Physiology Flashcards
Factors that promote juxtaglomerular secretion of renin
- Decreased pressure in renal afferent arterioles
- Decreased sodium delivery to macula densa of distal convoluted tubule
- Increased beta 1 noradrenergic stimulation to juxtaglomerular cells
Cranial nerve that transmits aortic arch information
Vagus nerve
Cranial nerve that transmits carotid sinus information
Glossopharyngeal nerve
Medullary nucleus that receives information from the baroreceptors
Solitary nucleus
Difference between Mobitz type 1 and 2 2nd degree AV block
Mobitz type 1 skips a beat after progressive prolongation of the PR Interval, while Mobitz type 2 skips it without this prolonged interval
Class 1 antiarrhythmics with potassium channel blocking effects
1A
Macroscopic changes after a myocardial infarction in day 1
- Dark mottling
* Pale with tetrazolium stain
Histologic changes after a myocardial infarction in 1 day
- Early coagulative necrosis (starts at 4 hours)
* Contraction bands
Macroscopic changes after a myocardial infarction in days 2 to 4
Hyperemia
Most abundant type of inflammatory cell after a myocardial infarction during days 2 to 4
Neutrophils
Postinfarction fibrinous percarditis is a common side effect during which period of time after a myocardial infarction
2 to 4 days
Macroscopic changes after a myocardial infarction in days 5 to 10
- Hyperemic border
* Central yellow-brown softening
Most abundant type of inflammatory cell after a myocardial infarction during days 5 to 10
Macrophages (formation of granulation tissue at margins)
Dressler syndrome occurs how long after a myocardial infarction
Weeks to months
Time it takes for troponin I to peak in plasma and how long does it stay elevated
Starts rising after 4 hours and peaks after 24 hours, stays elevated for 7 to 10 days
Time it takes for CK-MB to peak and how long does it stay elevated
Starts rising after 6 to 12 hours and peaks after 16 to 24 hours, stays elevated for 2 to 3 days
Cardiac enzyme that is the most useful in diagnosing a reinfarction
CK-MB
Cardiac malformation associated with congenital rubella
PDA
Cardiac malformation associated with a diabetic mother
Transposition of the great vessels
Treatment of HACEK group infections
- Third generation cephalosporins
* Fluoroquinolones
Jones criteria for rheumatic fever
Diagnosis requires 2 major or 1 major and 2 minor:
- Joint (migratory poloarthritis)
- Heart (carditis)
- Nodules in skin (subcutaneous)
- Erythema marginatum
- Sydenham corea
Minor: fever, arthralgias, elevated APR
Triad of Wegener’s granulomatosis (granulomatosis with polyangiitis)
- Focal necrotizing vasculitis
- Necrotizing granulomas in the lung and upper airway
- Necrotizing glomerulonephritis
Type of antibody associated with Wegener’s granulomatosis (granulomatosis with polyangiitis)
PR3-ANCA/c-ANCA (anti-proteinase 3)
Wegener’s granulomatisis (granuloamtosis with polyangiitis) treatment
Corticosteroids and cyclophosphamide
Main symptomatic difference between Wegener’s granulomatosis and microscopic polyangiitis
In microscopic polyangiitis there’s no nasopharyngeal involvement and no granulomas
Type of antibody associated with microscopic polyangiitis
MPO-ANCA/p-ANCA (anti-myeloperoxidase)
Pathologic and laboratory characteristic of Churg-Strauss syndrome
- Granulomatous, necrotizing vasculitis
* Eosinophilia
Type of cell necessary for truncus arteriosus partition
Neural crest cells
Failure in truncus arteriosus partition can give rise to what pathologies
- Transposition of the great vessels
- Tetralogy of Fallot
- Persistent truncus arteriosus
The outflow tract of the ventrciles is derived from which embryonic structure
Bulbus cordis
The coronary sinus is derived from which embryonic structure
Left horn of sinus venosus
The smooth part of the atrium is derived from which embryonic structure
Right horn of sinus venosus
The superior vena cava is derived from which embryonic structures
Right common cardinal vein and right anterior cardinal vein
The descending aorta is derived from which embryonic structures
Right and left dorsal aortas
Week at which heart starts beating
4th week
Vessel with the highest oxygen content of the fetal circulation
Umbilical vein
The posterior descending/interventricular artery (PDA) supplies which parts of the heart
- AV node
