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Pathology > Cardiovascular system and diseases > Flashcards

Cardiovascular system and diseases Flashcards

1
Q

Components of the circulatory system

A
  • A central pump - the heart
  • A distributary system (away) - aorta, arteries, arterioles
  • An oxygenation system - pulmonary vessels/lungs
  • A system for exchange - the capillaries
  • A collecting system (toward) - veins, vena cava
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2
Q

what are the four heart valves and where are they located?

A

tricuspid - between right atrium and right ventricle
pulmonary - between right ventricle and pulmonary artery
mitral - between left atrium and left ventricle
aortic - between left ventricle and aorta

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3
Q

Myocardium

A

The cardiac muscle composed primarily of a collection of specialized muscle cells - contract at their own pace

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4
Q

how are ventricular myocytes arranged?

A

circumferentially in a spiral orientation

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5
Q

coronary arteries

A

provide a constant supply of oxygenated blood to the heart

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6
Q

what are the Three major epicardial coronary arteries? what do they support?

A

Left anterior descending (LAD) artery - left ventricle, Left circumflex (LCX) artery - surroundings, Right Coronary artery - right ventricle

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7
Q

where do myocardial infarctions tend to happen? why?

A

at the LAD artery - causes pump failure meaning oxygenated blood cannot be taken to the rest of the body

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8
Q

when does Most coronary arterial blood flow to the myocardium occur?

A

during ventricular diastole, - when the microcirculation is not compressed by cardiac contraction

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9
Q

what does the Cardiac conduction system regulate?

A

heart rate and rhythm

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10
Q

what are the components of cardiac conduction and where are they located?

A

• The sinoatrial (SA) pacemaker of the heart, the SA node, located
near the junction of the right atrial appendage and the superior
vena cava
• The atrioventricular (AV) node, located in the right atrium along the atrial septum;
• The bundle of His, which courses from the right atrium to the
summit of the ventricular septum; and its major divisions
• The right and left bundle branches, which further arborize in the
respective ventricles through the anterior-superior and posterior-inferior divisions of the left bundle and the Purkinje network

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11
Q

arrhythmias

A

Conduction defects due to uncoordinated generation of impulses lead to non uniform and inefficient contraction

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12
Q

Ventricular fibrillation

A

ventricles are not contracted in a coordinated way

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13
Q

The Frank-Starling mechanism

A

Increased filling volumes dilate the heart and increase functional cross-bridge formation within the sarcomere to increase contractility

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14
Q

Activation of neurohumoral systems for Myocardial adaptation

A

Noradrenaline release, which increases heart rate and contractility. RAAS activation and atrial natriuretic peptide release to adjust filling volumes and pressures

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15
Q

Common cardiovascular

diseases

A
  • Atherosclerosis
  • Hypertension
  • Stroke
  • Heart Failure
  • Arrhythmia
  • Heart valve problems
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16
Q

Structure and function of the venous system

A

smaller diameter blood vessels, lower pressure, less smooth muscles, less contraction

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17
Q

Structure and function of arterial system

A

larger diameter blood vessels, higher pressure, more smooth muscles, more contraction

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18
Q

what is the ECM composed of?

A

elastin, collagen, and glycosoaminoglycans

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19
Q

what factors affect blood pressure?

A

cardiac

output (heart) and peripheral vascular resistance (vessels)

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20
Q

hypotension

A

(low pressures) results in inadequate organ perfusion and can lead
to dysfunction or tissue death

90/60

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21
Q

Hypertension

A

(high pressures) can cause vessel and end-organ damage

140/90

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22
Q

normal blood pressure

A

120/80

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23
Q

how are high BP and atherosclerosis linked?

A

high BP causes vessel damage, hardening of walls and plaque formation

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24
Q

risk factors of hypertension

A

age, genetics, BMI, diet (incl, Na intake), stress

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25
Q

Hypertension classification

A

Essential (idiopathic) hypertension - primary, multifactorial, genetics important

Secondary hypertension - results from other diseases

26
Q

regulating blood pressure through cardiac output

A

blood volume (sodium retention, mineralcorticoids, atriopeptin)

cardiac factors (heart rate and contractility)

27
Q

regulating blood pressure through peripheral resistance

A

humoral factors (constrictors and dilators such as hormones and mediators), neural factors (constrictors and dilators), local factors (pH, hypoxia)

28
Q

give n example of secondary hypertension for

  • renal
  • endocrine
  • cardiovascular
  • neurological
A

Renal - angiotensin II
Endocrine - Cushing’s Syndrome
Cardiovascular - narrow arteries
Neurological - vasopressin

