Cardiovascular Flashcards

1
Q

the pulmonary valve is

A

between right ventricle and pulmonary artery

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2
Q

the aortic valve is

A

between left ventricle and the aorta

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3
Q

right atrium receives deoxygenated blood from

A

IVC/SVC/coronary sinus

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4
Q

left atrium receives oxygenated blood from

A

right and left pulmonary veins

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5
Q

anterior/sternocostal surface of heart

A

mostly R ventricle

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6
Q

inferior/diaphragmatic surface of heart

A

mostly L ventricle

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7
Q

posterior surface/base of heart

A

L atrium + pulmonary veins

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8
Q

apex of heart

A

L ventricle

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9
Q

right border of heart consists of

A

right atrium

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10
Q

inferior border of heart consists of

A

L ventricle + R ventricle

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11
Q

left border of heart consists of

A

L ventricle (some of L atrium)

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12
Q

superior border of heart consists of

A

R/L atria and great vessels

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13
Q

surface marking for apex of heart

A

mid-clavicular line

5th intercostal space

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14
Q

auscultation of mitral valve

A

apex

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15
Q

auscultation for tricuspid valve

A

left lower sternal border 5th intercostal space

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16
Q

auscultation for pulmonary valve

A

left of sternum 2nd intercostal space

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17
Q

auscultation for aortic valve

A

right of sternum 2nd intercostal space

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18
Q

the first heart sound (S1) is

A

the closing of tricuspid/mitral valves at beginning of systole

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19
Q

the second heart sound (S2) is

A

the closing of aortic/pulmonary valves at beginning of diastole

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20
Q

superior mediastinum contains (5)

A
arch of aorta - 3 branches
superior vena cava - 4 tributaries 
vagus nerve
phrenic nerve
thymus/trachea/oesophagus etc
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21
Q

middle mediastinum contains (6)

A
heart
pericardium
bifurcation of trachea
origins of great vessels
cardiac plexus
phrenic nerves
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22
Q

what is the floor of the inferior mediastinum

A

the diaphragm

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23
Q

posterior mediastinum contains (5)

A
oesophagus
descending aorta - branches
azygous veins
sympathetic nerve trunks
thoracic splanchnic nerves
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24
Q

where does the right coronary artery arise from

A

anterior aortic sinus and runs in coronary sulcus

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25
Q

what does the right coronary artery supply

A

SAN
AVN
R atrium/R ventricle

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26
Q

where does the left coronary artery arise from

A

left posterior aortic sinus and divides in the atrioventricular groove

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27
Q

dominance refers to

A

70% people RCA supplies PDA
20% co-dominant from RCA and Cx
10% Cx supplies PDA

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28
Q

right marginal artery supplies

A

right ventricle and apex

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29
Q

left anterior descending supplies

A

R ventricle L ventricle and interventricular septum

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30
Q

left marginal artery supplies

A

left ventricle

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31
Q

left circumflex artery supplies

A

left atrium left ventricle

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32
Q

why are LV walls x3 thicker than RV

A

increased resistance of systemic circulation compared to pulmonary circulation

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33
Q

brachiocephalic trunk landmark

A

second right costal cartilage

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34
Q

the pericardium consists of

A

fibrous layer

serous layer= parietal and visceral

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35
Q

what is the pericardial cavity

A

space between parietal and visceral layers

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36
Q

mneumonic for pericardium

A

fart police smell villains

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37
Q

where is the oblique sinus

A

pericardial space behind the left atrium

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38
Q

what is the blood supply of the pericardium

A

pericardiacophrenic arteries

internal thoracic arteries

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39
Q

what innervates the pericardium

A

phrenic nerve

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40
Q

what supplies parasympathetic innervation of the heart

A

the vagus nerve

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41
Q

what supplies sympathetic innervation of the heart

A

sympathetic trunk via cardiac nerves

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42
Q

what provides motor innervation to the diaphragm

A

phrenic nerve

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43
Q

why do we get referred pain from heart damage

A

pain felt in cutaneous regions because dermatomes responsible for cutaneous pain are supplied by same spinal cord levels as visceral afferents from the heart

