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Y3 Cardiovascular pathology > Cardiovascular pathology 1 > Flashcards

Cardiovascular pathology 1 Flashcards

1
Q

Where does the heart develop from?

A

Splanchnic mesenchyme in the cardiogenic area

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2
Q

The embryological heart develops dilatations and constrictions which result in which 4 chambers?

A
  • Sinus venosus
  • Primordial atrium
  • Primordial ventricle
  • Bulbus cordis
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3
Q

How does the heart develop during cardiac looping?

A

The heart is converted from an elongated muscular tube into a C-shaped structure by a process termed looping

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4
Q

What are the precursors of the valve cusps called?

A

Endocardial cushions

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5
Q

Which two septum position the atria successively?

A

Septum primum

Septum secundum

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6
Q

The septum secundum is an incomplete partition and leaves …?

A

A foramen ovale

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7
Q

What is the role of the foramen ovale before birth?

A

Allows blood to pass from the right to the left atrium with reflux being prevented by a valve

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8
Q

What happens to the foramen ovale after birth?

A

Closes by fusion of the septum primum and septum secundum

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9
Q

The interventricular septum consists of which 3 parts?

A
  • Muscular portion
  • Membranous portion
  • Conotruncal ridged
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10
Q

What do the 4th left and right aortic arches form?

A

Left - forms the proximal part of the arch of the aorta

Right - forms the proximal part of the right subclavian artery

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11
Q

Describe the flow of blood through fetal circulation starting at the umbilical veins

A

Umbilical veins => liver/ductus venosus => vena cava => right atrium => either through the foramen ovale to the left atrium and then aorta or to the right ventricle to the pulmonary artery, ductus arteriosus and then aorta => systemic arteries => umbilical arteries => placenta

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12
Q

Which 2 parts of foetal circulation are oxygen and nutrient rich?

A

Placenta

Umbilical veins

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13
Q

Which part of foetal circulation is oxygen and nutrient poor?

A

Umbilical arteries

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14
Q

Name and describe the sac surrounding the heart

A

Pericardium

- one layer of mesothelium with a central layer of connective tissue and adipose tissue

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15
Q

Name and describe the outer surface of the heart

A

Epicardium

- one layer of mesothelium and one connective tissue and adipose tissue

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16
Q

Name the muscle layer of the heart

A

Myocardium

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17
Q

What is the endothelium?

A

Identical to arterial endothelium with connective tissue and Purkinje fibres - lines the inner part of the heart

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18
Q

Describe the histological features of myocardium (cardiac muscle)

A
  • Centrally placed nuclei
  • Sarcomeric cross striations
  • Ratio of muscle fibres to capillaries is 1:1
  • Purkinje fibres arranged in bundles
  • Connective tissue
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19
Q

Where are post-mortem clots seen in the heart and why do they occur?

A

Red clots in the atria, right ventricle, and large vessels at the base of the heart
- occur because the blood is static when circulation stops

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20
Q

How does rigor mortis affect the heart?

A
  • Occurs in the left myocardium and produces contracted rigid ventricular walls
  • Less pronounced in right side of heart
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21
Q

How will rigor mortis be different in the heart of animals with prolonged heart disease? Why is this?

A
  • The ventricular chambers may fail to contract during rigor mortis: grossly soft muscles
  • Occurs because there are inadequate glycogen reserves in cardiac myocytes
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22
Q

What are chicken fat clots?

A
  • Sedimentation of erythrocytes

- Clots consist of colourless fibrin with no erythrocytes

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23
Q

What is haemoglobin imbibition?

A

Postmortem lysis of erythrocytes which produces a diffuse red staining of the endocardium

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24
Q

An intracardiac injection of barbiturate can lead to the presence of what PM?

A

Crystalline deposits

25
Q

Name 5 post mortem changes that may be seen in the heart?

A
  • blood clotting
  • rigor mortis
  • chicken fat clots
  • haemoglobin imbibition
  • barbiturate crystals
26
Q

Give examples of pathophysiological mechanisms of cardiac dysfunction that can lead to heart failure?

A
  • Pump failure: weak contractility, myocardial disease
  • Obstruction of flow: valvular stenosis, vascular narrowing
  • Regurgitant flow
  • Shunted slow
  • Ruptures of the heart wall or major vessels
27
Q

What is cardiac syncope?

A

Fainting/loss of consciousness

- syndrome of cardiac failure decompensation

28
Q

Describe cardiac syncope, its characteristics and causes

A
  • a peracute/acute expression of cardiac disease
  • Characterised by collapse, loss of consciousness, extreme changes in heart rate and blood pressure
  • Massive myocardial necrosis, ventricular fibrillation, arrythmias and reflex cardiac inhibition
29
Q

What is congestive heart failure?

A

Slow, gradual loss of cardiac pumping efficiency

30
Q

What 3 factors is congestive heart failure associated with?

A
  • Pressure overload (hypertension or stenosis)
  • Volume overload (shunts, valvular regurgitation)
  • Progressive myocardial damage
31
Q

Reduced renal blood flow stimulates? What effect does this have on the heart?

A

RAAS - sodium and water retention

- Increased plasma volume and increase the workload on the already failing heart

32
Q

What are the 4 responses to congestive heart failure?