- Posterior 1/3 of interventricular septum
- Posterior 2/3 walls of ventricles
- Posteromedial papillary muscle
(INFERIOR WALL)
The posterior descending/interventricular artery (PDA) derives most frequently from which artery
Right coronary artery
Vein that carries the most deoxygenated blood in the body
Coronary sinus
Formula for cardiac output using the Fick principle
CO = rate of oxygen consumption/(arterial O2 content - venous O2 content)
Name the 2 formulas for mean arterial pressure
- MAP = CO x TPR
2. MAP = 2/3 diastolic pressure + 1/3 systolic pressure
Resistance is directly proportional to…
Viscosity and length of the vessel
Resistance is inversely proportional to…
Radius to the exponential 4
Period of highest oxygen consumption of the cardiac cycle
Isovolumetric contraction
Where are aortic and pulmonic regurgitation auscultated better
Left sternal border
Where do mitral regurgitation radiates to
Axilla
Characteristic murmur of mitral valve prolapse (MVP)
Late systolic crescendo murmur with midsystolic click
The Austin Flint murmur is seen in which pathology
Aortic regurgitation
The Graham Steell mumur is seen in which pathology
Pulmonic regurgitation
State the order of conduction velocity in the heart
Purkinje - Atria - Ventricles - AV node
ECG characteristics of Brugada syndrome
Pseudo-right bundle Branch block and ST elevations in V1-V3
Antiarrhythmic that blocks the bundle of Kent
Procainamide
Infection that can cause a third degree block
Lyme disease
Second Messenger associated to atrial natriuretic peptide (ANP)
cGMP
Effect of ANP on glomerular arterioles that contributes to the “aldosterone escape” mechanism
Dilation of afferent renal arterioles and constriction of efferent renal arterioles
Recombinant form of B-type natriuretic peptide used in the treatment of HF
Nesiritide
Cushing triad in response to increased intracranial pressure (ICP)
- Hypertension
- Bradycardia
- Respiratory depression
Formula for arterial and venous oxygen (to use in Fick principle equation)
Hgb x 1.34 x arterial or venous oxygen saturation
*Then multiply by 10 to get the correct units
Where is the SA node located
In the interatrial septum, right next to the opnening of the coronary sinus
What happens if the glossopharyngeal afferent fibers of the carotid sinus are suddenly severed
This sends a false signal to the medulla, telling this control center that the BP has dropped to 0, leading to increased activation of the SNS and inactivation of the PSNS
Primary determinators of SBP
Stroke volumen and arterial compliance
Primary determinator of DBP
Total peripheral resistance (TPR)
Equation for Flow (Q)
Q = change in pressure/resistance
Equation for total resistance of vessels in PARALLEL
1/Rt = 1/R1 + 1/R2 …
The decrease in tissue oxygenation that occurs within muscles during exercise is a stimulus for the production of what substance
Vascular endotelial growth factor
Commonly used index of left ventricle (LV) contractility
Rate of pressure development (dP/dT)
Equation for pulse pressure
- SBP - DBP
2. SV/compliance
Frank-Starling variable that is increased in non-pitting edema
Tissue oncotic pressure
The cardiac apex is formed by which chamber of the heart
Left ventricle
The anterior Surface of the heart is formed by which chamber
Right ventricle
Common site of origin of aberrant electrical impulses in atrial fibrillation
Pulmonary veins
Stenosis of the proximal subclavian artery can lead to what pathology
Subclavian steal syndrome
Pathogenesis of subclavian steal syndrome
Stenosis of the proximal subclavian artery leads to reversal of blood flow from the contralateral vertebral artery to the ipsilateral vertebral artery
Rate of the AV node
45 to 55 beats per minute
Formula for velocity
Velocity = Flow/Cross-sectional area
Factors that determine vasodilation in the heart
Adenosine, NO, CO2, decreased oxygen
Effect of increased pCO2 in blood vessels of the brain
Vasodilation
Factors that determine vasodilation in skeletal muscle
- Lactate
- Adenosine
- Potassium
- Hydrogen
- CO2
Artery that supplies the right ventricle
Right (acute) marginal artery
Heart tissue is developed from which embryologic structure
Lateral plate mesoderm
What are innocent/flow murmurs in the aortic area
Murmurs that appear during high flow states (eg, anemia, pregnancy)