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Lauras Cardio Anatomy > Lecture 2 > Flashcards

Lecture 2 Flashcards

1
Q

What mediates heart rate under normal conditions?

A

Vagal tone - parasympathetic innervation

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2
Q

Do sympathetic nerves increase or decrease heart rate?

A

Increase heart rate and contractility

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3
Q

What neurotransmitters do sympathetic nerves use to get from the CNS to the organs?

A

ACh then NA

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4
Q

How do sympathetic signals from the CNS reach the organs?

A

presynaptic sympathetic fibres from the brain travel inferiorly within the spinal cord tracts and then exit the spinal cord between T1- L2/3 spinal nerves (thoracolumbar) and then:

  • go into ganglion of that level and synapse
  • travel superiorly in the sympathetic chain to another ganglion and synapse
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5
Q

Where do nerves destined for the heart synapse?

A

cervical sympathetic ganglia and upper thoracic sympathetic ganglia as the cardiopulmonary splanchnic nerves

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6
Q

Where is the cardiac plexus and what does it contain?

A

Between the arch of the aorta and the pulmonary trunk ad contains sympathetic fibres, parasympathetic fibres and visceral afferent fibres

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7
Q

What neurotransmitters do parasympathetic nerves use to get from the CNS to the organs?

A

ACh on both the pre- and postsynaptic fibres

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8
Q

Which cranial nerves contain parasympathetic fibres?

A

3, 7, 9 and 10

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9
Q

Do the pelvic splanchnic nerves contain sympathetic or parasypathetic fibres?

A

parasympathetic fibres

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10
Q

What do the pelvic splanchnic nerves supply?

A

organs of the lower abdomen, pelvis and perineum

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11
Q

What are visceral afferent nerve ending stimulated by?

A

Chemical and infarcted tissue

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12
Q

Where do you find visceral afferent nerve endings?

A 
inner aortic arch 
pulmonary trunk 
around the SA node
outflow tracts of both ventricles 
papillary muscles 
vena cavae
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13
Q

What is pain in anatomical/ physiological terms?

A
  • stimulation of sensory receptor
  • afferent action potential reaches brain
  • we “feel” the pain according to the part of the brain that is stimulated by the action potential
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14
Q

How does somatic pain present?

A

Sharp, stabbing, well localised

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15
Q

How does visceral pain present?

A

dull, aching, nauseating and poorly localised

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16
Q

Where do pain sensations reach in the brain?

A

cerebral cortex

17
Q

What reaches the postcentral gyrus of the parietal lobe?

A

somatosensory - APs reaching here will bring body wall (somatic) sensations into consciousness

18
Q

What reaches the precentral gyrus of the frontal lobe?

A

somatomotor - APs reaching here will bring about contractions of body wall (somatic) skeletal muscle

19
Q

Give some examples of sharp central chest pain sources.

A 
Herpes zoster 
pec major muscle strain 
dislocated costochondral joint 
slipped thoracic intervertebral disc 
pericarditis
20
Q

Give some examples of dull (visceral) central chest pain sources.

A 
oesophagitis 
MI and angina 
pancreatitis 
cholecystitis 
ruptured aneurysm of aortic arch
21
Q

Which tubular structure does the vagus nerve run on?

A

trachea

22
Q

Where is the left phrenic nerve in relation to the left lung hilum?

A

anterior

23
Q

Which side of the body is the thoracic duct?

A

right

24
Q

How do pain signals from organs reach the brain?

A

Travel into sympathetic chain at cervical and T1-5 level, then into the spinal cord and up to the brain bilaterally

25
Q

Is pain is coming from a somatic structure, where is the radiation?

A

Along the affected dermatome(s)

26
Q

How does referred pain come about?

A

Afferent (sensory) fibres from soma and afferent (sensory) fibres from viscera enter the spinal cord at the same levels

27
Q

What percent of patients show a right dominant pattern?

A

~70%

28
Q

What percent of patients show a left dominant pattern?

A

Up to 35%

29
Q

Which coronary artery is more likely to be affected by atherosclerosis?

A

LAD branch of LCA (40-50%)
RCA (30-40%)
Circumflex branch of LCA (15-20%)
Left main stem coronary artery

30
Q

What supplies the SA and AV nodes?

A

SA nodal branch of RCA (60%)

AV nodal branch of RCA (80%)

31
Q

What supplies the interventricular septum?

A

LAD and posterior interventricular artery

32
Q

How do electrical signals flow through the heart?

A

SA –> AV –> Bundle of His –> R & L bundle of His –> Purkinje fibres

Lauras Cardio Anatomy (3 decks)

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