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All besides Zachow Lecture Flashcards

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1
Q

hypertension effects on LV

A

Contracts harder but ESV down

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2
Q

pathology of diastolic heart failure

A

hard ventricle

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3
Q

knee to chest for babies

A

reduce pressure in feet-less shunting across septal defects

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4
Q

s3 gallop

A

sudden deceleration of blood into LV from LA

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5
Q

pulm a,v, and bronchus relation

A

bronchus is most posterior

artery is posterior and superior to vein

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6
Q

dorsal vs ventral root

A

dorsal is afferent

ventral is efferent

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7
Q

RAMUS comes off of what

and goes where

A

intercostal nerve

to sympathetic trunk

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8
Q

CO=

A

SVxHR

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9
Q

SV=

A

EDV-ESV

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10
Q

EF=

A

SV/EDV

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11
Q

Calc Post PostTP from preTP

A

preTP/1-preTP=preodds
preoddsxLR=postodds
postodds/1+postodds=Post test prob

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12
Q

LR+ and LR- calc

A

sen/1-spec

1-sen/spec

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13
Q

sen
spec
PPV
NPV

calcs

A

TP/TP+FN
FP/FP+TN
TP/FP+TP
TN/TN+FN

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14
Q

natural freqs

A

10000xPPV=prev
prev x sen=# TP
10000-prev= # without disease
# without disease x (1-spec)=false positives

1-spec is important!

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15
Q

Pulse pressure=

A

Psys-Pdias

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16
Q

where hear RA, RV, LA, LV

A

RA-1/2 inch off right sternum in third costal space

RV-6th intercostal to right

LA-2nd intercostal to left

LV-5th intercostal-midclavicular

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17
Q

r, l, a, p, diaphragm

boarders of heart

A 
r-RA
l-LV+LA auricle
a-RV, some RA, some LV
p-La
Diaphragm-Mostly LV, some RV
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18
Q

dev of smooth walled atria
- RA and LA

dev rough wall atria

dev for crista terminalis

d for cornoary sinus

A

embryonic veins near heart

  • R horn of sinus venous for RA
  • Pulm ven for LA

prim atrium

sinus venus and prim atrium

sinos venosos
-ALL INFLOW ARE FROM SINUS VENOUSUM

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19
Q

where are all inflow to heart derived from?

A

sinus vensum (smooth)

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20
Q

d for small wall ventricle

  • rough?-L vs R
  • muscular septum
  • membranous septum
A

embryonic artery near heart

  • L is prim ventricle, R is proximal bulbus cordis
  • embryonic vent WALL(partial)
  • aorticopulm septum and endo card cushions (NC)
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21
Q

