Flashcards in CV Deck (88):
ascending aorta arises from?
pulmonary trunk arises from?
smooth mm/outflow of left and right ventricles arises from?
trabeculated part of left and right atria arises from?
trabeulated part of left and right ventricles arises from?
smooth part of left atrium arises from?
primitive pulmonary v
coronary sinus arises from?
left horn of sinus venosus
smooth part of right atrium arises from?
right horn of sinus venosus
SVC arises from?
right common cardinal v and right ant cardinal v
when does heart start to beat?
patent foramen ovale
d/t failure of septum primum and septum secundum to fuse after birth
most commonly occurs in membraneous septum
transposition of great vessels
tetralogy of fallot
persisten truncus arteriosus
aortic and pulmonary valves arises from?
endocardial cushions of outflow tract
mitral and tricuspid valves arise from?
fused endocardial cushions of AV canal
young liver synthesizes blood
yolk sac 3-8wks
bone barrow 18wk+
higher affinity for O2 d/t lower affinity for 2,3 BPG
what do you give to close PDA
what do you give to keep PDA open?
PGs E1 and E2
median umbilical ligament arises from?
allantois -> urachus
ligamentum arteriosum arises from?
ligamentum venosum arises from?
foramen ovale arises from?
nucleus pulposus arises from?
medial umbilical ligament arises from?
ligamentum teres hepatis arises from?
ligamentum hepatis in falciform ligament
SA and AV nodes get blood from?
right dominant circulation
PDA from RCA
most posterior part of heart?
left atrium -> enlargement = dysphagia or horseness
rate of O2 consumption/ (aaO2-vvO2)
2/3DP + 1/3SP
CO maintained by increased HR and SV
CO maintained by increased HR only
what does increased HR d/t diastole?
shortens it d/t increased filling time -> decreased CO
increased pulse pressure
aortic stiffening (isolated systolic HTN of elderly)
obstructive sleep apnea (increased sympathetics)
decreased pulse pressure
advanced heart failure
contractility increases d/t
catecholamines (increased Ca pump on SR)
increased intracellular Ca
decreased extracellular Na (decreased Na/Ca exchanger)
digitalis (blocks Na/K pump -> increased intracellular Na -> decreased Na/Ca exchange -> increased Ca
contractility decreased d/t
B1 blockade (decreased cAMP)
HF w/systolic dysfunction
non-dihyydropyridine Ca Ch blockers
Myocardial oxygen demand
increased myoCARDial O2 demand
increased heart Rate
increased Diameter of venticle (wall tension)
(pressure x radius) / 2x wall thickness
approximated by ventricular EDV
decreased by venodilators (nitroglycerin)
approximated by MAP
vasodilators (hydralazine) decrease afterload
what decreases both preload and afterload?
ACEI and ARBs
decreased in systolic HF
normal in diastolic HF
increased aortic pressure
loop is tall and skinny
loop gets wider to the right
loop gets wider to the left
mitral and tricuspid valve closure
loudest at mitral
aortic and pulmonary valve closure
loudest at left upper sternal border
in early diastole during rapid ventricular filling phase
associated with increased filling pressures
more common in dilated ventricles
normal in prego and kids
in late diastole, atrial kick
apex in LLD
high atrial pressure
absent in a-fib
d/t closed tricuspid valve bulging into atrium
atrial relaXation and downward displacement of closed tricuspid valve during ventricular contraction
absent in tricuspid regurg
increased right atrial pressure d/t villing against closed tricuspid
RA emptying into RV
inspiration -> decreased intrathoracic pressure -> increased venous return -> increased RV filling -> increased RV SV -> increased RV ejection time -> delayed closure of pulmonic valve
daled RV empyting
present during exhalation but exaggerated in inspiration
same in inhalation and exhalation
ASD -> L to R shunt - increased RA and RV volumes -> increased flow thru pulmonic
conditions that delay aortic valve closure
pulmonic closes before aortic
increased intensity of R heart sounds
increased MR, AR, VSD murmurs
decreased hypertrophic cardiomyopathy murmurs
MVP: later onset of click/murmur
valsalva phase II, standing up
decreased intensity of most murmurs
increased intensity of hypertrophic cardiomyopathy
MVP: earlier onset of click
increased VR and increased preload
decreased intensity of hypertrophic cardiomyopathy
increased intensity of AS
MVP: later onset of click
C/D systolic ejection murmur
aortic listening post -> radiates to carotids
pulsus parcus et tardus (weak pulse w/delayed peak)
SAD- syncope, angina, dyspnea on exertion
age related calcification or bicuspid valve
holosystolic high-pitched blowing murmur
RF or infective endocarditis can cause either
loudest at mitral post, radiates to axilla
ischemic heart disease (post-MI)
tricuspid post radiates to R sternal border
mitral valve prolapse
late systolic crescendo murmur w/midsystolic click
most frequent w/valvular lesion
loudest just before S2
benign, predispose to infective carditis
can be caused by myxomatous degeneration (CT disease), RF, chordae rupture
loudest at tricuspid
high pitched blowing early diastolic decrescendo murmur
long diastolic murmur and signs of hyperdynamic pulse when serve and chronic
often d/t aortic root dilation, bicuspid aortic valve, endocarditis, RF
progresses to LHF
follows opening snap
delayed rumbling late diastolic murmur
LA>>LV pressure during diastole
can lead to LA dialation
continuous machine like murmur
loudest at S2
congenital rubellla or prematurity
best heard at left intraclavicular area
speed of conduction
purkinje >atria > ventricles > AV node
SA >AV >bundle of His > purkinje/venticles
SA -> atria -> AV -> common bundle -> bundle brr -> fasicles -> purkinje fibers -> ventricles
torsades de pointes
long QT predisposes:
decreased K and increased Mg
Tx with Magenesium sulfate
drug induced long QT
anti Arrhythmics (class IA, III)
anti Cychotics (haloperidol)
anti Depressants (TCAs)
anti Emetics (odansetron)
congenital long QT
usually d/t ion ch defects
increased risk of SCD
jervell and lange-nielsen syndrome
pure cardiac phenotype
jervell and lange-nielsen syndrome
pseudo RBBB and ST elevation in V1-3
increased risk of ventriculat tachy and SCD
prevent SCD w/implantable cardioverter-defibrillator
MC type of ventricular pre-excitation syndrome
bundle of kent - abnormal fast accessory conduction pathway from atria -> ventricle
can cause supraventricular tachy
atrial natriuretic peptide
acts via cGMP
vasodilation and decreased Na resorption in renal collecting tubules