Michelle Summary Flashcards
Gs?
B1 B2 H2 D1 (heart and lungs)
Gi?
M2 (in SAN)
A2 (in heart)
Gq?
A1
M1
M3
Parasympathetic = short preganglionic fibres and sympathetic = long, true or false?
false, other way around
go into chains then go to eyes, heart, lungs etc
what is heamethonium?
non-competitive antagonist that sits in the nicotinic ganglionic channel and blocks it
conceptus?
fetrtilization > week 3
embryo?
week 4 > 8
foetus?
week 9 > birth
what are the 6 stages of development?
gametogenesis fertilization cleavage gastrulation morphogenesis organogenesis
gametogenesis?
forms oocyte or spermatozoa
fertilization?
fusion to form zygote in ampulla
cleavage?
rapid cell division
gastrulation?
germ layers form
- exoderm = outer - becomes skin and NS
- mesoderm = middle - becomes organs
- endoderm - becomes all tubes (gut and lungs etc)
morphogenesis?
cluster forms a 3D shape
organogenesis?
formation of organs and structures
zona pellucida?
protective layer around oocyte
primary bronchial buds?
bifurcation of rachea produces left and right bronchi
2ndary bronchial buds?
further bifurcation into 3 right and 2 left bronchi
what happens to foramen ovale in adults?
closes due to increased pressure and becomes the fossa ovalis
what gives rise to the heart?
visceral mesoderm
develops during week 4
heart tube from cranial > caudal?
truncus arteriosus (R aorta and pulm trunk)
bulbus cordus (R ventricle)
ventricle (left ventricle)
atrium (both atria)
sinus venosus (R. atria and coronary sinus)
what is septation?
division from folds into 4 heart chambers
what is churg strauss?
vasculitis with eosinophilic granulomatosis
assoc. with allergic airway hypersensitivity (asthma)
pANCA
wegner’s granulomatosis?
vasculitis of nose, lungs, kidneys and throat
causes sinusitis, renal failure etc
assoc. with epistaxis or haemoptysis
cANCA
what is kussmaul breathing?
deep laboured breathing in attempt to blow off CO2 to reduce metabolic acidosis
normal waist circumference?
<37 inches
components of med. diet?
starchy foods fish less meat olive oil swap dairy for soya
pressure in atria and ventricles during passive filling?
0
when are korotkoff sounds heard?
when cuff pressure between syst and dias
right axis deviation?
III is most +ve
I and II are -ve
left axis deviation?
I is most positive
II and III are -ve
prolonged PR interval?
> 0.2 secs
sign of heart block
U waves?
sign of bradycardia, hypokalaemia or digoxin
how is HR measured?
300/number of large squares between R waves
how do you measure irregular HR?
number of QRS’s in 30 large squares X10
how is MAP calculated?
1/3rd of (systolic + (2 X diastolic))
diastolic + 1/3rd pulse pressure
CO X SVR
what makes up total body fluid?
60% water
2/3 ICF, 1/3 ECF
baroreceptor firing in decreased BP?
decreased firing via aortic (vagus) and carotid (CN IX)
effect of decreased vagal stimulation on medulla?
increased HR > increased CO > increased BP
effect of increased sympathetic stimulation on medulla?
increased SV > increased CO > increased BP
effect of increased sympathetic vaso/veno-constrictor tone on medulla?
increased SV > increased BP
where is ADH produced and stored?
produced in hypothalamus
stored in posterior pituitary
what stimulates ADH release?
RAAS
increased ECF osmolality (monitored by osmoreceptors in brain)
what does ADH do?
acts on tubules to retain H2O which concentrates urine
vasoconstricts, esp in hypovolaemic shock
what counter-regulates the RAAS system and decreased BP?
Natriuretic peptides (NPs)
what are the 2 types of NP and where are they released from?
ANP = atrial myocytes BNP = ventricular myocytes, brain etc (increases in HF)
what do NPs do?
released in response to cardiac distension
- increase Na and H2O excretion
- decrease renin release
- vasodilate
there is no parasympathetic innervation in blood vessels smooth muscle, true or false?
true (apart from genitalia)
name 8 vasodilators
NO histamine bradykinin adrenaline dobutamine ANP BNP PGI2
name 5 vasoconstrictors
endothelin leukotrienes (asthma, mast cells) thromboxane A2 serotonin adrenaline on alpha (skin, gut, kidneys)
investigations for intermittent claudication?
non invasive = ABPI (systolic)
- should be 0.4-0.85
Invasive = MRA, CT angio/catheter
critical limb ischaemia?
pain at rest, worse lying flat, better moving around
6 Ps of acute limb ischaemia?
pain pallor pulseless perishingly cold paraesthesia paralysis
salvageable limb ischaemia?
<12 hrs
blanching mottled
non-salvageable limb ischaemia?
red, tender compartment of calf
>12 hrs
management of acute limb ischaemia?
ABC bloods ECG CXR anticoagulants arterial imaging if in doubt - urgent CT/catheter angio
3 components of diabetic foot sepsis?
diabetic neuropathy
peripheral vascular disease
infection
pathogenesis of aneurysm?
defect of elastin/collagen > dilation/increased aortic wall stress
AAA diagnosis?
1st line = US
CT if looking to tell whether its ruptured
diseases assoc with mitral regurg?
rheumatic disease MI/papillary rupture LVH cardiomyopathy Marfans
diseases assoc with mitral stenosis?
rheumatic fever SLE calcification amyloidosis prosthetic valve
diseases assoc with aortic regurgitation?
cusp rupture marfans rheumatoid arthritis SLE aortic dissection infection > perforation ankylosing spondylitis syphilis
diseases assoc with aortic stenosis?
congenital
age-related calcification
rheumatic disease
tricuspid regurgitation?
pan systolic
high pitched
