Cardiovascular Anatomy and Chest Pain Quiz
40 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the leading cause of death worldwide related to heart conditions?

  • Heart failure
  • Acute myocardial infarction
  • Hypertension-related complications
  • Coronary artery disease (correct)

Which of the following factors is NOT a common risk factor for atherosclerosis?

  • Hypercholesterolaemia
  • Regular exercise (correct)
  • Diabetes mellitus
  • Smoking

What is a primary feature of ischaemia?

  • Complete blockage of blood vessels
  • Increase in heart rate
  • Inadequate blood supply to a part of the body (correct)
  • Excess blood supply to the tissues

During the assessment of chest pain, which of the following investigations is useful?

<p>12 lead ECG (C)</p> Signup and view all the answers

Which of the following cellular changes is indicative of myocardial ischaemia?

<p>Necrosis of myocardial tissue (A)</p> Signup and view all the answers

Which of the following characteristics is typically assessed to differentiate cardiac from non-cardiac causes of chest pain?

<p>Duration and timing of pain (C)</p> Signup and view all the answers

What does an acute ST-elevation myocardial infarct indicate?

<p>Inadequate oxygen supply due to severe ischaemia (C)</p> Signup and view all the answers

Which of the following risk factors is associated with increased age?

<p>Age itself as a risk factor (A)</p> Signup and view all the answers

What initiates the calcium influx in myocytes during muscle contraction?

<p>DHP receptor activation (C)</p> Signup and view all the answers

What results from the small influx of Ca²⁺ into the myocyte?

<p>Opening of Ryanodine receptors (B)</p> Signup and view all the answers

Which component of the troponin complex binds to Ca²⁺ during muscle contraction?

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

What increases the likelihood of myocardial ischaemia or massive pulmonary embolism (PE)?

<p>Clinical evidence of increased intracardiac pressure (C)</p> Signup and view all the answers

What does the PR interval in an electrocardiogram (ECG) measure?

<p>Time taken for impulse conduction from atria to ventricles (B)</p> Signup and view all the answers

Which condition is characterized by chest pain or discomfort due to insufficient oxygen-rich blood to the heart muscle?

<p>Angina (A)</p> Signup and view all the answers

What is the leading cause of death worldwide associated with chest pain?

<p>Coronary artery disease (D)</p> Signup and view all the answers

Which physiological process is responsible for muscle relaxation after contraction?

<p>Calcium reuptake via SERCA (D)</p> Signup and view all the answers

What does a hazard ratio measure in clinical settings?

<p>Chances of an event occurring with exposure versus non-exposure (C)</p> Signup and view all the answers

What is the role of the calcium release channels in the sarcolemma?

<p>To release calcium into the cytosol upon DHP receptor activation (D)</p> Signup and view all the answers

Which of the following is considered a cardiorespiratory cause of elevated serum troponin?

<p>Acute pulmonary oedema (A)</p> Signup and view all the answers

Which statement correctly describes the QRS complex on an ECG?

<p>Indicates ventricular depolarization (C)</p> Signup and view all the answers

What mechanism is primarily responsible for the pumping of Ca²⁺ back into the sarcoplasmic reticulum?

<p>SERCA pump (D)</p> Signup and view all the answers

Which factor is commonly known to lead to elevated troponin levels aside from acute coronary syndrome?

<p>Acute aortic dissection (A)</p> Signup and view all the answers

Which statement is true regarding the examination of a large pneumothorax?

<p>Breath sounds may be diminished on the affected side (A)</p> Signup and view all the answers

What does excitation-contraction coupling in cardiac myocytes primarily involve?

<p>Calcium ions (Ca²⁺) (B)</p> Signup and view all the answers

What role does calcium play in muscle contraction?

<p>It binds to TN-C, initiating a conformational change. (D)</p> Signup and view all the answers

What happens to the troponin complex when calcium is removed?

<p>It resumes its inactivated position, blocking myosin binding. (A)</p> Signup and view all the answers

Why is TN-I particularly important in clinical practice?

