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medical sciences > Module 1.04 > Flashcards

Module 1.04 Flashcards

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USMLE® Step 1 flashcards
1
Q

what are the 3 branches of the aortic arch?

A

braciocephallic trunk, left common carotid artery, left subclavian artery

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2
Q

what are the two parts of the pericardium?

A

fibrous pericardium and serous pericardium

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3
Q

describe the fibrous pericardium

A

continuous with central tendon of the diaphragm, tough connective tissue which prevents over filling of the heart

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4
Q

describe the serous pericardium

A
  • two layers: parietal and visceral
  • visceral layer forms outter layer of the heart called the epicardium
  • each layer is mesothelium
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5
Q

what is the pericardial cavity?

A
  • found between inner and outter serous layer

- contains lubricating serous fluid

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6
Q

what are the functions of the pericardium?

A
  • fixes heart in mediastinum and limits its motion
  • its inextensible nature prevents overfilling of the heart
  • serous fluid provides lubrication between inner and outter pericardium
  • protection from infection
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7
Q

what is trabecular carnae where are they found?

A
  • a series of irregular muscular elevations

- found in the inflow portion of the ventricle

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8
Q

what are the 3 layers of the heart wall?

A

endocardium, myocardium, epicardium

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9
Q

describe the endocardial layer of the heart

A
  • inner most layer of the heart, lines cavities and valves
  • regulates contractions
  • simple squamous epithelial
  • subendocardial layer lies just below and is were pukyne fibres can be found
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10
Q

describe the myocardium layer of the heart

A
  • responsible for contractions of the heart
  • is made up of cardiac muscle which is involuntary
  • subepicardial layer lies between the myocardium and epicardium
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11
Q

desribe the epicardium

A
  • outter most layer of the heart formed by viseral layer of serous pericardium
  • connective tissue and fat secretes small amounts of serous fluid
  • simple squamous epithelium
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12
Q

what is the coronary sinus?

A
  • large venous structure located on the posterior aspect of the heart
  • responsible for most venous drainage
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13
Q

what are the tributaries of the coronary sinus?

A

great cardiac vein, anterior cardiac vein, posterior interventricular vein, posterior cardiac vein

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14
Q

what is the conduction system of the heart?

A
  • sinoatrial node depolarises and send signals for the atria to contract and the ventricles fill with blood
  • impulse travels to AV, it pauses for ventricles to fill (bundle of His)
  • impulse to purkyne fibres to cause contrcation of the ventricles
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15
Q

what is diastole?

A
  • the filling of the ventricles
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16
Q

what is systole?

A
  • ventricles contract and blood is forced out into aorta or pulmonary artery
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17
Q

what does it mean if a celll is depolarised?

A
  • the cell becomes positivley charged
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18
Q

what are the phases for the sino atrial node to fire an action potential?

A

PHASE 4: spontaneous depolarisation, slow influx of positive ions
PHASE 0: depolarisation, rapid influx of Ca2+, action potential
PHASE 3: efflux of K+, CA2+ stop moving, repolarisation

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19
Q

what are the phases of ventricle muscle cells contracting (purkyne fibres)?

A

PHASE 0: depolarisation, rapid influx of positive ions
PHASE 1: partial repolarisation
PHASE 2: plateau phase, K+ efflux, Ca 2+ influx
PHASE 3: repolarisation
PHASE 4: ions go back to original place, ventricle diastole

20
Q

what are the 3 reflexes that regulate blood pressure in the body?

A

baroreceptor reflex, chemoreceptor reflex, cardiopulmonary reflex

21
Q

what happens in the baroreceptor reflex?

A
  • barorecpetors are sensory nerve ending which monitor the degree of stretch in the aortic arch and carotid sinus
  • when stretched they fire an action potential in afferent fibres
  • high blood pressure detected, parasympathetic nervous system is activates to decrease heart rate along with increasing vasodilation of vessels, to decrease blood pressure
  • low blood presuure detected, sympathetic nervous system works to increase heart rate along with vasoconstriction to increase blood pressure
22
Q

why can baroreceptors not regulate blood pressure longterm?

A

Baroreceptors cannot regulate blood pressure long-term. This is because the mechanism that triggers baroreceptors resets itself once a more adequate blood pressure is restored.

23
Q

how is blood pressure sustained in the long term?

A

Renin-Angiotensin-Aldosterone System, ADH(antidiuretic hormone)/ vasopressin

24
Q

what is the role of renin in the Renin-Angiotensin-Aldosterone System?

A
  • renin is a peptide hormone which is released by the juxtaglomerular cells in the kidney glomerulus
  • renin is released in response to: sympathetic stimulation, decrease in sodium chloride to the distal convulated tubule, decreased blood flow to kidney
  • Renin facilitates the conversion of angiotensinogen to angiotensin I. This is then converted to angiotensin II using angiotensin-converting enzyme (ACE).
25
Q

what is the role of angiotensin || in the Renin-Angiotensin-Aldosterone System ?

