Basic Science Flashcards
Average blood pumped per min (in L)
4 to 6 L
Path of circulation of blood through the heart (in order):
Vena Cava
Right Atrium - Tricuspid Valve
Right Ventricle - Pulmonary Valve
Pulmonary Arteries (Deoxygenated)
Lungs - Capillary Beds
Pulmonary Veins (Oxygenated)
Left Atrium - Mitral Valve
Left Ventricle - Aortic Valve
Aorta
Heart Wall (Layers)
Pericardium
Epicardium
Myocardium
Endocardium
Cardiac Valves
Tricuspid Valve - Right
Bicuspid (Mitral) Valve - Left
Pulmonic Valve - Right
Aortic Valve - Left
Function of Pulmonary System
- Removes waste (CO2)
- Acid / Base Balance
- Low-pressure System
Function of Systemic System
- Deliver O2 and essential nutrients to the body.
- High Pressure System
Systole Cardiac Mechanics
- Atrial Relaxation
- Ventricle Pump / Contraction
- Tricuspid / Bicuspid Valves Close
- Pulmonic / Aortic Valves Open
Diastole Cardiac Mechanics
- Atrial Pump / Contraction
- Ventricular Relaxation
- Tricuspid / Bicuspid Valves Open
- Pulmonic / Aortic Valves Close
Blood Pressure
Systolic/Diastolic
120/80 (mm Hg) = Normal
140/90 (mm Hg) = Hypertension
The Coronary Arteries supply blood to _________.
Myocardium
The Right Coronary Artery feeds the ____________ of the heart.
Posterior
The Left Anterior Descending Artery feeds the ________ & _______ of the heart.
Front & Apex
The Left Circumflex Artery feeds the ___________ of the heart.
Left Lateral Side
Cardiac Coordination Process (in order):
Sinoatrial (SA) Node
Atrial-Ventricular (AV) Node
Bundle Branches
Perkinje Fibers
“Waves” of an EKG
P
QRS
T
U (Sometimes)
P wave of an EKG
Atrial Contraction
QRS Complex of an EKG
Ventricular Contraction
T wave of an EKG
Reset
R to R interval of an EKG
Timing of Ventricular Contractions
Heart Ejection Fraction
Amount of blood ejected from the heart during contraction
50% to 75% is normal
Below 50% is abnormal
Heart EF Formula
EF = Stroke Volume (mL) / End Diastolic Volume (mL)
Cardiac Output Formula
Stroke Volume * Heart Rate
EKG X-Axis Readings
Time
1 mm = 0.04 sec
5 mm = 0.2 Sec
5 lrg Boxes (2.5 cm) = 1 sec
30 lrg boxes (15 cm) = 6 sec
EKG Y-Axis Readings
Voltage of the Heart
1mm = 1 mV
Cardiac Cycle (PQRST)
P = Atrial Depolarization
QRS = Ventricular Depolarization
Plateau Phase
T = Rapid Phase (Ventricular Repolarization)
Standard EKG leads
Leads 1 through 3
Precordial EKG leads
V1 through V6
Reading Heart Rate (by EKG blocks)
of blocks / Heart Rate
1 / 300
2 / 150
3 / 100
4 / 75
5 / 60
6 / 50
(300 / # of blocks)
Bradychardia
Slow Heart Rate
Below 60 bpm
Tachycardia
Fast Heart Rate
Above 160 bpm
Heart Block 1st Degree
Between QR interval
(no clinical indication)
Heart Block 2nd Degree
Between QRST
Loss in Ventricular Beat
(Cured by Pacemaker)
Heart Block 3rd Degree
P wave = Doing its own thing
QRS wave = Doing its own thing
(Complete Heart Block)
(Get help immediately)
Cardiac Stress Test pharmacologic adjunctive drugs:
Regadenoson (Lexiscan) = Vasodilator
Adenosine (Adenocard) = Vasodilator
Dobutamine = Increased Heart Rate (Beta Blocker)
Atropine = Increases Heart Rate
Cardiac Stress Test Radiopharmaceuticals:
SPECT:
- Tc-99m Sestamibi (Cardiolite)
- Tc-99m Tetrofosmin (Myoview)
- Tl-201
PET:
- Rb-82 Chloride (Generator)
- N-13 Ammonia (Cyclotron)
Cardiac Stress Test target heart rate formula
(220 - age in years) * 0.85 = Target Heart Rate
Indications for Cardiac Stress Imaging
- Detection of obstructive coronary artery disease (CAD)
- Risk stratification of post-myocardial infarction prior to discharge