<p>It acts as a diagnostic marker for myocardial infarction. (C)</p> Signup and view all the answers

Which investigation is highly sensitive for detecting myocardial infarction?

<p>Troponin assay. (C)</p> Signup and view all the answers

What does the QRS complex predominantly reflect?

<p>Left ventricular depolarization (C)</p> Signup and view all the answers

What primarily causes chest pain during a myocardial infarction?

<p>Ischemia due to reduced blood flow. (A)</p> Signup and view all the answers

How is a Q-wave defined in the context of the QRS complex?

<p>It is the first wave being negative. (D)</p> Signup and view all the answers

Which of the following indicates ST segment elevation?

<p>The ST segment is above the level of the PR segment. (B)</p> Signup and view all the answers

When a patient reports having an irregular heart rate, what is the first step in the assessment?

<p>Take a detailed history from the patient. (B)</p> Signup and view all the answers

What does an ECG primarily assess in a patient with suspected myocardial infarction?

<p>Disruptions in normal electrical signals. (D)</p> Signup and view all the answers

What does ST segment depression indicate?

<p>The ST segment is below the level of the PR segment. (C)</p> Signup and view all the answers

Which of the following is NOT a modifiable risk factor for ischemic heart disease?

<p>Age. (C)</p> Signup and view all the answers

In acute myocardial ischemia, what abnormal finding might be observed in an ECG?

<p>T wave inversion in leads I, II, aVL, and V4-V6 (A)</p> Signup and view all the answers

What causes the initial spread of electrical impulses in cardiac myocytes?

<p>Movement of ions through gap junctions (C)</p> Signup and view all the answers

What is considered evidence of myocardial necrosis?

<p>Myocardial infarction (C)</p> Signup and view all the answers

What effect does the electrical vector generated by the left ventricle have on the QRS complex?

<p>It causes the QRS complex to be predominantly positive. (D)</p> Signup and view all the answers

Flashcards

Coronary Artery Disease (CAD)

The most common cause of angina and acute coronary syndrome, and a leading global cause of death.

Ischemia

A condition where a body part doesn't get enough blood due to a blockage in blood vessels.

Atherosclerosis

A common cause of CAD, involving plaque buildup in arteries.

Risk Factors for Atherosclerosis

Factors that increase the chance of plaque buildup in arteries, including Age, Sex, Genetics, Smoking, Hypertension, Hypercholesterolemia, Diabetes, Hemostatic Factors, Physical Activity, Obesity, Alcohol, Diet, and Social Deprivation.

Signup and view all the flashcards

Angina

Chest pain often caused by reduced blood flow to the heart.

Signup and view all the flashcards

Acute Coronary Syndrome

A group of conditions related to reduced blood supply to the heart, potentially serious.

Signup and view all the flashcards

Chest Pain Causes

Various factors can cause chest pain, encompassing both cardiac and non-cardiac issues. Distinguishing between them is essential.

Signup and view all the flashcards

Cardiac vs. Non -Cardiac Chest Pain

Differentiating between chest pain of cardiac origin (related to the heart) and non-cardiac origin (not related to the heart).

Signup and view all the flashcards

Chest pain with high jugular vein pressure

Suggests myocardial ischemia (heart muscle not getting enough blood) or massive pulmonary embolism (blood clot in lung).

Signup and view all the flashcards

Large pneumothorax

A collapsed lung, detected by absent breath sounds and a hollow sound when tapping on the chest.

Signup and view all the flashcards

Angina

Chest pain due to insufficient oxygen reaching the heart muscle.

Signup and view all the flashcards

Acute Coronary Syndrome (ACS)

Sudden reduction of blood flow to the heart, often due to a blocked artery.

Signup and view all the flashcards

Coronary Artery Disease (CAD)

The most frequent cause of chest pain and heart problems, leading to worldwide deaths.

Signup and view all the flashcards

Hazard Ratio

The risk of an event in an exposed group compared to a non-exposed group.

Signup and view all the flashcards

Elevated Serum Troponin

High levels of a protein released when heart muscle is damaged, and this is not necessarily due to heart attack.

