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Cardiorespiratory > :) > Flashcards

:) Flashcards

1
Q

on ECG, what is small box and large box on x axis?

A

small box: 40ms
large box: 0.2s

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2
Q

what is the J point on ECG?

A

The J (junction) point in the ECG is the point where the QRS complex joins the ST segment

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3
Q

how long should QRS complex usually last?

A

QRS complex: usually 60-100ms

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4
Q

what is normal PR interval?

A

120-200ms

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5
Q

calculate the HR of this ECG

A 
methods:
Heart rate (bpm) = 300 / RR interval in large squares
HR = 300/4.1 = **73 bpm**

OR

the rhythm strip should be 10seconds long, so can calculate HR as

  • R waves in rhythm strip x 6
  • HR = 11 x 6 = **66 bpm
  • use this method if irregular!!**
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6
Q

lead II records the electrical activity between which two areas?

A

right axilla and left leg

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7
Q

for each lead (I, II & III), where do you find negative and positve electrodes?

A
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8
Q

chest leads (V1-V6) view heart in which plane?

how do they change (V1-V6)?

A

horizontal plane !

V1-V6: starts in more downwards and gets more postive

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9
Q

in which patient populations do we see goblet cells futher down resp. tract than expected/

A

smokers !

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10
Q

what do the following supply?

  • right and left vertebral artery: - what do they go through to acheive this?
  • thyrocervical trunk:
  • internal thorcic artieries:
A
  • right and left vertebral artery: brain stem and cerebellum -> through the transverse foramen!
  • thyrocervical trunk: Inferior part of the thyroid gland, parathyroid glands, larynx, pharynx, platysma, brachial plexus, deep cervical and shoulder muscles, skin of the neck and shoulders
  • internal thorcic artieries: Skin and muscles of the anterior aspect of the thoracic cage and superior aspect of the abdominal wall, typical ribs, breasts, parietal pleura, sternum, pericardium and thymus.
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11
Q

what happens as a result of phrenic nerve paralysis?

A
  • results in elevation of the hemidiaphragm
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12
Q

trachea runs from where to where?

at which structures in trachea does the aorta cross over?

A

trachea: c6-t4
- aorta arches over left main bronchus and lung root

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13
Q

where does the oesphagus sit?

compared to trachea?

how does it incline?

A

oesophagus:

  • *- C6-T10**
  • inclines to the left but compressed by the aortic arch (T4) and root of left lung (left main bronchus: T5-6)
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14
Q

where do posterior intercostal arteries 1&2 orginate?

where do posterior intercostal arteries 3-12 orginate?

A

where do posterior intercostal arteries 1&2 orginate: costocervical trunk (branch that comes off subclavian arteries)

​where do posterior intercostal arteries 3-12 orginate: desecending aorta

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15
Q

where do u take a thoracentesis (a procedure to remove fluid or air from around the lungs) from?

A

below the level of the lung

mid-axillary line - 9th intercostal space in the inferior intercostal space

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16
Q

where would you do a thoracostomy (Thoracostomy is a minimally invasive procedure in which a doctor inserts a thin plastic tube into the pleural space — the area between the chest wall and lungs)

A

thoracostomy: mid-axillary line, inbetween 4th and 5th intercostal space

needle decompression: mid clavicular line, middle of 2nd / 3rd intercostal space

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17
Q

cardiac effusion is build up of fluid between which two cardiac layers?

what is the difference between build up of fluid between acute and chronic pericardial effusion before CO is reduced?

A
  • is the buildup of too much fluid between the viseral and parietal pericardium
  • acute pericardial effusion: can only accumulate about 150ml before cardiac output is reduced
  • chronic pericardial effusion: can accumlate about a litre before compromised
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18
Q

how do you manage cardiac tamponade?

A

management: pericardiocentesis Pericardiocentesis is a procedure done to remove fluid that has built up in the sac around the heart (pericardium). It’s done using a needle and small catheter to drain excess fluid.​

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19
Q

which BV drain into the right atrium and left atrium?

