Cardiovascular Pt 2 Flashcards
1
Q
What is systemic circulation?
A
Blood from the heart is distributed around the body before returning to the heart.
2
Q
What is pulmonary circulation?
A
Blood from the heart to the lungs and back to the heart.
3
Q
What are the three main types of blood vessels?
A
- Arteries
- Veins
- Capillaries
4
Q
What are smaller arteries called?
A
Arterioles
5
Q
What are smaller veins called?
A
Venules
6
Q
What is the function of capillaries?
A
Specialise in the exchange of substances between blood and cells / tissues.
7
Q
What type of blood do arteries carry?
A
Oxygenated (with exceptions: Pulmonary and umbilical arteries).
8
Q
What type of blood do veins carry?
A
Deoxygenated (with exceptions: Pulmonary and umbilical veins).
9
Q
Do arteries have valves?
A
No
10
Q
Do veins have valves?
A
Yes
11
Q
What are the three layers of blood vessels?
A
- Tunica intima
- Tunica media
- Tunica externa
12
Q
Structure of Arteries
A
Large portions of elastic tissue
Sympathetic Nerve Fibres - vasoconstriction
reduced SNS activity - nitric oxide released - vasodilation
13
Q
Structure of Arterioles
A
Small arteries - maintain BP
14
Q
Structure of Veins
A
Skeletal Muscle aids contraction
Pumping of heart is major drive
Respiratory Pump aids return
Valves
15
Q
Define capillary exchange
A
the key function of the cardiovascular system is to keep blood flowing through capillaries to allow exchange of water -osmosis
Nutrients - Facilitated diff. + A. Transport
Gases - CO2 and O2 by diffusion
16
Q
Where is your blood
A
64% systemic veins/venules
13% systemic arteries/ arterioles
9% Pulmonary vessels
7% Capillaries
7% Heart
17
Q
Define Portal Circulation
A
Venous blood passes from the Digestive tract, spleen and pancreas directly to the liver
Haptic first pass
Vessel that carries absorbed substances = portal vein
18
Q
What system causes Vasoconstriction
A
SNS (increases blood pressure)
19
Q
What is the thickest layer of the heart wall?
A
Myocardium
20
Q
What is the location of the heart
A
Rests on the diaphragm, in the thoracic, near the midline, pointing left.
Apex of heart formed by left ventricle and lies in 5th intercostal space
21
Q
What percentage of the heart is made up of myocardium?
A
95%
consists of smooth muscle
Function to pump blood out of the heart
22
Q
Function of the pericardium
A
Thin double layered membrane
Fibrous pericardium - attaches to diaphragm
inner serous pericardium
keeps heart in position within thorax
Allow free movement during contractions
23
Q
What is the function and structure of the myocardium?
A
Functions to pump blood out of the heart.
Thickest layer (95% of the heart)
Cardiac muscle - striated and involuntary.
Autorhythmic.
Coronary artery supplies blood to the myocardium
24
Q
Discuss myocardial metabolism
A
10% of total body oxygen consumed
aerobic organ
Fatty Acids are predominant fuel followed by glucose
heart can use lactic acid to produce ATP
25
what is the ineratrial septum
Separates the atria, iterventricular septum separates the ventricles
26
Describe heart blood flow from heart to lungs
Deox blood from inferior and superior vena cave arrives in right atrium.
Pumps blood through tricuspid valve and into right ventricle.
Which contracts and pumps blood through pulmonary valve and into pulmonary trunk.
blood flows to lungs for gas exchange
27
Describe blood flow from lungs to heart
Oxygenated blood returns to left atrium via pulmonary vein.
Left atrium pumps through mitral/bicuspid valve into left ventricle.
contracts pumps blood through aortic valve into ascending aorta.
28
Describe foramen ovale
within interartrial septum depression called fossa oxalis.
Called foramen ovale in foetal development - shunt blood from R to L atrium to bypass lungs
29
Define Ductus Arteriosum
In foetal life a temporary blood vessel called ductus arteriosus shunts blood from pulmonary trunk to aorta. Closes after birth to form ligaments arteriosum
30
What is the role of the sinoatrial node (SA node)?
