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Nicks phase 1 flashcards > cardiac anatomy and physiology > Flashcards

cardiac anatomy and physiology Flashcards

1
Q

what are the 3 key features of cardiac muscle?

A
  • striated
  • intercalated discs
  • cells communicate via gap junctions
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2
Q

why does cardiac muscle contraction last longer than skeletal muscle contraction?

A

after initial depolarisation there is a plateau phase (due to the slow Ca2+ channels)

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3
Q

what is the main metabolite used by cardiac muscle during aerobic respiration?

A

free fatty acids

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4
Q

what is the A band?

A

thick, myosin filaments

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5
Q

what is the I band?

A
  • thin, actin filaments
  • extend from Z line towards centre
  • also contains troponin and tropomyosin
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6
Q

what are the Z lines?

A
  • contain T tubules which transport action potentials into myofibrils
  • contain L-type calcium
    channels which open in response to chemical stimuli
  • triggers opening of further calcium channels on sarcoplasmic reticulum
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7
Q

what is a sarcomere?

A

functional unit, between a pair of Z lines

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8
Q

what is the sarcoplasmic reticulum?

A
  • membrane network surrounding contractile proteins

- contains calcium channels

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9
Q

what are the key features of myosin?

A
  • 2 heavy chains, 4 light chains
  • dual heads- perpendicular at rest, bend towards centre of sarcomere during contraction
  • 2 forms- alpha and beta
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10
Q

what are the key features of actin?

A
  • globular protein
  • double stranded macromolecular helix
  • thin filament
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11
Q

what are the key features of tropomyosin?

A
  • elongated muscle made of 2 helical peptide chains
  • occupies longitudinal grooves between 2 actin strands
  • partially covers binding sites- regulates interaction
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12
Q

what are the key features of the troponin complex?

A
  • troponin I- inhibits- binds to tropomyosin and holds in actin binding site
  • troponin T- binds troponin complex to tropomyosin
  • troponin C- high affinity calcium binding sites, when bound to Ca2+ TnI detaches and actin site is exposed
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13
Q

what does the right atrium receive blood from?

A
  • inferior vena cava
  • coronary veins
  • superior vena cava
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14
Q

what separates the 2 parts of atrium and what are the 2 parts of the atrium?

A
  • crista terminalis

- sinus venarum and atrium proper

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15
Q

what is found on the wall of the inter atrial septum?

A

fossa ovalis- remnant of foramen vale

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16
Q

what divides the inflow and outflow portions of the right ventricle?

A

supraventricular crest

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17
Q

what is contained within the inflow portion of the right ventricle?

A

trabeculae carnae

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18
Q

what is the outflow portion of the right ventricle known as?

A

conus arteriosus

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19
Q

what is the outflow portion of the right ventricle derived from?

A

bulbus cordis

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20
Q

what structures prevent the atrio-ventricular valves from opening during ventricular contraction?

A

papillary muscles- which attach to the valves via chordae tendonae

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21
Q

what is the outflow portion of the left atrium lined by?

A

pectinate muscles

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22
Q

what forms the first heart sound?

A

closing of the mitral and tricuspid valves

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23
Q

what forms the second heart sound?

A

closing of the aortic and pulmonary valves

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24
Q

where do the coronary arteries originate from?

A

aortic sinuses of the ascending aorta

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25
Q

what are the branches of the right coronary artery?

A
  • conus artery
  • sinus artery
  • right marginal branch
  • atrioventricular nodal artery
  • posterior descending artery
  • posterior left ventricular branch
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26
Q

what are the 2 terminal branches of the left coronary artery and what do they supply?

A
  • circumflex- obtuse marginal branches off this- circumflex supplies left atrium, marginal supplies left ventricle
  • left anterior descending artery- supplies most of front surface of heart and inter ventricular septum
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27
Q

what are the 3 layers of the pericardium?

A

1- fibrous outer layer
2- serious parietal layer
3- serous visceral layer

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28
Q

where are vagal fibres mainly distributed to?

