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Y1 Cardiovascular > Normal Structure And function > Flashcards

Normal Structure And function Flashcards

1
Q

Cardiac muscle is unstriated - TRUE OR FALSE

A

False - it is striated

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2
Q

Cardiac myocytes are electrically coupled by…

A

Gap junctions

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3
Q

Desmosomes have what function within cardiac muscle?

A

Provide mechanical adhesion between adjacent cardiac cells

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4
Q

Contractile unit of muscle

A

Myofibril

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5
Q

Actin filaments form the light/dark appearance of myofibrils?

A

Light

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6
Q

Within each myofibril, actin and myosin are arranged into….

A

Sarcomeres

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7
Q

Muscle tension is produced by ___ of actin filaments over myosin filaments

A

Sliding

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8
Q

Force generation depends upon ________ interaction between myosin and actin filaments

A

ATP-dependent

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9
Q

Requirements for muscle contraction (2)

A

ATP

Calcium

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10
Q

Role of calcium in muscle contraction

A

Binds to troponin, moving the tropomyosin away from the actin myosin binding site

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11
Q

Calcium is released from the _______ _______ in cardiac muscle

A

Sarcoplasmic reticulum

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12
Q

TRUE OR FALSE - the release of calcium from the sarcoplasmic reticulum is dependent on the presence of extra cellular calcium

A

True

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13
Q

Calcium induced calcium release is

A

The release of calcium in response to the release of calcium

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14
Q

Where does the CIcR start in cardiac muscle?

A

The calcium influx during ventricular muscle action potential through L-type calcium channels - travels down T-tubules increasing the release from SR

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15
Q

Channel that removes calcium from the cell back to the SR

A

Ca-ATPase

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16
Q

Excitation of the heart normally originations in the ________ cells of the ___ ____ ____

A

pacemaker cells of the SAN

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17
Q

The heart is normally under the control of the ___

A

SAN

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18
Q

TRUE or FALSE - the cells in the SAN have a resting membrane potential

A

False

The SAN constantly drifts towards depolarisation

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19
Q

The pacemaker potential is due to what 3 ion currents?

A

Na influx and K influx (funny current)
Transient Ca influx
Decreased K efflux

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20
Q

Ion channel responsible for the rising phase of the action potential in the SAN?

A

LTCC

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21
Q

Ion channel responsible for the falling phase of the action potential in the SAN?

A

K channel –> K efflux

LTCC inactivation

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22
Q

Why is conduction is delayed within the AVN?

A

to allow for atrial systole

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23
Q

Phase 0 of ventricular AP

A

Na influx

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24
Q

Phase 1 of ventricular AP

A

closure of Na, transient K efflux

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25
Q

Phase 2 of ventricular AP

A

LTCC balanced with transient K efflux

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26
Q

Phase 3 of ventricular AP

A

Ca channels close but delayed rectifier K channels remain open

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27
Q

Phase 4 of ventricular AP

A

resting membrane potential

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28
Q

Nerve which exerts continuous control over the heart?

A

Vagus nerve

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29
Q

Autonomic predominant control over the heart?

A

Parasympathetic

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30
Q

Ach from parasympathetic system acts on which receptor in the heart?

A

M2 muscarinic

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31
Q

NA from sympathetic system acts on which receptor in the heart?

A

B1 adrenoceptors

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32
Q

NA has a positive/negative chronotropic effect on the heart?

A

positive

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33
Q

ACh has a positive/negative chronotropic effect on the heart?

A

negative

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34
Q

P wave represents…

A

atrial depolarisation

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35
Q

QRS complex represents…

A

ventricular depolarisation

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36
Q

T wave represents…

A

ventricular repolarisation

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37
Q

Drug that can be used in extreme bradycardia

A

Atropine

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38
Q

Atropine works as…

A

competitive antagonist of ACh

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39
Q

Two requirements for cardiac muscle contraction

A

ATP and Calcium

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40
Q

requirement for cardiac muscle relaxation

A

ATP

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41
Q

Calcium binds to ______ to move the ______ out of the vicinty of the actin-myosin binding site

A

troponin, tropomyosin

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42
Q

Calcium is released from the _______ _______ during ventricular contraction

A

sarcoplasmic reticulum

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43
Q

T-tubules ensure…

A

that calcium gets to all levels of the cell to maximise contraction

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44
Q

What is the purpose of the refractory period in cardiac muscle?

