All besides Zachow Lecture Flashcards
hypertension effects on LV
Contracts harder but ESV down
pathology of diastolic heart failure
hard ventricle
knee to chest for babies
reduce pressure in feet-less shunting across septal defects
s3 gallop
sudden deceleration of blood into LV from LA
pulm a,v, and bronchus relation
bronchus is most posterior
artery is posterior and superior to vein
dorsal vs ventral root
dorsal is afferent
ventral is efferent
RAMUS comes off of what
and goes where
intercostal nerve
to sympathetic trunk
CO=
SVxHR
SV=
EDV-ESV
EF=
SV/EDV
Calc Post PostTP from preTP
preTP/1-preTP=preodds
preoddsxLR=postodds
postodds/1+postodds=Post test prob
LR+ and LR- calc
sen/1-spec
1-sen/spec
sen
spec
PPV
NPV
calcs
TP/TP+FN
FP/FP+TN
TP/FP+TP
TN/TN+FN
natural freqs
10000xPPV=prev
prev x sen=# TP
10000-prev= # without disease
# without disease x (1-spec)=false positives
1-spec is important!
Pulse pressure=
Psys-Pdias
where hear RA, RV, LA, LV
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
r, l, a, p, diaphragm
boarders of heart
r-RA l-LV+LA auricle a-RV, some RA, some LV p-La Diaphragm-Mostly LV, some RV
dev of smooth walled atria
- RA and LA
dev rough wall atria
dev for crista terminalis
d for cornoary sinus
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
where are all inflow to heart derived from?
sinus vensum (smooth)
d for small wall ventricle
- rough?-L vs R
- muscular septum
- membranous septum
embryonic artery near heart
- L is prim ventricle, R is proximal bulbus cordis
- embryonic vent WALL(partial)
- aorticopulm septum and endo card cushions (NC)
traverse sinus bouandaries
ant-AA and pulm trunk
post- SVC
oblique sinus boundaries
IVC and 4 pulm veins
what does L and central and right horns of sinus venous become
L and Central-cornoary sinus
Right-sinus venarium-smooth wall of RA
bulbs cordis resulted in
- prox 3rd
- conus cordis
- trunus arterioles
pros 3rd-trabeculated parts of RV
CC-smooth parts of RV and LV
truncus-root of AA and PT
what resulted from S-bend
prim atria became caudal to prim ventricle
now venous inflow goes in posterior, while arterial outflow is anterior
NC in developing heart (2)
endocardial cusions- bottom of septums (membranous)
tricostal ridges-create spiral septum
-also closure of inter ventricular septum
3 consequences of increase pO2, increase bradykinin, and decreased prostaglandins
ductus arteries shuts
umbilical vein shuts-lig teres
ductus venous shts-lig venousum
primum septal defect
sep primum no fuse to cusion
secundum septal defect
foramen oval not covered by septum secundum
ventral septal defect (2)
muscular-excessive respiration of embryologic septum
membranous-no aorticopulm septum
usually not cyanotic-but can be if large L to R force
tetralogy of fallot (4 symptoms)
pulm stenosis overring aorta RVH ventral septal defect CYANOTIC
Persistant aorticopulm trunk
Cyanotic-ox and does mix
Ventral septal defect
PR interval
P wave to Q wave
start of atrial depot to start of ventricular depol
ST segment
time form end of ventricular depot to start of vent repeal
- end of S to beginning of T
QT interval
begging of Q to end of T
- begining of vent depot to end of vent repol
what part of heart does precordial leads correspond to
v1-RV
v2/3-interventricular septum
4-apex of LV
5,6-lateral LV
what does Q wave rep
septum depoalrziating
moderator band ability
carry right bundle branch to anterior papillary muscle in RV
dorsal vs ventral horns
AFFERENT (+sensory) VS EFFERENT
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
para sympathetic (efferent) and sensory (afferent) -sensory (afferent)
sym (efferent) and sensory (efferent)
post gang sym
where are pre/post gang PSNS located
pre-brainstem/sacral spinal chord
post-heart wall
where re pre/post SNS located
pre-ventral horn of spinal chord
post-sympathetic chain
angina as back pain
pain travels on vagus to a dorsal horn
-level of dorsal horn determines dermatome in pain
esophagus and right atrium relationship and clinical?
