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Revision > GUMES CV > Flashcards

GUMES CV Flashcards

1
Q

what are the layers of the pericardium

A

fibrous
parietal
parietal cavity
visceral

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2
Q

what attaches the free edges of the valves to the papillary muscle

A

chordae tendinae

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3
Q

what are the korotkoff sounds

A

sounds of blood flow, one is systole and the second is diastolic

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4
Q

what is the interventricular septum

A

the wall of tissue that separates the right and elft ventricles of the heart

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5
Q

what is atrial septal defect

A

the absence of a septum between the atria leading to mixing of oxygenated and deoxygenated blood

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6
Q

what is ventricular septal defect

A

defect in the ventricular septum leading to blood flow between the ventricles under pressure

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7
Q

what is atrioventricular septal defect

A

birth defect whcih leads to holes between the chambers of the heart
can also mean the valves that control the blood flow between these chambers may not be formed correctly

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8
Q

describe artery structure

A

thick outer wall
small lumen
thick layer of muscle and elastic fibres

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9
Q

describe capillary structure

A

very small lumen and wall made of a single layer of cells

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10
Q

describe vein structure

A

thin layer of muscle and elastic fibres, large lumen and fairly thin outer wall

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11
Q

what is found in arteriole walls

A

muscle
elastic fibre
fibrous tissue

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12
Q

how does the lumen of arteries vary

A

increases as a pulse of blood passes through

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13
Q

why are the walls of arteries strong and elastic

A

to withstand the pulsing of the blood and prevent bursting.
maintain high blood pressure and prevent blood flowing backward

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14
Q

what is the function of capillaries

A

supply all the cells with their requirements and take away waste products

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15
Q

describe the wall of capillaries

A

one cell thick

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16
Q

how wide is the lumen of a capillary

A

enough for a singel red blood cell to pass through

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17
Q

why do capillaries not need strong walls

A

most of the blood pressure has been lost

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18
Q

what can pass through the cells of capillary walls

A

white blood cells

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19
Q

why do capillaries have narrow lumens and thin walls

A

to bring blood into close contact with body tissue and allow diffusion of materials between the two

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20
Q

describe the pressure of blood as it returns to the heart

A

low

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21
Q

describe the walls of veins

A

thin
mainly fibrous
less muscle and elastic tissue than arteries

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22
Q

why is there a wide lumen on veins

A

offers less resistance to blood flow

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23
Q

where is the AV node

A

centre almost

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24
Q

what are the AV bundles

A

stretch down from the AV node to provide action potential to the myocardium

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25
Q

describe the conduction system of the heart

A
  • SA node generates an impulse
  • atrial excitation begins
  • impulse is delayed at the AV node
  • impulse passes to the heart apex
  • ventricular excitation begins
  • ventricular excitation completes
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26
Q

what is the order of propagation of the action potential

A
  • SA node
  • interatrial bundles
  • internodal bundles
  • av node
  • av bundle
  • right and left bundle branches
  • purkinje fibres
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27
Q

what is the P wave

A

the activation of the atria

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28
Q

what is the PR interval

A

the time interval between the onset of atrial depolarisation and onset of ventricular depolarisation

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29
Q

what is the QRS complex

A

depolarisation of ventricles, consisting of the QR and S waves

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30
Q

what is the QT interval

A

the time interval between onset of ventricular depolarisation and end of ventricular repolarisation

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31
Q

what is the RR interval

A

time interval between the two QRS complexes

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32
Q

what is the T wave

A

ventricular depolarisation

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33
Q

what are the three phases of sinoatrial node action potential

A

4, 0 and 3

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34
Q

what is the first phase of the sinoatrial node action potential generation

A

phase 4
calcium enters and there is less potassium leaving the cell.

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35
Q

what occurs in phase 0 of sino atrial node conduction

A

calcium channels open

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36
Q

what occurs at stage 3 of the sino atrial node conduction

A

potassium leaves thereby making the charge more negative inside causing repolarisation

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37
Q

what is the pacemaker potential

A

when there is slow depolarisaiton of the SA node

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38
Q

when does the action potential occur for the SA node

A

phase 3

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39
Q

where on an ECG can the plateau of action potential be seen

A

ST segment

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40
Q

why is action potential referred to as fast response action potential

A

rapid depolarisation

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41
Q

what are the phases of the purkinje action potentials

A

0,1,2,3 and 4

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42
Q

what happens in phase 0 of purkinje action potential

A
  • sodium and calcium channels open and there is fast influx of postivie ions
  • potassium channels close to the intracellular charge stays positive
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43
Q

what happens in phase 1 of purkinje fibre action potential

A

there is initial repolarisation as there is now opening of potassium channels

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44
Q

what happens in phase 2 of purkinje fibre action potential

A

there is a plateau as the charge evens out since the calcium continues to enter the cell.

