Cardiovascular Flashcards
What embryonic structure gives rise to the: ascending aorta and pulmonary trunk?
truncus arteriosus (TA)
What embryonic structure gives rise to the: smooth part (outflow tract) of the left and right ventricles?
bulbus cordis
What embryonic structure gives rise to the: trabecullated part of the left and right atria?
primative aorta
What embryonic structure gives rise to the: trabeculated part of the left and right ventricle
primative ventricle
What embryonic structure gives rise to the: smooth part of the left atrium
primitive pulmonary veins
What embryonic structure gives rise to the: coronary sinus?
left horn of sinus venous (SV)
What embryonic structure gives rise to the: smooth part of the right atrium?
right horn of the sinus venosus (SV)
What embryonic structure gives rise to the: SVC?
the right common cardinal vein and right anterior cardinal vein
What is the first functional organ in vertebrate embryos?
the heart
how many weeks in does the heart start beating spontaneously?
4 weeks
Give the new name for the following anatomical structure post delivery: Umbilical vein
Ligamtentum teres hepatis
Give the new name for the following anatomical structure post delivery: Umbilical arteries
Medial umbilical ligament
Give the new name for the following anatomical structure post delivery: Ductus arteriosus
ligamentum ateriosum
Give the new name for the following anatomical structure post delivery: Ductus venosus
Ligamentum venosum
Give the new name for the following anatomical structure post delivery: Foramen ovale
Fossa ovalis
Give the new name for the following anatomical structure post delivery: Allantois
Urashus-median umbilical ligament
Give the new name for the following anatomical structure post delivery: Notochord
Nucleus pulpous of intervertebral disc
What is the urachus?
Part of the allantoic duct between the bladder and the umbilicus. A urachal cyst or sinus is a remnant.
What is contained within the falciform ligament?
the umbilical vein (fetus)/ligamentum teres hepatits
Preload is approximated by…
ventricular end diastolic volume
Afterload is approximated by….
MAP - mean arterial pressure
Leplace’s law: wall tension = pressure X radius / 2 X wall thickness
How do we compensate for an increased afterload
Left ventricle compensates via hypertrophy to decrease wall tension
What happens to the ejection fraction in systolic heart failure?
decreases
What happens to ejection fraction in diastolic heart failure?
not affected (normal)
What is the equation for EF?
EF = SV/EDV= EDV - ESV/EDV
What is the equation for calculating Resistance through the heart?
Resistance = driving pressure (change in pressure) / flow (Q)
= 8n (viscosity) X length / pie r 4
What effect does the following maneuver have on the heart?: Inspiration
Increase intensity of right heart sounds
What effect does the following maneuver have on the heart?: Valsalva’s (phase 2), standing (decrease venous return)
decrease intensity of most murmurs (including AS)
increase intensity of hypertrophies cardiomyopathy murmur
MVP: decrease murmur intensity, earlier oner of click/murmur
What effect does the following maneuver have on the heart?: Hand Grip (increase systemic vascular resistance)
increase in MR, AR, VSD murmurs
decrease intensity of AS, hypertrophic cardiomyopathy murmurs
MVP: increased murmur intensity, later onset of click/murmur
What effect does the following maneuver have on the heart?: rapid squatting (increased venous return, increased preload, increased after load with prolonged squatting
decreased intensity of hypertrophies cardiomyopathy murmur
increased intensity of AS murmur
MVP: increase murmur intensity, later onset of click/murmur
List the systolic heart sounds
aortic/pulmoni stenosis, mitral/tricuspid regurgitation, ventricular septal defect
List the diastolic heart sounds
aortic/pulmonic regurgitation, mitral/tricuspid stenosis
Describe mitral/tricuspid regurgitation murmurs
Holosystolic, high pitches, blowing murmur
Describe aortic stenosis (AS) murmurs
Crescendo/decrescendo systolic ejection murmur
Describe ventricular septal defect murmurs
Holosystolic, harsh-sounding murmur
Describe mitral valve prolapse
Late systolic crescendo murmur. Midsystolic click
Describe aortic regurgitation (AR) murmurs
High pitches. Blowing. Early diastole. Decrescendo murmur
Describe mitral stenosis murmurs
opening snap. Delayed rumble in late diastole.
Describe PDA murmurs
continuous machine-like murmur. Loudest at S2.
Describe mitral/tricuspid regurgitation murmurs
Holosystolic, high pitches, blowing murmur
Describe aortic stenosis (AS) murmurs
Crescendo/decrescendo systolic ejection murmur
Describe ventricular septal defect murmurs
Holosystolic, harsh-sounding murmur
Describe mitral valve prolapse
Late systolic crescendo murmur. Midsystolic click
Describe aortic regurgitation (AR) murmurs
High pitches. Blowing. Early diastole. Decrescendo murmur
Describe mitral stenosis murmurs
opening snap. Delayed rumble in late diastole.
Describe PDA murmurs
continuous machine-like murmur. Loudest at S2.
What characterizes atrial fibrillation?
Chaotic/irratic baseline with no discrete P wave.
What can results from atrial fibrillation?
atrial stasis and lead to thromboembolic shock
What characterizes atrial flutter?
rapid succession of identical, back-to-back artial depolarization waves. “Sawtooth” appearance
What characterizes ventricular fibrillation?
No identifiable waves - erratic rhythm.
What can ventricular fibrillation result in?
Fatal arrhythmia without immediate CPR and defib
What characterizes 1st degree AV block?
PR interval is >200 msec. Benign asymptomatic
What characterizes 2nd degree AV block?
Progressive lengthening of the PR interval until a beat is “dropped” (P wave not followed by a QRS complex). Usually asymptomatic.
What’s another name for 2nd degree AV block?
Mobitz (wenchebach) type 1 and 2
What characterizes Mobitz type 2 AV blocks?
dorpped beats that are not preceded by a change in the length of the PR interval (as in type 1). Often found as 2:1 block, where there are 2 or more P waves to 1 QRS complex.
Can heart block progress from one stage to another?
Yes
What characterizes 3rd degree heart block?
Atria and ventricle beat independant of each other. Both P and QRS are present, although the P waves bear no relation to the QRS complex. Atrial rate is faster than the ventricle rate.
What pathogen can result in 3rd degree heart block?
Lyme’s disease
What is released from atrial myocytes in response to increase blood volume and atrial pressures?
atrial natruiretic peptide
What does atrial natriuretic peptide cause?
vasodilation and decrease in Na+ reabsorption at the renal collecting tubule. Constricts efferent renal arterioles and dilates afferent arterioles via cGMP, promoting diuresis and contributing to “aldosterone escape” mechanism
What is released from the ventricular myocytes in response to increased tension?
B-type (brain) natriuretic peptide
What is the physiological action of B-type (brain) natriuretic peptide?
Similar physiologic action to ANP, with longer 1/2 life.
BNP blood test used for diagnosing heart failure (very good negative predictive value).
What congenital heart defect is associated with 22q11 syndromes?
truncus arteriosus, metrology of Fallot
What congenital heart defect is associated with Down syndrome?
ASD, VSD, AV septal defect (endocardial cushion defect)
What congenital heart defect is associated with Congenital rubella?
Septal defects, PDA, pulmonary artery stenosis
What congenital heart defect is associated with turner syndrome?
bicuspid aortic valve, coarctation of aorta (preductal)
What congenital heart defect is associated with Marfan Syndrome?
MVP (mitral valve prolapse), thoracic aortic aneurysm and dissection, aortic regurgitation
What congenital heart defect is associated with infants of diabetic mothers?
Transposition of the great vessels (fatal)
