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HHD 2 > Hypertension > Flashcards

Hypertension Flashcards

1
Q

Where does the apex beat of the heart take place?

A

in the left ventricle

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2
Q

Where is the apex (base of left ventricle) of the heart located?

A

in the 5th intercostal spaces
close to the mid clavicular line

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3
Q

How much does the heart weigh?

A

300g

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4
Q

The heart is the size of a ________.

A

fist

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5
Q

Where is the heart located?

A

middle mediastinum

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6
Q

The heart is protected by…

A

the rib cage

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7
Q

The heart is ________ to the lungs

A

medial

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8
Q

What is the function of the vena cava?

A

allows the influx of blood from the body in deoxygenated state

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9
Q

Arteries carry blood ________

A

away from the heart

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10
Q

The pericardium is divided into __________ and ___________ pericardium

A

fibrous
serous

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11
Q

Serous pericardium is divided into ___________ and ___________ pericardium

A

parietal
viseral

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12
Q

What is between the parietal and visceral pericardial layers of the serous pericardium?

A

pericardial fluid

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13
Q

The _________ serous pericardium is closest the the fibrous pericardium

A

parietal

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14
Q

The serous pericardium is designed to allow…

A

the heart to move against its surface

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15
Q

What are the chambers of the heart?

A

2 atria
2 ventricles

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16
Q

What separates the left and right ventricles?

A

the intraventricular septum

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17
Q

What ventricle has the thickest walls?

A

the left ventricle

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18
Q

Venous blood returns from which vessels into the right atrium?

A

superior vena cava
inferior vena cava

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19
Q

What valve is located between the right atrium and the right ventricle?

A

tricuspid valve

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20
Q

What valve is located between the left atrium and the left ventricle?

A

mitral valve
biscuspid valve

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21
Q

The heart sits within the ___________ space where it contracts and relaxes.

A

pericardial

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22
Q

The heart has a two pump system, namely…

A

pulmonary (to the lungs)
systemic (to rest of the body)

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23
Q

Briefly describe the two pump system of the heart

A

deoxygenated blood returned to heart by body
heart sends blood to lungs via pulmonary artery
gas exchange occurs in lungs
heart receives oxygenated blood via pulmonary vein
oxygenated blood is pumped to rest of the body via the aorta

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24
Q

What is diastole?

