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Phase 1 > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

What are the 2 phases of the blood and what percentages are they?

A

cellular (45%) and fluid component (55%)

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2
Q

How many litres of blood are the approximately in the body?

A

5

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3
Q

What does haematocrit mean what what is the normal value?

A

the volume of red blood cells

0.45

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4
Q

What is haemopoiesis?

A

the process of the production of blood cells and platelets which continues throughout life

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5
Q

Where does haemopoiesis occur in adults?

A

bone marrow

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6
Q

What is the lifetime of a red blood cell?

A

120 days

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7
Q

What is the lifetime of platelets?

A

7-10 days

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8
Q

What is the lifetime of white blood cells?

A

6 hours

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9
Q

Where are the precursor cells of red blood cells in an adult, child and in utero?

A

axial skeleton
all bones
yolk sac, then liver and spleen

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10
Q

What are precursor cells in the blood a sign of?

A

leukaemia

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11
Q

What are the hormonal growth factors that stimulate precursor stem cells to proliferate and differentiate into blood cells?

A 
RBC = erythropoietin
WBC = Granulocyte colony stimulating factor
Platelets = Tpo
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12
Q

What way will an oxygen dissociation curve shift if pH is decreased?

A

right

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13
Q

What way will an oxygen dissociation curve shift if temperature is decreased?

A

left

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14
Q

What are young red blood cells known as?

A

reticulocyte

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15
Q

What does haemoglobin do?

A

carries oxygen from the lungs to tissues where it transfers oxygen to myoglobin in muscles

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16
Q

Why is blood type AB a universal recipient?

A

has neither anti-A or anti-B antibodies in their plasma and has A and B antigens on surface of RBCs

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17
Q

Why is blood type O a universal donor?

A

has both anti-A and anti-B antibodies and no A or B antigens

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18
Q

What antigens does Rhesus refer to?

A

C,D,E antigens but D is the most important

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19
Q

What is normal haemoglobin level?

A

12.5-15.5

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20
Q

What condition is caused by low haemoglobin in the blood?

A

anaemia

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21
Q

What condition is caused by high haemoglobin in the blood?

A

polycythaemia

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22
Q

How is red cell size measured and what is a normal range?

A

Mean cell volume

82-96

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23
Q

What is macrocytic anaemia?

A

large red blood cells

MCV > 100

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24
Q

How is B12 absorbed?

A

intrinsic factor produced by the gastric parietal cells in the stomach where B12 binds to and is absorbed in the terminal ileum

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25
Q

What is Pernicious anaemia?

A

antibodies made against gastric parietal cells so less intrinsic factor is produced

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26
Q

What is haemolysis?

A

normal or increased cell production but decreased life span

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27
Q

What is the role of neutrophils?

A
  • phagocytose and kill bacteria

- release chemotaxins and cytokines

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28
Q

What is the general role of lymphocytes?

A
  • vital to immunity
  • generate antibodies against specific foreign antigens
  • immunological memory
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29
Q

Where are B lymphocytes made, stored and what is their role?

A

made in the bone marrow
stored in secondary lymphoid organs
differentiate into plasma cells and produce immunoglobulins when stimulated by exposure to foreign antigen

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30
Q

Where are T lymphocytes made, matured and what is their role?

A

made in bone marrow
mature in thymus
helper cells (CD4, help B cells in antibody generation) and cytotoxic cells (CD8)

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31
Q

What is acute myeloblastic leukaemia (AML)?

A

malignant proliferation of the precursor myeloblasts in the bone marrow

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32
Q

What is acute lymphocytic leukaemia (ALL)?

A

malignant proliferation of the lymphoblast precursor cells in the bone marrow

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33
Q

What is high grade lymphoma?

A

lymphocytes in the lymph nodes becoming malignant, usually spreads to the liver, spleen, bone marrow and blood

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34
Q

What does reduced numbers of platelets lead to?

A

Thrombocytopenia (risk of cerebral bleeding)

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35
Q

What does increased numbers of platelets lead to?

A

Thrombocytosis (can lead to arterial and venous thrombosis leading to increased risk of heart attack and stroke)

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36
Q

What are 5 proteins found in the blood?

A
  • coagulation proteins
  • plasma proteins
  • albumin
  • carrier proteins
  • immunoglobulins
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37
Q

Where are coagulation proteins produced and what is the key enzyme?

A

produced in the liver, key enzyme is thrombin

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38
Q

Where is albumin produced, what is its role and what does it carry?

A

produced in the liver
maintains oncotic pressure
carries fatty acids, steroids and thyroid hormones

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39
Q

What is the coagulation cascade?

A

series of proteolytic enzymes activated by exposure to tissue factor generate thrombin to form fibrin polymer (a clot)

40
Q

How do platelets adhere to collagen fibres?

A

via intermediary called Von Willebrand Factor that is already attached to collagen by glycoprotein 1b receptor

41
Q

What happens when platelets bind to collagen fibre wall?

A

release contents of secretory vesicles via exocytosis

42
Q

What is platelet activation?

A

platelet changes from a smooth discoid shape to a more spiky shape with psuedopodia increasing its surface area

43
Q

What is platelet aggregation?

A

increase in glycoprotein receptors on platelets that bind to fibrinogen enabling new platelets to adhere

44
Q

Why does cardiac muscle have a striated appearance?

A

repeating sarcomeres

45
Q

How are the cardiac muscle cells joined together?

A

at intercalated discs

46
Q

What are present in intercalated discs?

A

desmosomes that hold the cells together and attach to the myofibrils, and gap junctions

47
Q

What is the structure of myosin?

A

2 large polypeptide heavy chains and 4 smaller light chains

2 globular heads and long tail formed by 2 intertwined heavy chains

48
Q

What does the globular head of myosin contain?