A

artia- as it works to decrease heart rate rather than decrease the strength of contraction

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29
Q

what is the path of the left vagus nerve?

A

passes between left subclavian and left common carotid, crosses arch of aorta, reaches oesophagus, branches to oesophagus, cardiac plexus and pulmonary plexus

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30
Q

which vein does the right vagus cross?

A

arch of the azygos vein

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31
Q

which vertebrae do the phrenic nerves arise from?

A

C3, C4, C5

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32
Q

what are the functions of the pericardium?

A
  • protection of the heart

- provide a friction- free surface for the heart to accommodate its sliding movements- aided by pericardial fluid

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33
Q

what does each letter on the ECG represent?

A

P- atrial depolarisation
Q- left- right depolarisation
R- depolarisation of main mass of ventricles
S- depolarisation at ventricular base
T- ventricular repolarisation
U- repolarisation of interventricular septum

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34
Q

what is myogenic auto- regulation?

A

increased stretching in blood vessels can stimulate contraction in arteriolar smooth muscle

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35
Q

what local factors can cause vasoconstriction?

A
  • endothelin 1

- internal BP

36
Q

what local factors can cause vasodilation?

A
  • hypoxia
  • adenosine, bradykinin
  • NO
  • K+, CO2, H+
37
Q

what vasodilators are secreted by the endothelium?

A
  • NO

- prostacyclin

38
Q

what vasoconstrictors are secreted by the endothelium?

A

endothelin

39
Q

in neural regulation, what receptors does ACh from the parasympathetic nervous system act upon?

A
  • M2 receptors

- inhibits adenyl cyclase- reducing cyclic AMP

40
Q

In neural regulation, what receptors does adrenaline from the sympathetic nervous system act upon?

A
  • type 1 beta adrenoreceptors
41
Q

what are peripheral chemoreceptors stimulated by?

A
  • fall in PaO2 or pH

rise in PaCO2

42
Q

what do central chemoreceptors respond to?

A

increase in PaCO2

43
Q

where are the central and peripheral chemoreceptors found?

A
  • central- medulla

- peripheral- aortic and carotid bodies

44
Q

what does stimulation of central chemoreceptors cause?

A
  • vasoconstriction

- increased peripheral resistance and blood pressure

45
Q

what are the 2 types of baroreceptors?

A
  • primary (arterial- carotid sinus and aortic arch)

- secondary (veins- myocardium and pulmonary vessels)

46
Q

what does stimulation of baroreceptors cause?

A
  • inhibition of SYMP centre in medulla
  • inhibition of angiotensin
  • ADH release
47
Q

what is the firing rate from baroreceptors proportional to?

A

mean arterial pressure (MAP) and pulse pressure (PP)

48
Q

what are the main hormonal vasoconstrictors?

A
  • epinephrine (acting on alpha receptors)
  • angiotensin II
  • ADH/ vasopressin
49
Q

what are the main hormonal vasodilators?

A
  • epinephrine (acting on beta receptors)

- atrial natriuretic peptide (from atria)

50
Q

what is an inotropic effect?

A

an effect that changes the force of cardiac contraction

51
Q

what is a chronotropic effect?

A

an effect that changes the heart rate

52
Q

what is starlings law?

A

within physiological limits, the larger the volume of the heart, the greater the energy of its contraction and the amount of chemical change at each. contraction

53
Q

how does a pacemaker action potential occur?

A
  • hyperpolarisation (-60mV) activates HCN channels- allow slow Na+ influx- slow diastolic depolarisation
  • at -40Mv, activates Ca2+ channels- influx
  • +20mV- K+ channels open- efflux
  • repolarisation followed by hyperpolarisation
54
Q

what can alter to transfer of Na+ via a HCN channel?

A
  • catecholamines (e.g. adrenaline) increase transfer

- ACh slows rate of transfer

55
Q

in Einthovens triangle, where do leads I, II and III run?

A
  • lead I- right arm (-ve) to left arm (+ve)
  • lead II- right arm (-ve) to left leg (+ve)
  • lead III- left arm (-ve) to left leg (+ve)
56
Q

what does an ST elevation in leads V1-V6 or avL indicate?

