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A&P2 Spring 25’ > 4 Feb 25 CV A&P Key Concepts to Know > Flashcards

4 Feb 25 CV A&P Key Concepts to Know Flashcards

1
Q

What is the typical coronary artery setup in most individuals?

A

The right coronary artery supplies the posterior descending artery (PDA)

This setup is present in about 75% of people.

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2
Q

What does left coronary dominance indicate?

A

The circumflex artery supplies the posterior descending artery (PDA)

This occurs in approximately 15% of individuals.

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3
Q

What are the implications of having left coronary dominance?

A

Increased risk of coronary perfusion issues and higher mortality rates during procedures

This is due to more heart tissue depending on a single coronary artery.

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4
Q

How does positive pressure ventilation initially affect cardiac output?

A

It initially increases cardiac output due to increased preload

However, long-term effects can lead to preload issues.

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5
Q

What happens to pulmonary artery pressure during inspiration?

A

Pulmonary artery pressure decreases

This is due to the thoracic pressure becoming more negative.

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6
Q

What is the effect of positive pressure ventilation on preload and afterload?

A

Preload may be reduced; afterload is also affected differently for the right and left sides of the heart

The right side experiences a reduction in both preload and afterload, while the left side does not see a reduction in afterload.

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7
Q

What is ventricular wall compliance?

A

The ability of the ventricular walls to stretch and accommodate blood volume

Thicker walls (hypertrophy) reduce compliance, while thinner walls (dilated cardiomyopathy) increase it.

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8
Q

What are the normal heart sounds?

A

First, second, third, and fourth heart sounds

Each sound has clinical significance in diagnosing heart conditions.

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9
Q

What is aortic stenosis?

A

A narrowing of the aortic valve opening

This condition can lead to significant heart complications.

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10
Q

What is the role of atrial contraction in the heart?

A

It assists in filling the ventricles with blood

Atrial contraction is crucial for optimal cardiac output.

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11
Q

True or False: The left side of the heart benefits from decreased afterload during inspiration.

A

False

The left side does not experience a reduction in afterload due to thoracic pressure changes.

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12
Q

What is collateral circulation in the context of coronary arteries?

A

Alternative pathways for blood flow that develop when primary routes are obstructed

This can mitigate damage in cases of coronary artery blockage.

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13
Q

Fill in the blank: The posterior descending artery (PDA) is typically a branch of the _______.

A

right coronary artery

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14
Q

What is the significance of understanding coronary artery variations?

A

It is crucial for accurate diagnosis and treatment of coronary perfusion issues

Variations can impact surgical outcomes and patient management.

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15
Q

What is the primary method for getting air into a patient’s lungs when positive pressure ventilation is used?

A

Pushing air into the lungs

Positive pressure ventilation is used when normal breathing is insufficient or impossible.

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16
Q

What happens to cardiac output during the initial phase of positive pressure ventilation?

A

Cardiac output is expected to increase

This is due to increased preload as the chest fills with blood.

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17
Q

What effect does prolonged positive pressure ventilation have on venous return?

A

It impedes venous return

High intrathoracic pressure reduces the ability of blood to return to the heart.

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18
Q

How does positive pressure ventilation influence the left and right sides of the heart differently?

A

Left side output may increase; right side may decrease

Increased preload benefits the left side, while increased afterload affects the right side.

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19
Q

What is the relationship between thoracic pressure and filling pressure during positive pressure ventilation?

A

Increased thoracic pressure leads to higher filling pressures

This can create an obstruction to blood flow into the heart.

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20
Q

What structural change occurs in the ventricular wall due to severe aortic stenosis?

A

Hypertrophy of the ventricular wall

This adaptation helps generate more force but reduces compliance.

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21
Q

What is the effect of reduced compliance of the ventricular wall on filling pressure?

A

Increased filling pressure is required

Thicker walls resist expansion, necessitating higher pressures to fill the ventricle.

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22
Q

In terms of compliance, how does a highly compliant ventricle behave?

A

Requires low filling pressures

Thin-walled ventricles can easily stretch to accommodate blood.

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23
Q

What happens to the pressure-volume relationship in a ventricle with reduced compliance?

A

The slope of the passive filling curve increases

This indicates that more pressure is needed to achieve the same volume.

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24
Q

What is the characteristic of a pediatric heart compared to an adult heart in terms of compliance?

A

Pediatric hearts have less compliant ventricles

This makes them less able to accommodate increased venous return.

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25
Q

What is a potential risk when administering fluids to young children?

A

Their hearts may not accommodate large volumes

Pediatric hearts rely more on increasing heart rate than stroke volume to manage fluid return.

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26
Q

True or False: Aortic regurgitation leads to increased ventricular wall compliance.

A

True

This condition can stretch the ventricular walls, making them easier to fill.

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27
Q

What type of hypertrophy can occur in the heart?

A

Both thickening and thinning of the heart wall

Hypertrophy can be adaptive but may also lead to filling difficulties.

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28
Q

Fill in the blank: The __________ of the ventricular wall affects the heart’s ability to fill with blood.

