ASAP V2 Flashcards
Tunica Intima
Innermost layer of blood vessels, composed of endothelial cells, providing a smooth surface for blood flow.
Tunica External
Outermost layer of blood vessels, composed of connective tissue, providing support and protection to the vessel.
Tunica Media
Middle layer of blood vessels, primarily consisting of smooth muscle cells, responsible for vessel tone and diameter regulation.
Elastic vs Musuclar arteries
Elastic closer to heart, larger, higher elastin content
Muscular have internal elastic laminar and assists in directing blood flow to regions
3 arteries off the aortic arch
Brachiocephalic
left common Carotid
left Subclavian
Haemostasis
1.vasoconstriction to reduce blood flow
2.formation of temporary platelet plug at injury site
3.coagulation cascade
4.Fibrinolysis, clot dissolves after tissues repaired
Haematopoiesis (formation of blood cells)
-Occurs in red bone marrow (soft,spongy bone in middle)
Blood flow through heart
SVC/IVC
Right atrium
Tricuspid valve
Reign ventricle
Pulmonary valve
Pulmonary artery
Lung
Pulmonary vein
Left atrium
Mitral Valve
Left ventricle
Aortic valve
Aorta
Layers of heart
Endocardium (innermost)
Myocardium (middle muscular layer)
Epicardium (CT for lubrication and protection)
Conduction system of the heart
-SA node=natural pace maker causes atria contractions
-AV node=delays signal from SA then ventricle contraction
-Bundle of His= pathways for electrical signals to travel from AV node to ventricles
-Purkinje fibres= terminal branches of bundle of his
Starling forces
Capillary/Hydrostatic (pressure exerted by fluid in capillary outwards)
Interstitial (pressure exerted by fluid outside capillary, inwards)
Plasma Colloid Osmotic (pressure exerted by proteins such as albumin pulling fluid towards capillary)
Interstitial fluid colloid osmotic (pressure exerted by proteins such as albumin pulling fluid towards the interstitial fluid)
Hormonal extrinsic pathway of cardiac regulation
-Adrenaline and noradrenaline released from adrenal medulla and bind too extracellular receptors on the surface of target cardiac cells
-target cells initiate a response acting to increase of decrease cardiac function
-stimulation of sympathies nerves innervating the adrenal medulla results in the released of adrenaline (80%) and noradrenaline (20%)
-stimulates alpha receptors within blood vessels and beta receptors in the myocardium, having a chronotropic (Heart beats with less force) or ionotropic (heart beats with more force)
Aortic murmurs
Where, When, what
2nd ICS, right sternal adge
Aortic regurgatation - blowing diastolic mumrmur
Aortic stenosis- high pitched, midsystolic (can cause dyspnea, and angina)
Mitral stenosis and regurgitation
5th ICS midclavicular line
Stenosis- low pitched mid diastolic murmur loudest over apex
Regurgitation- systolic murmur heart at apex
Where to Ausculate pulmonary valve
2nd ICS left sternal edge
Where to ausculate tricuspid valve
4th ICS left sternal edge
Cardiac output at rest
4-5L/min
Cumulative incidence
Number of new events divided by total population at risk
Respiratory membrane/blood air barrier
Fused basal lammina between two pops of epithelial cells, the alveolar epithelium and endothelium of pulmonary cavities
Anatomical dead space resp
Where gas exchange does not occur
Tidal volume, total ventilation
Tidal volume is the amount of air that is inhaled or exhaled
Total ventilation is volume of air moved per minute (tidal volume times resp rate)
Peptide hormones
-short Half life
-bind to cell surface receptors
Steroid hormones
-derived from cholesterol
-made in smooth ER and mitochondria
-not stored
-longer half life
-modulate gene expression (by activating or repressing gene transaction)
Amine hormones
-Amino acid derived
-Stored in vesicles until needed
-short half life
-cell surface receptors
Upregulation and down regulation for hormone stimulation
High levels of hormone causes target cells to produce receptors, low levels mean they lose receptors
Factors effecting plasma conc of hormone
Rate of secretion, rate of binding to carrier proteins, and rate of metabolism
Pancreas- Alpha cells
Produce glucagon —> increase blood sugar levels
Pancreas - Beta cells
Produce insulin —> decrease blood sugar levels
Pancreas - Delta cells
produce somatostatin —> inhibits the release of other hormones eg insulin and glucagon
Pancreas - PP cells
Produce pancreatic peptide —> regulate appetite and digestion
Stimulation of insulin secretion
Occurs through glucose-stimulated insulin secretion (GSIS)
•When blood glucose levels rise, glucose molecules are transported into pancreatic beta cells via glucose
transporters (GLUT2).