A

2 binding sites, one for attaching to the thin filament and one for ATP

49
Q

What is the structure of actin?

A

thin filament also containing troponin and tropomyosin
single polypeptide with other actin monomers to make 2 intertwined helical chains
each actin molecule has a binding site for myosin

50
Q

What is the structure of tropomyosin?

A

elongated molecule that occupies the grooves between 2 actin strands, overlies myosin binding sites on actin

51
Q

What is the purpose of troponin?

A

changes shape when Ca2+ binds to it, pushing the tropomyosin exposing myosin binding sites

52
Q

What is the A band region of the sarcomere?

A

all of myosin with some overlapping actin

53
Q

What is the I band region of the sarcomere?

A

only occupied by actin

54
Q

What are Z lines on the sarcomere?

A

defines the end of a sarcomere

55
Q

What is the H zone on a sarcomere?

A

only contains myosin

56
Q

What is the M line on a sarcomere?

A

centre of the H zone

57
Q

What is titin?

A

elastic protein filaments from Z line to the M line that maintain alignment of the thick filaments in the middle of each sarcomere

58
Q

What is the sarcoplasmic reticulum and what is its role?

A

membrane network that surrounds the contractile proteins

releases Ca2+ when Ca2+ binds to it ryanodine receptor

59
Q

When an action potential is generated, there is an influx of Ca2+ via the T tubules, what does this then cause to happen?

A

small increase in cytosolic Ca2+ concentration, the ions bind to ryanodine receptors on sarcoplasmic reticulum, causing release of many Ca2+ into cytoplasm, initiating cardiac muscle contraction

60
Q

What is the power stroke?

A

myosin head drops ADP to pull actin filament over the myosin, decreasing the z lines

61
Q

Does contraction last longer in skeletal or cardiac muscle and why?

A

longer in cardiac muscle due to slower calcium channels

62
Q

What is the refractory period?

A

time after an action potential where a second impulse cannot cause a second contraction of muscle

63
Q

What supplies blood to myocardial cells?

A

coronary arteries

64
Q

Where do the coronary arteries exit from?

A

behind the aortic valve cusps in first part of aorta

65
Q

Where do the coronary arteries drain into?

A

single vein called the coronary sinus which empties into the right atrium

66
Q

What 3 ion channels contribute to pacemaker potential?

A

K+ channels, F-type channels and Ca2+ channels

67
Q

What cells does the atrioventricular node consist of?

A

modified cardiac cells that have lost contractile capability but conduct action potentials with low resistance

68
Q

Why is the AV node being elongated an important feature?

A

enables the atria to empty blood into the ventricles before ventricular excitation

69
Q

What cells do the purkinje fibres make contact with to spread the action potential through the ventricles?

A

ventricular myocardial cells

70
Q

How are parasympathetic fibres transmitted to the heart?

A

vagus nerve

71
Q

What 3 things are decreased for parasympathetic stimulation of the heart?

A

heart rate
force of contraction
cardiac output

72
Q

How are sympathetic fibres transmitted to the heart?

A

Postganglionic fibres innervate the entire heart

73
Q

What is the P wave on an ECG?

A

atrial depolaristion

74
Q

What is the PR interval on an ECG?

A

time taken for atrai to depolarise and electrical activation to get through AV node

75
Q

What is the QRS complex on an ECG?

A

ventricular depolarisation

76
Q

What is the ST segment on an ECG?

A

interval between depolarisation and repolarisation

77
Q

What is the T wave on an ECG?

A

ventricular repolarisation

78
Q

What is dextrocardia?

A

heart on the right side of the chest instead of left

79
Q

What would an ECG show for acute anterolateral myocardial infarction?

A

ST segments raised in anterior (V3, V4) and lateral (V5, V6) leads

80
Q

What would an ECG show for acute inferior myocardial infarction?

A

ST segments raised in inferior (II, III, aVF) leads

81
Q

Where would you palpate for the left ventricle?

A

5th left intercostal space and midclavicular line

82
Q

What is stroke volume?

A

volume of blood ejected from each ventricle during systole

83
Q

What is cardiac output?

A

volume of blood each ventricle pumps as a function of time

84
Q

What is total peripheral resistance?

A

the total resistance to flow in systemic blood vessels from beginning of aorta to vena cava

85
Q

What is preload?

A

volume of blood in left ventricle which stretches the cardiac myocytes before left ventricular contraction

86
Q

What is afterload?

A

the pressure the left ventricle must overcome to eject blood during contraction

87
Q

What is compliance?

A

how easily the heart chamber expands when filled with blood volume

88
Q

What is hyperemia?

A

increase in blood flow

89
Q

What happens on day 19 of embryology of the heart?

A

2 endocardial tubes form that fuse together 2 days later to form a single heart tube

90
Q

What does the proximal 1/3 of the bulbus cordis give rise to?

A

muscular right ventricle

91
Q

What does the conus cordis (lower part of bulbus cordis) give rise to?

A

smooth outflow portion of the right and left ventricles

92
Q

What does the truncus cordis (upper part of bulbus cordis) give rise to?

A

proximal aorta and pulmonary trunk

93
Q

What does the primitive ventricle give rise to?

A

the left ventricle

94
Q

What does the primitive atrium give rise to?

A

anterior part of right atrium, entire left atrium and the right and left auricles

95
Q

What does the sinus venosus give rise to?

A

part of the right atrium, vena cava and coronary sinus

96
Q

What does the aortic sac give rise to?

A

aorta and pulmonary artery

97
Q

What fuses to become the interatrial septum around 3 months after birth?

A

the septum secundum and valve of the foramen ovale

Phase 1 (5 decks)

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