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The aorta distributes deoxygenated blood to all parts of the body.
The aorta distributes deoxygenated blood to all parts of the body.
False
The myocardium is the outermost layer of the heart.
The myocardium is the outermost layer of the heart.
False
The pericardial cavity contains pericardial fluid.
The pericardial cavity contains pericardial fluid.
True
Blood flows from the left atrium to the left ventricle before being pumped through the pulmonary artery.
Blood flows from the left atrium to the left ventricle before being pumped through the pulmonary artery.
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The tricuspid valve is located between the left atrium and the left ventricle.
The tricuspid valve is located between the left atrium and the left ventricle.
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The human heart consists of six chambers.
The human heart consists of six chambers.
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The epicardium is made up of endothelial cells.
The epicardium is made up of endothelial cells.
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The heart is located between the lungs, behind the sternum.
The heart is located between the lungs, behind the sternum.
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The pulmonary arteries contain oxygenated blood.
The pulmonary arteries contain oxygenated blood.
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Veins carry deoxygenated blood back to the heart, with the exception of the pulmonary veins.
Veins carry deoxygenated blood back to the heart, with the exception of the pulmonary veins.
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The left atrium receives deoxygenated blood from the body.
The left atrium receives deoxygenated blood from the body.
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Coronary arteries supply oxygenated blood to the heart muscle.
Coronary arteries supply oxygenated blood to the heart muscle.
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The aorta is the only artery that carries deoxygenated blood.
The aorta is the only artery that carries deoxygenated blood.
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Systemic circulation begins at the right ventricle.
Systemic circulation begins at the right ventricle.
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Interruptions of coronary circulation can lead to heart attacks.
Interruptions of coronary circulation can lead to heart attacks.
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Capillaries are the blood vessels where oxygen is delivered to tissues and carbon dioxide is collected.
Capillaries are the blood vessels where oxygen is delivered to tissues and carbon dioxide is collected.
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CK-BB is predominantly found in the skeletal muscle tissues.
CK-BB is predominantly found in the skeletal muscle tissues.
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The myocardium expresses more CK-MB than CK-MM.
The myocardium expresses more CK-MB than CK-MM.
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Total CK levels in males can reach up to 200 U/L.
Total CK levels in males can reach up to 200 U/L.
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The concentration of CK-MB begins to rise in the blood within the first hour after a myocardial infarction.
The concentration of CK-MB begins to rise in the blood within the first hour after a myocardial infarction.
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Skeletal muscle primarily expresses CK-BB isoenzyme.
Skeletal muscle primarily expresses CK-BB isoenzyme.
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The highest level of CK-MB in blood occurs around 24 to 48 hours after a heart attack.
The highest level of CK-MB in blood occurs around 24 to 48 hours after a heart attack.
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An AMI can potentially be ruled out within the first 4 hours of symptom onset.
An AMI can potentially be ruled out within the first 4 hours of symptom onset.
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Non hemolyzed serum or plasma samples are used for measuring CK levels.
Non hemolyzed serum or plasma samples are used for measuring CK levels.
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Elevations in Troponin-I and Troponin-T can persist for up to 10 days after a myocardial infarction (MI).
Elevations in Troponin-I and Troponin-T can persist for up to 10 days after a myocardial infarction (MI).
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Troponin-T (TnT) can be detected in healthy individuals.
Troponin-T (TnT) can be detected in healthy individuals.
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The liver is the primary site of production for creatine in the body.
The liver is the primary site of production for creatine in the body.
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Both Troponin-I and Troponin-T can experience increases in patients with chronic renal failure.
Both Troponin-I and Troponin-T can experience increases in patients with chronic renal failure.
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The assay range for Troponin I is 0.01-25 ng/mL.
The assay range for Troponin I is 0.01-25 ng/mL.
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Creatine kinase (CK) plays a role in converting phosphocreatine into adenosine triphosphate (ATP).
Creatine kinase (CK) plays a role in converting phosphocreatine into adenosine triphosphate (ATP).
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The normal 99th percentile limit for Troponin-T is 0.04 ng/mL.
The normal 99th percentile limit for Troponin-T is 0.04 ng/mL.
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Phosphocreatine serves as an energy reservoir for the rapid buffering and regeneration of ATP in tissues that consume ATP quickly.
Phosphocreatine serves as an energy reservoir for the rapid buffering and regeneration of ATP in tissues that consume ATP quickly.
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Troponin C has diagnostic value in detecting cardiac conditions.
