Polishing Flashcards
(72 cards)
Describe the coronary venous drainage
Great cardiac vein: arises at apex, runs in AV sulcus and around to the coronary sinus. Drains territory supplied by LCA
Middle cardiac vein: runs in posterior interventricular septum
Small cardiac vein: starts on right marginal side, runs in AV sulcus to drain into coronary sinus
How can CKD cause hTn?
- Kidneys cannot filter blood as effectively
- Less sodium detected by macula densa
- Renin release
- Plus: increase in blood volume because less is filtered out
What is phaeochromocytoma?
- Tumour of chromaffin cells in adrenal gland
- Overproduction of catecholamines
How can diabetes cause hypertension (two mechanisms)
Mech 1: Hyperglycaemia damages kidneys, leading to renin release and hypertension
Mech 2: Glucose stays in blood, creating an osmotic gradient that causes hypertension
List three causes of secondary hypertension
- Phaeochromocytoma
- Chronic Kidney Disease
- Diabetes
How can hypertension damage the brain
- Vascular damage
- Increased arterial clot formation
Which muscle does the long thoracic nerve supply?
Serratus anterior
Why is the long thoracic nerve vulnerable to damage?
- Long, superficial course
What property of a pressure-volume loops tells us its compliance?
Its slope (change in volume per change in pressure)
Describe the gradient of lung ventilation from the apical to the basilar regions
Ventilation is lowest at the lung apices, and highest at the lung bases.
How does the V/Q ratio change from lung base to lung apex?
It increases
Describe the four different kinds of mechanoreceptors in the lung (and, briefly, their roles)
- Stretch receptors (Hering-Breuer reflex)
- Muscle receptors (increase respiration in response to activity)
- Juxtacapillary receptors (respond to capillary engorgement and chemicals)
- Irritant receptors (cough reflex)
What receptors are on the end of bronchopulmonary C-fibres?
Juxtacapillary receptors
Effect of obstructive/restrictive lung disease on lung volumes
Obstructive: increased reserve volume
Restrictive: all lung volumes (including TLC) decreased
Are the symptoms of a STEMI and NSTEMI different?
- No
- They are the same
Recap ECG lead placement
- Leads V1-V6:
Fourth ICS parasternal right side (V1)
Fourth ICS parasternal left side (V2)
Fifth ICS mid-clav left side (V4)
Between V2 and V4 (V3)
Anterior axilla fifth ICS (V5)
Middle axilla fifth ICS (V6) - Limb leads (traffic light):
Right Arm: Red
Left Arm: Yellow
Left Foot: Green
Right foot: Black
List two non-atherosclerotic causes of myocardial infarction
- Coronary artery dissection
- Vasospasm
List some causes of Type 2 MI
- Anaemia
- Hypotension
- Sepsis
Describe conservative treatment of peripheral vascular disease
- Risk factor reduction (weight loss, smoking cessation, exercise)
- Medication (aspirin, hTn meds, diabetes medication, statin)
Describe more invasive methods of treating peripheral vascular disease
- PCI (stent placement)
- Surgical bypass
Recall some inherited and acquired causes of hypercoagulability
Inherited:
- Factor V Leiden Mutation
- Protein C/S deficiency
Acquired:
- Pregnancy
- Malignancy
- Birth control pills
- HRT
How does oestrogen increase coagulation in pregnancy, HRT, and oral contraceptive use?
- Increased factors VII, X, XII, and XIII
- Decrease protein S
What is added to plasma in aPTT testing?
- Calcium
- Phospholipids
Describe the innervation of the visceral and parietal pleura (basic overview)
Parietal:
- Mediastinal surface: phrenic nerve
- Lateral surface: intercostal nerves
Visceral:
- Autonomic
