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Foundations of Medicine > Week 3 Science and Scholarships: Cardiovascular > Flashcards

Week 3 Science and Scholarships: Cardiovascular Flashcards

1
Q

Identify the two types of large arteries

A

Elastic and Muscular

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2
Q

Examples of large elastic arteries

A

Aorta and pulmonary arteries

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3
Q

examples of large, muscular arteries

A

femoral, radial and brachial arteries

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4
Q

large Elastic arteries are made of predominantly

A

elastic fibres

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5
Q

large muscular arteries are made of predominantly

A

smooth muscle

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6
Q

function of large arteries

A

Blood is distributed fast into target areas via large arteries

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7
Q

structure of arteries

A

tunica intima
tunica media
tunica adventitia

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8
Q

what is tunica intima made up of

A

endothel, lamina propria, basement membrane, sub endothelial connective tissue
-thinnest layer

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9
Q

what is tunica media made up of

A

smooth muscle (elastic fibres) and elastic lamellae

-thickest in arteries

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10
Q

what is tunica adventitia/externa made up of

A

connective tissue , nerve fibres and vasa vasorum
-thickest in veins
-sometimes has smooth muscle in veins ONLY

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11
Q

describe the structure of capillaries

A

no smooth muscle
only endothelium
sometimes pericytes
erythrocytes are able to squeeze through capillaries

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12
Q

changes in diameter of vessels change what

A

the pressure of blood

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13
Q

structure of arterioles

A

small blood vessels (about 30-5 μm in diameter) with 1-4 layers of smooth muscle

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14
Q

structure of valves

A

-extensions of intima (made of endothelium)
-supported by CT that proveides strength and flexiiblity

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15
Q

function of valves

A

allow for unidirectional flow of blood through veins i.e blood can flow back towards the heart

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16
Q

location of lymphatic vessels

A

they start blind (open ended)

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17
Q

structure of lymphatic vessels

A

contain valves to direct lymph flow

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18
Q

function of arteries

A

deliver blood to the tissues from the heart

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19
Q

identify types of arteries

A

muscular
elastic
arterioles

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20
Q

function of veins

A

return blood from the tissues to the heart

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21
Q

identify types of veins

A

medium
large
venules

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22
Q

similarities in wall structure of veins and arteries

A

-both have 3 layers (intima,media,adventitia)

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23
Q

what is endothelium

A

-simple Squamous epithelium
-smooth
-antithrombogenic

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24
Q

what structure is found between tunica intima and tunica media

A

IEL
internal elastic lamina

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25
Q

what is vaso vasorum

A

small vessels supplying O2 and nutrients to outer wall

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26
Q

key features of elastic arteries

A

-conducting arteries
-large diameter, thick wall and located close to heart
-media has high elastin content organised as numerous concentric elastic laminae
-vasa vasorum in adventitia

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27
Q

key features of muscular arteries

A

-distributing arteries
-prominent IEL that marks outer of tunica intima
-media has more smooth muscle fibres (many visible nuclei)
-EEL marks outer media
-vasa vasorum in adventitia

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28
Q

EEL means

A

external elastic lamina

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29
Q

key features of arterioles

A

-resistance vessels
-small diameter, thin, less complex walls
-thick wall RELATIVE to luminal diameter
-tunica media (smooth muscle) most prominent

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30
Q

function of arterioles

A

-regulates/slows blood flow & pressure through capillaries

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31
Q

key features of venules

A

-tunica intima is reduced to endothelium
-tunica media is thin layer of smooth muscle and elastic fibres
-adventitia fuses with connective tissue
-small venules can be surrounded by pericytes

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32
Q

function of venules

A

collect blood from capillaries

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33
Q

function of medium veins

A

Blood reservoir due to high capacitance

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34
Q

key features of medium veins

A

-thin walled
-large and irregular lumen
-intima can form valves
-media has low muscle content is patchy
-adventitia is broadest and has vasa vasorum

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35
Q

function of large veins

A

act as blood reservoir

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36
Q

key features of large veins

A

-no valves
-no IEL
-muscular media but thinner than large arteries
-prominent adventitia with lots of collagen
-no EEL
-vasa vasorum in adventitia