Troponin C has diagnostic value in detecting cardiac conditions.
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Cardiac Troponin I (cTnI) is a specific marker for indicating cardiac infarction.
Cardiac Troponin I (cTnI) is a specific marker for indicating cardiac infarction.
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Troponin T is the smallest of the three troponin subunits.
Troponin T is the smallest of the three troponin subunits.
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CTnI levels can remain elevated for up to 6-10 days after an acute myocardial infarction.
CTnI levels can remain elevated for up to 6-10 days after an acute myocardial infarction.
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The molecular weight of Cardiac Troponin I is 24 kilodaltons.
The molecular weight of Cardiac Troponin I is 24 kilodaltons.
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Troponin levels begin to rise 8-10 hours after the onset of myocardial injury.
Troponin levels begin to rise 8-10 hours after the onset of myocardial injury.
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Troponin I binds to the actin filament to hold the troponin-tropomyosin complex in place.
Troponin I binds to the actin filament to hold the troponin-tropomyosin complex in place.
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Less than 15% of troponin is found in the cytosol.
Less than 15% of troponin is found in the cytosol.
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Is myocardial infarction caused by a lack of blood flow to the heart muscle?
Is myocardial infarction caused by a lack of blood flow to the heart muscle?
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Cardiac markers are solely composed of enzymes.
Cardiac markers are solely composed of enzymes.
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The ECG is always a conclusive diagnostic tool for acute myocardial infarction.
The ECG is always a conclusive diagnostic tool for acute myocardial infarction.
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Creatine kinase MB and cardiac troponins T and I are commonly used markers for detecting myocardial injury.
Creatine kinase MB and cardiac troponins T and I are commonly used markers for detecting myocardial injury.
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It can take between 2 to 24 hours for cardiac markers to show increased levels in the blood.
It can take between 2 to 24 hours for cardiac markers to show increased levels in the blood.
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Troponin is a single protein that plays a role in muscle contraction.
Troponin is a single protein that plays a role in muscle contraction.
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Cardiac markers can be used alone for diagnosing an acute myocardial infarction effectively.
Cardiac markers can be used alone for diagnosing an acute myocardial infarction effectively.
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SGOT and LDH were the primary markers used for assessing cardiac injury until the early 2000s.
SGOT and LDH were the primary markers used for assessing cardiac injury until the early 2000s.
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Study Notes
Cardiac Markers
- Cardiac markers are biomarkers used to assess heart function.
- Early markers were enzymes, now other proteins are used.
- Cardiac markers leak from damaged myocardial cells into the bloodstream.
Heart Structure and Tissues
- The heart is a vital organ for blood circulation, located between the lungs, behind and slightly to the left of the sternum.
- The heart has three layers:
- Innermost: Endocardium - composed of endothelial cells and lines the heart chambers and valves.
- Middle: Myocardium - the muscular layer consists of heart muscle cells.
- Outermost: Epicardium - composed of epithelial cells, forming the outer cell layer.
- The pericardium is a membranous sac surrounding the heart, anchoring it to the diaphragm and sternum.
- It consists of two layers: fibrous pericardium and serous pericardium (visceral and parietal).
- A pericardial cavity lies between the layers and contains fluid.
Heart Chambers
- The heart has four chambers: right atrium, right ventricle, left atrium, and left ventricle.
- Deoxygenated blood enters the right atrium, travels to the right ventricle, and is pumped to the lungs for oxygenation.
- Oxygenated blood returns to the heart via the pulmonary veins, enters the left atrium, then the left ventricle, and is pumped to the body.
- The left ventricle is the largest and strongest chamber, pumping oxygenated blood to the body via the aorta.
Heart Valves
- Four heart valves ensure one-way blood flow:
- The tricuspid valve is located between the right atrium and right ventricle.
- The mitral valve is located between the left atrium and left ventricle.
- The pulmonary valve is located between the right ventricle and the pulmonary artery.
- The aortic valve is located between the left ventricle and the aorta.
Blood Vessels
- Arteries have thick walls with smooth muscle and elastic fibers, carrying oxygenated blood away from the heart.
- Veins have thinner walls than arteries, carrying deoxygenated blood toward the heart.
- Capillaries are very thin, single-cell walls, allowing for the exchange of materials between blood and tissues.
- Blood flows away from the heart in arteries and towards the heart in veins.
- Arteries have thick walls; Veins have thinner walls; Capillaries are single-celled.