• Inside the beta cells, glucose undergoes metabolism through glycolysis, leading to an increase in intracellular
ATP levels.
• This rise in ATP levels triggers the closure of ATP-sensitive potassium channels (KATP channels), depolarising
the cell membrane and leading to the opening of voltage-gated calcium channels.
• The influx of calcium ions (Ca2+) triggers the exocytosis of insulin-containing vesicles, releasing insulin into the
bloodstream, thus promoting the uptake and storage of glucose by cells throughout the body.
Autonomic NS regulation of insulin secretion
Sympathetic —> inhibits secretion when low blood glucose levels
Parasympathetic —> stimulated secretion in response to high plasma glucose
Insulin actions
-Facilitates glucose uptake, stimulates glycogenesis, inhibits gluconeogenesis
-Increases conversion of glucose to fatty acids in adipose tissues, decrease lipolysis
-promotes activ transport of amino acids into muscle, increases protein synthesis
Diabetes mellitus complications
-Micro and Macro-vascular changes (stroke, hypertension, Atherosclerosis)
-Peripheral Neuropathy (impaired reflexes, incontinence , pain/numbness)
HPA (Hypothalamic-Pituitary-Adrenal) Axis
Hypothalamus
-Regulates body functions including sleep, temp, hunger and thirst
-link between nervous system and endocrine system
Pituitary Gland
-“Master Gland” regulates other endocrine glands
-Anterior pituitary (adenohypophysis) is made of glandular tissues, has a vascular connection to hypothalamus
-Posterior pituitary (neuropophysis) is made of nerve fibres and glial cells, has a neural connection to hypothalamus
What is released from anterior pituitary
-TSH (Thyroid Stimulating Hormone)
-Prolactin
-ACTH (Adrenocorticotrophic Hormone)
-LH (Luteinizing Hormone)/FSH (Follicle Stimulating Hormone)
-GH (Growth Hormone)
What is released by the Posterior pituitary
-ADH (Anti-diuretic Hormone AKA Vasopressin)
-Oxytocin (for milk ejection and uterine contraction)
-NB: these are stored here, but produced in the hypothalamus
TSH do what
Stimulates thyroid gland to release thyroxine —> regulates metabolism, temp, weight
Prolactin do what
Stims breast for lactation
ACTH do what
-Stimulates adrenal gland —> releases cortisol and other steroid hormones
-released by corticotrophs
ADH/Vasopressin do what
Regulates water balance by promoting water reabsorption in the kidneys and vasoconstriction
GH do what
-effects bone, tissues and liver
-Countercts insulin
-released by somatotrophs
-AKA somatotropin
-interacted with tyrosine kinase linked receptors in cell surface
Hypophysiotropoic hormones
-released by hypothalamus to either stimulate or suppress the secretion of anterior pituitary hormones
-two types, releasing hormone, inhibiting hormone
EG: Gonadotropin-releasing hormone (GnRH) stimulates the release of FSH and LH
Somatostatin
-AKA Growth Hormone Inhibiting hormone
-released by hypothalamus
IGF-1 and IGF-2
-IGF-1 Peptide hormone that stimulates cell growth and proliferation in various tissues.
-IGF-2 Growth-promoting hormone primarily involved in foetal growth and development.
