Cardiovascular System Flashcards
The right AV valve is called the ______
Tricuspid
The left AV valve is called the ______
Mitral
The right Semi-lunar valve is called the ______
Pulmonary valve
The left Semi-lunar valve is called the ______
Aortic valve
Pressure in the right is ___ of the left side. This is because _________________________________
1/6
It doesn’t have to pump as far as the left side
The right muscle wall is about ___cm thick and the left muscle wall is about ______cm thick.
- 5cm
1. 3-1.5cm
Cardiac muscle cells are joint by __________ so action potentials can move in a ____ and _____ manner
Gap junctions
Fast and smooth
What are the 3 coronary arteries?
LAD - Left Anterior Descending
RCA -Right Coronary Artery
Circumflex
What part of the heart does the LAD supply?
The front, anterior of interventricular septum
What part of the heart does the RCA supply?
Posterioer of the interventricular septum and right side
What part of the heart does the Circumflex supply?
Left side
Hibernating Myocardium refers to _____________________
Chronic Cardiac Ischaemia
Myocardial Scarring refers to _______________________________________
Fibrosis after tissue injury and necrosis
Stunned Myocardium refers to ______________________________________________
Poor myocardial function despite revascularisation
Congenital heart disease is caused by ____________________________________
Faulty embryogenesis during the 3rd to 8th week
Terminal branches of coronary arteries can be connected by __________
Anastomoses
If a coronary vessel is blocked there may be sufficient flow through ____________ to supply the heart muscle. This is called _________________
Anastomoses
Collateral Circulation
The SA node is located where the ________ joins the __________. It is connected to the AV node, which is located _______________________________, via ____________.
Vena Cava
Right atrium
Posteriorly in the lower part of the atrial septum
Internodal tracts
The depolarisation rate of the SA node is influenced by the ____. The _________ increase heart rate, the ____________ decrease heart rate
ANS
Sympathetics
Parasympathetics
____________ regulate the rate of blood flow by varying the degree of ________
Peripheral arterioles
Vasoconstriction
Why does BP not drop to 0 during diastole but gradually decrease?
Resistance offered by the capillaries maintains the pressure
What is Atrial Fibrilliation (AF)?
A common arrythmia caused by the inability of the atria to contract smoothly
What are the risk factors for AF?
Old age
CVS disease
Chronic Pulmonary Disease
Hyperthyroidism
AF starts as a single focus that evolves into ________________ of depolarisation at a ___ impulse/minute. The ___ node is unable to respond to all the stimuli so ____________________ which causes the ______ to contract at _______ times a minute
Multiple areas 400 impulse/min AV Only a few impulse result in ventricular contraction 140-160
The diagnosis of AF is made by noting the ________ of ________ in the ECG, this indicates that ________________________
Absence of P-waves
Atria are not contracting properly
How do we treat AF?
- Slow the heart rate to give the ventricles more time to passively fill
- Medications usually impede the transmission of impulses through the AV node
- Restore normal rhythm by applying an electric shock (Electrical Cardioversion)
- Use of drugs that terminate arrhythmia
Summarise Right-Left Shunts:
- Blood from the right side goes to the left side
- Decrease in O2 levels this causes bluish skin colour (Cyanosis)
- Fingertips and toes become swollen
- Associated with Tetralogy of Fallot
Summarise Left-Right Shunts:
- Blood from the left goes to the right
- No effect on O2 levels
- Associated with Pulmonary Hypertension, Hypertrophy of the right ventricle and Ventricular-septal defects
Summarise Tetralogy of Fallot:
- Aorta is elargned, Pulmonary Artery is Narrowed (Pulmonary Stenosis)
- Ventricular Spetal defect results in right-left shunt
- Right ventricular hypertrophy due to the pulmonary stenosis
Describe the pathogenesis of Valvular Heart Disease:
- Infection by β-streptrococcal, Inflammation and Degeneration cause valve damage
- Scarring of the leaflets (Fibrosis, thickening and calcification
- Obstruction and abnormal diversion of flow
- Valvular stenosis (narrowing) and incompetence (causes leakage)
- We get hypertrophy or congestion
What is rheumatic fever?
A complication of β Haemolytic streptrococcal infection.
Which valves are affected by Rheumatic fever most often?
Mitral is most common
Aortic is next
Tricuspid is after the aortic
Pulmonary is least common
What are the clinical features of Rheumatic fever?
Murmurs caused by turbulent flow Heart Failure Polyarthritis Chorea Subcutaneous Nodules
How do with treat rheumatic fever?
Ten years of monthly penicillin injections
Corticosteroids to suppress immune reactions
Valve replacement
What are the 3 types of valve replacements?
Bioprosthetic = valve comes from animaland is coated with a chemical to prevent rejection Biologic = valves come from donors Mechanical = Synthetic material, anticogulation drugs must be taken to avoid clots
What is Mitral prolapse?
- Most common heart problem
- Mitral valves and chordae tendinae become thickened and enlarged
- Leaflets can sag uni or bi laterally
What are the symptomes of mitral prolapse?
- Usually asymptomatic
- Palpitations
- Chest pain
- Difficulty breathing after exertion
- Fatigue
- Cough
- shortness of breath while lying down
What is heart failure?
Failure to pump adequate amounts of blood, can be acute or chronic
What is forward (systolic) Heart failure?
Inability of the heart to pump blood at a sufficient rate to meet the bodies oxygen demands
What is backwards (diastolic) heart failure?
Inability of the heart to pump blood at a sufficient rate to meet the bodies oxygen demands ONLY WHEN FILLING PRESSURES ARE ABNORMALLY HIGH
What is Congestive heart failure?
Fluid in the lungs or body resulting from inadequate pumping from the heart and high heart filling and venous pressures
What are the symtoms of heart failure?
Swollen legs and ankles Angina Shortness of breath Fatigue Loss of appetite Weight gain or loss
How do we manage heart failure?
Smoking Nutrition Alcohol Physical Activity Sleep
Beta Blockers
ACE inhibitors
Diuretics like frusemide
Describe the Pathogenesis of Coronary Artery Disease
- LDL deposition
- Damage to the endothelium
- Plaque formation (Can be stable if fibrosis is good or unstable if fibrosis is bad)
- Cholesterol crystals form and we get debris
- Fibrosis and calcification
- we can get thrombus formation and deep layer injury
What are the risk factors for Coronary Artery Disease?
Smoking Nutrition Alcohol Physical Activity Sleep Obesity and Diabetes General ones like age, family history etc
What is Angina Pectoris?
- Transient mocardial ischemia not severe enough to cause permanent damage
- Chest pain radiates towards the neck, arms and shoulder
- Stable angina can be treated with nitroglycerin
What are the symptoms of a Myocardial Infarction?
- Severe Chest Pain
- Sweating
- Nausea and Vomiting
- Unstable Angina
- Shortness of breath
Can have no symptoms
What is myocardial infarction?
Necrosis of the heart tissue caused by sudden blockage, haemorrhage or spasm of an coronary artery or a sudden increase in O2 demand that can’t be met
