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CV Flashcards

(88 cards)

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1
Q

ascending aorta arises from?

A

truncus arteriosus

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2
Q

pulmonary trunk arises from?

A

truncus arteriosus

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3
Q

smooth mm/outflow of left and right ventricles arises from?

A

bulbus cordis

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4
Q

trabeculated part of left and right atria arises from?

A

primitive atrium

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5
Q

trabeulated part of left and right ventricles arises from?

A

primitive ventricle

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6
Q

smooth part of left atrium arises from?

A

primitive pulmonary v

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7
Q

coronary sinus arises from?

A

left horn of sinus venosus

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8
Q

smooth part of right atrium arises from?

A

right horn of sinus venosus

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9
Q

SVC arises from?

A

right common cardinal v and right ant cardinal v

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10
Q

when does heart start to beat?

A

we 4

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11
Q

patent foramen ovale

A

d/t failure of septum primum and septum secundum to fuse after birth

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12
Q

VSD

A

most commonly occurs in membraneous septum

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13
Q

conotruncal abnormalities

A

transposition of great vessels
tetralogy of fallot
persisten truncus arteriosus

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14
Q

aortic and pulmonary valves arises from?

A

endocardial cushions of outflow tract

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15
Q

mitral and tricuspid valves arise from?

A

fused endocardial cushions of AV canal

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16
Q

fetal erythropiesis

A 
young liver synthesizes blood
yolk sac 3-8wks
liver 6wk-birth
spleen 10-28wk
bone barrow 18wk+
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17
Q

hemoglobin

A

alpha always
gamma goes
becomes beta

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18
Q

fetal hemoglobin

A

alpha2 gamma2

higher affinity for O2 d/t lower affinity for 2,3 BPG

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19
Q

what do you give to close PDA

A

indomethacin

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20
Q

what do you give to keep PDA open?

A

PGs E1 and E2

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21
Q

median umbilical ligament arises from?

A

allantois -> urachus

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22
Q

ligamentum arteriosum arises from?

A

ductus arteriosus

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23
Q

ligamentum venosum arises from?

A

ductus venosus

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24
Q

foramen ovale arises from?

