Heart

Question 1

Right coronary artery blood distribution

Answer 1

Inferior wall 2 3 avf

Question 2

Left ant descending artery

Answer 2

Anterior wall v1-v4

Question 3

Left circ

Answer 3

1 avl v5 v6. Lateral wall

Question 4

Lead v5 detection of ischemia

Answer 4

75% up to 90% with v4

Question 5

Acute mi after surgery with heart block. What side ruptured

Answer 5

Rca because it aupplies 90% of av node. It also supplies inferior wall

Question 6

Coronary perfusion

Answer 6

When aortic pressure is greater then lvedp

When propofol dilates arteries phenelpherine constricts and leads to increased coronary perfusion by increasing afterllad and decreasing tachycardia

Phenylepherine can constrict coronary arteries but the nitric oxide can in the coronary artery can overcome these weak affects

Question 7

Epi vs ne on receptors

Answer 7

Both have agonistic affects on alpha 1/2 and b1 but epi also exclusively acts on beta 2. You can remmeber this because epi is given for bronchospasm

Since ne acts on on alpha one and not beta 2 it results in increased sbp and dbp while epi acts on both cause an increase in sbp while decreasing diastolic

Question 8

Dopamine and renal preservation

Answer 8

Has no clinical afffect in saving kidneys

Question 9

Hypotensive and cardiogenic

Answer 9

Use ne and dobutamine

Dobutamine does b1» beta 2

Question 10

Disadvantage of dopamine

Answer 10

Tachyarryjtmias like afib

Both ne and dop stimulate alpha one

Dopamine

Question 11

Cathecholamine degradation

Answer 11

In liver its comt then mao
In nerve endings its mao then comt

Both produce bma

Question 12

Dopexamine

Answer 12

Opposite of dobutamine b2»b1

Question 13

Isopreternol

Answer 13

Used mainly for cardiac stimulation

Question 14

Dopamine vs dobutaminr

Answer 14

Dopamine more increase in tachycardia compared to doubutamine

Question 15

Dromotropy

Answer 15

Increases conductance through cardiac fibers

Question 16

Lusitropy

Answer 16

Means relaxation of the heart

Question 17

Beta receptors via

Answer 17

G protoen that turns atp to camp via adenylate cyclase. Leads to increased intracellulsr calcium

Question 18

Alpha receptor moa

Answer 18

Via phospholipasw c

Question 19

Nitric oxide moa

Answer 19

Leads to increased cgmp

No leads to methhemoglonemia

Question 20

Vasopressin

Answer 20

40 units

Increases svr

Question 21

Svr equation

Answer 21

=map-cvp/co. *80

Question 22

Nitroprusside

Answer 22

Produces met hgb by taking an electron from fe2+ to fe3+

The notroprusside molexule becomes u stable with additional hgb and breaks into five cyanide molecules and nitric oxide. The nitric oxide goes to stimulate cgmp. The cynaide then either binds to methgb to make cyanamet hgb , bind to cytochorme oxidase or bind with thiosulfate to produce thiocyanate. The thicynate js cleared by kidneys

Question 23

Nitroprusside affects on ph

Answer 23

By binding to cytochrome oxidase it prevents etc from working and causes anarrobic metabolism. This leads to increased mvo2 becUse cells cant use o2

Treatment is with sodium nitrite. The met hgn can act as a sink for cn- by the production of cyanamet hb.

Classic treatment is thiosulfate which binds to cn producing thiocyanate

Question 24

Nitroprusside and ards

Answer 24

Can cause pulm shunt that results from vasodialating hypoxic areas

Question 25

Carotid body

Answer 25

Located at the bifurcation. In by glossopharngeal out by vagus nerve. Promarily affect circulatory changes

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