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Medicine year 1 > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Blood pressure

A

hydrostatic force exerted against blood vessel walls by blood

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2
Q

Systolic arterial pressure

A

force exerted on aorta and systemic arteries by blood when the heart contracts

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3
Q

Diastolic arterial blood pressure

A

force exerted on walls of the aorta and systemic arteries by blood when the heart relaxes

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4
Q

Pulse pressure

A

difference between systolic and diastolic blood pressure

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5
Q

Mean arterial blood pressure

A

average arterial blood pressure during a single cardiac cycle

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6
Q

When calculating MAP, which value is doubled and why

A

Diastolic blood pressure
As the diastolic portion of the cycle is twice as long as the systolic portion

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7
Q

Average systolic value (resting)

A

90-120

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8
Q

Average resting diastolic blood pressure (resting)

A

60-80

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9
Q

Average pulse pressure

A

30-50

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10
Q

Average (resting) map

A

70-105

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11
Q

What are baroreceptors used for

A

relaying information derived from blood pressure within the autonomic nervous system

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12
Q

What happens when blood pressure increases (3)

A

walls of blood vessels stretch more
Baroreceptors are activated
Signals are sent to the medulla

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13
Q

what does the brain do in response to increased baroreceptor firing (2)

A

Parasympathetic activity increases
Sympathetic activity decreases

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14
Q

What is the result of the brain’s response to increased baroreceptor firing (3)

A

Decreased cardiac output
Decreased vascular resistance
Decreased blood pressure

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15
Q

What happens when blood pressure decreases (3)

A

walls of the blood vessels stretch less
Baroreceptors detect less stretch
Signalling to the brain decreases

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16
Q

what is the brain’s response to decreased baroreceptor signalling (2)

A

increased sympathetic activity
Decreased parasympathetic activity

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17
Q

What is mean arterial blood pressure a product of (2)

A

Cardiac output and systemic vascular resistance

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18
Q

what is cardiac output the product of (2)

A

heart rate and stroke volume

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19
Q

What is cardiac output

A

Volume of blood pumped by each ventricle per minute

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20
Q

How does the sympathetic nervous system increases heart rate

A

releasing noradrenaline

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21
Q

How does the parasympathetic nervous system decrease heart rate

A

Releasing acetylcholine

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22
Q

What is stroke volume

A

volume of blood pumped by each ventricle per heart beat

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23
Q

What happens if sympathetic nerves innervate ventricular myocardium (2)

A

increases force of contraction
Which increases stroke volume

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24
Q

What is systemic vascular resistance

A

sum of resistance in all vasculature of the systemic circulation

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25
Q

What regulates systemic vascular resistance

A

Contraction and relaxation vascular smooth muscles

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26
Q

What is meant by vasomotor tone

A

Vascular smooth muscles are partially contracted even at rest

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27
Q

What is vasomotor tone caused by

A

tonic discharge of sympathetic nerves

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28
Q

What does tonic discharge of sympathetic nerves result in

A

Continuous release of noradrenaline

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29
Q

Describe autorhythmicity

A

the heart is capable of beating in the absence of stimuli

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30
Q

Where does excitation of the heart originate

A

Pacemaker cells in the sino-atrial node

31
Q

Sinus rhythm meaning

A

when the heart is driven by the sino-atrial node

32
Q

What exists in place of a stable resting membrane potential in pacemaker cells of the sino-atrial node

A

Generation of regular and spontaneous pacemaker potentials

33
Q

Describe the pacemaker potential

A

Slow depolarisation of the pacemaker membrane to a threshold

34
Q

What causes the pacemaker potential (3)

A

funny current
Decreased potassium ion efflux
Calcium ion influx

35
Q

What is the funny current

A

depolarising cation current caused by influx of sodium ions through HCN channels

36
Q

Once a threshold is reached for pacemaker cells, what happens(2)

A

rising phase
Falling phase

37
Q

Describe the rising phase of an action potential in a pacemaker cell (2)

A

caused by opening of L-type calcium ion channels
Calcium ion influx occurs

38
Q

Describe the falling phase of the action potential in pacemaker cells (2)

A

Caused by inactivation of L-type calcium ion channels and activation of potassium ion channels
Potassium ion efflux occurs

39
Q

How does cell to cell spread of excitation occur

A

via gap junctions

40
Q

What is the result of the slow conduction velocity within the atrioventricular node (2)

A

Conduction is delayed
So atrial systole precedes ventricular systole

41
Q

What allows rapid spread of action potentials to the ventricles (2)