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37
Q

Differences between arteries and veins

A

-arteries are a part of a high-pressure system whereas veins are a part of a low pressure system
-arteries act as a pressure reservoir whereas veins act as a blood reservoir
-arteries are at a full blood capacity whereas veins are at a 30-70% blood capacity
-arteries don’t contain valves whereas veins do (intima)
-arteries contain a circumferential, middle layer of muscle, where is veins contain a patchy and discontinuous layer of muscle
-arteries have thinner adventitia, where is veins have thicker adventitia than their media
-arteries have small lumen, thick walls and circular cross section whereas veins have large lumen, thin walls and collapsed cross section

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38
Q

function of capillaries

A

sites of exchange between blood vessels and tissues

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39
Q

identify the types of capillaries

A

continuous ,fenestrated, sinusoidal (discontinous)

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40
Q

wall structure of capillaries

A

-reduced complexity compared to large vessels
-endothelium
+/- fenestrations
+/- tight junctions
-pinocytotic vesicles
-basal lamina
+/- pericytes
-smallest diameter vessels

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41
Q

Key features of endothelial cells

A

-have an anti-thrombogenic function
-thin to maximise exchange
-breakdown Lipoproteins to triglycerides and cholesterol
-contain intercellular tight junctions
-contain Pinocytotic vehicles

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42
Q

Features of continuous capillaries

A

-most widespread
-tight junctions
-many pinocytotic vesicles
-no gaps between endothelial cells
-rapid exchange

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43
Q

more tight junctions means

A

More selective barrier

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44
Q

if there are more pinocytotic vesicles means

A

More exchange

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45
Q

Features of fenestrated capillaries

A

-endothelial cells are pierced by many fenestrations
+/- thin diaphragm

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46
Q

What do fenestrated capillaries allow for

A

Extensive exchange between blood and tissues, but limited in terms of particle size

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47
Q

If a fenestrated capillary has a diaphragm then …

A

This makes it more selective

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48
Q

Fenestrated capillaries vs continuous capillaries

A

Continuous are slower exchange, but are more selective

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49
Q

key features of sinusoidal capillaries?

A

-large diameter
-tortuous pathway
-incomplete endothelial lining
-large fenestrations
-discontinuous basal lamina

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50
Q

what do sinusoidal capillaries allow for

A

-maximum exchange between blood and tissues
-gaps in wall, can allow for the movement of whole cells

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51
Q

Outline the functions of blood

A
  1. Transport gases, wastes, hormones and nutrients around the body
  2. Regulates pH and ion concentration in the interstitial fluids by the diffusion of ions and absorption acids
  3. Restrict fluid loss at the injury site through the clotting process
  4. Defends against toxins and pathogens via WBC action
  5. Stabilises body temperature by absorbing the heat produced by skeletal muscles
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52
Q

what is serum

A

Plasma which has undergone coagulation

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53
Q

identify components of blood

A

Plasma
-water
-electrolytes
-nutrients eg metabolic wastes, hormones, dissolved gases
-plasma proteins eg albumin

Cellular elements

-RBC + WBC
Lymphocytes
-Monocytes
-Neutrophils
-Eosinophils
-Basophils
-Platelets

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54
Q

Function of water in blood

A

water provides circulatory volume and medium for dissolved solutes
-transport &distribution, heat loss

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55
Q

function of electrolytes in blood

A

important in volume regulation osmolarity, pH regulation and membrane potential

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56
Q

examples of plasma proteins

A

albumin
antibodies
coagulation factors
pH buffering

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57
Q

Function of albumin in blood

A

drives oncotic/osmotic pressure/
-linked to carrier proteins,

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58
Q

List WBC’s from most to least abundant

A

Never let monkeys, eat bananas
neutrophil
lymphocyte
monocytes
eosinophil
basophil

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59
Q

outline process of haemostasis

A

1.vascular spasm
2.circulating platelets are activated by and adhere to exposed collagen at injured vessel
3.activated platelets release ADP and thromboxane
4.these chemicals attract other platelets passing by
5.newly attracted platelets adhere to other platelets and attract even more platelets to form the platelet plug
6.cascading events convert fibrinogen into the fibrin meshwork
7.uninjured endothelium releases nitric oxide and prostacyclin which causes the confinement of the platellet to the site of injury and later promotes fibrinolysis as a means of homeostasis

