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CABS2: Cardiology > 1,000ft view Cardiology > Flashcards

1,000ft view Cardiology Flashcards

1
Q

What is the size of the heart

A

same size as a closed fist
base= superior portion
apex = point

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2
Q

where is the atria located

A

primarily posterior between the lung hila

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3
Q

what is medial sternal widening

A

width between the lungs is wider on x-ray
aortic dissection until proven otherwise

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4
Q

what are the layers of the wall of the heart

A

pericardium
epicardium
myocardium

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5
Q

what is the pericardium

A

parietal layer is the outer aspect, helps to anchor to surrounding structure. contains serous fluid to prevent inflammation

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6
Q

what layer of the heart wall is adhered to the heart, smooth, transparent and slipper

A

Epicardium

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7
Q

what is the myocardium

A

cardiac muscle

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8
Q

what is the endocardium

A

smooth linking for the chambers and valve
continuous blood vessel endothelium

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9
Q

what is endothelium

A

thick connective tissue linking the inner ascpect of the heart

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10
Q

what type of cells is the heart made of

A

contractile, involuntary, striated muscle cells
- slower than skeletal muscle
- plateau phase
excitatory and conductive muscle fibers - automatic rhythmical electrical stimulation on the cardiac muscle cells

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11
Q

what is the plateau phase

A

allows blood to move the way it needs to move throughout the heart

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12
Q

how are cardiac muscles aranged

A

branching networks rather than parallel to one another

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13
Q

What are the junctions between cardiac muscle cells

A

intercalculated discs

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14
Q

what is the purpose of intercalculated discs

A

allows for rapid transmission of cellular activity via gap junctions and electrical conduction

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15
Q

what is released when action potential is triggered

A

calcium

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16
Q

What are the specific cardiac muscle troponins

A

Troponin I and Troponin T
protein is released during ischemic event and can be detected in blood

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17
Q

what is the timing for troponin level changes s/p MI

A

will elevate within 3 hours

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18
Q

how long does cTnT remain elevated

A

7-14 days

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19
Q

how long does cTnI remain elevated

A

10-14 days

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20
Q

what contracts during diastole

A

atria to forcefully propel blood into the ventricles

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21
Q

What does the fibrous skeleton allow

A

the ventricular and atrial contraction/depolarization to remain separate and keep passage of ions from transmitting to one another

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22
Q

what are the two types of septum within the heart

A

Interatrial septum
intraventricular septum

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23
Q

What are valves within the heart made up of

A

dense connective tissue - covered by endocardium

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24
Q

what are the atrioventricular valves

A

Tricuspid valve
Mitral valve

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25
Q

what are the semilunar valves

A

Pulmonic and aortic valves

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26
Q

What attach the AV values to the Ventricular walls

A

chordae tendineae

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27
Q

What is the normal generator of cardiac electrical conduction

A

sinoatrial node

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28
Q

what passively fills the right atria

A

SVC and IVC
and receives blood from the venous blood from coronary vasculature via the venous sinus.

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29
Q

what is the tricuspid valve

A

3 leaflet valve encased in endothelium
opens when atrial pressures are greater than ventricular
closes when ventricular pressures are greater than atrial
closes very easily with minimal back-flow of blood
fairly soft closure

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30
Q

What are the different pressures of the right and left atria

A

Right increases 4-6mmHg
Left increases 7-8mmHg

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31
Q

what part of the heart is the low pressure system

A

right part of the heart

32
Q

what part of the heart receives deoxygenated blood

A

right atria and ventricle

33
Q

what is the pulmonic valvue

A

semilunar valves
connects the RV with the pulmonary trunk
snaps shut during beginning of diastole

