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Cardio > All besides Zachow Lecture > Flashcards

All besides Zachow Lecture Flashcards

1
Q

hypertension effects on LV

A

Contracts harder but ESV down

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2
Q

pathology of diastolic heart failure

A

hard ventricle

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3
Q

knee to chest for babies

A

reduce pressure in feet-less shunting across septal defects

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4
Q

s3 gallop

A

sudden deceleration of blood into LV from LA

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5
Q

pulm a,v, and bronchus relation

A

bronchus is most posterior

artery is posterior and superior to vein

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6
Q

dorsal vs ventral root

A

dorsal is afferent

ventral is efferent

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7
Q

RAMUS comes off of what

and goes where

A

intercostal nerve

to sympathetic trunk

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8
Q

CO=

A

SVxHR

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9
Q

SV=

A

EDV-ESV

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10
Q

EF=

A

SV/EDV

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11
Q

Calc Post PostTP from preTP

A

preTP/1-preTP=preodds
preoddsxLR=postodds
postodds/1+postodds=Post test prob

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12
Q

LR+ and LR- calc

A

sen/1-spec

1-sen/spec

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13
Q

sen
spec
PPV
NPV

calcs

A

TP/TP+FN
FP/FP+TN
TP/FP+TP
TN/TN+FN

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14
Q

natural freqs

A

10000xPPV=prev
prev x sen=# TP
10000-prev= # without disease
# without disease x (1-spec)=false positives

1-spec is important!

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15
Q

Pulse pressure=

A

Psys-Pdias

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16
Q

where hear RA, RV, LA, LV

A

RA-1/2 inch off right sternum in third costal space

RV-6th intercostal to right

LA-2nd intercostal to left

LV-5th intercostal-midclavicular

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17
Q

r, l, a, p, diaphragm

boarders of heart

A 
r-RA
l-LV+LA auricle
a-RV, some RA, some LV
p-La
Diaphragm-Mostly LV, some RV
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18
Q

dev of smooth walled atria
- RA and LA

dev rough wall atria

dev for crista terminalis

d for cornoary sinus

A

embryonic veins near heart

  • R horn of sinus venous for RA
  • Pulm ven for LA

prim atrium

sinus venus and prim atrium

sinos venosos
-ALL INFLOW ARE FROM SINUS VENOUSUM

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19
Q

where are all inflow to heart derived from?

A

sinus vensum (smooth)

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20
Q

d for small wall ventricle

  • rough?-L vs R
  • muscular septum
  • membranous septum
A

embryonic artery near heart

  • L is prim ventricle, R is proximal bulbus cordis
  • embryonic vent WALL(partial)
  • aorticopulm septum and endo card cushions (NC)
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21
Q

traverse sinus bouandaries

A

ant-AA and pulm trunk

post- SVC

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22
Q

oblique sinus boundaries

A

IVC and 4 pulm veins

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23
Q

what does L and central and right horns of sinus venous become

A

L and Central-cornoary sinus

Right-sinus venarium-smooth wall of RA

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24
Q

bulbs cordis resulted in

  • prox 3rd
  • conus cordis
  • trunus arterioles
A

pros 3rd-trabeculated parts of RV

CC-smooth parts of RV and LV

truncus-root of AA and PT

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25
Q

what resulted from S-bend

A

prim atria became caudal to prim ventricle

now venous inflow goes in posterior, while arterial outflow is anterior

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26
Q

NC in developing heart (2)

A

endocardial cusions- bottom of septums (membranous)

tricostal ridges-create spiral septum
-also closure of inter ventricular septum

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27
Q

3 consequences of increase pO2, increase bradykinin, and decreased prostaglandins

A

ductus arteries shuts

umbilical vein shuts-lig teres

ductus venous shts-lig venousum

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28
Q

primum septal defect

A

sep primum no fuse to cusion

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29
Q

secundum septal defect

A

foramen oval not covered by septum secundum

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30
Q

ventral septal defect (2)

A

muscular-excessive respiration of embryologic septum
membranous-no aorticopulm septum

usually not cyanotic-but can be if large L to R force

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31
Q

tetralogy of fallot (4 symptoms)

A 
pulm stenosis 
overring aorta
RVH
ventral septal defect
CYANOTIC
32
Q

Persistant aorticopulm trunk

A

Cyanotic-ox and does mix

Ventral septal defect

33
Q

PR interval

A

P wave to Q wave

start of atrial depot to start of ventricular depol

34
Q

ST segment

A

time form end of ventricular depot to start of vent repeal

- end of S to beginning of T

35
Q

QT interval

A

begging of Q to end of T

- begining of vent depot to end of vent repol

36
Q

what part of heart does precordial leads correspond to

A

v1-RV
v2/3-interventricular septum
4-apex of LV
5,6-lateral LV

37
Q

what does Q wave rep

A

septum depoalrziating

38
Q

moderator band ability

A

carry right bundle branch to anterior papillary muscle in RV

39
Q

dorsal vs ventral horns

A

AFFERENT (+sensory) VS EFFERENT

40
Q

what nerve fibers travel in vagus
-what nerve type has cell bodies in here

what nerve fibers travel in paravert trunk
what type of nerve has cell body here

A 
para sympathetic (efferent) and sensory (afferent)
-sensory (afferent)

sym (efferent) and sensory (efferent)
post gang sym

41
Q

where are pre/post gang PSNS located

A

pre-brainstem/sacral spinal chord

post-heart wall

42
Q

where re pre/post SNS located

A

pre-ventral horn of spinal chord

post-sympathetic chain

43
Q

angina as back pain

A

pain travels on vagus to a dorsal horn

-level of dorsal horn determines dermatome in pain

44
Q

esophagus and right atrium relationship and clinical?

thoracic aorta and left atriuM?

