N715 Exam 3 New Pt 1
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Questions and Answers

What is the primary structural change that occurs in the heart to form a ventricular septal defect?

  • Failure of the foramen ovale to close
  • Excessive fusion of endocardial cushions
  • Inadequate development of the muscular interventricular septum (correct)
  • Premature partitioning of the aorta
  • Which of the following is a common indicator of cyanosis due to a right-to-left shunt?

  • Increased pulmonary blood flow
  • Decreased oxygen saturation in systemic circulation (correct)
  • Elevated systemic pressure
  • Peripheral cyanosis in extremities
  • How does mitochondrial function affect cardiac muscle performance in cases of right ventricular hypertrophy?

  • Increased ATP production enhances contractility
  • Normal function is maintained regardless of hypertrophy
  • Enhanced fatty acid oxidation improves efficiency
  • Decreased mitochondrial biogenesis leads to energy deficits (correct)
  • What effect does pulmonary stenosis have on the right ventricle?

    <p>Increases ventricular wall thickness (C)</p> Signup and view all the answers

    Which neurohumoral response system primarily helps the body cope with hypotension by increasing blood pressure?

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

    What is the first step in the partitioning of the atria during fetal heart development?

    <p>Formation of the septum primum (D)</p> Signup and view all the answers

    Which physiological mechanism is likely disrupted in a patient with significant right ventricular hypertrophy?

    <p>Oxygen exchange efficiency (D)</p> Signup and view all the answers

    During which week of gestation does the partitioning of the ventricles occur?

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

    How does increased preload affect ventricular function?

    <p>It enhances cardiac output by improving contraction strength. (D)</p> Signup and view all the answers

    What is the consequence of poor electrical conduction in the cardiac system?

    <p>The heart may develop bradycardia or heart blocks. (A)</p> Signup and view all the answers

    In the context of pulmonary hypertension, what is a significant risk factor?

    <p>Mean pulmonary artery pressure exceeding 35 mmHg. (C)</p> Signup and view all the answers

    What role do intercalated discs play in cardiac muscle function?

    <p>They enable unified contraction of cardiac muscle fibers. (C)</p> Signup and view all the answers

    What does the Frank-Starling law indicate about heart function?

    <p>Optimal ventricular filling leads to enhanced cardiac performance. (A)</p> Signup and view all the answers

    How do catecholamines affect cardiac function?

    <p>They enhance both heart rate and myocardial contractility. (B)</p> Signup and view all the answers

    What impact does right ventricular hypertrophy have on the heart's overall function?

    <p>It may result in compromised cardiac output and function. (C)</p> Signup and view all the answers

    Which of the following is a major consequence of untreated mitochondrial dysfunction in cardiac cells?

    <p>Reduced ability of the heart to generate action potentials. (C)</p> Signup and view all the answers

    What physiological change occurs during the QRS interval in an ECG?

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

    What condition is characterized by ineffective contraction of heart cells despite electrical stimulation?

    <p>Cardiac contractility impairment. (B)</p> Signup and view all the answers

    What is the primary physiological consequence of ventricular septal defect in Tetralogy of Fallot?

    <p>Mixing of oxygenated and deoxygenated blood (D)</p> Signup and view all the answers

    How does cyanosis primarily occur in the context of Tetralogy of Fallot?

    <p>Insufficient oxygenated blood reaches systemic circulation (B)</p> Signup and view all the answers

    Which of the following best describes the role of mitochondria in ventricular septal defect-related conditions?

    <p>They are essential for energy production and can suffer dysfunction (C)</p> Signup and view all the answers

    What is a common clinical manifestation of right ventricular hypertrophy in Tetralogy of Fallot?

    <p>Boot-shaped heart on chest x-ray (C)</p> Signup and view all the answers

    In the context of pulmonary stenosis, what physiological change typically occurs?

    <p>Increased pressure in the right ventricle (D)</p> Signup and view all the answers

    What mechanism contributes to the episodes of tet spells in patients with Tetralogy of Fallot?

    <p>Transient obstruction of the right ventricular outflow tract (A)</p> Signup and view all the answers

    Which of the following best describes the changes observed in the coronary arteries due to inflammatory responses in conditions like Kawasaki disease?

    <p>Narrowing and potential aneurysm formation (C)</p> Signup and view all the answers

    What is the main cause of the hypertrophy of the right ventricle in Tetralogy of Fallot?

    <p>Obstruction of blood flow due to pulmonary stenosis (A)</p> Signup and view all the answers

    Which of the following symptoms indicates a more severe case of cyanosis in Tetralogy of Fallot?

