Applied Anatomy Of The Heart

Question 1

Heart innervation

Answer 1

SAN AVN. Bundle of His. Left and right bundle branches. Purkinje fibres

Question 2

3 components of the cardiac plexus

Answer 2

Vagus nerve
Sympathetic nerves
General visceral afferent nerves

Question 3

Effect of vagus nerve on firing rate

Answer 3

Decrease

Question 4

Effect of sympathetic chain ganglia on rate of firing

Answer 4

Increase

Question 5

Where do heart sympathetic fibres enter the spinal cord

Answer 5

T1 - T5

Question 6

What causes referred pain

Answer 6

Brain cannot distinguish between visceral and somatic sensation

Question 7

What vessel usually supplies the SAN and AVN

Answer 7

Right coronary artery

Question 8

What vessel usually supplies the bundle branches

Answer 8

Interventricular arteries

Question 9

How do impulses travel through the heart if a bundle branch becomes ischaemic

Answer 9

Through myocytes

Question 10

How does bundle branch block impact ECG

Answer 10

prolonged QRS

Question 11

How long does severe ischaemia take to cause ECG changes

Answer 11

Minutes

Question 12

What is stenosis

Answer 12

Valves don’t open properly

Question 13

What is regurgitation

Answer 13

Valves don’t close properly

Question 14

Causes of valvular dysfunction

Answer 14

Aging
Rheumatic fever
Bacterial endocarditis

Question 15

Are mitral regurgitation and aortic stenosis systolic or diastolic murmurs

Answer 15

Systolic

Question 16

Are mitral stenosis and aortic regurgitation systolic or diastolic murmurs

Answer 16

Diastolic

Question 17

What is mitral regurgitation

Answer 17

Blood moves through Mitral valve during systole

Question 18

Where is the murmur heard in mitral regurgitation

Answer 18

Apex
Pansystolic, louder in late systole

Question 19

What causes the murmur in aortic stenosis

Answer 19

Turbulence as blood pushed through stenotic aortic valve

Question 20

Where and when is the murmur heard in aortic stenosis

Answer 20

Systolic - usually mid systolic
Right 2nd intercostal space

Question 21

Is aortic stenosis more severe when the murmur is heard in early or late systole

Answer 21

Late

Question 22

What does a mitral stenosis murmur sound like

Answer 22

Soft rumbling

Question 23

What is cardiac remodelling

Answer 23

Heart muscle changing size based on workload

Question 24

Pre load

Answer 24

Volume of blood in ventricles at end of diastole

Question 25

Afterload

Answer 25

Resistance ventricle must overcome to circulate blood

Question 26

Concentric hypertrophy

Answer 26

Wall thickness increased by new sarcomeres due to increased afterload

Question 27

How does concentric hypertrophy affect compliance

Answer 27

Decreased

Question 28

Eccentric hypertrophy

Answer 28

Reduced compliance leads to volume overload, follows on from concentric hypertrophy

Question 29

What is eccentric hypertrophy

Answer 29

Chamber dilation

Question 30

How does eccentric hypertrophy effect oxygen demand and mechanical efficiency

Answer 30

Increases oxygen demand
Decreases mechanical efficacy

Question 31

Atrial remodelling

Answer 31

Any persistent change in atrial structure

Question 32

Does atrial fibrillation risk increase or decrease with increasing atrial size

Answer 32

Increase

Question 33

Atrial fibrillation

Answer 33

Ectopic firing and re entry of electrical activity

Question 34

What is absent in the ECG of a person with atrial fibrillation

Answer 34

P waves