thoracic aorta and left atriuM?
eso is right behind RA
-RAH=trouble swallowing
again behind
what is arch of azygos/aorta superiorfial too and clinical
right bronchus
left bronchus
disentionsion can result in trouble breathing
where is right vagus in regards to eso and azygos
right between
development of heart tube from sphlanic mesoderm
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
order of heart tube
truncus bulbus, ventricle, atrium, sinus venosus
creation of pulm vein
grow into lungs, divide into 4, gets pulled back
what happens to bulbs cordis
gets incorporated into ventricle-becomes smooth part
formation of ventricular septum
-CRITICAL ALWAYS FORGET THIS
embryonic-from wall of ventricle-bublus cordis/primitive ventricule= becomes MUSCULAR
aortipulm part-ingrowth of heart tube by NC cells-membranous
keep baby alive with patent ductus arteriorsis and another problem
how close ductus arteriosis
give O2-solve hypoxia, give prostalgnim- keep ductus arteriorisis open
O2 from breathing, less prostaglandins from mom, bradykinin increases after born
squatting and vasculature
constricts peripheral vasculature
- increases blood to RA/RV
- less L to right shunting
SNS-pregang release
postgang receptor
postgang release
ACH
N2 receptor-cholinergic-nicotenic
-allow inward Na and Ca
norepi
a1 vs a2
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
where are B1 and B2 located
B1-heart
B2-heart and smooth muscle beds
B1 actvation
chrono and ionotropy up
B2 activation
- chrono and ionotropy up
- negative ionotropy
- relax SM, metabolize glycogen in liver, create glycogen in skel muscle
Norepi syn
SNS post gang neurons-dopamine to norepi
2 types of dopamine receptors
DA1-VSM
DA2-presynaptic SNS and SNS gangla
-inhibits secretion of norepi/SNS transmission
COMT/MAO
degrade norepi/epi
adrenal medulla secretions
-chromaffin cells
epi (and some norepi)
-mod post gang SNS cells-sun epic and norepi-stim by ACh
Epi binding
all dose effects B1
low dose effects B2-most wanna be on, unless have a decent amount
high dose effects a1
noreepi binding
potent for a1 and B1
- low doses more for a1 than B1
- low affinity for B2
PSNS travel in which named nerves
3, 7, 9, 10 (75% in 10), sacral pelvic nerves
PSNS-what does pressgang release into synapse
what is receptor of post gang coupled too-what is receipor called
ACh/muscarine
Na in channel
CM-cholinergenic-muscarine
ACh syn
@pregang ANS/postgang PSNS
cholinesterase fucntion
destroyed ACh-decrease of ANS tone
symthomimetics vs cholinomimetics
-fucnion on which receptors
stimulate SNS or PSNS tone
-stimulate the differing receptors-CM or NR-R
where do high/low pressure affronts travel on
high-vagal
low-glossopharyngeal
ANP function
naturesis-at hyptensive atria
-expel Na so H2O out
endothelial cell functions *7
metabolize materials selective perm barrer Acetyl cholinerstase/MAO produce NO have ACE Produce VWF/selectins/tPA (clot buster)
angiogen pathway
no oxy, HIF1, VEGF secreted from endothelial cell, protease degrades BM, migrate there, proliferate, differentiate
angiogen is adult endothelial cells dividing
plaque formation
injury, monocytes and SM invades, depoisiotn of ECM, plaque
probably in tunica media
HOW DOES VENTRICLE DEVELOP
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
ventricular foramen
ventricle wall develops into muscular ventricular septum-but not all the way up=foramen
-endocardial cushions/aorticopulm septum grow down to close
sterling law
EDV up, SV up
EDV up, ionotropy up