A

bundle of HIs
Purkinje fibres

42
Q

What is the sole point of electrical contact between t he atria and ventricles

A

atrioventricular node

43
Q

What is the resting membrane potential of contractile cardiac muscle cells

44
Q

Describe phase 0 of action potentials in contractile cardiac muscle cells (2)

A

there is rapid sodium ion influx
The membrane potential is reversed to +20mV

45
Q

Describe phase 1 of action potentials in contractile cardiac muscle cells (2)

A

sodium ion channels close
There is transient potassium ion efflux

46
Q

Describe phase 2 of action potentials in contractile cardiac muscle cells

A

there is influx of calcium ions via L-type calcium ion channels

47
Q

Describe phase 3 of action potentials in contractile cardiac muscle cells (2)

A

L-type calcium ion channels close
Potassium ion efflux occurs

48
Q

What is phase 4 of action potentials in contractile cardiac muscle cells

A

The resting membrane potential is restored

49
Q

Describe the plateau phase

A

When the membrane potential do contractile myocytes is maintained near the peak of the action potential for a few hundred milliseconds

50
Q

What is the main cause of the plateau phase in contractile myocytes

A

Influx of calcium ions via L-type calcium channels (phase 2)

51
Q

What are the ECG waves (3) and what events cause them

A

P wave caused by atrial depolarisation
QRS wave caused by ventricular depolarisation
T wave caused by ventricular repolarisation

52
Q

Is the vagus nerve part of the sympathetic or parasympathetic nervous system

A

Parasympathetic nervous system

53
Q

What dominates under normal resting conditions

A

Vagal tone caused by continuous influence of the vagus nerve on the sino-atrial node

54
Q

What is the importance of vagal tone

A

it slows intrinsic heart rate from roughly 100 bpm to a normal resting heart rate

55
Q

What is supplied by the vagus nerve (2)

A

sino-atrial node
Atrioventricular node

56
Q

What is the effect of vagal stimulation (3)

A

slower rate of firing of the sino-atrial node
Increased atrioventricular node delay
Decreased heart rate

57
Q

Describe the neurotransmitter action involved in vagal stimulation (2)

A

acetylcholine
Acting at muscarinic M2 receptors (G-protein coupled)

58
Q

What is supplied by cardiac sympathetic nerves (3)

A

sino-atrial node
Atrioventricular node
Myocardium

59
Q

What is the effect of cardiac sympathetic nerve stimulation (3)

A

Increased rate of firing of the sino-atrial node
Decreased atrioventricular node delay
Increased force of contraction

60
Q

Describe the neurotransmitter action involved in cardiac sympathetic nerve stimulation (2)

A

noradrenaline
Acting at β1 adrenoceptors (g protein coupled)

61
Q

Summarise RAAS effect (2)

A

increases systematic vascular resistance
Increases plasma volume

62
Q

Summarise Natriuretic peptides (3)

A

opposes RAAS system
Reduces blood volume
Reduces blood pressure

63
Q

Summarise ADH (3)

A

Increase systemic vascular resistance
Increases blood pressure
Regulates extracellular fluid volume and osmolality to manage fluid load/deficit

64
Q

What is renin

A

an enzyme found in plasma

65
Q

When is renin released (3)

A

Due to sympathy stimulation of renal nerves
Due to decreased blood flow to the kidneys
Dye to reduced salt delivery to the kidneys

66
Q

what is the sequence of events that occurs in the renin angiotensin aldosterone system (4)

A

Renin is released from kidneys
Angiotensinogen is converted to angiotensin 1
ACE converts angiontensin I to angiotensin II
Angiotensin II causes vasoconstriction and stimulates the release of aldosterone from the adrenal cortex

67
Q

What is the effect of aldosterone (2)

A

increases renal absorption of plasma and water
Increases plasma volume

68
Q

When are natriuretic peptides release (2)

A

in response to cardiac distension
In response to neurohormonal stimuli

69
Q

What is the effect of natriuretic peptides (6)

A

decrease renin release
Vasodilation
Excretion of salt and water in kidneys
Reduce blood volume
Decrease blood pressure
Decrease SVR

70
Q

What are the two types of natriuretic peptides

A

atrial natriuretic peptides
Brain-type natriuretic peptides

71
Q

Where is ADH made and stored (2)

A

a peptide hormone made by the hypothalamus
Stored in the posterior pituitary

72
Q

What stimulates secretion of ADH (2)

A

reduced extracellular fluid volume
Increased plasma osmolarity

73
Q

Effects of ADH (6)

A

increase reabsorption of water in kidney tubules
Vasoconstriction
Increases plasma volume
Increases cardiac output
Increases blood pressure
Increases SVR

Medicine year 1 (21 decks)

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