Cardiac Anatomy and Physiology Quiz
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Questions and Answers

What is the average weight of an adult male heart?

  • 350 g
  • 325 g (correct)
  • 300 g
  • 275 g

    • Which layer of the cardiac wall is most susceptible to myocardial ischemia?

  • Myocardium
  • Pericardium
  • Endocardium (correct)
  • Epicardium

    • What primarily generates the 'pumping' work of the heart?

  • Coronary arteries
  • Myocardium muscle fibers (correct)
  • Electrical impulses
  • Pericardium structure

    • What are the contractile proteins found in the myocardium?

    <p>Actin and myosin</p> Signup and view all the answers

    Which process is primarily controlled by the cardiac conducting system?

    <p>Cardiac cycle</p> Signup and view all the answers

    What is recorded by an electrocardiogram (ECG)?

    <p>Changes in electrical potential</p> Signup and view all the answers

    What is the primary function of cardiac markers?

    <p>Diagnose and assess cardiac conditions</p> Signup and view all the answers

    Which of the following chambers is correctly matched with its position in the heart?

    <p>Left Ventricle - pumps blood to the aorta</p> Signup and view all the answers

    What best describes the progression of Congestive Heart Failure (CHF) severity?

    <p>It can range from mild stress-induced impairment to severe life-threatening conditions.</p> Signup and view all the answers

    Which of the following factors can influence the clinical findings in CHF?

    <p>Extent and rate of heart performance abnormalities.</p> Signup and view all the answers

    What is the primary role of the New York Heart Association (NYHA) classification in CHF?

    <p>To functionally stage CHF patients based on severity.</p> Signup and view all the answers

    What is a significant challenge in identifying CHF early?

    <p>An objective test for heart failure is lacking.</p> Signup and view all the answers

    What characteristic should an ideal biomarker for detecting CHF possess?

    <p>It must increase progressively with the disease severity.</p> Signup and view all the answers

    Which of the following is NOT typically a primary characteristic of CHF?

    <p>Total loss of heart functionality.</p> Signup and view all the answers

    What is the most severe form of acute ischemic disease?

    <p>Acute myocardial infarction</p> Signup and view all the answers

    In the sequence of ECG changes after acute myocardial infarction, which statement is true?

    <p>The ST segment elevates hours after the infarction occurs.</p> Signup and view all the answers

    Acute coronary syndrome (ACS) includes which of the following conditions?

    <p>Acute myocardial infarction</p> Signup and view all the answers

    What distinguishes NSTEMI from STEMI in terms of cell death?

    <p>NSTEMI may lead to necrosis but generally has less cell death.</p> Signup and view all the answers

    What causes acute myocardial infarction?

    <p>Imbalance of oxygen supply and demand in the myocardium</p> Signup and view all the answers

    Which type of angina is characterized by activity-induced chest pain?

    <p>Stable angina</p> Signup and view all the answers

    Which of the following statements about ischemic heart diseases in the Philippines is true?

    <p>Ischemic heart diseases were the leading cause of death.</p> Signup and view all the answers

    What happens to myocytes when blood supply is blocked for more than a few minutes?

    <p>They die through necrosis.</p> Signup and view all the answers

    In the case of angina, what is a common symptom associated with the condition?

    <p>Severe chest pain</p> Signup and view all the answers

    What is the relationship between NSTEMI and the ST segment in an ECG?

    <p>NSTEMI results in no visible changes in the ST segment.</p> Signup and view all the answers

    What does NYHA Class II suggest about a patient's condition?

    <p>Mild symptoms and slight limitation during ordinary activity.</p> Signup and view all the answers

    Which cardiac marker is recommended if clinical presentation suggests Acute Coronary Syndrome (ACS)?

    <p>Troponin I (cTnI)</p> Signup and view all the answers

    What is one of the principal reasons cardiac biomarkers are used in clinical practice?

    <p>To detect presence of myocardial ischemia.</p> Signup and view all the answers

    Which marker was widely used as the first cardiac marker following its discovery?

    <p>Creatine Kinase</p> Signup and view all the answers

    What is a disadvantage of using Lactate Dehydrogenase (LD) as a cardiac marker?

    <p>Elevated in many other conditions.</p> Signup and view all the answers

    What symptoms characterize NYHA Class IV heart failure?

    <p>Symptoms experienced while at rest.</p> Signup and view all the answers

    What does the release of intracellular proteins into circulation indicate?

    <p>Cell death and myocardial damage.</p> Signup and view all the answers

    What is the primary role of Troponin T in cardiac assessment?

    <p>Analyzes heart muscle damage.</p> Signup and view all the answers

    Which of the following describes a key limitation of Aspartate Transaminase (AST) as a cardiac marker?

    <p>It has a high false-negative rate.</p> Signup and view all the answers

    Which marker is often replaced by Troponin I or T for better sensitivity in myocardial infarction detection?

