1.Platelets contain alpha and dense granules.

Activated platelets excrete the contents of these granules into their canalicular systems and into surrounding blood. There are three types of granules:

dense (or delta) granules (containing ADP or ATP, calcium, and serotonin) lambda granules similar to lysosomes and contain several hydrolytic enzymes. Alpha granules (containing P-selectin, platelet factor 4, transforming growth factor1, platelet-derived growth factor, fibronectin, B-thromboglobulin,vWF, fibrinogen, and coagulation factors V and XIII). 2. which region of the developing embryo becomes the neural plate: dorsal lip region
-invagination of the neural plate results in formation of what structure:neural groove -neural folds on either side of the neural groove fuse to form what critical structure:neural tube -neurulation takes place during what week of embryonic development:4th week -an increase in what protein marker is often seen with neural tube defects:alpha-fetoprotein (AFP) -what disease is associated with low-maternal AFP:down syndrome -caudal neural tube defects can be prevented by maternal consumption of what vitamin:Folate -which antiepileptic drug is associated with neural tube defects: valproic acid -which groove separates the alar and basal plates :Sulcus limitans -which plate contains neurons with afferent functions:Dorsally located alar plate -which plate contains neurons with efferent functions:ventrally located basal plate -what are the 3 primary vesicles from rostral to caudal Prosencephalon Mesencephalon Rhombencephalon

-which structures are considered part of the CNS:brain, spinal cord, olfactory bulb and tract, optic nerve, and retina -which structures make up the PNS:cranial nerves III-XII, spinal nerves, and autonomic ganglia and nerves -from which embryologic origin are the cells of the PNS derived :Neural crest cells -what cell types and tissues are derived from neural crest cells :pseudounipolar neurons of pripheral ganglia, schwann cells, neurons of autonomic ganglia, leptomeninges, chromaffin cells of adrenal medulla, melanocytes, odontoblasts, parafollicular C cells, pharyngeal arches, and aorticopulmonary septum -what re the 3 divisions of the autonomic nervous system Sympathetic Parasympathetic Enteric -which tissues are innervated by the ANS:smooth muscle, cardiac muscle, and glands -which divisions of the ANS is responsible for the fight-or-flight response:Sympathetic Deep Lymph Nodes 1. Submental 2. Submandibular (Submaxillary)

Anterior Cervical Lymph Nodes (Deep) 3. Prelaryngeal 4. Thyroid 5. Pretracheal 6. Paratracheal

Deep Cervical Lymph Nodes 7. Lateral jugular 8. Anterior jugular 9. Jugulodigastric

Inferior Deep Cervical Lymph Nodes 10. Juguloomohyoid 11. Supraclavicular (scalene)

Heat Loss Factors affecting heat loss include:

wind (heat loss is more rapid in wind) humidity (heat loss is less in high humidity) radiation (70% of the bodys heat loss can occur through an uncovered head) convection (heat loss from convection can be reduced by proper clothing).

A number of factors predispose a person to hypothermia. These include:

being immobilised (e.g. being trapped or suffering a stroke and lying outside all night) being seriously injured (e.g. major burns or spinal cord injuries) being very young or very old being under the influence of alcohol being involved in endurance activities being unconscious.
White fibrocartilage consists of a mixture of white fibrous tissue and cartilaginous tissue in various proportions. It owes its flexibility and toughness to the former of these constituents, and its elasticity to the latter. It is the only type of cartilage that contains type I collagen in addition to the normal type II. Fibrocartilage is found in the pubic symphysis, the annulus fibrosus of intervertebral discs, menisci, and the TMJ. During labor, relaxin loosens thepubic symphysis to aid in delivery, but this can lead to later joint problems.

primary ossification center is in diaphysis secondary ossification center is in epiphysis Low voltage is produced by: 1.The damping effect of increased layers of fluid, fat or air between the heart and the recording electrode 2.Loss of viable myocardium 3.Diffuse infiltration or myxoedematous involvement of the heart Specific causes of low voltage include: Pericardial effusion Pleural effusion