Sets rate and rhythm of the heart. (pacemaker)
Located in R A wall
Initiates cardiac conduction - each nerve impulse propagates each atrium via gap junctions causing atrial contraction.
31
Define Heart Contraction
The myocardium performs periodic contractions through a network of cardiac fibres that are self-excitable
Hormones, age, sex, body position, exercise, stress, temp all influence heart rate and strength
SNS increase rate and strength of contraction, vasoconstriction
PNS - decreases rate and strength via vagus nerve. Little effect on blood vessels
32
What does the atrioventricular node (AV node) do?
Conducts impulses at a slightly slower rate to allow the atria to finish contracting. (Relay station)
Bottom right of interatrial septum
33
Function of bundle of his
Atrioventricular bundle
conduct from atria to ventricles
R and L bundle branches extend towards interventricular septum from bundle of his
34
Function of Purkinje Fibres
rapidly conduct nerve impulse beginning at apex of the heart up the remainder of the ventricular myocardium causing ventricular contraction
35
Define Pulse Rate
A blood pressure wave originating from the heart
Adult 70-90bpm
36
What is the term for resting heart rate over 100 bpm?
Tachycardia
37
What is the term for resting heart rate under 60 bpm?
Bradycardia
38
What is cardiac output?
The volume of blood being pumped out by the heart per minute, averaging 5 L.
39
What is blood pressure?
The pressure exerted by circulating blood on the blood vessels.
1 of the vital signs
40
What is cholesterol
A vital compound for cell structure and function. It is in every body cell
Acquired from liver cells and diet.
41
What are the functions of cholesterol?
* Cell membrane integrity
* Vitamin D and calcium metabolism
* Sex hormones (e.g., oestrogen, testosterone)
42
Lipoproteins define LDL and HDL
LDL -low density
75%
from the liver to the cells
In excess associated with cholesterol deposits in arteries.
HDL - high density
Remove excess cholesterol from body cells and transport it to the liver.
Prevent accumulation in blood.
43
What is atherosclerosis?
Narrowing and hardening of arteries.
44
What causes atherosclerosis?
Damage of the vascular endothelium creating inflammation, leading to LDL deposition in the tunica intima
LDL becomes oxidised and attracts macrophages
Macrophages surround the LDL and attempt to destroy it creating foam cells
Vascular smooth muscle cells proliferate
Cap is formed over the atherosclerotic plaque to wall off plaque from blood
CAUSE hereditary, male, age, ethnicity.
Hyperglycaemia, obesity, hyperlipidaemia, hypertension, smoking
Endothelial damage due to free radicals/ oxidative stress, hyperglycaemia, high BP
45
46
Fill in the blank: The pressure exerted by circulating blood on the blood vessel walls is called _____
Blood Pressure
47
True or False: The left ventricle is thicker than the right ventricle.
True
48
What is the function of the coronary arteries?
Supply the myocardium with an abundance of oxygenated blood.
49
What does vasodilation do to blood pressure?
Lowers blood pressure.
50
What does vasoconstriction do to blood pressure?
Increases blood pressure.
51
What percentage of blood is found in systemic veins / venules?
64%
52
What are the two types of adrenergic influence on heart rate?
* Sympathetic Nervous System: Increases rate and strength of contraction
* Parasympathetic Nervous System: Decreases rate and strength of contraction
53
What is the average pulse rate for adults?
70 to 90 bpm
54
What vessels are commonly affected by atherosclerosis?
Coronary, carotid, cerebral arteries, aorta, major arteries of the extremities
55
What are common clinical manifestations of atherosclerosis?
Angina pectoris, myocardial infarction
56
What initiates the pathophysiology of atherosclerosis?
Damage of the vascular endothelium
57
What happens to LDLs in the process of atherosclerosis?
They deposit in the damaged tunica intima and become oxidized
58
What are foam cells?
Macrophages that surround fatty material in an attempt to destroy it
59
What is the first step necessary for atherosclerosis to occur?
Endothelial damage
60
What are some risk factors for atherosclerosis?
