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1
Q

what are the 3 nasal muscles

A
  • procures
  • nasalis
  • levator labii superioris alaeque nasi
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2
Q

what is Daltons Law?

A

“total pressure (PTotal) of a mixture of gases is the sum of their individual partial pressures (Px)”

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3
Q

what is Henrys Law?

A

this states that the concentration of O2 dissolved in water is proportional to the partial pressure in the gas phase

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4
Q

where does the trachea extend from?

A

laryngeal inlet = C3
trachea begins = C6

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5
Q

what are the 2 processes of the arytenoid cartilage?

A

1- vocal process = attachment for vocal ligament
2- ,muscular process = attachment for the circo-arytenoid muscles

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6
Q

function of the infra hyoid muscles

A

depress the larynx
- sternohyoid
- thyrohyoid
- sternothyroid

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7
Q

what are the 5 laryngeal elevators?

A

digastric
mylohyoid
stylohyoid
geniohyoid
thyrohyoid

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8
Q

what 4 muscles are involved in closure of the laryngeal inlet?

A
  • salpingopharyngeus
  • palaptopharyngeus
  • stylopharyngeus
  • stylohyoid
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9
Q

what are the layers of the heart

A

endocardium
myocardium
serous pericardium
parietal pericardium
fibrous pericardium

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10
Q

exact located on SA node

A

right atrium
- located at the junction of the crista terminalis in the upper wall of the right atrium and the opening of the SVC.

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11
Q

exact location of the AV node

A

within the atrioventricular septum
near the opening of the coronary sinus

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12
Q

where are purkinje fibres located?

A

in the subendocardial surface of the ventricular walls

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13
Q

how does the parasympathetic system have a negative chronotropic effect?

A

Ach acts on M2 receptors to decrease cAMP production.
= reduces the rate of phase 1 depolarisation.
- it does this by hyperpolarsing the membrane potential which is done by increasing the extent and duration of opening of K channels, therefore increasing K conc.

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14
Q

what is the signal delay in the AV node?

how long does the signal take to reach the AV node from the SA?

A

0.09 secs

0.03

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15
Q

where is the openings of the right and left coronary artery?

A

right coronary artery = can be found on the aortic sinus of the right cusp of the aortic valve.

left coronary artery = can be found on the aortic sinus on the left cusp of the aortic valve.

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16
Q

obstruction of the right coronary artery can lead to what type of infarct

A

inferior infarct

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17
Q

obstruction of the LAD will cause what type of infarct?

A

anteroseptal infarct

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18
Q

obstruction of the circumflex artery will cause what type of infarct?

A

lateral infarct

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19
Q

what will anterior infarct cause

A

loss of left ventricle function, which can cause ventricular fibrillation.

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20
Q

where are chemo sensitive receptors located?

A

ventral surface of medulla in the BBB

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21
Q

what will the hering-breur reflex do?

A

it helps to prevent over inflation of the lungs
(it involves slowly adapting pulmonary stretch receptors)

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22
Q

what things cause an abnormal level of respiratory drive?

A
  • hypoxia
  • direct stimulation of respiratory centre
  • psychogenic
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23
Q

glomus cells

A

they are the primary site of sensory transduction in aortic and carotid bodies.

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24
Q

what are the 3 ways we classify MI?

