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CVS Questions 1) State the anatomical location of the heart 2) Where is the transverse sinus of the heart located? 3) Describe the layers of the pericardium from outside to inside, including the cavity 4) What is meant by cardiac tamponade? 5) Do you understand the difference between systole & diastole? 6) Which property of arteries allows them to recoil? 7) Describe the structure of arteries from outside to inside 8) What is an end artery? 9) What are venae comitantes? 10) The heart contracts isovolumetrically. What is meant by this? 11) What is heard during the 1st, 2nd and sometimes 3rd heart sounds? 12) What is a heart murmur? 13) Give the equation for cardiac output 14) Draw label the primordial heart 15) Match the atria on the left with the embryological parts which make them up on the right Left atrium Right atrium Develops from most of primitive atrium Develops from a small portion of primitive atrium Absorbs proximal part of pulmonary veins Sinus venosus 16) Arteries of the body begin as bilaterally symmetrical arched vessels. These remodel to create the major arteries of a newborn. Which arch forms the arch of the aorta & the proximal part of the right subclavian artery? Which arch forms the right pulmonary artery and the left pulmonary artery? 17) The left recurrent laryngeal nerve loops around the arch of the aorta. Why is this clinically significant? 18) Briefly describe atrial septation 19) Briefly describe ventricular septation 20) How is foetal circulation different to that of a newborn? 21) What are the names of the remnants of the following embryological structures when in an adult? Foramen ovale Ductus arteriosus Ductus venosus Umbilical vein 22) How do left to right heart shunts and right to left heart shunts differ? 23) Match the following congenital defects with their descriptions: Patent ductus arteriosus Pulmonary atresia Aortic lumen is narrow in the region of the ligamentum arteriosum. This increases the afterload on the left ventricle and can lead to left ventricular hypertrophy Blood flows from the higher pressure aorta into the lower pressure pulmonary artery. This can overload the pulmonary circulation Blood cannot leave the right ventricle because the pulmonary valve is absent. Blood moves from the right to the left atrium, into the aorta and though the ductus arteriosus into the lungs 4 factors: ventricular septal defect, overriding aorta, pulmonary stenosis & right ventricular hypertrophy, leading to a cyanotic defect (atresia means it’s not there) Coarctation of the aorta (coarctation means narrowing) Tetralogy of Fallot 24) Draw and label the ventricular action potential 25) Draw and label the SAN action potential 26) Explain how Ca2= causes cardiac muscle contraction 27) Give 3 examples of the effects of increased sympathetic activity on the CVS 28) Define flow and velocity and describe the two types of flow 29) Fill in blanks: resistance increases as viscosity … … or radius … … 30) Explain how arteries can adapt to prevent turbulent flow 31) Why is there a high pressure in arteries? 32) Draw a graph of pressure against to show a distensible and rigid tube 33) Define total peripheral resistance 34) At what stage of the cardiac cycle does blood flow into the arteries? 35) What is pulse pressure and therefore if a patient has a blood pressure of 130/85mmHg, what is their pulse pressure? 36) What would be the average pressure of this patient? 37) How is blood supply to tissues autoregulated? 38) What is central venous pressure and what does it show clinically? 39) What happens to arterial and venous pressures and therefore cardiac output when you eat a meal? 40) How do IV fluids increase blood pressure and where would adrenaline enter this pathway? 41) Give equations for CO and BP 42) To increase ventricular filling would you increase arterial pressure or venous pressure? 43) Define Starling’s Law and draw curve 44) When we exercise, venous pressure increases due to muscle contraction. What protective mechanism does the body use to stop this overfilling the heart and causing pulmonary oedema? 45) How does our body stop postural hypotension from happening? 46) What is auto-tranfusion? 47) What is the total CO of an average person? 48) Give some adaptations of pulmonary circulation 49) Describe tissue fluid formation using Starling’s forces 50) Why does a patient with pulmonary oedema sit up and how is it treated? 51) Give some adaptations of cerebral circulation 52) Hypercapnia causes vaso….. Hypocapnia causes vaso….. 53) Explain basis of ECG-why and what can we see 54) List the 8 things to look at when interpreting an ECG 55) Explain what is happening in heart at p wave, qrs and t wave 56) Draw where 6 limb leads view heart from 57) Where are 4 limb cables and 6 chest cables placed on body? 58) Name four types of rhythmic disturbances of the heart 59) Give two causes of these arrhythmias 60) Name the four classes of anti-arrhythmic drugs with an example of each 61) Explain the mechanism of action of lidocaine 62) Why would you give propranolol after an MI? 63) How does a Ca2+ channel blocker work? 64) Give two conditions in which there’s an increased risk of thrombus formation 65) Define hypertension and explain two ways of treating it 66) Why does a patient with angina experience chest pain on exertion? 67) What is the primary action of GTN spray? 68) Define heart failure 69) Would right or left heart failure present with shortness of breath and pulmonary crackles? 70) What is systolic dysfunction and what are some consequences of it? 71) How do neuro-hormonal systems respond to heart failure? 72) Give two ways to treat heart failure by increasing inotropy to increase CO 73) How else could you treat heart failure? 74) A 45 year female presents to A and E with chest pain. Give 5 differential diagnoses 75) What are the modifiable risk factors for ischaemic heart disease? 76) What is chronic stable angina? 77) Describe an exercise stress test 78) Complete table Stable Unstable Non-STEMI Degree of occlusion ECG changes Presence of biomarkers Treatment 79) If an ECG has ST elevation in views V1-V4, which coronary artery is occluded? 80) What does this ECG show? STEMI 81) What does this ECG show? 82) Shock is a caused by poor perfusion throughout the body due to a fall in arterial pressure. What conditions can cause poor regional perfusion? 83) Name three types of circulatory shock with examples 84) What is disruptive shock?