    <p>Lactate Dehydrogenase (LD)</p> Signup and view all the answers

    What is the typical LD1:LD2 ratio observed after the onset of myocardial infarction (MI)?

    <p>0.75</p> Signup and view all the answers

    Which cardiac marker is considered the most reliable serum maker of myocardial infarction?

    <p>Serum CK-MB</p> Signup and view all the answers

    Which enzyme is primarily found elevated in the serum after muscle injury?

    <p>CK-MM</p> Signup and view all the answers

    How soon after the onset of myocardial infarction do CK levels typically exceed the normal range?

    <p>6-8 hours</p> Signup and view all the answers

    Which troponin protein is nearly absent from normal serum and is specific to cardiac muscle injury?

    <p>Both A and C</p> Signup and view all the answers

    What is the expected CK-MB level trend after myocardial infarction symptoms begin?

    <p>Increase at 4-6 hours, then drop to normal in 2-4 days</p> Signup and view all the answers

    What condition does elevated lactate dehydrogenase (LDH) indicate?

    <p>Various conditions including muscle and organ damage</p> Signup and view all the answers

    What does an increase of plasma CK indicate?

    <p>Damage in the brain and muscles</p> Signup and view all the answers

    What is the reference value for cardiac troponins in the serum?

    <p>&lt; 0.1 ng/mL</p> Signup and view all the answers

    Which enzymes are primarily used for the detection of acute myocardial infarction (AMI)?

    <p>AST, LDH, CK</p> Signup and view all the answers

    Study Notes

    Cardiac Anatomy and Physiology

    • Average human heart weighs approximately 325 g in men and 275 g in women.
    • The heart is enclosed by a pericardium and has four chambers: left atrium, right atrium, left ventricle, and right ventricle.
    • The cardiac wall consists of three layers: epicardium (outer), myocardium (middle), and endocardium (inner).
    • Myocardial muscle fibers contract and relax to generate heart pumping action and contain contractile proteins like actin, myosin, and troponins.
    • The cardiac cycle includes systole and diastole, regulated by the cardiac conducting system.
    • An electrocardiogram (ECG) records the heart's electrical potential changes.

    Cardiovascular Diseases

    • Two major cardiovascular diseases diagnosed via biomarkers:
      • Acute myocardial infarction (AMI), the severe form of ischemic heart disease.
      • Congestive heart failure (CHF).

    Epidemiology

    • In the Philippines, ischemic heart diseases accounted for 29,442 deaths (18.7% of total) from January to April 2022.

    Acute Myocardial Infarction

    • Occurs from an imbalance of oxygen supply/demand leading to myocyte injury and death.
    • Myocyte necrosis occurs after blood supply is blocked for more than a few minutes.
    • Angina is chest pain that may precede AMI; stable angina is activity-induced.

    Acute Coronary Syndrome (ACS)

    • Comprises ischemic events varying from angina (no cell death) to NSTEMI (partial necrosis) and STEMI (complete necrosis).
    • STEMI shows ST segment elevation on ECG, whereas NSTEMI does not exhibit ST segment changes.

    Congestive Heart Failure (CHF)

    • A condition where the heart cannot pump adequate blood, necessitating external support as the disease progresses.
    • Symptoms vary based on various factors, including overall health and heart disease causes.
    • Utilizes the New York Heart Association (NYHA) classification to assess patient function:
      • Class I: No symptoms during typical activity.
      • Class II: Mild symptoms with slight activity limitation.
      • Class III: Marked limitations, comfortable only at rest.
      • Class IV: Severe limitations, symptomatic at rest.

    Cardiac Damage Markers

    • Serum biomarkers indicate cardiac damage, helping assess myocardial infarction occurrence, extent, and timing.

    Cardiac Markers for ACS

    • Initial markers:
      • Glutamic oxaloacetic transaminase (SGOT, AST).
      • Lactate dehydrogenase (LD).
      • Creatine Kinase (CK).
    • Current markers: Troponin I (TnI), Troponin T (TnT), and myoglobin.

    Troponins

    • Troponins are complex proteins critical for muscle contraction regulation.
    • TnI and TnT are specific to the myocardium, while TnC is present in both cardiac and skeletal tissues.
    • A significant rise in troponin levels occurs after an acute myocardial infarction, making them the most important markers for cardiac injury.
    • Reference value for troponin: levels should be < 0.1 ng/mL.

    Clinical Implications

    • Cardiac troponins are essential for diagnosing acute myocardial infarction, particularly as they may elevate even in the absence of CK-MB increases.
    • The transition from initial to current markers represents advancements in cardiac health diagnostics, emphasizing the need for specific biomarkers to enhance patient management.

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    Description

    Test your knowledge on the structure and function of the human heart with this quiz on cardiac anatomy and physiology. Explore the details of heart chambers, walls, and the unique properties of myocardial muscle fibers. Perfect for students of medicine and biology.

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