A

eso is right behind RA
-RAH=trouble swallowing

again behind

45
Q

what is arch of azygos/aorta superiorfial too and clinical

A

right bronchus

left bronchus

disentionsion can result in trouble breathing

46
Q

where is right vagus in regards to eso and azygos

A

right between

47
Q

development of heart tube from sphlanic mesoderm

A

splanchnic mesa-angiogenic clusters
-lateral go ventrally, become endocardial tubes, and fuse to make heart tube

-medial stays dorsal, becomes 2 dorsal aorta that fuse and with heart tube become first aortic arch

48
Q

order of heart tube

A

truncus bulbus, ventricle, atrium, sinus venosus

49
Q

creation of pulm vein

A

grow into lungs, divide into 4, gets pulled back

50
Q

what happens to bulbs cordis

A

gets incorporated into ventricle-becomes smooth part

51
Q

formation of ventricular septum

-CRITICAL ALWAYS FORGET THIS

A

embryonic-from wall of ventricle-bublus cordis/primitive ventricule= becomes MUSCULAR

aortipulm part-ingrowth of heart tube by NC cells-membranous

52
Q

keep baby alive with patent ductus arteriorsis and another problem

how close ductus arteriosis

A

give O2-solve hypoxia, give prostalgnim- keep ductus arteriorisis open

O2 from breathing, less prostaglandins from mom, bradykinin increases after born

53
Q

squatting and vasculature

A

constricts peripheral vasculature

  • increases blood to RA/RV
  • less L to right shunting
54
Q

SNS-pregang release

postgang receptor

postgang release

A

ACH

N2 receptor-cholinergic-nicotenic
-allow inward Na and Ca

norepi

55
Q

a1 vs a2

A

PKC-Ca channels open-smooth muscle contract

inhibit effect of a1-negative feedback for a1-
located at prejuctional membrane of some post-gang SNS fibers

56
Q

where are B1 and B2 located

A

B1-heart

B2-heart and smooth muscle beds

57
Q

B1 actvation

A

chrono and ionotropy up

58
Q

B2 activation

A
  • chrono and ionotropy up
  • negative ionotropy
  • relax SM, metabolize glycogen in liver, create glycogen in skel muscle
59
Q

Norepi syn

A

SNS post gang neurons-dopamine to norepi

60
Q

2 types of dopamine receptors

A

DA1-VSM

DA2-presynaptic SNS and SNS gangla
-inhibits secretion of norepi/SNS transmission

61
Q

COMT/MAO

A

degrade norepi/epi

62
Q

adrenal medulla secretions

-chromaffin cells

A

epi (and some norepi)

-mod post gang SNS cells-sun epic and norepi-stim by ACh

63
Q

Epi binding

A

all dose effects B1

low dose effects B2-most wanna be on, unless have a decent amount

high dose effects a1

64
Q

noreepi binding

A

potent for a1 and B1

  • low doses more for a1 than B1
  • low affinity for B2
65
Q

PSNS travel in which named nerves

A

3, 7, 9, 10 (75% in 10), sacral pelvic nerves

66
Q

PSNS-what does pressgang release into synapse

what is receptor of post gang coupled too-what is receipor called

A

ACh/muscarine

Na in channel

CM-cholinergenic-muscarine

67
Q

ACh syn

A

@pregang ANS/postgang PSNS

68
Q

cholinesterase fucntion

A

destroyed ACh-decrease of ANS tone

69
Q

symthomimetics vs cholinomimetics

-fucnion on which receptors

A

stimulate SNS or PSNS tone

-stimulate the differing receptors-CM or NR-R

70
Q

where do high/low pressure affronts travel on

A

high-vagal

low-glossopharyngeal

71
Q

ANP function

A

naturesis-at hyptensive atria

-expel Na so H2O out

72
Q

endothelial cell functions *7

A 
metabolize materials
selective perm barrer
Acetyl cholinerstase/MAO
produce NO
have ACE
Produce VWF/selectins/tPA (clot buster)
73
Q

angiogen pathway

A

no oxy, HIF1, VEGF secreted from endothelial cell, protease degrades BM, migrate there, proliferate, differentiate

angiogen is adult endothelial cells dividing

74
Q

plaque formation

A

injury, monocytes and SM invades, depoisiotn of ECM, plaque

probably in tunica media

75
Q

HOW DOES VENTRICLE DEVELOP

A

bulbs cordis + primitive ventricle

-primitive ventricle becomes trabeculated part of LV

bulbs cords becomes

  • pros 3rd-trabeculated part of RV
  • conus cordis-smooth parts of ventricles
  • truncus arteriosus
76
Q

ventricular foramen

A

ventricle wall develops into muscular ventricular septum-but not all the way up=foramen
-endocardial cushions/aorticopulm septum grow down to close

77
Q

sterling law

A

EDV up, SV up

EDV up, ionotropy up

Cardio (5 decks)

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