Cardiology Overview

Question 1

Parasympathetic stimulation will not affect which chambers of the heart?

Answer 1

ventricles (little or no innervation)

Question 2

Pacers of the heart:

Dominant pacemaker of the heart

60-100 bpm

Answer 2

SA node

Question 3

Only normal pathway between atria and ventricles

Has delay = ventricular filling

Answer 3

AV node

Question 4

What is the dominant pacemaker of the heart?

Answer 4

SA node

Question 5

Splits into right and left bundles

Answer 5

Bundle of His

Question 6

Line entire endocardial surface of ventricles

Answer 6

Purkinje fibers

Question 7

If SA node fails – what are the backups?

Answer 7

Atria
AV junction
ventricles

Question 8

Arises from right aortic sinus and runs in the AV groove at crux of heart, turns south and becomes PDA

Answer 8

Right coronary artery

Question 9

Arises from left aortic sinus of the ascending aorta, passes between LA and pulmonary artery

Supplies left atrium

Answer 9

Left coronary artery

Question 10

Cardiac output

Answer 10

stroke volume X heart rate

Question 11

What are the stroke volume factors and their contributions?

Answer 11

Preload +
Contractility +
Afterload –

Question 12

This part of the brain controls blood pressure by generating sympathetic firing, integrates cardiovascular reflexes, integrates signals from neural networks/circulating hormones and drugs

Answer 12

Medulla

Question 13

Released from atria when stretched (increase in blood volume)

Leads to higher Na+ excretion = decreased blood volume

Answer 13

ANP – atrial natriuretic peptide

Question 14

Released when sympathetic nervous system is activated

Answer 14

Epinephrine

Question 15

Hormonal control of blood pressure:

Decreased blood pressure and decreased volume = triggered release

This catalyzes conversion of A 🡪 A1 (A1 converted to A2 by ACE)

This is released during blood loss even before fall in arterial pressure

Answer 15

renin

Question 16

Hormonal control of blood pressure:

vasoconstriction of the arteries only (powerful vasoconstrictor)

Increases Na+ reabsorption (decreased excretion) in proximal tubules

Releases aldosterone which promotes Na+ reabsorption in distal tubules

Answer 16

Angiotensin II

Question 17

Hormonal control of blood pressure:

Released by ANG-II

Promotes water reabsorption

Enhances NE release, decreased NE uptake, sensitizing vascular smooth muscle to NE

Answer 17

AVP

Question 18

Sudden relaxation in skeletal muscles, decreased respiration,
unconsciousness

Can be triggered by emotional experiences

Increased parasympathetic, decreased SAS 🡪 bradycardia

Answer 18

Vasovagal syncope

Question 19

Where exchange takes place

Includes arterioles, capillaries, venuoles

Begins where smallest arteries enter organ and ends where smallest veins leave organ

Answer 19

Microcirculation

Question 20

Responsible for vascular resistance (70-80%)

Answer 20

Arteries and arterioles

Question 21

Exchange; endothelial tube – no smooth muscle

Moves through pores; porosity of capillaries differ in organs (ex: liver vs BBB)

Answer 21

Capillaries

Question 22

Blood reservoir

More permeable than caps to large and small molecules

Answer 22

Venuoles

Question 23

Microvessels carrying fluid, serum proteins, lipids, foreign substances from interstitial fluid back to
circulation

GI, liver, skin 🡪 most extensive lymphatic systems (pulmonary circulation as well)

Answer 23

Lymphatic system

Question 24

Ventricular contraction is called what?

Answer 24

Systole

Question 25

Ventricular relaxation is called what?

Answer 25

Diastole

Question 26

Which heart sound is described below? Early systole, mitral and tricuspid closes Best heard at the apex Normal heart sound

Answer 26

S1

Question 27

Which heart sound is described below? End of systole, pulmonary and aortic valves close Comprised of A2 and P2 - Fused with expiration, split with inspiration

Answer 27

S2

Question 28

Which heart sound is described below? Part of what makes up S2 Occurs first louder Heard throughout the precordium

Answer 28

A2: aortic

Question 29

Which heart sound is described below? Part of what makes up S2 Occurs second softer Heard best at the 2nd and 3rd left ICS Close to the sternum (listen for splitting of S2 here)

Answer 29

P2: pulmonic

Question 30

Which heart sound is described below? Early in diastole “ventricular gallop” Has to do with volume overload states - (normal in kids and pregnancy, abnormal in adults)

Answer 30

S3

Question 31

Which heart sound is described below? Pressure overload Late in diastole Always pathological “atrial gallop”

Answer 31

S4

Question 32

Describe the pathway of the normal conduction cycle of the heart

Answer 32

SA node 🡪 AV node 🡪 AV bundle (bundle of His) 🡪 L and R bundle branches of the interventricular septum 🡪 Purkinje fibers

Question 33

Name and describe the three layers of the heart

Answer 33

Endocardium - Inner, Lining of endothelial cells Myocardium - Muscle Epicardium - Outer, Visceral pericardium

Question 34

Oblique ear lobe crease (often) bilateral in patients >50 years old 🡪 significant CAD also presence of preauricular crease

Answer 34

Lichtstein’s Sign

Question 35

5th ICS, MCL or 7-9cm lateral to midsternal line

Answer 35

Point of Maximal Impulse