A
  • Cardiac dilation: activation of the RAAS causes a compensatory response in the form of cardiac dilation to try and increase CO
  • Hypertrophy: increased in the size of an organ due to an increase in cell size
  • Decompensation: compensatory mechanisms no longer sufficient
  • Death
33
Q

What are the causes of left sided heart failure?

A
  • Left sided cardiomyopathies

- Dysfunction of aortic and mitral valves

34
Q

Describe the subacute and chronic forms of left sided heart failure

A

Subacute - pulmonary congestion and oedema

Chronic - pulmonary congestion, oedema, fibrosis and haemosiderosis (excessive accumulation of iron deposits)

35
Q

What are the causes of right sided heart failure?

A
  • Right sided cardiomyopathies
  • Pulmonary hypertension
  • Dysfunction of tricuspid and pulmonary valves
36
Q

Describe the subacute and chronic forms of right sided heart failure

A

Subacute - passive system congestion, hepatomegaly and splenomegaly
Chronic - systemic oedema, nutmeg liver

37
Q

Congenital defects of the heart and pericardium may present what clinical signs?

A
  • poor exercise intolerance
  • cyanosis
  • coughing
  • stunted body growth
38
Q

What are the causes of congenital defects of the heart and pericardium?

A
  • Single or multiple gene defects.
  • Toxins (thalidomide, ethanol),
  • Physical agents (irradiation)
  • Nutritional deficiencies (vit A, Zinc).
39
Q

What is agenesis of the heart?

A

Absence of the heart - not viable

40
Q

Describe amorphous globosus and its appearance

A

Spherical, covered in hair, acardiac monster attached to the placenta by a cord in cows.
Severely anomalous second fetus.

41
Q

Congenital development of the heart at an abnormal site outside of the thoracic cavity is termed?

A

Ectopia cordis

42
Q

Name some examples of congenital defects of the heart and pericardium

A
  • Patent ductus arteriosus
  • Atrial septal defects
  • Ventricular septal defects
  • Pulmonic stenosis
  • Tetralogy of Fallot
  • Persistent right aortic arch
43
Q

Where is the ductus arteriosus found in vivo?

A
  • Vascular channel between the pulmonary artery and aorta

- Allows blood to bypass the lungs during foetal life

44
Q

A patent ductus arteriosus cases blood to be shunted where?

A

From the left side of the heart to the right

45
Q

What are the consequence of a patent ductus arteriosus?

A
  • Pulmonary hypertension => right ventricle pressure overload (concentric hypertrophy) => Left atria and ventricle volume overload (eccentric hypertrophy)
46
Q

Give 2 examples of atrial septal defects

A
  • Failure of closure of the foramen ovale (septal shunt that allows blood to bypass the lungs of the foetus)
  • Faulty development of the interatrial septum
47
Q

Which 3 breeds to predisposed to atrial septal defects?

A

Doberman
Pincher
Samoyed

48
Q

Describe a ventricular septal defect and name which breeds are predisposed to it

A

Failure of closure of interventricular septum

- Bulldog, Springer spaniel and West Highland white terrier.

49
Q

What are the consequence of failure of closure of the interventricular septum?

A
  • Shunt left-to-right => equal ventricular pressures
  • Pressure hypertrophy of the right ventricle
  • Volume hypertrophy of the left ventricle due to additional blood
50
Q

What are the 3 types of semi-lunar valve stenosis?

A
  • Name is dependant on the level of narrowing
  • Supra valvular
  • Valvular
  • Subvalvular
51
Q

What causes semi-lunar valve stenosis?

A

Circumferential band of fibrous or muscular tissue of the valvular tissue – above, below or at the level of the valve

52
Q

Describe pulmonic stenosis, its causes and consequence

A
  • Valvular lesions: whitish bands of connective tissue visible at the base of the semi-lunar valve
  • Pressure overload → concentric hypertrophy (right)
53
Q

Describe subaortic stenosis, its causes and consequence

A
  • Subvalvular lesions
  • Thick zone of endocardial fibrous tissue that encircles the left ventricular outflow tract below the valve
  • Causes a pressure overload => concentric hypertrophy of the left side
54
Q

How does subaortic stenosis appear microscopically?

A

Endocardial mesenchymal proliferation, mucin and metaplastic cartilage.
- Gap between the valve and the lesion

55
Q

Which 4 lesions make up the Tetralogy of Fallot?

A
  • Ventricular septal defect
  • Pulmonic stenosis
  • Dextroposition of the aorta
  • Hypertrophy of the right ventricular myocardium
56
Q

Which is the main clinical signs of Tetralogy of Fallot?

A

Cyanosis

57
Q

What are valvular haematomas?

A

Haematocyst or lymphocysts frequently observed on the atrioventricular valves in ruminants. Generally, they regress spontaneously and do not produce any functional abnormalities.

58
Q

What are the consequence of a persistent right aortic arch?

A

Oesophageal obstruction and proximal dilation => regurgitation

59
Q

What is a peritoneopericardial diaphragmatic hernia?

A

Dogs with incomplete development of the diaphragm. Abdominal viscera can be located in the pericardial sac.

Y3 Cardiovascular pathology (4 decks)

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