CV system and its anatomy

Question 1

what is a CV system used for?

Answer 1

transport of O2, of CO2, of hormones and of heat

varies with tissues needs

Question 2

What can peripheral vascular disease cause?

Answer 2

it is a peripheral artery disease and due to vasospasm and atherosclerosis inflammation
causes ischaemia

Question 3

how does CVD prevalence change with age?

Answer 3

as you get older you have a higher prevalence of CVD

Question 4

what does cardiac output depend on and how can you figure it out?

Answer 4

depends on

• heart rate
• stroke volume; volume pumped per beat

CO = HR x SV

Question 5

what does it mean by systole and diastole?

Answer 5

systole is the pumping phase of the heart
-> muscle expands
diastole is the relaxing part of the cycle
-> muscle recoils

Question 6

how would systolic and diastolic pressure be seen on a graph and what does this show?

Answer 6

systolic is the peak of the curve and diastolic is the trough
at diastolic this is when the blood is pumped out
there is a pressure gradient from arteries (ABP) to veins (CVP)

Question 7

what is the relationship between cardiac output and venous return?

Answer 7

venous return = cardiac output

• if this is not true the system is out of balance

Question 8

what does the mean ABP depend on?

Answer 8

• volume of blood pumped out per min

- resistance of circulation

Question 9

how can you calculate the systemic and pulmonary mean ABP? how do you calculate the TPR using PVR

Answer 9

systemic mean ABP = TPR x CO
-> should be around 90mmHg (narrower vessels so higher pressure)
pulmonary mean ABP = PVR x CO
-> should be around 12-15 mmHg

to find TPR = 7 x PVR

Question 10

what can constriction arterioles cause?

Answer 10

this causes the ABP to increase as ABP = CO x TPR and as arterioles constrict the TPR increases so ABP increases also

Question 11

what happens when arterioles in the tissue constrict? and what occurs when they dilate?

Answer 11

when tissue arterioles constrict, the local resistance increases and so the total blood flow will decrease; causing pressure in capillaries to decrease
when they dilate, the local resistance decreases, total blood flow increase and capillary pressure increases

Question 12

what are the types of vessels and their elastic functions?

Answer 12

1. elastic arteries; for strength and have elastic recoil
2. muscular arteries; for distribution
3. capillaries; for exchange of nutrients, gases etc.
4. arterioles; have varying resistance to affect ABP and the total blood flow

Question 13

what is the role of venues/veins?

Answer 13

• determine filling of ventricles
• venues increase vein pressure causing pressure in capillary to increase => oedema
• has a reservoir function

Question 14

what are the functional parts of the CVS?

Answer 14

• conducting part ; arteries and veins

- exchange part ; capillary bed

Question 15

what is the structure of the vessel wall?

Answer 15

1. tunica externa; collagen
2. tunica media ; thick smooth muscle
   - > thickest layer
3. tunica intima ; endothelium
   - > can have valves

Question 16

why does arterioles have elastic tissue?

Answer 16

need it to expand and recoil due to the high blood pressure in the arterioles

Question 17

what is capillary beds made up of?

Answer 17

endothelial cell layer

-> one cell thick wall; allows diffusion to cells though the extracellular space

Question 18

how can arterioles control blood pressure to allow blood flow into capillary beds?

Answer 18

they will constrict the pre-capillary sphincters to control BP

Question 19

where does the descending aorta emerge and where does it bifurcate?

Answer 19

emerges from the diaphragm at T12

and bifurcates at L4; where common iliac arteries are

Question 20

what are the three GI tract branches?

Answer 20

• superior mesenteric
• inferior mesenteric
• coeliac trunk

Question 21

where do each of the GI tract artery branches lead to?

Answer 21

1. coeliac trunk leads to the foregut
2. superior mesenteric artery leads to the midgut where the colon is
3. inferior mesenteric artery leads to the hindgut; up to rectum and upper anal canal

Question 22

what does the GI tract hepatic portal vein split up into?

Answer 22

it leads to liver 
but splits up into inferior mesenteric 
-> leads to rectum 
splenic vein
-> leads to spleen 
superior mesenteric vein

Question 23

what does the internal artery become? and where do these branches go to?

Answer 23

the internal iliac artery leads to the pelvic organs and it branches off into the superior gluteal artery, the obturator artery and the inferior gluteal artery

Question 24

what does the external iliac artery branch off to become?

Answer 24

it becomes the femoral artery which leads to the inguinal ligament ; bands that connect abdomen to pelvis deep in the groin

Question 25

what are the major arteries within the upper limb?

Answer 25

proximally you have the subclavian, axillary and brachial arteries distally you have the radial and ulnar arteries

Question 26

what are the major arteries within the lower limb?

Answer 26

proximally you have the femoral and popliteal arteries | distally you have the tibial arteries and the fibular artery

Question 27

what are the major veins within the upper limb?

Answer 27

in the upper limb superficially; cephalic vein, basilica vein which drains into the axillary deep veins are the ulnar and radial vein and the brachial and axillary

Question 28

what are the major veins in the lower limbs?

Answer 28

superficially; the great and small saphenous vein deep veins are the anterior and posterior tibial and popliteal vein these veins all drain into the femoral vein

Question 29

what are deep veins?

Answer 29

they are vena comitantes; accompanying veins surround the peripheral arteries the contraction of the arteries helps with vein drainage -> have valves

Question 30

what are subcutaneous veins?

Answer 30

they have valves and are important in coronary bypasses

Question 31

what do the internal and external carotid arteries supply?

Answer 31

internal carotid supplies the brain via the carotid canal | the external carotid supplies the neck and face

Question 32

where do the common carotid arteries bifurcate?

Answer 32

they will bifurcate at superior border of thyroid cartilage | so at C3/C4 vertebrae

Question 33

what is the carotid pulse lateral to?

Answer 33

the cricoid cartilage | C5/C6

Question 34

what is the cerebral arterial circle made up of?

Answer 34

it is made up of the vertebral arteries and the internal carotid arteries

Question 35

where do the dural venous sinuses drain?

Answer 35

the dural venous sinuses drain via the internal jugular vein

Question 36

what is the external jugular superficial to?

Answer 36

the sternocleidomastoid

Question 37

what does the carotid sheath contain?

Answer 37

it carries the internal jugular vein, the common carotid artery and the vagus nerve the sheath drains into the brachiocephalic vein

Question 38

how to know if someone is having a stroke?

Answer 38

if it is more than 24 hours then it is a stroke a TIA will resolve itself within 24 hours can lead to death look for FAST symptoms; Face, Arm, Speech, Time

Question 39

how can you find out if a patient has a stroke? what happens if they do?

Answer 39

CT scan look at medical history give an anticoagulant medication if history is clear - if so give 300mg aspirin stat

Question 40

if patient has had a stroke and has hyperlipidaemia, what medication should be given?

Answer 40

alteplase can be given a secondary prevention is aspirin 300mg for 14 days then add statins on

Question 41

for patients who have had a stroke, what is the next step for treatment after aspirin and alteplase?

Answer 41

use aspirin and then clopidogrel 75mg after 2 weeks of aspirin 300mg indefinitely

Question 42

what other treatment measures can you take for a patient having a stroke?

Answer 42

- oxygen therapy - keep blood sugar at 4-11 mmol/litre - nutrition - rehabilitation

Question 43

how to manage dysphagia and nutrition?

Answer 43

use SALT assessment for initial management then rehabilitation as soon as patient can tolerate it - help them sit up

Question 44

what is the treatment for patients with TIA?

Answer 44

- clopidogrel 300mg loading | then clopidogrel 75mg daily and atorvastatin 20-80mg starting immediately