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60
Q

outline process of haematopoiesis

A

-low RBC count
-hypoxia
-hypoxia detected by kidneys
-kidneys release erythropoietin
-this stimulates erythropoiesis
-increasing RBC count
-oxygen levels increase

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61
Q

describe the location of the heart

A

-Thoracic cavity
-Posterior to the sternum
-2nd costal cartilages T4/T5
-anterior to oesophagus
-rests on diaphragm
-pericardial cavity
-slight left

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62
Q

identify the three layers of the heart

A

epicardium
myocardium
endocardium

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63
Q

what is the parietal pericardium

A

inner serous and outer fibrous pericardium

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64
Q

what’s the visceral pericardium

A

epicardium

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65
Q

identify the AV valves

A

bicuspid and tricuspid

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66
Q

identify semilunar valves

A

aortic and pulmonary

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67
Q

function of right heart

A

Right atrium and right ventricle. Receives deoxygenated blood from the body and pumps it towards the lungs

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68
Q

function of left heart

A

Left atrium and left ventricle. Receives oxygenated blood from the lungs and pumps it into the body

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69
Q

anterior surface of heart

A

sternocostal

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70
Q

what is posterior surface of heart known as

A

diaphragmatic

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71
Q

left and right surface of heart

A

pulmonary

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72
Q

what is meant by base of heart

A

the posterior side

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73
Q

what is in the base of heart

A

left atrium and bit of right atrium

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74
Q

where’s apex of heart

A

-left ventricle
-5th intercostal space (ICS)

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75
Q

trace blood flow of heart

A

-SVC/IVC
-right atrium
-tricuspid valve
-right ventricle
-pulmonary valve
-pulmonary artery
-lung
-pulmonary vein
-left atrium
-mitral valve
-left ventricle
-aortic valve
-aorta
-body

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76
Q

identify structures in RA

A

-auricle
-pectinate muscles
-fossa ovalis
-opening coronary sinus
-IVC and SVC
-interatrial spetum
-tricupsid valve

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77
Q

identify structures of RV

A

-tricuspid valve
* Papillary muscles
* Tendinous cords
* Pulmonary valve
* Interventricular septum

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78
Q

identify structures of LA

A
  • 4 pulmonary veins
    -left auricle
    -floor oval fossa
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79
Q

identify structures of LV

A
  • Ventricular walls
  • Bicuspid valve/Mitral valve
  • Aortic valve
  • Papillary muscles
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80
Q

where do u listen to aortic valve

A

right 2nd ICS next to sternum

APT-M 2245

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81
Q

where do u listen to bicuspid valve

A

left 5th ICS & midclavicular line

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82
Q

where do u listen to pulmonary valve

A

left 2nd ICS next to sternum

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83
Q

where do u listen to tricuspid valve

A

left 4/5th ICS next to sternum

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84
Q

describe structure of AV vs SL valves

A

AV are leaflets whereas SL are cusps

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85
Q

function of valves

A

support unidirection of blood flow and avoid regurgitation

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86
Q

name two coronary arteries

A

RCA and LCA

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87
Q

where do coronary arteries originate

A

from aorta superior to aortic valves

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88
Q

function of RCA

A

-supplies AV and SA node
-supplies diaphragmatic and more posterior

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89
Q

define BP

A

pressure exerted on artery walls by blood

90
Q

describe endocardium

A

Inner layer of wall that lines chambers

91
Q

describe myocardium

A

Middle, thickest wall layer

92
Q

describe epicardium

A

Outer layer of wall in contact with pericardial cavity

93
Q

what makes up pericardial sac

A

-Inner serous parietal layer of sac
-Outermost fibrous pericardium layer

94
Q

what walls are thickest out of the 4 chambers

A

ventricular walls and left side

95
Q

what makes up inner surface of pericardial sac

A

mesothelium (simple squamous epithelium )

96
Q

what is systolic blood pressure

A

measures the pressure in the arteries when the heart beats eg120

97
Q

what is diastolic blood pressure

A

measures the pressure in the arteries between heartbeats. eg80

98
Q

Normal limits for BP

A

120/80

99
Q

what can cause high BP
(external)

