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Pathophysiology Atherosclerosis and Atrial Fibrillation.pdf Flashcards
Study
1
Question
What is atherosclerosis characterized by?
Answer
Atherosclerosis is characterized by patchy intimal plaques (atheromas) that encroach on the lumen of medium-sized and large arteries. The plaques contain lipids, inflammatory cells, smooth muscle cells, and connective tissue.
2
Question
What are the risk factors for atherosclerosis?
Answer
Risk factors for atherosclerosis include dyslipidemia, diabetes, cigarette smoking, family history, sedentary lifestyle, obesity, and hypertension.
3
Question
How is the diagnosis of atherosclerosis made?
Answer
The diagnosis of atherosclerosis is clinical and confirmed by angiography, ultrasonography, or other imaging tests.
4
Question
What are the treatments for atherosclerosis?
Answer
Treatment for atherosclerosis includes risk factor modification, lifestyle and dietary changes, physical activity, antiplatelet drugs, and antiatherogenic drugs.
5
Question
What is arteriosclerosis?
Answer
Arteriosclerosis is a general term for several disorders that cause thickening and loss of elasticity in the arterial wall.
6
Question
Why is atherosclerosis considered the most serious form of arteriosclerosis?
Answer
Atherosclerosis is considered the most serious and clinically relevant form of arteriosclerosis because it causes coronary artery disease and cerebrovascular disease.
7
Question
Which arteries can be affected by atherosclerosis?
Answer
Atherosclerosis can affect all large and medium-sized arteries, including the coronary, carotid, cerebral arteries, the aorta and its branches, and major arteries of the extremities.
8
Question
What is the leading cause of morbidity and mortality in developed countries like the US?
Answer
Atherosclerosis is the leading cause of morbidity and mortality in the US and most developed countries.
9
Question
How many deaths worldwide were attributed to cardiovascular disease, primarily coronary and cerebrovascular atherosclerosis, in 2019?
Answer
In 2019, cardiovascular disease, primarily coronary and cerebrovascular atherosclerosis, caused about 18 million deaths worldwide accounting for 30% of all deaths.
10
Question
How many people died of cardiovascular disease in the US in 2019?
Answer
In 2019, about 558,000 people died of cardiovascular disease in the US.
11
Question
What is the clinically relevant form of arteriosclerosis that causes coronary artery disease and cerebrovascular disease?
Answer
Atherosclerosis
12
Question
Which arteries can be affected by atherosclerosis?
Answer
Coronary, carotid, cerebral, aorta, branches of the aorta, and major arteries of the extremities
13
Question
What is the leading cause of morbidity and mortality in the US and most developed countries?
Answer
Atherosclerosis
14
Question
How many deaths worldwide were caused by cardiovascular disease primarily coronary and cerebrovascular atherosclerosis in 2019?
Answer
About 18 million deaths worldwide
15
Question
How many people died of cardiovascular disease in the US in 2019?
Answer
About 558,000
16
Question
Where is atherosclerosis rapidly increasing in prevalence?
Answer
Low and middle-income countries
17
Question
What is the earliest visible lesion of atherosclerosis?
Answer
Fatty streak
18
Question
What are the three major components of an atherosclerotic plaque?
Answer
Lipids, inflammatory cells, smooth muscle cells
19
Question
What is the connective tissue matrix that may contain thrombi and calcium deposits in an atherosclerotic plaque?
Answer
A connective tissue matrix
20
Question
What is considered to be an inflammatory response to injury in atherosclerosis?
Answer
All stages of atherosclerosis, from initiation and growth to complication of the plaque (e.g., myocardial infarction, stroke)
21
Question
What role is thought to have a primary initiating role in atherosclerosis?
Answer
Endothelial injury
22
Question
What kind of blood flow is associated with the initiation of atherosclerosis?
Answer
Non-laminar or turbulent blood flow (e.g., at branch points)
23
Question
What are the three major components of the atherosclerotic plaque?
Answer
Lipids, inflammatory and smooth muscle cells, connective tissue matrix
24
Question
What is the primary initiating role in endothelial injury leading to atherosclerosis?
Answer
Nonlaminar or turbulent blood flow
25
Question
What is inhibited by nonlaminar or turbulent blood flow in the arterial tree?
Answer
Endothelial production of nitric oxide
26
Question
What stimulates endothelial cells to produce adhesion molecules that recruit inflammatory cells?
Answer
Nonlaminar or turbulent blood flow
27
Question
What are some risk factors for atherosclerosis mentioned in the text?
Answer
Dyslipidemia, diabetes, cigarette smoking, hypertension, oxidative stressors, systemic infection, and inflammation
28
Question
What is the net effect of risk factors on endothelial cells in atherosclerosis?
