cardio1 Flashcards
flat facies, protruding tongue, small ears
down syndrome
inferioer epigastric is 1 of 2 branches of
external iliac artery
atria and ventricles depolarize independently of each other
narrow QRS complexes (since ventricular depolariziin is normal)
AV nodal pacemaker
what lies posterior to thoracic aorta and LA
descending thoracic aorta
common cause of secondary MR
decompensated HF: causes dilation of mitral valve annulus; restiricted movement of chordae tendiance causing insufficiencet closure of intrinsically normal mitral valve; resuliting in MR
derived from common cardinal veins (give rise to constituents of systemic venous circulation)
SVC
all veins in developing embryo drain into
sinus venosus
aging heart
decrease in LV chamber size
AR due to aortic root dilation heard best at
right upper sternal border
murmur of AR due to valuvlar path: best heard at left third ICS
septic emboli from vavlulaer eegetaions to palsm and soles
janeway elesions
crowded glomeruli, tubulointerstiial atrophy and fibrosis and focal inflammatory infiltrates
renal artery stenosis
unlikely to survive with severe coarctation
true
incomplete fusion of atrial septum primum and secudnum
pfo
aplasia of septum primum or septum secudnum
ASD
failure of aorticopulmonary septum to develop
truncus arteriosus
AV nodal artery most often arises from dominant coronary arery
left dominant then it would be LCX
traumatic aortic rupture: sudden decelration in MVC ; most common site is
aortic isthmus
tethered by ligamentum arteriosum; relatively fixed and immobe
widespreaad venous and arteriolar dilatiaton along w increased capillary permeability
decrease venous return
pda murmur maximal intestinay at
S2
ductus arterious derives from which aortic arch
6th
decreaesd metabolism and fucntion to match reduction in coronary blood flow
myocardial hiberatnion
leads to decreased contraiclty;
reversible w resvascularizaiotn
dicrotic pulse seen in
one during systole and the other during diastole
severe systolic dysfunction and high systemic arterial pressure
slow rising low amplitude pulse
pulsus parvus et tardus
(diminished SV) : pulsus parvus
prolonged LV ejection time (puslus tardus)
MR: venous pulse curve
promiment V wave
relieved by nitro
unstable angina
stable angina
prinzmetal angina
linear developemnt of aorticopulmonary septum
transposiiont of great arteries
failed fusion of superior and inferior endocardial cushions results in defects in
atriovental septum and valves (mitttral and tricuspid valves)
homogenous acellular thickening of arteriolar walls
hyaline arteriosclerosis
smalll pulse amplitdue w delayed peak and slower upstroke of arterial pulse
pulsus parvus
pulsus tardus
deu to diminshed stroke volume and prolonged ejection time
MVP vs Rheumatic heart disease
MVP is seen in developed nations: predisposing conditiosn for native valve infective endocaridts
seen in developing nations (mvp or rhueamitc heart diseaes)
rheumatic heart disease
brachiocephalic vein drains the
ipsilateral jugular and subclavian veins
bilateral brachiocephalic veins combine to form
SVC
brachiocephalic (innominate vein) vs SVC obstruction
same symtpoms; but brachiocepahil is unilateral (one side of face)
SVC : bilateral
subclavian is continuation of axillary vein. both drain blood from
upper extremity
right external jugular vein drains into
rt subclavin vein
so obsturciton of right brachiocephailc vein will also cause congestion of structures drained by external jugular vein
NOTCH1 gene mutation
familial bicuspid aortic valve disease: associated w mutation affecting NOTCH1 gene
forced pulsations in intracranial arteires w each herat beat
head bobbing
abrupt distension and collapse of carotid arteries (corrigan sign ) and peripheral arteries
water hammer pulse (peripheral)
deviation of infundibular septum
TOF
ACE is located
in small lung (pulm vessels )
thus angio2 is higher in pulm vein compaired to pulm artery
angiotensioning eproduced in
liver
varicose veins are superifical or deep venous system
superiical; thus does not increase risk for pulm embolism or phelegmasia alba dolens
massive iliofemoral thrombosis cause actue rise in tissue pressure that impairs arterial inflow, leading to
phlegmasia alba dolens (painful white milk leg)
complicataiosns of varicose veins
chronici edema, stasis dermatitis skin ulceratison poor wound healing infection
what causes varicose veins
increased intraluminal pressure or loss of vessel wall tesnile strength lead to venous dilation and failure of venous valves.
