Cardiovascular system Flashcards

1
Q

What is the name of the cardiac muscle heart is made from?

A

Myocardium

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2
Q

Which area of the heart does the low oxygenated blood leave the heart towards the lungs?

A

right ventricle through pulmonary arteries

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3
Q

Which area of the heart does oxygenated blood enter from the lungs?

A

left atrium via pulmonary veins

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4
Q

What is the mediastinum?

A

the central compartment of the thoracic cavity, situated between the lungs. It contains all the thoracic structures except the lungs.

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5
Q

what is the sternum angle?

A

the joint between the manubrium (top) and body (middle) of the sternum

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6
Q

An imaginary line is drawn from the sternum angle to the vertebrae. Which vertebrae is the sternum angle between? and what is this imaginary line called?

A

T4 and T5

Thoracic plane

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7
Q

What does the thoracic plane do?

A

it splits the mediastinum into two main compartments- superior mediastinum and inferior mediastinum. the inferior mediastinum is then further divided into 3 parts - anterior, middle and posterior mediastinum.

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8
Q

What are the Azygos system of veins and what do they do?

A

H shaped configuration of azygos, hemiazygos and accessory hemiazygos veins. These drain the posterior thoracic wall

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9
Q

What does the thoracic duct do?

A

drains lymph from both lower limbs, the abdomen (except convex area of liver), left hemithorax, left upper limb and left side of face and neck.

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10
Q

What is the phrenic nerve?

A

A paired nerve (one from the left and one from the right) that provides motor function to diaphragm.

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11
Q

Which nerve roots does the phrenic nerve come from?

A

C3, C4, C5

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12
Q

What does the vagus nerve provide?

A

the vagus nerve provides the bulk of the parasympathetic input into the GI system and heart.

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13
Q

Which cranial nerve is the vagus nerve?

A

10

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14
Q

Where are the phrenic and vagus nerve positioned compared to the root of the lungs?

A

Phrenic nerve - anterior (infront)
vagus nerve - posterior (back)

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15
Q

What is the pericardium?

A

membrane that covers the heart

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16
Q

What does the pericardium consist of?

A
  1. Outer fibrous pericardium
  2. Inner serous pericardium - split into two - visceral (inner layer) and parietal (outer layer). The inner visceral layer is also called the epicardium which is the external layer of the heart.
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17
Q

What is the pericardial cavity?

A

A cavity filled with lubricating fluid between the two layers (visceral and parietal) of the inner serous pericardium.

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18
Q

What is Cardiac tamponade?

A

When blood of fluid accumulates in the pericardium.

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19
Q

What is pericarditis?

A

Inflammation of the pericardium caused by either bacterial or viral infection. This could lead to cardiac tamponade.

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20
Q

What is a dissecting aortic aneurysm?

A

When there is a tear in the inner layer of the aorta. Blood then rushes through the tear causing the inner and middle layers of the aorta to split.

This could lead to cardiac tamponade.

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21
Q

What is acute myocardial infarction?

A

when blood flow to heart muscle is cut off - known as heart attack. This could lead to cardiac tamponade.

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22
Q

What is the treatment of cardiac tamponade?

A

Pericardiocentesis.

Draining the accumulated fluid in the pericardium.

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23
Q

What are the 3 layers of the heart?

A
  1. epicardium (also called the visceral pericardium which is in the inner layer of the serous pericardium)
  2. Myocardium
  3. Endocardium
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24
Q

What does the epicardium consist of?

A

connective tissue. Provides protective layer.

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25
Q

What does the myocardium consist of ?

A

myocytes or cardiac muscle cells. It’s the muscular layer of the heart.

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26
Q

What does the endocardium consist of ?

A

layer of epithelium and connective tissue. It is continuous with the endothelial lining of the blood vessels.

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27
Q

Cardiac muscle.

A
  1. striated
  2. non voluntary
  3. muscle cells form highly branched interconnecting layer of fibres.
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28
Q

What does it mean that the heart operates as a functional syncytium?

A

electrical stimulus to any one part of the heart can cause contraction of the whole myocardium

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29
Q

The intercalating discs separate the cardiac muscle cells. What are the functions of desmosomes and gap junctions here?

A

1.Desmosomes hold the cells together.
2. Gap junctions pass electrical signals between cells.

30
Q

What is the fibrous skeleton?

A

Dense collagen that surrounds the heart. It is an electrical insulator between atria and ventricles preventing electrical signals from passing between the two by any route accept the AV bundle. Ensures the atria contract before the ventricles.

31
Q

What do papillary muscles and chordae tendineae do ?

A

Papillary muscles extend from the ventricle walls and attach to chordae tendineae which are attached to the atrioventricular valves. They help open and close the valves.

32
Q

What are the two types of atrioventricular valves?

A

Tricuspid (right)
bicuspid/mitral (left)

33
Q

In the atriums there is a fossa ovalis. What is this?

A

An embryological remnant of the foreman ovale which is a hole between the two atria in the foetal heart.

34
Q

Semilunar values are either aortic valve or pulmonary valve. They are both tricuspid. The aortic value is between the left ventricle and the aorta. Behind the aortic value is what? and what does this do during the end of systole?

A

Aortic sinus. At the end of systole this fills up causing the valves to shut.

35
Q

What is the difference between the intrinsic and extrinsic conducting systems of the heart?

A

Intrinsic conducting systems control contraction and its made up of cardiac muscle cells.

Extrinsic conducting system is controlled by nerves and controls things like heart rate, contraction force, etc.

36
Q

In the right ventricle there is a moderator band (septomarginal trabecular). What does this do?

A

It provides a shortcut for electrical impulses.

37
Q

Coronary arteries supply the heart with a rich blood supply. Where to coronary arteries arise from?