A

compliance

Compliance refers to how easily the ventricular walls can stretch and accommodate blood.

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29
Q

What physiological change occurs in the thorax during positive pressure ventilation?

A

Increased thoracic pressure

This can hinder blood flow into the heart.

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30
Q

What can result from using high levels of positive end-expiratory pressure (PEEP)?

A

Reduced cardiac output

Sustained high pressure can impede venous return to the heart.

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31
Q

What should be considered when giving volume to pediatric patients?

A

Kidneys aren’t fully developed, and the volume returning to the heart must be carefully monitored due to their immature systems.

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32
Q

How do pediatric heart ventricular walls compare to adults?

A

Pediatric heart ventricular walls are probably less compliant than adults.

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33
Q

What is the first heart sound a result of?

A

The closure of the AV valves when the ventricle starts to build pressure.

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34
Q

What is the duration and pitch of the first heart sound?

A

Approximately 0.14 seconds and low pitch.

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35
Q

When does the second heart sound occur?

A

After ejection is finished.

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36
Q

What is the duration and pitch of the second heart sound?

A

Approximately 0.11 seconds and higher pitch than the first heart sound.

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37
Q

True or False: The fourth heart sound should be audible in healthy individuals.

A

False.

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38
Q

What can cause the atrial heart sound to be audible?

A

Mitral valve stenosis or if the atria contracts when it is fuller than normal.

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39
Q

What condition is the third heart sound associated with?

A

Heart failure or low compliance ventricles.

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40
Q

What happens to the third heart sound in a low compliance ventricle?

A

Turbulence or blood rattling occurs as it hits the walls.

41
Q

What is aortic stenosis characterized by?

A

An abnormal murmur during systole when blood shoots through a stenotic valve.

42
Q

What type of murmur is associated with a regurgitant aortic valve?

A

A diastolic murmur.

43
Q

When is the loudest point of the murmur for mitral stenosis?

A

At the end of diastole.

44
Q

What characterizes mitral regurgitation?

A

Backwards flow of blood during systole.

45
Q

Where is the best place to auscultate the aortic valve?

A

On the right side of the sternum around the second intercostal space.

46
Q

Where can the pulmonic valve be auscultated?

A

On the left side of the chest near the second intercostal space.

47
Q

Where is the tricuspid valve best auscultated?

A

Medial left side of the patient in the fifth intercostal space.

48
Q

Where is the mitral valve located for auscultation?

A

In the fifth intercostal space, further lateral from the tricuspid valve.

49
Q

What is the mnemonic used to remember auscultation sites?

A

All Patients Take Meds.

50
Q

What physiological phenomenon can cause splitting of the second heart sound?

A

Deep inspiration.

51
Q

What is a phono cardiogram used for?

A

To record heart sounds and identify frequencies of heart murmurs.

52
Q

What are the divisions of the mediastinum?

A

Superior and inferior mediastinum.

53
Q

What are the three parts of the inferior mediastinum?

A

Anterior, middle, and posterior.

54
Q

What are the two designations of the mediastinum?

A

Superior and inferior

55
Q

What are the three parts of the inferior mediastinum?

A

Anterior, middle, and posterior

56
Q

What structures are found in the middle mediastinum?

A
  • Heart
  • Pericardium
  • Ascending aorta
  • Superior vena cava
  • Pulmonary arteries
  • Pulmonary veins
  • Pericardiacorenic nerves
57
Q

What is the function of the pericardiacorenic nerves?

A

Responsible for sensory perception in the pericardium and innervation to the diaphragm

58
Q

What structures are located in the posterior mediastinum?

A
  • Esophagus
  • Thoracic aorta
  • Thoracic duct
  • Vagus nerves
  • Azygous vein
  • Hemiazygous veins
59
Q

True or False: The thoracic aorta runs down the front of the chest cavity.

A

False

60
Q

What happens if there is an air bubble in the arterial line?

A

It dampens changes in the cardiovascular system

61
Q

What is the significance of the dichrotic notch in arterial pressure tracings?

A

It is used to calculate heart rate and EKG data

62
Q

What can cause an over-damped arterial tracing?

A
  • Air bubbles in the line
  • Blood clots in the line
  • Gain on the amplifier turned down
63
Q

What is the consequence of under-damping in an arterial tracing?

A

Excessive artifacts in the tracing

64
Q

What is an epicardial blood vessel?

A

A blood vessel that can be seen on the surface of the heart

65
Q

What is the term for deeper blood vessels within the heart wall?

A

Endocardial or subendocardial blood vessels

66
Q

Where is ischemia most likely to occur in the heart?

A

In the subendocardial blood vessels

67
Q

What is the effect of severe aortic stenosis on ventricular pressure?

A

Pressure inside the ventricle must be much higher than normal

68
Q

What type of murmur is associated with aortic stenosis?

A

Systolic murmur

69
Q

What type of murmur occurs during diastole?

A

Murmur associated with mitral stenosis

70
Q

Fill in the blank: The circumflex artery can sometimes be an anastomosis between the _______ and the _______.

