Exam I CV DSA and CIS

Question 1

Where are the ganglia of sympathetics to heart

Answer 1

upper thoracic or cervical chain

Question 2

Describe R and L distribution of fibers to the heart

Answer 2

R sided fibers pass to the right deep cardiac plexus and inn R heart and SA node
L sided fibers pass deep to L cardiac plexus and inn L heart and AV node

Question 3

what is result of hyperSympathetic tone to R side of heart (SA node)

Answer 3

supraventricular tachycardia

paroxysmal supraventricular tachy

Question 4

What is result of hypersymapthetic tone to L side heart

Answer 4

ectopic foci

ventricular tachy ventricular fib

Question 5

What type of SD can increase sympathetic tone to heart

Answer 5

upper thoracic dysfunction
upper rib dysfunction
cervical dysfunction

Question 6

where are the parasympathetics to heart from

Answer 6

vagus nn (CN 10)
right vagus- SA
L vagus- AV

Question 7

What is the course of vagus CN

Answer 7

from medulla through jugular foramen with connections to first cervical somatic nerves
enters chest via thoracic inlet

Question 8

What type of SD can affect vagus nn

Answer 8

occipitomastoid compression affecting jugular foramen
occiput, atlas and axis (upper cervical)
thoracic inlet: upper thoracics, upper ribs, clavicles, lower cervicals, cervical fascia, ECT

Question 9

Describe lymph drainage from heart

Answer 9

right lymphatic duct that courses through thoracic inlet on way into heart

Question 10

what drives lymphatics

Answer 10

diaphragmatic function and muscle activity

Question 11

What environmental signals may have negative impact on epigenetics

Answer 11

poor nutrition, toxic thoughts/mental stress
physical stress
environmental toxins
SD

Question 12

Where is SD usually found with anterior wall MI and inferior MI

Answer 12

anteriro T2-3 left

inferior C2 at cranial base

Question 13

what are the goals of OMM integration

Answer 13

bring autonomic balance back to CV system

improve arterial supply and venous and lymph drainage to heart

Question 14

what is the goal in OMM Tx of CHF

Answer 14

reduce intravascular and interstitial volume overload
improve tissue perfusion
optimize cardiac function

Question 15

What is spinal facilitation

Answer 15

peripheral irritation
CNS sensitization
sensitization of neighboring neurons
disseminated sensitivity throughout all tissue served by that area

Question 16

viscero-somatics are assoc with what type spinal type SD?

Answer 16

type II

Question 17

What are the JNC rules for Tx HTN if age 30-59

Answer 17

> 140/90

Question 18

What age and up do you Tx HTN if >150/90

Answer 18

above 60

Question 19

what is a still murmur

Answer 19

grade 1-3 early systoly
best hear low left sternal border
infancy- adolescence 2-6 yrs
innocent
can sound like a ventricular septal defect of hypertrophic cardiomyopathy

Question 20

what is a venous hum

Answer 20

grade 1-6 continuoys murmur louder in diastole
best herad over low anterior neck, louder on right
lasts age 3-8

Question 21

a medium - alrge VSD would sound how

Answer 21

thrill at LLSB
split or single S2
holosystolic murmur at LLSB without radiation grade 2-5

Question 22

what does an ASD sound like

Answer 22

grade 2-3 systolic ejection murmur best heard at ULSB
wide fixed split S2
absent thrill

Question 23

What does PDA sound like

Answer 23

continuous murmur in ULSB crescendo decrescendo

normal S1

Question 24

what are characteristics of tetraology of fallot

Answer 24

central cyanosis, clubbing of nail beds
grade 3-4 long systolic ejection fraction heart at ULSB with holosystolic murmur at LLSB
systolic thrill
slightly increased S1, single S2

Question 25

what are characteristics of coarctation of aorta

Answer 25

systolic ejection murmur hear best in interscapular region
normal s1 S2
decreased of delayed femoral pulse
may have increased L ventricular impulse

Question 26

What are the key features of innocent murmurs

Answer 26

senstive (change with position or respiration0)
short duration
single
small
soft
sweet (not harsh sounding)
systolic