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CVS Flashcards

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1
Q

Where does the apex of the heart sit & what is the superior and inferior border

A

apex - 5th intercostal space
Superior - top of the heart
inferior - bottom of the heart

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2
Q

What is the mediastinum & what does it contain and where is it located

A

Located anteriorly
central compartment of the thoracic cavity
Contains - Heart, Great vessels, Thymus, Oesophagus, Trachea

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3
Q

In the heart what is the coronary sulcus and where is it located

A

Located anteriorly & posteriorly
Marks devision between atria & ventricles
continues posteriorly & anteriorly
RCA in sulcus anteriorly

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4
Q

In the heart what is the Anterior inter-ventricular sulcus and where is it located

A

Located anteriorly
marks devision between ventricles
Continues posteriorly as posterior inter-ventricular sulcus
LAD from LCA in sulcus anteriorly

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5
Q

In the heart what is the role of the Auricles and where is it located

A

Located anteriorly
Atrial appendages
Increase capacity

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6
Q

In the heart what is the role of the posterior inter ventricular sulcus sulcus and where is it located

A

Posteriorly, marks devision between ventricles
continues to the anterior
PDA from LCA or RCA in sulcus

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7
Q

What are the two layers of pericardium in the heart fibrous & serous

A

Fibrous - tough/inelastic, attached to diaphragm, open end is fused with great vessels
Serous - PARIETAL LAYER (fused to fibrous pericardium) VISCERAL LAYER continues epicardium, PERICARDIAL CAVITY space between parietal and visceral layers contains pericardial fluid

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8
Q

Describe the three layers of the heart wall

A

outer - Epicardium (visceral serous pericardium)
Middle - Myocardium (cardiac muscle)
Inner - Endocardium - (Continues with endothelium of large vessels of heart)

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9
Q

What are the four main valves in the heart

A

Atrioventricular valves, right AV - triscupid, Left AV - Biscupid (mitral)
Semilunar Valves - 3 semilunar cusps from ventricles to the pulmonary and aorta

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10
Q

What are the three arteries which branch of the aortic arch

A

Brachiocephalic (branches into right Subclavian & right common caratoid)
Left common caratoid
Left Subclavian

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11
Q

What are the three main functions of blood

A

transport, protection, regulation

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12
Q

Describe the basic structure of Arteries and Veins

A

outer to inner
Tunica externa - connective tissue
Tunica media - smooth muscle & elastic tissue
tunica interna - layer of epithelial cells )endothelium)

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13
Q

What is a the structural difference between large arteries and medium arteries

A

Large elastic arteries - have much wider diameters, Tunica media contains lots of elastic fibres and less smooth muscle, used for conducting blood.
Medium - Tunica media is mostly smooth muscle and less elastic fibres, used for Distribution

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14
Q

Describe the structural changes in the Arterioles & Anastomoses

A

Arterioles - Tunica media is mostly smooth muscle & less elastic fibres the wall thickness is 50% of vessel diamter, used as resistance vessels
Anastomoses - is the point where two blood vessels join

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15
Q

What is Atherosclerosis what is its affect & and which arteries are most affected

A

an inflammatory disease where cholesterol enters the vessel wall, Narrows lumen & renders wall less elastic, increases resistance to blood flow and decreases circulation. Arteries affected are coronary, aortic arch, abdominal aorta

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16
Q

Describe the structure of capillaries and what are the three types

A

single layer of endothelial cells & basement membrane , highly permeable three types are Continuous, Fibrous, Sinusoid

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17
Q

What are the two types of Venules

A

Postcapillary - smallest, no tunica media, sparse tunica externa & very porous
Muscular - microscopic, Tunica media, 1-2 laers of smooth muscle, sparce tunica externa, no exchange with interstitial fluid

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18
Q

What are the main characteristics of Veins

A

low pressure, system contains 60-70% of blood, structurally similar to arteries but with a poorly developed tunica media, large lumen
Contain valves to prevent backflow

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19
Q

What is the pressure of the systemic circuit and Pulmonary circuit

A

Pulmonary - 10-25 mmHg

Systemic - 5-10 mmHg

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20
Q

What are the four stages of the cardiac cycle

A 
Ventricular filing (0,5s)
Isovolumetric contraction (0.05s)
Ejection (0.3s)
Isovolumetric relaxation (0.08s)
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21
Q

