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ESA2 Unknown > CVS > Flashcards

CVS Flashcards

0
Q

Muscular arteries

A

Same as elastic, but less elastic membranes, more SMC and unmyelinated nerve endings

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1
Q

Structure of elastic arteries

A

TI endothelial, sub endothelium of CT
TM fence started elastic membranes, SMC, collagen
TA fibroelastic CT and vaso vasorum

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2
Q

Structure of arterioles

A

D<0.1mm
1-3 SMC
External elastic lamina is abscent
TA is scant

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3
Q

Length of systole and diastole

A

280ms

700ms

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4
Q

Spread of excitation down septum

A

Endocardial to epicardial

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5
Q

Define ionotropy and chronotropy

A

Ionotropy is contract ability

Chronotropy is rate

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6
Q

Receptor that is responsible for vasoconstriction

A

Alpha 1

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7
Q

Autonomic nervous system that dominates heart at rest
Natural heart rate
If parasympathetic knocked out

A

Parasympathetic dominates
60bpm
100bpm

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8
Q

The autonomic changes involved in increasing heart rate

A

Decrease in parasympathetic

Then increase in sympathetic

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9
Q

Link resistance, flow and pressure drop in arterioles

A

Flow constant in all CVS so due to high R, high pressure drop

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10
Q

Pulse pressure and average pressure

A

Pulse: difference between systolic and diastolic
Average: diastolic + 1/3’systolic pressure

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11
Q

Name the vasodilator metabolites

A

H+, K+, Adenosine

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12
Q

Define pre load and after load

A

Pre load- end diastolic stretch of myocardium

After load- force necessary to expel blood into the arteries

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13
Q

How the body prevents pulmonary oedema in excercise

A

Heart rate already high so stroke vol kept low but CO is high

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14
Q

How haemorrhage effects venous pressure

A

Decreased blood vol, decreased CO and arterial pressure, recognised by barro receptors that increase HR and TPR which lowers VP and hence AP even further

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15
Q

What is special about SAN myocardium a membrane potential

A

Less negative so fast Na chan remain inactive, only slow Na chan open during repolarisation so you get timed depolarisation

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16
Q

Causes of Arrhythmias

A

Ectopic Pace Maker activity
After Depolarisation
Reentry loop

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17
Q

Class 1 anti arrythmic

A

V gated Na chan blockers eg lidocaine, this prevents after depolarisations

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18
Q

Class 2 anti arrythmic

A

Beta adrenoceptor antagonists eg propranolol and atenolol

Decreases ionotropy and chronotropy so reduced O2 demand from myocardium

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19
Q

Class 3 anti arrythmic

A

K+ chan blockers! lengthened absolute refractory period preventing another AP too soon,
Not generally used

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20
Q

Class4 anti arrythmic

A

Ca2+ chan blockers eg Verapamil
Decreases HR and AV node conduction
Decreases contractile force

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21
Q

What does adenosine do as an antiarrythmic?

A

Resets the heart as it hyper polarises the cell

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22
Q

How do ACE inhibitors work?

A

Prevent vasoconstrictor angiotensin 2 so decreases pre and after load
Also decreases aldosterone and therefor blood vol.

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23
Q

What is the action of an organic nitrate spray?

A

SMC release NO2 -> NO which is a vasodilator

Primarily acts as a venodilator, then on coronary arteries

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24
The colours of the limb leads
Red RU Yellow LU green LL Bike RL
25
Placement of chest leads
1 is 4th intercostal space RHS of sternum 2nd is LHS of above 4th is 5th intercostal space mid clavicular line 6th is mid axillary
26
How to work out ECG rate
300/no of squares
27
What would a ventricular ectopic beat look like
Wider, taller and may be every 3rd or 4th
28
ECG of atrial fibrillation
P wave abscent, instead irregular fibrillation waves between QRS complexes
29
What does ventricular fibrillation look like on ECG
Uncoordinated contraction
30
1st degree heart block
PR interval elongated from 200ms, conduction delay
31
2nd degree T1 heart block
PR interval is erratic, gets longer till a QRS complex is dropped
32
2nd degree T2 heart block
Excitation sometimes fails to pass AVN or bundle of His
33
Compete 3rd degree heart block
No conduction at AVN, ventricles have ectopic pacemaker but beats are slower
34
Bundle branch block
Lengthened QRS complex
35
Blood flow of pulmonary cvs
Low r, short, wide vessels, low pressure
36
How is blood diverted from alveoli not well oxygenated?
Hypoxia pulmonary vasoconstriction
37
How does coronary endothelium produce a high basal flow?
Continuous production of NO
38
3 cerebral circulation protection mechanisms
Myogenic auto regulation: increased bp causes vasoconstriction across trans mural wall Metabolic Regulation: increased CO2 causes vasodilation Regional activity: highly active has high release of adenosine
39
Cushings reflex
Increased ICP decreases blood flow to vaso motor control regions and increases it's sympathetic activity so increased arterial blood pressure
40
Chest pain from heart problems location
Central retrosternal
41
Signs of unstable angina
Ischemic chest pain at rest, depressed ST
42
Treatment of angina
Acute - Nitrate spray, Prevent - beta and Ca chan blockers and oral nitrates Prevention of cardiac event: aspirin, statins, ACE inhibitors
43
Cause of thrombosis from atheroma?
Exposure of thrombogenic necrotic core
44
She do you get NSTEMI MI
Infarct is not full thickness
45
Class 1 heart failure
None symptomatic but limitation of physical activity (LPA)
46
Class 2 heart failure
Slight LPA leading to symptoms, none at rest
47
Class 3 heart failure
Marked LPA and symptoms, none at rest
48
Class 4 heart failure
Inability to do activity without symptoms and some symptoms at rest
49
Congestive heart failure
Both sides of the heart failing
50
Describe RAAS
Renin angiotensin aldosterone system, makes HF worse Decreased bp causes renin release from kidneys Angiotensin 1 converted to angiotensin 2, this is a vasoconstrictor and causes release of aldosterone increasing blood vol
51
Action of cardiac glycosides
Increase CO and heart contractility by inhibiting Na/K pump so inhibits NCX so intra cellular Ca raises
52
Define shock
Inadequate distributed tissue perfusion
53
Cardiogenic shock
Inability to eject enough blood eg Arrhythmias
54
Mechanical shock
Restriction of filling the heart eg cardiac tamponade
55
Hypovolaemic shock
Loss of circulating fluid eg haemorrhage
56
Normovolaemic shock -
Fall in TPR eg sepsis
57
How to treat shock?
Fluids and adrenaline
58
Pericardial sac in to out
Serous, parietal, fibrous
59
Phrenic nerves
C3 C4 C5, motor and sensory to diaphragm, sensory to pericardium Right phrenic nerve over RA Left over left
60
How is heart attached to sternum?
Sternopericardiac ligament

ESA2 Unknown (3 decks)

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