Thyroid hormones (types and description)
-T3, regulates metabolism, growth and development
-T4 (thyroxine), regulates metabolism and energy balance
-Caclitonin, regulates calcium levels in blood, and bone metabolism (also —> parathyroid hormone production)
Thyroid disorders
-Hashimotots disease (hypothyroidism due to inflammation and destruction)
-Graves’ disease (hyperthyroidism due to antibody production)
Hypo and hyper calciumia
Hyper—> weakness, fatigue, kidney stones, bone pain (Fixed by Calcitonin and Vitamin D aka calcitrol)
Hypo—> muscle spasms and tetany and seizures (fixed by parathyroid hormone)
Cortisol
-released from the adrenal glands
-increases BP and HR
-suppresses immune function
-regulates glucose metabolism, and promotes gluconeogenesis
-inhibits hone formation and bone resorption
-influences mood, cognition and stress response
Cushing’s syndrome
Hypercortisolsim
Catecholamine hormones
-made by adrenal glands
-use g coupled protein receptors
Upper GI tract
-Mouth (for chewing)
-Oesophagus
-Stomach (mechanical digestion and small amount of absorption)
-Duodenum (digestion due to arrival of bile and pancreatic juice + absorption)
GI tract wall
-Mucosa (innermost layer of epithelium, lamina proprietor and muscularis mucosa)
-Submucosa (blood vessels, lymph tissue and nerves for support and nutrition of mucosa)
-Muscularis externa (provides rhythmic contractions that propel food)
-Seboas (outermost layers secretes a slippery fluid to reduce friction)
Motility in GI tract
-smooth muscle contractions
-Propulsive movements = peristalsis
-Mixing movement = segmentation
-gradient of segemntation also helps
Liver and gallbladder secretions GI tract
Bile (bile salts, alkaline secretions, bilirubin)
What does exocrine pancreas secrete
Digestive enzymes eg; lipase, amylase, trypsin
What does the small intestine secrete
-Succus entericus, enzymes
CCK hormone
-secreted from duodenum
-regulates lipid and protein digestion
Emesis (vomiting) mech
1.Coordinated by the vomiting centre in the medulla of the brainstem
2.Deep inspiration; glottis is closed; uvula is raised
3.Stomach, oesophagus, and gastroesophageal sphincter is relaxed
4.Respiratory muscles (diaphragm and abdominal) are contracted; stomach is squeezed between descending diaphragm and increasing intra-abdominal pressure
5.Sensation of nausea, salivation, sweating, rapid heart rate is regulated by the ANS
6.Excessive vomiting results in the loss of fluids and acids
MMC (migrating motility complex)
-starts after most nutrients are absorbed
Acinar cells
Exocrine cells in pancreas that produce and secrete digestive enzymes, and bicarbonate ions into small intestine
Chyme
-Comes from stomach goes to small intestine
Pathway for filtration - Kidneys, bigger things
Renal Papilla (tip of renal pyramids, with the renal medulla)
Minor calyces
Major calyces
Renal pelvis
Ureter
Anal sphincters
-internal is involuntary, external voluntary
-both made of smooth muscle
Bladder sphincters
-composed of bands of skeletal muscle
-Internal is involuntary, external is voluntary
Efferent vs affertent
Afferent= bring towards
Efferent= carry away
peritubular capillarie role in blood filtration
-surround the nephron and its parts (eg: vasa recta run along the loop of henle) and are highly permeable allowing the exchange of fluids and solutes
Cortical nephrons vs juxtamedullary nephrons
Cortical = in renal cortex
Juxtamedullary = long nephron loops that extend into the medulla, are needed to produce concentrated urine
Proximal convoluted Tubule (PCT)
Extends from Bowmans capsule and reabsorbs glucose, ions, amino acids and water
Loop of Henle
-establishment of osmotic gradient through the reabsorption of water and ions
Distal Convoluted Tubule (DCT)
-Fine tuning of ion reabsorption and secretion, especially sodium, potassium and calcium
collecting duct (nephron)
-receives filtrate from multiple nephrons, collecting urine and transporting it to renal pelvis
How fluid moves through nephron
Bowman’s capsule, PCT, loop of henle, DCT, collection duct
Glomerulus
-tuft of capillaries where blood is filtered, small molecules go into bow,and capsule, while retaining larger proteins and blood cells
-reabsorption of water, glucose, ions +secretion of waste products into the tubular fluid
Mesangial cells
-provide support to glomerular capillaries, prevent collapse
-phagocytosis
-cytokine secretion
Mesangial cells
-provide support to glomerular capillaries, prevent collapse
-phagocytosis
-cytokine secretion
ADH (antidiuretic hormone)
-Increase water reabsorption in the collecting ducts —> more concentrated urine
-released from pituitary gland, after hypothalamus ducts changes in blood osmolality or concentration
-ADH released when fluid levels low or osmolality is high
Aldosterone
-Released by adrenal glands (adrenal cortex)
-stimulates the reabsorption of sodium ions in the distal tubules and collecting duct
-higher sodium levels in blood = more water= high blood volume and pressure
Also promotes excretion of potassium ions into filtrate, helping to maintain proper levels in body