Obesity Emphysema Pneumothorax Contrictive pericarditidis Previous massive MI End-stage dilated cardiomyopathy Infiltrative myocardial diseases i.e. restrictive cardiomyopathy due to amyloidosis, sarcoidosis, haemochromatosis Scleroderma Myxoedema

in fasting state muscle releases alanine which gives gluconeogenic substrate pyruvate and an amino group for urea synthesis Glycogen storage disease type II (also called Pompe disease or acid maltase deficiency) is an autosomal recessive metabolic disorder, which damages muscle and nerve cells throughout the body. It is caused by an accumulation of glycogen in the lysosome due to deficiency of the lysosomal acid alpha-glucosidase enzyme. It is the only glycogen storage disease with a defect in lysosomal metabolism.... The usual presenting features are cardiomegaly (92%), hypotonia (88%), cardiomyopathy (88%), respiratory distress (78%), muscle weakness (63%), feeding difficulties (57%) and failure to thrive (53%). Mesoderm components MESODERM: Mesothelium (peritoneal, pleural, pericardial)/ Muscle (striated, smooth, cardiac) Embryologic Spleen/ Soft tissue/ Serous linings/ Sarcoma/ Somite Osseous tissue/ Outer layer of suprarenal gland (cortex)/ Ovaries Dura/ Ducts of genitalia Endothelium Renal Microglia Mesenchyme/ Male gonad

Work of Breathing

1.

Components of Work o elastic work - work to overcome: lung elastic recoil thoracic cage displacement abdominal organ displacement o frictional work - work to overcome: air-flow resistance (major) viscous resistance (lobe friction, minor) o inertial work - work to overcome: acceleration and deceleration of air (negligible due to low mass of air) acceleration and deceleration of chest wall and lungs (negligible due to overdamping

na 142 k 4.5 hco3 26 cl 103 ca2.5

. Diameter (nm) % protein % cholesterol % phospholipid % triacylglycerol & cholesterol ester 4 8 31 50 84

Density (g/mL) Class

>1.063 1.0191.063 1.0061.019 0.951.006 <0.95

HDL LDL IDL VLDL

515 1828 2550 3080

33 25 18 10 <2

30 50 29 22 8

29 21 22 18 7

Chylomicrons 100-1000

Choroid plexus is present in all components of the ventricular system except for the cerebral aqueduct, [1] [1] frontal horn of the lateral ventricle, and occipital horn of the lateral ventricle.

Choroid plexus

It is found in the superior part of the inferior horn of the lateral ventricles. It follows up along this boundary, continuous with the inferior of the body of the lateral ventricles. It passes into the interventricular foramen, and is present at the top of the third ventricle. There is also choroid plexus in the fourth ventricle, in the section closest to the bottom half of the cerebellum.

Omenta
Sources Structure From To Contains

Dorsal mesentery

Greater omentum Greater curvature of stomach (andspleen)

Transverse colon

Gastrosplenic ligament

Stomach

Spleen

Short gastric artery, Left gastro-omental artery

Gastrophrenic ligament

Stomach

Diaphragm

Left inferior phrenic artery

Gastrocolic ligament

Stomach

Transverse colon

Right gastro-omental artery -

Splenorenal ligament

Spleen

Kidney

Splenic artery, Tail of pancreas

Ventral mesentery

Lesser omentum

Lesser curvature of the stomach (andduodenum)

Liver

The right free margin-hepatic artery, portal vein, and bile duct. Along the lesser curvature of the stomach-left and right gastric artery.

Hepatogastric ligament

Stomach

Liver

Right and left gastric artery

Hepatoduodenal ligament [edit]Mesenteries

Duodenum

Liver

Hepatic artery proper, hepatic portal vein, bile duct, autonomic nerves

Sources

Structure

From

To

Contains

Dorsal mesentery

Mesentery proper

Small intestine (jejunum and ileum)

Posterior abdominal wall

Superior mesenteric artery

Transverse mesocolon

Transverse colon

Posterior abdominal wall

Middle colic

Sigmoid mesocolon

Sigmoid colon

Pelvic wall

Sigmoid arteries

Mesoappendix

Mesentery of ileum

Appendix

Appendicular artery

[edit]Other ligaments and folds Sources Structure From To Contains

Ventral mesentery

Falciform ligament Liver

Thoracic diaphragm, Round ligament of liver, paraumbilical anterior veins abdominal wall