A

occlusion of the left anterior descending artery

57
Q

what does an ST elevation in leads II, III or avF indicate?

A

occlusion of the right coronary artery

58
Q

what does an ST elevation in leads II, III or V4 indicate?

A

occlusion of the left circumflex artery

59
Q

what is haematopoiesis?

A

formation of blood cells

60
Q

what are the 3 main processes involved in haematopoiesis?

A
  • erythropoiesis
  • myleopoiesis
  • thrombopoiesis
61
Q

what is acute anaemia?

A
  • blood loss due to injury

- RBC and plasma lost in equal amounts, so haematocrit remains at 45%

62
Q

what is chronic anaemia?

A
  • loss of RBC due to inflammatory disorders or malignancy

- haematocrit drops to around 20%

63
Q

what is iron-deficiency anaemia?

A
  • caused by malabsorption, poor diet

- haematocrit remains at 45%- reduction in mean corpuscular Hb and a reduction in mean corpuscular volume

64
Q

what is megaloblastic anaemia?

A
  • macrocytosis (produces very large RBC)
  • caused by vitamin B12/ folate deficiency
  • reduced haematocrit
65
Q

what is pernicious anaemia?

A
  • autoimmune
  • antibodies produces against gastric parietal cells and intrinsic factor
  • results in B12 malabsorption
66
Q

what is haemolytic anaemia?

A
  • shorter lifespan of RBC (less than 30 days)
  • increased RBC turnover and production
  • leads to jaundice and anaemia
67
Q

what growth factor stimulates white blood cell maturation?

A

granulocyte-macrophage colony stimulating factor (GM-CSF)

68
Q

what can monocytes differentiate into?

A
  • macrophages (phagocytose foreign material)

- dendritic cells (present antigens to immune system)

69
Q

what is the function of basophils?

A
  • migrate to tissues, become mast cells
  • filled w/ histamine-containing granules
    express surface IgE
70
Q

what is the function of eosinophils?

A
  • inflammation
  • allergic response
  • protection against parasites
71
Q

what is acute leukaemia?

A
  • haemopoietic stem cells proliferate without differentiation
  • bone marrow precursor cells replaced
  • causes anaemia, neutropenia and thrombocytopenia
72
Q

what is acute myeloblastic anaemia?

A

proliferation of myeloblasts (neutrophil precursor)

73
Q

what is acute lymphatic leukaemia?

A

proliferation of lymphoblasts

74
Q

what is a high grade lymphoma?

A

malignant tumour developing from lymphocytes

75
Q

how are platelets formed?

A
  • myeloid stem cell differentiates into megakaryoblast
  • undergoes endomitosis to form a megakaryocyte
  • packages proteins into granules- forms platelet precursor extensions
76
Q

what happens when platelets are activated?

A
  • undergo a shape change- from smooth discord to speculated and pseudopodia
  • increases SA
  • number of glycoprotein 11b/11a receptors increases
  • affinity of receptors for fibrinogen increases
  • fibrinogen links receptors- platelet aggregation
77
Q

what are coagulation proteins?

A

series of enzymes that circulate in an inactive state- sequentially activated in a cascade sequence

78
Q

which blood type is recessive?

A

O

79
Q

what differentiates one blood type from another?

A

antigenic and immune properties

80
Q

what antibodies does O serum contain?

A

anti A and anti B

81
Q

what antibodies does AB serum contain?

A

NONE

82
Q

what are agglutinogens?

A

antigens

83
Q

what antigens does rhesus blood contain?

A

C, D and E

84
Q

what is the function of VWF?

A

required for platelets to bind to damaged blood vessels

85
Q

what is released the na blood vessel is damaged?

A

endothelin-1 - to constrict the blood vessel to reduce blood flow to the damaged area to prevent blood loss

86
Q

what are there vasa vasorum?

A

blood vessels found within the adventitia layer of the walls of blood vessels

Nicks phase 1 flashcards (16 decks)

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