BOOK
Crash Course Cardiovascular System E-Book
Jonathan Evans | Daniel Horton-Szar | David E Newby
(2012)
Additional Information
Book Details
Abstract
The new series of Crash Course continues to provide readers with complete coverage of the MBBS curriculum in an easy-to-read, user-friendly manner. Building on the success of previous editions, the new Crash Courses retain the popular and unique features that so characterised the earlier volumes. All Crash Courses have been fully updated throughout.
- Almost 160 illustrations present clinical, diagnostic and practical information in an easy-to-follow manner
- Friendly and accessible approach to the subject makes learning especially easy
- Written by students for students - authors who understand exam pressures
- Contains ‘Hints and Tips’ boxes, and other useful aide-mémoires
- Succinct coverage of the subject enables ‘sharp focus’ and efficient use of time during exam preparation
- Contains a fully updated self-assessment section - ideal for honing exam skills and self-testing
- Self-assessment section fully updated to reflect current exam requirements
- Contains ‘common exam pitfalls’ as advised by faculty
- Crash Courses also available electronically!
- Online self-assessment bank also available - content edited by Dan Horton-Szar!
Now celebrating over 10 years of success - Crash Course has been specially devised to help you get through your exams with ease.
Completely revised throughout, the new edition of Crash Course is perfectly tailored to meet your needs by providing everything you need to know in one place. Clearly presented in a tried and trusted, easy-to-use, format, each book in the series gives complete coverage of the subject in a no-nonsense, user-friendly fashion.
Commencing with 'Learning Objectives', each chapter guides you succinctly through the topic, giving full coverage of the curriculum whilst avoiding unnecessary and often confusing detail. Each chapter is also supported by a full artwork programme, and features the ever popular 'Hints and Tips' boxes as well as other useful aide-mémoires. All volumes contain an up-to-date self-assessment section which allows you to test your knowledge and hone your exam skills.
Authored by students or junior doctors - working under close faculty supervision - each volume has been prepared by someone who has recently been in the exam situation and so relates closely to your needs. So whether you need to get out of a fix or aim for distinction Crash Course is for you!!
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Crash Course: Cardiovascular System | iii | ||
| Copyright | iv | ||
| Series editor foreword | v | ||
| Prefaces | vi | ||
| Acknowledgements | vii | ||
| Dedication | viii | ||
| Contents | ix | ||
| Chapter 1: Overview of the cardiovascular system | 1 | ||
| Why do we need a cardiovascular system? | 1 | ||
| Functions of the cardiovascular system | 1 | ||
| The heart and circulation | 1 | ||
| Chapter 2: Anatomy, histology and development of the cardiovascular system | 3 | ||
| Anatomy | 3 | ||
| The mediastinum | 3 | ||
| Pericardium | 3 | ||
| External structure of the heart | 4 | ||
| Internal structure of the heart | 5 | ||
| Coronary arteries | 5 | ||