34
Q

how does the left atria receive blood

A

from the right and left pulmonary veins

35
Q

what is attached to the left atria

A

left atrial appendage

36
Q

what is the mitral valve

A

2 leaflet valve (bicuspid valve), encased in endothelium

37
Q

what is the thickest part of the myocardium

A

left ventricle: needs to push against systematic vascular resistance

38
Q

what is the end of diastolic volume

A

left ventricle: fills with 110-125mL of blood
relaxation part before contraction

39
Q

what is the pattern of left ventricular contraction

A

twist in a wringing motion with the inner, subendocardial, layer twisting rightward and outer, subepicardial, layer twisting leftward
causes base to be pulled downward during systole will untwist during diastole

40
Q

what opens during ventricular contraction (systole)

A

aortic valve

41
Q

what artery feeds the heart itself with blood

A

coronary artery

42
Q

What is the P wave

A

atria contraction / depolarization

43
Q

what is the QRS complex

A

ventricular contraction / depolarization

44
Q

what is a Q wave

A

downard deflection

45
Q

what is the RS complex

A

ventricular depolarization complete

46
Q

what is the pause between P and Q wave called

A

AV node pause - isometric

47
Q

what is the T wave

A

ventricular depolarization begins at the apex and pregresses superiorly
(resetting)

48
Q

what is the pause between S and T waves

A

plateau phase - pause before repolarization

49
Q

when do coronary vessels fill

A

during diastolic relaxation

50
Q

what determines coronary vascular resistance

A

hormones
neural stimulation
metabolic demand
peripheral vascular resistance

51
Q

what does the right coronary artery do

A

supply the right atrium and right ventricle

52
Q

what does the left circumflex artery do

A

supplies the left atrium and left ventricle

53
Q

what does the left anterior descending artery do

A

supplies the right ventricle, left ventricle and interventricular septum

54
Q

what does the left marginal artery do

A

supplies the left ventricle

55
Q

what are the left coronary artery branches

A

left circumflex and left anterior descending

56
Q

what is key about the right coronary artery

A

conduction system

57
Q

systole

A

squeezing

58
Q

diastole

A

relaxation - filling

59
Q

what valves are open during diastole

A

Tricuspid and Mitral valves - AV valves

60
Q

from the SA node - where does the stimulation go to

A

Travel along intranodal pathway to right atria and Bachman bundle to left atria

61
Q

how long is the pause at the AV note

A

0.12 second pause

62
Q

what is the ejection fraction

A

at the end of diastole
during contraction about 60% ejected
about 70mL from each of the ventricles into either pulmonary or systemic circulation

63
Q

how much blood remains in the ventricles after contraction

A

40-50ish mL remains

64
Q

how is ejection fraction measured

A

via ultrasound

65
Q

what valves open during systole

A

Pulmonic and Aortic valves (semilunar valves)

66
Q

where is a majority of the blood within the body

A

within the capillaries

67
Q

What is the formula for cardiac output

A

stoke volume + heart rate = Cardiac output

68
Q

what makes up the stroke volume

A

blood volume and vascular resistance

69
Q

what is preload

A

pressure that fills the ventricles - diastolic measurement
BP in the LV right before ventricular contraction begins

70
Q

what is afterload

A

the resistance the left ventricle needs to push against
systemic vascular resistance

71
Q

what type of vasculature has greater amounts of tunica media

A

artery

72
Q

what valves close during S1

A

AV values close and systole begins

73
Q

what valve closes during S2

A

semilunar valves close and diastole begins

74
Q

what can falsely elevate troponin levels

A

renal failure

75
Q

when do we draw troponin levels

A

chest pain concerning for Acute Coronary Syndrome (ACS)
cardiac strain
CHF

76
Q

what is CPK-MB

A

creatine phosphokinase MB
creatinine kinase is enzyme that is found within the heart, skeletal muscle and brain
takes longer to elevate, returns back to normal earlier than troponin

77
Q

What is a BNP

A

B-type natriuretic peptide - hormone that was initially identified in the brain, diuretic and hypotensive effects
typically from cardiac ventricle - rate of elevation correlates with degree of heart failure
elevated with HTN, CHF, and atherosclerosis

CABS2: Cardiology (11 decks)

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