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Cardio Year 2 > Introduction to Cardiovascular Medicine > Flashcards

Introduction to Cardiovascular Medicine Flashcards

1
Q

3 major coronary arteries and what they supply

A

LAD- anterior left ventricle and anterior 2/3 septum

Left circumflex- lateral wall of LV

Right Coronary Artery- Right ventricle, inferior LV, posterior 1/3 septum

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2
Q

left coronary arteries are a branch of what?

A

left main coronary artery

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3
Q

blood supply of conduction system?

A

Sinus node- right coronary artery or left circumflex

AV node- posterior descending artery

Hi-purkinje- anterior 2/3 done by LAD, posterior 1/3 by PDA

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4
Q

vagal efferents to heart

A

distributed to sinus and AV nodes

primarily cause decrease in HR

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5
Q

sympathetic efferents to heart

A

wide distribution

increase HR, conduction velocity, contractility

cause vasoconstriction via a-adrenergics

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6
Q

p cells

A

sinus and av node cells

simple structure, few sarcomeres, undifferentiated junctions

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7
Q

difference in APs in between nodes and muscles?

A

refer to notes

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8
Q

diagram the ionic flow in the muscle during contraction and relaxtion

A

refer to notes

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9
Q

diagram Ca’s interaction with troponin and how it results in muscle contraction

A

refer to notes

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10
Q

carotid sinus massage

A

manual carotid body massage which induces parasympathetic surge

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11
Q

describe the baroreflex system in the cardiovascular system

A

stretch in carotid or aortic sinus

afferent fibers (hering/glossopharyngeal or vagal respectively)

nucleus tractus solitarius

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12
Q

preloads effect on tension generation. how does inotropy affec this?

A

greater preload = greater stretch in muscle fibers = greater sarcomere overlap = greater ability to generate tension = greater CO

increased ionotropy will increase CO at a given heart size

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13
Q

inotropy

A

the force and velocity of myocardial contraction independent of initial length

related to rate and amount of intracellular Ca influx

more Ca = greater myosin and actin interaction = more force

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14
Q

afterload. how is it related to blood pressure?

A

tension developed by a muscle after it starts to contract

related by law of laplace

T = P x r / (2wall thickness)

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15
Q

easiest way to decrease afterload. how can this be calculated

A

decrease system vascular resistance

SVR = BP- CVP/ CO

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16
Q

phases of diastole

A

begins before LV ejection is complete- triggered by reuptake of Ca- “lusitropy”

isovolumic relaxation- no valves open. ends when LV P falls below LA

Rapid filling- most LV filling occurs right after mitral valve opens. determined by LA pressure, LV compliance, LV elastic recoil

diastasis- little volume change occurs

atrial kick- LA contraction

17
Q

draw the cardiac cycle

A

refer to notes

18
Q

ejection fraction

A

SV/EDV

19
Q

determinants of LV systolic fxn

A

preload, contractility, peripheral vascular tone

20
Q

determinants of LV diastolic fxn

A

lusitropy, LA pressure, LV compliance, HR, atrial contraction

21
Q

draw 3 different LV function curves

A

refer to notes

22
Q

swan ganz catheter

A

balloon inflated in pulmonary tree and finds pulmonary wedge pressure, roughly equivalent to LV diastolic pressure or LA pressure

normal is 0-12

23
Q

what can be see on chest xray

A

cardiac enlargement- heart failure

increased pulmonary venous pressure- redistribution of blood to upper lung fields and pulmonary edema as fluffy infiltrates

24
Q

echocardiogram and terms

A

ultrasound of heart

hypokinesis- less movement than expected

akinesis- no movement

dyskinesis- segments move in opposite direction than expecgted

25
Q

sympathetic squeeze

A

systemic vasconstriction forces blood into pulmonary compartment, blood, and brain

increases BP

26
Q

normal CVP

A

0-5 mmHg

27
Q

3 regulators of circulation

A

total blood volume (renal blood flow, angiotensin 2, aldosterone, ADH, ANP, renal sympathetic tone)

cardiac function (BV, sympathetic tone of heart, arteries and venous system, cardiac hypertrophy)

PVR (venous tone affects volume in periphery and pulmonary trees; arteries affects flow)

28
Q

3 types of cardiac stress

A

volume load- LV needs to increase SV

pressure load- LV needs to generate more P

underloading- LV is insufficintly filled

29
Q

types of adaptations to cardiac stress

A

sympathetic stimulation- increased HR, contractility, vasotone

salt and water retention

cardiac hypertrophy

30
Q

2 types of cardiac hypertrophy

A

volume load- causes eccentric hypertrophy- bigger heart, sarcomeres added in series

pressure load- concentric hypertrophy, sarcomeres added in parallel

31
Q

physiological stressors

A

valsalva (increased intrathoracic pressure)

hemorrhage

erect posture (orthostatic)

digestion

temp regulation

32
Q

2 types of exercise stressors/adaptations

A

isotonic- volume load- eccentric LVH- endurance

isometric- pressure load, concentric LVH- strength

Cardio Year 2 (4 decks)

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