cardio CDB Flashcards
closure or ductus venosus
ligamentum venosum
closure of foramen ovale
fossa ovalis
closure of ductus arteriosus
ligamentum arteriosum
closure or umbilical vein
ligamentum teres
adult strictures of truncus arteriosus
ascending aorta
pulmonary trunk
adult structure or bulbus cordis
infundibulum/ conus arteriosus(smooth part) of RV
adult structure of primitive ventricle
trabecular walls of the LV and RV
adult structure of primitive atrium
auricles
pectinate muscles of left and right atroa
adult structure of sinus venosus
coronary sinus
sinus venarum
smooth wall of RA
-oblique vein of LA
ductus arteriosus
functional closure?
anatomica closure?
mediated by?
96 hours
1-3 mos
bradykinin
foramen ovale
funcltional closure?
anatomical closure?
immediately
1-3 mos
heart
directed towards
downward, forward, left
layers of the heart (outer to inner)
epicardium
myocardium
endocardium
upper margin of the fossa ovalis
annulus ovalis
it is a modified trabeculae carnae located in the RV that crosses the intraventricular septum
moderator band
cardiac valve located bet the RIGHT atrium and ventricle that contains 3 cusps
- MC valve involved in endocarditis in IV drug user
TRICUSPID VAlve (try drugs, tricuspid!)
cardiac valve found bet LEFT ventricle and atrium
- slightly smaller than tricuspid
- MC in marfans, Lupus, endocarditis, RH
- does not leave a septal sound
mitral valve
triangle of kock boundaries
- septal leaflet of tricuspid valve
- opening of coronary sinus
- tendon of todaro
where is the SA node located?
right atrium,
lateral to the sinus venarum
junction where the SVC enters the right atrium
what phase of the action potential-
- upstroke of action potential
- increase Ca conductance
phase 0
what phase of the action potential-
- repolarization
- caused by increase in K and inactivation of Ca channels
- more gradual descent
phase 3
what phase of the action potential-
- slow diastolic depolarization
- principal feature if the pacemaker fiber
- due to inward Na current at the end of repolarization
phase 4
what phase of the action potential-
-‘ot present in SA node action potential since plateau is not sustained
phase 1 & 2
ability of the heart to initiate AP in response to an inward depolarizing current
- depends on the stimulus applied
excitability
electrolytes that determine the excitability of the heart
na
k
ca
mg
(refractory period)
- begins with the upstroke of the AP
- ends after the plateau
- no AP can be initiated
absolute refractory period
(refractory period)
- slightly longer than ARP
- peroid in which conducted AP cannot be elicited
effective refractory period
(refractory period)
- peroid when depolarization is almost complete
- an AP can be elicited but requires a higher inward current
relative refractory period
cardiac muscle fiber action potential RMP
-90mv approaching K equilibrium potential
(HEART SOUNDS)
- closure of AV valves at start of ventricular systole
- lub
S1
(HEART SOUNDS)
- shorter “dup”
- closure of aortic and pulmo ic valves just after ventricular systole
S2
in inspiration, there is further decrease in intrathoracic pressure - more blood comes in from the vena cava and into the R side of the heart- delayed closure of pulmonic valve
physiologic splitting
(HEART SOUNDS)
- coincides wih period of rapid ventricular filling
- physiologic un children and yound adults
- pathologic in those more than 40
- due to block in overloaded ventricle
S3
(HEART SOUNDS)
- coincides with C wave
- always pthologic
- heard before the 1st heart sound when atrial pressure is high and ventricle is stiff
- due to concentric ventricular hypertrophy
S4
dermatomal level of the cardiac pain-
heart?
referred to intercostal nerves and intercostobrachial nerves?
T1-T4
T2
T2- if radiates to finger tips CERVICAL
- if radiates to middle aspect of L middle arm
CARDIAC
inferior wall MI
referred to epigastrium?
T7,8,9
branches of the LCA
LAD
LCX
(infarct localization)
LAD
area involved?
- anterior wall of LV
- anterior part of IVS
(infarct localization)
Lcx
area involved?
lateral wal of LV
(infarct localization)
RCA
area involved?
posterior wall of LV
posterour part of IVS
right ventricle
smallest branches of the arteries
-site of highest resistance
arterioles
largest cross sectional and surface area
site for exchange of nutrients, water and gases
capillaries
lowest pressure
contain the highest proportion of blood in the cardiovascular system
-reservoir of blood
veins
directly proportional to the viscosity of blood
resistance
describes the distensibility of blood vessels
capacitance
streamlined flow
laminar flow
predicts weather blood flow will be laminar or turbulent
reynolds number
- flows crosswise in the vessel and along the vessels
- forms whorls in blood
- eddy currents
turbulence
- volume of blood that fills a ventricle during diastole
- 120ml
EDV
volume of blood that remains in the ventricles after systole
-50 ml
ESV
difference bet EDV and ESv
stroke volume
most important determinant of stroke volume
pulse pressure
conditions that present with different BP in extremities
coarctation of the aorta
dissecting thoracic aneurism
neurodegenerative disease presents with parkinsonism and autonomic dysfunction (eg orthostatic hypotension) and loss of balance
multiple systems atrophy (shy drager syndrome)
conditons that presents with pulsus paradoxus
- cardiac tamponade
- status asthmaticus
pericadiocentesis
approach?