| Coronary veins | 5 | ||
| Great vessels | 5 | ||
| The vascular tree | 5 | ||
| Development of the heart and great vessels | 7 | ||
| Development of the vasculature | 12 | ||
| Circulatory adaptations at birth | 14 | ||
| Congenital abnormalities | 15 | ||
| Left-to-right shunts | 15 | ||
| Atrial septal defect | 15 | ||
| Ventricular septal defect | 16 | ||
| Patent ductus arteriosus | 16 | ||
| Right-to-left shunts | 17 | ||
| Tetralogy of Fallot | 17 | ||
| Transposition of the great arteries | 17 | ||
| Obstructive congenital defects | 17 | ||
| Coarctation of the aorta | 17 | ||
| Histology | 18 | ||
| Tissue layers of the heart and pericardium (Fig. 2.41) | 18 | ||
| Pericardium | 18 | ||
| Heart | 18 | ||
| Epicardium | 18 | ||
| Myocardium | 18 | ||
| Endocardium | 18 | ||
| Fibrous heart skeleton | 19 | ||
| Valves | 19 | ||
| Cardiac myocytes | 19 | ||
| Ultrastructure of the typical cardiomyocyte | 19 | ||
| Structure of the vessels | 20 | ||
| Anatomical classification | 20 | ||
| Functional classification | 20 | ||
| Conductance | 22 | ||
| Resistance | 22 | ||
| Exchange | 22 | ||
| Capacitance | 22 | ||
| Compliance of capacitance vessels | 22 | ||
| Capillaries | 23 | ||
| Lymphatic vessels | 23 | ||
| Endothelial cells | 23 | ||
| Vascular smooth muscle | 24 | ||
| Structure | 24 | ||
| Contraction of vascular smooth muscle | 24 | ||
| Effect of sympathetic innervation | 25 | ||
| Vascular smooth muscle relaxation | 25 | ||
| Chapter 3: Cardiac electrophysiology and arrhythmia | 27 | ||
| Introduction | 27 | ||
| The conduction system | 27 | ||
| Resting membrane potential | 27 | ||
| Cardiac action potential | 28 | ||
| Fast cell action potential | 28 | ||
| Slow cell action potential (Fig.3.4) | 29 | ||
| Refractory period | 30 | ||
| Control of heart rate | 30 | ||
| Excitation contraction coupling | 31 | ||
| Electrocardiography | 32 | ||
| Bipolar limb leads | 33 | ||
| Unipolar limb leads | 33 | ||
| Chest leads | 33 | ||
| Normal electrocardiogram | 33 | ||
| Why the T wave is in the same direction as the R wave | 35 | ||
| Cardiac axis | 35 | ||
| Anterior chest leads (V1-V6) | 35 | ||
| Assessment of rate | 35 | ||
| Assessment of rhythm | 36 | ||
| Arrhythmia | 36 | ||
| Definitions and classification | 36 | ||
| Altered sinus rhythms | 37 | ||
| Mechanisms of arrhythmia | 37 | ||
| Heart block (Fig. 3.16) | 37 | ||
| Bundle branch block (Fig. 3.17) | 37 | ||
| Extrasystole (ectopic beats) | 39 | ||
| Wolff-Parkinson-White syndrome | 39 | ||
| Supraventricular tachycardias | 39 | ||
| Atrial fibrillation | 39 | ||
| Ventricular arrhythmias | 40 | ||
| Ventricular tachycardia | 40 | ||
| Ventricular fibrillation | 40 | ||
| Cardiac arrest | 40 | ||
| Anti-arrhythmic drugs | 40 | ||
| Class I: sodium channel blockers | 40 | ||
| Class II: beta-blockers | 40 | ||
| Class III: potassium channel blockers | 41 | ||
| Class IV: calcium channel blockers | 42 | ||
| Other drugs not in this classification | 42 | ||
| Drugs used to treat bradyarrythmias | 42 | ||
| Other treatments for arrhythmias | 42 | ||
| Carotid sinus massage | 42 | ||
| Direct current (DC) shock therapy | 42 | ||
| Radiofrequency ablation | 42 | ||
| Pacemaker | 42 | ||
