.3)..