Answer
Endothelial binding of monocytes and T cells, migration of these cells, and initiation of vascular inflammatory response
29
Question
What do monocytes in the subendothelium transform into?
Answer
Macrophages
30
Question
What happens to lipids in the blood, particularly LDL and VLDL cholesterol, in atherosclerosis?
Answer
They bind to endothelial cells and are oxidized in the subendothelium
Pathophysiology Atherosclerosis and Atrial Fibrillation.pdf Flashcards
Study
1
Question
What were the lifetime risks to develop AF at age 40 years for men and women in the Framingham Heart Study?
Answer
Men: 26, Women: 23
2
Question
What were the lifetime risks to develop AF at age 55 years for men and women in the Rotterdam study?
Answer
Men: 23.8, Women: 22.2
3
Question
What factor largely explains the higher incidence of AF in men compared to women, according to the text?
Answer
Underlying risk factors of AF and taller stature in men
4
Question
After adjusting for AF-related risk factors, what did the CHARGE-AF Consortium report about male sex as an independent risk factor for AF?
Answer
Male sex was no longer an independent risk factor for AF
5
Question
Which population had a consistently lower lifetime risk for AF in men compared to women across all age groups?
Answer
Chinese adults
6
Question
Which racial group is reported to have a lower prevalence of AF compared to individuals of European ancestry?
Answer
Individuals of African ancestry
7
Question
What did the Multi-Ethnic Study of Atherosclerosis (MESA) report about the prevalence of AF in Hispanic and Asian individuals in the United States compared to white and African American individuals?
Answer
Hispanics: 61, Asians: 39, White: 112, African American: 58
8
Question
What racial and ethnic differences in AF prevalence have been observed in studies?
Answer
AF is less prevalent in individuals of African descent compared to European ancestry. Hispanics and Asians in the United States have lower incidence rates of AF compared to whites and African Americans.
9
Question
What did the MultiEthnic Study of Atherosclerosis (MESA) report about the prevalence of AF in Hispanics and Asians in the United States?
Answer
MESA reported a lower prevalence of AF in Hispanics and Asians, with age and sex-adjusted incidence rates of 61 in Hispanics and 39 in Asians compared to 112 in whites and 58 in African Americans.
10
Question
Which racial and ethnic groups have been found to have a lower risk of AF compared to whites, according to The Healthcare Cost and Utilization Project?
Answer
Hispanics and Asians have been found to have a lower multivariable-adjusted risk of AF compared to whites, with a hazard ratio of 0.78 and 95% CI of 0.77-0.79.
11
Question
What are some modifiable risk factors for AF related to physical activity and lifestyle?
Answer
Physical inactivity and sedentary lifestyle, hypertension, obesity, and diabetes are known risk factors for AF. Obstructive sleep apnea (OSA) is common in obese individuals and has been associated with a sedentary lifestyle.
12
Question
How does a sedentary lifestyle contribute to the risk of AF?
Answer
A sedentary lifestyle is known to increase the risk of AF by inducing structural and electrical remodeling of the atrium. Conditions such as hypertension, obesity, diabetes, and obstructive sleep apnea (OSA) are associated with sedentary behavior and can lead to AF.
13
Question
What are the primary mechanisms contributing to the pathogenesis of AF in endurance athletes?
Answer
The pathogenesis of AF in endurance athletes is attributed to increased vagal tone, which may shorten and increase the dispersion of atrial effective refractory period (ERP), promoting pulmonary vein firing and localized reentry.
14
Question
What is a modifiable risk factor for atrial fibrillation specifically in comparison to whites?
Answer
Hypertension
15
Question
How does a sedentary lifestyle increase the risk of atrial fibrillation?
Answer
By inducing structural and electrical remodeling of the atrium
16
Question
What is obstructive sleep apnea (OSA) associated with in obese individuals?
Answer
Sedentary lifestyle
17
Question
What are the two primary mechanisms attributed to the pathogenesis of atrial fibrillation in endurance athletes?
Answer
Increased vagal tone and progressive cardiac remodeling
18
Question
What are some of the factors contributing to the excess risk of atrial fibrillation in obesity?
Answer
Left atrial enlargement, increased left ventricular mass, and diastolic dysfunction
19
Question
According to the Framingham Heart Study, how much increased risk of atrial fibrillation was observed in men and women with diabetes respectively?
Answer
40% in men and 60% in women
20
Question
What may be more predictive of atrial fibrillation risk than the actual diagnosis of diabetes in older adults?
Answer
Level of blood glucose
21
Question
How do glucose intolerance and insulin resistance contribute to the development of the atrial fibrillation substrate in diabetes mellitus?