location?
directed toward?
infrasternal angle
5th or 6th ICS near sternum
introduced to the left of the xiphoid process upward backward direction
myocarditis
etiology?
drugs that causes myocarditis?
morphology?
coxsackie virus, t cruzi, b burgdorferri
drugs: doxorubicin, daunorubicin, cocaine
morphology: interstitial inflam infiltrate with focal myocyte necrosis
(congenital disease)
mc genetic risk of CHD
down syndrome
mc heart dae assic in congenital rubella syndrome
PDA
mc cyanotic CHD
- booth shaped heart
- cyanosis apparent after 2 mos hypoxic spell
tetrallogy of fallot
components of TOF
- pulmonic stenosis
- RVH
- overriding of the aorta
- VSS
TOF
tx?
sx?
propanolol
surgery- blaylock tausig
(congenital disease)
assoc with offspring of diabetic mothers
switching of aorta and pulmo arteries
-pts die within days w/o sx
xray?
transposition of great arteries
engg on a string
(congenital disease)
tricuspid valve is displaced, atrialized RV ASD
-can be caused by LITHIUM
ebstein anomaly
box shaped heart
(congenital disease)
- single great artery
- early cyanosis with irreversible pulmo HPN
- VSD present
truncus arteriosus
(congenital disease)
- anomalous connections by pulmonary veins to systemic veins
- blood in pulmonary veins goes to RA
- needs ASD patent foramen ovale
MC variant?
xray?
TAP VC
supracardiac
figure of 8, snowman appearance
(congenital disease)
mc adult chd- asymptomatic till 30 y/o
-fixed widely aplit S2
mc type?
ASD
secundum
(congenital disease)
MC CHD
-frequently assoc with other defects (TOF, Cri du chat, Fetal alcohol syndrome)
morphology?
mc type?
VSD
swiss cheese septum
membranous
(congenital disease)
- assoc with congenital rubela
- cont machinery like murmur
tx?
PDA
indomethacin
(congenital disease)
- weak delayed or absent femoral pulses
- BP maybe higher in the arms and legs
cxray?
assoc with?
coarctation of the aorta
- rib notching, figure of 3
- turners syndrome
intact BV
-assoc with atherosclerotic, syphilitic and congenital aneurism
true aneurism
BV non intact
-assic with post MI, rupture BV grafts
blood is in bet 2 vessel lyers
false aneurism
rupture triad in aneurism
left flank pain
hypotension
pulsatile mass
defect at the junction of the communicating branches with main cerebral vessels
-due to lack of INTERNAL elastic lamina and SM
mc site?
berry aneurism
anterior communicating
ca that causes thrombophlebitis
pancreatic ca
mc cause of SAH
trauma
test to detect thoracic outlet syndrome(compression of the neurovascular components of the neck
adsons test
ca that causes thrombophlebitis
pancreatic ca
mc cause of SAH
trauma
test to detect thoracic outlet syndrome(compression of the neurovascular components of the neck
adsons test
ca that causes thrombophlebitis
pancreatic ca
mc cause of SAH
trauma
test to detect thoracic outlet syndrome(compression of the neurovascular components of the neck
adsons test
ca that causes thrombophlebitis
pancreatic ca
mc cause of SAH
trauma
test to detect thoracic outlet syndrome(compression of the neurovascular components of the neck
adsons test
ca that causes thrombophlebitis
pancreatic ca
mc cause of SAH
trauma
test to detect thoracic outlet syndrome(compression of the neurovascular components of the neck
adsons test
ca that causes thrombophlebitis
pancreatic ca
mc cause of SAH
trauma
test to detect thoracic outlet syndrome(compression of the neurovascular components of the neck
adsons test
ca that causes thrombophlebitis
pancreatic ca
mc cause of SAH
trauma
test to detect thoracic outlet syndrome(compression of the neurovascular components of the neck
adsons test
ca that causes thrombophlebitis
pancreatic ca
mc cause of SAH
trauma
test to detect thoracic outlet syndrome(compression of the neurovascular components of the neck
adsons test
ca that causes thrombophlebitis
pancreatic ca
mc cause of SAH
trauma
test to detect thoracic outlet syndrome(compression of the neurovascular components of the neck
adsons test