traverse sinus bouandaries

A

ant-AA and pulm trunk

post- SVC

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22
Q

oblique sinus boundaries

A

IVC and 4 pulm veins

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23
Q

what does L and central and right horns of sinus venous become

A

L and Central-cornoary sinus

Right-sinus venarium-smooth wall of RA

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24
Q

bulbs cordis resulted in

  • prox 3rd
  • conus cordis
  • trunus arterioles
A

pros 3rd-trabeculated parts of RV

CC-smooth parts of RV and LV

truncus-root of AA and PT

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25
what resulted from S-bend
prim atria became caudal to prim ventricle now venous inflow goes in posterior, while arterial outflow is anterior
26
NC in developing heart (2)
endocardial cusions- bottom of septums (membranous) tricostal ridges-create spiral septum -also closure of inter ventricular septum
27
3 consequences of increase pO2, increase bradykinin, and decreased prostaglandins
ductus arteries shuts umbilical vein shuts-lig teres ductus venous shts-lig venousum
28
primum septal defect
sep primum no fuse to cusion
29
secundum septal defect
foramen oval not covered by septum secundum
30
ventral septal defect (2)
muscular-excessive respiration of embryologic septum membranous-no aorticopulm septum usually not cyanotic-but can be if large L to R force
31
tetralogy of fallot (4 symptoms)
``` pulm stenosis overring aorta RVH ventral septal defect CYANOTIC ```
32
Persistant aorticopulm trunk
Cyanotic-ox and does mix Ventral septal defect
33
PR interval
P wave to Q wave | start of atrial depot to start of ventricular depol
34
ST segment
time form end of ventricular depot to start of vent repeal | - end of S to beginning of T
35
QT interval
begging of Q to end of T | - begining of vent depot to end of vent repol
36
what part of heart does precordial leads correspond to
v1-RV v2/3-interventricular septum 4-apex of LV 5,6-lateral LV
37
what does Q wave rep
septum depoalrziating
38
moderator band ability
carry right bundle branch to anterior papillary muscle in RV
39
dorsal vs ventral horns
AFFERENT (+sensory) VS EFFERENT
40
what nerve fibers travel in vagus -what nerve type has cell bodies in here what nerve fibers travel in paravert trunk what type of nerve has cell body here
``` para sympathetic (efferent) and sensory (afferent) -sensory (afferent) ``` sym (efferent) and sensory (efferent) post gang sym
41
where are pre/post gang PSNS located
pre-brainstem/sacral spinal chord | post-heart wall
42
where re pre/post SNS located
pre-ventral horn of spinal chord | post-sympathetic chain
43
angina as back pain
pain travels on vagus to a dorsal horn | -level of dorsal horn determines dermatome in pain
44
esophagus and right atrium relationship and clinical? thoracic aorta and left atriuM?
eso is right behind RA -RAH=trouble swallowing again behind
45
what is arch of azygos/aorta superiorfial too and clinical
right bronchus left bronchus disentionsion can result in trouble breathing
46
where is right vagus in regards to eso and azygos
right between
47
development of heart tube from sphlanic mesoderm
splanchnic mesa-angiogenic clusters -lateral go ventrally, become endocardial tubes, and fuse to make heart tube -medial stays dorsal, becomes 2 dorsal aorta that fuse and with heart tube become first aortic arch
48
order of heart tube
truncus bulbus, ventricle, atrium, sinus venosus
49
creation of pulm vein
grow into lungs, divide into 4, gets pulled back
50
what happens to bulbs cordis
gets incorporated into ventricle-becomes smooth part
51
formation of ventricular septum | -CRITICAL ALWAYS FORGET THIS
embryonic-from wall of ventricle-bublus cordis/primitive ventricule= becomes MUSCULAR aortipulm part-ingrowth of heart tube by NC cells-membranous
52
keep baby alive with patent ductus arteriorsis and another problem how close ductus arteriosis
give O2-solve hypoxia, give prostalgnim- keep ductus arteriorisis open O2 from breathing, less prostaglandins from mom, bradykinin increases after born
53
squatting and vasculature
constricts peripheral vasculature - increases blood to RA/RV - less L to right shunting
54
SNS-pregang release postgang receptor postgang release
ACH N2 receptor-cholinergic-nicotenic -allow inward Na and Ca norepi
55
a1 vs a2
PKC-Ca channels open-smooth muscle contract inhibit effect of a1-negative feedback for a1- located at prejuctional membrane of some post-gang SNS fibers
56
where are B1 and B2 located
B1-heart | B2-heart and smooth muscle beds
57
B1 actvation
chrono and ionotropy up
58
B2 activation
- chrono and ionotropy up - negative ionotropy - relax SM, metabolize glycogen in liver, create glycogen in skel muscle
59
Norepi syn
SNS post gang neurons-dopamine to norepi
60
2 types of dopamine receptors
DA1-VSM DA2-presynaptic SNS and SNS gangla -inhibits secretion of norepi/SNS transmission
61
COMT/MAO
degrade norepi/epi
62
adrenal medulla secretions | -chromaffin cells
epi (and some norepi) | -mod post gang SNS cells-sun epic and norepi-stim by ACh
63
Epi binding
all dose effects B1 low dose effects B2-most wanna be on, unless have a decent amount high dose effects a1
64
noreepi binding
potent for a1 and B1 - low doses more for a1 than B1 - low affinity for B2
65
PSNS travel in which named nerves
3, 7, 9, 10 (75% in 10), sacral pelvic nerves
66
PSNS-what does pressgang release into synapse what is receptor of post gang coupled too-what is receipor called
ACh/muscarine Na in channel CM-cholinergenic-muscarine
67
ACh syn
@pregang ANS/postgang PSNS
68
cholinesterase fucntion
destroyed ACh-decrease of ANS tone
69
symthomimetics vs cholinomimetics | -fucnion on which receptors
stimulate SNS or PSNS tone | -stimulate the differing receptors-CM or NR-R
70
where do high/low pressure affronts travel on
high-vagal | low-glossopharyngeal
71
ANP function
naturesis-at hyptensive atria | -expel Na so H2O out
72
endothelial cell functions *7
``` metabolize materials selective perm barrer Acetyl cholinerstase/MAO produce NO have ACE Produce VWF/selectins/tPA (clot buster) ```
73
angiogen pathway
no oxy, HIF1, VEGF secreted from endothelial cell, protease degrades BM, migrate there, proliferate, differentiate angiogen is adult endothelial cells dividing
74
plaque formation
injury, monocytes and SM invades, depoisiotn of ECM, plaque probably in tunica media
75
HOW DOES VENTRICLE DEVELOP
bulbs cordis + primitive ventricle -primitive ventricle becomes trabeculated part of LV bulbs cords becomes - pros 3rd-trabeculated part of RV - conus cordis-smooth parts of ventricles - truncus arteriosus
76
ventricular foramen
ventricle wall develops into muscular ventricular septum-but not all the way up=foramen -endocardial cushions/aorticopulm septum grow down to close
77
sterling law
EDV up, SV up | EDV up, ionotropy up

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