cardio Flashcards
what forms the superior surface of the heart in the mediastinum
the left atrium and the pulmonary veins
what forms the inferior border of the heart in the mediastinum
mainly the right ventricle
where is the apex beat in the mediastinum
in the let 5th intercostal space directly under the mid clavicular line
what makes up the left border of the heart in the midiastinum, name 4
the left atrial appendage
the aortic knuckle
the left pulmonary artery
the left ventricle
at what level is the plane that divides the mediastinum into an inferior and superior part
the sternal angle (angle of louis) and the level of the T4 or T5 vertebra
what divides the mediastinum into anterior, middle and posterior
the pericardium of the heart
what are thee 2 divisions of the serous pericardium
parietal pericardium
visceral pericardium
what order of the layers around the heart is the correct one:
a. the heart, visceral pericardium, parietal pericardium, fibrous pericardium
b. the heart, fibrous pericardium, parietal pericardium, visceral pericardium
c. the heart, parietal pericardium, visceral pericardium, fibrous pericardium
d. fibrous pericardium, visceral pericardium, parietal pericardium
a
what is the condition where there is an accumulation of serous fluid within the 2 serous pericardial layers
cardiac tamponade
where around the heart could you drain serous fluid without damaging the lung
left of the xiphisternum as the left lung is not in this area
at what stage of the cardiac cycle do the coronary arteries fill with blood
diastole
where in the heart do the coronary arteries arise from (be specific)
the aortic root sinuses, at the ostia behind the aortic valve leaflets
what are the 2 divisions of the Right Coronary Artery?
right marginal artery
posterior descending artery
what are the 2 divisions of the left common carotid artery
the circumflex artery
left anterior descending artery
which coronary artery runs in the right atrioventricular groove
the right coronary artery
what coronary artery runs in the left atrio ventricular groove
the circumflex artery
what coronary artery supplies the anterior septum (ventricular septum)
the left anterior descending artery
another name for the right marginal artery
posterolateral artery
what artery supplies the anterior right ventricle
the right marginal/ acute artery
what artery supplies the interventricular septum on the posterior of the heart
the posterior descending artery, aka the posterior interventricular artery
define coronary dominance
coronary dominance is defined by which artery (right common carotid of left’s circumflex) gives rise to the PDA
what proportion are right dominant in terms of coronary arteries
70%
what proportion are left dominant in therms of coronary arteries
10%
what proportion are codominant in therms of coronary arteries
20%
where in the right atrium is the SAN
the right atrium sulcus, ie the opening of the superior vena cava into the right atrium
what parts of the heart lack valves
at the entry of the inferior and superior vena cava into the right atrium and at the entry of the pulmonary veins into the left atrium. due to constriction of the entrances of these vessels into the heart on the contraction of the atria
what valves are 1. pathologically affected when the ventricles are affected
2. pathologically affected when the pulmonary arteries and orta are affected
- the mitral and tricuspid valve
2, the oortic and semilunar valves
name the muscle and cords of the mitral and tricuspid valve
the papillary muscles
the chordae tendinae
what is the transverse sinus of the pericardium
where the blood vessels (eg superior vena cava and aorta) pass out of the pericardium together
name the smooth portions of the right atrium
sinus venosus
name the trabeculated portion of the right atrium
crista terminalis. this separates the 2 siunus venosus portions of the right atrium.
How many layers of pericardium are there around the heart?
3 layers - 1 fibrous, 2 serous
3 functions of the fibrous pericardium
1) Tough connective tissue, protects heart
2) Anchors heart to surrounding structures
3) Prevents overfilling of heart
What is the myocardium:
Middle contractile layer. It is composed if mainly cardiac muscle fibres and connective tissue.
Function of the connective tissue of the myocardium.
Forms a fibrous skeleton of the heart. Which is reinforced in origin of great vessels and valves.
Electrically silent so limits spread of action potential.
What is the endocardium?
White sheet of squamous epithelium which ones chambers and covers valves. It is continuous with endothelium of blood vessels.
Where does the right atrium receive blood from?
Superior vena cava, inferior vena cava, coronary sinus
what type of red blood cell is responsible for phagocytosis of bacteria and foreign material
neutrophils
what forms the right border of the heart
the right atrium
what are the cells called that are derived from monocytes and present antigens to the immune system
dendritic cells
what blood cells are involved in inflammation and allergic response and have a special role in the protection against parasites
eisinophils
what cells become mast cells on migrating to tissues and so secrete histamine from their histamine-containing granules. They also express surface IgE
basophils
what stem cell do platelets differentiate from?
myeloid stem cells
how many amplification pathways are there for platelet activation and what are they?
- uding ADP and ATP give the purinergic receptors (p2y1, P2y12, p2x1), thrombin and Thromboxane A2
what cell is thromboxane A2 made in and from what and using what enzyme?
cell= platelet. from= prostaglandin H2. COX1
what does COX stand for in terms of platelet activation and aggregation
Cyclooxygenase (1 and2)
what acid is converted into prostaglandin H2 in both platele and endothelial cells?
arachidonic acid
what enzyme is affected by a low dose of aspirin?
COX1 (cyclooxygenase 1) so resulting in a lack of clotting
what factor inhibits coagulation? what enzyme is used to make this? from what? and what is the process called?
plasmin. TPO (tissue plasminogen activator). plasminogen. fibrinolytic system.
what coagulation factors are synthesised in the liver?
10, 9, 7, 2, 8, 5. remember 1972; differences are also 8 and 5.
to inhibit coagulation, the endothelial cell produces what from prostaglandin H2?
prostacyclin
what is fibrin broken down to in the fibrinolytic process?
fibrin degradation products (FDP)
what do platelets release after changing shape as part of their activation process?
alpha granules and dense granules
which 3 immunoglobulins are able to cross the placenta and which one isn’t
can= IgG, IgA, IgE. Can’t= IgM
what does fibrin bind to in the wall of the blood vessel? Give 2
collagen and VWF.
what is the name on the receptor on the platelet that binds to fibrin
aIIbB3
what is the purpose of fibrin in coagulation
to bind to the aIIbB3 receptor on 2 platelets as it has 2 binding sites and so stabalise the clot
where is fibrinogen manufactured?
the liver