JGA (Juxtaglomerular Apparatus) components and function of each
-Juxtaglomerular cells=smooth muscle that secretes enzyme renin
-Macula Densa=group off specialised cells in distal convoluted tubule, sense NaCl conc
-Mesangial cells, support, phagocytosis,
Waste products in urine
Urea, creatinine, uric acid
Inulin clearance vs creatinine clearance
Inulin Is neither reabsorption or secreted by renal tubules = ideal marker for GFR measurement
Creatinine is affected by tubular secretion and reabsorption
Regulation of bladder sphincters
-urge to pee appears around 200ml
-internal sphincter opens at 500ml (regulated by reduced sympathetic outflow), due to stretch receptors
-external is relaxed by somatic nervous innervation
Microglia
immune cells of CNS
Astrocytes
Star shaped cells, providing structure and Nutrient supply
Satellite cells
Support cells ing PNS ganglia
Epedymel cells
Line brain and spinal cord, producing CSF
Oligodendrites
Produce myelin sheeth in CNS
Schwann cells
produce myelin sheath in PNS
Blood Brain barrier
Epithelium -tight junctions preventing free movement
Pericytes-regulates molecules moving through layers
Basement membrane - structural support
Astrocytes- encapsulate blood vessels= monitoring
Action potential sequence of events
- Resting potential (-70mV)
- Reaching threshold (-55mV) - voltage gates Na+ channels open
- Depolarisation (+40mV) - influx of Na+, increased voltage, Na+ close, K+ open
- Repolarisation (-70mV) - K+ exits, restoration of resting potential
(.5) Hyper-polarisation (<-70mV) excess of cations
Saltatory vs continuous conduction
Saltatory (myelinated) = rapid nerve impulse propagation jumping between nodes of ranvier
Continuous (unmyelinated) = slower nerve pulse propagation along entire length of axon
Sequence of synaptic transmission
- Neurotransmitters are packaged into vesicles at the presynaptic neuron.
- Vesicles mobilise and dock at the presynaptic cell membrane.
- Action potential reaches the terminal end of the presynaptic neuron.
- Voltage gated Ca2+ channels open; depolarising the membrane.
- Vesicles detect a change in Ca2+ concentration; bind to the cell membrane.
- Neurotransmitters (in carrier vesicles) exit the axon terminals via exocytosis and enter the extracellular
- Neurotransmitters diffuse across the synaptic cleft.
- Neurotransmitters bind to receptors on the postsynaptic neuron.
- A new action potential is initiated through postsynaptic stimulation.
Neurotransmitter types
Amino acid (eg glutamate or GABA)
Classic amine (eg dopamine, adrenaline)
Graded vs action potential
Graded - ligand gated, short membrane, and can summation
Action - voltage gated, all of nothing long axon with no loss of strength
Telencephalon
Largest division housing the cerebral cortex, responsible for higher cognitive functions; located at the anterior region of the brain.
Diencephalon
Contains the thalamus and hypothalamus, pivotal for sensory relay physiological regulation; situated between the telencephalon and mesencephalon.
Mesencephalon
Also known as the midbrain, serves as a conduit for auditory and visual reflexes; located between the diencephalon and metencephalon.
Metencephalon
Houses the cerebellum and pons, crucial for movement coordination and balance maintenance; positioned between the mesencephalon and myelencephalon.
Myelencephalon
Includes the medulla oblongata, controlling autonomic functions like breathing and heart rate; situated at the posterior end of the brainstem.
Frontal lobe
primary motor cortex, responsible for motor, planning, reasoning judgement, and is separated from parietal lobe by the central sulcus-central succumbs sperates it from the motor cortex
Parietal lobe
Primary sensory area, responsible for facilitating somatosensation (pain touch, priopreception etc)
Occipital lobe
Primary visual area
Temporal lobe
Primary auditory area: responsible for language, hearing and memory
Insular lobe
Responsible for motor control, decision making, sensory function
Brain metabolism
-can only use glucose
-needs high oxygen supply prev eating anaerobic respiration bc no lactic acid and lots of ATP
Circle of Wills
-goes into anterior cerebral artery at top
-anterior communicating artery
-middle cerebral artery cuts through middle
-posterior communicating artery
-posterior cerebral artery
-goes into basilar artery at bottom
DORSAL LATERAL AND VENTRAL COLLUM
Dorsal Column Sensory function
Lateral Column Sensory and motor function
Ventral Column Sensory and motor function
Proprioception
Positional sense of muscles, regulated by muscle spindles and golgi tendons
Different types of Nervous system receptors and their function
Proprioceptor/mechanoreceptor: touch, two point discrimination, muscle proprioception
Thermoreceptor: temperature
Nociceptor: pain
The DCML pathway
Responsible for conveying precise touch, proprioception, and vibratory sensations via large, myelinated fibres that ascend through the dorsal columns of the spinal cord to the brainstem and then to the thalamus.
