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CVS > 1. Haemodynamics > Flashcards

1. Haemodynamics Flashcards

1
Q

Which side of the body does the aorta branch into the brachiocephalic trunk?

A

Right side

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2
Q

What can cause a pericardial effusion?

A

Bacterial infection (pericarditis)
Viral infection
Heart wall rupture if weakened by previous MI
Stab wound

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3
Q

Name the procedure used to drain fluid from the pericardial sac.

A

Pericardiocentesis

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4
Q

What type of muscle is present in the tunica media of arterioles?

A

smooth muscle

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5
Q

Why are coronary arteries referred to as end arteries?

A

They have very little anastomoses
A particular branch of coronary artery will supply a discrete region of the heart with little overlap from other vessels.

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6
Q

What might you notice about the heart sounds of a patient with pericarditis ?

A

Early stages - friction rub

Later stages - obscured apex beat, soft and distant sounds

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7
Q

What is the difference between plasma and serum?

A

Plasma - from unclotted blood, contains clotting factors

Serum - from clotted blood, does not contain clotting factors (fibrinogen)

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8
Q

What is the biggest determinant of peripheral resistance?

A

Arteriole contraction state

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9
Q

Which part of the body is most affected by an increase in blood viscosity?

A

Periphery - blood cannot reach these areas

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10
Q

What is the commonest cause of increased plasma viscosity (leading to whole blood viscosity increase)?

A

Multiple Myeloma (cancer of plasma cells)

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11
Q

Explain why minor changes in plasma viscosity can be used to measure the inflammatory response.

A

Acute phase plasma proteins, released in response to inflammation, cause small increases in blood viscosity.

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12
Q

Which protein is most commonly used to measure inflammation?

A

C-reactive protein (CRP)

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13
Q

Name the 2 different types of blood flow.

A
  1. Laminar

2. Turbulent

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14
Q

What are the characteristics of laminar flow?

A

Velocity is greater in the middle than in the periphery - parabolic profile.
Blood flows in streamlines

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15
Q

How does turbulent flow differ from laminar flow?

A

Blood flows in all directions in the vessel, continually mixing.

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16
Q

In what situations would you expect turbulent flow in a vessel?

A
  • When the rate of blood flow becomes too great
  • When it passes by an obstruction in a vessel (stenosis)
  • When it makes a sharp turn
  • When it passes over a rough surface (atheroma)
  • When there is increased resistance to blood flow
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17
Q

Turbulent flow is often present after an area of stenosis.What is stenosis?

A

Narrowing of a vessel.

18
Q

Comment on the flow of blood in a stenotic blood vessel.

A

Flow distal to the stenosis is decreased

19
Q

Comment on the velocity of blood distal to stenosis.

A

Velocity distal to stenosis is increased.

20
Q

Why can multiple stenosis in an artery be critical?

A

The blood flow will become further decreased with each stenosis.

21
Q

Explain why post-stenosis aneurysms occur.

A

When the velocity of blood increases, energy ( velocity squared) increased, causing post-stenotic dilatation.

22
Q

What noise will you hear when listening to a post-stenotic artery?

A

Bruit noise - turbulence.

23
Q

If you can palpate the turbulent blood flow, it is called a ________.

A

Thrill

24
Q

What is the significance of the dicrotic notch on an aortic pressure tracing?

A

Signified the point that the aortic valve shuts, the end of systole.

25
Q

What is pulse pressure?

A

The difference between peak systolic pressure and the end diastolic pressure.
(PSP -EDP)
120-80 = 40 mmHg commonly

26
Q

How can the mean arterial pressure be estimated?

A

Diastolic pressure + 1/3 pulse pressure

commonly 80 + 13 = 93 mmHg

27
Q

If mean arterial pressure falls below __________, organ perfusion is impaired.

A

70 mmHg

28
Q

What 2 things determine the strength of a pulse?

A
  1. The force which the LV is able to eject the blood into the arterial system.
  2. The pulse pressure. The greater the pulse pressure, the stronger the pulse.
29
Q

What may cause a “thready pulse”?

A

LV failure, aortic valve stenosis, hypovoloemia (severe dehydration).

30
Q

What is the name given to a strong pulse.

A

A bounding pulse

31
Q

What effect can bradycardia have on the pulse?

A

Lowers diastolic pressure, leading to increased/widened pulse pressure and a bounding pulse.

32
Q

What effect does low peripheral resistance have on pulse pressure?

A

Lowers diastolic pressure (vasodilation of arteries), increasing the pulse pressure.

33
Q

When might there be low peripheral resistance ?

A

Hot bath
Exercise
Pregnancy

34
Q

Whenever there is a bounding pulse, the explanation will include _________________.

A

Widening of the pulse pressure.

35
Q

When might you see a bounding pulse?

A

In heart block / bradycardia

36
Q

What areas of the heart does the LAD artery supply?

A

Left ventricle
Right ventricle
Interventricular septum

37
Q

What area of the heart does the left marginal artery supply?

A

Left Ventricle

38
Q

What area of the heart does the left circumflex artery supply?

A

Left atrium

Left ventricle

39
Q

What area of the heart does the right coronary artery supply?

A

Right atrium

Right ventricle

40
Q

What areas of the heart does the right marginal artery supply?

A

Right ventricle

Apex

41
Q

What area of the heart does the posterior interventricular artery supply?

A

Right ventricle
Left ventricle
Interventricular septum

42
Q

What vessels are known as the ‘capacitance vessels’?

A

Veins - ability to store blood to cope with temporary imbalances between the amount of blood returning to the heart and the amount being pumped out.

CVS (16 decks)

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