epicardial vessels
large confaorny arteris of heart
dilation of arterioles regulates CBF; not arteries
why does nulliparity increases risk of ovarian cancer
repeated ovulation or even ovarin inferitlity inflict minor trauma to ovarian surfaceb
thus OCP is a protecetive factor: lesss repair at ovarian surface due to reduced lifeteime ovulation frequency
protective factors for ovarian cancer
breast feeding, ocp’s tubal. ligation; multiparity
ovarian tumor that appears yellow due to lipid content in theca cells
granulosa cell tumor
cuboidal cells in microfollicular patttern around pink eosinophlic center; which ovarian tumor
granulosa cell tumor
granulosa cell tumor seen in
post menopausal women
bilobed nuclei and inclusion like nucleoli
reed sternberg
nests of epithelial cells with abundant clear cytoplasm
RCC
external urethral sphincter vs internal urethral sphincter
external: skeletal muscle at distal end of urethra innervated yb pudendal nerve; volunteary constriciton of this matinisn continence
internal: smooth muscle at proximal junction of bladder and uretrha. SNS controls sphincter to constrict
increased fetal urintation caused by
high cardiac output due to anemia or twin twin tanrsufiosn
polyhydramnios
antiepileptic therpay substantial risk factor for
NTD
PCOS: excess androgen from (increased activyt of 17 a hydroxylase and 3bhsd): prevents
prevents developmetn of monthly dominant follicle; resulting in anovulatory cycles
menstraul irregulariy: decereased progesterone secretion
progestorone: inhibitor to estrogen driven proliferation
long term risk for endometiral hyperplasia and carcinoma
anterolateral papillary umscle has dual blood supply
LAD
LCX
posteromedial papillary doesnto: comes from DPA
location right atrium near septal leaflet of tricuspid valve and orifice of coronary sinus
AV node
compression of IVC by gravid uterus in pregmant women
true
reduces venous return
seen in supine hypotension
supine hypotension vs orthostatic hypotension
orthostatic: upon standing
can be affected by vasovaga l syncope: withdrawla of symp efferent actiivty;
expansion of plasma volume inpregnancy as well as increase in rbc masss
neprilysin inhibitor increases effect of
endogenous natriuretic peptide
SLE and advanced malgianncy
nonbacterial thrombotic endocarditis
sysetmic embolization can occur
why is orthopnea caused
actue exacerbation of baseline pulmonary edema that occurs when central venous, pulmonary venous and cardiac filling pressures are increased by redistrubtion of blood that had been pooled in dependent veins back into central circulation
constant substernal crushing pain
MI pain
pleuriitc sharp
periciaridits chest pain
exacerbated by swallowing or ocuhgin
murmurs in infective endocarditis
mitral and aortic regurgi
function of prostacyclin
inhibit platelet aggregation; oppsoes thromboxane A2
converts kininogen into bradykinin
kallikrein
role in triggering fibrinolytic pathwya
amorphous and accelular pink material
amyloidosis
myofibirllay necrosis and inflammatory mononuclear infiltrate
acute myocarditis
anteiror surface of heart formed by
RA superiorly
RV inferiorly
repetitive activitigy involving upper costal cartialge at costochrondal or costosternal junctoisn
pain reproduced w palpation and worsened w movement in hcanges of posistion
costochrondritis or costosternal sydnroem
ventricular repsone in AF is depednetn on transmission of abnormal atrial impulses through
AV node
each time av node is excited; it enters refractory period druing which additional atrial impusles cannot be transmitted to ventricles
bundle branch block causes
widening of QRS
cardiacy hypertorphy w patchy interstiial fibrosis
HOCM
endocardial thickening and noncompliant ventricular wall
restrictive cardiomhyopathy
what affects phase 4 of AP; reudicng rate of sponatenous depolarizino in cardiac pacemeaker
adenosine and acetylcholline
activate potassium channels and increase potassium conducatance causing membrane potential to remain negative for longerp eriod; adenosnien also hinibits L type ca channels prolonging depolariziation time
what affects phase 4 of AP; reudicng rate of sponatenous depolarizino in cardiac pacemeaker
adenosine and acetylcholline
activate potassium channels and increase potassium conducatance causing membrane potential to remain negative for longerp eriod; adenosnien also hinibits L type ca channels prolonging depolariziation time
thigh claudication + gluteal claudication & and imptoence
Leriche syndrome
most common site of thrombus formation
left atrial appendage
where do standford a aortic didsseciton orginiation
sinotubular junction
function of titin
elastic protein that anchors the beta myosin heavy chains to z discs and contribute to passive myocardial tesnion
infireor surface of heart formedy by
left ventricle and right ventricle supplied by PDA (RCA)
distal lda spares
V1 and V2
in thrombus at bifurcation of main pulm artery
there is no history of exretion related dyspena and chest discomfort
tru
one main common finding in PAH
progressive dyspnea
where do stanford b aortic dissection originate
left subclavian artery
where do standford a aortic didsseciton orginiation
sinotubular junction
IVC is formed by union of
right and left common iliac veins
drains lymph from entire left side of body and regions inferior to umbilicus
thoracic duct