A
  • location of infarction
  • ECG
  • cause of the infarct
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25
cause: TYPE 1 MI
spontaneous MI related to ischemia due to a primary coronary event.
26
cause: TYPE 2 MI
MI secondary to ischemia due to increase in oxygen demand or decreased supply
27
cause: TYPE 3 MI
sudden unexpected cardiac death with symptoms suggestive of MI
28
cause: TYPE 4 MI
MI associated with percutaneous coronary intervention
29
cause: TYPE 5 MI
MI associated with cardiac surgery
30
how will you diagnose MI?
Clinical History - ECG, STEMI or NSTEMI Raised cardiomyocyte markers in the blood. - Troponin T - Creatine Phosphokinase - AST - Myoglobin
31
3 causes of Ventricular Tachycardia?
1) acute LV damage 2) chronic LV damage 3) long QT interval syndrome
32
common side effects of ACE inhibitors?
cough angioneurmtic oedema NEVER IN PREGANCY renal dysfunction
33
common side effects of ARB
renal dysfunction Never in pregnancy
34
common side effects of b-blockers
bradycardia/heart block tired asthma (try not give to them)
35
common side effects of CCB
ankle oedema from amlodipine heart block from diltiziam and verampamil
36
common side effects of diuretics
hypokalaemia diabetes gout
37
what is brugarda syndrome
this is a channelopathy that that effects the way electrical signals pass through the heart
38
2 tests that look at the disturbance of cardiac rhythm?
ECG Holters test
39
what is the innate immune response characterised by?
- heat - swelling - redness - pain
40
what are 5 systemic effects of a dysregulated inflammation (SIRS)?
1) systemic vasodilation and reduced blood volume (poor organ perfusion) 2) bad O2 delivery 3) lactic acidosis, cellular dysfunction and organ damage. 4) ATP levels fall 5) mitochondria dysfunction can lead to cell death
41
what happens to the mitochondria during sepsis?
in this inflammatory disease, higher concentrations of ROS will inhibit mitochondria respiration. Mitochondria and ATP levels will then drop below a threshold that can trigger cell death.
42
what explains why people recover rapidly after sepsis?
because instead of all the mitochondria dying, they are able to adopt a low energy state, almost like hibernation during the time of the inflammation. then once the infection clears up, mitochondria will function normally again.
43
in sepsis, what happens to the electron transport chain? what effect does this have?
in disease there will be premature termination of the electron transport chain, this will lead to excess ROS production.
44
what are the 3 steps involved in the treatment os sepsis?
resuscitation (aggressive fluids targets) early antibiotics/golden hour (SEPSIS 6) triage to appropriate place of care.
45
in the triage of sepsis, what are the 3 different ward levels of care?
L1 - ward = 1 cure to 6-8 patients L2 = HDU (high dependancy unit) = 1 nurse to 3 patients L3= ICU= 1 nurse to 1 patient
46
how many people with downs will have heart defects? what are the common ones?
50% AVSD VSD ASD Patent ductus arteriosus
47
what extra genes are associated with cell migration and cell adhesion causing heart defects in Down syndrome?
DSCAM COL6A2A
48
what is locus heterogeneity and what is an example of it?
locus heterogeneity= where mutations in different places can lead to the same phenotype. Long QT syndrome, mutations in the Na or K channel can lead to the same delayed repolarisation.
49
what are 3 clinical indications of MI?
- ECG changes (ST elevation) - chest pain - raised troponin levels
50
what is the definition of cardiac rehab
the co-ordinated sum of activities required to influence favourably the underlying cause of the CVD, as well as provide the best possible physical, mental and social condition.
50
what are the national recommendations for exercise?
- 150 mins of exercise a week - reduce sedentary - relaxation - 2x strength training sessions a week
51
what are 9 psychological benefits of cardiac rehabilitation?
- improved mood - increased sex drive - reduced depressive thoughts - reduced anxiety - increased self confidence - return to work
52
what are different roadblocks as to why people to quit smoking ?
- negative moods - other smokers - triggers and cravings - time pressures
53
the health belief model looks at why someone might start changing their behaviour, what 3 things does it include?
1) individual perception 2) modifying factors 3) likelihood of action
54
what is COM-B?
this is the correct health belief model: - compatibility (an individuals physical and psychological capacity to engage in the task) - opportunity (all the factors that lie outwith the individual that make that behaviour possible) - motivation
55
what are the 4 prevention measures in disease?
primordial = factors that effects systems that determine the risk factor primary = detection and management of risk factors for future disease secondary = screening for asymptomatic patient Terry = treating the diseased patient
56
Quality of Life definition
a combination of a person physical, mental and social wellbeing, not merely the absence of disease
57
what are the 3 stages of gas exchange?
ventilation = moving gas to the site of exchange. gas exchange = capillary beds at lungs and tissues cellular respiration = cells use oxygen in processes
58
what are the features of the lungs that facilitate diffusion
- thin - permeable - moist
59
what will run through Forman caecum where is it found
- emissary veins - nasal veins - superior sagital sinus - ethmoid bone
60
what will run through the sphenopalatine Forman where is it found
- sphenopalatine nerve - nasopalatine nerve - superior nasal nerve - between sphenoid and ethmoid bone
61
what will run through the incisive canal?
- nasopalatine artery - greater palatine nerve
62
what are the 4 arteries that will anastomose at the Kiesselbach area?
- anterior ethmoidal - sphenopalatine artery - greater palatine artery - superior labial artery
63
3 branches of the ophthalmic nerve?
nasociliary anterior ethmoidal lateral and septal nasal branches
64
maxillary nerve divisions
nasopalatine greater palatine
65
what are the 2 muscles of the pharyngeal opening and what happens when they contract ?
salpingopharyngeus tensor villi palatini - when either muscle contracts, this will create positive pressure in the oral cavity. so air will open the pharyngotympanic tube and flow into the middle ear cavity.
66
how do you get mouth breathing?
inflammation and swelling of the pharyngeal tonsils may obstruct the airway and lead to mouth breathing. it may result in adenoid face which refers to the appearance of the face which appears from persistent adenoid hypertrophy.
67
what may enlargement of the tubal tonsils cause?
may obstruct the pharyngotymapanic tube and cause middle ear infections.
68
describe the innervation of the nasal cavity?
V1= ophthalmic (anterior) V2= maxillary (posterior) olfactory
69
what are the intrinsic ligaments of the larynx?
fibro elastic membrane vocal ligaments vestibular ligaments
70
apart from drugs what can be used during end of life care?
pets music aroma therapy gentle touch
71
what are he borders of the safety triangle?
lateral border = pec major anterior border = pec minor apex = axilla base = nipple
72
what are the boundaries of the oblique fissure?
posterior y = T3/T4 LATERALLY = mid axillary line anterior = rib 6
73
what will pass through the esopogeal hiatus?
oesophagus right and left vagus trunks oesophageal branches of left gastric vessels
74
LYMPAHTICS OF LARYNX
above vocal fold = superior deep cervical below vocal folds = pre and para trachea
75
laryngospams
stimulation of internal superior laryngeal fibres, triggering reflex closure of the airway
76
aspiration pneumonia
compromised swollowing co-ordination often due to a stroke or neurological conditions
77
what are the principles of care in the last days?
1) informative, timely and sensitive communication 2) descsions about a persons care should be made by a multidisciplinary team 3) each persons physical, psychological, social and spiritual needs should be taken Ito consideration 4) consideration should be given to the well being of the patients.
78
where would you listen for pulmonary valve stenosis?
and ejection systolic murmur will be heard in the upper left sternal angle.

MD3001resp (41 decks)

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