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44
Q

where is pain felt during myocardial infarction

A

right shoulder region

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45
Q

what are the nerve roots of the phrenic nerves

A

anterior rami of C3 C4 C5

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46
Q

what structures are supplied by the vagus nerve (6)

A
pharynx 
larynx
heart
lungs
foregut
midgut
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47
Q

left common carotid artery supplies

A

most of cerebral hemisphere + L face and neck

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48
Q

left subclavian artery supplies

A

vertebral
thyrocervical
axillary arteries

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49
Q

what supplies the SAN

A

60 % people RCA

40% people LCA

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50
Q

what supplies the AVN

A

posterior descending artery

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51
Q

what is haemocrit

A

the percentage of RBCs in the cellular component of blood

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52
Q

components of blood proportions are

A

45% cellular
55% fluid
45% haemocrit

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53
Q

where are erythrocytes formed in adults

A

bone marrow in axial skeleton

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54
Q

where are erythrocytes formed in children and foetuses

A

bone marrow in bones in children

liver/yolk sac/bone marrow in foetus

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55
Q

what is the erythrocyte regulatory hormone

A

erythropoietin

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56
Q

5 types of leukocytes

A
eosinophil
neutrophil
basophil
monocyte
lymphocyte
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57
Q

eosinophil characteristics

A

bilobed nucleus
upregulated in parasitic infection
decrease histamine
bright pink/orange granules

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58
Q

neutrophil characteristics

A

most abundant
multilobed nucleus - increase with age
granular cytoplasm
acute inflammation/phagocytic function

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59
Q

basophil characteristics

A

bilobed nucleus
dark blue granules fill cell
precursor to mast cells
contain histamine = allergic response

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60
Q

monocyte characteristics

A

kidney shaped nucleus
pale blue cytoplasm
differentiate into dendritic cells/macrophages
adaptive immunity

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61
Q

lymphocyte characterists

A

fried egg appearance
B or T cells
immature = bigger than RBC

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62
Q

B lymphocytes become

A

plasma and produce antibodies

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63
Q

what do T cells do

A

mediate inflammation

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64
Q

platelet features

A

anucleate and discoid
stain blue
4 types of granules

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65
Q

where are platelets formed

A

from megakaryocytes in the bone marrow

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66
Q

platelet life span

A

5-10 days

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67
Q

platelet regulatory hormone

A

thrombopoietin

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68
Q

name 4 soluble plasma proteins

A

albumin
carrier proteins
coagulation factors
immunoglobulins

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69
Q

what is haemostasis

A

maintenance of balance of blood flow so it is liquid in vessels but clot outside

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70
Q

what allows blood to stay liquid

A

coagulation factors and platelets are INACTIVE

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71
Q

what activates platelets

A

tissue factor found on all cells except endothelial cells

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72
Q

what happens when you cut yourself

A

vessel damage leads to vessel constriction
slow of blood flow to area and endothelial surfaces press together
bleeding is stopped by platelet plug and coagulation cascade

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73
Q

formation of platelet plug 5 steps

A
  1. endothelium disrupted = expose collagen fibres
  2. platelets adhere to VWF which is bound to collagen
  3. binding causes release of dense granules and thrombin form platelet
  4. platelet is activated = spiculated shape
  5. fibrinogen binds to platelets to allow more platelets to aggregate
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74
Q

what does the release of platelet dense granules do

A

causes platelet amplification

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75
Q

what does the release of thrombin do

A

platelet activation and further thrombin release via positive feedback

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76
Q

how does the platelet plug stay where its wanted

A

prostaglandins produced by undamaged endothelium = inhibit aggregation
nitric oxide from undamaged endothelium = vasodilation and inhibit aggregation