A

it prevents tetanic contraction within the heart muscle.

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45
Q

Calcium is taken back into the sarcoplasmic reticulum by…

A

the Ca-ATPase

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46
Q

SV =

A

EDV - ESV

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47
Q

EDV is determined by…

A

the venous return to the heart

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48
Q

EDV determines the….

A

preload

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49
Q

diastole

A

the heart ventricles are relaxed and fill with blood

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50
Q

systole

A

the heart ventricles contract and pump blood into the aorta and pulmonary artery

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51
Q

5 phases of cardiac cycle

A
  1. passive filling
  2. atrial contraction
  3. isovolumetric ventricular contraction
  4. ventricular ejection
  5. isovolumetric ventricular relaxation
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52
Q

What phase during the cardiac cycle is the P wave seen?

A

during phase 2 - atrial contraction

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53
Q

The ventricles are 80% full by the end of passive filling - true or false

A

true

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54
Q

The atria contract between the ____ and the ____ _____

A

P wave and the QRS complex

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55
Q

Where is the QRS complex seen in the cardiac cycle?

A

Phase 3 - the isovolumetric ventricular contraction

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56
Q

The first heart sound occurs when?

A

during isovolumetric ventricular contraction

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57
Q

What causes the first heart sound?

A

the pressure in the ventricles exceeding that of the atria

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58
Q

T wave signals…

A

ventricular repolarisation

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59
Q

What happens during ventricular ejection?

A

valves open and the SV is ejected

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60
Q

what causes the second heart sound?

A

the ventricular pressure falling below the aortic and pulmonary artery pressure

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61
Q

Auscultation for aortic valve

A

right sternal edge, 2nd intercostal space

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62
Q

Auscultation for pulmonary valve

A

left sternal edge, 2nd intercostal space

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63
Q

Auscultation for tricuspid valve

A

inferior left sternal margin, 4th intercostal space

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64
Q

auscultation for mitral valve

A

5th intercostal space in mid-clavicular line

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65
Q

during diastole the ventricles are _______ and ____ with blood

A

relaxed and fill with blood

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66
Q

During systole the ventricles ____ and ____ blood into the ____ and _____ _____

A

contract and pump blood into the aorta and pulmonary artery

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67
Q

At a heart rate of 75bpm, ventricular diastole lasts (0.5/0.3) secs and ventricular systole lasts (0.5/0.3) secs

A

0.5, 0.3

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68
Q

5 stages of the cardiac cycle

A
  1. Passive Filling
  2. Atrial Contraction
  3. Isovolumetric Ventricular Contraction
  4. Ventricular Ejection
  5. Isovolumetric Ventricular Relaxation
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69
Q

Events during passive filling of the heart

A

Pressure in atria and ventricles is nearly 0, AV valves are open allowing venous return to flow into ventricles, Ventricles fill about 80%

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70
Q

Events during atrial contraction

A

P wave signals depolarisation of atria, End diastolic volume of ~130ml

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71
Q

Events during isovolumetric ventricular contraction

A

Ventricular contraction starts QRS of ECG, pressure rises, first heart sound as ventricular pressure rises over atria, tension rises rapidly

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72
Q

Events during ventricular ejection

A

aortic and pulmonary valves open, aortic pressure rises, ESV left behind

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73
Q

Events during isovolumetric ventricular relaxation

A

T wave signals ventricular repolarisation, ventricles relax and pressure falls, aortic and pulmonary valves shut leading to second heart sound

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74
Q

When might splitting of the heart sound be heard?