- Risk stratification w/ chronic stable CAD
- Risk stratification w/ low risk acute coronary syndrome patients
- Risk stratification (general)
Cardiac Stress Test Early Termination:
Symptoms: Angina Pectoris, Dyspnea or Fatigue, Ataxia / Dizziness
- Poor Perfusion
- PATIENT REQUESTS TERMINATION
- Excessive SI changes
- Sustained Tachy-arrhythmias
- Developed left bundle branch block
- Blood Pressure response
Cardiac Stress Test Contraindications:
- Asthmatic
- Patients receiving aminophylline in the last 24 hours
- Systolic BP below 90 mm Hg
- Profound sinus bradycardia (HR < 40 bpm
- Allergies
- > 400 lbs = Convert to Pet
- > 280 lbs = 2 Day Exam
Blood Perfusion Formula
Perfusion = mL/g or mL/min/g
Ischemia
Inadequate blood flow to meet metabolic & oxygen demand
PCI or PTCA
- Percutaneous Coronary Intervention
- Percutaneous Transluminal Coronary Angiplasty (ie: stint)
- Revascularization
CABG
- Coronary Artery Bypass Graft
- Heart is stopped for the procedure
- Blood is pumped through a heart/lung bypass machine
- Single to Quadruple Bypass
Sarcoidosis
- Granulos Inflammation of Tissue
- Most commonly in Lungs / Lymphnodes
- Can go to Bones, Spleen, and Heart
Amyloidosis
- ATTR or Transthyretin Amyloidosis
○ Accumulation of abnormal transthyretin proteins
○ Misfolded proteins > aggregate >tissue damage
○ Affect heart, kidneys, nerves, eyes, joints, etc…
○ Medication to reduce or stabilize TTR production - AL or Amyloid Light Chain Amyloidosis
○ Plasma cell disorder
○ Light chains in blood and urine
○ Chemotherapy and stem cell transplantation
Tc99m-PYP
Pyrophosphate
Used in Amyloidosis Treatment
Myocarditis
Inflammation of the Heart Muscle
Most commonly viral infection
Pericarditis
Inflammation of the lining around the heart (pericardium)
Most commonly viral infection
Cardiac Tumor
Can get tumor anywhere in the heart
Most common tumor is from metastatis
Endocarditis
Infection of the heart valves
Caused by bacteria
Cardiac Autonomic Innervation
Uses MIBG (similar to how norepinephrine works)
Binds to receptors
Cardiac Right to Left Shunt
- Use of MAA (Macro-Aggregated Albumin)
- MAA should stop in lungs
- MAA bypasses the lungs through a septal hole in heart
- Causes poor oxygen circulation throughout the body
- Scan quantifies how much shunt is present from lungs to the rest of body
Axial Skeleton
- Skull
- Maxilla
- Mandible
- Spine (C, T, L)
- Ribs
Appendicular Skeleton
- Scapula
- Pelvis
- Extremities
Osteo-
Bone
Capillary Size
10-30 microns
If cancer has metastasized, the cancer is automatically at stage ____.
4
4 Quadrants of the Abdomen
Right Upper
Left Upper
Right Lower
Left Lower
Calvarium
Skull
Cerebral Cortex is responsible for:
- Large motor skills
- Bodily function
Cerebellum is responsible for:
- Fine motor skills
- Balance
Lateral ventricles are responsible for:
- Containing and circulating cerebrospinal fluid
- Transfers nutrients around the brain
A DaT Scan views the ________.
Striatum
- Caudate Head
- Putamen (Tail)
The cell wall contains a triple layer of polar membranes that allow what soluble material through (per layer)?
Top layer - Water Soluble
Middle Layer - Fat Soluble
Bottom Layer - Water Soluble
Lipids/Fats
Cholesterol
Phospholipids
Triglycerides
Carbohydrates
Molecules that contain C, H, O chains
End in “ose”
“Glucose”
“Sucrose”
“Xylose”
Proteins
Amino Acid Chains
Enzymes end in “ase”
How many naturally occurring Amino Acids are found in the body?
21
Octreotide
8 Amino Acid Bond