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77
Q

why do we have a coagulation cascade

A

occurs around platelet plug to support and reinforce

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78
Q

what enzyme converts prothrombin to thrombin

A

clotting factor Xa

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79
Q

what is the role of thrombin enzyme

A

convert soluble fibrinogen to insoluble fibrin

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80
Q

fibrinolytic pathway

A

plasminogen converted to plasmin to break down fibrin

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81
Q

what level is the arch of the aorta

A

T4

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82
Q

type A have

A

A antigen on surface of RBC and anti-B antibodies in plasma = co-dominant

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83
Q

type B have

A

B antigens on surface of RBC and anti-A antibodies in plasma = co-dominant

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84
Q

type AB have

A

A and B antigens on surface of RBC but no anti-A or anti-B in plasma = universal recipient

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85
Q

type O have

A

no A or B on surface of RBC but BOTH anti-A and antiB antibodies in plasma = universal donor

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86
Q

what is rhesus

A

C, D, E antigens

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87
Q

what is rhesus postivie

A

D antigen present

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88
Q

what is rhesus negative

A

D antigen NOT present

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89
Q

what is rhesus sensitisation in pregnancy

A

mother has RhD negative baby has positive
mothers blood recognises as foreign = makes antibodies against
takes time so 1st baby unaffected but mother = sensitised to RhD positive blood

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90
Q

what is rhesus disease

A

mother has antibodies against RhD positive baby
attacks baby RBC
causes anaemia and jaundice

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91
Q

4 features of a cardiac myocyte

A

intercalated discs
centrally nucleated
striated
branching

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92
Q

what is systole

A

isovolumetric ventricular contraction and ventriucular emptying (not completely)
0.3 secs

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93
Q

what is diastole

A

isovolumetric ventricular relaxation and ventricular filling

0.5 secs

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94
Q

isovolumetric definition

A

change in pressure but not in volume

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95
Q

what is responsible for 80% ventricular filling

A

rapid ventricle filling - rest is slow filling due to equalising pressures

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96
Q

what is diastis

A

little to no net movement of blood

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97
Q

what is atrial booster

A

sudden pressure increase due to atrial contraction (SAN) allowing ventricles to be actively filled

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98
Q

what is the length of a cardiac cycle

A

0.8 secs

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99
Q

what is starling’s law

A

the larger the volume of the heart the greater the energy of its contraction and amount of chemical change at each contraction
larger end diastolic volume = larger stroke volume

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100
Q

what is compliance

A

relationship between change in stress and the resultant strain e.g. how easily blood chamber expands when filled with blood

101
Q

what is diastolic distensibility

A

pressure required to fill the ventricle to the same diastolic volume

102
Q

what is elasticity

A

myocardial ability to recover its normal shape after removal of systolic stress

103
Q

parasympathetic stimulation of the heart casues

A

decrease heart rate
decrease force of contraction
decrease CO

104
Q

sympathetic stimulation of heart causes

A

increase heart rate
increase force of contraction
increase CO

105
Q

myosin structure

A

2 heavy chains and 2 light chains

106
Q

what is actin

A

polymerised globular protein with troponin and tropomyosin

107
Q

what is titin

A

elastic filaments that maintain sarcomere alignment

108
Q

molecular sarcomere contraction 4 steps

A
  1. action potential inhibits calcium pumps = calcium escape from sarcoplasmic reticulum
  2. calcium binds to troponin = changes shape so moves tropomyosin to expose myosin binding site on actin
  3. myosin head bind to actin bridges formed = ADP released = myosin head move forward = contraction
  4. energy from atp pulls z lines closer together = contraction
  5. ATP attach to myosin head = breakdown of bridges
109
Q

where are calcium ions stored

A

sarcoplasmic reticulum

110
Q

what is excitation-contraction coupling

A
  1. motor neuron connect with muscle at neuromuscular junction
  2. Acetylcholine diffuse along synaptic cleft depolarise sarcolemma
  3. depolarisation = Ca2+ released to stimulate contraction
111
Q

pressure of pulmonary circulation

A

20/8

112
Q

pressure of systemic circulation

A

120/80

113
Q

what constitutes microcirculation

A

arterioles capillaries and venules

114
Q

artery features

A

thick muscular wall to sustain force of LV contractions
elastic for systole
diastolic pressure supplies elastic recoil