Left umbilical Round ligament of Liver vein liver

Umbilicus

Ventral mesentery

Coronary ligament Liver

Thoracic diaphragm

Ductus venosus

Ligamentum venosum

Liver

Liver

Phrenicocolic

Left colic Thoracic

ligament

flexure

diaphragm

Ventral mesentery

Left triangular ligament, right Liver triangular ligament

Umbilical folds

Urinary bladder

Ileocecal fold

Ileum

Cecum

Broad ligament of the uterus

Uterus

Pelvic wall

Mesovarium, mesosalpinx, mesometrium

Ovarian ligament

Uterus

Inguinal canal

Suspensory ligament of the ovary

Ovary

Pelvic wall

Ovarian artery

In addition, in the pelvic cavity there are several structures that are usually named not for the peritoneum, but for the areas defined by the peritoneal folds:
Name Location Genders possessing structure

Rectovesical pouch

Between rectum and urinary bladder

Male only

Rectouterine pouch

Between rectum and uterus

Female only

Vesicouterine pouch

Between urinary bladder and uterus

Female only

Pararectal fossa

Surrounding rectum

Male and female

Paravesical fossa

Surrounding urinary bladder

Male and female

Nerve supply to peritoneum:

Nerve supply to Parietal peritoneum: Parietal peritonem is sensitive to pain, temperature, touch and pressure. It is innervated in accordance to the region where it exists, as explained below;

The parietal peritoneum lining the anterior abdominal wall is supplied by lower six thoracic and first lumbar nerves. It should be kept in mind that these are the same nerves that supply the muscles and skin of the anterior abdominal wall.

In the region of diaphragm, the nerve supply is different. The central part of the diaphragmatic peritoneum is innervated by phrenic nerves. Peripherally, the nerve supply comes through the lower six thoracic nerves.

In the pelvic region, the parietal peritoneum is mainly supplied by the obturator never, which is a branch of the lumbar plexus.

Nerve supply to visceral peritoneum: Unlike the parietal peritoneum, the visceral peritoneum is sensitive only to stretch and tearing. The sensations of touch, pressure or temperature are absent. The sensation of pain arises secondary to tearing and is very limited. It is of less severe nature and is referred to an area of abdominal wall according to the affected region of intestinal tract. The nerve supply comes through the autonomic afferent nerves that supply the underlying viscera or the ones that travel in the mesenteries. Over distension of a viscus causes stretch of visceral peritoneum and leads to pain.
1.

The cavernous sinus comprises one or more venous channels (sometimes a plexus). * It is located in a dural compartment bounded by the body of the sphenoid bone and the anterior portion of the tentorium. In addition to the venous channels, the dural compartment contains (outside the endothelium) the internal carotid artery, sympathetic plexus, abducent nerve, and, further laterally, the oculomotor, trochlear, and ophthalmic nerves

2. The middle cerebral artery, the larger terminal branch of the internal carotid artery, is frequently regarded as the continuation of that vessel. It passes laterally in the lateral fissure and gives rise to numerous branches on the surface of the insula. Small, central branches (lenticulostriate arteries) enter the anterior perforated substance, supplying deeper structures of the hemispheres and are liable to occlusion (lacunar strokes) or rupture (Charcot's "artery of cerebral hemorrhage"). It supplies the motor and premotor areas and the sensory and auditory areas. It also supplies the language areas in the dominant hemisphere.Occlusion of the middle cerebral artery causes a contralateral paralysis (hemiplegia) and a sensory defect. The paralysis is least marked in the lower limb (territory of anterior cerebral artery). When the dominant (usually left) side is involved, there are also disturbances of language (aphasia).

3. The brain is supplied by the two internal carotid and the two vertebral arteries. 4. The subarachnoid space communicates with the fourth ventricle by means of apertures: a
median (Magendie) one and two lateral (Luschka) ones.

