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Sinclair Paramedic 2100 > 5-Cardiology > Flashcards

5-Cardiology Flashcards

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1
Q

Where is the heart located, size and apex/base location

A
  • Midsternally
  • Size of patients fist
  • Base on top, apex at bottom
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2
Q

What is the pericardium

A
  • Sack around the heart

- Contains a small amount of fluid

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3
Q

Layers of the pericardium (3)

A
  • Fibrous (outer)
  • Serous (middle)
  • Visceral/Epicardium (internal)
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4
Q

Layers of the heart and what they do (3)

A
  • Epicardium-Outer layer
  • Myocardium-Beats
  • Endocardium-Smooth inner layer
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5
Q

What is a myofibril

A

Rod-like unit that makes up a muscle cell in the heart

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6
Q

Intercalated discs

A

Connect myofibrils

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7
Q

Desmond

A

“Spot welds” between myofibrils

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8
Q

Gap junction

A

Allows signal to pass from one myofibril to the next

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9
Q

4 chambers of the heart and what their roles are

A
  • RA-Reservoir for venous blood
  • LA-Reservoir for oxygenated blood
  • RV-Low pressure pulmonary pumping
  • LV-High pressure systemic pumping
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10
Q

What is the role of the Atrioventricular septum (2)

A
  • Separate atria from ventricles

- Does not allow impulse to go back to the atria

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11
Q

What are the heart valves controlled by and through

A
  • Controlled by papillary muscles

- Controlled though chordae tendineae

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12
Q

What are the 2 main types of heart valves

A
  • Atrioventricular

- Semilunar

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13
Q

What are the 2 atrioventricular valves, 2 semilunar valves and where are they

A
  • Tricuspid-Right side
  • Mitral-Left side
  • Aortic-Aorta from LV
  • Pulmonic-Pulmonary vein from RV
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14
Q

Describe semilunar valves

A
  • Passive- control unidirectional flow
  • Open during systole
  • Closed during diastole
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15
Q

What is the RCA and where does it go

A

Right coronary artery, supplies right side anterior of the heart

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16
Q

What is the LCA, what does it split into and where do they go

A

-Left coronary artery

  • Left circumflex artery, lateral and rear sides
  • Left anterior descending artery, anterior and down
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17
Q

What is the coronary sinus (3)

A
  • Meeting point of heart veins that blood deposits into
  • Drains left ventricle into right atrium
  • Roughly pairs arterial circulation
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18
Q

Steps of blood flow through the heart, start at RA (14)

A
  1. RV
  2. Tricuspid valve
  3. RV
  4. Pulmonic valve
  5. Pulmonary artery
  6. Lungs
  7. Pulmonary vein
  8. LA
  9. Mitral valve
  10. LV
  11. Aortic valve
  12. Aorta
  13. Body circulation
  14. Inferior/superior vena cava
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19
Q

What valves are open and closed during the systolic phase

A

Open- Aortic valve, pulmonic valve (semilunar valves)

Closed- Mitral valve, tricuspid valve (Atrioventricular valves)

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20
Q

What valves are open and closed during diastole

A

Open- Mitral valve and tricuspid valve (Atrioventricular valves)

Closed- Aortic valve and pulmonary valve (Semilunar valves)

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21
Q

What is preload

A

-The amount of blood delivered to the heart during diastole

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22
Q

What is Starlings Law

A

-The more the myocardium is stretched, the more forcefully it will contract

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23
Q

What is afterload

A

Pressure in the aorta against which the left ventricle must pump blood during systole

(Resistance a contraction must over come to eject blood)
(Decreased vessel size=increased pressure)

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24
Q

What is stroke volume and what effects it (3)

A

The amount of blood ejected by the hear in each contraction

  • Preload
  • Contractile force
  • After load
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25
Q

What can change contractile force, 2 example and how they work

A

Catecholamines (hormones)

  1. Epinephrine
  2. Norepinephrine

-Enhance contractile fore by acting on the beta-adrenergic receptors

26
Q

What is the cardiac output formula

A

CO=stroke volume x HR

27
Q

What is the normal range for stroke volume

A

Normal SV 60-100ml

28
Q

What is the Fick Principle (4 main point)

A
  • Utilization of O2 is dependent upon
  • Adequate O2 in the environment
  • Movement of O2 across alveolar and capillary membrane, into arterial bloodstream
  • Adequate RBCs to take oxygen
  • Proper tissue diffusion
  • Efficient off loading of oxygen at the tissue level
29
Q

