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Cardiology > Applied Anatomy > Flashcards

Applied Anatomy Flashcards

1
Q

What are the three layers of the vessels ?

A

Tunica intima – thin innermost endothelial lining
Tunica media – middle smooth muscle and elastin layer
Tunica adventitia – outer connective tissue coat with collagen

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2
Q

What are the 5 types of blood vessels?

A

Arteries –> Arterioles –> Capillaries –> Venules –> Veins

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3
Q

Which is high pressure out of the artery and vein?

A

The artery

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4
Q

What feature does an artery have and why?

A

The artery is more muscular

Maintain the high pressure system

Helps to maintain blood pressure

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5
Q

What are the three types of arteries ?

A

3 types of arteries
Large elastic (conducting)
Medium muscular (distributing)
Small arteries and arterioles (resistance)

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6
Q

What vessel is a large elastic artery ?

What is the normal size

A

Aorta
Pulmonary trunk

2cm

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7
Q

What is the regular size for a large elastic artery ?

Why is this important ?

A

2cm

For diagnosing a AAA

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8
Q

What are the features of the medial muscular artery?

A

smooth muscle

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9
Q

What is the function of the medium muscular artery ?

A

Distributing blood to areas that require it

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10
Q

What artery does antihypertensives target ?

A

Arterioles

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11
Q

Which artery does the peripheral resistance/ blood pressure come from ?

A

arterioles

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12
Q

Explain hydrostatic pressure

A
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13
Q

Explain osmotic pressure

A
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14
Q

Explain structure of capilaries

A

Exchange vessels

Form interweaving networks of capillary beds

Local control through pre-capillary sphincters

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15
Q

When do the sphincters of the capillaries open/ close?

A
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16
Q

What type of veins is there ?

A

Venules and veins

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17
Q

What is a venous plexus ?

A

multiple veins coming together

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18
Q

How big is the inferior vena cava

A

3cm

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19
Q

Why do we have a volume reservoir in the veins?

A
  • The body will compensate when needed by using the blood in veins whilst making new blood cells.
  • Increase ventricular filling and thus cardiac output needed during exercise
    accommodate for volume differences in relation to changes in blood pressure
    maintain cardiac output by compensatory mechanisms during times of blood loss (small amount of bleeding/ donating blood…)
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20
Q

Which veins do not have valves ?

A

Those within thoracic cavity

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21
Q

What is anastomoses?

A

Communication between branches of an artery

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22
Q

What is an AV shunt ?

A

Connections between small arteries and veins allowing blood flow without going into the capillary beds

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23
Q

What is collateral circulation

A

where alternate channels increase in size to provide a blood supply beyond a blockage

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24
Q

When do you check for collateral circulaiton ?

A

When taking an ABG

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25
Q

What is a portal system ?

Where are they ?

A

2 capillary beds in series e.g. liver, pituitary

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26
Q

What is an Arcade ?

A

– A series of anastomosing arterial arches between the arterial branches

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27
Q

What problems can you get with blood pressure ?

A

hypertension/ hypotension/ shock

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28
Q

What problems can you get with an artery wall ?

A
  • Aneurysm
  • Dissection
  • Coarctation
  • Venous insufficiency
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29
Q

What inflammatory problems can you get with the vessels?

A

vasculitis, arteritis, phlebitis, thrombophlebitis

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30
Q

What obstructions can you get with the vessels ?

A
  • Atherosclerosis
  • Arterial occlusion
  • VTE/DVT
  • Embolism
  • Thrombosis, vasospasm, (SOL)
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31
Q

What is the main cause of thrombophlebitis?

A

Inserting a cannula

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32
Q

What is AV malfromations the main cause of ?

A

Subarachnoid haemorrhage

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33
Q

What level does the aorta become the abdominal aorta ?

A

T12

34
Q

Wher does the right brachial artery supply ?

A

right head neck and upper limb

35
Q

What location is the Inferior mesenteric artery?

A

L3

36
Q
A
37
Q

What location is the Renal ?

A

L1 + L2

38
Q

What location is the Gonodal artery ?

A

L3

39
Q

Where does the aorta bifurcate into the common illiac artery?

A

l4

40
Q

If you had an AAA between 3-5.5 would you intervene ?

A

No surgical intervention required?

Keep a close eye and regular scans

41
Q

When does an AAA need repared

A

5.5 and above

42
Q

What are the risk factors of AAA?

A

HTN
Smoking
Age
Connective tissue disorder
> 70 with abdominal pain required a scan to check no AAA!

43
Q

Where is the most common place for an AAA

A

Abdominal

44
Q

Who is commonly gets a aortic disection

A

men age 50-70 with HTN

45
Q

Explain the difference between type A and B for a aortic dissection using stanford DeBakey.

A

Type A - More dangerous.
This can result in a prolapse of the aortic valve which leads to leaking of blood into the pericardium and can result in a tamponade. Includes the aortic arch

Type B - Only includes descending aorta.

46
Q

What can happen to blood pressure of there is a problem with the aorta eg AAA or aortic disection?

A

Big difference between two arms !

47
Q

Whats first line treatment for aortic disections ?

A

CT scan

Type A - Surgical intervention
Type B - medical intervention

48
Q

Why is it important that the internal jugular vein is directly connected to the right atrium?

