L8: SA Cardiovascular Pathology (Craft)

Question 1

Sinus of valsalva =

Answer 1

Openings to coronary arteries

Question 2

First part of heart to be damaged in hypoxic event

Answer 2

LV

Question 3

Layers of wall of heart

Answer 3

Trebeculae
Endocardium
Myocardium
Fat CT
Serous pericardium (visceral layer)
Pericardial space
Serous pericardium (parietal layer)
Fibrous pericardium

Question 4

Layer of dense collagen that forms the fibrous cardiac “skeleton” and electrically insulates atria from ventricles

Answer 4

Central Fibrous Body (CFB)

-has occassional plates of chondroid and osseous metaplasia

Question 5

Normal wall thickness ratio of LV:RV

Answer 5

2-3:1

Question 6

3 routine sections for heart histopath:

Answer 6

IVS
LV free wall
RV free wall

Question 7

1st place for heart degeneration

Answer 7

Papillary muscle

Question 8

Heart failure –>

Answer 8

• dec. myocardial contractility and compliance (fibrosis

- dysrythmias, arrythmias

Question 9

Cardiac compensation: HYPERTROPHY

Answer 9

• repeated stretching due to dilation of chamber (overload) can cause
• requires time, healthy myocardium, adequate nutrition of mycardium
• only works for so long as cells will outgrow blood supply
• further stretching causes dilation

Question 10

Cardiac compensation: DILATION

Answer 10

• stretching of myofibers
• maintains connections and architecture
• degenerative
• result of chronic volume overload

Question 11

Other cardiac compensatory methods

Answer 11

• Inc. HR, peripheral resistance, blood volume

- redistr. Of blood flow to areas of lowest pressure via shunting, peripheral vasoconstriction

Question 12

Clinical syndromes of cardiac decompensation

Answer 12

Cardiac syncope (acute cardiac failure)
CHF (chronic)

Question 13

Chars. Of cardiac syncope

Answer 13

• arrhythmia
• massive necrosis
• extreme changes in BP and HR
• collapse, loss of consciousness, death
• may not have lesions on histo

Question 14

Chars. Of CHF

Answer 14

• forward and/or backward failure

- eventual progression to full failure

Question 15

Cycle of cardiac decompensation –> hypoxia

Answer 15

1) renin release from kidneys
2) aldosterone release from adrenal cortex
3) Na and H2O retention
4) increased plasma volume
5) edema, inc. BP
6) EPO stimulation
7) polycythemia
8) increased blood viscosity

*failing heart must pump a greater volume of thicker fluid

Question 16

Right Ventricular Hypertrophy results from:

Answer 16

• pulmonary hypertension
• congenital abnormalities
• tricuspid (right AV) incompetence
• mechanical obstruction: heartworm

Question 17

Cor Pulmonale

Answer 17

RV hypertrophy +/- failure due to long term pulmonary hypertension (increased pulmonary resistance due to obstruction)

Question 18

Causes of LV Hypertrophy

Answer 18

• Systemic hypertension (renal disease most common)
• Congenital abnormalities (aortic stenosis)
• Mitral incompetence
• Endocrine dz (hyperthyroidism, acromegaly)

Question 19

Causes of Right Heart Failure

Answer 19

• valvular insufficiency (tricuspid or pulmonary valves)
• pulmonary hypertension: obstruction of forward flow
• cardiomyopathy

Question 20

Normal blood flow through heart

Answer 20

Inferior vena cava –> RA –> tricuspid valve –> RV –> pulmonary valve –> Left pulmonary artery –> left pulmonary veins –> LA –> mitral valve –> LV –> aortic valve –> aorta