5. The ciliary, pterygopalatine, otic, and submandibular ganglia are associated with certain of
the cranial nerves. In these ganglia, parasympathetic fibers synapse, whereas sympathetic and other fibers merely pass through.

1. Hepatic hemengioma is associated with: A. Vinyl Chloride. 2. Which of the disease is common in I/V drug abusers: A. Infective Endocarditis. 3. Typhoid carriers are: A. Usually asymptomatic. 4. Intestinal metaplasia due to reflux esophagitis leads to: A. Adenocarcinoma. 5. Embryological marker that reappears in circulation in Ca Colon is: A. CEA. 6. Which of the following is peculiar for crohn`s disease is: A. Perianal Lesions. 7. Anemia of pregnancy is due to: A. Increase plasma volume. 8. Major complication of severe burn: Formation of granulation tissue. Carcinoma formation. 9. What is Inappropriate about hyper parathyroidism: A. There is increase PO4 renal absorption. 10. A 25 year old lady complaining of palpitations, heat intolerance on examination her pulse is 112b/min, BP 120/80, R/R 20 br/min. She is most probably a case of: A. Hyperthyroidism. 11. Resection of Anterior lobe of pituitary will lead to: A. Decrease glucocorticoids. 12. A 6 year old boy is complaining of proximal muscular weakness was found to be Ca++ channel antibodies positive. The most probable diagnosis is: Lambert Eaten Syndrome. Mysthenia Gravis. 13. In pulmonary embolism, respiratory failure is due to: A. Ventilation / perfusion mismatch. 14. Left ventricular failure will lead to: A. Increase pulmonary arteriolar Pressure. 15. Immediate effect after injury to a vessel is: Vasoconstriction 16. Effects of hyper parathyroidism in Ca. lung is due to: Parathyroid like protein Parathyroid hormone 17. Spleenectomy will help in treating which type of anemia: A. Hereditary Spherocytosis. 18. Malignant Tumor that will not metastasize: A. Basal cell carcinoma.

19. Achlasia is due to: A. Absence of Myenteric plexus. 20. After a traffic accident a lady is brought to a hosp the IMMEDIATE step you do: A. Clear airway. 21. Ameobic infection reaches lungs via: Direct extension from liver. By aspiration of ova of Entameoba histolitica. By aspiration of trophozoits of Entameoba histolitica. Via Portal vein. 22. In Hypothyroidism there is increase in: A. Cholesterol 23. In thyroid disease the antibodies are directed against: A. Thyroglobin. Limbic system: A ring shaped collection of structures including hypothalamus, pituitary gland, thalamus, amygdala, and hippocampus, Plays important role in expression of survival instincts, drives and emotions. They mediate effects of mood on external behavior and play a vital role in keeping conditions inside your body constant. Smell information enters directly into your limbic system which is why smells are often associated with strong memories and emotions and also depicts sexual and sensual feelings both in male and female. Also known as mammalian brain, because it is thought to have emerged in mammals

The phrayngeal Pouches i created a formula for them ... 1A, 2P, 3 TIP, 4 SPUB It might seem even more difficult but let me explain ... 1A .. 1 for the 1st letter of Alphabet which is A stands for Auditory ... So, 1st Pouch gives the epithelial lining of Auditory tube and middle ear cavity 2P ... 2 for the 2nd letter of the Alphabet which is the P ... for Palatine ... So, 2nd pouch gives the epithelial lining of cryPts of Palatine tonsil 3 TIP ... 3 then 3 letters TIP & start with T of Three ... these letters are the

