Cardio Anatomy - Differential Diagnosis of Chest Pain Flashcards
Visceral afferents are pain fibres that travel to the spinal cord alongside?
Sympathetic nerves
Reflex visceral afferents travel mainly in the? Less so in the?
Vagus nerve (CN X) Glossopharyngeal nerve (CN IX)
Is sympathetic innervation to the heart uni- or bilateral?
Bilateral
Where do cardio-splanchnic nerves that supply sympathetic innervation to the heart and lungs come from?
T1-T5 ganglia + cervical ganglia
What nerve fibres does the cardiac plexus contain?
Sympathetic
Parasympathetic
Visceral afferent
Parasympathetic signals reach the heart via?
The vagus nerve, CN X
Pain is stimulation of a?
sensory receptor
Somatic pain is typically?
Sharp, stabbing and well localised in nature
Visceral pain is typically?
dull, aching, nauseating and poorly localised
Where does somatic (body wall structure) pain come from?
Muscular Joint Bony Intervertebral disc (fibrous) pericardial Nerve
Where does visceral pain come from?
Heart and great vessels
Trachea
Oesophagus
Abdominal viscera
Where does cardiac pain usually radiate to?
Upper limbs
Back
Neck
What is radiating pain?
The pain is felt both at the actual site of the pathology and also radiating (spreading away from there)
What causes radiating pain?
Visceral afferents (pain fibres from orgins) plug into the spinal cord at the same time as somatic sensory fibres enter the spinal cord
When skin mechanoreceptors are stimulates the AP is propagated centrally to the CNS and sensation reaches consciousness where?
at the cerebral cortex
Where does the pain pathway cross?
In the spinal cord
Body wall sensations are brought into consciousness by APs arriving in the?
Postcentral gyrus of the parietal lobe (somatosensory)
APs originating from the pre central gyrus of the frontal lobe bring about contractions of?
Body wall skeletal muscle (somatic)
In reference to radiating pain, if pain is originating in a somatic structure the radiation is along the affected?
Dermatome(s)
If from the heart, the radiation is bilaterally to which dermatomes?
Cervical and upper thoracic dermatomes
Visceral radiating pain is ____ in nature
aching, dull and poorly localised (visceral)
Referred pain is?
the sensation of pain is “felt” ONLY at a site remote from the actual area of injury or disease
What causes referred pain?
Due to afferent (sensory) fibres from soma and afferent (sensory) fibres from viscera (visceral afferents) entering the spinal cord at the same levels
Which arteries are commonly used as grafts for coronary artery revascularisation?
Radial artery
Internal thoracic artery
Great saphenous vein
AV node damage results in what type of heart block?
Complete heart block
Bundle branch damage results in?
Bundle branch block