A

right atrium: SVC, IVC and coronary sinus

left atrium: 4 pulmonary veins - back from lungs to heart

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20
Q

the atrioventricular node is supplied by which artery?

where do myocardial infarctions predominately occur?

A
  • the atrioventricular node is located close (and supplied by the) right coronary artery.

LCA: ~ 60%
RCA: ~ 30-40%
Circumflex of LCA: ~ 15-20%

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21
Q

where does the conducting system begin in the heart?

A

The sino-atrial node is where the conducting system begins

22
Q

describe the paths of th coronary arteries - what do they both anastmose with?

A

RCA: anastomoses with circumflex branch of LCA: gives rise to posterior interventricular artery

LCA: loops around apex and branches into left anterior descending (LAD). anastamoses with posterir interventricular artery

23
Q

what is this describing:

The WHAT are rounded or irregular muscular columns which project from the inner surface of the right and left ventricle of the heart

A

trabeculae carnae

24
Q

what determines the race of firing of cardiac pacemaker cells?

A
  • the rate of firing of cardiac pacemaker cells is determined by rate of closure of K channels
25
Q

what is sinus arrythmia?

A

Sinus arrhythmia refers to a changing sinus node rate with the respiratory cycle, on inspiration and expiration. This is quite common in young, healthy individuals and has no clinical significance. The heart rate increases with inspiration, due to the Bainbridge reflex, and decreases with expiration.

26
Q

which areas of heart can u find pacemaker cells? (3)

A

SAN
AVN
Bundle of His / Purkinje Fibres

27
Q

out of muscle types (skeletal, cardiac and smooth)

which have cell-cell junctions?

if so, what are they?

A

Skeletal muscle = no have cell-cell junctions.

Smooth muscle = gap junctions (, to allow a rapid spread of depolarisation, as in cardiac muscle)

cardiac muscle = intercalated discs: contain gap junctions, desmosomes & fascia adherens ( actin filaments attach thin filaments in the muscle sarcomeres to the cell membrane)

28
Q

in cardiac muscle, which bands make up the thick (1) and thin (1) filaments?

A

made of:

i) A bands = thick filaments
ii) I bands = thin filaments

29
Q

what are: a) sarcolemma b) sarcomere c) sarcoplasmic reticulum

A
  • A & I bands are surroundered by membrane: sarcolemma
  • sarcoplasmic reticulum: like ER, contains Ca2+ ions
  • sarcomere: functional contractile unit of muscle (made of A&I band and actin and myosin)
30
Q

which are the depolarisng ions & repolarising ions in cardiac AP?

A

depol: Na+ & Ca2+
repol: K+

31
Q

Q

what is the effect of sympathetic and parasympathetic on the heart?

what NT and receptor used for each? ^

A

A

sympathetic: increaeses HR and force of contraction. secretion of noradrenalin and activation of B1 adrenoreceptor

parasympathetic: decreases HR. secretion of ACh and activation of muscarinin (M2) receptors

32
Q

for skeletal, cardiac and smooth muscle - what are they striated and vol / invol?

A

Skeletal muscle is voluntary and striated

cardiac muscle is involuntary and straited

smooth muscle is involuntary and non-striated.

33
Q

calmodulin is assocaited with which type of muscle contraction?

tropinin C is associated with which type of muscle contraction

A

calmodulin is assocaited with smooth muscle muscle contraction?

tropinin C is associated with cardiac muscle muscle contraction

34
Q

what are NTs and Rs for sym and parasym of bronchiole sm?

A

parasympathetic: Ach & M3 muscarinin receptors
- sympathetic: adrenalin / noradrenaline and B2 adrenergic receptor

35
Q

how does smooth muscle contraction occur?

A

  • thin filaments slide past the thick filaments, pulling on the dense bodies (connected to the sarcolemma)
  • dense bodies pull on the intermediate filaments’ networks through the sarcoplasm
  • causes entire muscle fibre to contract - ends are pulled towards the centre, causing midsecction to bulge
36
Q

what are the two overaching types of smooth muscle organization (think innervation) ?

what are the difference between these? ^

where each found?