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45
Q

when does phase three of purkinje fibre action potential begin

A

once the calcium channels close and there is only potassium moving out of the cell to reduce the intracellular charge

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46
Q

what is phase three of purkinje fibre action potential

A

calcium channels are inactivated, potassium ions continue to move out

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47
Q

what occurs at phase four of purkinje action potential

A

true resting potential

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48
Q

what is the blood pressure measurement

A

systolic over diastolic

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49
Q

what is the average blood pressure

A

120/80 mmhg

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50
Q

what do arterioles do

A

dissipate the blood pressure

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51
Q

do arteries have valves

A

no

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52
Q

do veins have valves

A

yes

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53
Q

why do veins have valves

A

to direct blood flow against gravity

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54
Q

what is cardiac output

A

the volume of blood pumped by the heart per minute. a function of heart rate and stroke volume

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55
Q

what is the stroke volume

A

the volume of blood pumped out of the heart with each beat

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56
Q

what increases cardiac output

A

increased heart rate or stroke volume

57
Q

what is the preload

A

the amount of blood entering the heart

58
Q

what does preload affect

A

strength of contraction and stroke volume

59
Q

what inervates the sinoatrial node

A

sympathetic and parasympathetic nerve fibres

60
Q

what slows the pacemaker potential of the sinoatrial ndoe

A

acetylcholine

61
Q

effect of acetylcholine on the heart rate

A

decrease

62
Q

what increases the pacemaker potential of the sinoatrial node

A

noradrenaline

63
Q

effect of noradrenaline on heart rate

A

increase

64
Q

how does adrenaline release increase heart rate

A

enters the bloodstream and is delivered to the heart where it binds with sa node receptors to increase the heart rate

65
Q

what innervates the ventricular myocardium

A

sympathetic nerve fibres

66
Q

how does an increase in sympathetic activity lead to increased stroke volume

A

release of noradrenaline from the nerve fibres causes an increase in the strength of myocardial contraction

67
Q

how does noradrenaline increase stroke volume

A

increases the intracellular concentration of calcium in myocardial cells, facilitating faster actin myosin cross bridging.

68
Q

what is the mean arterial blood pressure

A

the average blood pressure pushing blood around the body

69
Q

what is the pulse pressure

A

the difference between the systolic and diastolic blood pressures

70
Q

which reflexes control blood pressure

A

baroreceptors and chemoreceptors

71
Q

where are baroreceptors found

A

in the carotid sinus or in the aortic arch

72
Q

what are baroreceptors sensitive to

A

change in stretch in arteries caused by increased pressure

73
Q

what are chemoreceptors sensitive to

A

changes in blood oxygen, carbon dioxide and pH

74
Q

where are chemoreceptors found

A

carotid bodies and aortic bodies

75
Q

what decreases parasympathetic stimulation of the heart to increase heart raet

A

decreased blood oxygen and increases carbon dioxide

76
Q

what increases sympathetic stimulation of the heart

A

decreases blood oxygen and pH and increased carbon dioxide

77
Q

what is starlings law

A

if the heart chambers are intially distended with blood, the ensuing beat is more forceful than if the chambers were intially empty

78
Q

why does force of contraction increase as the heart muscle stretches

A

filling of the chambers

79
Q

what controls blood pressure

A

endothelial cells
elasticity effects
drugs
hydrostatis and oncotic pressure
active and reactive hyperaemia

80
Q

what is blood flow affected by

A
  • diameter of the tuble
  • pressure gradient across the tube
  • length of the tube
  • viscosity of the fluid
81
Q

why is deep vein thrombosis in the legs common

A

the veins have a low pressure gradient so flow is going to be slower

82
Q

what causes angina

A

lack in oxygen to the heart leading to anaerobic respiration causing lactic acid production and pain

83
Q

what can be used to treat angina

A

nitrates which are vasodilators and will increase oxygen delivery to the heart and relieve the pain of angina

84
Q

which heart receptors does acetylcholine bind to

A

M2

85
Q

where are beta one receptors found

A

heart

86
Q

where are beta two receptors found

A

lungs

87
Q

what is the composition of blood

A

55% plasma and 45% cells

88
Q

what are the cells found in blood

A

red blood cells
white blood cells
platelets

89
Q

what is the significance of the biconcave shape of red blood cells

A
  • larger surface area for rapid gaseous exchange
  • allows transport in the narrow capillaries as they have a bending movement
  • allows expansion to accomodate fluid in hypotonic solutions
90
Q

what happens to red blood cells in hypotonic solutions

A

they expand

91
Q

what happens to red blood cells in isotonic solutions

A

they are normal

92
Q

what happens to red blood cells in hypertonic solutions

A

shrink

93
Q

what is the process of red blood cell turnover

A

they are formed in the bone marrow and go through the circulation, where 10% of hemolysis occurs, and then destroyed if they are 120 days old or damaged

