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YEAR 2 S2 PATHOLOGY > Cardiovascular system and diseases I > Flashcards

Cardiovascular system and diseases I Flashcards

1
Q

what is the purpose of the valves in the heart

A

maintain uniddirectional blood flow through the heart

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2
Q

what is the cardiac muscle mainly composed of

A

cardiac myocytes

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3
Q

ventricular myocytes are arranged how

this is to enable what

A

CIRCUMFERENTIALLY in a SPIRAL ORIENTATION

enables contraction and relaxation

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4
Q

what are the 3 major epicardial coronary arteries

A

1) left anterior descending (LAD) artery
2) left circumflex (LCX) artey
3) right coronary artery

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5
Q

when does most coronary arterial blood flow occur

A

during VENTRICULAR DIASTOLE when the microcirculation is not COMPRESSED by cardiac contraction

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6
Q

the SA node does what

A

pacemaker of the heart

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7
Q

where is the SA node located

A

near the junction of the right atrial appendage and the superior vena cava

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8
Q

the AV node location

A

right atrium along atrial septum

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9
Q

bundle of His location

A

from right atrium to summit of ventricular septum

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10
Q

in the PQRST wave what does each wave/segment mean

inc PR segment

A

P: atrial depolarisation
PR segment: time taken from atria to ventricle
QRS: ventricular depolarisation
ST segment: period between ventricular depolarisation to myocardial contraction
T wave: ventricular repolarisation

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11
Q

conduction defects (eg arrhythmias) are caused by what

A

uncoordinated impulse generation

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12
Q

what is the Frank-Starling mechanism

A

a compensatory mechanism: inc FILLING VOLS DILATE the heart and O INC FUNCTIONAL CROSS-BRIDGE formation within sarcomeres O INC CONTRACTILITY

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13
Q

give 3 compensatory mechanisms for the heart

A

1) Frank-Starling mechanism
2) Activation of neurohormonal systems
3) myocardial mechanisms

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14
Q

give examples of ways NEUROHORMONAL SYSTEMS can act as compensatory mechanisms

A

1) release NORADRENALINE by adrenergic cardiac nerves of the autonomic NS (inc HR, myocardial contractility, vascular resistance)
2) renin-angiotensisn-aldosterone system ACTIVATION
3) release of atrial natriuretic peptide

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15
Q

common cardiovascular diseases

A
  • atherosclerosis
  • hypertension
  • stroke
  • heart failure
  • arrhythmia
  • heart valve problems
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16
Q

hypotension results in what

A

inadequate organ perfusion and can lead to dysfunction or tissue death

17
Q

hypertension results in what

A

vessel and end-organ damage

18
Q

hypertension is responsible for what % of deaths due to heart disease

A

45%

19
Q

hypertension is responsible for what % of deaths due to stroke

A

51%

20
Q

what is classed as clinically significant hypertension

A

sustained systolic >139 mm Hg

sustained diastolic > 89mm Hg

21
Q

what are the risk factors for hypertension

A
  • age
  • genetics: African and Caribbean origin
  • BMI
  • diet (Na+ intake)
  • stress
22
Q

what are the 2 types of hypertension

A

1) ESSENTIAL (idiopathic)
- 90-95% of cases
- complex, multifactorial (inc genetics)

2) SECONDARY

23
Q

how is blood pressue calculated

A

cardiac output x peripheral resistance

24
Q

what can affect cardiac output

A

1) BLOOD VOLUME
(Na, mineralocorticoids, atriopeptin)
2) CARDIAC FACTORS
(heart rate, contractility)

25
Q

what can affect peripheral resistance

A

1) HUMORAL FACTORS
- constrictors: Angiotensin II, Catecholamines, Endothelin
- dilators: Prostaglandins, Kinins, NO

2) LOCAL FACTORS:
pH, hypoxia

3) NEURAL FACTORS:
- constrictors: α-adrenergic
- dilators: β-adrenergic

26
Q

what are the symptoms of hypertension

A
  • persistent headache
  • blurred/double vision
  • nosebleeds
  • shortness of breath
27
Q

what is a possible effect of hypertension on the brain

A
  • TIA (transient ischaemic attack)

- stroke

28
Q

what is a possible effect of hypertension on the EYE

A

retinopathy

29
Q

what is a possible effect of hypertension on the legs

A

peripheral vascular disease

30
Q

what is a possible effect of hypertension on the kidneys

A

renal failure

31
Q

what is a possible effect of hypertension on the heart

A

LVH- left ventricular hypertrophy
CHD- coronary heart disease
HF- heart failure

32
Q

what are the 4 types of antihypertensive drugs

A

1) ACE inhibitors/ angiotensin receptor antagonists
2) Beta-blockers
3) Ca channel blockers
4) Diuretics

33
Q

what heart diseases can hypertension cause

A
  • systemic hypertension causes LEFT HEART HYPERTROPHY

- pulmonary hypertension causes RIGHT HEART HYPERTROPHY

34
Q

what is the morphology of hypertensive left ventricular hypertrophy

A
  • left ventricle wall thickens
  • inc HEART WEIGHT
  • ventricular wall STIFFENS which impairs DIASTOLIC filling causing LEFT ATRIAL enlargement
35
Q

if hypertensive heart disease is in the early stages, what is experienced by patient
how is it diagnosed
if it progresses what can it cause

A

usually ASYMPTOMATIC

  • diagnosed using ELECTROCARDIOGRAM or ECHOCARDIOGRAPHY
  • if progression: can cuase HF or ISCHAEMIC HEART DISEASE

YEAR 2 S2 PATHOLOGY (22 decks)

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