Pencil Villain Shared "Physiology" - 140 Picmonics

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Physiology

Cardiac Cycle - Systole
Characteristics
AV Node
AV Node Conducts Signal to Bundle of His
Bundle of His Signals Purkinje Fibers to Contract Ventricles
Tricuspid Valve Closes
Pulmonary Valve Opens
Mitral Valve Closes
Aortic Valve Opens
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2 mins
Cardiac Cycle - Diastole
Characteristics
Aortic Valve Closes
Pulmonary Valve Closes
Ventricles Relax
Mitral Valve Opens
Tricuspid Valve Opens
Ventricles Fill
Sinoatrial (SA) Node Fires
Atrial Contraction
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3 mins
Lymphatics
Characteristics
Recycles 10% of Interstitial Fluid
Transport Large Lipids from Lacteals
Unidirectional Valves
Lymph Nodes Filter Lymph
WBCs Monitor Lymph for Pathogens
Merge with Veins
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2 mins
Aortic Stenosis
Characteristics
Age-related Calcifications
Bicuspid Aortic Valve
Crescendo-decrescendo Murmur
Systolic Murmur
Ejection Murmur
Ejection Click
Radiates to Carotids and Apex
Pulsus Parvus et Tardus
Syncope
Helmet Cells
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2 mins
Aortic Regurgitation
Auscultation
Diastolic Murmur
Immediate High-pitched
Blowing Murmur
Clinical Findings
Wide Pulse Pressure
Water Hammer Pulse
Head Bobbing
Pulsating Nail Bed
Considerations
Can Cause Austin Flint Murmur
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1 min
Tricuspid Regurgitation
Holosystolic
Blowing Murmur
Radiates to Right Sternal Border
Enhanced by Inspiration
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1 min
Mitral Stenosis
Characteristics
Murmur Follows Opening Snap
Late Diastolic Murmur
Enhanced by Expiration
Low-Pitched Rumbling
Dilation of Left Atrium (LA)
Recurrent Attacks of Rheumatic Fever
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2 mins
Mitral Regurgitation
Characteristics
Holosystolic
Blowing Murmur
Loudest at Apex
Radiates toward Axilla
Louder by Squatting
Hand Grip
Expiration
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1 min
Right to Left Heart Shunts
The 5 Ts
Truncus Arteriosus
Transposition of the Great Vessels
Tricuspid Atresia
Tetralogy of Fallot
Total Anomalous Pulmonary Venous Return (TAPVR)
Associations
Cyanosis at Birth
May Require PDA
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1 min
Left-to-Right Heart Shunts
The 3 Ds
Ventricular Septal Defect (VSD)
Atrial Septal Defect (ASD)
PDA
Associations
Later Cyanosis
Clubbing
Eisenmenger's Syndrome
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2 mins
Atrial Septal Defect (ASD)
Pathophysiology
Hole in Septum between the Atria
Symptoms
Often Asymptomatic
Wide and Fixed Split S2
Cyanosis and Dyspnea
Easily Fatigued
Diagnosis
Chest X-ray shows Increased Pulmonary Vascular Markings
Echocardiogram
Treatment
Surgery if CHF as Child
Antibiotic Prophylaxis
Most Close Spontaneously
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2 mins
Ventricular Septal Defect (VSD)
Pathophysiology
Opening at Intraventricular Septum
Most Common Congenital Heart lesion
Symptoms
High-pitched Holosystolic Murmer (over left sternal border)
Dyspnea and Respiratory Distress
Loud Pulmonic S2
Diagnosis
Echocardiogram
Treatment
Small VSDs Close Spontaneously
Large VSDs Require Surgery
Complications
Endocarditis
Eisenmenger's Syndrome
CHF
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2 mins
Patent Ductus Arteriosus
Continuous
Machine like murmur
Often Due to Congenital Rubella
Prematurity
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1 min
Persistent Truncus Arteriosus
Common Arterial Trunk
Single Trunk Emerges from Both Ventricles
Symptoms
Cyanosis
Pulmonary Congestion
Heart Failure
Single S2 Sound
Diagnosis
Echocardiogram
Chest X-ray
Treatment
Early Surgical Correction
Avoids Pulmonary Hypertension
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2 mins
Tetralogy of Fallot (TOF)
Features
Blue Baby Syndrome
Mechanism
PROVe Acronym
Pulmonary Infundibular Stenosis
Right Ventricular Hypertrophy
Overriding Aorta
Ventricular Septal Defect (VSD)
Diagnosis and Treatment
Boot-Shaped Heart
Squatting for Tet Spells
Surgery
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2 mins
Total Anomalous Pulmonary Venous Return (TAPVR)
Pathophysiology
Pulmonary Veins Do Not Connect to Left Atrium
Oxygenated Blood Return to Right Atrium
Incompatible with Life without a Shunt
With Obstruction
Vessel Enters at an Acute Angle
Severe Cyanosis
Pulmonary Edema
Without Obstruction
Delayed Manifestation (1 or 2 years)
Right Heart Failure
Chest X-ray Shows "Snowman"
Diagnosis
Echocardiogram
Treatment
Surgical Correction
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3 mins
Transposition of Great Vessels
Pathophysiology
Pulmonary and Systemic Circulation are in Parallel
Incompatible with Life without a Shunt
Symptoms
Severe Cyanosis at Birth
Single S2 sound
Diagnosis
Echocardiogram
Chest X-ray shows "Egg-shaped Silhouette"
Treatment
Prostaglandin
Avoid NSAIDs
Surgical Correction
Balloon Atrial Septostomy
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2 mins
Coarctation of The Aorta
Pathophysiology
Constriction of a Portion of Aorta
Turner Syndrome
Symptoms
Asymptomatic Hypertension
BP Higher in Upper Extremities, Right Arm
CHF
Diagnosis
Echocardiogram
Cardiac Catheterization
3 Sign on Chest X-Ray
Rib Notching
Treatment
Surgical Correction
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2 mins
12 Lead Contiguous Leads - Lateral Wall MI
Leads Elevated
Lead I
Lead aVL
Lead V5
Lead V6
Artery Affected
Circumflex
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1 min
12 Lead Contiguous Leads - Anterior Wall MI
Leads Elevated
Lead V3
Lead V4
Artery Affected
Left Anterior Descending (LAD)
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55 secs

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