Answer
They mediate the development by altering cardiac structure through impaired mitochondrial function and oxidative stress
22
Question
What is a well-established independent predictor of atrial fibrillation related to high blood pressure?
Answer
Increased left atrial size
23
Question
What is the increased risk of atrial fibrillation (AF) in men with diabetes?
Answer
40% increased risk of AF in men with diabetes
24
Question
What is the increased risk of AF in women with diabetes?
Answer
60% increased risk of AF in women with diabetes
25
Question
What may be more predictive than the actual diagnosis of diabetes in older adults in relation to AF?
Answer
Level of blood glucose
26
Question
What pathophysiological factors mediate the development of the AF substrate in individuals with glucose intolerance and insulin resistance?
Answer
Glucose intolerance and insulin resistance
27
Question
What molecular mechanism is involved in the alteration of cardiac structure due to insulin resistance in individuals with AF?
Answer
Impaired mitochondrial function and oxidative stress
28
Question
What is a well-established independent predictor of AF related to chronic hypertension?
Answer
Increased left atrial size
29
Question
Apart from left atrial size, what other pathologic features of chronic hypertension are associated with AF?
Answer
Left ventricular hypertrophy and impaired diastolic dysfunction
30
Question
What common factor among individuals with chronic hypertension increases left atrial pressure and volume, leading to AF?
Answer
Elevated left ventricular end-diastolic pressure
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Unit 6 Nerve ID.pdf Flashcards
Study
1
Question
What is the capital city of France?
Answer
Paris
2
Question
What is the largest planet in our solar system?
Answer
Jupiter
3
Question
Who wrote the play 'Romeo and Juliet'?
Answer
William Shakespeare
4
Question
What is the chemical symbol for gold?
Answer
Au
5
Question
What is the powerhouse of the cell?
Answer
Mitochondria
6
Question
What is the tallest mountain in the world?
Answer
Mount Everest
7
Question
What is the capital city of Japan?
Answer
Tokyo
8
Question
Who painted the Mona Lisa?
Answer
Leonardo da Vinci
9
Question
What is the largest ocean on Earth?
Answer
Pacific Ocean
10
Question
What year did the Titanic sink?
Answer
1912
11
Question
What is the currency of Germany?
Answer
Euro
12
Question
Who discovered penicillin?
Answer
Alexander Fleming
13
Question
What is the largest desert in the world?
Answer
Sahara Desert
14
Question
What is the chemical symbol for iron?
Answer
Fe
15
Question
Who is known as the 'Father of Modern Physics'?
Answer
Albert Einstein
16
Question
What are the components and functions of the Glossopharyngeal nerve?
Answer
1. Special Sensory (Taste from the Posterior 1/3 of the tongue) 2. Visceral sensory from the carotid sinus and carotid body 3. Visceral Motor (Parasympathetic Preganglionic motor fibers to the otic ganglia and then to the parotid gland secretomotor - Lesser petrosal nerve) 4. Somatic branchial Motor to stylopharyngeus muscle (nucleus ambiguous) 5. Somatic general Sensory from the posterior 1/3 of the tongue and oropharynx (Inner surface of tympanic membrane - Afferent limb of the gag reflex) 6. Superior and inferior ganglia at the level of the jugular foramen that contain sensory cell bodies
17
Question
What are the components of the Lingual branch of the Glossopharyngeal nerve when tagged in the tonsillar bed?
Answer
1. Special sensation from the posterior third of the tongue 2. Somatic sensation from the posterior third of the tongue
18
Question
What are the components and functions of the Superior Laryngeal nerve?
Answer
1. Somatic motor (External laryngeal nerve to cricothyroid) 2. Somatic general Sensation above the true vocal folds (Cough reflex) 3. Special sensation (Taste fibers from the epiglottis and root or very posterior of the tongue)
19
Question
What are the components of the Internal Laryngeal nerve?
Answer
1. Somatic general Sensation above the true vocal folds (Cough reflex) 2. Special sensation (Taste fibers from the epiglottis and root or very posterior of the tongue) 3. Preganglionic parasympathetic secretomotor fibers to the mucosal glands
20
Question
What are the functions of the Vagus nerve?
