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Systemic Path > Cardio 1 > Flashcards

Cardio 1 Flashcards

1
Q

Mesothelioma may arise within the pericardial cavity from pericardial mesothelial cells. Where else in the body can mesothelioma arise?

A

The pleural cavities and the peritoneal cavity.

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2
Q

Which is the lower pressure system: the pulmonary or systemic circulation?

A

Pulmonary circulation is lower pressure

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3
Q

Is dysfunction of the mitral valve more likely to cause left-sided heart failure or right-sided heart failure?

A

Left-sided heart failure

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4
Q

Name the heart valve at the outflow of the left atrium.

A

Left atrioventricular valve (“mitral” valve)

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5
Q

In which direction (left to right or right to left) does blood flow in a patent foramen ovale? And why?

A

Left to right (postnatally). This is because the pressure in the left atrium exceeds the pressure in the right atrium.

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6
Q

You are performing a necropsy on a pig. As you peel the pericardial sac off the heart you are reminded of the appearance of soft butter when two slices of bread are peeled apart. What are you dealing with? And what is the most likely cause?

A

Fibrinous or fibrinosuppurative pericarditis; either is fine. [NOT fibrous pericarditis, hemopericardium, hydropericardium, or intrapericardial injection of spreadable dairy products.] In pigs this is typically caused by bacterial septicemia, e.g., Haemophilus parasuis

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7
Q

Which is the higher pressure system: the pulmonary or systemic circulation?

A

Systemic circulation is higher pressure

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8
Q

There are six short- and long-term compensations that help maintain cardiac output for a while in the face of cardiac disease. The first is increased heart rate. What are the other five?

A

(1) Increased heart rate
(2) Increased peripheral resistance
(3) Increased blood volume
(4) Redistribution of blood flow
(5) Cardiac dilation
(6) Myocardial hypertrophy

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9
Q

In which direction (left to right or right to left) does blood flow in a patent ductus arteriosus? And why?

A

Left to right (postnally). This is because the pressure in the aorta exceeds the pressure in the pulmonary trunk. Blood takes the “path of least resistance” and a proportion of aortic blood is sent via the PDA into the pulmonary trunk. This causes overperfusion of the lungs.

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10
Q

What does the term hemopericardium mean?

A

The accumulation of whole blood in the pericardial cavity

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11
Q

There are six BASIC pathophysiologic mechanisms of cardiac dysfunction. The first is “pump failure” (i.e., weak contractility and emptying of chambers; impaired filling of chambers). What are the other five?

A

(1) Pump failure: Weak contractility and emptying of chambers, impaired filling of chambers.
(2) Obstruction to forward blood flow: Valvular stenosis, vascular narrowing, systemic or pulmonary hypertension.
(3) Regurgitant blood flow: Volume overload of chamber behind failing affected valve.
(4) Shunted blood flows from congenital defects: Septal defects in heart, shunts between blood vessels.
(5) Rupture of the heart or a major vessel: Cardiac tamponade, massive internal hemorrhage.
(6) Cardiac conduction disorders (arrhythmias): Failure of synchronized cardiac contraction.

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12
Q

In which domestic species is the congenital cardiac abnormality “PDA” (patent ductus arteriosus) most commonly seen?

A

Dogs

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13
Q

What is indicated by serous atrophy of epicardial fat?

A

A negative plane of energy. e.g., anorexia, starvation, cachexia, GIT parasitism etc.

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14
Q

Right-sided heart failure often causes severe edema. Different domestic species manifest edema in different anatomic locations. Which of the following is most typical in a COW with heart failure?
(1) Ascites; (2) Hydrothorax; (3) Subcutaneous edema

A

(3) Subcutaneous edema

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15
Q

Which side of the heart (right or left) propels blood through the pulmonary circulation?

A

Right

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16
Q

What is the term for accumulation of serous fluid (i.e., a transudate, not blood or exudate) in the pericardial space?

A

Hydropericardium

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17
Q

Name the major blood vessels that enter the right atrium.

A

Cranial vena cava AND caudal vena cava

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18
Q

Name the heart valve at the outflow of the right ventricle.

A

Pulmonic valve

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19
Q

Is dysfunction of the pulmonic valve more likely to cause left-sided heart failure or right-sided heart failure?

A

Right-sided heart failure

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20
Q

Right-sided heart failure often causes severe edema. Different domestic species manifest edema in different anatomic locations. Which of the following is most typical in a DOG with heart failure?
(1) Ascites; (2) Hydrothorax; (3) Subcutaneous edema

A

(1) Ascites

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21
Q

What are three possible reasons for the development of hydrothorax, and what, briefly, is the pathogenesis of each?

A

(1) Hypoproteinemia (-> decreased colloid oncotic pressure): e.g., liver failure, protein-losing nephropathy, protein-losing enteropathy
(2) Heart failure (-> decreased hydrostatic pressure); may also see ascites or hydrothorax
(3) Widespread vascular injury (-> leakage of plasma and plasma proteins); certain infectious diseases such as heartwater in ruminants, African horse sickness, African swine fever, bovine ephemeral fever … [many are exotic]

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22
Q

Name the major blood vessel that leaves the left ventricle.