What is the name of the nerve which gives the impulse for a heart beat

A

Sinoatrial node, The ability of the node to depolarize is NOT governed by extrinsic nerves, the rate however is

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22
Q

What are the End diastolic, Stroke, & End systolic volumes

A

Diastolic - 120 ml
Stroke - 70 ml
systolic - 50ml

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23
Q

What is starling’s law

A

When the muscle fibres are stretched further it will produce more force when the contract

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24
Q

How does peripheral control of haemodynamic function work to increase and decrease pressure

A

varies the blood vessel diameter through 2 mechanisms - Autonomic & Metabolic

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25
Describe the auto-regulation process of blood pressure
Baroreceptors - measure stretch in the walls Brainstem - communicates with nerves which control heart & blood vessels Changes occur in HEART RATE STROKE VOLUME & BLOOD VESSEL DIAMETER, NORMAL BLOOD PRESSURE RESUMED
26
how is hypertension a +ve feedback cycle
Vascular remodelling to high blood pressure leads to thicker walls but thinner lumen diameter therefore increasing pressure
27
Which blood vessel has the highest resistance
Atrioles
28
Changes to blood flow are excecuted through chag-ing vascular tone what are the two mechanisms which are used to do this
|ntrinsic - the blood vessels in the local area themselves change Extrinsic - Some external factor
29
What are the 4 main factors to determining vascular tone
Myogenic response Endothelial secretions Vasoactive metabolites temperature
30
what is the myogenic response
when the myocytes in the vessel wall are stretched, they become depolarized and are primed to then contract. Increase in pressure causes consriction & decrease in pressure causes dilation
31
What is Raynaud's syndrome
Spasm in small arteries and blood flow is constricted
32
How does extrinsic control work
it is a higher lvel of control which overrides intrinsic controls to meet the needs of the whole body, works through vasomotor nerves & vasoactive hormones
33
Name a sympathetic and parasympathetic thingy which causes vasodilation
Noradrenaline - sympathetic | Ach - parasympathetic
34
Name 4 hormones which are involved in vasodilation/constriction
Adrenaline - both depending on what areas Vasapressin (ADH) - consrtiction Angiotension - constriction Atrial Natriuretic Peptide (ANP) - dilation
35
Which type of receptors react to adrenaline & noradrenaline where are they typically found and why
B - receptors mostly found in skeletal muscles, myocardium & liver. For fight or flight. We want active muscles, heart rate to increase & high glucose levels
36
Which area is blood moved from during fight or flight
digestive system
37
What blood pressure indicates hypertension
<140 mmHg
38
List some causes of hypertension
Smoking, Obesity, Diet, Exercise (lack of), genetic
39
What is secondary hypertension
Where there is one definite cause of high blood pressure
40
What is often caused by hypertension
atherosclerosis, stroke, myocardial infraction, heart failure, renal failure, retinopathy
41
Why does blocking the sympathetic nervous system reduce blood pressure
Stops the blood vessels from being constricted and so reduce pressureReduce affects on: Heart (B1-blockers), Blood vessels (a1-blockers). Reduce renin release from the kidney (B1-blockers)
42
List four methods of reducing blood pressure
Block the sympathetic nervous system (B - blockers) Reduce the blood volume (diuretics) Hormones to inhibit vasoconstriction Vasodilation through blocking (ca2+ channel blockers) [calcium encourages muscle to constrict]
43
How does the B-adrenoreceptor blocker propranolol affect blood pressure
Blocks B1 & B2. Blocks the B1 sympathetic tone on the heart & reduces renin release from the kidney, reduces blood pressure , heart rate & stroke volume
44
What are the side affects of B-adrenoreceptor blockers, propranolol.
Also Blocks B receptors in the lungs therefore can exacerbate asthma. Hypoglycemia, vivid dreams, intolerance to exercise
45
How do a-adrenoreceptor blockers work
they are Competitive reversible antagonists, lower blood pressure by lowering the sympathetic tone in the aterioles
46
What are the two main adverse affects of a-adrenoreceptor blockers
