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eMRCS questions > Physiology Cardio book > Flashcards

Physiology Cardio book Flashcards

1
Q

Cardiovascular changes in pregnancy

A

Increase stroke rate 35%
Venous dilation 150%- due to increase plasma and
Red cell mass 20-30
Ventricular enlargement
Resting HR 15%

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2
Q

Frank starling law

A

Stroke volume is a function of end diastolic volume

Greater volume entering heart at diastole - greater stretch and SV

Due to Ca affinity to troponin C

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3
Q

BP in each area of heart and pulmonary circulation

A

Right atrium- 0-4
RIght ventricle- 25/0-4
Pulmonary artery-25/15
Left atrium- 5-10
Left ventricle- 120/0-10

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4
Q

What can you use to measure pulmonary artery pressure and estimate left atrial pressure

A

Stanz ganz catheter

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5
Q

Cause of third and fourth HS

A

3rd- rapid ventricular filling- dilatation

4th- ventricular hypertrophy/HF- due to forceful atrial contraction

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6
Q

Normal central venous pressure

A

8-12

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7
Q

Wnckebach phenomenon

A

PR interval becomes progressively more prolonged until QRS is missed

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8
Q

Cause of high CO due to reduced peripheral resistance

A

Beriberi, AV fistula, hyperthyroidism, anaemia

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9
Q

Factors aiding recovery from shock

A

Baroreceptors- sympathetic stimulation
Reverse stress relaxation- vasoconstriction
Angiotensin- kidneys

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10
Q

Most important electrolyte in myocardial contracility

A

Intracellular Ca- bind to trop C activating actin-myosin

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11
Q

Pressures in capillary beds and interstitial tissues

A

Arterial end- filtration highest
Oncotic pressure highest venous end

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12
Q

% coronaries receive of CO

A

5%

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13
Q

Coronary blood flow

A

70-80ml/min rest
300-400 per 100g of tissue

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14
Q

O2 consumption of heart

A

8ml/100g at rest

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15
Q

Fick principal

A

The Fick principle states that the uptake or release of oxygen by a tissue is the product of the amount of oxygen delivered to the tissue times the difference in oxygen content between the blood entering and leaving the tissue.

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16
Q

Distribution of water in human body

A

2/3 of weight is water (66%)

Of that 2/3 intracellular (40%)
1/3 extracellular (20%)

Of which
2/3 Interstitial (13%)-between cells
Intravascular (6%)- blood
Transcellular (1%)- CSF, synovial fluid

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17
Q

Factors affecting turbulence of blood flow

A

Velocity v
Diameter d
Density p
Viscosity n

vdp/n

So increased velocity, diameter, density increase turbulence
Decreased viscosity increases

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18
Q

Where main site of RBC formation is in adults

A

Flat bones

19
Q

Types of shock and features

A

Cardiogenic- increased PVR due to low SV
Neurogenic- loss of autonomic- low PVR
Septic- low PVR, high CO

20
Q

Classification of shock

A

<15- <750ml- normal, slightly anxious, urine >30ml/hr

15-30- 750- 1500- HR >100, BP normal, urine 20-30

30-40- 1500-2000ml- BP low, urine 5-15, HR 120-140

> 40- >2000ml- BP low, urine neg, HR >140

21
Q

Effects of haemorrhage shock on physiology

A

Increase in HR
Reduced central venous pressure
Splanchnic vasoconstriction

22
Q

Waves of JVP and what causes them

A

a- atrial contraction
x descent- ventricle contraction
c wave- bulge in tricuspid
v wave- rapid atrial filling
y descent- opening of tricuspid passively

23
Q

Abnormalities seen on JVP waves

A

Cannon a - complete HB, as contracting against closed TV
Large a- RVH, pulmonary HTN
Absent a- AF

Large V- TR

24
Q

Features of cardiac cells

A

Have intercalated discs which join 2 together- z lines
Branched structure
Uninucleated
Involuntary striated muscle

25
Q

Septal vs anterolateral vs lateral st changes

A

Septal- V1-3

Anterolateral- V1-6

Lateral- V4-6, I, aVL

26
Q

Which organs contain which adrenoreceptors

A

a1- smooth muscle contraction- blood vessels, uterus, ureters, liver- gluconeogenesis and glycogenolysis

a2- negative feedback

b1- cardiac contractility

b2- smooth muscle relaxation
Bronchioles, GI, vessels
Liver- glycogenolysis and gluconeogenesis

27
Q

Clotting cascade

A

Intrinsic- XII- XI- IX- VIII (activates X by IX)

Extrinsic- VII, X, tissue factor

Common X- II (thrombin)- I fibrin
V required from thrombin activation

Several stages require Ca

28
Q

What happens when you stand in the CVS

A

SV falls
Increase in SVR
Reduction in baroreceptor stimulation causing reduction in vagal stimulation and increasing sympathetic

29
Q

What causes stimulation of RBC production

A

High altitude
Resp disease
Haemorrhage
Increased RBC segregation products

30
Q

Structure and properties of myoglobin

A

Single chain protein
Contains haem
Instant binding rather than cooperative
Hyperbolic dissociation curve
Store O2 in muscles- rapid release when needed

31
Q

Pulse pressure during shock, exercise and ACEi

A

Narrow in shock
Increase in exercise
ACEi effective treatment of reducing PP

32
Q

Types of haemoglobin

A

HbA- adults
HbF- fetus- higher O2 dissociation
HbS- sickle

33
Q

Uses of Central venous catheter

A

CVP monitoring
TPN delivery
Drug infusion
Haemodialysis

34
Q

Location of SA node
Blood supply
Nerve supply

A

RA near the entrance of SVC
RC blood supply
T1-4 symptomatic, vagal para

35
Q

Normal EF

A

Around 60%
Increases with exercise

36
Q

Baroreceptor location and properties

A

Wall of the heart
Carotid and aorta
Increase stimulation when stretched with more pressure - inhibits symp

Afferent from carotid part of glossopharyngeal
Aortic- vagus

37
Q

Where is renin produced

A

Juxtaglomerular apparatus om response to low BP, Na or symp

38
Q

Anrep and Bowditch effect

A

Anrep -Myocardial contractility increases with increase after load

Bowditch- Increase in MC in response to increased HR

39
Q

When do papillary muscles contract

A

Prior to ventricular contraction
To close mitral and TV

40
Q

Cardiac index

A

CI=CO/BSA (body SA)

41
Q

Types of lymphatic vessels and properties

A

Initial lymphatics- valveless, no smooth muscle, in smooth muscle and intestinal walled, fluid transported due to muscular contractions

Collecting - valves, smooth muscle, contract via peristalsis

42
Q

What is oedema

A

Accumulation in extravascular space

Nephrotic- transudate

43
Q
A

eMRCS questions (45 decks)

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