29
Q

Symptoms of hypertension

A

Persistent headache, Blurred or double vision, Nosebleeds, Shortness of
breath

30
Q

complications of hypertension

A

stroke, retinopathy, vascular disease, renal failure, coronary heart disease

31
Q

treating hypertension

A
  • ACE inhibitors or angiotensin receptor antagonists - reduce angiotensin II effect
  • Beta-blockers - decrease contractility
  • Calcium channel blockers - relaxes smooth muscle arteries
  • Diuretics - removes water and sodium to reduce body volume
32
Q

Systemic hypertension

A

causes left heart hypertrophy (most common)

33
Q

Pulmonary hypertension

A

causes right heart hypertrophy

34
Q

Morphology of hypertensive left ventricular hypertrophy

A

Left ventricular wall thickening, Increased heart weight, Ventricular wall stiffness impairs diastolic filling causing left atrial enlargement

35
Q

how to clinically diagnose hypertensive heart diseases

A

by electrocardiogram or echocardiography

36
Q

Atherosclerosis

A

(“hardening of the arteries”) is a generic term for thickening and loss of elasticity of arterial walls

37
Q

intimal lesions

A

atheromatous or fibrofatty

plaques which protrude into and obstruct vascular lumens

38
Q

cholesterol link to atherosclerosis

A

Associated with increased LDL-cholesterol and reduced HDL-cholesterol

39
Q

risk factors of atherosclerosis

A

Non-modifiable: Age, Gender (M>F), Positive family history, Genetic abnormality (eg, ACE gene)

modifiable: Hyperlipidemia, Hypertension, Smoking, Diabetes, Obesity, Physical inactivity

40
Q

Atherosclerotic plaques features

A

protrude into vessel lumens, raised lesion with a yellow necrotic core (lipid, debris, foam cells, fibrin) covered by a white fibrous cap (dense collagen). Crystalline cholesterol clefts, a shoulder containing macrophages, and neovascularisation

41
Q

what are the three principal components of plaques

A
  1. Cells: SMCs, macrophages, and other leukocytes (shoulder)
  2. Extracellular matrices: collagen, elastin, proteoglycans (cap)
  3. Intracellular and extracellular lipid (core)
42
Q

early plaque morphology

A

fatty streaks - lipid filled foam macrophages

43
Q

foam cells

A

macrophages that are unable to digest lipids - causes deposition

44
Q

advanced complications of atherosclerosis

A

ruptured lesion that thrombose and eventually become a clot

45
Q

Consequences of

atherosclerotic plaques

A

rupture or ulceration leads to thrombosis. haemorrhage. atheroembolism. aneurysm

46
Q

Ischemic heart disease

A

reduced blood flow due to obstructive atherosclerotic lesions in the coronary arteries

47
Q

Clinical manifestations of ischemic heart disease

A
  • Angina pectoris
  • Myocardial infarction, most important
  • Heart failure
  • Sudden cardiac death
48
Q

Angina pectoris

A

chest pain

49
Q

Patterns of angina pectoris

A

1) Stable or typical angina
2) Variant (Prinzmetal, vasospastic) angina
3) Unstable (crescendo) angina

50
Q

Myocardial Infarction

A

heart attack - death of cardiac muscle due to

prolonged severe ischemia

51
Q

Causes of coronary

arterial occlusion

A

coronary atherosclerosis, vasospasm, emboli from left atrium

52
Q

symptoms of myocardial infarction

A

severe chest pain, sweating, nausea and vomiting

53
Q

aneurysm

A

dilation of vessel wall

54
Q

usual duration of angina pectoris

A

15sec to 15min - +30min is more likely heart attack

55
Q

main ECG change in myocardial infarction

A

elevated ST segment

56
Q

heart failure

A

impaired ability to function as a pump to support a physiological circulation

57
Q

when does congestive heart failure occur

A

when heart is unable to pump blood at a rate sufficient to meet the metabolic demands or only at an elevated filling pressure

58
Q

Different forms of heart failure

A

acute, chronic, left, right

59
Q

causes of left heart failure

A

1) congestion of the pulmonary circulation - cant be taken back to heart
2) stasis of blood in the left-sided chambers - contraction not forceful enough
3) hypoperfusion of tissues leading to organ dysfunction

60
Q

morphological and clinical effects of left heart failure

A

left ventricle hypertrophy and dilation, left atrium dilation. pulmonary congestion and odema

61
Q

right heart failure

A

secondary consequence of LHF due to increase in pressure in the pulmonary circulation

62
Q

example of a hallmark of right heart failure

A

pretibial and pedal oedema

Pathology (8 decks)

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