* Hereditary
* Male sex
* Age (men > 45, women > 55)
* Ethnicity (South Asian, African or Caribbean)
* Hyperglycaemia
* Obesity
* Hyperlipidaemia
* Hypertension
* Smoking
* Stress
* Sedentary lifestyle
* Excessive alcohol
* Trans fats
* Gut/oral dysbiosis
* Intestinal permeability
61
What does ischaemic mean?
Inadequate blood supply to an organ or tissue
62
What are common symptoms of atherosclerosis due to blood vessel lumen stenosis?
Angina pectoris, myocardial infarction, stroke, transient ischaemic attack
63
What is hypercholesterolaemia?
Elevated blood cholesterol
64
What are the causes of hypercholesterolaemia?
* Familial factors
* Age-related factors
* Diet (high refined sugars, trans fats)
* Sedentary lifestyle
* Diabetes mellitus
* Obesity
* Excessive alcohol
* Smoking
65
What is angina pectoris associated with?
Ischaemic heart disease due to obstruction or spasm of coronary arteries
66
What are the types of angina?
* Stable: Pain with physical exercise
* Unstable: Occurs randomly, even at rest
67
What are the signs and symptoms of myocardial infarction?
* Severe chest pain (central, radiating)
* Sweating
* Nausea
* Pale and clammy skin
* Light-headedness
* Shortness of breath
* Overwhelming anxiety
68
What is the treatment for myocardial infarction?
* Oxygen
* Aspirin
* GTN spray
* Angioplasty
* Thrombolytic therapy
* CPR
69
What is heart failure?
The heart is impaired as a pump, failing to supply sufficient blood flow
70
What are the causes of heart failure?
* Coronary heart disease
* Hypertension
* Heart valve diseases
* Insulin resistance
71
What are the signs and symptoms of right-sided heart failure?
* Systemic oedema
* Ascites
* Portal hypertension
* Pulmonary oedema
* Congestion bronchitis
* Cardiac asthma
72
What is a stroke also known as?
Cerebrovascular accident
73
What is the acronym F.A.S.T. used for in stroke recognition?
* Face
* Arms
* Speech
* Time
74
What is an aneurysm?
Abnormal local dilations of arteries due to weakness of the vessel wall
75
What are the two types of hypertension?
* Primary (95%)
* Secondary (5%)
76
What are common treatments for hypertension?
* ACE inhibitors
* Diuretics
* Calcium channel blockers
* Beta-blockers
77
What is valve stenosis?
Fibrosis and calcification of the valve leading to obstruction of blood flow
78
What characterizes atrial fibrillation?
Irregular rhythm leading to inadequate blood supply and risk of thrombus formation
79
What is endocarditis?
An inflammation of the endocardium and valves, usually a bacterial infection
80
What is myocarditis?
Inflammation of the myocardium, often due to viral infection
81
What is pericarditis?
Acute inflammation of the pericardium, often due to viral infection
82
What is deep vein thrombosis (DVT)?
Thrombus formation in the deep veins of the legs
83
What are signs and symptoms of varicose veins?
* Aching and fatigue of legs
* Distended blue veins
84
What are the signs of a transient ischaemic attack?
Symptoms similar to stroke but last no longer than 24 hours
85
What is a common natural approach to managing hypertension?
Diet, exercise, avoiding salt and caffeine, magnesium supplementation
86
What is the treatment for deep vein thrombosis?
* Complete rest
* Heparin
* Warfarin
87
What is the pooling of the venous blood and chronically dilated superficial veins called?
Varicose veins
## Footnote
Signs and symptoms include aching and fatigue of legs, and distended blue veins.
88
What diagnostic methods are used for varicose veins?
Doppler and ultrasound
## Footnote
These methods help visualize blood flow and vein structure.
89
What is the conventional approach to treat varicose veins?
Leg elevation, ablation (e.g. laser), surgical excision
## Footnote
These methods aim to relieve symptoms and prevent complications.
90
What are some natural approaches to treating varicose veins?
Vitamin C, rutin, herbs (e.g. horse chestnut), hydrotherapy, exercise, homeopathy (aesculus, hamamelis)
## Footnote
Weight reduction is also recommended if appropriate.
