PCS 3

Question 1

Where can you hear the heart valves

Answer 1

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

Question 2

How can you tell if someone has cardiomegaly

Answer 2

if heart shadow on xray is more than half the thorax shadow

Question 3

What are the two layers of the pericardium

Answer 3

Fibrous pericardium

Serous Pericardium

Question 4

What are the contents in the posterior mediastinum

Answer 4

Descending aorta
Azygous, hemiazygous veins
Thoracic ducts
Esophagus
Sympathetic trunk

Question 5

What part of vessel wall is responsible for dilation and constriction

Answer 5

Tunica media

Question 6

What happens in primary haemostasis

Answer 6

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

Question 7

What happens in secondary haemostasis

Answer 7

Reinforces soft clot with fibrin. Cell based and classical pathways.

Question 8

Describe the extrinsic pathway of clotting

Answer 8

Uses tissue factor

Question 9

Describe the intrinsic pathway of clotting

Answer 9

Series of coagulation factors causing fibrinogen to turn into fibrin

Question 10

Describe the steps of the cell based model of clotting

Answer 10

initiation, amplification, propagation

Question 11

What converts testosterone to oestrogen

Answer 11

aromatase

Question 12

What is lucitropy

Answer 12

the rate of muscle relaxation

Question 13

What is preload

Answer 13

The amount of sarcomere stretch experienced by cardiac muscle cells at the end of ventricular filling

Question 14

What is myocardial contractility

Answer 14

ability of the heart to contract

Question 15

What are some positive inotropic agents

Answer 15

Digitalis
Catecholamine
Phosphodiesterase inhibitors

Question 16

What are some negative inotropic agents

Answer 16

Beta adrenoceptor antagonists

Calcium channel antagonists

Question 17

What is afterload

Answer 17

Pressure the heart must work against to eject blood during systole

Question 18

What conditions are beta blockers prescribed for

Answer 18

Angina
Heart failure
Atrial fibrillation
Heart attack
High Blood Pressure

Question 19

How are beta blockers dangerous to people with asthma or COPD

Answer 19

Bronchoconstriction because it activated the sympathetic nerves innervating the bronchioles

Question 20

What conditions can be managed with calcium channel blocking drugs

Answer 20

High blood pressure
cardiac arrhythmias
coronary heart disease
Hypertrophic cardiomyopathy

Question 21

What proteins metabolise adrenaline

Answer 21

Monoamine oxidase

Catechol - o - methyl transferase

Question 22

Which node in the heart is most receptive to adrenaline

Answer 22

Sino atrial

Question 23

Features of steroid hormones

Answer 23

Made of cholesterol
Acts in cytosol and nucleus
Modifies transcription by binding to DNA
More permanant

Question 24

Features of peptide hormones

Answer 24

Made of amino acids
Acts of cell surface
Rapid less permanant

Question 25

How are signals from the hypothalamus transmitted to the anterior pituitary gland

Answer 25

Portal blood vessels and capillary beds

Question 26

How are signals from the hypothalamus transmitted to the posterior pituitary gland

Answer 26

Transport down nerve fibres

Question 27

What hormones are released from the posterior pituitary gland

Answer 27

Oxytocin | ADH

Question 28

What hormones are released from the anterior pituitary gland

Answer 28

``` Growth hormone Prolactin Adenocorticotropic hormone Thyroid stimulating hormone FSH LH ```

Question 29

Metabolic effects of growth hormone

Answer 29

Muscle building Increased lipolysis Increased gluconeogenesis - produces IGF

Question 30

Indirect metabolic effects of growth hormone

Answer 30

Growth plates make more cartilage increasing bone length

Question 31

What are the male sex hormones

Answer 31

``` Androsterone Dehydroepiandrosterone (DHEA) Androsteridiol testosterone dihydrotestosterone ```

Question 32

What hormones are produced in the adrenal cortex

Answer 32

Aldosterone Cortisol Androgens

Question 33

What cells in the testes secrete testosterone

Answer 33

Leydig cells

Question 34

How do signals transmit through cells

Answer 34

Ca2+ signalling cascades

Question 35

Which vitamins are fat soluble

Answer 35

A,D,E,K

Question 36

which vitamins are water soluble

Answer 36

B1, B2, B3, B5, B6, B9, B12, C

Question 37

What are the 5 types of vertebrae

Answer 37

``` Cervical Thoracic Lumbar Sacral Coccygeal ```

Question 38

What are the 4 nerve axon type

Answer 38

General sensory afferent General visceral afferent General somatic efferent General visceral efferent

Question 39

What does the sympathetic system innervate

Answer 39

Thoracic and lumbar (fight or flight)

Question 40

What does the parasympathetic system innervate

Answer 40

Cervical and sacral (rest and digest)

Question 41

How does a nicotinic receptor work

Answer 41

When activated, pore opens and ions pass through.

Question 42

How does a muscarinic receptor work

Answer 42

protein coupled receptor that sets off a cell signalling chain

Question 43

What is an agonist

Answer 43

drug binds to receptor to produce an effect. These drugs have an affinity for the receptor and causes intrinsic activity

Question 44

What is an antagonist

Answer 44

drugs bind to receptor but doesn't produce and effect. It prevents access of the neurotransmitter to the receptor

Question 45

What is nociception

Answer 45

Information from nociceptors indicated tissue damage

Question 46

What part of the brain controls the information received about sensory information

Answer 46

Thalamus

Question 47

What do A delta nerve fibres do

Answer 47

Simple, naked nerve endings Thinly myelinated Responsible for the initial sharp pain

Question 48

What do C fibres do

Answer 48

Follow initial pain responsible for slow poorly localised pain

Question 49

What do sensory nerves use as its transmitters

Answer 49

Glutamate CGRP Substance P

Question 50

What is the mechanism of action of painkillers

Answer 50

They block enzymes that produce prostaglandins. Prostaglandins + histamines increase nociceptor sensitivity

Question 51

What does the spinothalamic tract do

Answer 51

Pain, temperature, simple touch

Question 52

What does the dorsal tract do

Answer 52

Discriminative touch, proprioception, vibration

Question 53

Varieties of pain

Answer 53

Cutaneous Somatic Visceral Referred

Question 54

Consequences of nerve damage

Answer 54

Axons sprout from cut ends of nerves and they grow in the wrong place