A

at inspiration as the inspiratory pressure is not high enough to promote pulmonary valve closure at the exact same time as the aorta.

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75
Q

When does the JVP occur in relation to the atrial pressure wave?

A

right after atrial pressure waves

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76
Q

Systolic blood pressure is…

A

the pressure exerted by the blood on the walls of the aorta and systemic arteries when the heart contracts

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77
Q

Systolic blood pressure should be maintained between ____ and ____ and not exceed ____mmHG

A

90 and 120, not exceed 140mmHg

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78
Q

Diastolic blood pressure is…

A

the pressure exerted by the blood on the walls of the aorta and systemic arteries when the heart relaxes

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79
Q

Diastolic pressure should not reach or exceed…

A

90mmHg

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80
Q

Blood normally flows in the arteries in a laminar fashion - True or false?

A

True

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81
Q

Korotkoff sounds are heard when…

A

The cuff pressure is between the systolic and diastolic blood pressure

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82
Q

Where is diastolic pressure recorded according to korotkoff sounds?

A

when no sounds are heard any more

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83
Q

1st korotkoff sound

A

the first sound is heard at peak systolic pressure

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84
Q

Pressure gradient =

A

MAP - Central Venous pressure

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85
Q

The right atrial pressure is…

A

close to zero

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86
Q

5th Korotkoff sound

A

no sound is heard because of uninterrupted smooth laminar flow

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87
Q

The MAP is the average _____ blood pressure during a single ____ ____

A

arterial, cardiac cycle

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88
Q

MAP =

A

[(2xdiastolic) + systolic] / 3

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89
Q

How much MAP is required to perfuse the coronary arteries, brain and kidneys?

A

60 mmHg

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90
Q

MAP is also equal to?

A

CO x TPR

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91
Q

SV is…

A

the volume of blood pumped by each ventricle of the heart per heartbeat

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92
Q

Parasympathetic system has an effect on the arteries and arterioles - True or False?

A

False - the sympathetic stimulation causes vasoconstriction

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93
Q

What effect does sympathetic stimulation have on the veins?

A

increased vasoconstriction –> increased venous return and greater SV

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94
Q

Where do the baroreceptors originate?

A

aortic arch

carotid sinus

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95
Q

How do the aortic baroreceptors send signals to the medulla?

A

CN X - the vagus nerve

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96
Q

How do the carotid sinus baroreceptors send signals to the medulla?

A

CN IX - the glossopharyngeal nerve

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97
Q

Foramen where the CN X exits the skull

A

the jugular foramen

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98
Q

Foramen where CN IX exits the skull

A

the jugular foramen

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99
Q

The baroreceptor reflex is important in acute and chronic situations - true or false?

A

False - the baroreceptor reflex becomes desensitised in chronic high blood pressure and thus only adapts to acute changes

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100
Q

Action of sympathetic nervous system in baroreceptor reflex

A

Causes vasoconstriction when the MAP decreases; MAP decrease causes reduced firing of baroreceptors decreasing vagal tone and increase sympathetic tone

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101
Q

Sympathetic effect on TPR

A

causes an increase in TPR

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102
Q

Long term control of MAP is largely controlled by…

A

blood volume

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103
Q

Around ___% of body weight in men is water

A

60%

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104
Q

Total body fluid =

A

Intracellular fluid (2/3rd) + Extracellular fluid (1/3rd)

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105
Q

ECF =

A

plasma volume + interstitial fluid

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106
Q

What two main factors affect ECF volume?

A

Water excess or deficit

Na excess or deficit

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107
Q

Hormones that regulate ECF volume (3)

A

RAAS
ANP
ADH

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108
Q

Renin is released from…

A

the kidneys

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109
Q

Renin stimulates the release of?

A

angiotensin I

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110
Q

Angiotensin I is produced from?

A

angiotensinogen from the liver

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111
Q

AngI is converted to Ang II by?

A

Angiotensin converting enzyme

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112
Q

ACE is produced by?