| Chapter 4: The cardiac cycle and control of cardiac output | 43 | ||
| The cardiac cycle | 43 | ||
| The ventricular cycle | 43 | ||
| 1. Ventricular filling (diastole) | 43 | ||
| 2. Isovolumetric contraction (systole) | 43 | ||
| 3. Ejection (systole) | 43 | ||
| 4. Isovolumetric relaxation (diastole) | 45 | ||
| The atrial cycle | 45 | ||
| Heart sounds | 45 | ||
| Normal heart sounds (Fig.4.4) | 45 | ||
| Splitting of the second heart sound (Fig.4.5) | 45 | ||
| Added heart sounds (Fig.4.4) | 45 | ||
| Murmurs | 47 | ||
| Valvular heart disease | 47 | ||
| Mitral stenosis | 47 | ||
| Mitral regurgitation | 47 | ||
| Aortic stenosis | 47 | ||
| Aortic regurgitation | 47 | ||
| Echocardiography | 47 | ||
| Rheumatic heart disease | 48 | ||
| Infective endocarditis | 49 | ||
| Control of cardiac output | 50 | ||
| Definitions and concepts | 50 | ||
| Preload | 50 | ||
| Afterload | 50 | ||
| Contractility | 50 | ||
| Positive inotropes | 50 | ||
| Negative inotropes | 51 | ||
| Starling's law of the heart | 51 | ||
| Change in preload | 52 | ||
| Change in afterload | 52 | ||
| Chapter 5: Haemodynamics and vascular function | 53 | ||
| Haemodynamics in blood vessels | 53 | ||
| Blood flow and velocity | 53 | ||
| Vascular resistance | 53 | ||
| Poiseuille's law | 53 | ||
| Blood viscosity | 54 | ||
| Arteries | 55 | ||
| The pulse waveform | 55 | ||
| Arterial blood pressure | 55 | ||
| Measurement of arterial blood pressure | 55 | ||
| Normal blood pressure | 56 | ||
| Mean arterial blood pressure (mABP) | 56 | ||
| Pulse pressure | 56 | ||
| Arterioles | 56 | ||
| Control of vascular smooth muscle (VSM) tone | 57 | ||
| Local influences | 57 | ||
| Myogenic tone | 57 | ||
| Endothelium-derived substances | 57 | ||
| Endothelium-derived dilator factors | 57 | ||
| Endothelium-derived constrictor factors | 57 | ||
| Metabolic factors | 57 | ||
| Other local factors | 58 | ||
| Systemic influences | 58 | ||
| Autonomic nervous influences | 58 | ||
| Sympathetic vasoconstrictor nerves | 58 | ||
| Sympathetic vasodilator nerves | 59 | ||
| Parasympathetic vasodilator nerves | 59 | ||
| Hormonal influences | 59 | ||
| Catecholamines | 59 | ||
| Antidiuretic hormone (ADH) | 59 | ||
| Angiotensin II | 59 | ||
| Natriuretic peptides | 60 | ||
| Autoregulation | 60 | ||
| Hypertension | 60 | ||
| Classification and causes | 60 | ||
| Malignant hypertension | 61 | ||
| Complications of hypertension | 61 | ||
| Effects of hypertension of the vessels | 61 | ||
| Antihypertensive drugs | 61 | ||
| Angiotensin-converting enzyme inhibitors | 61 | ||
| Angiotensin II receptor antagonists | 62 | ||
| Diuretics | 62 | ||
| Alpha-blockers | 62 | ||
| Calcium channel blockers | 62 | ||
| Beta-blockers | 62 | ||
| Choice of drugs | 62 | ||
| Capillaries | 62 | ||
| Solute exchange | 63 | ||
| Fluid exchange | 64 | ||
| 1. Hydrostatic pressure | 64 | ||
| 2. Oncotic pressure | 64 | ||
| Net filtration | 65 | ||
| Lymph and the lymphatic system | 65 | ||
| Distribution of the lymphatic tissues | 65 | ||
| Veins and venules | 67 | ||
| Passive influences | 67 | ||
| Blood volume | 67 | ||
| Posture | 67 | ||
| Skeletal muscle pump | 67 | ||
| Respiratory pump | 68 | ||
| Active influences | 68 | ||
| Sympathetic innervation | 68 | ||