What is the formula for blood pressure

A

BP = CO (mL/min) x PVR

30
Q

What is PVR

A

Resistance of vessels to blood flow

31
Q

What regulates systolic BP number

A

Contractility of the heart

32
Q

What regulates diastolic BP number

A

Vasoconstriction and vasodilation

33
Q

What is pulse pressure

A

The difference between systolic and diastolic numbers

34
Q

What is the mean arterial pressure

A

The average arterial pressure during a single cardiac cycle

35
Q

What is the formula for mean arterial pressure (MAP)

A

MAP=DP + 1/3 (SP-DP)

36
Q

What are the 4 components of blood

A
  • Plasma
  • Red blood cells (Erythrocytes)
  • White blood cells (Leukocytes)
  • Platelets (Thrombocytes)
37
Q

What is the role of plasma

A

Fluid part of blood

38
Q

What is the role of Erythrocytes

A

Carries O2, makes the blood red

39
Q

What is the role of Leukocytes

A

Protect the body from infection

40
Q

What is the role of Thrombocytes

A

Clots blood

41
Q

What 4 things regulate heart function

A
  • Brain via autonomic nervous system
  • Receptors in blood vessels, kidneys, brain and heart for homeostasis
  • Chemoreceptors
  • Baroreceptors
42
Q

Whale are Chemo and Baroreceptors located and what does each do

A

Aortic arch and carotid arteries

  • Chemoreceptors- Regulate O2, CO2 and pH levels
  • Baroreceptors- Regulate blood pressure
43
Q

4 key points about the sympathetic nervous system

A
  • Adrenergic receptors
  • Fight or flight
  • Alpha-beta response
  • Norepinephrine
44
Q

4 key points about the parasympathetic nervous system

A
  • Cholinergic receptors
  • Rest and digest
  • Vagus nerve response
  • Acetylcholine
45
Q

The role of alpha 1 receptors

A

Vasoconstriction

46
Q

The roles of the beta 1 receptors

A
  • Increase HR (+ Chronotropic)
  • Increase automaticity (+ Inotropic)
  • Increase Contractility (+ Dromotropic)
47
Q

What is the role of the beta 2 receptor

A

Bronchodilation

48
Q

Define automaticity

A

Able to initiate impulses

49
Q

Define excitability

A

Able to be stimulated to act

50
Q

Define conductivity

A

Able to conduct impulses

51
Q

List the normal electrical sequence of the heart

A
  1. SA node
  2. Internodal pathways
  3. AV node
  4. Bundle of His
  5. Bundle branches
  6. Perkinje fibers/network
52
Q

What and where is the SA node

A

Dominant pacemaker site of the heart that is innervated by SNS and PNS

Top of RA

53
Q

List the 4 internodal pathways

A

Anterior internodal tract
Middle internodal tract
Posterior internodal tract
Bachmanns bundle

54
Q

What is the Bundle of His

A

Brings impulses from AV node in the atria through the atrioventricular septum into the bundle branches

55
Q

Intrinsic firing rates of the SA, AV and ventricles

A

SA- 60-100
AV- 40-60
Ventricles- 20-40

56
Q

Describe phases 0-4 of action potential

A
  1. Rapid depolarization
  2. Early rapid repolarization
  3. Plateau phase
  4. Rapid repolarization
  5. Period between action potentials
57
Q

Describe phase 0- Rapid depolarization (2)

A
  • Fast Na channels open, allowing NA into cell

- Inside becomes positive

58
Q

Describe phase 1- Early rapid repolarization (4)

A
  • Na channels close, Na flow stops
  • K continues to leave
  • Decrease in number of positive electrical charges in the cell
  • Returns to resting permeability state(allowing muscles to contract)
59
Q

Describe phase 2- Plateau phase (4)

A
  • Prolonged phase of repolarization
  • Ca enters, initiating contraction
  • K continues to slowly leave
  • Completion of muscle contraction occurs
60
Q

Describe phase 3- Rapid repolarization (3)

A
  • Cell becomes more negative
  • Slow calcium channels close
  • Repolarization is completed
61
Q

Describe phase 4 (2)

A
  • Period between action potentials

- Activates Na-K pumps, returning the cell to its normal state

Sinclair Paramedic 2100 (10 decks)

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