stuck Flashcards
areola and lateral quadrant of the breast lymph drainage?
axillary nodes
suspensory ligament soft the breast?
- made from condensed connective tissue
- connect deep fascia of the breast to the dermis of the skin
- support the breast
medial quadrants of breast lypmph drained by?
parasternal lymph nodes
inferior quadrants of breast lymph drained by?
inferiorphrenic lymph nodes
what are the diastolic and systolic pressure in pulmonary circulation?
systolic = 30mmHg
diastolic = 12mmHg
what are the systolic and diastolic pressures in the aorta?
systolic = 120mmHg
diastolic = 80mmHg
what is the primary controller of coronary blood flow?
local metabolism, this is what controls the coronary artery radius.
during exercise where will the distribution of CO change to?
1- the heart (done via active hyperaemia)
2- skin (the core body temp increases, causing decreased sympathetic innervation to the skin)
what is the first order of kinetics?
occurs when a constant proportion of the drug is eliminated per unit time.
what is albumin?
- this is a plasma protein that helps to create osmotic forces
- it does this by helping to pull fluid into capillaries
- it binds to free drug
what is the Bainbridge reflex?
this is a sympathetic reflex that is a response to increased blood in the atria, causing increased heart rate and contractility, preventing the damming of the blood in veins.
what is decremental conduction?
the more frequently the AV node is stimulated, the slower it will conduct.
This prevents rapid conduction to the ventricle in cases of rapid atrial rhythms.
what is atrial fibrillation?
irregular and fast heart beat
what will the cardinal vein drain?
the trunk and head region of the embryo
what will the umbilical vein drain?
it will bring oxygenated blood from the placenta.
what will the vitelline vein drain?
the yolk sac
what are the 2 parts of the bulbis cordis?
conus cordus
trunks arteriosus
what will the conus cordis become?
the aortic vestibule and the infundibulum
what will the trunks arteriosus become?
it will divide into the pulmonary and aortic trunk.
what channel will digoxin inhibit?
Na/K ATPase
resting membrane potential can’t be restored
what are the 4 cranial veins?
1- cerebral veins
2- dural venous sinuses
3- diploic veins
4- emissary veins.
where will berry aneurysms occur?
circle of willis
anterior cerebral arteries
associated with sub-arachnoid haemorrhage
where will syphilitic aneurysms occur?
thoracic aorta
where will mycotic aneurysms occur?
they will effect the walls of arteries that have been effected by infection.
or in the brain secondary to an embolism.
describe takayasu arteritis?
pulseless disease
<30 yrs women
histologically it will have giant cells
treat with steroids.
angioma
benign tumour of blood vessel
what is subendocardial ischeamia due to?
epicardial coronary artery stenosis
this is the main cause of angina.
how is total occlusion of the left anterior descending artery compensated for by the body?
by filling from the collaterals of the right coronary artery.
what will ECG’s of angina have?
ST depression
myogenic theory?
(acute flow auto regulation)
- stretch induces vascular depolarisation of smooth muscle due to increase in arterial pressure
- limiting blood flow through vessel to prevent damage
- stretch activated calcium channels trigger contraction
what will subendocardial infarct result in?
results in necrosis exclusively involving the inner most aspect of the myocardium.
metabolic theory?
(acute flow autorgulation)
- increase in arterial pressure, increases 02
- high degree of oxygen delivery will trigger constriction of vasculature
- occlusion of blood supply
- reduced blood flow and protect vessel walls.
what happens if an etherosclerotic plaque ruptures?
contents leak out
resulting in platelet aggregation and arterial thrombosis.
- platalets will express prothrombinase which will cause more thrombi to form, this can totally occlude the coronary artery.
what is the test for inducible ischeamia?
(test for chest pain)
- this is a test for new regional abnormalities in contractile function at peak exercise that were not present at rest.
What will a subendocardial infarct result in?
It will result in necrosis exclusively involving the inner most aspect of the myocardium.
Type 1 MI
Spontaneous MI related to ischaemia due to a primary coronary event.