Postural hypotension (there is less vasoconstriction when standing up therefore less blood can go to the end when posture changes leading to dizzieness) Reflex tachycardia Can lead to impotence in men
47
What is agiotensin 2 and what does it do
It is converted from angiotensin 1 by a converting enzyme. Causes a strong constricting response from the blood vessel therefore raising blood pressure
48
ACE inhibitors do what with regards to blood pressure
lowers blood pressure, By blocking Angiotensin converting enzyme & blocking the release of aldosterone which increases blood volume
49
What does aldosterone do with regards to blood pressure
it is released from the kidney to increase blood volume which increases blood pressure
50
What are some adverse affects of ACE inhibitors
Can cause a sudden fall in blood pressure on 1st dose | persistant irritant cough
51
What are the advantages of Angiotensin 2 receptor blockers compared to ACE inhibitors
There is no associated cough
52
How do Diuretics reduce blood pressure
Reduce reabsorption of sodium which osmotically reabsorbs water therefore reducing the blood volume
53
What is the main adverse affect of diuretics
fall in K+ in plasma, which can give rise to cardiac arrhythmia
54
How do calcium channel blockers lower blood pressure
Prevent calcium entering the vascular smooth muscle cells therefore preventing their depolarisation and stopping them constricting
55
What are the adverse affects of calcium channel blockers
Headache, Constipation, Cardiac arrhythmia, gum hyperplasia
56
What is Angina Pectoris
Chest pain due to myocardial ischemia *reduction in oxygen getting to the heart) occurs due to the narrowing of coronary blood vessels
57
What are the three types of Angina
Stable angina - attacks are predictable Unstable angina - unpredictable attacks Variant Angina - unpredictable attacks
58
What is the bainbridge reflex
when more blood come back to the heart it causes stimulation of the SA node which stimulates baroreceptors in the atria causing increased heart rate
59
Name two Nitrovasodilators how they are taken and their uses
GTN: Sub-lingui; tablet or spray not orally active AMyl Nitrate: inhaled Uses to stable angina (i.e. taken immesiatley before exercise)
60
A Nitrovasodilators are pro - drugs, what is meant by this term
inactive, so must be metabolised before becoming active
61
What does Nitric Oxide do
Activates soluble guanylate cyclase (sGC), binds to oxygen binding site, activates an enzyme which converts GTP to cGMP which cause vasodilitation
62
Which blood vessel do Nitrovasodilators affect most and why is the advantageous
Dilates veins mostly, therefore decreasing the blood going back to the heart & reduce the affects of angina however if you take too much arteries will dilate giving a headache as more blood flow to the brain through cerebral arteries
63
When nitrate is taken a lot a tolerance is built up, how do we combat this tolerance
By having a nitrate - free period at night when an anginal attack is not likely
64
What affect do positive inotropic agents have on the heart
Increase the force of contraction of the heart can push with, have no affect on the rate of contraction
65
What are 4 major factors in causing heart failure
Heart rate, rilling, outflow resistance, contractile state of the heart
66
Name some symptoms of right a left ventricular failure
left - fatigue , pulmonary oedema | Right - Venous diestension - oedema - peripheral tissue synosis
67
What is the main method of treating heart failure
reduce preload / afterload or make the heart workd harder (using positive isotropes)
68
What are 5 types of drug treatments for heart failure
Diuretics, ACE inhibitor | Vasodilators (reduce preload), Low does B-blockers, Positive Inotropes
69
How does Dopamine affect the heart
acts on dopamine receptors to release noradrenaline from the sympathetic nervous system to increase the force and rate of contraction of the heart (short term)
70
How does Dobutamine affect the heart
acts on B1 & B2 adrenoceptors, increasing rate of force of the heart (short term)
71
Some drugs slow calcium being removed from the heart muscle, causing build up. what does this cause
a stronger contraction of the heart muscle
72
What does degoxin do and what are some of the adverse affects
Low theraputoc index, very toxic, cardiac arrhythmias
73
What is the affect of having low K+ in the blood
increase in likelyhood of cardiac arrhythmias

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