Lecture 6 Coronaries and Veins Flashcards

1
Q

What are the three types of cardiac veins?

A

Coronary sinus, anterior cardiac veins, and Thebesian veins

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2
Q

Why does blood flow fall during ventricular contraction?

A

Because the muscle is contracting so no blood can flow through it

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3
Q

Name 2 ways coronary flow is controlled

A

Local control like muscle, nervous control that is less powerful

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4
Q

Where does the heart’s energy supply come from in the fed state?

A

Krebs cycle and glycolysis

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5
Q

Where does the heart’s energy supply come from in the fasting state?

A

Fat, lactic acid, ketone bodies

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6
Q

What causes the chest pain during ischemia / hypoxia / coronary stenosis or blockage?

A

The use of glucose and production of lactic acid as a metabolite during respiration without O2

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7
Q

Name 5 factors of ischemic heart disease

A

Aging, male, genetics, diabetes

Cigarettes, cholesterol, lack of exercise, blood pressure

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8
Q

Define atherosclerosis

A

The buildup of plaques made of fats and cholesterol

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9
Q

Define arteriosclerosis

A

Rigid arteries

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10
Q

Name 3 key steps of atherosclerosis

A
  • Cholesterol and fats get below endothelial layers
  • Turbulent flow and inflammation + scarring
  • Reduced lumen, possibly even acute occlusion
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11
Q

What can worsen the symptoms of mild ischemic heart disease and how is it diagnosed?

A

Exacerbated by exercise, fear, cold exposure, full stomach.

Diagnose with treadmill stress test.

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12
Q

Symptoms of mild vs severe ischemic heart disease:

A

Mild: chest pain, radiates to left arm, shoulder, neck

Severe: thrombus/blood clot, embolus if in circulation

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13
Q

What happens in ischemic heart disease to avoid complete occlusion of smaller arteries?

A

Vascular remodeling

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14
Q

How can you treat ischemic heart disease?

A

Coronary bypass or coronary artery angioplasty

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15
Q

What is myocardial infarction (obstruction of local blood supply)?

A

Chronic obstruction by atherosclerosis leading to thrombus/embolus, and coronary spasm (sudden sustained contraction in artery)

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16
Q

Process of myocardial infarction:

A
  • Blood flow stops
  • infarction of area with stagnant blood, tissue death
  • subendocardial muscle is usually more reliant on O2 (more active) so most damaged
17
Q

Causes of death after myocardial infarction include:

A
  • Systolic stretch, decreased cardiac output
  • Lower gas exchange from pulmonary edema
  • Fibrillation
  • Rupture of heart
18
Q

What is useful about veins being temporary blood reservoirs?

A

When dehydrated or hemorrhaged, veins constrict and release blood to maintain arterial pressure even in the loss of blood volume

19
Q

Define vascular capacitance:

A

The total quantity of blood that can be stored in a given portion of the circulation for each mmHg

20
Q

How is capacitance calculated?

A

Distensibility times volume divided by increase in pressure

21
Q

How can veins compensate for changes in blood volume?

A

Veins can constrict to transfer more blood into the heart, increasing cardiac output. They can also ‘buffer’ pressure changes by absorbing extra pressure from drinking or transfusions.