A

-poor diet
-smoking and alcohol
-lack of exercise
-FHx
-co morbidities
-medication

100
Q

what’s the difference between primary and secondary hypertension

A

primary (most common) often results from a mixture of causes whereas secondary often occurs from another disease and can be fixed

101
Q

identify different grades of HTN

A

normal
elevated
hypertension stage 1
hypertension stage 2
hypertensive crisis

102
Q

how is HTN diagnosed

A

using sphygmomanometer with multiple repeats

103
Q

what may influence accuracy of BP reading

A

stress
physical activity
time of day
resting or not
posture
caffeine
smoking

104
Q

define HTN

A

a condition where the force of blood against the walls of the arteries is consistently too high

105
Q

what is mean arterial pressure (MAP)

A

a measure of the average pressure in the arteries during a cardiac cycle

106
Q

how to calculate MAP

A

2/3 x diastolic + 1/3 x systolic

107
Q

how to calculate CO

A

heart rate x stroke volume

108
Q

what is total peripheral resistance (TPR)

A

refers to the resistance to blood flow in the systemic circulation, primarily in the arterioles

109
Q

where is the main difference in thickness of heart walls

A

in the myocardium

110
Q

function of pericardial sac

A

Keeps heart in place, prevents overexpansion, lubricates (↓ friction with beating), protects against infection & injury

111
Q

what surrounds the pericardial sac

A
  • Mesothelium (simple squamous epithelium) covers surface facing pericardial cavity
  • Fibrous (dense) connective tissue
112
Q

describe the structure of the epicardium

A

outermost layer
CT+fat+nerves+mesothelium cells
protects and lubricates heart surface

113
Q

describe the structure of the myocardium

A

-thick, middle layer of heart
-Composed of cardiac muscle fibres
-responsible for pumping blood through circulatory system

114
Q

describe the structure of the endocardium

A

-inner most layer
-endothelial cells
-provides smooth surface for blood flow within chambers

115
Q

describe the structure of heart valves

A

-dense CT core = fibrosa
-covered either side by fibroelastic CT and endothelium

116
Q

identify the structures of the cardiac conduction system

A

SA node
AV node
bundle of HIS
bundle branches
purkinje fibres

117
Q

describe location of SA node

A

localised in the right atrium near the entry of the superior vena

118
Q

describe location of AV node

A

localised in the right atrium , above cardiac skeleton that separates atria and ventricles

119
Q

describe location of bundle of HIS

A

normally found distal to the AV node next to tricuspid valve in the atria

120
Q

describe location of purkinje fibres

A

run subendocardial and “deliver” the excitation to the cardiomyocytes

121
Q

Describe how the membrane becomes depolarised and repolarised in cardiac conduction

A

-resting membrane at -70 m/v
-slow influx of Na+ depolarises membrane
-T-type Ca2+ transient channels open and membrane becomes more depolarised
-then Ca2+ L-type channels open and membrane becomes more depolarised
-threshold reached, action potential fired
-K+ channels open, efflux of K+ initiates hyper polarisation

122
Q

how does the autonomic NS effect heart beat frequency

A

-Parasympathetic (vagal) stimulation increases the K+ efflux and causes hyperpolarisation and slows the depolarisation

-decreased vagal influence, Sympathetic stimulation increases the Ca2+ influx and causes faster depolarisation

123
Q

identify the two broad stages of cardiac cycle

A

diastole and systole

124
Q

Outline what happens in diastole

A

 Isovolumetric relaxation (ventricular pressures drop below the aortic and pulmonary pressures)
 Rapid inflow into ventricles
 Diastasis (reduced inflow into the ventricles)
 Atrial contraction (100% full)
(4 phases)

125
Q

Outline what happens in systole

A

 Isovolumetric contraction
 Rapid ventricular ejection
 Reduced ventricular ejection
(3 phases)

126
Q

what valves are open in diastole

A

mitral and tricuspid open
semilunar closed

127
Q

what valves are open in systole

A

aortic and pulmonary open
AV closed

128
Q

how many phases in cardiac conduction system

A

7
(4+3)

129
Q

define cardiac output

A

volume blood elected from the left ventricle each minute (HR x SV)

130
Q

define cardiac cycle

A

rhythmic sequence of events that occur during one complete heartbeat (systole and diastole)

131
Q

define stroke volume

A

blood ejected from the left ventricle with each cardiac cycle.

