Circulatory System

1. Kept open by PGE2
2. Closes within 2-3 days after birth
   1. ligamentum arterisum
3. Patent ductus arteriosus
   1. HF
   2. Associated with rubella infection
   3. Treat with PGE2 inhibitors: indomethacin
   4. Heart shunted from aorta to pulmonary arteries

1. Oval fossa

1. Ligamentum venosum

1. Ventricular septal defect
2. Over-riding aorta
3. Pulmonary artery stenosis
4. hypertrophy of RV

1. Supplied by
   1. Vasa Vasorum
   2. Nervi vasorum
   3. In elastic arteries and large veins

1. Veins don't have elastic

1. Tunica media dilated

1. Bleeding around the vessel

Anmerkungen:

• Allows LDLs to enter

1. Fatty deposits under endothelium- basement membrane
   1. Macrophages go investigate become foam cells
      1. Were macrophages, but ingested oxidised LDLs so look foamy
         1. LDLs
            1. low density lipoproteins
               1. Transports triglycerides surrounded by proteins, phospholipids and cholesterol
                  1. Bring cholesterol to body cells from liver
            2. HDLs
               1. bring cholesterol from body cells to liver
                  1. Remove excess cholesterol
                     1. Good
            3. Should be low
      2. Leads to a fatty streak

         Anmerkungen:

         • Everything ocurring in basement membrane so far (on top of the tunica media)
         1. Smooth muscle cells from tunica media migrate to tunica externa to create barrier between clot and blood- fibrous cap

            Anmerkungen:

            • Macrophages promote this
            1. Also put down calcium which stiffens vessel
               1. The clot can become unstable and rupture
                  1. Leading the the clotting cascade

1. No blood goes to hands/feet
2. can be caused by cold or anxiety

1. Don't close
2. Post-capillary venules
   1. Lymphatic cells migrate between tissue and blood

1. Stroke
   1. Ischaemic
      1. Blocked vessel in brain blocked
   2. Haemorrhage
      1. Blood vessel burst
2. Peripheral Artery Disease
3. Coronary artery disease
4. Renal failure
5. Dementia
6. HF
7. Retinal vein occlusion

1. Overweight
2. Lack of exercise
3. High salt diet
4. Alcohol
5. Smoking
6. Genetic
7. Low birth weight

1. RAA system
2. Sympathetic NS
3. Arteriosclerosis
   1. In elderly= high systolic BP

1. Type 1
   1. >140/90
   2. >135/85
      1. Ambulatory
         1. Best
2. Type 2
   1. >160/100
      1. >150/95
3. Severe
   1. >180/110
4. After diagnosing
   1. Cardiovascular risk
   2. Look for end-organ damage
      1. Urine test
      2. Blood test
      3. Physical examination- heart
      4. ECG

1. Essential (primary) = don't know what causes it
2. Secondary- cause
   1. <30years
   2. Renal problems
   3. Severe treatment-resistant
   4. Cushings

1. <55yr
   1. A
      2. -pril
         1. ACE inhibitor
      3. or angiotensin II antagonist if intolerant
         1. -asartan
2. >55yrs/ black
   1. C or D
      1. A and C/D
         1. A +C+D
            1. Add diuretic, alpha blocker, beta blocker
               1. B= -lol
      2. C= pine
      3. D= actone

Anmerkungen:

• most common. Can also get left dominant and co-dominant

1. Contains
   1. Great vessels
   2. Trachea
   3. Oesophagus
   4. Vagus and phrenic nerves
2. Borders
   1. Transverse line from sternal angle to T4/5
   2. Pleura
   3. Thoracic inlet

1. Thoracic aorta
2. Oesophagus
3. Borders
   1. Pericardium (heart)
   2. Diaphragm
   3. Transverse line between sternal angle and T4/5
   4. Pleura
4. Vagus nerve
5. Thoracic duct

1. Heart
2. Right and left main bronchi
3. Pericardial sac

1. pH= 6.1 + log10([HCO3-]/0.23x PCO2)