Signup and view all the flashcards

Cardiorespiratory Causes of elevated Troponin

Reasons for elevated troponin that involve the heart and/or lungs. Pulmonary embolism, oedema and arrhythmias are examples.

Signup and view all the flashcards

Non-Cardiorespiratory Causes of elevated Troponin

Reasons for elevated troponin unrelated to the heart or lungs.

Signup and view all the flashcards

Cardiac Myocyte

A heart muscle cell.

Signup and view all the flashcards

Depolarization (T-tubule)

The electrical signal traveling down the T-tubule in a myocyte, activating DHP receptors.

Signup and view all the flashcards

DHP Receptors

Voltage-sensitive L-type calcium channels in the sarcolemma, activated by depolarization.

Signup and view all the flashcards

Calcium Influx

The small amount of extracellular calcium entering the cell through open channels.

Signup and view all the flashcards

Calcium-induced Calcium Release (CICR)

The small initial calcium influx triggering a large calcium release from the SR.

Signup and view all the flashcards

Ryanodine Receptors (RyR)

Channels in the sarcoplasmic reticulum (SR) that release stored calcium when triggered.

Signup and view all the flashcards

Sarcoplasmic Reticulum (SR)

An organelle that stores calcium in the myocyte.

Signup and view all the flashcards

Troponin C (TN-C)

A component of the troponin complex that binds calcium, initiating muscle contraction.

Signup and view all the flashcards

Troponin-Tropomyosin Complex (TM)

A complex that regulates actin-myosin interaction in the muscle.

Signup and view all the flashcards

SERCA Pump

Active transport pumping calcium back into the sarcoplasmic reticulum after contraction.

Signup and view all the flashcards

ECG P-wave

Represents atrial depolarization (activation).

Signup and view all the flashcards

ECG PR interval

Time from beginning of P-wave to beginning of QRS complex, assessing atria-ventricle conduction.

Signup and view all the flashcards

ECG QRS complex

Represents ventricular depolarization (activation).

Signup and view all the flashcards

QRS complex

The part of an ECG tracing that reflects left ventricle depolarization, although it may not show all three waves.

Signup and view all the flashcards

ST segment

The part of the ECG tracing corresponding to the plateau phase of a heart muscle cell's electrical activity.

Signup and view all the flashcards

Q-wave

The first negative deflection(wave) of the QRS complex in an ECG tracing.

Signup and view all the flashcards

ST segment elevation

When the ST segment is displaced above the PR segment level on an ECG, suggesting potential ischemia or infarction.

Signup and view all the flashcards

ST segment depression

When the ST segment is displaced below the PR segment level on an ECG tracing, indicating potential myocardial ischemia.

Signup and view all the flashcards

Myocardial infarction

Evidence of cell death in the heart muscle due to reduced blood flow.

Signup and view all the flashcards

Myocardial ischemia

Reduced blood flow to the heart muscle, not necessarily causing cell death.

Signup and view all the flashcards

Cardiac myocyte

A specialized, striated muscle cell of the heart.

Signup and view all the flashcards

T wave inversion

An inverted T wave in an ECG, suggesting potential myocardial ischaemia

Signup and view all the flashcards

Cardiac Myocyte Contraction

The shortening of a heart muscle cell driven by interactions between actin and myosin, triggered by calcium.

Signup and view all the flashcards

Troponin-C (TN-C)

A protein that binds calcium and initiates a conformational change in the troponin complex, allowing muscle contraction.

Signup and view all the flashcards

Troponin-I (TN-I)

A protein in the troponin complex that inhibits myosin-actin binding when calcium is low, preventing contraction.

Signup and view all the flashcards

Myocardial Infarction (MI) Marker

Troponin is a valuable indicator released into the bloodstream upon damage to heart muscle tissue.

Signup and view all the flashcards

Ischemic Heart Disease

A common condition where the heart doesn't get enough oxygen.

Signup and view all the flashcards

Troponin Assay

A blood test used to measure troponin levels, aiding in diagnosing heart damage.

Signup and view all the flashcards

ECG in Diagnosing Ischemia

Electrocardiogram (ECG) can detect irregularities/disruptions in heart electrical activity related to ischemia.