A

pulmonary vascular endothelium

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113
Q

AngII stimulates the release of?

A

aldosterone

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114
Q

Aldosterone is produced

A

in the zona glomerulosa of the adrenal cortex

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115
Q

AngII causes (2)

A

systemic vasoconstriction, ADH release

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116
Q

Aldosterone is a steroid hormone - True or false

A

True

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117
Q

Aldosterone acts ont eh kidneys to?

A

increase sodium and water retention

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118
Q

Increasing sodium and water retention causes?

A

increase in plasma volume

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119
Q

Renin is released from where in the kidney?

A

the juxtaglomerular apparatus

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120
Q

3 things which stimulate renin release

A

(1) renal artery hypotension
(2) stimulation of renal sympathetic nerves
(3) decreased Na in renal tubular fluid

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121
Q

Cells responsible for sensing Na in the renal tubules

A

Macula densa cells

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122
Q

Type of cells that release renin

A

granular cells

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123
Q

Where is atrial naturietic peptide produced?

A

atrial myocytes

124
Q

What stimulates production of ANP?

A

atrial distension

125
Q

ANP causes…

A

excretion of salt and water from the kidnyes

126
Q

ANP acts to ________ the RAAS system

A

counteract

127
Q

ADH is also known as?

A

Vasopressin

128
Q

ADH is synthesised by the _______ and stored in the ________

A

hypothalamus, posterior pituitary

129
Q

What two things stimulate the release of ADH?

A
  1. reduced ECF volume

2. Increased ECF osmolarity

130
Q

Normal osmolarity of ECF is…

A

280mosml/l

131
Q

AD acts on the kidney tubules to…

A

increase the reabsorption of water

132
Q

ADH acts on the blood vessels to…

A

cause vasoconstriction

133
Q

The actions of ADH on the blood vessels is important in…

A

hypovolaemic shock

134
Q

Pulse pressure =

A

SBP - DBP

135
Q

Resistance = (Pouiseilles law)

A

[n.L]/r^4

136
Q

What has the greatest effect on resistance?

A

radius

137
Q

Extrinsic control of vascular smooth muscle involves which two factors?

A

hormones

nerves

138
Q

Which nerves supply the vascular smooth muscle?

A

sympathetic

139
Q

Sympathetic nerves supply _____ to the vascular smooth muscle

A

noradrenaline

140
Q

Noradrenaline acts on __ ________ in the vascular smooth muscle

A

a-adrenoceptors

141
Q

True or False - blood vessels are partially constricted at rest to maintain blood pressure

A

True - this is called vasomotor tone

142
Q

What causes the vasomotor tone?

A

the tonic discharge from sympathetic fibres

143
Q

Adrenaline is released from…

A

the adrenal medulla above the kidneys

144
Q

Adrenaline acts differently depending on the organ and receptor - True or False?

A

True

145
Q

Adrenaline acts on a adrenoceptors in the cardiac and skeletal muscles to vasodilation - True or False

A

False - acts on B2 adrenoceptors to cause vasodilation

146
Q

What adrenoceptors does adrenaline act on in the skin, gut and kidney arterioles? What is the effect?

A

a-adrenoceptors, causes vasoconstriction

147
Q

Why does adrenaline have alternating effects in different organs?

A

allows for strategic distribution of blood flow

148
Q

Angiotensin II and ADH cause _______

A

vasoconstriction

149
Q

Intrinsic controls of vascular smooth muscle are…

A

local metabolic changes which can override extrinsic effects

150
Q

Effect of increased PO2 on vascular smooth muscle

A

constriction

151
Q

Effect of increased PCO2 on vascular smooth muscle

A

vasodilation

152
Q

Effect of increased H+ on vascular smooth muscle

A

vasodilation

153
Q

Effect of increased EC K+ on vascular smooth muscle

A

vasodilation

154
Q

Effect of decreased osmolality on vascular smooth muscle

A

constriction

155
Q

Humoral agents which increase relaxation of vascular smooth muscle

A

histamine, bradykinin, Nitric oxide

156
Q

Humoral agents which increase vasoconstriction of vascular smooth muscle

A

serotonin, thromboxane A2, leukotrienes, endothelin

157
Q

Endothelin is produced by…

A

endothelial cells

158
Q

What factors can damage endothelial health? (4)

