Cardiovascular: What is the differential diagnosis of central chest pain? Flashcards

1
Q

how do sympathetic nerve fibres get from the CNS to the organs?

A
CNS
pre-ganglionic fibres
sympathetic chain ganglion (synapse)
post-synmpatic fibre
organ
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2
Q

what is transmitted between the pre-ganglionic fibres and post-ganglionic fibres? (sympathetic)

A

acetylcholine

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3
Q

what is transmitted between the ganglion and the organ? (sympathetic)

A

noradrenaline

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4
Q

where do the pre-synaptic fibres from the brain exit the spinal chord?

A

T1-L2/3 spinal nerves

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5
Q

what are the cardio-pulmonarys splanchnic nerves

A

sympathetic nerves to the heart and lungs

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6
Q

how do the parasympathetic signals from the CNS reach the organs?

A
CNS
pre-ganglionic fibres
sympathetic chain ganglion (synapse)
post-synmpatic fibre
organ
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7
Q

what is transmitted between the ganglion and the organ? (parasympathetic)

A

acetylcholine

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8
Q

what are the 4 cranial nerves which show parasympathetic activity and how do they reach the organs?

A

oculomotor nerve
facial nerve
glossopharyngeal nerve
vagus nerve

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9
Q

where in the heart are the baroreceptors found?

A

aortic arch

coronoid sinus

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10
Q

where are the chemo-receptor nerve endings found?

A

root of aorta

IV septum

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11
Q

where are skin mechanoreceptors stimulated at?

A

right T5 anterior ramus [dermatome]

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12
Q

where do the sensory APs arrive when the left side of the chest wall is touched?

A

post-central gyrus of right cerebral hemisphere

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13
Q

what is the cause of:

  • re-activation of dormant virus
  • pain can be felt anywhere in that dermatome
  • pain proceeds blisters usually at T4/T5 dermatome with CENTRAL CHEST PAIN
A

Herpes Zolster - shingles

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14
Q

what is the cause of:

  • Pectoralis major or intercostal muscle strain
  • Slipped thoracic intervertebral disc
  • CENTRAL CHEST PAIN
A

muscle, joint or bone pain (general)

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15
Q

what is the cause of:

  • pleurisy
  • peri-cardititis
  • CENTRAL CHEST PAIN
A

Parietal pleura and fibrous pericardium

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16
Q

dull visceral plain is felt in the heart due to?

A

angina and MI

17
Q

dull visceral pain is felt in the abdominal viscera due to?

A

gastritis, cholecystilitys, pancreatitis, hep. etc.

18
Q

dull visceral pain flet in the aorta is due to?

A

ruptured aneurysm or aortic arch

19
Q

where does the coronary arteries arise from?

A

right and left aortic sinuses of the ascending aorta

20
Q

where is the right coronary artery?

A

in coronary right atrio-ventricular groove

21
Q

where is the left (main stem) coronary artery?

A

in left trio-ventricular groove between pulmonary trunk an left auricle

22
Q

where the most common site of occlusion for coronary atherosclerosis?

A
  1. Anterior Inter-ventricular branch
  2. right coronary artery
  3. left coronary artery
  4. circumflex artery
23
Q

what is damaged in a complete heart block?

A

AVN