A

relaxation of the chamber
filling of chamber with blood

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25
What prevents the heart from collapsing during diastole?
the resting pressure
26
What is systole?
contraction of the chamber ejection of the blood
27
What is the normal blood pressure?
120/80 mmHg
28
What is the normal blood pressure?
120/80 mmHg
29
What are the atrioventricular valves?
[valves between the chambers of the heart] tricuspid (right AVV) Mitral/ bicuspid (left AVV)
30
What are chordae tendinae?
these are fibrous connections between the valve leaflets and the papillary muscles
31
What are papillary muscles?
these are pilar-like muscles which are seen within the cavity of the ventricles
32
What is the function of the chordae tendinae and papillary muscles?
they ensure that there is no backflow during ventricular contraction
33
Ventricles contract from the ________ upwards
apex
34
What are the semilunar valves ?
Pulmonary valve (right hand side with pulmomary artery) Aortic valve (left side)
35
What is the function of the coronary arteries?
supply the myocardium
36
Where do coronary arteries originate from?
the aortic root aortic sinus
37
Coronary arteries are ___________ diastole
open
38
Innervation of coronary arteries is controlled by ______________.
autonomic vagus regulation cranial nerve X
39
The left coronary arteries tend to look after what part of the heart?
the front part of the heart
40
The right coronary arteries tend to look after what part of the heart?
right ventricle Distal right coronary artery looks specifically after the back of the heart (some of the front of the heart)
41
Name the coronary arteries of the heart
Left main coronary artery; circumflex coronary artery, left anterior descending coronary artery Right coronary artery: distal right coronary artery
42
What is an end artery? Give examples
is an artery that is the only supply of oxygenated blood to a portion of tissue coronary arteries opthalamic arteries
43
What are the layers of the heart?
Pericardium Myocardium Endocardium
44
The endocardium is made up of ...
squamous epithelium
45
The myocardium consists of __________ and ______________.
cardiomyocytes pacemaker cells (set electrical rhythm)
46
The pericardium consists of _____________ and __________________ membranes
serous (parietal and visceral) membranes fibrous membranes
47
State the features of cardiomyocytes
short, fat cells 1 central nucleus abundant mitochondria intercalated discs co-odrinated contraction
48
What facilitates the co-ordinated contraction of cardio-myocytes?
they are joined by desmosomes
49
Cardiomyocytes are joined end to end by _____________.
intercalated discs
50
The action potential in the heart is generated by ...
cells of the SAN (sinoatrial node)
51
Action potential generation is automatic however it can be altered by ______________.
autonomic vagus innervation
52
What is the normal resting heart rate ?
60-100 bpm
53
What is the resting membrane membrane potential of the heart?
-90mV
54
How is the resting membrane potential of the cell generated?
outside of the cell is more positive than inside of the cell this is usually due to the action of Na+/K+ pumps; 3 Na+ out and 1 K+ in; this a potential difference
55
Briefly describe mechanism of action of the SAN?
the "door" opens allows diffusion of Na+ ions in an attempt to neutralises the inside of the cell
56
What are the phases of action potentials of cardiac muscles?
phase 4 phase 0 phase 1 phase 2 phase 3
57
Describe what occurs in phase 4 of an action potential
Na+, Ca2+ channels are closed Open K+ rectifier channels to keep the membrane potential stable at -90mV
58
Describe what occurs in phase 0 of an action potential
Rapid influx of Na+ through open fast Na+ channels approaching 0mV threshold potential of -50mV is reached (or not) full depolarisation (+40mV)
59
Describe what occurs in phase 1 of an action potential
Transient K+ channels open and K+ efflux occurs to return the membrane potential to 0mV
60
Describe what occurs in phase 2 of an action potential
influx of Ca2+ through L type Ca2+ channels is electrically balanced by K+ efflux through delayed rectifer channels
61
Describe what occurs in phase 3 of an action potential
Ca2+ channels close but the delayed rectifier channels remain open and the membrane potential can return to -90mV
62
Briefly describe the electrophysiology of the heart (include how contraction is stimulated)
action potential generated by the SAN atria depolarises then contracts the signal reaches the AVN (atrioventricular node) there is a delay at AVN to ensure ventricles are adequately filled The action potential then travels down the bundle of His and then up through the purkinje fibres This stimulates depolarisation of ventricles Ventricles contract
63
The atrioventricular node (AVN) is described to be the ...
relay station
64
Normal heart rate values are _________
60-100 bpm number of times the heart beats per minute
65
What is the standard/normal cardiac output value?
5L/min
66
What is the stroke volume?
the amount of blood in ventricles at the moment it beats volume of blood pumped out of the left ventricle during each systolic contraction
67
Cardiac output can be calculated by...
HR x SV the amount of blood the heart pumps in 1 minute
68
Mean arterial pressure (mmHg) is calculated by
CO x SVR (systemic vascular resistance) Pdias + 1/3 (Psyst - Pdias) the average arterial pressure throughout the cardiac cycle (diastole and systole) Pdias- pressure at diastole Psyst- pressure at systole
69
Define essential hypertension
Essential hypertension is defined as a BP of 140/90mmHg with no secondary cause identified a blood test must be performed to eliminate secondary causes
70
Give examples of secondary causes of hypertension
renal artery stenosis - renin released by kidneys as sensitive to hypotension/hypovolaemia endocrine disorders medication cancers pregnancy heart injury
71
What are the risk factors for hypertension
obesity aerobic exercise <3x per week alcohol intake smoking diabetes afro-carribean age >60 years family history sleep apnoea dyslipidaemia high salt intake
72
What are the causes of hypertension?
excess sodium ions dysregulation of renin- angiotensin- aldosterone increases sympathetic drive (stress, catecholamine driven event) insulin resistance increased periperal resistance (narrow arteries) endothelial dysfunction- high blood pressure can lead to endothelial damage
73
What causes small vessel atherosclerosis?
thrombosis endothelial injury inflammatory cascade oxidative stress (ROS) autonomic regulation genetic predisposition age (all increase peripheral resistance)
74
What is small vessel atherosclerosis (SVA)?
occurs in microcirculation building of atheroma narrowing of the lumen
75
What is the presentation of hypertension?
asymptomatic usually picked up on picked up on opportunistic screening
76
What are the end-organ damage symptoms of hypertension?
visual changes renal failure angina (ischaemic heart disease, chest pain) sensory and/or motor deficit
77
List some complications of hypertension
coronary heart disease cerebrovascular accident left ventricular hypertrophy heart failure retinopathy peripheral artery disease (SVA) Kidney disease - microvasculature of kidneys vascular dementia
78
What are the investigations for hypertension?
Electrocardiogram fasting glucose (diabetes) eGFR (kidney disorder?) fasting lipid panel urinalysis (cytology, culture, microscopy) Check for endocrine disorders i.e. insulin
79
What are some modifiable risk factors of hypertension ?
stop smoking lose weight diet modification reduce alcohol intake exercise
80
What kinds of medication are administered for hypertension?
calcium channel blockers E.g. nifedipine

HHD 2 (37 decks)

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