115
Q

arteriole features

A

smooth muscle walls
site of resistance to vascular flow
determines arterial pressure
distributes flow to tissues/organs

116
Q

capillary features

A

endothelial cells and pericytes

fenestrated

117
Q

what is the role of precapillary sphincters

A

control blood flow to tissue

118
Q

what happens to substances and fluid that move into tissue

A

it becomes lymph

119
Q

how much of total blood do veins hold

A

70%

120
Q

3 functions that allow venous return against gravity

A

valves prevent backflow
muscle action peristalsis
respiratory pump

121
Q

lymph vessels features

A
low pressure
valves
drains excess fluid from tissues
no RBC/large proteins but all other blood components
fluid is eosinophilic
122
Q

where does lymph drain

A

subclavian veins

123
Q

stroke volume equation

A

end diastolic volume - end systolic volume

124
Q

cardiac output equation

A

heart rate x stroke volume (typically 5L/min)

125
Q

blood pressure equation (BP)

A

CO x total peripheral resistance

126
Q

pulse pressure equation (PP)

A

systolic - diastolic pressure

127
Q

mean arterial pressure (MAP)

A

diastolic pressure + 1/3rd pulse pressure

128
Q

Ohm’s Law, force =

A

pressure gradient / resistance

129
Q

what is the end systolic volume

A

volume of blood left in ventricle after contraction

130
Q

what is the end diastolic volume

A

volume of blood in ventricle before contraction (how much filled)

131
Q

Poiseuille’s equation, flow =

A

radius of blood vessel to power of 4

132
Q

what does PACE stand for

A

preload
afterload
contractility
‘eart rate

133
Q

preload definition

A

volume of blood in LV which stretches cardiac myocytes before LV contraction

134
Q

what happens if preload increases

A

increased end diastolic volume
myocardial fibres stretch more
increase force of contraction = starling
increase stroke volume

135
Q

afterload definition

A

pressure LV must overcome to eject blood during contraction

136
Q

what happens of afterload increases

A

decreases stroke volume

137
Q

increase venous return would cause

A

increase EDV
increase stretch of muscle
increase force of contraction
increase stroke volume and cardiac output

138
Q

what is contractility

A

the force in which the heart contracts

independent of load and reliant on sympathetic innervation/hormonal factors

139
Q

increase contractility would cause

A

heart contracts with more strength = higher pressure

140
Q

what is vascular resistance

A

resistance that must be overcome to push blood through the circulatory system

141
Q

which cells are auto-rhythmic

A

pacemaker cells

142
Q

which cells are non-autorhythmic

A

cardiac contractile cells

143
Q

which clotting factors is vitamin K necessary for

A

2, 7, 9, 10

remember as 1972

144
Q

cardiac myocyte action potential 6 steps

A
  1. action potential from adjacent cells = Na+ into cells = rapid depolarisation
  2. opens K+ channels = K+ out of cell = partial repolarisation
  3. Ca2+ channels open and enter = plateau
  4. Ca2+/Na+ channels close only K+ open and moving out = repolarisation
  5. resting potential maintained
145
Q

3 differences between cardiac action potential and regular action potential

A
cardiac = calcium leaving cell causes a plateau
cardiac = 200-300ms vs 1ms
cardiac = longer refractory period
146
Q

why does cardiac action potential have a longer refractory period

A

to prevent muscle fatigue

147
Q

pacemaker action potential

A
  1. HCN channels allow Na+ in = depolarisation
  2. threshold is -40mV
  3. Ca2+ voltage gated channels = calcium in = even more positive
  4. too positive = K+ open and exit = repolarisation
  5. resting potential restored
148
Q

why does the SAN determine the pace of the heart

A

because resting potential is closer to threshold = action potential initiated more rapidly than in AVN