The lateral spinothalamic pathway
carries pain and temperature sensations via smaller, unmyelinated fibres that synapse in the spinal cord and then ascend contralaterally to the thalamus.
The anterior spinothalamic pathway
also conveys crude touch and pressure sensations but projects to different regions of the thalamus, providing a parallel route for somatosensory information processing.
Function of Bones
Protection Encloses internal organs and organ systems, protecting them.
Support Contains a rigid structural framework
Movement Anchors skeletal muscle
Mineral Storage Stores minerals for homeostasis and ionic balance
Blood cell production Red bone marrow enables haematopoiesis (BC production)
Energy storage Yellow bone marrow stores fat/energy
Function of Bones
Protection Encloses internal organs and organ systems, protecting them.
Support Contains a rigid structural framework
Movement Anchors skeletal muscle
Mineral Storage Stores minerals for homeostasis and ionic balance
Blood cell production Red bone marrow enables haematopoiesis (BC production)
Energy storage Yellow bone marrow stores fat/energy
Types of bones
Long bone Cylindrical in shape; longer than they are wide; provide leverage for movement.
Short bone Cube-like in shape; equal in dimensions; provide stability, support, movement.
Flat bone Thin; often curved; enable muscle attachment and protection of organs.
Sesamoid bone Small; ball-like; form from within a tendon; protect tendons.
Irregular bone Complex; no clear characteristic shape; protection for organs.
Bone Composition
Cortical bone is the outer edge of the bone; it is the prominent composition in diaphysis; contains osteons; has strength in a uniform direction.
Trabecular bone is the internal bone latticework; it is the prominent composition in heads of long bones, contains trabeculae (bony struts); has strength in multiple directions.
Bone parts
Diaphysis Shaft; made of cortical (compact) bone
Epiphysis Ends of bone; made of trabecular (spongy) bone
Metaphysis Between epiphysis and diaphysis; contains trabecular (spongy) bone
Osteoblast
Cells responsible for synthesizing and depositing the extracellular matrix of bone tissue; enable bone formation, mineralization, and repair
Osteoblast
Cells responsible for synthesizing and depositing the extracellular matrix of bone tissue; enable bone formation, mineralization, and repair
Osteocyte
Mature bone cells that are derived from osteoblasts; embedded in the mineralized matrix of bone tissue; help maintain bone health and integrity
Osteoclast
Large, multinucleated cells that are responsible for breaking down and resorbing bone tissue; enable bone remodelling, repair, and maintenance
Structural Classification of Joints
Bony joint Complete fusion of two bones
Fibrous joint Held together by dense collagen fibres
Cartilaginous joint Held together by cartilage (hyaline or fibrocartilage)
Synovial joint Held together by fibrous joint capsules and ligaments; contains a joint space
Functional Classification of Joints
Synarthrosis Immobile; no movement Bony; fibrous
Amphiarthrosis Partially mobile; minor movement Cartilaginous
Diarthrosis Freely mobile; wide range of movement Synovial
Actin and myosin
two main proteins involved in muscle contraction.
Actin and myosin
two main proteins involved in muscle contraction.
Sacromere
the basic contractile units of muscle fibres.
When the myosin heads bind to actin, the sarcomeres shorten, causing the muscle fibre to contract.
Extensibility
the ability to be extended or stretched.
interstitial cells of Cajal
“Pacemaker cells of gut”
*coordinate movement of intestines *
interstitial cells of Cajal
Layers of epidermis, deepest to most superficial
Stratum basale, stratum spinosum, stratum granulosum, stratum lucidum, and stratum corneum
(Barry stops grabbing little children)
Progesterone role
thickening your uterine lining and creating a good environment for a fertilized egg to implant
5 moments of hand hygiene
Before touching a patient, after touching a patient, before a procedure, after a procedure of body fluid risk, after touching a patients surroundings
Wrist tenderness cause
Hypotrophic pulmonary autropathy - long cancer
Integumentary system
Skin, glands, hair, nails
Four principles approach
autonomy, nonmaleficence, beneficence, and justice
Primary lymphoid organs
Bone marrow, thymus,
Rate (epidemiology)
new cases/per pop
Measure of the frequency of occurrence of a particular event or condition relative to the size of the population at risk, often expressed per unit of time.
