ILA 3 - Chest Pain Flashcards
The maintenance of blood pressure is an important homeostatic function of the cardiovascular system.
Which of the following best describes the relationships of blood pressure (BP) & systemic vascular resistance (SVR) with the sympathetic nervous system?
A. Sympathetic nerves decrease peripheral blood vessel diameter thereby decreasing systemic vascular resistance and decreasing blood pressure.
B. Sympathetic nerves decrease peripheral blood vessel diameter thereby increasing systemic vascular resistance and increasing blood pressure.
C. Sympathetic nerves do not influence peripheral blood vessel diameter and have no effect on systemic vascular resistance and blood pressure.
D. Sympathetic nerves increase peripheral blood vessel diameter thereby decreasing systemic vascular resistance and decreasing blood pressure.
E. Sympathetic nerves increase peripheral blood vessel diameter thereby increasing systemic vascular resistance and increasing blood pressure.
B. Sympathetic nerves decrease peripheral blood vessel diameter thereby increasing systemic vascular resistance and increasing blood pressure.
Sympathetic stimulation of the peripheral blood vessels causes vasoconstriction which decreases their diameter thus increasing their vascular resistance and increasing the blood pressure.
BP = CO x SVR
The end diastolic volume (EDV) in the average healthy person’s left ventricle is 120mls.
If we assume normal ventricular function, what would you expect the end systolic volume (ESV) to be?
A. 0mls
B. 10mls
C. 50mls
D. 70mls
E. 100mls
C. 50mls
EDV of 120 mls.
Stroke volume of 70 mls in the average person
Leaving an ESV of 50 mls
Cardiac arrythmias can complicate a myocardial infarction.
Which artery most frequently supplies the AVN?
A. Left anterior descending artery
B. Left circumflex artery
C. Left coronary artery
D. Posterior descending artery
E. Right coronary artery
E. Right coronary artery
The RCA supplies the area above including both SA & AV nodes.
The LAD supplies most of the area below the AV conducting system, the His-Purkinje system.
During pregnancy the foetal circulation is adapted to developing in-utero.
What is the purpose of the Ductus Arteriosus in the foetal cardiovascular system?
A. allow blood to bypass the foetal Liver by shunting maternal blood to the Inferior Vena Cava.
B. allow blood to bypass the foetal lungs by shunting it from the Pulmonary Artery to the Aorta
C. allow blood to bypass the foetal lungs by shunting it from the Right Atrium to Left Atrium.
D. allow blood to bypass the foetal systematic circulation by shunting it from the Aorta to the Pulmonary Artery.
E. allow blood to bypass the foetal systemic circulation by
B. allow blood to bypass the foetal lungs by shunting it from the Pulmonary Artery to the Aorta
Which of the following equations calculates Cardiac Output?
A. heart rate ÷ mean blood pressure
B. heart rate ÷ stroke volume
C. mean blood pressure ÷ systemic vascular resistance
D. mean blood pressure x stroke volume
E. mean blood pressure x systemic vascular resistance
C. mean blood pressure ÷ systemic vascular resistance
Mean blood pressure = Cardiac output x systemic vascular resistance
Cardiac output = Heart rate x Stroke volume
Thrombosis is a major cause of coronary artery disease.
Occlusion of which artery below is most likely to result in a fatal heart attack?
A. Left anterior descending artery
B. Left circumflex artery
C. Left main coronary artery
D. Right circumflex artery
E. Right main coronary artery
C. Left main coronary artery
Occlusion of the left main coronary artery - it supplies the largest area of heart muscle via its many branches including the left circumflex and LAD.
Heart failure is a possible complication of myocardial damage.
Which of the following best describes the finding of pulmonary oedema in the presence of a normal central venous pressure?
A. biatrial failure
B. biventricular failure
C. left heart failure
D. respiratory failure
E. right heart failure
C. left heart failure
A raised central venous pressure is a reflection of right sided heart failure. Respiratory failure can lead to right heart failure.
Left sided heart failure causes and increase in pulmonary pressure leading to pulmonary oedema.
A 20-year-old patient attends the emergency department with an acute onset of supraventricular tachycardia requiring electrical cardioversion.
