CPR (Cardiopulmonary Renal) Flashcards by Jessica Lin

Role of thrombomodulin

Anticoagulant signal that inhibits platelet attachment and aggregation to prevent blood coagulation and allow unobstructed flow of blood in normal conditions.

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Role of prostacyclin

Antithrombogenic factor that prevent platelet aggregation and release of clotting factors

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Role of von Willebrand factor

Prothrombogenic factor that promotes clot formation

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Which type of cells produce ACE?

Pulmonary endothelial cells

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What factor promotes the conversion of angiotensin I to angiotensin II?

ACE (Angiotensin converting enzyme)

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Contains endothelial cells held together by tight junctions and contain gap junctions

Tunica Intima

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Locations of continuous/somatic capillaries

1) Connective tissue
2) Muscle tissue
3) Nerve tissue
4) Exocrine glands
5) Cerebral cortex

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Locations of fenestrated/Visceral Capillaries

1) Peptide-secreting endocrine organs
2) Ciliary processes (eye)
3) Choroid plexus (ventricles)
4) Kidney-glomeruli
5) Lamina propria of GIT

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Locations of Discontinuous/ Sinusoidal capillaries

1) Liver
2) Spleen
3) Bone marrow

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Significance of HEV (High Endothelial Vessels)

Vessels are ports of entry for lymphocytes into lymphatic organ. They play an important role in “homing effect” in lymphoid organs like lymph node.

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Blood pressures that indicate Hypertension:

High blood pressure of greater than 130 mmHg (systolic) or greater than 80mmHg (diastolic)

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“Hardening of arterial walls” due to loss of elasticity of Tunica media or thickening of the arterial walls.

Arteriosclerosis

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Plaque Formation and atheroma development

Atherosclerosis

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Superior boundary of the mediastinum

Superior thoracic aperture

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Inferior boundary of the mediastinum

Diaphragm

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Anterior boundary of the mediastinum

Sternum

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Posterior boundary of the mediastinum

Thoracic vertebrae

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Location of the Plane of Ludwig

An imaginary horizontal plane across the thorax at the level of T4/T5 posteriorly and the 2nd rib anteriorly
-Other names include: Transverse Thoracic or Transthoracic Plane

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Which type of tissue forms the central core of heart valves?

Avascular dense connective tissue

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The pacemaker of the heart

Sinoatrial node

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What is the biological function of arteriovenous shunts in the skin?

Temperature-dependent regulation of blood flow.

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What are the 4 esophageal constrictions?

1) Arch of the aorta
2) Left principle bronchus
3) The diaphragm at the esophageal hiatus (T10)

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Cardiac Tamponade

Impaired cardiac output due to an accumulation of fluid, pus, gas, blood or tissue in the pericardial space

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Pulses Paradoxus

Exaggerated fall in systolic blood pressure (10mmHg) during inspiration

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What is the treatment for cardiac tamponade?

Pericardiocentesis

Beck's Triad

1. Increased pressure outside the heart decreases end-diastolic ventricular filling 2. Increased pressure reduces end-systolic atrial filling capacity 3. Increased fluid: reduced heart sounds

S1 heart sound

Closing of the mitral and tricuspid valves

S2 heart sound

Closure of the aortic and pulmonic valves

Auscultation site for the Aortic valve

Right sternal border at 2nd intercostal space

Auscultation site for the Pulmonary valve

Left costal border at 2nd intercostal space

Auscultation site for the tricuspid valve

Left sternal border at 5th intercostal space

Auscultation site for the mitral valve

5th left intercostal space in midclavicular line

Intercostal pain

Sharp pain in the thorax unilaterally worsens with chest wall movements including breathing

The tunica intima contains:

1) Endothelium 2) Subendothelial layer 3) Internal elastic lamina

The tunica media contains:

Smooth muscle and elastic fibers

The tunica externa contains:

Collagen fibers, reticular (type III collagen), ground substance/extracellular matrix (proteoglycans and glycoproteins) all secreted by smooth muscle cells.

S1 heart sound

Closing of the mitral and tricuspid valves

S2 Heart sound

Closure of the aortic and pulmonic valves

What causes referred pain from a myocardial infarction? Which nerve?

The intercostobrachial nerve connects the T2 spinal nerve with the medial cutaneous nerve of the arm/forearm

Which mediastinum contains: 1) Esophagus 2) Esophageal plexus 3) Descending thoracic aorta 4) Thoracic duct 5) Sympathetic chain (Anterior, Posterior, Middle)

Posterior

Opening between right and left atria during fetal life

Foramen ovale

Connective tissue partition separating structures

Septum/Septae

Abnormal development of the interventricular septum, with resultant consequences

Ventricular Septal Defect

Abnormal development of the interatrial septum, with resultant consequences

Atrial Septal Defect.

A thin membrane/fold grows from the roof of atrium towards endocardial cushions at the AV canal

Septum Primum

Space between inferior edge of septum primum and the endocardial cushions.

Foramen/ostium primum.

Intracardiac shunting of blood from left to right after birth causing mixture of oxygenated and deoxygenated blood in the right side of the heart

Acyanotic heart defect

Caused by failure of septum primum and septum secundum to fuse after birth

Patent Foramen Ovale

The foramen ovale becomes:

The fossa ovalis

The umbilical vein becomes:

The ligamentum teres

The ductus venosus becomes

The ligamentum venosum

The ductus arteriosum becomes:

The ligamentum arteriosum

The umbilical artery becomes

The medial umbilical ligament

Resting Tension in the heart

Force required to stretch a resting muscle to different lengths

Active Tension in the heart

When a muscle is stimulated to contract whilst its length is held constant, it develops an additional force called active tension

The peak isometric tension in the heart

The total tension developed (active and passive). This depends on the initial myocardial muscle length.

Norepinephrine increases the [ ] of the cardiac muscle

Contractility

How efficiently the myocardium contracts from a given myocardial muscle length.

When afterload is large, does shortening of the cardiac muscle occur?

The [ smaller or larger ] the afterload the faster the shortening velocity

Smaller

Changes in myocardial muscle fiber length is:

The Preload

The forces the muscle must overcome to open the valves and to eject a given volume of blood

Afterload

The contractile ability of the heart

Inotropic state

Starling's Law of the heart states that:

As EDV increases, the stroke volume increases

Cardiac defects associated with 22q11 deletions (DiGeorge's)

Truncus arteriosus and Tetralogy of Fallot

Cardiac defects associated with down syndrome

VSD, ASD, AV septal defect (endocardial cushion defect)

Cardiac defects associated with Turner syndrome

Coarctation of the aorta

Cardiac defects associated with offspring of diabetic mother

Transposition of the great vessels

Cardiac defects associated with congenital rubella

Septal defects, PDA, pulmonary artery stenosis

Cardiac defects associated with Marfan Syndrome

Aortic insufficiency (late complication)

The Myogenic Response

Responsible for autoregulation of blood flow. Stretch of blood vessel wall by increasing pressure causes contraction of the smooth muscle of resistance arterioles. A decrease in radius increases Resistance to keep the blood flow constant.