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Cardiopulmonary > Basic cardiac > Flashcards

Basic cardiac Flashcards

1
Q

cardiac A&P

A

The heart is located in the mediastinum (membranous partition between the lungs), which is behind and slightly to the L of the sternum.
•surrounded by a sac called the pericardium
•the heart is a muscular organ made up of muscular tissue called myocardium
• the inner chambers of the heart are lined by a layer of tissue called the endocardium
•heart is perfused by coronary arteries during diastole (only stucture that recieves blood during diastole)
•2 superiorly located atria
•2 inferiorly located ventricles

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2
Q

Aorta

A

artery leading from the L ventricle to the body

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3
Q

Superior Vena Cava

A

carries deoxygenated blood from the upper body systemic circulation to the right atrium of the heart

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4
Q

Inferior Vena Cava

A

large vein that carries the deoxygenated blood from the lower and middle body into the right atrium of the heart

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5
Q

Pulmonary artery

A

The pulmonary artery carries deoxygenated blood from the right ventricle to the lungs

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6
Q

Atrioventricular valves

A

2 atrioventricular valves

  • Tricuspid (R),
  • Mitral/bicuspid (L)
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7
Q

Pulmonic valve

A

from R ventricle to pulmonary artery

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8
Q

Aortic valve

A

from L ventricle to the aorta

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9
Q

Order of blood flow

A

deoxygenated blood from the body enters the R ATRIUM via the SUPERIOR and INFERIOR VENA CAVA. The blood then flows through the TRICUSPID atrioventricular valve into the R VENTRICLE. During systole the blood travels through the PULMONIC valve into the PULMONARY ARTERY, the blood is then oxygenated in the lung capillaries before traveling into the PULMONARY VEINS. From there the now oxygenated blood flows into the L ATRIUM and then through the BICUSPID/MITRAL valve and into the L VENTRICLE. Finally the blood travels through the AORTIC VALVE into the AORTA and out to the rest of the body.

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10
Q

Unique features of the heart

A
  • Excitability: the ability to respond to electrical stimulus
  • Conductivity: the ability to transmit electrical impulse from cell to cell within the heart
  • Regularity: the ability to repeat the cycle in synchrony with regularity
  • Automaticity: initiates its own electrical impulse
  • Contractility: ability to stretch as a single unit and passively recoil while actively contracting
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11
Q

Diastole

A

rest and filling, if not specified it refers to ventricular diastole but it occurs in both A and V

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12
Q

Systole

A

contraction of the L ventricle, unless otherwise specified

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13
Q

Atrial kick

A

70% passive, 30% of blood ejected from atria is due to atrial contraction

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14
Q

Ejection fraction

A

the amount of blood ejected from the L V during systole. Normal is approximately 60%

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15
Q

Cardiac output

A

The amount of blood pumped by the heart in one minute
•A product of stroke volume and HR
• CO= SV x HR
•Adjusts based on the body’s needs
•Average at rest CO= 5 liters per minute (4-8 LPM)

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16
Q

CO normal values

A

Average at rest CO= 5 liters per minute (4-8 LPM)

17
Q

Cardiac index

A
  • Cardiac index is simply the cardiac output taking in to consideration the size of the individual’s body.
  • The amount of blood pumped per minute per square meter of body mass
  • Normal 2.5-4.2 L/min
  • Less than 2.5 L/min will cause a significant decline in aerobic capacity
18
Q

Stroke volume

A

• the amount of blood pumped out with each beat
Affected by:
- Preload: the amount of tension on the myocardial wall before contraction (amt of venous return to the heart
- Frank- Starling principle: states that the more tension present before systole, the stronger the contraction
- Afterload: force that must be overcome to initiate shortening of the muscle. Resistance of BP.

19
Q

Preload

A

he amount of tension on the myocardial wall before contraction (amt of venous return to the heart

20
Q

Frank- Starling principle

A
  • States that the more tension present before systole, the stronger the contraction
  • the heart is like a muscular container. Principles that apply to skeletal muscle also apply to the heart. Length=volume, tension/resistance=pressure. Frank Starling principle basically says that the heart muscle will work more effectively when slightly lengthened. However, it can be placed in passive insufficiency (chronically overstretched) when the pt has CHF. Afterload due to vascular compliance and resistance
21
Q

Order of normal electrical conduction

A

1) the sinoatrial (SA) node (pacemaker) generates impulses (located near the top right corner of the R atrium)
2) the impulses pause (.1 seconds) at the atrioventricular node (near bottom L corner of the R atrium)
3) the atrioventricular (AV) bundle connects the atria to the ventricles
4) the bundle branched conduct the impulses through the interventricular septum (myocardial wall separating ventricles)
5) the Purkinje fibers depolarize the contractile cells of both ventricles (located around the lateral myocardial wall of the R ventricle

22
Q

Nervous system and activity

A

•Nervous System:
- Parasympathetic= decreased HR and contractility via vagus nerve
- Sympathetic= increased HR and contractility
•Endocrine System:
- Catecholamines (Epinephrine and Norepinephrine)
- increased HR, contractility and peripheral vascular resistance
•Local tissue: during exercise increased acidity due to increased CO2 and lactic acid, decreased O2 dilate vessels which increases local blood flow

23
Q

Reflexes

A
  • Baroreflex- pressure
  • Bainbridge Reflex
  • Chemoreflex- chemical
  • Ergoreflex ergoreceptors
24
Q

Baroreflex

A
  • stimulated via mechanoreceptors in heart, great vessels, intrathoracic, cervical vessels
  • most notable in the internal coratids
  • sensitive to pressure and stretch
  • activation causes vagal activity
  • Results: vasodilation, decreased HR and contractility
25
Q

Bainbridge reflex

A
  • mechanoreceptors in the R atrium
  • responds to stretch (increased volume)
  • activates sympathetic control
  • increases HR and contractility
  • Ex: respiratory sinus arrhythmia
26
Q

Chemoreflex

A
  • located in the carotid and aorta
  • sense CO2 levels
  • mainly increase rate and depth of ventilation
  • also have a cardiac effect
27
Q

Coronary Perfusion

A

•Myocardium perfused during diastole (aortic valve blocks their origin during systole)
2 main vessels:
Right coronary artery
•Posterior descending artery branches off
Left main coronary artery (2 branches)
•Left anterior descending artery
•Left circumflex artery

28
Q

R coronary artery

A 
Perfuses:
•right atrium
•most of R ventricle
•part of inferior L ventricle
•portions of interventricular septum
•portions of conduction system
29
Q

posterior descending artery

A

perfuses the posterior heart

30
Q

L anterior descending artery

A 
Perfuses:
•anterior L ventricle
•apex of LV
• portion of interventricular septum
-may have branches called diagnols
31
Q

Left circumflex artery

A

Perfuses
•lateral and part of inferior LV
•portions of LA

Cardiopulmonary (4 decks)

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