1. Anatomy and Haemodynamics

Question 1

Capillaries are composed of…..

Answer 1

A single layer of endothelial cells surrounded by basal lamina

Question 2

What do tissues that are more metabolically active have?

Answer 2

Higher capillary density

Question 3

What is perfusion rate?

Answer 3

Rate of blood flow

Question 4

Anatomically where does the apex of the heart lie?

Answer 4

At the left fifth intercostal space

Question 5

What are the two layers of the pericardial sac?

Answer 5

Parietal and visceral layers

Question 6

What condition does excessive fluid build-up in the pericardium lead to?

Answer 6

Cardiac tamponade

Question 7

What is pericardiocentesis?

Answer 7

Removal of fluid from the pericardium

Question 8

What two structures is the transverse pericardial sinus behind?

Answer 8

The pulmonary trunk of the pulmonary arteries and the ascending aorta

Question 9

What is the oblique sinus?

Answer 9

The point posterior to the heart where the parietal and visceral layers of the pericardial sac are continuous with one another

Question 10

What coronary artery often gets blocked in an MI

Answer 10

Anterior interventricular artery

Question 11

What is the coronary sinus? Where does it drain into?

Answer 11

Main venous drainage of the heart, into the right atrium

Question 12

What is blood serum?

Answer 12

Plasma minus clotting factors (fibrinogen)

Question 13

What is the commonest cause of increased plasma viscosity and therefore slugging of blood in peripheries?

Answer 13

Multiple myeloma (cancer of plasma cells)

Question 14

What can lead to increased whole blood viscosity?

Answer 14

Polycythaemia (inc RBC), thrombocythaemia (inc platelets), leukaemia (inc WBC), inc plasma viscosity

Question 15

What is CRP?

Answer 15

C-reactive protein. Is an acute phase plasma protein, which increases in response to inflammation, so is used as a measure of inflammation. Can lead to minor changes in plasma viscosity.

Question 16

What is laminar blood flow?

Answer 16

Blood flowing in streamlines, with each layer remaining the same distance from the wall. The velocity of blood in the centre is greatest.

Question 17

What is turbulent flow?

Answer 17

Blood flowing in all directions and continually mixing

Question 18

What causes turbulent flow?

Answer 18

Rate of blood flow becomes too great, passes by an obstruction in the vessel, makes a sharp turn, passes over a rough surface, increased resistance to blood flow

Question 19

What is a thrill?

Answer 19

Vibration accompanying a cardiac or vascular murmur that can be palpated

Question 20

What is a bruit?

Answer 20

An abnormal sound generated by turbulent flow of blood in an artery due to a stenosis

Question 21

What causes the diacritic notch in a descending aorta pressure tracing?

Answer 21

Closure of the aortic valve

Question 22

How do you calculate pulse pressure?

Answer 22

Systolic pressure-diastolic pressure

Question 23

How do you calculate mean arterial pressure?

Answer 23

Diastolic pressure+1/3 pulse pressure

Question 24

What does mean arterial pressure have to fall below for organ perfusion to be impaired?

Answer 24

70 mm Hg

Question 25

What is the strength of a pulse determined by?

Answer 25

Force with which the left ventricle is able to eject blood, and the pulse pressure

Question 26

What is a pulse

Answer 26

The shockwave that arrives shortly before the blood itself

Question 27

What can reduced pulse volume result from?

Answer 27

Left ventricular failure, aortic valve stenosis, hypovolaemia

Question 28

What does bradychardia do to the pulse pressure?

Answer 28

Widens the pulse pressure and leads to a bounding pulse (strong pulse)

Question 29

What can increase pulse pressure other than bradycardia?

Answer 29

Low peripheral resistance eg in exercise and pregnancy

Question 30

Where does the left coronary artery arise from?

Answer 30

Left aortic sinus, above left flap of aortic valve