CPR (Cardiopulmonary Renal) Flashcards
Role of thrombomodulin
Anticoagulant signal that inhibits platelet attachment and aggregation to prevent blood coagulation and allow unobstructed flow of blood in normal conditions.
Role of prostacyclin
Antithrombogenic factor that prevent platelet aggregation and release of clotting factors
Role of von Willebrand factor
Prothrombogenic factor that promotes clot formation
Which type of cells produce ACE?
Pulmonary endothelial cells
What factor promotes the conversion of angiotensin I to angiotensin II?
ACE (Angiotensin converting enzyme)
Contains endothelial cells held together by tight junctions and contain gap junctions
Tunica Intima
Locations of continuous/somatic capillaries
1) Connective tissue
2) Muscle tissue
3) Nerve tissue
4) Exocrine glands
5) Cerebral cortex
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
Locations of Discontinuous/ Sinusoidal capillaries
1) Liver
2) Spleen
3) Bone marrow
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.
Blood pressures that indicate Hypertension:
High blood pressure of greater than 130 mmHg (systolic) or greater than 80mmHg (diastolic)
“Hardening of arterial walls” due to loss of elasticity of Tunica media or thickening of the arterial walls.
Arteriosclerosis
Plaque Formation and atheroma development
Atherosclerosis
Superior boundary of the mediastinum
Superior thoracic aperture
Inferior boundary of the mediastinum
Diaphragm
Anterior boundary of the mediastinum
Sternum
Posterior boundary of the mediastinum
Thoracic vertebrae
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
Which type of tissue forms the central core of heart valves?
Avascular dense connective tissue
The pacemaker of the heart
Sinoatrial node
What is the biological function of arteriovenous shunts in the skin?
Temperature-dependent regulation of blood flow.
What are the 4 esophageal constrictions?
1) Arch of the aorta
2) Left principle bronchus
3) The diaphragm at the esophageal hiatus (T10)
Cardiac Tamponade
Impaired cardiac output due to an accumulation of fluid, pus, gas, blood or tissue in the pericardial space
Pulses Paradoxus
Exaggerated fall in systolic blood pressure (10mmHg) during inspiration
What is the treatment for cardiac tamponade?
Pericardiocentesis
Beck’s Triad
- Increased pressure outside the heart decreases end-diastolic ventricular filling
- Increased pressure reduces end-systolic atrial filling capacity
- 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
Contractility
How efficiently the myocardium contracts from a given myocardial muscle length.
When afterload is large, does shortening of the cardiac muscle occur?
NO
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.