149
Q

speed of transmission through pacemaker cells is

A

slower than through cardiac myocites because in pacemaker Ca2+ used to depolarise = slower

150
Q

sympathetic stimulation of pacemaker action potential

A

adrenaline/noradrenaline bind to Beta1 = increase Na permeability so threshold reached faster

151
Q

parasympathetic stimulation of pacemaker action potential

A

acetylcholine bind to muscarinic receptor = decrease Na permeability so threshold reached slower

152
Q

what regulates peripheral resistance

A

vasoconstriction/vasodilation
autonomic NS - sympathetic = constriction
blood viscosity
MAINLY ARTERIOLE RESISTANCE

153
Q

3 types of vasoconstrictors and examples

A
local = endothelin 1
hormonal = adrenaline/angiotensin 2/ADH
medulla = pressor region
154
Q

role of pressor region

A

increases blood pressure by increasing vasoconstriction = increase cardiac output

155
Q

name 7 local causes of vasodilation

A
NO
H+
lactic acid
hypoxia
increased CO2
bradykinin
prostaglandin/prostacyclin
156
Q

3 hormonal vasoconstrictors

A

angiotensin 2, vasopression, adrenaline

157
Q

medulla source of vasodilation is

A

depressor region = inhibits pressor region

158
Q

where are central baroreceptors located

A

atria
ventricles
pulmonary artery

159
Q

role of central baroreceptors

A

inhibit pressor region
RAAS
ADH if increased pressure
= decrease BP

160
Q

where are central chemoreceptors located

A

in the medulla

161
Q

role of central chemoreceptors

A

respond to changes in pH as CO2 cant cross BBB

162
Q

where are peripheral baroreceptors/chemoreceptors located

A
aortic arch (vagus nerve)
carotid sinus (glossopharyngeal nerve)
163
Q

role of peripheral chemoreceptors

A

stimulated by decrease O2/pH/increase CO2 = decrease BP

164
Q

role of peripheral baroreceptors

A

stimulated by high BP = lower BP

165
Q

nervous system involvement in lowering BP

A

decrease sympathetic NS

increase parasympathetic NS

166
Q

what is the developmental significance of the ligamentum arteriosum

A

remnants of shunt between PA and aorta

shunt closes at birth

167
Q

how may fibrous pericardium contribute to reduction in ventricular filling

A

pericardium swells with fluid over time
will limit ventricular filling = lower stroke volume
this increases heart rate to try and increase cardiac output as pericardium is resistant to stretch

168
Q

what phase of the cardiac cycle do coronary arteries fill

A

pressure is highest during systole so some CA fill but most in the myocardium so squeezed empty
during diastole pressure in myocardium decreases so CA fill

169
Q

where is the SAN located

A

superior end of crista terminalis at the junction of SVC and RA

170
Q

what is the thoracic duct

A

main lymphatic channel draining lymph from half of body back to bloodstream

171
Q

what does the greater splanchnic nerves supply and where is pain felt

A

foregut but felt in epigastrum

172
Q

what does the lesser splanchnic nerves supply and where is pain felt

A

midgut but felt round umbilicus

173
Q

what does the least splanchnic nerves supply and where is pain felt

A

hindgut but felt suprapubic region

174
Q

what structures drain blood into the azygous system

A

body walls
mediastina viscera
lateral/posterior chest wall
lateral/posterior abdo wall

175
Q

difference between L and R laryngeal nerve

A

left passes through thorax

176
Q

where do the sympathetic nerves attach to the nervous system

A

T1-T12

L1-L2

177
Q

sympathetic nerves to head/neck disrupted leads to

A

Horner’s syndrome

178
Q

what factors affect BP (5)

A
CO
compliance
volume of circulating blood
lifestyle factors
genetics
179
Q

when is the myocardium perfused

A

in heart relaxation (diastole)

180
Q

during cardiac cycle theres a greater flow of blood through which coronary arteries