A

high BP, hypercholesterolaemia, diabetes, smoking

159
Q

Endothelial produced vasodilators have what effects? (3)

A

Anti-thrombotic; anti-inflammatory; anti-oxidants

160
Q

Effect of cold temperature on vascular smooth muscle?

A

vasoconstriction

161
Q

Nitric oxide is produced from?

A

L-Arginine

162
Q

Nitric oxide has a long half-life - T or F?

A

False, it has a short half life of a few seconds

163
Q

Calcium is released from the endothelial wall in the presence of…

A

shear stress - leads to activation of NOS –> NO

164
Q

NO activates ____ which aids vascular smooth muscle relaxation

A

cGMP

165
Q

Four factors which influence venous return

A

Increased blood volume
Increased vasomotor tone
Increased skeletal muscle pump
Increased respiratory pump

166
Q

What does increasing venous return do?

A

increases atrial pressure and thus EDV and SV

167
Q

Are venous smooth muscles supplied by nerves?

A

yes sympathetic nerves

168
Q

An increase in CO increases DBP - true or false?

A

false - increases SBP

169
Q

Metabolic hyperaemia causes a decrease in what two things?

A

TPR and DBP

170
Q

Exercise causes an increase in…

A

pulse pressure

171
Q

Likely effects of chronic exercise on CVS (6)

A

reduction in sympathetic tone; increases parasympathetic tone to the heart; cardiac remodelling; reduction in plasma renin levels; improved endothelial function; decreased arterial stiffening

172
Q

Sympathetic stimulation increases HR by exerting what two effects?

A

increasing rate of SAN firing

decreases AV nodal delay

173
Q

condition where the pericardial cavity fills with blood preventing contraction

A

cardiac tamponade

174
Q

Coronary arteries branch of at…?

A

the ascending aorta, almost instantly after leaving the ventricle

175
Q

Vein that drains blood back into the right atrium from the myocardium

A

coronary sinus

176
Q

Vagus nerve descends where?

A

lateral to the trachea, behind the hila of the lungs, medially by the heart

177
Q

Where does the phrenic nerve descend?

A

down the lateral side of the heart

178
Q

The left coronary artery splits into what three branches?

A

circumflex, left marginal and left anterior descending

179
Q

the left anterior descending artery has what extra branch?

A

the lateral branch

180
Q

The right coronary artery splits into which 2 arteries?

A

right marginal artery anteriorly;

posterior interventricular artery

181
Q

mitral stenosis can be heard when?

A

during diastole (without pulse)

182
Q

mitral regurgitation can be heard when?

A

during systole (with pulse)

183
Q

What germ layer is the heart derived from?

A

visceral part of the lateral mesoderm

184
Q

during cranio-caudal folding the heart moves from where to where?

A

the cervical to thoracic area

185
Q

there are initially how many pairs of the aortic arches?

A

6

186
Q

the 3rd arch of the aorta develops into…

A

the common carotid artery and the first part of the internal carotid artery

187
Q

The 4th aortic arch develops into…

A

the right subcalvian artery and part of the aortic arch

188
Q

the 6th aortic arch becomes…

A

the sprout branches that form the pulmonary arteries and ductus arteriosus on the left

189
Q

the ductus arteriosus becomes what post-birth?

A

the ligamentus arteriosum

190
Q

What is the function of the Vitelline veins?

A

drain the yolk sac - important in development of gut and portal system

191
Q

What is the function of the umbilical veins?

A

oxygenated blood from the placenta - right vein degenerates

192
Q

Which umbilical vein degenerates?

