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Flashcards in Chronic Stable angina Deck (28):
1

what 4 processes occur in cellular injury

1. decreased ATP
2. membrane damage
3. increased intracellular calcium
4. increased oxygen derived free radicals

2

what does reduced ATP lead to?

1. reduced action of Na-K-ATPase
2. increased anaerobic glycolysis
3. detachment of ribosomes

3

name 2 processes leading to membrane damage in cells

decreased ATP synthesis -> decreased phospholipid synthesis

raised intracellular Ca -> activates proteases and phospholipases

4

what does raised intracellular Ca lead to

activation of enzymes:
ATPase
phospholipase
proteases
endonucleases

5

what is ischaemia repercussion injury?

some reversibly injured cells can die after blood is restored to the myocardium. possibly caused by:

1. Oxygen free radicals
2. mitochondrial permeability transition
3. Inflammation associated injury
4. Complement proteins

6

what is athersclerosis

the accumulation of lipid and fibrous tissue within the intimate or arteries called plaques.
Chronically it can affect the media and the whole structure of the artery

7

describe the structer of atheromatous plaques

core --> mainly cholesterol (also cellular debris, crystals, foam cells)
fibrous cap --> collagen, elastin, sm muscle, proteoglycan

Cellular area of T lymphocytes and macrophages

8

describe the structure of a stable plaque

concentric
rich in fibrous storm
rich in smooth muscle

9

describe the structure of an unstable plaque

eccentric
rich in lipids
Macrophages ++
inflammation ++
endothelial cell injury

10

describe the consitutional risk factors for atherosclerosis

age
gender
FHx

11

describe some of the major risk factors for atherosclerosis

smoking
HTN
hyperlidiaemia
DM

12

describe some of the softer risk factors for atherosclerosis

Obesity
Personality/stress
Lack of exercise
infection

13

4 complications of coronary artery atheroma

1. gradual narrowing of vessel
2. ulceration of the plaque
3. rupture and fissuring
4. superimposed thrombosis

14

4 clinical features of atherosclerosis

1. plaque rupture of coronary artery
2. thrombosis
3. occlusion of coronary artery
4. MI

15

List some of the complications of MI

sudden death
cardiac arrhythmias
LV failure
ventricular wall rupture
Papillary muscle fibrosis/rupture
Mural thrombosis
Ventricular aneurysm

16

what is Darcy's law

Q= (P1-P2)/R

17

what are autocoids

chemicals released from damaged tissue

histamine, bradykinin, 5ht, prostaglandins

18

name a vasodilator endothelial factor

BO

19

how does flow induced vasodilation occur

downstream vasodilation causes increased flow
this activates shear sensors in the endothelium and leads to vasodilation

20

which mechanism altering the radius of resistance vessels is under extrinsic control?

human alerting response

nerves - sympathetic vasoconstrictor action are dependant on firing

hormone -- adrenaline
angiotensin II

21

which part of the aorta is the aortic root

runs between aortic valve and sinotubular junction

22

what branches off the aortic root

RCA LCA

23

which parts of the aorta are situated within the pericardial sac

the aortic root
the ascending aorta (up to 1cm pro to brachiocephalic trunk)

24

what is the significance of parts of the aorta being situated within the pericardial sac

risk of tamponade if dissection occurs

25

what are the major branches of the aortic arch

1. the bracheocephalic trunk
2. left common carotid
3. left subclavian artery

26

major branches of descending thoracic aorta

1. bronchial
2. oesophageal
3. intercostal
4. spinal
5. pericardial

27

define ischaemia

lack of blood supply from stenotic or occluded artery

this results in a lack of oxygen and essential metabolites

causes cell injury more rapidly than hypoxia

28

define infarction

irreversible cell damage due to ischaemia and hypoxia