94
Q

where are red blood cells destroyed

A

by macrophages in the spleen liver and bone marrow

95
Q

what happens after red blood cell breakdown

A

the iron from the heme is transported in circulation by transferrin along with amino acids and they are returned to bone marrow for new red blood cell formation

96
Q

what happens to the biliverdin release from heme following red blood cell breakdown

A

converted to bilirubin and transported to the liver for bile excretion

97
Q

what is erythropoietin

A

a hormone produced by kidney cells to stimulate red blood cell production

98
Q

what does a decrease in red blood cells lead to

A

reduced oxygen delivery to cells including in the kidney, which triggers erythropoietin release to stimulate the stem cells in bone marrow to increase production of red blood cells

99
Q

why does haemolysis occur if we transfuse incompatible blood types

A

antigens are attachments on red blood cells and the specific blood types have specific antigens to pair with the specific antibodies.
when incompatible blood types are transfused, the host antibodies identify the transfused antigens as foreign antigens, bind to them and cause haemolysis, ultimately rejecting the blood transfusion

100
Q

what are the antigens found on blood type A

A

A

101
Q

what are the antibodies for blood type A

A

anti B

102
Q

explain the significance of rhesus factor in pregnancy

A

if a rh negative mother conceives an rh positive foetus, the mother develops anti rh antibodies and due to maternal circulation, the anti rh antibodies may attach the red blood cells of the rh foetus, causing haemolysis

103
Q

what are risk factors for endocarditis

A

rheumatic valves
prosthetic valves
dental abscess

104
Q

what are the micoorganisms involved in endocarditis

A

streptococcus viridans and staphylococcus aureus

105
Q

what is the function of a valve in the heart

A

prevent the backflow of blood

106
Q

why is the sinoatrial node considered the pacemaker of the heart

A

it generates an electrical stimulus causing contraction of the atria, initiating the cardiac cycle

107
Q

what is systole

A

contraction of both ventricles

108
Q

what is diastole

A

relaxation of both ventricles

109
Q

what is auscultation

A

listening to the sounds of the heart

110
Q

what is phase four of the sinoatrial node action potential

A

inward movement of sodium via leaky sodium channels, slow depolarisation

111
Q

what is phase zero of sinoatrial node action potential

A

membrane potential threshold reached, action potential triggered leading to depolarisation, calcium channels open, calcium enters the cell

112
Q

what is phase three of the sinoatrial node action potential

A

repolarisation, calcium channels close, potassium leaves the cell

113
Q

what are the stages of ventricle action potential

A

4, 0, 1, 2, 3

114
Q

stage four of ventricle action potential

A

resting membrane potential, sodium and calcium channels are closed but potassium are open to maintain the resting potential

115
Q

stage 0 of ventricle action potential

A

action poential, rapid influx of sodium

116
Q

stage 1 of ventricle actiokn potential

A

potassium channels open and potassium leaves, membrane potential is 0

117
Q

stage 2 of ventricle action potential

A

plateau, calcium channels open, influx of calcium, potassium leaves, balance between the two

118
Q

stage 3 of ventricle action potential

A

repolarisation, calcium channels close, potassium stays open

119
Q

what is excitation contraction coupling

A

couple of the electric excitation brought by the action potential to the mechanical contraction of the cardiac myocytes and subsequently the myocardium

120
Q

what is starlings law

A

the more the heart stretches, the stronger the force of contraction

121
Q

what affects how much the heart stretches prior to contraction

A

duration of diastole, as the longer it is the more the ventricles will fill.
venous return, as the more blood there is being returned, the more it will fill

122
Q

which branch of the nervous system modulates cardiac output

A

autonomic

123
Q

what is inotropy

A

contractility

124
Q

what is chronotropy

A

rate, frequency

125
Q

what is lusitropy

A

rate of myocardial relaxation

126
Q

what is dromotropy

A

conductivity of cardiac muscle

127
Q

what does blood pressure mean

A

the force exerted by blood against any unit area of the vessel wall

128
Q

what is systemic vascular resistance

A

the peripheral resistance

129
Q

what is peripheral resistance

A

the resistance that must be overcome to push blood through the circulatory system

130
Q

how do you calculate the mean arterial pressure

A

diatolic blood pressure plus one third of pulse pressure

131
Q

what is cardiac output times by the peripheral resistance

A

mean arterial pressure

132
Q

how can blood pressure be modified

A

acting on the alpha adrenoreceptors on the blood vessels

133
Q

what does alpha one adrenoreceptor lead to

A

vasoconstriction

134
Q

what is the hydrostatic pressure

A

the pressure exerted on the capillary wall by blood

135
Q

how does fluid enter the interstitial space

A

through pores on the capillary walls

136
Q

why does pressure exerted by blood decrease as blood moves along the capillary

A

because fluid is leaving via the pores

137
Q

where are the baroreceptor impulses carried

A

to the medulla

138
Q

why do baroreceptors not respond to hypertension

A

they are reset to the higher blood pressure level

Revision (48 decks)

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