A

right umbilical

193
Q

What does the left umbilical vein become?

A

the definitive umbilical vein

194
Q

What do the cardinal veins give rise to?

A

the systemic venous system

195
Q

The anterior cardinal veins give rise to…

A

the jugular and left brachiocephalic vein, and the SVC

196
Q

the posterior cardinal veins give rise to…

A

the azygous and hemiazygous systems, gonadal and renal veins, iliac veins, IVC

197
Q

What two systems are involved in the circulatory systems?

A

the cardiovascular system, the lymphatic system

198
Q

What are the roles of the circulatory system? (5)

A

transport of oxygen and nutrients; transport of CO2 and metabolic waste; temperature regulation; distribution of hormones; penile erection in males

199
Q

where is most of the blood held in the circulatory system?

A

veins ~60%

200
Q

What are the 3 basic layers to the blood vessels?

A

Tunica intima, tunica media, tunica adventitia

201
Q

What makes up the tunica intima?

A

single layer of squamous epithelial cells attached to a basal lamina and a thin layer of connective tissue

202
Q

What makes up the tunica media?

A

smooth muscle and elastic tissue

203
Q

What makes up the tunica adeventitia?

A

connective tissue

204
Q

true or false - large arteries can get all the nutrients from the lumen of their vessel?

A

false - only the inner half - the rest can receive nutrients from the vaso vasorum

205
Q

What is the vaso vasorum?

A

the vascular supply to the large arteries.

206
Q

what cells in the basal lamina may help capillaries constrict to control blood flow?

A

pericytes

207
Q

what are the 3 types of capillary?

A

continuous, fenestrated, sinusoidal (discontinuous)

208
Q

which type of capillary is most common?

A

continous

209
Q

Where are continuous capillaries found?

A

skin, lung, muscle, connective tissue, nerves

210
Q

What feature determines fenestrated capillaries?

A

they have pore in their walls

211
Q

where are fenestrated capillaries found?

A

in the mucosa of the gut, endocrine glands, glomeruli of the kidney

212
Q

What feature determines sinusoidal capillaries?

A

lack a basal lamina and have large gaps throughout

213
Q

where are sinusoidal capillaries usually found?

A

liver, spleen, bone marrow

214
Q

3 layers of the heart

A

endocardium, myocardium, epicardium

215
Q

Where does the endocardium extend to?

A

the valves

216
Q

What is included in the endocardium structure? (4)

A

endothelium, basal lamina, collagen fibres, denser connective tissue

217
Q

what is the sub-endocardium?

A

extension of the endocardium (loose connective tissue) which contains small blood vessels, nerves and impulse conducting system

218
Q

Features of the myocardial cells

A

one central nucleus (maybe 2), irregularly placed intercalated discs

219
Q

What feature is likely found in the epicardial layer of the heart?

A

large branches of the coronary blood vessels

220
Q

lymphatic capillaries begin as…

A

blind sacs

221
Q

most of the excess interstitial fluid returns to…

A

the venous system

222
Q

The passing of lymph through lymph nodes provides opportunities for…

A

immunological surveillance

223
Q

Things that aid the movement of lymph (2)

A

hydrostatic pressure, muscles around the lymph vessels, valves within the vessels

224
Q

The lymphatic system helps to deliver fats to the _____ from the _____ _____

A

liver, small intestine

225
Q

What is shock?

A

an abnormality of the circulatory system resulting in inadequate tissue perfusion and oxygenation

226
Q

What affects Stroke Volume (3)?

A

Preload, Myocardial contractility, Afterload

227
Q

What is hypovolaemic shock?

A

where a loss in blood volume –> decreased venous return –> decreased EDV and SV –> Decreased CO and MAP –> inadequate perfusion

228
Q

The heart can compensate for what loss in blood volume?

A

30%

229
Q

What is cardiogenic shock?

A

Sustained hypotension caused by decreased cardiac contractility

230
Q

How does cardiogenic shock lead to inadequate tissue perfusion?