abbreviations given in kaplan for those derivatives and stands for Thymus and Inferior Parathyroid gland 4 SPUB ... 4 then 4 letters SPUB ... Also the abbreviations given in the notes for Superior Parathyroid gland and Ultimobranchial Body The Arches ... The Nerves ... March 1975 i.e. 1975 = X, IX, VII, V and March to remember it is V3 .... Arrange them .... Arch 1 gives V3, 2 gives VII, 3 gives IX and both 4 & 6 will have X The Arteries ... 1st - part of MAXillary a. -------------- 1st arch is MAXimal 2nd- Stapedial a. & Hyoid a. ------- Second for Stapedial 3rd- Common Carotids and parts of internal Carotids ---- C is the 3rd letter of Alphabet 4th- on the lt. --> AORtic Arch and on the Rt.--> Rt. Subclavian ---4th arch (4 limbs) = Systmeic & Also remember that AOR is from FOUR 6th- Pulmonary arteries and Ductus arteriosus ---- 6th arch= Pulmonary and Pulmonary - Systemic Shunt ( Ductus ) Muscles (Mesoderm) & Skeletal (Neural Crest) Derivatives ... 1st arch ... Muscles => V3 innervates M.D. My T.V. i.e. Muscles of mastication ( masseter, temporalis, pterygoid) Digastric ( Anterior Belly) Mylohyoid tensor Tympani tensor Veli Skeletal => I'M getting Skeletal like Silvester

Skeletal remind u of skeletal derivatives then I for the 1 i.e. 1st arch and for Incus M for Malleus/Maxilla/Mandible 2nd Arch .... To remember the Muscles innervated by the CN VII ... Imagine someone making the Facial Expression to say " PSS ... " Facial Expression muscles Posterior Belly of digastric Stapedius ----> and it reminds u of the other skeletal derivative Stapes Stylohyoid -----> and it reminds u of the the Hyoid ... but not all the Hyoid, we still in the 2nd level so choose the lesser that is above i.e. the Lesser Horn of the upper body of the Hyoid.( and when u get to the 3rd arch do the opposite )

6. Because the lung is centered vertically around the heart, part of the lung is superior to the heart,
and part is inferior. This has a major impact on the V/Q ratio apex of lung higher base of lung lower In a subject standing in orthostatic position (upright) the apex of the lung shows higher V/Q ratio, while at the base of the lung the ratio is lower but nearer to the optimal value for reaching adequate blood oxygen concentrations. The main reason for lower V/Q ratios at the base is that both ventilation and perfusion increase when going from the apex to the base, but Q does it more strongly thus lowering the V/Q ratio. The principal factor involved in the genesis of V/Q dishomogeneity between the apex and the base of the lung is gravity (this is why V/Q ratios change in positions other than the orthostatic one).

7. Cranial and spinal neural crest: major derivatives GAMES:

Glial cells (of peripheral ganglia)

Arachnoid (and pia) Melanocytes Enteric ganglia Schwann cells

8. the ventilation/perfusion ratio (or V/Q ratio) is a measurement used to assess the efficiency and
adequacy of the matching of two variables It is defined as: the ratio of the amount of air reaching the alveoli to the amount of blood reaching the alveoli. "V" ventilation the air that reaches the alveoli "Q" perfusion the blood that reaches the alveoli

Epidemic: An outbreak of disease that attacks many peoples at about the same time and may spread through one or several communities. Endemic: a disease that exists permanently in a particular region or population. Malaria is a constant worry in parts of Africa.

Pandemic: When an epidemic spreads throughout the world.

IGM :first antibody produced,exists as a pentmer,traps free antigens,affinity low,avidity high,most active at activating complement,not an opsonin,does not mediate adcc.found in ABO blood group IGg:major antibody produced after igm,activates complement,opsonizes and mediates adcc,actively transported across placenta,also found in graves disease and throtoxicosis,has memory,present in Rh blood group system

9.

IGA:produced in submucosa,dimer,imp component of breast milk,protects mucosal surfaces of body 10. IGE:bound to mast cells and basophils,mediates typ1 allergic reaction,protects against parasites

11. Branches of Facial Nerve: Great Nerve Cut Can Produce Motor Palsy.
G- Greater superficial petrosal nerve N- Nerve to stapedius C- Corda tympani C- Communicating branch P- Posterior auricular nerve M- Muscular branches to stylohyoid and posterior belly of digastric P- Peripheral branches

12. Circumduction>Hemiparesis
Stamping Slapping> Tabes, SACD (POST COLUMN) Spastic> UMN Ataxic>cerebellar lesions Apraxic> Frontal lobe ds-dementia Waddling>B/L sup gluteal N, Muscular dystrophy Festooned>Parkinson Festinant>Parkinson, CO poisoning, AS Positive rhombergs >Sensory ataxia
Question Answer