132
Q

What are the two main factors that influence stroke volume

A

preload and after load

133
Q

What is preload?

A

End-diastolic pressure when the ventricle is filled (at end-diastolic volume)

134
Q

What is after load?

A

the resistance or pressure the heart must overcome to eject blood during systole

135
Q

describe pressure changes in cardiac cycle

A

1.atrial pressure increases as systole is occurring, contraction causes pressure increase
2.AV valves open, blood flow into ventricles, increasing ventricular pressure
3.Ventricles contract, increasing pressure
4.Ventricle pressure>Atrial pressure so AV valves close
5.Ventricle pressure>Aortic pressure so SL valves open
6.ventricle pressure drops as blood leaves ventricle
7.Aortic pressure>Ventricular pressure, SL valves close
8.Ventricular pressure continues to drop until it goes below atrial pressure, left atrium refills (bc AV valves open) and cycle repeats

136
Q

Define the frank starling mechanism

A

the greater the return of venous blood to the heart, the greater the subsequent output that can be achieved

137
Q

when is aortic pressure high

A

higher in systole

138
Q

what is longer diastole or systole

A

diastole

139
Q

units for BP

A

mmHg

140
Q

identify two factors that impact blood flow

A

-pressure difference/ gradient along a vessel
-resistance to blood flow through a vessel

141
Q

blood flows from area of __ to __

A

high pressure to low pressure

142
Q

how does measuring BP work

A
  1. Cuff inflated above systolic pressure. Arterial inflow ceased.
  2. Cuff slowly deflated until it drops below arterial pressure. Arterial inflow restored. At this point, first Korotkoff sounds are heard.
  3. Cuff deflates to below diastolic pressure, at which points Korotkoff sounds disappear.
143
Q

how does flow/ resistance affect arterial pressure

A

 If flow and/or resistance increase, arterial pressure (particularly systolic pressure)
will increase.
 Conversely, if flow and/or resistance decrease, arterial pressure will decline.

144
Q

define pulse pressure

A

difference between diastolic and systolic pressure
-indicates elasticity and compliance of arterial walls

145
Q

define conductance

A

the measures of blood flow for a given pressure difference

146
Q

define resistance

A

the impediment to blood flow in a vessel. Can be
increased with vasoconstriction and decreased with vasodilation

147
Q

how is acute control of blood flow achieved

A

achieved primarily through rapid vasoconstriction or vasodilation of resistance arteries

148
Q

what mechanisms determines where blood flow goes?

A

 Vasodilators released from active tissue.
 Endothelial derived factors.
 Dampened sympathetic control.
 Muscle pump

149
Q

what term describes blood flow within a capillary

A

vasomotion

150
Q

what term describes blood flow through a capillary

A

intermittent

151
Q

how do non lipid substances move through capillary

A

diffuse through intercellular clefts located between endothelial cells.

152
Q

identify the 4 starling forces

A

-capillary hydrostaic
-interstital fluid
-plaasma colloid osmotic
-interstitial fluid colloid osmotic

153
Q

what leads to net outward force in capillary

A

Elevated capillary pressure at arterial end results in a net outward force

154
Q

what leads to net inward force in capillary

A

Lower capillary pressure at venous end, leads to a net inward force

155
Q

how does arterial pressure influence CO

A

increase arterial pressure increases CO and ventricular filling

156
Q

how does exercise influence venous return

A

Muscle pump promotes increase in venous return.

157
Q

what is Hypovolemia

A

Decrease in venous return with severe dehydration or blood loss

158
Q

how do postural changes influence venous return

A

Rapid shift in body position may increase (lying down) or decrease (standing up) venous return.

159
Q

how does muscle length influence influence cardiac muscle active tension

A

cardiac muscle active tension increased with muscle length.

160
Q

what does thedifference between active tension and passive tension represent

A

difference=the force exerted on the volume of blood during contraction.