The Circulatory System
- The heart pumps blood throughout the body delivering oxygen and nutrients and carrying away carbon dioxide and waste.
- Blood travels through arteries, arterioles, capillaries, venules, and veins.
- Pulmonary circulation moves blood between the heart and lungs.
- Systemic circulation moves blood between the heart and the rest of the body.
Coronary Circulation
- Coronary arteries supply oxygenated blood to the heart muscle.
- Cardiac veins carry deoxygenated blood away from the heart muscle.
- Coronary circulation is vital for the heart's health.
- Interruptions can cause heart attacks.
Types of Heart Disease
- Various diseases can affect the heart, including valve disease, aneurysm, coronary artery disease, cardiomyopathy, and pericarditis.
- These diseases can significantly impact heart function.
Heart Attack (Myocardial Infarction)
- Myocardial Infarction (MI) is a condition caused by blocked blood flow to the heart muscle.
- Different types of MI exist, with variations in their causes and characteristics.
- Symptoms of a heart attack can include weakness, chest pain, dizziness, and shortness of breath.
- Location of the pain can be the area of the stomach.
- Location to look for discomfort can be back, neck, arms, and lower jaw area.
Cardiac Markers
- Different types of cardiac markers exist, and each has different uses and limitations.
- The timing for detection of cardiac markers varies depending on the type of marker being assessed.
- Until the 1980s, SGOT and LDH were used to evaluate cardiac injury.
- Currently, CK-MB (a creatine kinase subtype), and cardiac troponins (T and I) are also used for MI detection.
- An ECG can also diagnose an MI.
- Note: The perfect cardiac marker test for precise diagnosis does not exist.
- Various tests are used in combination for accurate assessment.
Troponin
- Troponin is a protein complex crucial for muscle contraction.
- Troponin has three subunits: TnC, TnT, and TnI.
- TnC has calcium binding ability-has no diagnostic value.
- Cardiac troponin (cTnI) is a cardiac muscle protein used in the diagnosis of myocardial infarction.
- cTnI is rapidly released into the bloodstream following a heart attack.
- cTnI levels stay elevated for a longer period and are also evaluated in diagnosis.
Total Creatine Kinase (CK) and CK-MB
- CK is a naturally occurring enzyme in tissues.
- CK catalyzes the conversion of creatine and consumes ATP.
- The most significant result of CK activity is the production of phosphocreatine.
- CK is also evaluated with respect to the function of muscle tissue.
- CK-MB is a specific form of CK found in the heart, used for diagnosing MI.
- Elevated CK-MB levels show evidence of myocardial damage.
- The level rises in 4-6 hours and reaches peak 12 to 24 hours after MI.
Myoglobin
- Myoglobin is an iron-containing protein which can bind to and release oxygen.
- It's released from damaged tissues, and levels in blood rise rapidly after myocardial damage.
- Myoglobin is not specific to the heart; therefore, it doesn't consistently indicate MI.
Lactate Dehydrogenase (LDH)
- LDH is an enzyme in all body tissues
- LDH is released from damaged cells (injury marker)
- LDH has different isoenzymes with different distributions in tissues.
- LDH levels rise after the cellular destruction from MI
- Measuring LDH is a useful tool to detect various injuries
- In addition to detecting myocardium damage LDH is a good indicator of other conditions
CK - Isoenzymes
- CK exists as a dimer protein, a combination of two subunits (B or M).
- Different combinations result in several isoenzymes (CK-BB, CK-MB, CK-MM).
- CK-MB is specific to the heart, therefore useful.
- Skeletal muscle expressions of CK-MM.
- CK-MM expressed in myocardium
LDH Measurement
- LDH is measured using a serum sample.
- Elevated LDH levels often suggest tissue damage.
- Strenuous exercise may cause temporary LDH elevation or falsely increase results.
- Hemolysis (rupture of red blood cells) during blood collection causes falsely high LDH results.
- Elevated LDH levels and change in ratio usually indicate tissue damage.
LDH Result Interpretation
- LDH is used as a marker for myocardial infarction(AMI) and other heart conditions.
- LDH level is evaluated in relation to myocardial infarction.
- Elevated levels of LDH and changes in the ratio of the LDH isoenzymes suggest tissue damage.
- Various conditions besides cardiac disease can cause elevated LDH levels.
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Description
Test your knowledge on cardiac markers and the anatomy of the heart. This quiz covers the essential functions and structures of the heart, including its layers and chambers. Assess your understanding of how heart markers are used in evaluating heart health.