Which of the following best describes the normal pathway of conduction through the heart?
A = Sino Atrial Node (SAN)
B = Bundle of his
C = Contraction of the atria
D = Purkinje fibres
E = Atrio Ventricular Node (AVN) ]
F = Contraction of the ventricles
A, C, E, B, D, F
The maintenance of blood pressure is an important homeostatic function of the cardiovascular system.
Which of the following best describes the relationships of blood pressure (BP) & systemic vascular resistance (SVR) with the parasympathetic nervous system?
A. Parasympathetic nerves decrease peripheral blood vessel diameter thereby decreasing systemic vascular resistance and decreasing blood pressure.
B. Parasympathetic nerves decrease peripheral blood vessel diameter thereby increasing systemic vascular resistance and increasing blood pressure.
C. Parasympathetic nerves do not have a major influence on peripheral blood vessel diameter as blood vessels do not have parasympathetic innervation.
D. Parasympathetic nerves increase peripheral blood vessel diameter thereby decreasing systemic vascular resistance and decreasing blood pressure.
E. Parasympathetic nerves increase peripheral blood vessel diameter thereby increasing systemic vascular resistance and increasing blood pressure.
C. Parasympathetic nerves do not have a major influence on peripheral blood vessel diameter as blood vessels do not have parasympathetic innervation.
There is no parasympathetic innervation of blood vessels.
A 72-year-old patient is diagnosed with severe mitral valve stenosis.
An increase in which of the following is consistent with mitral valve stenosis?
A. Left atrial end-diastolic pressure
B. Left atrial end-systolic pressure
C. Left ventricular end-diastolic pressure
D. Left ventricular end-systolic pressure
E. Mean aortic pressure
B. Left atrial end-systolic pressure
Mitral stenosis causes an increased resistance to blood flow across the valve therefore a higher pressure is required to force blood from atrium to ventricle i.e. a higher left atrial end systolic pressure.
Patients with chronic obstructive pulmonary disease (COPD) can develop pulmonary hypertension.
Which of the following is most likely to complicate severe pulmonary hypertension?
A. biatrial failure
B. biventricular failure
C. isolated septal hypertrophy
D. left heart failure
E. right heart failure
E. right heart failure
Severe pulmonary hypertension means the right ventricle has to work harder to pump blood through the pulmonary artery. Ultimately the right ventricle is unable to generate sufficient pressure and therefore starts to fail.
The pericardium is a double walled sac that surrounds the heart.
Which nerve innervates the pericardium?
A. Internal Thoracic nerve
B. Medial Pectoral nerve
C. Phrenic nerve
D. T2-T4 intercostal nerves
E. Vagus nerve
C. Phrenic nerve
A 83 year old patient develops shortness of breath, severe peripheral oedema and ascites following a recent heart attack.
Which of the following best describes the aetiology of their signs and symptoms?
A. biatrial failure
B. biventricular failure
C. isolated septal hypertrophy
D. left heart failure
E. Right heart failure
B. Biventricular failure
With regard to the normal cardiac cycle.
Which of these following statements is correct?
A. Atrial contraction occurs before the P-wave on ECG
B. Atrial systole corresponds to closure of the tricuspid valve
C. For part of the cardiac cycle, both atrial and ventricular diastole occur together
D. Ventricular systole corresponds to closure of the pulmonary valve
E. Ventricular volume increases during ventricular systole
C. For part of the cardiac cycle, both atrial and ventricular diastole occur together
Atrial systole opens the tricuspid valve
P wave precedes atrial contraction
Ventricular systole opens the pulmonary valve
Ventricular volume decreases during systole
Both atria and ventricles are in diastole during the isovolumetric ventricular relaxation phase of the cardiac cycle.
Acute heart failure can be a complication following myocardial infarction.
An increase in which of the following pressures signifies left heart failure?
A. Left atrial end-diastolic pressure
B. Left atrial end-systolic pressure
C. Left ventricular end-diastolic pressure
D. Left ventricular end-systolic pressure
E. Mean aortic pressure
C. Left ventricular end-diastolic pressure
In heart failure there is reduced contractility therefore there will be a reduction in stroke volume so end diastolic volume and end diastolic pressure will be increased.