Type 2 MI
MI secondary to ischamia due to increased oxygen demand and decreased supply.
Type 3 MI?
Sudden unexpected cardiac death with symptoms suggestive of myocardial ischeamia
Type 4 MI?
MI associated with percutanious coronary stent thrombosis
Type 5 MI?
MI associated with cardiac surgery
What 4 conditions are associated with varicose veins?
1- oesophageal varices
2- haemorrhoids
3- varicocele
4- stasis dermatitis
What is a dissecting aortic aneurysm associated with?
Marfan’s syndrome (connective tissue defect)
What is the most common cause of death with dissecting aortic aneurysms?
Rupture of the dissection outwards into the pericardial, pleura or peritoneal cavity.
Angiosarcoma?
Malignant tumour
Occurs in:
- skin
- soft tissue
- breast
- liver
- bone
- spleen
Kaposi’s sarcoma?
Malignant tumour
- associated with HIV/AIDS
- This is an angioproliferative tumour that is derived from endothelial cells.
3 step management of STEMI’s
1- drugs (anti platelets)
2- PCI
3- beta blockers
Statins (lower cholesterol)
ACE inhibitors
Why will there be raised cardiomyocyte markers in MI?
Because the membrane is not working properly so these markers will leak out
What is a transmural infarction?
Refers to a MI that involves the full thickness of the myocardium.
when would you hear an apical ejection click?
in aortic stenosis
- this will occur at the opening of the aortic and pulmonary valves
combination of what 4 defects in tetralogy of fallout?
- VSD
- Pulmonary stenosis
- right ventricular hypertrophy
- overriding aorta
SYSTOLIC MURMUR
What type of murmur will VSD have?
pan systolic murmur
What type of hormone is vasopressin?
Antidiueretic hormone that will increase reabsorption of water in the kidneys.
Aldosterone?
Aldosterone is secreted from the adrenal glands
- it stimulates reabsorption of sodium in the kidney
What receptors does endothelin bind to?
ETa receptors on vascular smooth muscle causing vasoconstriction.
BUT
It can bind to ETb receptors which would cause the release of NO = vasodilation, promoting Na and water excretion.
What receptors does norepinephrine have a high affinity for?
A1 and B1
Where is renin released from?
Juxtaglomerular cells in the kidney.
- activates B1 receptors
What happens if endothelin binds to ETb receptors?
= production of nitric oxide
- promotes Na and H20 excretion
How does an increase in ROS during hypertension effect constriction of blood vessels?
H202 this will uncouple the eNOS enzyme = no vasodilation.
Conn’s syndrome?
Endocrine disease
- zona glomerulus
- increased aldosterone
Cushing’s syndrome?
- zona fasiculata
- increased cortisol
What are the 3 roles of angiotensin 2?
1- vasoconstriction
2- release of aldosterone from zona glomerulus
3- ADH from pituitary
Duplications in what region on the chromosome will lead to congenital heart defects in those with downs?
DS-CHD
What 2 genes were over expressed in patients with downs and heart problems?
DSCAM
COL6A2
What deletion is present with catch 22 and DiGeorges syndrome?
22q11.2
What cardiac abnormalities are associated with DiGeorgie’s syndrome?
1- tetralogy of fallot
2- VSD
3- interuption of aortic arch.
Loss of function associated with prolonged QT interval?
Mutation in KCNQ1
Gain of function associated with long QT interval?
SCN5A Na channel.
- sodium channel constantly open making it harder to repolarise, therefore a prolonged QT interval.
What is an example of locus heterogeneity?
The 2 different causes of long QT interval.
What is a compound heterozygote?
The presence of 2 different alleles at a particular gene locus.
What will mutations on either side of PCSK9 cause?
1- on one side, there will be a breakdown in LDL receptor levels which will cause and increase in LDL.
2- on the other side, there will be recycling of the receptors, leading to lower cholesterol levels.
Treat with = Indisiran
Thrombectomy?
Brain
Sucks clot out
Thromobolysis
Brain
Heart
kidney
(Dissolves clot)
Angioplasty
Heart
- balloon stent