A

Aorta

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23
Q

Right-sided heart failure often causes severe edema. Different domestic species manifest edema in different anatomic locations. Which of the following is most typical in a HORSE with heart failure?
(1) Ascites; (2) Hydrothorax; (3) Subcutaneous edema

A

(3) Subcutaneous edema

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24
Q

Name the heart valve at the outflow of the left ventricle.

A

Aortic valve

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25
Q

What is the characteristic non-cardiac lesion seen in ACUTE right-sided heart failure?

A

Acute passive congestion in liver (-> hepatomegaly)

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26
Q

In which direction (left to right or right to left) does blood flow in an atrial septal defect? And why?

A

Left to right (postnatally). This is because the pressure in the left atrium exceeds the pressure in the right atrium.

27
Q

What is the most common pericardial neoplasm?

A

Mesothelioma (a malignant tumor of mesothelial cells)

28
Q

What is the most common cause for hemopericardium in horses?

A

Spontaneous aortic rupture. [NOT hemangiosarcoma; you’re thinking of dogs.]

29
Q

Right-sided heart failure often causes severe edema. Different domestic species manifest edema in different anatomic locations. Match each of the following animals to the most common type of edema shown in heart failure (e.g., a-1):
(a) Cat; (b) Dog; (c) Horse; (d) Ruminant
(1) Ascites; (2) Hydrothorax; (3) Subcutaneous edema

A

(a) Cat - (2) Hydrothorax
(b) Dog - (1) Ascites
(c) Horse - (3) Subcutaneous edema
(d) Ruminant - (3) Subcutaneous edema

30
Q

Hydropericardium and hydrothorax are synonyms. True or false?

A

False. Fluid accumulates in the pericardial cavity in hydropericardium but in the pleural cavities in hydrothorax.

31
Q

Which is more likely to be rapidly fatal: hemopericardium or hydropericardium? And why?

A

Hemopericardium is more likely to be rapidly fatal as blood accumulation is typically sudden and caused by a bleeding vessel or chamber. The pericardium cannot distend, resulting in the heart being compressed by accumulated blood within the fibrous pericardial sac and failing acutely. This is called cardiac tamponade.
PLEASE NOTE THAT AT THIS POINT ONLY HALF THE ANSWER REQUIRED HAS BEEN PROVIDED. THE REMAINDER IS BELOW. PLEASE FINISH YOUR ANSWERS IN EXAMS.
In contrast, fluid accumulates slowly and at low pressure in hydropericardium, allowing the pericardium time to expand to some degree. This avoids compression of the heart.

32
Q

What does the term “forward failure” mean as it pertains to the systemic effects of heart failure?

A

The decreased blood flow to peripheral tissues caused by heart failure.

33
Q

List four gross NON-CARDIAC lesions that may be caused by accumulation of blood behind a failing chamber (backward failure).

A

(1) Subcutaneous edema; (2) Ascites; (3) Pulmonary edema; (4) Hepatic congestion and hepatomegaly

34
Q

Which side of the heart (right or left) propels blood through the systemic circulation?

A

Left

35
Q

You are performing a necropsy on a cow. As you peel the pericardial sac off the heart you are reminded of the appearance of soft butter when two slices of bread are peeled apart. What are you dealing with? And what is the most likely cause?

A

Fibrinous or fibrinosuppurative pericarditis; either is fine. [NOT fibrous pericarditis, hemopericardium, hydropericardium, or intrapericardial injection of spreadable dairy products.] In cattle this is typically caused by bacterial septicemia, e.g., Histophilus somni. It can also be caused by “hardware disease” AKA traumatic reticulopericarditis, where the pericardium is penetrated by a nail or wire from the gut.

36
Q

The accumulation or backing up of blood “upstream” from a failing heart chamber is called …

A

Backward failure

37
Q

What is the most common cause for hemopericardium in dogs?

A

“Leaking” cardiac hemangiosarcomas. Typically these are located on the right auricle.

38
Q

Pulmonary lesions are typically associated with which type of heart failure: left-sided or right-sided?

A

Left-sided

39
Q

Which organs “suffer the most” in an animal with a patent ductus arteriosus?

A

The lungs. A proportion of aortic blood is sent via the PDA into the pulmonary trunk. This causes overperfusion of the lungs.

40
Q

Name two normal fetal cardiac shunts AND their names postnatally.

A

(1) Foramen ovale -> fossa ovalis
(2) Ductus arteriosus -> ligamentum arteriosum

41
Q

What does the term hydropericardium mean?

A

Accumulation of serous fluid (i.e., a transudate, not blood or exudate) in the pericardial space

42
Q

Name the major blood vessel that leaves the right ventricle.

A

Pulmonary trunk

43
Q

Mesothelioma is the most common pericardial neoplasm. Is it benign or malignant?

A

Malignant, despite its -oma name. There is no benign form of mesothelioma.

44
Q

Name the major blood vessels that enter the left atrium.