| Circulating catecholamines | 68 | ||
| Regulation of blood flow in specific tissues | 68 | ||
| Coronary circulation | 68 | ||
| Cerebral circulation | 69 | ||
| Pulmonary circulation | 70 | ||
| Cutaneous circulation | 70 | ||
| Chapter 6: Integrated control of the cardiovascular system and cardiovascular reflexes | 73 | ||
| Arterial baroreceptors and the baroreflex | 73 | ||
| Central pathways | 74 | ||
| Medulla | 74 | ||
| Hypothalamus | 74 | ||
| Cardiorespiratory interactions | 74 | ||
| Sinus arrhythmia (Fig.6.2) | 75 | ||
| Arterial chemoreceptors | 75 | ||
| Other cardiopulmonary receptors | 76 | ||
| Atrial stretch receptors | 76 | ||
| Unmyelinated mechanoreceptor fibres | 76 | ||
| Chemosensitive fibres | 76 | ||
| Coordinated cardiovascular responses | 76 | ||
| Orthostasis | 76 | ||
| Valsalva manoeuvre | 76 | ||
| Diving reflex | 77 | ||
| The alerting/defence response | 77 | ||
| Syncope (fainting) | 77 | ||
| Cardiovascular response to exercise | 78 | ||
| Dynamic exercise | 78 | ||
| Static exercise | 79 | ||
| Blood pressure during static and dynamic exercise (Fig.6.4) | 79 | ||
| Anaerobic exercise | 80 | ||
| Shock and haemorrhage | 80 | ||
| Haemorrhage | 80 | ||
| Immediate response (seconds to minutes) | 80 | ||
| Intermediate response (minutes to hours) | 81 | ||
| Long-term response (hours to days) | 82 | ||
| Shock | 82 | ||
| Hypovolaemic shock | 82 | ||
| Cardiogenic shock | 82 | ||
| Obstructive shock | 82 | ||
| Septic shock | 83 | ||
| Anaphylaxis | 83 | ||
| Chapter 7: Atherosclerosis and ischaemic heart disease | 85 | ||
| Arteriosclerosis and atherosclerosis | 85 | ||
| Arteriosclerosis | 85 | ||
| Atherosclerosis | 85 | ||
| Risk factors | 85 | ||
| Non-modifiable | 85 | ||
| Modifiable | 85 | ||
| Pathogenesis | 85 | ||
| Lipids and the cardiovascular system | 87 | ||
| Lipid transport and metabolism | 87 | ||
| Hyperlipidaemia | 87 | ||
| Treatment of hyperlipidaemia | 87 | ||
| Drugs used to lower cholesterol | 87 | ||
| Statins (e.g. simvastatin, atorvastatin) | 87 | ||
| Bile acid binding resins (e.g. colestipol and colestyramine) | 87 | ||
| Ezetimibe | 87 | ||
| Drugs used to lower triglyceride levels | 89 | ||
| Niacin | 89 | ||
| Fibrates | 89 | ||
| Ischaemic heart disease | 89 | ||
| Risk prediction and primary prevention | 89 | ||
| Classification | 90 | ||
| Stable angina | 90 | ||
| Treatment | 91 | ||
| Pharmacological treatment of angina | 91 | ||
| Organic nitrates | 91 | ||
| Calcium channel blockers (e.g. nifedipine, verapamil, diltiazem) | 91 | ||
| Beta-blockers (e.g. atenolol, metoprolol) | 93 | ||
| Nicorandil | 93 | ||
| Ivabradine | 93 | ||
| Interventional treatments | 93 | ||
| Percutaneous coronary intervention (PCI) | 93 | ||
| Coronary artery bypass graft (CABG) | 94 | ||
| Acute coronary syndromes | 94 | ||
| Biochemical markers of myocyte necrosis | 94 | ||
| Investigations | 94 | ||
| Management | 94 | ||
| Drugs used in the treatment of ACS | 95 | ||
| Antiplatelet agents | 95 | ||
| Aspirin | 96 | ||
| Clopidogrel | 97 | ||
| GPIIb/IIIa inhibitors | 97 | ||
| Anticoagulant agents | 97 | ||
| Beta-blockers | 97 | ||
| Thrombolytic therapy | 98 | ||
| Primary PCI | 98 | ||
| Complications | 98 | ||