High Cal, Low phos MC cause of primary MC parathy disorder Low cal, high phos High Cal high Phos PTH vit D receptors Calcitonin receptors Low urine cal, high phos N ALP Bones, Groans, Psychic moans, abdo stones

primary hyperpara single adenoma primary hyperparathy Sec hyperparathy Tertiary hyperpara on osteoblasts Osteoclasts Hypopara Hypoparathy
memorize

13. Fibrous pericardium and the parietal layer of serous pericardium are supplied by
phrenic nerves. The visceral layer of serous pericardium has different innervations than the parietal layer. It is innervated by branches of sympathetic trunks and vagus nerves

Highly radiosensitive tumours are: Lymphoma Wilm's tumour

Myeloma Ewing's sarcoma Seminoma Moderately radiosensitive tumours are: Small cell lung carcinoma Carcinoma of breast Teratoma Ovarian carcinoma Basal cell carcinoma Medulloblastoma Dysgerminoma Nasopharyngeal carcinoma Relatively Resistant tumours are: Squamous cell carcinoma of lung Hypernephroma (Renal Cell Carcinoma) Rectal carcinoma and carcinoma colon Bladder carcinoma Soft tissue carcinoma such as fibrosarcoma Carcinoma of cervix Highly Resistant tumours are: Melanoma Osteosarcoma Pancreatic carcinoma Hepatoma
Email ThisBlogThis!Share to TwitterShare to Facebook Definitions
Stressed volume is what? Blood volume in the arteries

Which vasculature has the highest largest total cross-sectional and surface area?

Capillaries

What is CO in relation to pressure and TPR?

CO=(map-right atrial pressure)/tpr

What is resistance equation?

R=8visl/pir^4

When an artery is added in parallel, does total

Decrease

resistance increase or decrease?

Shear stress is highest at the center or the wall?

At wall because velocity is zero.

Pulmonary wedge pressure measures what?

Left atria pressure

P wave

Atrial depolarization

PR interval

Beginning of P wave to the beginning of Q wave

PR interval increases under what conditions?

Heart block, AV node delay

QRS

Ventricle depolarization

QT interval

Entire period of depolarization and repolarization of the ventricles

ST segment

End of S to beginning of T Isoelectric Period when the ventricles are depolarized

T wave

Ventricles are repolarized

What is the resting membrane potentials for ventricles, atria, and Purkinje system?

-90mV

Phase 0 of ventricles, atria, and Purkinje system

Na conductance influx

Phase 1 of ventricles, atria, and Purkinje system

Brief period of initial repolarization with efflux of K

Phase 2 of ventricles, atria, and Purkinje system

Plateau. Inward Ca and outward K

Phase 3 of ventricles, atria, and Purkinje system

Repolarization. Ca inward decreases and K outward increases, IK

Phase 4 of ventricles, atria, and Purkinje system

Resting membrane potential. IkI

Which phase has Ik?

Phase 3 repolarization

Which phase has IkI?

Phase 4, resting membrane potential

What are the phases of SA node?

Phases 0,3,4

Phase 0 of SA node?

Inward of Ca

How is phase 0 of ventricles different from phase 0 of SA node?

Ventricle phase 0=Na influx SA node phase 0= Ca influx

Phase 3 of SA node?

Repolarization of K efflux

Phase 4 of SA node?

Slow depolarization caused by Na influx If channels.

When are funny channels turned on?

During phase 3 - repolarization

Which phases are not present in SA node but present in ventricle AP?

Phase 1, 2

Conduction velocity is fastest in what system? Slowest in what?

Fastest - Purkinje system Slowest - AV node

Absolute refractory period (ARP)

No action potential can be initiated Upstroke of AP to end of plateau

Effective refractory period (ERP)

Slightly longer than ARP Conducted AP cannot be elicited

Relative refractory period (RRP)

AP can be elicited, but more than usual inward current is required

Chronotropic effects affects what?