    <p>Clubbing of fingers and toes (A)</p> Signup and view all the answers

    What is a potential consequence of untreated ventricular septal defects in infants?

    <p>Fluid overload leading to pulmonary hypertension (D)</p> Signup and view all the answers

    Which characteristic finding is associated with aortic valve displacement in Tetralogy of Fallot?

    <p>Displacement over the ventricular septal defect (A)</p> Signup and view all the answers

    What physiological response occurs in the body after the development of pulmonary stenosis?

    <p>Increased workload on the right ventricle (C)</p> Signup and view all the answers

    Which cellular mechanism is primarily affected in patients with mitochondrial dysfunction in cardiac conditions?

    <p>Aerobic respiration efficiency (B)</p> Signup and view all the answers

    What is the effect of increased neutrophil elastase during the inflammatory response in vascular conditions?

    <p>Enhanced scar formation in arteries (A)</p> Signup and view all the answers

    Flashcards

    Preload

    The volume of blood in the ventricles at the end of diastole (relaxation phase) that stretches the cardiac muscle fibers before contraction.

    Neurohumoral responses

    The body's hormonal and nervous system responses to maintain blood pressure and fluid balance.

    Natriuretic peptides

    Hormones that cause vasodilation and decrease sympathetic tone, reducing sodium and fluid retention when blood pressure is too high.

    BNP (Brain Natriuretic Peptide)

    A natriuretic peptide released in response to high blood pressure or volume.

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    RAAS (Renin-Angiotensin-Aldosterone System)

    A system that increases blood pressure by constricting vessels and promoting sodium and fluid retention.

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    Septation

    The process of partitioning different heart structures (atria, ventricles, aorta and pulmonary trunk) during development.

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    Endocardial cushions

    Structures in the atrioventricular canal that grow and fuse to create separation between the atria and ventricles, as well as atrioventricular valve formation.

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    Foramen ovale

    A temporary opening between the atria that allows blood to bypass the lungs in the fetus.

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    Cardiac Output

    The amount of blood pumped by the heart per minute.

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    Afterload

    The force the heart must overcome to pump blood out.

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    Contractility

    The strength of the heart's contraction.

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    Pulmonary Circulation

    Blood flow through the heart to the lungs and back.

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    Systemic Circulation

    Blood flow throughout the body.

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    Frank-Starling Law

    The heart pumps more effectively with greater filling.

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    Electrocardiogram (ECG)

    A recording of the electrical activity of the heart.

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    Conduction System

    Pathways for electrical signals in the heart.

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    Automaticity

    Heart cells' ability to generate their electrical impulses independently.

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    Kawasaki Disease Theories

    Possible causes of Kawasaki disease, including genetic predisposition, viral exposure (like Epstein-Barr, Coronavirus, and Retrovirus), developing immune system issues, and abnormal immune response to common antigens.

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    Kawasaki Disease Diagnostic Criteria

    Specific criteria to diagnose Kawasaki disease, including a fever of at least 5 days and four of six signs: eye redness, mouth sores, swollen neck glands, skin changes, and rash.

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    Kawasaki Disease Nonspecific Findings

    Additional symptoms or signs seen with Kawasaki disease, such as heart inflammation (myocarditis/pericarditis), diarrhea, joint pain, kidney issues (proteinuria, WBCs in urine), reduced blood cells, and elevated inflammation markers.

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    Kawasaki Disease Complications

    Potential problems that can arise from Kawasaki disease, such as possible coronary artery aneurysms, myocarditis (heart inflammation).

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    Kawasaki Disease Stage 1

    First stage (up to 12 days), characterized by inflammation of blood vessels (capillaries, arterioles, venules) and the heart muscle (myocardium).

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    Kawasaki Disease Stage 2

    Second stage (Days 13-25), showing blood vessel breakdown (acute necrotizing vasculitis), potential aneurysm formation due to weak vessel structures.

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    Kawasaki Disease Stage 3

    Third stage (Days 26-40), with scar tissue formation, decreased blood vessel elasticity, and risk of blood clots (thrombosis).

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    Kawasaki Disease Stage 4

    Fourth stage (after Day 41), displaying heart muscle damage, scarring of the inner lining of the blood vessels (intimal thickening), and possible heart dysfunction.

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    Tetralogy of Fallot

    A congenital heart defect with four problems: thick right ventricle, shifted aorta, narrowed pulmonary artery, and hole between ventricles.