A
  • angiotensin || is a potent vasoconstricter
  • it acts directly on the kidney to increase sodium reabsorption in the proximal convoluted tubule
  • sodium is reabsorbed by sodium- hydrogen exchanger
  • angiotensin || also promotes the release of aldosterone
26
Q

what is the role of aldosterone in the Renin-Angiotensin-Aldosterone System ?

A
  • aldosterone promotes salt and water retention by increasing epithelial sodium channels in the distal convulated tubule
  • aldosterone increases the activity of the basolateral sodium-potassium ATP-ase. This consequently, increases the electrochemical gradient for movement of sodium ions.
27
Q

overall how does the Renin-Angiotensin-Aldosterone System (RAAS) regulate blood pressure?

A

-More sodium collects in the kidney tissue and water then follows by osmosis. This results in decreased water excretion and therefore increased blood volume and blood pressure.

28
Q

how is ADH (anti-diuretic hormone)involved in regulation of blood pressure?

A
  • ADH is produced in the hypothalamus and stored and released in the posterior pituatry gland
  • it increases the permability of the collecting duct and also stimulates sodium reabsorption in the ascending limb of the loop of henle
  • This increases water reabsorption thus increasing plasma volume and decreasing osmolarity.
29
Q

what is orthostasis?

A
  • maintenance of standing upright
  • when you stand up blood pressure below the heart increases and blood pressure above the heart decreases
  • immediatley activates baroreceptor reflex
    - > increases heart rate and causes vasoconstriction
30
Q

what is agonist and antagonist receptors?

A

AGONIST - activates receptors

ANTAGONIST- combines at the same site and blocks the effect of the agonist on the receptor

31
Q

what stages of erthropoesis takes place in the bone marrow?

A

stem cell -> proerthyrocyte -> early erythroblast (ribosome synthesis) -> late erythrocyte (haemoglobin accumulation) -> normublast -> reticulucyte (stays in bone marrow for 3 days) -> then reticulucyte enters the circulation

32
Q

what stages of erthropoesis takes place in circulation?

A

reticulucyte - 24, 48 hrs -> erythrocyte - 120 days -> older erythrocyte (aged/ damaged)

33
Q

how are old red blood cells removed?

A
  • macrophages in the spleen
34
Q

what nutrients are absorbed in the small intestine for erthropoesis?

A

amino acids, monosaccharides, lipids, vit B12, folic acid, iron

35
Q

what is hypoxia?

A
  • decrease in oxygen level

- causes hormone to be released from kidney to stimulate erythropoesis

36
Q

what are the features of erythrocytes ?

A
  • binocave
  • no nucleus
  • primary function is to carry O2 and CO2 around the body
37
Q

what is a leukocyte?

A
  • white blood cells

- function is to protect the body from invading pathogens

38
Q

describe neutrophils

A
  • most common white blood cell
  • life span : 8-10 hrs
  • lobed nucleus
  • phagocytic
  • non specific
39
Q

describe monocytes and macrophages

A
  • antigen presenting cell

- kill intracellular organisms

40
Q

describe basophils

A
  • grunnels contain histamines

- when activated by antibodies the cell empties their grunnels into the peripheral blood

41
Q

each phase of the cardiac action potential, description and main movement of ions

A

phase 0: rapid depolarisation, rapid sodium influx
phase 1: early repolarisation, efflux of potassium
phase 2: plateau, slow influx of calcium
phase 3: final repolarisation, efflux of pottassium
phase 4: resting potential restored

42
Q

extrinsic pathway of coagulation cascade?

A
  • tissue factor produced upon tissue injury
  • tissue factor allow 7 (VII) to become 7a (VIIa)
  • VIIa and tissue factor allows the start of the common pathway (X -> Xa)
43
Q

intrinsic pathway of coagulation cascade?

A
  • 12 (XII) -> 12a (XIIa)
  • 12a allows factor 11 (XI) to become activated to 11a (XIa)
  • 11a aids formation of 9a (IXa)
  • 9a allows the formation of 7a (VIIa)
  • 7a and 5a (Va) allows for start of common pathway
44
Q

common pathway of coagulation cascade

A

X -> Xa

  • Xa causes prothrombin to become thrombin
  • thrombin causes fibrinogen to become fibrin
45
Q

cell based model of clotting?

A
  • INITIATION: extrinsic pathway
  • AMPLIFICATION: thrombin formed from extrinsic pathway cause activation of factor VII in intrinsic pathway
  • PROPOGATION: Xa and Va forms prothrombinase complex to form thrombin at a faster rate

medical sciences (11 decks)

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