A

fossa ovalis

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25
nucleus pulposus arises from?
notochord
26
medial umbilical ligament arises from?
umbilical aa
27
ligamentum teres hepatis arises from?
ligamentum hepatis in falciform ligament
28
SA and AV nodes get blood from?
RCA
29
right dominant circulation
PDA from RCA | 85%
30
most posterior part of heart?
left atrium -> enlargement = dysphagia or horseness
31
CO
SVxHR or rate of O2 consumption/ (aaO2-vvO2)
32
MAP
COxTPR or 2/3DP + 1/3SP
33
early exercise
CO maintained by increased HR and SV
34
late exercise
CO maintained by increased HR only
35
what does increased HR d/t diastole?
shortens it d/t increased filling time -> decreased CO
36
increased pulse pressure
hyperthyroidism aortic regurg aortic stiffening (isolated systolic HTN of elderly) obstructive sleep apnea (increased sympathetics) exercise (transient)
37
decreased pulse pressure
aortic stenosis cardiogenic shock cardiac tampenade advanced heart failure
38
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
39
contractility decreased d/t
``` B1 blockade (decreased cAMP) HF w/systolic dysfunction acidosis hypoxia/hypercapnia non-dihyydropyridine Ca Ch blockers ```
40
Myocardial oxygen demand
``` increased myoCARDial O2 demand increased Contractility increased Afterload increased heart Rate increased Diameter of venticle (wall tension) ```
41
wall tension
(pressure x radius) / 2x wall thickness
42
preload
approximated by ventricular EDV | decreased by venodilators (nitroglycerin)
43
afterload
approximated by MAP | vasodilators (hydralazine) decrease afterload
44
what decreases both preload and afterload?
ACEI and ARBs
45
EJ
``` SV/EDV (EDV-ESV)/EDV normal 55% decreased in systolic HF normal in diastolic HF ```
46
increased afterload
increased aortic pressure decreased SV increased ESV loop is tall and skinny
47
increased preload
increased SV | loop gets wider to the right
48
increased contractility
increased SV increased EF decreased ESV loop gets wider to the left
49
S1
mitral and tricuspid valve closure | loudest at mitral
50
S2
aortic and pulmonary valve closure | loudest at left upper sternal border
51
S3
in early diastole during rapid ventricular filling phase associated with increased filling pressures mitral regurg HF more common in dilated ventricles normal in prego and kids
52
S4
in late diastole, atrial kick apex in LLD high atrial pressure ventricular hypertrophy
53
a wave
Atrial contraction | absent in a-fib
54
c wave
RV Contraction | d/t closed tricuspid valve bulging into atrium
55
x descent
atrial relaXation and downward displacement of closed tricuspid valve during ventricular contraction absent in tricuspid regurg
56
v wave
increased right atrial pressure d/t villing against closed tricuspid
57
y descent
RA emptying into RV
58
normal splitting
inspiration -> decreased intrathoracic pressure -> increased venous return -> increased RV filling -> increased RV SV -> increased RV ejection time -> delayed closure of pulmonic valve
59
wide splitting
daled RV empyting pulmonic stenosis RBBB present during exhalation but exaggerated in inspiration
60
fixed splitting
same in inhalation and exhalation | ASD -> L to R shunt - increased RA and RV volumes -> increased flow thru pulmonic
61
paradoxical splitting
conditions that delay aortic valve closure aortic stenosis LBBB pulmonic closes before aortic
62
inspiration
increased intensity of R heart sounds
63
handgrip
increases afterload increased MR, AR, VSD murmurs decreased hypertrophic cardiomyopathy murmurs MVP: later onset of click/murmur
64
valsalva phase II, standing up
decreased preload decreased intensity of most murmurs increased intensity of hypertrophic cardiomyopathy MVP: earlier onset of click
65
rapid squatting
increased VR and increased preload decreased intensity of hypertrophic cardiomyopathy increased intensity of AS MVP: later onset of click
66
AS
C/D systolic ejection murmur LV>>aortic pressure 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
67
MR/TR
holosystolic high-pitched blowing murmur | RF or infective endocarditis can cause either
68
MR
loudest at mitral post, radiates to axilla ischemic heart disease (post-MI) MVP LV dilation
69
TR
tricuspid post radiates to R sternal border | RV dilation
70
MVP
mitral valve prolapse late systolic crescendo murmur w/midsystolic click most frequent w/valvular lesion mitral post loudest just before S2 benign, predispose to infective carditis can be caused by myxomatous degeneration (CT disease), RF, chordae rupture
71
VSD
holosystolic harsh loudest at tricuspid
72
AR
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
73
MS
``` follows opening snap delayed rumbling late diastolic murmur LA>>LV pressure during diastole RF can lead to LA dialation ```
74
PDA
continuous machine like murmur loudest at S2 congenital rubellla or prematurity best heard at left intraclavicular area
75
PR interval
76
QRS
77
speed of conduction
purkinje >atria > ventricles > AV node
78
pacemakers
SA >AV >bundle of His > purkinje/venticles
79
conduction pathway
SA -> atria -> AV -> common bundle -> bundle brr -> fasicles -> purkinje fibers -> ventricles
80
torsades de pointes
long QT predisposes: drugs decreased K and increased Mg Tx with Magenesium sulfate
81
drug induced long QT
``` ABCDE anti Arrhythmics (class IA, III) aBx (macrolides) anti Cychotics (haloperidol) anti Depressants (TCAs) anti Emetics (odansetron) ```
82
congenital long QT
usually d/t ion ch defects increased risk of SCD romano-ward syndrome jervell and lange-nielsen syndrome
83
romano-ward syndrome
AD long QT pure cardiac phenotype
84
jervell and lange-nielsen syndrome
AR long QT sensoineural deafness
85
brugada syndrome
AD asian males pseudo RBBB and ST elevation in V1-3 increased risk of ventriculat tachy and SCD prevent SCD w/implantable cardioverter-defibrillator
86
wolff-parkinson-white
MC type of ventricular pre-excitation syndrome bundle of kent - abnormal fast accessory conduction pathway from atria -> ventricle widened QRS delta wave can cause supraventricular tachy
87
atrial natriuretic peptide
atrial myocytes acts via cGMP vasodilation and decreased Na resorption in renal collecting tubules
88
brain natriuretic peptide
ventricular myocytes via cGMP longer half life the ANP used to Dx HF (very good neg predictive value)

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