Week 1
Lecture 1 Anatomy
The heart is located in the anterior part of the mediastinum, immediately posterior to the sternum.
Para(sternal) = next to (sternal).
Posterior and superior mediastinum important to understand (EXAM QUESTION).
Artery away from heart to organs (oxygenated), and from vein to heart (deoxygenated).
Blood flows from right atrium (RA) to left atrium (LA).
Tetralogy of Fallot (EXAM QUESTION): pulmonary stenosis – VSD – overriding aorta – enlarged RV.
Stenosis = narrowing.
Forming primitive heart by looping (atrium migrates from caudal to cranial) and rotation (right
atrium and ventricle rotate to ventral.
Integumentary system functions as body temperature regulator, cell fluid maintenance, synthesis of
vitamin D and detection of stimuli.
Skeletal system functions in the shape, allows movement, makes blood cells, protects the organs and
stores minerals.
Muscular system: contractibility and movement.
Nervous system: controlling, regulating and communicating,
Endocrine system: regulates all biological processes in the body.
Lymphatic system: protection from illness-causing invaders.
Digestive system: provides energy.
Lecture 2 Physiology
Potassium is negatively charged. Calcium initiates contraction.
Noradrenaline is a sympathetic stimulation and acetylcholine parasympathetic (opens K +).
Long QT syndrome is a mutation in an ion channel causing impaired repolarization.
We do NOT measure individual action potentials in an ECG, but electrical differences between
regions in the heart.
PR interval = AV-node conduction
QRS = enlarged ventricles/ something wrong with bundled branges?
QT = ventricle depolarization and repolarization (T-wave represents repolarization of the ventricles).
Signal to left = positive, right = negative.
STUDY: Einthoven’s triangle.
Diastole is the filling phase and systole the contractile phase.
Isovolumetric means that there is no change in volume.
EDV - ESV = SV.
Ejection fraction: SV / EDV (in %).
CO = SV X HR.
Frank-Starling mechanism (EXAM QUESTION), increased filling pressure > increased stroke volume.
If AV-node does not delay signal, whole heart contract at the same time (atria will not fill the
ventricles). Atria only 10-20%, ventricles most = passive. So not that big of a problem.
1nd heart sound (systole): closing mitral and tricuspid valve (valves between atria and ventricles).
2nd heart sound (diastole): closing of aorta and pulmonary valves.
WEEK 2
Lecture 1 Anatomy
Most blood in your body is in the veins (systemic venous system, 64%).
Deep venous system: when you are hot/ exercised and need to lower your body temperature.
Superficial venous system: when you want to stay hot.
, RIMA can be used as a bypass (right internal thoracic artery), because without this artery you still get
blood directly from the aorta.
Anastomoses: 2 main arteries connect and form circle of Willy (can take over blood flow with other
arteries if needed).
Study: hemorraghes with CT-scans (and dia 27/66).
Azygos (unpaired) vein connects superior and inferior vena cava.
Lecture 2 Physiology
Mean arterial pressure = (diastolic pressure (low)) + (pulse pressure/3).
Compliance of a vessel = Δ volume/Δ pressure.
Resistance blood vessels = 8Ln/pi r4.
= (8 x length x viscosity)/ (pi x radius4).
Know by heart!
Neural controls; norepinephrine (vasoconstrictor), NO (vasodilator).
Hormonal controls; epinephrine (vasoconstrictor), epinephrine (vasodilator).
Epinephrine is both a vasoconstrictor and a vasodilator because it has 3 different receptors. Alpha 1
and 2 can have smooth muscle contraction and beta relaxation.
Autoregulation in tissues (local regulation); ET-1 (vasoconstrictor), oxygen and NO (vasodilator).
Lecture 3
Anemia is a reduced capacity of the blood to transport oxygen.
Plasma: blood cells, fibrinogen.
Serum: no clotting factors or white blood cells.
Endothelial cells: anti-thrombotic, want to keep your blood flowing.
How? 1. Binding anti-thrombin III, inhibits thrombin directly.
2. Activated protein C, inhibits factor 5a and 7a.
3. Production of Tissue Factor Pathway Inhibitor, inhibits factor 7a.
Hemostasis: the prevention of blood loss (vasoconstriction, formation platelet (thrombocytes) plug,
blood cloth (coagulation, thrombosis), dissolution of fibrin (blood) clot (fibrinolysis).
Extrinsic pathway tissue factor binds to factor 7, intrinsic collagen binds to factor 12. Without
calcium the whole cascade does not run and factor 5 and 10a are present in both systems.
Know by heart!
Table 12.15 anticlotting roles of endothelial cells.
Week 3
Lecture 1 Anatomy
Functions of the respiratory system are; gas exchange, moves air, protects from environment,
produces sounds and participates in olfactory sense.
When doing a corona test, a swab from pharyngeal tonsil through inferior meatus is taken.
When talking, the epiglottis closes (goes down) off the larynx as a lit.
During swallowing the larynx is elevated and the epiglottis folds back (vocal cords closed).
External intercostal muscles lift diaphragm up (hand in outside), internal lifts down (inside pocket).
Deep inhale, rib cage lifted up: external intercostal muscles, sternocleidomastoid, serratus anterior,
pectoralis minor and scalene muscles.
Exhale: no muscles needed. But forceful exhalation is with internal intercostal and transversus
thoracis muscles, and abdominal muscles.
The vagal nerve comes from your brain (autonomic, parasympathetic branch).