A

left in most people

181
Q

what are the consequences of a LAD occlusion

A

myocardial infarction in front/bottom of LV and front of septum
nausea, shortness of breath, pain in head/jaw/neck
induces cardiac arrest

182
Q

what are the consequences of a RCA occlusion

A

RCA supplies SAN/AVN
chest pain, shortness of breath
leads to ischaemic myocardium and conduction abnormalities

183
Q

are RBC precursors found in the blood

A

no, this is a sign of leukemia

184
Q

what is myogenic autoregulation

A

when blood flow increase smooth muscle constricts until diameter is normalised/slightly reduced.
when blood flow decrease smooth muscle relaxes and dilates in response.

185
Q

what is intrinsic autoregulation

A

when arterioles either vasoconstrict or vasodilate in response to changes in resistance seemingly automatically to maintain constant blood flow

186
Q

what is hyperaemia

A

increase in blood flow

187
Q

what is active hyperaemia

A

increase in blood flow when metabolic activity is increased

188
Q

what is reactive hyperaemia

A

transient increase in organ blood flow that occurs following a brief period of ischaemia

189
Q

what happens at the P wave

A

atrial depolarisation

0.08-0.11s

190
Q

what happens at PR interval

A

time taken for atria to depolarise and electrical activation to reach AVN
0.12-0.2s

191
Q

what happens at the QRS complex

A

ventricular depolarisation

0.06-0.1s

192
Q

what happens at ST segment

A

interval between depolarisation and repolarisation

0.005-0.150s

193
Q

what happens at the T wave

A

ventricular repolarisation

194
Q

what happens at QT segments and how long does it take

A

ventricular depolarisation then repolarisation

0.2-0.4s

195
Q

what is the conduction pathway

A

SAN
AVN
bundle of His
Purkinje fibres

196
Q

how is the His-Purkinje system specialised (4)

A

rapid conduction
large fibres
high permeability at gap junctions
spreads from endocardium to pericardium

197
Q

what does an ECG show

A

changes in voltage over time

198
Q

p waves are positive in every lead apart from

A

aVR

199
Q

t waves are positive in every lead apart from

A

aVR/sometimes V1/V2

200
Q

what is anaemia

A

reduction in haemoglobin in the blood

201
Q

what is the normal Hb levels

A

12.5-15.5g/dl

202
Q

what is iron deficiency anaemia

A

iron needed for Hb production

lack of iron result in reduced production of small red cells

203
Q

what is MCV

A

mean corpuscular volume

= average size of RBC

204
Q

how does vitamin B12/folate deficiency lead to anaemia

A

B12/folate needed for DNA synthesis

deficiency = RBCs cannot be made in bone marrow = less are released = anaemia

205
Q

what is haemolysis

A

normal/increased RBC production but decreased life span (<30 days)

206
Q

how is a delay created at AVN

A

has less gap junctions

207
Q

what happens at day 19 heart development

A

2 endocardial tubes form

208
Q

what happens at day 22 heart development

A

embryo undergoes lateral folding

2 endocardial heart tubes fuse to form single tube

209
Q

what develops from the bulbus cordis

A

proximal 1/3 = muscular RV

conus cordis = smooth outflow portion of LV/RV

210
Q

what develops from the truncus cordis/arteriosus

A

proximal aorta and pulmonary trunk

211
Q

what develops from the primary ventricle

A

left ventricle

212
Q

what develops from the primary atrium

A

anterior RA
entire LA
L/R auricles

213
Q

what develops from the sinus venosus

A

part of RA/VC/coronary sinus

214
Q

where is the CVS embryologically derived from

A

mostly the mesoderm

some contribution from neural crest cells from ectoderm

215
Q

what occurs in cardiac looping

A
  1. bulbus cordis and primary ventricle grow
  2. BC moves inferiorly, anteriorly and right
    PV moves to left
  3. PA, SV move superiorly and posteriorly
    truncus arteriosum form
216
Q

what are the stages of cardiac embryological development

A
  1. heart tube fuse
  2. cardiac looping
  3. cardiac septation = 4th - 5th week
217
Q

what is vasculogenesis

A

angioblasts from mesoderm coalesce to form angioplasties cords throughout embryonic disc
= migrate to form the aorta