Count (epidemiology)
Total number of cases or occurrences of a particular event or condition.
Incidence (epidemiology)
Rate of new occurrences of a condition or event within a specified period.
Prevalence (epidemiology)
Proportion of a population with a particular condition or characteristic at a specific point in time.
Principles of Indigenous care
Respect
Acknowledge and honour the cultural heritage, traditions, and values of Indigenous communities.
Reciprocity
Ensure mutual benefit and respect in all interactions, avoiding exploitation or tokenism.
Accountability
Be open and accountable in all practices, providing clear and honest communication; be culturally sensitive.
Levels of intervention
Primordial
Prevention of risk factors; focuses on preventing the development of risk factors themselves
Primary
Prevention of disease in high-risk individuals; aims to reduce the incidence of disease
Secondary
Early detection and prompt treatment of disease; aims to halt the progression of disease
Tertiary
Reducing the impact of an ongoing illness; aims to improve quality of life and reduce complications
Ottawa Charter
Strengthen community action
Empower communities to take collective responsibility for health.
Develop personal skills
Enhance individual abilities to make informed health decisions.
Create supportive environments
Establish environments that promote and sustain health.
Reorient health services
Shift health services towards prevention and health promotion.
Build healthy public policy
Advocate for government policies that prioritise health and well-being.
Ethical Approaches
Consequentialism
When making ethical decisions, the main thing to do is to weigh the consequences.
Utilitarianism
A branch of consequentialism in which an individual attempts to effectuate the greatest good to the greatest number.
Deontology
Consequences alone do not determine rightness; instead, the rightness of a Deontology action is determined by the action itself and whether it conforms to a moral rule
(e.g. don’t tell lies, don’t steal, keep promises).
Virtue Ethics
Character, not actions, is the focus of ethics; try and attain a perfect balance of characteristics, such as empathy, depending on the situation.
Paternalism
The doctor is in total control; opacity is present in communication to keep spirits up
To be paternalistic (fatherly) is to act for another’s good without regard for their preferences or wishes; it is not
necessarily against their wishes, but without regard for them.
5A’s
1 Ask
2 Assess
3 Advise
4 Assist
5 Arrange
Giving feedback
Make sure it is timely, clear and appropriate
Carer
A person who provides unpaid care and support to family members and friends who have a physical, emotional, or cognitive ailment.
Tripartite Account of Consent
Voluntary
Consent must be genuinely voluntary; no coercion or manipulation
Informed
The consenting party must be provided with adequate information and adequate opportunity for deliberation
Competent
The consenting party must be sufficiently competent or autonomous (and able to understand the nature of what is being offered)
Self care Strategies
Exercise
Mindfulness
Quality sleep.
Hobbies/relaxation
Professional support
Why medical students high risk of mental illness
Lack of Work-Life Balance
Long Hours and Sleep Deprivation
Emotional/Psychological Stressors
Academic Pressure
Health impact pyramid
Counselling and Education
eg on nutrition or exercise
Clinical Interventions
eg control of BP, cholesterol, diabetes etc
Long lasting protecting interventions
eg immunizations, brief interventions, colonoscopy
Changing the context to make individuals decisions healthy
eg ionization of salt, tobacco taxes, smoke free laws
Socioeconomic Factors
eg anti-poverty, education, access to healthcare, elimination of disparities
Australias Health Landscape
Specialist, acute, and residential care
Specialised medical treatment for acute conditions, provided in hospitals or residential facilities.
Primary health and community care
Basic healthcare services delivered in community settings, focusing on prevention, early intervention, and management of common health issues.
Health promotion and disease prevention
Activities aimed at improving public health through education, lifestyle modifications, and interventions targeting risk factors and behaviours.
Determinants of health and demographic other factors
Social, economic, environmental, and biological factors influencing health outcomes, including demographics such as age, gender, ethnicity, and socioeconomic status.
Heart sounds
S1 (“lub”):
Closure of AV valves (mitral and tricuspid) at the start of systole.
S2 (“dub”):
Closure of semilunar valves (aortic and pulmonic) at the start of diastole.
S3:
Occurs in early diastole during rapid ventricular filling; can be normal in youth but often indicates heart failure in older adults.
S4:
Occurs in late diastole during atrial contraction; usually indicates a stiff or hypertrophic ventricle. arterial stenosis