Signup and view all the flashcards

Heart Irregular/Fast Rhythm

An irregular or abnormally fast heart rate detected by a fitness tracker, such as a Fitbit.

Signup and view all the flashcards

Study Notes

Week 2 Learning Outcomes

  • Describe the heart's functional anatomy during the cardiac cycle
  • Describe the heart's blood supply and arteries that supply specific regions
  • Understand the pathophysiology of atheroma
  • Identify common risk factors for atheroma
  • List and describe common causes of chest pain
  • Formulate patient questions to differentiate cardiac from non-cardiac chest pain causes
  • Describe important clinical examination features for identifying chest pain causes
  • Describe useful diagnostic investigations for chest pain
  • Describe the features of a 12-lead ECG
  • Describe the features of an acute ST-elevation myocardial infarction
  • Describe the role of blood tests in assessing chest pain
  • Explain the cellular changes in myocardial ischaemia

Pre-reading

  • Coronary artery disease (CAD) is the leading cause of death worldwide.
  • It's the most common cause of angina and acute coronary syndrome.
  • Ischemia occurs when a part of the body doesn't get enough blood supply.
  • Common risk factors for atherosclerosis include age and sex.

Additional Notes

  • Chest pain accompanied by increased intracardiac pressure suggests myocardial ischemia or pulmonary embolism.
  • A large pneumothorax presents with absent breath sounds and hyper-resonant percussion on the affected side.
  • Other causes of chest pain include aortic dissection, massive pulmonary embolism, and esophageal rupture.

Angina and Acute Coronary Syndrome (ACS)

  • Angina is chest pain or discomfort caused by insufficient oxygen to the heart muscle.
  • ACS encompasses various conditions with reduced blood flow to the heart.
  • CAD is the most common cause of angina and ACS, frequently related to a blockage in the coronary arteries.
  • Hazard ratios indicate the likelihood of an event in a group exposed to a certain factor compared to a non-exposed group.

Causes of Elevated Serum Troponin

  • Cardiorespiratory causes: include pulmonary embolism and acute pulmonary edema.
  • Non-cardiorespiratory causes: include prolonged hypotension, severe sepsis, and severe burns. Others include stroke and subarachnoid hemorrhage.

Sectional Anatomy of the Heart

  • Diagrams illustrate the heart's major structures and vessels.

Blood Supply of the Heart

  • Diagrams illustrate coronary arteries and their branching patterns.

Cardiac Myocyte Excitation-Contraction Coupling

  • Depolarization via T-tubules activates DHP receptors in the sarcolemma.
  • Calcium influx triggers the release of more calcium from the sarcoplasmic reticulum (SR).
  • Calcium binding to troponin alters the actin-myosin interaction leading to muscle contraction.
  • Calcium reuptake by SERCA pumps lowers cytosolic calcium for relaxation.

ECG Analysis

  • P wave: atrial depolarization; PR interval: atrial to ventricular impulse conduction.
  • QRS complex: ventricular depolarization.
  • ST segment: action potential plateau.
  • Different types of ST segment deviations have implications based if there is elevation or depression.

Myocardial Infarction (MI)

  • Myocardial infarction is a myocardial necrosis.
  • Insufficient blood flow causes myocardial ischemia.
  • Cardiac myocytes are specialized striated muscle cells.
  • Gap junctions facilitate ion movement (important for coordinated contraction).
  • Actin-myosin interactions lead to sarcomere shortening.
  • Myocardial infarction manifests with noticeable T wave inversions.
  • Troponin I is released into circulation when cardiac myocytes die, used to diagnose myocardial infarction.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

Related Documents

Chest Pain PDF

Description

This quiz focuses on the functional anatomy of the heart during the cardiac cycle, along with the blood supply and specific arteries. It also explores the pathophysiology of atheroma, risk factors, and how to differentiate between cardiac and non-cardiac chest pain. Prepare to assess your understanding of diagnostic investigations, ECG features, and myocardial ischemia.

More Like This

Use Quizgecko on...
Browser
Open
Browser
Browser