CVS Flashcards by Charley Frew

In which week does the embryo fold

4th week

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What is the pressures of the atria in utero?

RA pressure > LA pressure
(to allow oxygenated blood to pass through foramen ovale)

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What are the remnants of the fetal shunts called?

Fossa ovalis (PO)
Ligamentum arterisoum (DA)
Ligamentum teres (DV)

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What’s the membrane resting potential in ventricular myocytes?

-85mV

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What channel type is responsible for the uptake of AP in pacemaker cells

L type Ca channels

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What effect does hyperkalaemia have on the spread of action potentials?

Cardiac myocytes depolarise inactivating sodium channels so slowing down the spread

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What does Ca bind to initiate myocyte contraction?

Troponin C

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Adenosine MoA?

Slows down AV node conduction

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What is the pressure in the LV if the Left atrial pressure is 5-20 mmHg?

5-20mmHg
Otherwise blood cannot flow there during diastole

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Which coronary artery runs through the atrioventricular groove?

Right coronary artery

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Where do the L and R coronary arteries arise from?

L and R aortic sinus

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What aspect of the heart does the circumflex artery supply?

Left lateral

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What structure separates the aorta and pulmonary trunk?

Transverse pericardial sinus

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What effect on aBP, CVP & TPR will major blood loss have?

aBP - decreased (less blood in body)
CVP - decreased (less blood in body)
TPR - increased (try to maintain BP)

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Which leads for a lateral infarct?

I, avL, V5, V6

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Which leads for a anterolateral infarct?

I, aVL, V3, V4, V5, V6

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Where would you check for the apex beat?

Left 5th intercostal space, mid-clavicular line

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Which muscles help prevent inversion of the mitral and tricuspid valves in systole?

Papillary muscles (via chordae tendinae)

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What type of anaemia can aortic valve stenosis cause?

Microangiopathic haemolytic anaemia

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What’s a bounding pulse?

When diastolic pressure drops suddenly (strong pulse)

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How are SV and EDV linked?

proportional to each other

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Which ion flows through HCN channels?

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Which ion is responsible for the depolarisation of SA NODE cells?

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What is the name for receptors responsible for Ca induced Ca release?

Ryanodine recpetors

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Which 2 parts of the primitive heart form the outflow tract?

Truncus arteriosus and bulbus cordis (form the aorta and pulmonary trunk)

Why can stasis happen in the LA?

Blood can pool in the left auricle

Define the 3 holes in atrial seperation?

Foramen Ovale - formed by septum secendum Ostium primum - gap at the bottom of septum primum before it fuses ostium secondum - hole made at the top of septum primum by apoptosis

What is the most common cause of an atrial septal defect?

Deformation of septum primum/secondum

What features are present in tetralogy of fallot?

Pulmonary stenosis Overriding aorta Septal defect (ventricular) Hypertrophy of RV (POSH)

Is tricuspid atresia cyanotic or not?

Cyanotic

What is classed as severe hypertension?

Systolic > 180 Diastolic > 110

Which leads look at the Left anterior descending artery?

Septal leads (V1 and V2)

Which leads look at the anterior aspect of the heart?

V3 and V4

Which drug would you give in Wolff parkinson white?

Amiodarone (increases absolute refractory period)

What heart failure is present if the apex is displaced to the left?

Left sided heart failure

What forms the R, L and Inferior border of the heart?

R - RA L - LV Inferior - RV

Why could the heart shadow become enlarged?

Dilated LV Ventricular hypertrophy Pericardial effusion

Where can the apex beat be felt?

Left 5th intercostal sapce at the mid-clavicular line

What regions of the heart does the LAD supply?

Anterior aspect (LV & RV) and intraventricular septum

What are the changes in the arterial wall which lead to arterial occlusion?

Plaque forms and then ruptures Thrombus forms which occludes artery

Why is a R coronary artery more likely to cause rhythm disturbance?

Supplies the AV node and SA node

When is the aorta narrowest and widest?

Narrowest - lowest aortic pressure Widest - highest aortic pressure

Which valves are connected by chordae tendineae? What's the function?

Mitral and tricupsid valve Pull the valve flaps taught during ventricular systole so blood doesn't flow back into the atria

Describe the structures of the pericardial sac?

Outer fibrous layer Double serous layer: inner visceral layer outer parietal layer

What is a complication of cardiac tamponade and what causes it?

A fall in arterial blood pressure due to compression of the heart Outer fibrous layer cannot expand so this puts extra pressure on the heart providing it from filling properly in diastole

What's the consequence of a R to L shunt?

LA/LV overload

What 2 things cause the ductus arteriosus to close at birth?

Increased oxygen levels - pressure Reduction in circulating prostaglandins

Why does a PDA cause LV failure?

LV overload/dilation due to more blood returning to L side of the heart from pulmonary circulation

Define VF

Abnormal rapid ventricular activity with the loss of co-ordinated contraction

How do you measure a patients BP manuallly?

1. Inflate cuff while palpating radial pulse 2. Inflate to 30 mmHg above where the pulse disappears 3. Release slowly, listen to stethoscope over brachial artery 1st Korotkoff sound = systolic BP 2nd Korotkoff sound = diastolic BP

What does hypertension do to the blood vessels?

Atheroma development Weakening of blood vessels

Where in the body can hypertension be visualised?

Retina

What would tall R waves on ECG suggest?

LV hypertrophy

What would show as a pan-systolic murmur? Which muscle could be effected?

Mitral regurgitation (papillary muscle)

What is the difference between pericardial effusion and cardiac tamponade?

Tamponade - trauma Pericardial effusion - Inflammation of pericardium

How do you remember the congenital heart defects?

CYANOTIC (5 Ts) Tetralogy of fallot Transposition of great vessels Truncus arteriosus Tricupsid atresia Total anomalous pulmonary venous drainage ACYANOTIC (3 HOLES) ASD VSD PDA (3 BLOCKED PIPES) Aortic stenosis Pulmonary stenosis Coarctation of aorta

What murmur is an aortic stenosis?

Ejection systolic murmur

What murmur is an aortic stenosis?

Ejection systolic murmur

What's the difference between inotropic and chronotropic?

Inotropic - affecting contractility Chronotropic - affecting rate

What causes a pan-systolic murmur?

mitral or tricuspid valve regurgitation

Where do the cardiac veins drain into and what does that then drain into?

Into the coronary sinus which then drains into the RA