Cardiovascular: What is the differential diagnosis of central chest pain? Flashcards
how do sympathetic nerve fibres get from the CNS to the organs?
CNS pre-ganglionic fibres sympathetic chain ganglion (synapse) post-synmpatic fibre organ
what is transmitted between the pre-ganglionic fibres and post-ganglionic fibres? (sympathetic)
acetylcholine
what is transmitted between the ganglion and the organ? (sympathetic)
noradrenaline
where do the pre-synaptic fibres from the brain exit the spinal chord?
T1-L2/3 spinal nerves
what are the cardio-pulmonarys splanchnic nerves
sympathetic nerves to the heart and lungs
how do the parasympathetic signals from the CNS reach the organs?
CNS pre-ganglionic fibres sympathetic chain ganglion (synapse) post-synmpatic fibre organ
what is transmitted between the ganglion and the organ? (parasympathetic)
acetylcholine
what are the 4 cranial nerves which show parasympathetic activity and how do they reach the organs?
oculomotor nerve
facial nerve
glossopharyngeal nerve
vagus nerve
where in the heart are the baroreceptors found?
aortic arch
coronoid sinus
where are the chemo-receptor nerve endings found?
root of aorta
IV septum
where are skin mechanoreceptors stimulated at?
right T5 anterior ramus [dermatome]
where do the sensory APs arrive when the left side of the chest wall is touched?
post-central gyrus of right cerebral hemisphere
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
Herpes Zolster - shingles
what is the cause of:
- Pectoralis major or intercostal muscle strain
- Slipped thoracic intervertebral disc
- CENTRAL CHEST PAIN
muscle, joint or bone pain (general)
what is the cause of:
- pleurisy
- peri-cardititis
- CENTRAL CHEST PAIN
Parietal pleura and fibrous pericardium
dull visceral plain is felt in the heart due to?
angina and MI
dull visceral pain is felt in the abdominal viscera due to?
gastritis, cholecystilitys, pancreatitis, hep. etc.
dull visceral pain flet in the aorta is due to?
ruptured aneurysm or aortic arch
where does the coronary arteries arise from?
right and left aortic sinuses of the ascending aorta
where is the right coronary artery?
in coronary right atrio-ventricular groove
where is the left (main stem) coronary artery?
in left trio-ventricular groove between pulmonary trunk an left auricle
where the most common site of occlusion for coronary atherosclerosis?
- Anterior Inter-ventricular branch
- right coronary artery
- left coronary artery
- circumflex artery
what is damaged in a complete heart block?
AVN