HR Funny channels (phase 4 depolarization)

Dromotropic effects affects what?

Conduction velocity in AV node

Affects inward Ca current and outward K current

Negative dromotropic effects cause changes to what interval?

Increases PR interval

What parts of the heart has PANS innervation and what parts dont? What's the neurotransmitter and what receptors?

SA node, atria, and AV node has PANS vagal innervation, ventricles don't! ACh, M3

SANS affects heart through what neurotransmitter and what receptor?

NE, Beta-1 receptor

SANS positive chronotropic effect through what channels?

Increase HR through If channels in phase 4

SANS positive dromotropic effect through what channels?

Increases conduction velocity through AV node Increases inward Ca current phase 0 of AV node.

T tubules are well developed where and poorly developed where?

Well developed in the ventricles. Poorly developed in the atria.

What are dyads?

T tubules with sarcoplasmic reticulum

What type of calcium channels are in heart muscles? What type of receptors?

L-type Ca channels (dihydropyridine receptors)

What type of receptors are on Ca channels inside the SR?

Ryanodine receptors

Ca binds to what inside the sarcomeres?

Troponin C

EF equation?

EF=SV/EDV

Inotropy

Heart contractility

How does stimulation of beta-1 receptors increase inotropy?

Increases the inward Ca current during plateau of each AP

Cardiac glycosides (digitalis) increases inotropy how?

Inhibiting Na,K ATPase, diminishes Na/Ca counter exchange and causes increased Ca intracellularly

Preload

End-diastolic volume, related to right atrial pressure

Afterload

Left ventricle - aortic pressure Right ventricle - pulmonary artery pressure

What factor has been increased?Increased in end-diastolic volume, increase in stroke volume

Increased pre-load

What factor has been increased? Decrease in SV, increase in end-sytolic volume

Increased afterload

What factor has been increased? Increased SV, decrease in end-systolic volume

Increased contractility

When cardiac output and venous return are simultaneously plotted, the point they intercept is?

Right atrial pressure

How does TPR affect CO and venous return?

Decrease CO and venous return

Stroke volume is what?

End-diastolic volume minus end-systolic volume

What is the equation for stroke work?

Stroke work=aortic pressure x stroke volume

What is cardiac output according to Fick's principle?

CO=O2 consumption/ (O2 in pulmonary vein-O2 in pulmonary artery)

a wave on venous pulse curve

Increase in atrial pressure caused by atrial systole

Fourth heart sound is due to what?

Filling of ventricles by atrial systole

First heart sound

Closing of AV valves

Which AV valve closes first?

Mitral

Second heart sound

Closing of semilunar valves

Which semilunar valves close first?

Aortic valve

Third heart sound

Rapid flow of blood from atria into the ventricles

What are baroreceptors and where are they located?

Stretch receptors located within the walls of the carotid sinus near the bifurcation of the common carotid arteries and aortic arches

Which baroreceptors only respond to increase arterial pressure and not decrease arterial pressure?

Aortic baroreceptors

Valsalva maneuver causes what response?

Increase in HR

What are the four actions of Angiotensin II?

1. Secretion of aldosterone 2. Increase Na-H exchange in the proximal convoluted tubule. 3. Increases thirst 4. Vasoconstriction of the arteries

Where are the chemoreceptors located?

Near the bifurcation of the common carotid arteries and along the aortic arch

Where is ADH (vasopressin) released from?

Posterior pituitary gland

What is the function of ADH? Name specific receptors involved.

1. Vasoconstrictor to increase TPR by activing V1 receptors on arterioles 2. Water reabsorption by V2 receptors

EDRF is produced where? What does it cause? What is the mechanism of EDRF? What is a form of EDRF?

Produced in endothelial cells Causes relaxation of vascular smooth muscle Mechanism involves activation of cGMP One form of EDRF is NO

Which organs exhibit autoregulation?

Heart, brain, and kidney

Which prostaglandins are vasodilators and which ones are vasoconstrictors? (PGE or PGF)

PGE - vasodilator PGF - vasoconstrictor

What are the most important metabolic factors for coronary circulation?