A

Decreased cardiac contractility –> decreased SV –>Decreased CO and MAP –> Inadequate tissue perfusion

231
Q

Example of obstructive shock?

A

Tension Pneumothorax

232
Q

How does a tension pneumothorax lead to inadequate tissue perfusion?

A

Increased intrathoracic pressure –> decreased venous return –> decreased end diastolic volume & decreased SV –> Decreased CO and MAP –> Inadequate tissue perfusion.

233
Q

What can cause neurogenic shock?

A

Spinal Cord injury

234
Q

How does a spinal cord injury lead to inadequate tissue perfusion?

A

Loss of sympathetic tone –> massive venous and arterial vasodilation –> decreased venous return and TPR –> Decreased CO and MAP –> Inadequate tissue perfusion

235
Q

Steps in treatment of Shock?

A

ABCDE
High flow oxygen
Volume replacement

236
Q

Extra step in treatment of Cardiogenic shock…

A

ABCDE, high flow oxygen, volume replacement, inotropes

237
Q

Extra step in treatment of shock due to tension pneumothorax…

A

ABCDE, high flow oxygen, volume replacement, Immediate chest drain

238
Q

Extra step in treatment of anaphylactic shock

A

ABCDE, high flow oxygen, volume replacement, adrenaline

239
Q

Extra step in treatment of septic shock

A

ABCDE, high flow oxygen, volume replacement, vasopressors

240
Q

If someone is suffering from haemorrhagic shock, how would you expect to find their pulse?

A

Fast and thready, potentially weak

241
Q

If someone is suffering from haemorrhagic shock, how would you expect to find their peripheries?

A

cool and potentially clammy

242
Q

In the presence of blood loss, the baroreceptor reflex sends signals to…

A

the medulla in the CNS

243
Q

The medulla (increases/decreases) vagal tone during haemorrhagic shock?

A

decreases

244
Q

The medulla (increases/decreases) sympathetic activity during haemorrhagic shock?

A

increases

245
Q

An increase in constriction of the veins during haemorrhagic shock leads to….

A

increased stroke volume

246
Q

An increase in constriction of the arteries during haemorrhagic shock leads to….

A

increased TPR

247
Q

Effect of sympathetic NS on the heart?

A

increased HR and contractility

248
Q

Effect of parasympathetic NS on the heart?

A

decrease HR

249
Q

Where do visceral afferent fibres travel?

A

alongside sympathetic nerves

250
Q

Visceral reflex afferents from baroreceptors travel mainly in the…

A

vagus nerve (CN X)

251
Q

Where are the sympathetic ganglia held?

A

sympathetic chain in the thoracolumbar region

252
Q

What are splanchnic nerves?

A

pairs of visceral efferents or afferents that carry fibres of the autonomic nervous system

253
Q

Which set of splanchnic nerves are not sympathetic?

A

pelvic

254
Q

Where are the cardiopulmonary splanchnic nerves are predominantly sided where?

A

the left side

255
Q

Where is the cardiac plexus found?

A

At the level of the carina, around the pulmonary trunk

256
Q

WHere are the ganglia for the parasympathetic nerves found?

A

on the target organ

257
Q

Where are the parasympathetic outputs?

A

cranial and sacral regions

258
Q

what 4 cranial nerves have their ganglia in the head?

A

Vagus nerve (CN X), Occulomoter (III), Facial (VII), Glossopharyngeal (IX)

259
Q

CN III

A

Occulomotor

260
Q

CN VII

A

Facial

261
Q

CN XI

A

Glossopharyngeal

262
Q

What is pain?

A

an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage

263
Q

Somatic sources of chest pain (6)

A

muscle; joint; boney; intervertebral disc; fibrous; nerve

264
Q

Visceral sources of chest pain (4)

A

Heart and great vessels, trachea, oesophagus, abdominal viscera

265
Q

Somatic pain is typically described as…

A

well localised, typically sharp and stabbing pains

266
Q

Visceral pain is typically described as…

A

dull, aching, nauseating and poorly localised

267
Q

Radiating pain is described as…

A

pain felt in the centre of chest AND spreading from there

268
Q

Referred pain is described as…

A

pain only felt at a site remote from the area of tissue damage

269
Q

Where does referred pain tend to travel?