A
  1. Right coronary artery arises from the right aortic sinus
  2. Left coronary artery arises from the left aortic sinus
38
Q

What does the LEFT coronary artery divide into and what do these branches supply?

A
  1. anterior intraventricular branch - supplies anterior wall of both ventricles.
  2. Circumflex branch- in 40% of people it supplies the SA node.
39
Q

What does the RIGHT coronary artery divide into and what do these branches supply?

A
  1. sinoatrial node branch - in 60% of people this supplies the SA node.
  2. marginal branch - supplies right border of the heart
  3. Large posterior inter ventricular branch that descends in the posterior inter ventricular groove.
40
Q

What is the coronary sinus?

A

An area is the heart that gets deoxygenated blood deposited by cardiac veins.

41
Q

All blood vessels, except capillaries, have a three layered wall. What are these three layers?

A
  1. Tunica intima (inner)
  2. Tunica media (middle)
  3. Tunica adventitia (outer)
42
Q

Which type of blood vessel creates the diastolic blood pressure?

A

Elastic arteries. The blood pressure created when the walls of the elastic arteries expand (systole) and recoil (diastole) is the diastolic blood pressure.

43
Q

What is the name of the muscular arteries, and what are 3 examples?

A

Conduit arteries.

3 examples are radial, cerebral and coronary arteries.

44
Q

What is the difference between proximal and distal arterioles?

A
  1. Proximal arterioles have many layers of SMOOTH MUSCLE and are richly innovated by sympathetic nerve fibres.
  2. Distal (closer to capillaries) only have 1-3 layers of smooth muscle and are poorly innervated by sympathetic nerve fibres.
45
Q

What are arteriovenous anastomosis and where are they found? Do the richly or poorly innervate the sympathetic nervous system?

A

vessels which directly link the arteries and veins, bypassing the capillaries. Only found in skin and nasal mucosa. They are richly innervated by sympathetic nervous system.

46
Q

What is hypertension? and what are the two forms?

A
  1. high blood pressure.
  2. primary (the most common) and secondary.
47
Q

The initial treatment for hypertension is lifestyle changes, but antihypertensive drugs can also be used. What are these?

A
  1. B blocker
  2. ACE inhibitors
  3. Calcium antagonists
  4. Diuretics
48
Q

At what level does the aortic arch start?

A

T4/T5

49
Q

What are the 3 branches that come out of the aortic arch?

A
  1. Brachiocephalic trunk which branches into right subclavian artery and right common carotid artery.
  2. Left common carotid artery
  3. Left subclavian artery.
50
Q

Where does the common carotid artery arise from?

A

The aortic arch

51
Q

At what level does the common carotid artery branch, and what are the two branches?

A

at C3 the common carotid artery branches into internal carotid artery and external carotid artery. The internal supplies the brain and the external supplies the neck face and scalp.

52
Q

What are the two major arteries in the forearm?

A

ulner and radial arteries

53
Q

What does the subclavian artery supply and what does the subclavian artery become in the upper limb?

A

Supplies the arm, thoracic wall, shoulder and neck.

In the upper limb, the subclavian artery becomes the axillary and then brachial artery.

54
Q

The abdominal aorta gives off 4 branches, what are these?

A
  1. Coeliac trunk (at T12)
  2. Superior mesenteric artery (at L1)
  3. renal artery (L1/2)
  4. inferior mesenteric artery (L3)
55
Q

The abdominal aorta then splits into common iliac artery. The common iliac artery then splits into internal and external iliac artery. what do these supply?

A
  1. internal iliac artery supplies pelvic cavity and perineum
  2. external iliac artery continues as the femoral artery and supplies lower limbs.
56
Q

Veins do not have branches. What do they have instead?

A

tributaries

57
Q

What drains the posterior thoracic wall?

A

Azgyos system of veins

58
Q

which vertebrae is the base of the heart situated between?

A

T6-T9

59
Q

What are the 4 surfaces of the heart?

A
  • anterior surface (covers mainly right ventricle)
  • inferior surface (covers mainly left, but partly right ventricle)
  • left surface - (covers left ventricle). This is the lateral side of the heart next to left lung
  • Base surface - posterior aspect of heart (covers mainly left but partly right atrium)
60
Q

What are 3 ways to treat myocardial infarction?

A
  1. primary percutaneous intervention (PCI) - angioplasty (widens blocked vessel using stent). The blocked vessel is accessed via artery in groin.
  2. Thrombolytics - medicines used to breakdown blood clots
  3. Coronary artery bypass graft- blood vessel from somewhere else in body is attached above and below blockage to bypass the block
61
Q

Why are veins and venules called capacitance vessels?

A

Because they contain up to two thirds of the circulating blood and any one time.

62
Q

When does the descending/thoracic aorta become the abdominal aorta?

A

When it passes through the aortic hiatus at T12.

63
Q

What does the internal jugular vein drain?

A

head and neck

64
Q

What does the subclavian vein drain?

A

Upper limb

65
Q

WHat doe the internal jugular vein and subclavian vein join to make? and then what do both of these on each side join to make?

A

The internal jugular vein and subclavian vein join together to form brachiocephalic vein on each side of the body. Two brachiocephalic veins then join together to form the superior vena cava

66
Q

What is the inferior vena cava formed of ?

A

The common iliac veins which drain the lower limbs and pelvis.

67
Q

What is the portal venous system?

A

Collection of veins that drain into the liver before draining into the inferior vena cava

68
Q

Where does the pulmonary trunk arise from?

A

Conus arteriosus which is in the right ventricle.

69
Q

The outer layer of blood vessels is the tunica adventitia. What does the contain in large blood vessels?

A

Vasa vasorum which is responsible for nourishing the media.

70
Q

What are the main resistance blood vessels?

A

Arterioles