A
  • *multi-unit smooth muscle:**
  • each smooth muscle cell recieves synpatic input.
  • little electrical coupling
  • each SMC can contract independently of neighbour: fine control
  • (similar to motor unit in skeletal muscle)
  • location: intrinsic muscles of eye & SM of larger BV
  • *single-unit smooth muscle:**
  • autonomic NS innervates a single cell within a sheet or bundle
  • AP is propogated by gap junctions to neighboring cell: whole bundle contracts as a functional syncytium
  • slow, steady contractions (allow food substances to move around body)
  • location: walls of all viseceral organs
37
Q

what is AP length in:

a) smooth muscle
b) skeletal muscle?

A

a) smooth muscle: 10-50ms
b) skeletal muscle: 2ms

smooth muscle is longer !!

38
Q

Blood glucose levels:

  • which tissues are highly dependent on extracellular glucose concentration? (2)
A
  • brain and rbc both highly dependent on extracullar glucose concentration
  • the brain uses 60% of blood glucose !
39
Q

what are the first part of the ventricles to contract?

A

papillary muscles - they close the AV valves before main ventricular contraction

40
Q

how long delay occurs at AVN?

AV node does not start to transmit action potentials down into the Bundle of His in the ventricles until HOW MANY MS after the start of the SA node action potential

A

delay - 60 ms

AV node does not start to transmit action potentials down into the Bundle of His in the ventricles until 120ms after the start of the SA node action potential

41
Q

describe what the ventricular AP is like during the depolarisation stage AND during the refractory period (and why)

A
  • *- starts wth normal nerve-like AP with Na influx**, yet a prolonged depolarisation occurs: the plateau
  • the plateau is from prolonged entry of calcium into the cell, which comes from extracellular space

THEN

  • get a long refractory period before a new AP
  • this prevents the muscle contracting prematurely and keeps cells synchronous
42
Q

what do each of Class 1-4 antiarrhythmic drug classes block?

A

Class 1: Na+ channel blocker

Class II: B blocker - e.g. Propranolol

Class III - Potassium-channel blockers

Class IV - Calcium-channel blockers. e.g Verapamil

43
Q

where are ECG lead points I, II, III?
where are ECG lead points aVR, aVL?

A
  • *Lead I:** records the signal voltage between the left and right axillae
  • *Lead II:** records the voltage betwen the right axila and leg
  • *Lead III:** records the voltage between the left axilla and leg

togther: give a picture of the electrical activity of the heart in a frontal plane

  • *aVR:** points up to right axilla
  • *aVL**: points up to left axilla
  • *aVF:** points down to groin

= 6 limb leads

44
Q

draw and label an ECG from lead II

what do each part show?

A
  • P wave: start of depol of atria
  • *- QRS wave:** start of depol of ventricles
  • *- T wave**: repolaristion of ventricles
45
Q

what are ST segment changes important for diagnosis of ?

A

acute myocardial infarction

46
Q

The six limb leads (I, II, III, aVR, aVL, and aVF) provide a view of the heart from the edges of a WHAT plane?

Chest / precordial leads: 6 give info about cardiac vector in WHAT plane?

A

The six limb leads (I, II, III, aVR, aVL, and aVF) provide a view of the heart from the edges of a frontal plane as if the heart were flat.

Chest / precordial leads: 6 give info about cardiac vector in proximal axial plane

47
Q

what are V1-V6 (horizontal plane chest leads) normally like?

A

V1 and V2 normally are mainly negative with a Small R wave but large S wave

V3 and V4 are usually bipolar

V5 and V6 are normally, mainly positive (i.e. large R wave, small S wave)

48
Q
A
49
Q
A
50
Q

what is S like on normal ECG for V1-V6?

which precoridal leads should T wave be largest on?

A

S wave:

  • large on V1 & V2
  • progessively smaller to V5
  • should be gone by V6

T wave: large on V2 and V3

51
Q

what do each of Q, R & S represent on ECG?

A

Q wave representing septal depolarisation

R wave representing ventricular depolarisation

S wave representing depolarisation of the Purkinje fibres / signifies the final depolarization of the ventricles, at the base of the heart

Cardiorespiratory (41 decks)

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