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    Tetralogy of Fallot Patho

    The heart doesn't develop properly, reducing blood flow to the lungs due to the four heart defects.

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    Tet Spells

    Episodes of severe cyanosis in TOF, often triggered by exertion or stress, when more deoxygenated blood enters systemic circulation.

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    TOF Pulmonary Stenosis

    Narrowing of the pulmonary artery valve, obstructing blood flow to the lungs, causing the right ventricle to work harder.

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    TOF Right Ventricular Hypertrophy

    Thickening of the right ventricle, due to the increased effort needed to push blood through the narrowed pulmonary artery.

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    TOF Ventricular Septal Defect

    Hole in the wall between the ventricles, enabling mixing of oxygenated and deoxygenated blood.

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    TOF Overriding Aorta

    Aorta positioned above the ventricular septal defect, receiving mixed blood, leading to overall reduced oxygen in the body.

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    Cyanosis

    Bluish discoloration of the skin due to low blood oxygen levels.

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    Study Notes

    Cardiovascular Overview

    • Afterload is cardiac output - the force against which the heart pushes.
    • Contractility is the pump function.
    • Preload is the venous system return to the heart, directly affecting delivery to the right atrium.
    • Blood is oxygenated in the lungs.
    • Major and minor vessels transport blood.
    • Veins have valves, returning blood to the heart.
    • Arteries provide afterload.
    • Capillary beds are crucial for perfusion to tissues.

    Conducting System

    • The sinoatrial node (pacemaker) initiates the heartbeat.
    • Internodal pathways conduct signals.
    • The atrioventricular node (AV node) delays signal.
    • The atrioventricular bundle (Bundle of His) transmits the signal.
    • Bundle branches transmit to Purkinje fibers.
    • Purkinje fibers stimulate ventricular contraction.

    Electrical Conduction

    • Heart cells have automaticity generating their own action potentials.
    • Cells usually fire in unison.
    • Sometimes abnormal beats occur, which affects cardiac contractions.
    • Intercalated discs mechanically influence cardiac tissue.

    Heart Anatomy and Function

    • Heart's four chambers: right atrium, right ventricle, left atrium, and left ventricle.
    • Blood flow through the heart and vessels.
    • Heart valves regulate blood flow.
    • Heart rate and stroke volume influence cardiac output.

    Cardiac Output

    • Heart rate (HR) multiplied by stroke volume (SV) equals cardiac output (CO).
    • Factors like autonomic innervation, hormones, etc. impact CO.
    • Factors affecting heart rate, stroke volume and cardiac output are briefly discussed

    Perfusion

    • Delivery of oxygen and nutrients to tissues.
    • Normal blood pressure values are given for various vessels.

    Hypertension

    • End-organ failure results from high blood pressure.
    • High pressure affects the brain, heart, eyes, kidneys, and peripheral vascular system.
    • Pressure and volume affect the efficiency of the ventricular function.
    • Frank Starling law describes the effectiveness of pumping.

    Heart Failure

    • Myocardial infarction is the typical cause for heart failure.
    • Myocardial damage impacts heart function.
    • Impaired heart function leads to fluid retention.
    • Ejection fraction measurements define severity.
    • Structural issues, increased pressure and inflammation play a role in heart failure.

    Fetal Circulation

    • Fetal lungs are not functional initially.
    • Blood bypasses the lungs.
    • Specific vessels and pathways allow this.
    • After birth, the circulatory system adjusts to lung function.

    Cardiovascular Diseases

    • Myocardial infarctions (MIs) or heart attacks are emphasized.
    • Causes of MI, including coronary artery blockages.
    • Subendocardial and transmural infarctions.
    • Clinical presentation, diagnosis, and pathophysiology of MI.
    • The factors affecting preload, afterload, myocardial tissue.
    • Complications from the described conditions are also summarized.
    • An overview of different types of cardiac diseases is summarized.

    Kawasaki Disease

    • Acute febrile systemic vasculitis affecting medium-sized blood vessels.
    • Myocarditis and coronary artery aneurysms.
    • Fever, conjunctivitis, oral changes, extremity changes, and polymorphous rash.
    • Diagnostic criteria and complications discussed.

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    N715 Exam 3 Part 1 PDF

    Description

    This quiz explores the key concepts of the cardiovascular system, including afterload, preload, and contractility. It also covers the heart's conducting system and electrical conduction, detailing how signals are transmitted through the heart. Test your knowledge on how the heart functions to pump blood efficiently.

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