A

Right coronary artery, left coronary artery

71
Q

True or False: The circumflex artery anatomy is consistent across all patients.

A

False

72
Q

What happens to blood flow during diastole in the presence of a leaky valve?

A

Backward blood flow occurs

73
Q

What is the typical consequence of a filling problem in the ventricle?

A

Increased preload and blood volume

74
Q

What is the effect of a leaky mitral valve on pulse pressure?

A

It leads to a pretty wide pulse pressure due to backward blood flow during diastole

Blood is not all ejected forward into the system; some returns through the leaky valve.

75
Q

During which phase does backward blood flow occur with mitral regurgitation?

A

Diastole

Backward flow can’t happen during systole because the mitral valve is closed.

76
Q

What happens to the atria during systole in the case of mitral regurgitation?

A

The atria may fill with abnormal volume due to backward blood flow

The mitral valve should be closed during systole, leading to relatively empty atria.

77
Q

What is the consequence of increased atrial filling in mitral regurgitation?

A

Higher atrial pressure and potentially much higher V wave

Atria is filled from multiple sources, causing extra volume and pressure.

78
Q

What can reduce backward blood flow through a leaky mitral valve?

A

Reducing the afterload the left side of the heart has to work against

Lower pressure in the ventricle during systole results in less backward flow.

79
Q

True or False: Atrial kick is not important in heart pathologies.

A

False

Atrial contraction becomes crucial for filling in many heart conditions.

80
Q

What is the difference between systolic dysfunction and diastolic dysfunction?

A

Systolic dysfunction involves difficulty in generating stroke volume; diastolic dysfunction involves filling problems

Systolic dysfunction is marked by thin, less compliant walls; diastolic dysfunction by thick, less compliant walls.

81
Q

What is eccentric hypertrophy?

A

A condition where the left ventricular walls are thin

This can result from congenital issues or conditions like aortic valve insufficiency.

82
Q

What causes concentric hypertrophy?

A

Thickening of the heart walls due to factors like untreated hypertension or aortic stenosis

This leads to diastolic dysfunction due to less compliant walls.

83
Q

What is the role of collateral circulation during ischemia?

A

It helps deliver nutrients to areas affected by ischemia

However, the ability of surrounding blood vessels to dilate is crucial for its effectiveness.

84
Q

What can happen if the body lays down too much scar tissue after a heart injury?

A

It can lead to dilated cardiomyopathy

Excessive scar tissue may impair heart function and lead to further complications.

85
Q

Fill in the blank: The backward blood flow through the mitral valve occurs during _______.

A

Diastole

86
Q

What happens to the atria over time with high atrial pressure?

A

They become stretched and less coordinated

This increases the risk of atrial arrhythmias.

87
Q

What factors can impair blood vessels’ ability to dilate in the heart?

A

High cholesterol, smoking, high blood pressure, diabetes

These factors lead to reduced blood flow and increase the risk of heart attacks.

88
Q

What is the effect of aortic stenosis on left ventricular walls?

A

They become thickened due to increased pressure

This can lead to diastolic dysfunction.

89
Q

True or False: Atrial flutter is beneficial for heart function.

A

False

Atrial flutter disrupts coordinated contraction between the atria and ventricles.

90
Q

What can excessive volume retention in heart failure lead to?

A

Stretching of the heart and potential for further dysfunction

This necessitates careful management, sometimes requiring diuretics.

91
Q

What is the role of fibroblasts in scar tissue formation?

A

Fibroblasts lay down scar tissue, which can lead to dilated cardiomyopathy if excessive

Excessive scar tissue can impair heart function by affecting muscle cells that are not severely damaged.

92
Q

What condition can result from excessive scar tissue deposition in the heart?

A

Dilated cardiomyopathy

This condition occurs when the heart muscle becomes weakened and enlarged, affecting its ability to pump blood effectively.

93
Q

How do ACE inhibitors help in the context of scar tissue deposition?

A

They slow the deposition of scar tissue by reducing the activity of fibroblast growth factors

This helps prevent excessive scar formation in the heart.

94
Q

What is a potential consequence of having non-functional areas in the heart wall?

A

Decreased ejection fraction (EF)

Non-functional areas can lead to inefficient blood flow during systole.

95
Q

True or False: All areas of the heart wall should contract uniformly during systole.

A

True

Any bulging or non-functional areas can disrupt normal contraction and blood flow.

96
Q

What is the significance of thyroid function in relation to cardiac output?

A

Thyroid function is important for regulating metabolic demand and cardiac output

Thyroid hormones influence heart rate and myocardial contractility.

97
Q

Fill in the blank: Excessive scar tissue can lead to _______ in the heart.

A

dilated cardiomyopathy

98
Q

What are the potential topics to be discussed in the upcoming lecture?

A

Thyroid function, congenital differences between young and adult hearts, and shock

The lecture aims to explore how the body handles shock and the differences in heart development.

99
Q

What happens during systole if part of the heart wall is non-functional?

A

There may be outward stretches instead of efficient blood flow into the aorta

This can lead to complications such as low ejection fraction.

A&P2 Spring 25’ (6 decks)

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