PCS 3 Flashcards
Where can you hear the heart valves
Aortic valve - right 2nd intercostal space
Pulmonary valve - left 2nd intercostal space
Tricuspid valve - left 4th/5th intercostal space
Mitral valve - mid axillary line intercostal space
How can you tell if someone has cardiomegaly
if heart shadow on xray is more than half the thorax shadow
What are the two layers of the pericardium
Fibrous pericardium
Serous Pericardium
What are the contents in the posterior mediastinum
Descending aorta Azygous, hemiazygous veins Thoracic ducts Esophagus Sympathetic trunk
What part of vessel wall is responsible for dilation and constriction
Tunica media
What happens in primary haemostasis
causes soft clot rich in platelets and Von Willebrand factor. Von Willebrand factor attaches to subendothelial collagen which causes platelets to bind. This changes the platelet shape causing them to degranulate causing their surface to be negatively charged
What happens in secondary haemostasis
Reinforces soft clot with fibrin. Cell based and classical pathways.
Describe the extrinsic pathway of clotting
Uses tissue factor
Describe the intrinsic pathway of clotting
Series of coagulation factors causing fibrinogen to turn into fibrin
Describe the steps of the cell based model of clotting
initiation, amplification, propagation
What converts testosterone to oestrogen
aromatase
What is lucitropy
the rate of muscle relaxation
What is preload
The amount of sarcomere stretch experienced by cardiac muscle cells at the end of ventricular filling
What is myocardial contractility
ability of the heart to contract
What are some positive inotropic agents
Digitalis
Catecholamine
Phosphodiesterase inhibitors
What are some negative inotropic agents
Beta adrenoceptor antagonists
Calcium channel antagonists
What is afterload
Pressure the heart must work against to eject blood during systole
What conditions are beta blockers prescribed for
Angina Heart failure Atrial fibrillation Heart attack High Blood Pressure
How are beta blockers dangerous to people with asthma or COPD
Bronchoconstriction because it activated the sympathetic nerves innervating the bronchioles
What conditions can be managed with calcium channel blocking drugs
High blood pressure
cardiac arrhythmias
coronary heart disease
Hypertrophic cardiomyopathy
What proteins metabolise adrenaline
Monoamine oxidase
Catechol - o - methyl transferase
Which node in the heart is most receptive to adrenaline
Sino atrial
Features of steroid hormones
Made of cholesterol
Acts in cytosol and nucleus
Modifies transcription by binding to DNA
More permanant
Features of peptide hormones
Made of amino acids
Acts of cell surface
Rapid less permanant
How are signals from the hypothalamus transmitted to the anterior pituitary gland
Portal blood vessels and capillary beds
How are signals from the hypothalamus transmitted to the posterior pituitary gland
Transport down nerve fibres
What hormones are released from the posterior pituitary gland
Oxytocin
ADH
What hormones are released from the anterior pituitary gland
Growth hormone Prolactin Adenocorticotropic hormone Thyroid stimulating hormone FSH LH
Metabolic effects of growth hormone
Muscle building
Increased lipolysis
Increased gluconeogenesis - produces IGF
Indirect metabolic effects of growth hormone
Growth plates make more cartilage increasing bone length
What are the male sex hormones
Androsterone Dehydroepiandrosterone (DHEA) Androsteridiol testosterone dihydrotestosterone
What hormones are produced in the adrenal cortex
Aldosterone
Cortisol
Androgens
What cells in the testes secrete testosterone
Leydig cells
How do signals transmit through cells
Ca2+ signalling cascades
Which vitamins are fat soluble
A,D,E,K
which vitamins are water soluble
B1, B2, B3, B5, B6, B9, B12, C
What are the 5 types of vertebrae
Cervical Thoracic Lumbar Sacral Coccygeal
What are the 4 nerve axon type
General sensory afferent
General visceral afferent
General somatic efferent
General visceral efferent
What does the sympathetic system innervate
Thoracic and lumbar (fight or flight)
What does the parasympathetic system innervate
Cervical and sacral (rest and digest)
How does a nicotinic receptor work
When activated, pore opens and ions pass through.
How does a muscarinic receptor work
protein coupled receptor that sets off a cell signalling chain
What is an agonist
drug binds to receptor to produce an effect. These drugs have an affinity for the receptor and causes intrinsic activity
What is an antagonist
drugs bind to receptor but doesn’t produce and effect. It prevents access of the neurotransmitter to the receptor
What is nociception
Information from nociceptors indicated tissue damage
What part of the brain controls the information received about sensory information
Thalamus
What do A delta nerve fibres do
Simple, naked nerve endings
Thinly myelinated
Responsible for the initial sharp pain
What do C fibres do
Follow initial pain responsible for slow poorly localised pain
What do sensory nerves use as its transmitters
Glutamate
CGRP
Substance P
What is the mechanism of action of painkillers
They block enzymes that produce prostaglandins. Prostaglandins + histamines increase nociceptor sensitivity
What does the spinothalamic tract do
Pain, temperature, simple touch
What does the dorsal tract do
Discriminative touch, proprioception, vibration
Varieties of pain
Cutaneous
Somatic
Visceral
Referred
Consequences of nerve damage
Axons sprout from cut ends of nerves and they grow in the wrong place