91
What condition is also referred to as 'piles'?
Haemorrhoids
## Footnote
They are dilated veins in the anal canal.
92
What are the common causes of haemorrhoids?
Chronic constipation, chronic cough, hypertension (portal hypertension), obesity, pregnancy, abdominal bloating
## Footnote
These factors increase pressure in the anal area.
93
What are the signs and symptoms of haemorrhoids?
Bright red blood with bowel movements, protruding haemorrhoids, anal itching
## Footnote
These symptoms indicate irritation and possible inflammation.
94
What is Raynaud’s Syndrome characterized by?
Intermittent attacks of ischaemia in extremities
## Footnote
Most common in women aged 30–40 years.
95
What are common causes of Raynaud’s Syndrome?
Extreme temperature, emotional stimuli, rheumatological diseases (e.g. RA)
## Footnote
These triggers can provoke symptoms in susceptible individuals.
96
What are the signs and symptoms of Raynaud’s Syndrome?
Vasospasm followed by hyperaemia, pallor, cyanosis, redness, pain
## Footnote
These symptoms reflect changes in blood flow to the extremities.
97
What treatments are recommended for Raynaud’s Syndrome?
Minimise stress, exercise regularly, keep warm, stop smoking, topical nitrates, herbs (ginger, capsicum), homeopathy, acupuncture
## Footnote
These approaches help manage symptoms and improve circulation.
98
What is oedema?
Excess fluid accumulation in interstitial spaces
## Footnote
The most common type is pitting oedema.
99
What distinguishes pitting oedema from non-pitting oedema?
Pitting oedema can be pressed and leaves an indentation; non-pitting is associated with lymphoedema or hypothyroidism
## Footnote
Pitting indicates fluid that can be displaced, while non-pitting suggests more chronic conditions.
100
What are the common causes of oedema?
Heart failure, renal disease, hepatic disease, drugs (long-term steroids, NSAIDs), DVT (late complication)
## Footnote
These conditions can disrupt fluid balance in the body.
101
What is the treatment approach for oedema?
Treat the cause, diuretics, exercise, lose weight (if overweight), raise legs, avoid prolonged standing, lymphatic drainage and massage, herbs (nettle root, dandelion leaf)
## Footnote
Addressing the underlying issue is crucial for effective management.
102
What is ascites?
An excessive accumulation of fluid in the peritoneum
## Footnote
Most commonly associated with liver cirrhosis.
103
What are the primary causes of ascites?
Liver cirrhosis (80%), malignancy of liver, stomach, colon, pancreas, ovary, heart failure, constrictive pericarditis
## Footnote
Portal hypertension is a significant factor in the development of ascites.
104
What are the signs and symptoms of ascites?
Abdominal distension, discomfort, nausea, suppressed appetite, dyspnoea
## Footnote
These symptoms can significantly affect quality of life.
105
What treatments are available for ascites?
Diuretics, surgery (hepatic shunt), alternative approaches (nutrition, herbs, homeopathy, acupuncture)
## Footnote
Treatment may vary based on the underlying cause.
106
What is differential diagnosis?
The process of differentiating between two or more conditions that share similar presentations
## Footnote
It is essential for accurate diagnosis and treatment.
107
Name three cardiovascular causes of chest pain.
Stable angina, unstable angina, myocardial infarction
## Footnote
These conditions are critical to identify due to their severity.
108
What are common pulmonary causes of chest pain?
Pulmonary embolism, pneumothorax, pneumonia, pleurisy
## Footnote
These conditions can affect breathing and require immediate attention.
109
What gastrointestinal conditions can cause chest pain?
Gastro-oesophageal reflux, pancreatitis, hepatitis
## Footnote
These issues often present with similar pain patterns.
110
List some musculoskeletal causes of chest pain.
Rib joint inflammation, rib fracture, inflammation of rib cartilage
## Footnote
These causes are generally less life-threatening but can cause significant discomfort.
111
What neurological condition can present with chest pain?
Shingles
## Footnote
This condition can cause referred pain in the chest area.