A

If there is a build-up of pressure in the right atrium you will see it in the right jugular vein.

49
Q

What is the definition of a pulse?

A

A palpable systolic blood pressure ?

50
Q

What are the major pulses in the head and neck ?

A
  • Carotid - C6
  • Temporal
  • Facial
51
Q

What condition can you get in the temporal pulse ?

A

Temporal artertitis ?

The patient can go blind if not found

52
Q

What are the pulses in the lower limb arteries ?

A
  • Femoral
  • Popliteal
  • Dorsalis Pedis Pulse
  • Posterior Tibial Pulse
53
Q

Why would you feel for the arteries in the legs?

A
  • Check there is no peripheral arteriole disease
  • Reduced blood supply to legs
  • This leads to limb ischemia
54
Q

What are the arteries within the lower limbs?

A

Iliac arteries
Femoral artery
Popliteal artery
Anterior tibial artery
Posterior tibial artery
Dorsalis pedis artery

55
Q

What are the common sites of trauma for the lower limb arteries?

A

Superficial (eg ones you can palpate)
Close to bone/ joints

56
Q

When a patient gets a fracture or dislocation what do you need to check?

A

Check they are nuerovascularly intact.

57
Q

What is an arteriogram ?

A

An arteriogram is an imaging test that uses x-rays and a special dye to see inside the arteries. It can be used to view arteries in the heart, brain, kidney, and other parts of the body.

58
Q

What is claudication ?

A

Intermiditted blood loss - eg when walking

59
Q

Symptoms of a limb schema? (6 P)

A

Pain
Pulseless
Palour
Perishingly cold
Paralyses
Paraesthesia (Loss of sensation

60
Q

Treatment of limb sichema

A

Potentially surgery

61
Q

What is this ?

A

Tissue necrosis

62
Q

Arterieal ulcers !!

A
63
Q

Venous ulcers!!

A
64
Q

Common site of compression in lower limb arteries ?

What is this called ?

What is the treatment ?

A

Popliteal artery
By the tarsal tunnel of the foot

Compartment syndrome

Surgery

65
Q

What can make you likely to get compartment syndrome?

A

Fracture
Cast
Deep burns
Ischaemic reperfusion injury

66
Q

What is this vein ?

A

Dorsal venous arch

67
Q

What are the veins in the lower limb ?

A

Deep veins

Superficial veins
Dorsal venous arch
Short saphenous vein
Long saphenous vein
(direct superficial to deep perforators)

68
Q

Where is a DVT found ?

A

Within the deep veins
Usually legs

69
Q

How much bigger is one leg than the other in a DVT?

A

3cm bigger than the other

70
Q

What is this ?

A

Varicose vein

71
Q

What are the stages of Virchow’s triad ?

A
72
Q

What are the three stages of virchows triad ?

A
  • hypercoagulation state
  • Vascular wall injury
  • circulatory statis
73
Q

What does virchows triad assess ?

A

Risk of DVT

74
Q

What are the stages of venous insufficiency?

A
75
Q

What are the pulces in the upper limb arteries ?

A

-Axillary
- Radial
- Barchial
- Ulna

76
Q

What are the arteries in the upper limbs ?

A

Subclavian artery
Axillary artery
Brachial artery
Radial artery
Ulnar artery
Palmar arches

77
Q

What can cause problems in arteries ?

A

Trauma
Athersclerosis
Arterial thombosis vs embolus

78
Q

What are true end arteries ?

A

Where there is no anastamosis

79
Q

What are the veins in the upper limb ?

A

Deep veins - brachial and riadial

Superficial veins
Basilic vein
Cephalic vein
Cubital vein

80
Q

CASE STUDY

Primary care:
72 year old male
5/12 intermittent claudication
Sudden onset sever pain in lower limb
PMH & SH:
Hypertension, hypercholesterolaemia,
Smokes 35 cigarettes/ day

On examination:
BMI = 32
Feet on floor while sat in chair = top picture
Feet elevated = bottom picture

When he puts his feet up the colour drains from the right foot.

A

Peripheral arterial disease secondry to atherosclerosis.

81
Q

CASE STUDY

Primary care:
25 year old female
2/7 hot and swollen left leg
PMH & SH:
OCP
Smokes 20 cigarettes/ day

On examination:
Left leg pitting oedema to mid thigh
Left leg 5 cm > then right below tibial tuberosity
Localised tenderness along deep veins
HR 74 bpm & BP 115/72 mmHg
Temp 36.8oC

What investigations are we gonna do

A

Deep vein thrombosis - Most likely

Differential
compartment syndrome
Vasculitis
Superficial thrombolites
Cellulitis
Ruptured bakers cyst

Investigations
well score D dimer - if raised ultrasound known as a Doppler

82
Q

Case Study

Primary care:
32 year old male
RTC – thrown from motorbike & landed on left arm
10/10 pain
PMH & SH:
Nil

On examination:
Deformity of left arm
Open wound
No other apparent injury
HR 115 bpm & BP 95/52 mmHg

A

Humeral shaft fracture
Humeral Head fracture
Dislocation

Comprise brachial artery and vein
Radial and Brachial pulse will be compromised

Treatment
- Fluid brings BP up
- Pain brings HR down
- Assess neuromuscular structure
- Refer on to the orthapedic team

Cardiology (18 decks)

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