Answer
1. Special Sensation (Taste fibers from the epiglottis and the very root posterior of the tongue) 2. Visceral Sensory a. Monitors the Viscera (e.g., Heart and Baroreceptors at arch of aorta, Chemoreceptors of aortic bodies, Thoracic and Abdominal viscera) b. Sensory from the mucosa above and below the vocal folds (Afferent of the cough reflex) 3. Visceral Motor (Parasympathetic Preganglionic Motor Fibers to the Viscera - Heart, Lungs, Esophagus, Abdominal Organs, Microscopic ganglia in the walls of the organs, Secretomotor to the glands in mucosa - Dorsal motor nucleus) 4. Somatic Motor (Branchial motor - Motor fibers to the Muscles of the Palate, Larynx, and Pharynx - nucleus ambiguous, Efferent of the cough reflex) 5. Somatic Sensory (General sensation from some of the external meatus and part of the tympanic membrane - auricular branch, Dura of posterior cranial fossa) 6. Superior ganglia of the Vagus has cell bodies of the somatic sensory fibers 7. Inferior or Nodose ganglia has cell bodies of the visceral sensory fibers
21
Question
What are the cell bodies of the somatic sensory fibers in the auricular branch of the posterior cranial fossa?
Answer
Superior ganglia of the Vagus
22
Question
What are the cell bodies of the visceral sensory fibers in the auricular branch of the posterior cranial fossa?
Answer
Inferior or Nodose ganglia
23
Question
Which muscle of the soft palate is innervated by V3 instead of the vagus nerve?
Answer
Tensor palatini
24
Question
Which muscle of the pharynx is innervated by the glossopharyngeal nerve instead of the vagus nerve?
Answer
Stylopharyngeus
25
Question
Which muscle of the tongue is innervated by the vagus nerve instead of the hypoglossal nerve?
Answer
Palatoglossus
26
Question
Which nerve innervates all of the laryngeal muscles except the cricothyroid muscle?
Answer
Inferior Recurrent laryngeal nerve
27
Question
Which nerve innervates the cricothyroid muscle instead of the inferior recurrent laryngeal nerve?
Answer
External laryngeal nerve
28
Question
Which pharyngeal arch is associated with the Glossopharyngeal nerve and its functions?
Answer
Arch 3
29
Question
Which pharyngeal arch is associated with the Vagus nerve, swallowing, superior laryngeal nerve, and pharyngeal branches?
Answer
Arch 4
30
Question
Which pharyngeal arch is associated with the Vagus nerve, recurrent laryngeal nerves, and speaking functions?
Answer
Arch 6
Unit 6 Nerve ID.pdf Flashcards
Study
1
Question
Controls voluntary movements and sensory information
Answer
Motor nerves
2
Question
Regulates involuntary functions like heart rate and digestion
Answer
Autonomic nerves
3
Question
Transmits information from the body to the brain and vice versa
Answer
Sensory nerves
4
Question
Coordinates muscle movements and maintains balance
Answer
Cerebellum nerves
5
Question
Regulates hormone production and the body's internal environment
Answer
Endocrine nerves
6
Question
Controls conscious thoughts, reasoning, and decision-making
Answer
Cerebral cortex nerves
7
Question
Regulates sleep, mood, and emotions
Answer
Limbic system nerves
8
Question
Facilitates communication between the brain and spinal cord
Answer
Brainstem nerves
9
Question
Controls reflex actions such as pulling hand away from a hot surface
Answer
Spinal cord nerves
10
Question
Sensory fibers: Inferior or Nodose ganglia has cell bodies of the visceral sensory fibers
Answer
Innervation of muscle groups
11
Question
Muscles of the soft palate innervation
Answer
Vagus except tensor palatini (V3)
12
Question
Muscles of the pharynx innervation
Answer
Vagus except stylopharyngeus which is glossopharyngeal
13
Question
Muscles of the tongue innervation
Answer
Hypoglossal except palatoglossus which is vagus
14
Question
Innervation of laryngeal muscles
Answer
Inferior Recurrent laryngeal nerves except for the cricothyroid from external laryngeal nerve
15
Question
Auricular branch Dura of posterior cranial fossa
Answer
Innervation of the Dura of posterior cranial fossa
16
Question
Superior ganglia of the Vagus
Answer
Contains cell bodies of the somatic sensory fibers
17
Question
Inferior or Nodose ganglia
Answer
Contains cell bodies of the visceral sensory fibers
18
Question
Innervation of muscle groups
Answer
1. All muscles of the soft palate are vagus except tensor palatini which is V3 2. All muscles of the pharynx are vagus except stylopharyngeus which is glossopharyngeal 3. All muscles of the tongue are hypoglossal except palatoglossus which is vagus 4. All laryngeal muscles are innervated by the inferior recurrent laryngeal nerves except cricothyroid which is from the external laryngeal nerve
19
Question
Branchial Pharyngeal Arches Arch 3
Answer
Glossopharyngeal nerve components and functions listed above
20
Question
Branchial Pharyngeal Arches Arch 4
Answer
Vagus: Swallowing - Superior laryngeal nerve and Pharyngeal Branches Vagus: Recurrent Laryngeal nerves - Speaking