| Chapter 8: Heart failure, myocardial and pericardial disease | 99 | ||
| Heart failure | 99 | ||
| Causes of heart failure | 99 | ||
| Those that damage cardiac muscle itself | 99 | ||
| Those that demand extra work of the heart | 100 | ||
| Compensatory mechanisms | 100 | ||
| The vicious cycle of heart failure | 101 | ||
| Clinical features | 101 | ||
| Treatment of heart failure | 102 | ||
| General measures | 103 | ||
| Diuretics | 103 | ||
| Angiotensin-converting enzyme inhibitors | 103 | ||
| Beta-blockers | 103 | ||
| Aldosterone antagonists | 103 | ||
| Cardiac glycosides | 103 | ||
| Nitrates | 103 | ||
| Inotropic drugs | 104 | ||
| β1-Sympathomimetics | 104 | ||
| Phosphodiesterase inhibitors | 104 | ||
| Device therapy | 104 | ||
| Cardiac resynchronization therapy (CRT) | 104 | ||
| Implantable cardiac defibrillators (ICDs) | 104 | ||
| Ventricular assist device | 104 | ||
| Transplantation | 104 | ||
| Diseases of the myocardium | 104 | ||
| Myocarditis | 104 | ||
| Cardiomyopathy | 104 | ||
| Dilated cardiomyopathy | 104 | ||
| Hypertrophic cardiomyopathy | 105 | ||
| Restrictive cardiomyopathy | 106 | ||
| Diseases of the pericardium | 106 | ||
| Acute pericarditis | 106 | ||
| Pericardial effusion | 106 | ||
| Haemopericardium | 106 | ||
| Cardiac tamponade | 106 | ||
| Chapter 9: Vascular disease | 109 | ||
| Arterial disease | 109 | ||
| Occlusive arterial disease | 109 | ||
| Chronic | 109 | ||
| Intermittent claudication | 109 | ||
| Critical limb ischaemia | 109 | ||
| Acute limb ischaemia | 110 | ||
| Examination | 110 | ||
| Femoral pulse | 110 | ||
| Popliteal pulse | 110 | ||
| Posterior tibial pulse | 110 | ||
| Dorsalis pedis pulse | 110 | ||
| Buerger's test | 110 | ||
| Doppler ultrasonography | 111 | ||
| Aneurysmal disease | 111 | ||
| Abdominal aortic aneurysm | 112 | ||
| Aortic dissection | 112 | ||
| Carotid artery disease | 113 | ||
| Diseases of the veins | 113 | ||
| Varicose veins | 113 | ||
| Aetiology | 114 | ||
| Other sites of varicosities | 114 | ||
| Deep vein thrombosis (DVT) | 115 | ||
| Chapter 10: Basic history and examination of the cardiovascular system | 117 | ||
| Taking a history | 117 | ||
| Risk factors | 117 | ||
| Past medical history | 117 | ||
| Family history | 117 | ||
| Review of systems | 117 | ||
| Respiratory system | 117 | ||
| Gastrointestinal system | 118 | ||
| Genitourinary system | 118 | ||
| Clinical examination | 118 | ||
| General appearance | 118 | ||
| Hands and arms | 118 | ||
| Radial pulse | 118 | ||
| Brachial pulse | 118 | ||
| Blood pressure | 118 | ||
| Face and neck | 119 | ||
| Carotid pulse | 119 | ||
| Jugular venous pulse | 121 | ||
| Thorax | 122 | ||
| Inspection | 122 | ||
| Palpation | 122 | ||
| Auscultation | 122 | ||
| Normal heart sounds | 123 | ||
| Added heart sounds | 123 | ||
| Murmurs | 123 | ||
| Abdomen | 124 | ||
| Legs | 124 | ||
| Cardiovascular examination summary | 124 | ||
| Self-assessment | 127 | ||
| Single best answerquestions (SBAs) | 129 | ||
| Extended matching questions(EMQs) | 135 | ||
| Objective structured clinicalexamination (OSCE) stations | 137 | ||
| 1. This gentleman has been complaining of shortness of breath on exertion. Please examine his cardiovascular system | 137 |