218
Q

what is angiogenesis

A

driven by growth factors = adds to vasculogenesis through proliferation and sprouting

219
Q

what does 3rd aortic arch develop into

A

L/R common/internal/external carotid arteries

220
Q

what does 4th aortic arch develop into

A
Left = part of aortic arch
Right = part of right subclavian artery
221
Q

what does 6th aortic arch develop into

A
left = L pulmonary artery and ductus arteriosus
right = R pulmonary artery
222
Q

foetal circulation

A
  1. oxygenated from placenta via umbilical vein
  2. bypass liver via ductus venosus = combine with deoxy in IVC
  3. join with blood from SVC and enter RA
  4. RA shunted to LA
  5. blood to aorta via ductus arteriosus
  6. deoxy to placenta via umbilical arteries
223
Q

what occurs after birth

A
  1. increased alveolar O2 = vasodilation of pulmonary vessels

2. increased LA pressure/decrease RA pressure = foramen ovale close

224
Q

what happens to the foramen ovale after it closes

A

becomes the fossa ovalis

225
Q

3 granulocytes

A

neutrophils
eosinophils
basophils

226
Q

2 agranulocytes

A

lymphocytes

monocytes

227
Q

the heart is mainly composed of

A

myocardium

228
Q

what are the heart valves composed of

A

fibro-elastic connective tissue

229
Q

what is the surface of the heart valves covered by

A

endocardium

includes a layer of endothelial cells

230
Q

what is the surface of the heart covered by

A

mesothelial cells that form the visceral pericardium

231
Q

what does the medial layer of blood vessels contain

A

smooth muscle
elastic
collagen

232
Q

what does the adventitia layer of blood vessels contain

A

densely packed collagen and elastic fibres

233
Q

how does cardiac muscle differ from skeletal muscle

A
structurally = branched, central mononuclear, no stem cells
physiological = contract/relax without rest, secrete hormones
234
Q

what hormone does cardiac muscle secrete and what does it do

A

ANP

when stretched excessively = increase water/K+/Na+ excretion and inhibit RAAS

235
Q

what is the role of gap junctions

A

allow ion transfer between cardiac smooth muscle = electrochemical coupling

236
Q

what colour do purkinje fibres stain with PAS

A

magenta

237
Q

purjinke fibres histology characteristics

A

large vacuoles
pale H&E bc few myofibrils
stores glycogen

238
Q

histology of valves

A

thick collagen occasional elastic tissue
both surfaces have endothelial cellss
fibrous chordae tendinae

239
Q

what is the pericardium made up of

A

single layer of mesothelial cells on BM with thin loose elastic and fibrous tissue

240
Q

what is the endocardium made up of

A

endothelial cells on BM with thin loose elastic and fibrous tissue

241
Q

what are the colours of an elastic artery with mallorys stain

A
elastic = red
collagen/muscle = blue
242
Q

capillary diameter is same as

A

RBC

243
Q

what are the 4 functions of endothelial cells

A
  1. AT across membrane
  2. influence muscle tone
  3. coagulation
  4. produce cell adhesion molecules to influence lymphocyte/neutrophil migration
244
Q

what type of muscle do large veins have in their medial layer

A

smooth muscle

245
Q

what colour do lymph vessels stain

A

blood plasma and valves stain pink

246
Q

what are reticulocytes

A

immature RBC with some visible ribosomes = dark staining granules

247
Q

why can muscular arteries reduce their diameter

A

have smooth muscle in media

248
Q

elastic tissue van gieson with iron haemotoxylin counter stain

A

elastic = black
smooth muscle = mushroom
collagen = pink

249
Q

name 2 hormonal vasodilators

A

atrial natriuretic peptide

adrenaline