A

along the dermatomes

270
Q

Which dermatome would herpes zoster most likely cause a sharp somatic chest pain?

A

T4/5

271
Q

Common radiations of cardiac chest pain?

A

Jaw, arm, neck, back

272
Q

What is a myocardial infarction?

A

irreversible death of part of the myocardium due to the occlusion of its arterial blood supply

273
Q

3 surfaces of the heart affected by an MI

A

Anterior, Inferior, Anterolateral

274
Q

Where do 40-50% of MIs occur?

A

the LAD

275
Q

where do 30-40% of MIs occur?

A

the right coronary artery

276
Q

where do 15-20% of MIs occur?

A

the circumflex artery

277
Q

Commonly used vessels in the revascularisation/bypass grafting of the heart?

A

radial/internal thoracic artery and the great saphenous vein

278
Q

What may occur if the ischaemia affects the SAN or AVN?

A

arrhythmias

279
Q

AVN damage during MI can result in…

A

complete heart block

280
Q

Bundle branch damage during an MI can result in…

A

bundle branch block

281
Q

decreased PO2 causes ______ of the coronary arterioles

A

vasodilation

282
Q

Adenosine is naturally produced from?

A

ATP

283
Q

sympathetic vasoconstriction around the coronary arterioles is overridden by ______ ______ during exercise

A

metabolic hyperaemia

284
Q

coronary arterioles are supplied by sympathetic vasoconstrictor nerves which act via __-adrenoceptors

A

a-adrenoceptors

285
Q

peak left coronary blood occurs during (systole/diastole)

A

diastole - the contraction of the heart during systole constricts the movement of blood in to the coronary arterioles

286
Q

Which arteries anastamose to form the circle of willis?

A

carotids and basilar arteries

287
Q

which arteries supply the brain?

A

internal carotids and vertebral arteries

288
Q

which particular part of the brain is very sensitive to hypoxia?

A

grey matter

289
Q

What types of stroke can occur?

A

ischaemic or haemorrhagic

290
Q

arterial pressure range within the brain?

A

60-160mmHg

291
Q

autoregulation of brain arterial pressure fails when…

A

MABP is outwith 60 - 160mmHg

292
Q

an increase in PCO2 within the brain causes vaso_______

A

dilation

293
Q

why can hyperventilation lead to fainting?

A

causes a decrease in PCO2 which causes vasoconstriction within the brain.

294
Q

three things which cross the blood brain barrier?

A

oxygen, carbon dioxide, glucose

295
Q

average intracranial pressure

A

8-13mmHg

296
Q

Cerebral perfusion pressure =

A

MABP - ICP

297
Q

How does glucose cross the BBB?

A

facilitated diffusion

298
Q

pulmonary BP is typically a (high/low) pressure system

A

low pressure system - approx 10% of that of the systemic

299
Q

how do the lungs protect against pulmonary oedema?

A

the absorptive forces exceed the filtration forces

300
Q

hypoxia causes vasoconstriction of the pulmonary arterioles - why?

A

helps direct blood flow to areas of the lung where the ventilation is better

301
Q

circulating adrenaline causes vasodilation in the skeletal smooth muscle via __adrenoceptors

A

b2-adrenoceptors

302
Q

the one way venous valves and the skeletal muscle pump allows ?

A

blood to flow back towards the heart

303
Q

Blood pools in the limb veins if…

A

venous valves become incompetent

304
Q

What is the result of blood pooling in the limbs?

A

varicose veins

305
Q

why don’t varicose veins lead to a reduction in cardiac output?

A

there is chronic compensatory increases in blood volume

Y1 Cardiovascular (12 decks)

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