161
Q

how do autonomic controls influence CO

A
  • Sympathetic stimulation has both a chronotropic and inotropic effect.
    -Increased HR.
    -Increased contractility.
  • Parasympathetic stimulation suppresses HR, slows AV conduction and modestly reduces contractility.
162
Q

describe sympathetic innervtion of heart

A

-To increase HR and contractility of the myocardium: cardioacceleratory centre of medulla sends out messages via the sympathetic nerves through the paravertebral ganglion.
-These nerve fibres innervate the SA,AV node and myocardium. -This causes stimulation of adrenal medulla resulting in release of adrenaline and noradrenaline,
-these hormones bind to B1 receptors and cause depolarisation of the nodal cells (threshold is reached) and signals are sent faster, increasing HR and atrial myocardium contractility.

163
Q

what reflex regulated BP

A

baroreflex

164
Q

what is meant by isovolumetric contraction

A

a phase of the cardiac cycle during which the ventricles of the heart contract, but there is no change in the volume of blood within the ventricles

165
Q

simply describe starlings law

A

-more EDV
-more preload
-more SV
-more forceful contraction

166
Q

what is meant by isovolumetric relaxation

A

time where all valves are closed and volume of blood in ventricles remains constant

167
Q

distinguish between hydrostatic and osmotic pressure

A

hydrostatic pressure pushes fluid out of blood vessels into tissues, while osmotic pressure draws fluid back into blood vessels from the tissues

-osmotic driven by albumin vs hydro driven by plasma volume

168
Q

large veins are found

A

closer to surface of body

169
Q

list two types of blood flow

A

laminar and turbulent

170
Q

values for different degrees of HTN

A

normal 120-129 and 80-84
grade 1: 140-159 and 90-99
grade 2: 160-179 and 100-109
grade 3 180+ and 110+

171
Q

values for different degrees of HTN

A

normal 120-129 and 80-84
grade 1: 140-159 and 90-99
grade 2: 160-179 and 100-109
grade 3 180+ and 110+

172
Q

outline baroreceptor reflex

A

1.Change in blood pressure detected by baroreceptors in aortic arch and carotid sinus
2.this sensory (afferent) message is sent to cardioregulatory centres of the medulla (AP sent out faster or slower depending) via afferent cranial nerves (9,10)
3.Cardioregulatory centres send out an efferent message that triggers the sympathetic or parasympathetic NS
4. Changes in CO (SV and HR) and constriction/dilation of blood vessels
5.Increase/decrease in BP

173
Q

normal waist circumferences

A
  • Men: (102 cm or less)
  • Women: (88 cm or less)
174
Q

what causes isolated diastolic hypertension

A

various factors
-excess salt
-smoking
-alcohol
-lack of exercise
-genetic influence

175
Q

what are pallor of palmar creases indicative of

A

anaemia

176
Q

what is peripheral cyanosis indicative of

A

poor peripheral perfusion

177
Q

what are janeway lesions, Osler nodes and splinter haemorrhages indicative of

A

infective endocarditis (splinter haemorrhages least specific)

178
Q

what is capillary refill > than 3s indicative of

A

poor Peripheral perfusion (PVD)

179
Q

what is tar staining indicative off

A

smoking

180
Q

what is tendon xanthomata indicative of

A

hyperlipidaemia

181
Q

what is clubbing indicative of

A

various non specific
-infective endocarditis, CHD

182
Q

what is scleral jaundice indicative of

A

severe congestive heart failure leading to hepatic congestion

183
Q

what is conjunctival pallor indicative of

A

severe anaemia

184
Q

what is arcus cornealis indicative of

A

hyperlipidaemia

185
Q

what is xanthelasma indicative of

A

hypercholesterolaemia

186
Q

what is malar flush indicative of

A

pulmonary HTN and low CO eg mitral stenosis

187
Q

what is poor dental hygiene indicative of

A

increased infective endocarditis risk

188
Q

what is central cyanosis indicative of

A

CHF, COPD, cyanotic congenital heart disease

189
Q

what is high arched palate indicative of

A

marfan’s : congenital heart disease

190
Q

what are bruits

A

turbulent blood flow, atherosclerosis

191
Q

what is a raised JVP indicative of (>3 cm)