Hypoxia and adenosine

What are the sympathetic innervation receptors on skeletal muscles? What do they cause?

Alpha-1: vasoconstriction Beta-2: vasodilation

Skin has what kind of innervation?

Extensive sympathetic innervation

What are the vasodilator metabolites of skeletal muscle?

Lactate, K, and adenosine

ADH released from where and does what?

Released from atria when it detects a decrease in blood volume. ADH causes both vasoconstriction and increased water reabsorption

At which site is systolic blood pressure the highest? (not aorta)

Renal artery

Postextrasystolic contraction produces increased pulse pressure because?

Contractility is increased

The ventricles are completely depolarized during which isoelectric portion of the electrocardiogra?

ST segment

Two P waves preceding each QRS complex means what?

Decreased conduction through AV node

End-diastolic volume and what can be used interchangeably?

Right atrial pressure

What is pulse pressure?

Difference between the highest and lowest arterial pressures.

During which phase of the cardiac cycle is aortic pressure highest?

Highest level actually coincides with the beginning of the reduced ventricular ejection phase.

Cardiac output of the right side of the heart is what percentage of the cardiac output of the left side of the heart?

100%

Which phase of the ventricular action potential coincides with diastole?

Phase 4

During which of the cardiac cycle does the mitral valve open?

14. femoral artery is on psoas

femoral nerve .... illliacus femoral vein.... pectinius

15. The relations of the right kidney:

1. Anteriorly1 suprarenal gland, liver, second part of duodenum, right colic flexure 2. Posteriorly1 diaphragm, 12th rib, costodiaphragmatic recess of the pleura, psoas muscle, quadratus lumborum muscle, transversus abdominis muscle The relations of the left kidney: 1. Anteriorly1 suprarenal gland, spleen, stomach, pancreas, left colic flexure, coils of jejunum 2. Posteriorly1 diaphragm, costodiaphragmatic recess of the pleura, 11th and 12th rib, psoas muscle, quadratus lumborum muscle, transversus abdominis muscle

16. The blood supply to the breast is derived from 3 sources. The predominant supply of blood comes from the perforating branches of theinternal mammary arteries, derived from the internal thoracic artery. The breast is further supplied by the lateral thoracic andthoracoacromial arteries (branches of the axillary artery) as well as posterior intercostal arteries (branches of the thoracic aorta). 17. Venous drainage of the breast is mainly accomplished by the axillary vein. The subclavian, intercostal, and internal thoracic veinsalso aid in returning blood to the heart.

18. a waves are absent in atrial fibrillation p waves also absent

19. small waves in atrial flutter 20. giant a waves seen in tricuspid stenosis 21. cannon a waves seen in complete heart block 22. c wave corresponds to closure of tricuspid valve 23. x wave first negative wave comes after a wave coincides with 4th heart sound 24. glomerular capillary pressure is 60mmhg 25. c wave during ventricular contraction tricuspid cusps are slightly pushed into rt atrium causing rise in pressure 26. c wave may be seen in rt hert overload lbbb and a-v block 27. x wave occurs in early part of atrial diastole as pressure in chamber falls due to relaxation and dilatation 28. x wave shallow in ccf and ts and exacerbate in pericardial tamponade and constrictive pericarditis 29. inc volume in rt ventricle eg in asd and vsd produce a stronger ventricular contraction and steep x descent 30. v wave occurs due to pooling of blood in rt atrium while tricuspid valve is close 31. large v waves due to reflux of blood in rt atrium in tricuspid regurgitation 32. y wave is second negative wave occurs with third heart sound during rapid inflow phase of cardiac cycle 33. higher the venous return steeper is the descent of y wave 34. kussmaul's sign is the inspiratory rise in jvp seen in constrictive pericarditis or pericardial tamponade
Site Normal pressure range [4] (in mmHg) 38 systolic Right ventricular pressure diastolic 38 systolic Pulmonary artery pressure diastolic 412 1530 1530

Central venous pressure

35. 36. its 18 mmhg in effernt arteiole

Pulmonary vein/ 215 Pulmonary capillary wedge pressure systolic Left ventricular pressure diastolic 3-12 100140