A

Pulmonary veins

45
Q

What is the characteristic non-cardiac lesion seen in ACUTE left-sided heart failure?

A

Acute pulmonary congestion & edema

46
Q

You are performing a necropsy on a bison. You notice that the epicardial fat is white to yellow and abundant. What is the term for this and what does it suggest?

A

Normal epicardial fat. It suggests that the animal was maintaining its energy requirements and was not anorexic, starved, cachexic etc.

47
Q

You are performing a necropsy on a horse. As you peel the pericardial sac off the heart you are reminded of the appearance of soft butter when two slices of bread are peeled apart. What are you dealing with? And what is the most likely cause?

A

Fibrinous or fibrinosuppurative pericarditis; either is fine. [NOT fibrous pericarditis, hemopericardium, hydropericardium, or intrapericardial injection of spreadable dairy products.] In horses this is typically caused by bacterial septicemia, e.g., Streptococcus equi

48
Q

Name the heart valve at the outflow of the right atrium.

A

Right atrioventricular valve (“tricuspid” valve)

49
Q

Veins always …
(a) carry blue blood
(b) carry deoxygenated blood
(c) travel towards the heart

A

(c) travel towards the heart

50
Q

You are performing a necropsy on a bison. You notice that the epicardial fat is grey to clear and gelatinous. What is the term for this and what does it suggest?

A

Serous atrophy of fat. It suggests a negative plane of energy. e.g., anorexia, starvation, cachexia, GIT parasitism etc.

51
Q

What are three characteristic non-cardiac lesions seen in CHRONIC left-sided heart failure?

A

(1) Chronic pulmonary edema; (2) Pulmonary fibrosis; (3) Pulmonary hemosiderosis (lungs appear tan-brown due to the presence of “heart failure cells” in alveoli. These are alveolar macrophages containing recycled iron pigments from red blood cells that have been “squeezed” into the alveolar lumen and phagocytosed.)

52
Q

What is the characteristic non-cardiac lesion seen in CHRONIC right-sided heart failure?

A

Chronic passive congestion of the liver (-> enhanced reticular pattern that, in this case, can actually be called “nutmeg liver”)

53
Q

What is the term for the accumulation of whole blood in the pericardial cavity?

A

Hemopericardium

54
Q

The decreased blood flow to peripheral tissues caused by heart failure is called …

A

Forward failure

55
Q

Right-sided heart failure often causes severe edema. Different domestic species manifest edema in different anatomic locations. Which of the following is most typical in a CAT with heart failure?
(1) Ascites; (2) Hydrothorax; (3) Subcutaneous edema

A

(2) Hydrothorax

56
Q

By far the most common cause for hemopericardium in dogs is “leaking” cardiac hemangiosarcomas. What are three other, less common causes?

A

(1) Idiopathic; (2) Spontaneous atrial rupture; (3) Blunt force thoracic trauma (e.g., by car); (4) Intracardiac injections; (5) Other cardiac neoplasm (e.g., aortic body tumor AKA chemodectoma)

57
Q

Which vessels are connected in the congenital cardiac abnormality “PDA” (patent ductus arteriosus)

A

The aorta and pulmonary trunk

58
Q

What does the term “backward failure” mean as it pertains to the systemic effects of heart failure?

A

The accumulation or backing up of blood “upstream” from a failing heart chamber

59
Q

Is dysfunction of the aortic valve more likely to cause left-sided heart failure or right-sided heart failure?

A

Left-sided heart failure

60
Q

Explain the pathogenesis whereby renal HYPOTENSION (not hypoxia) caused by a failing heart can worsen heart disease.

A

Failing heart -> Reduced flow to peripheral tissues -> RENAL HYPOTENSION ->
Renin release from juxtaglomerular apparatus (JGA) -> Aldosterone release from adrenal cortex -> Sodium & water retention -> Increased plasma volume -> Increased workload for already failing heart -> WORSENING HEART DISEASE

61
Q

Mesothelial cells are the flattened cells that line serous body cavities and produce a small amount of lubricating fluid. What are the names of the (a) benign and (b) malignant neoplasms that arise from mesothelial cells?

A

(a) Trick question. There is no such thing as a benign mesothelial tumor. (b) Mesothelioma is the malignant neoplasm arising from mesothelial cells.

62
Q

Is dysfunction of the tricuspid valve more likely to cause left-sided heart failure or right-sided heart failure?

A

Right-sided heart failure

63
Q

Explain the pathogenesis whereby renal HYPOXIA (not hypotension) caused by a failing heart can worsen heart disease.

A

Failing heart -> Reduced flow to peripheral tissues -> RENAL HYPOXIA -> Erythropoietin release from kidney -> Increased erythropoiesis in bone marrow
-> Polycythemia -> Increased blood viscosity -> Increased workload for already failing heart -> WORSENING HEART DISEASE

64
Q

Arteries always …
(a) carry red blood
(b) carry oxygenated blood
(c) travel away from the heart

A

(c) travel away from the heart

Systemic Path (10 decks)

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