A

right heart failure

192
Q

what are thrills and heaves

A

thrills=palpable murmurs
heaves=right ventricular hypertrophy

193
Q

pitting sacral oedema and pitting oedema are indicative of

A

RHF

194
Q

how to check for mitral stenosis and mitral regurgitation

A

dynamic manœuvre (left lateral),
-bell for mitral stenosis and diaphragm for mitral regurgitation
-both on expiration

195
Q

how to check for aortic regurgitation

A

use diaphragm (patient leans forward)
-check at erbs point on expiration

196
Q

dullness and crackles when percussing and ausculting lungs respectively indicate

A

pleural effusion (LHF)

197
Q

features of continuous capillaries (CNS)

A

-most widespread
-very tight junctions
-few pinocytotic vesicles
-no gaps between endothelial cells
-restricted exchange

198
Q

function of heart

A

-pumps blood and viral nutrients around the body
-some heart cells have endocrine function, releasing signalling hormones

199
Q

shape of heart

A

conical, broad based and pointed apex

200
Q

size of heart

A

size of human closed fist =14 x 9 cm

201
Q

outline histology of cardiac muscle

A

-branched, cylindrical cells, single nucleus
-intercalated discs that allow for synchronised contractions by connecting adjacent cells
-many mitochondria

202
Q

SA node function

A

natural pacemaker of heart, generates consistent AP’s
-sets the electrical rythm of heart by firing 60-100 times a minute

203
Q

AV node function

A

-cluster of cells
-allow atria to contract before ventricles, by delaying electrical signal briefly

204
Q

bundle of HIS function

A

pathway for electrical impulse from AV node to ventricles, allowing coordinated contraction

205
Q

function of purkinje fibres

A

specialised cardiac muscle fibres rapidly transmitting electrical pulses, stimulating ventricular muscle contraction for efficient pumping

206
Q

aortic stenosis murmur

A

-decrescendo/crescendo sound
-high pitched
-systolic
-radiation to carotid arteries

207
Q

mitral regurgitation murmur

A

-blowing
-parasytollic (throughout sytole)
-high pitched
-radiates to axilla

208
Q

aortic regurgitation murmur

A

-blowing, decrescendo
-diastolic
-no radiation

209
Q

mitral stenosis murmur

A

-mid diastolic
-rumbling
-low pitched
-no radiation

210
Q

crushing central chest pain, radiating to neck/left arm

A

MI/angina

211
Q

tearing chest pain, radiates to back and sudden onset

A

aortic dissection

212
Q

pleuritic chest pain that is relieved by sitting forward

A

pericarditis

213
Q

factors effecting blood flow through vessel

A

*Blood Vessel Diameter
*Blood Viscosity
Vessel Length
Pressure Gradient
Turbulence (or laminar)
Elasticity of Blood Vessels

214
Q

describe parasympathetic innervation of heart

A

-Parasympathetic messages are sent via vagus nerve from dorsal root ganglion to the SA,AV node only (mostly impacts HR)
-Ach is released, which forces efflux of K+, causing hyperpolarisation
-therefore making it harder for HR to increase

215
Q

contrast chronotropic vs inotropic

A

Chronotropic effects refer to changes in heart rate, whereas inotropic effects refer to changes in the strength of heart contractions.

Chronotropic mechanisms influence the rate of depolarization of the sinoatrial (SA) node, whereas inotropic mechanisms influence calcium levels in cardiac muscle fibers.

to increase BP: Positive chronotropic effects increase heart rate, whereas positive inotropic effects increase the force of heart contractions

to decrease BP: Negative chronotropic effects decrease heart rate, whereas negative inotropic effects decrease the force of heart contractions,

216
Q

what is capillary hydrostatic pressure

A

-in the capillary
-pressure exerted by fluid inside capillary towards interstitial fluid

217
Q

whats interstitial fluid pressure

A

-in the interstitial fluid
-pressure exerted by fluid inside the plasma towards capillary

218
Q

what is plasma colloid osmotic pressure

A

-towards capillary
-pressure exerted by proteins such as albumin, pulling fluid towards the capillary

219
Q

what is interstitial fluid colloid osmotic pressure

A

-towards the interstitial fluid
-pressure exerted by proteins, such as albumin, pulling fluid towards interstitial fluid

220
Q

factors effecting resistance (blood flow)

A

-lumen radius
-viscosity of blood

221
Q
A

Foundations of Medicine (18 decks)

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