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NREMT Review > Cardiac > Flashcards

Cardiac Flashcards

1
Q

Ejection fraction

A

percentage of blood ejected on each ventricular beat
normal is 67%

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2
Q

stroke volume

A

volume of blood ejected on each stroke
70 ml is normal

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3
Q

factors affecting stroke volume

A

preload (venous return)
cardiac contractility (inotropy, dromotropy)
afterload (systemic vascular resistance)

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4
Q

cardiac output

A

amount of blood heart pumps in 1 min
hr x sv

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5
Q

layers of heart

A

endocardium- innermost layer
myocardium- mid layer
pericardium- outer layer

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6
Q

pericardium

A

protective sac that surrounds the heart

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7
Q

layers of pericardium

A

visceral- innermost lining of the sac

25 ml of pericardial fluid

parietal-second or middle lining of the sac

fibrous- outermost lining

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8
Q

what separates right and left atria, ventricles

A

interatrial septum
intraventricular septum

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9
Q

blood flow through heart

A

1: superior and inferior vena cava returns blood to heart
2: right atrium-> tricuspid valve
3: right ventricle-> pulmonic valve->pulmonic artery
4: Lungs-> pulmonary vein
5:Left atrium-> Mitral valve
6:Left ventricle -> Aortic valve
7: Aorta (largest artery in body)
7A: aorta feeds heart muscle by way of coronary arteries

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10
Q

when are coronary arteries perfused

A

diastole

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11
Q

Left Coronary artery supplies what

A

Left ventricle, inter-ventricular septum, part of right ventricle, hearts conduction system

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12
Q

Left coronary artery branches

A

Left anterior descending
left circumflex

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13
Q

Right coronary artery supplies what

A

portion of right atrium, portion of right ventricle, part of conduction system

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14
Q

branches of RCA

A

posterior descending
marginal branch

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15
Q

Collateral circulation

A

protective mechanism providing alternative path for blood to flow in event of blockage

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16
Q

Layers of blood vessles

A

tunica intima- innermost

tunica media- middle layer, elastic fibers, gives vessels strength and allows for recoil

tunica adventitia- outermost lining, fibrous, gives strenght

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17
Q

vessles of circulatory system

A

oxygenated blood -> aorta -> arteries -> arterioles ->capillaries

deoxygenated
capillaries-> Venules -> veins ->Vena cava

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18
Q

what does cardiac axis mean

A

portion of heart is requiring more energy to depolarize

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19
Q

Extreme right
right
left
extreme left

A

right atrium
right ventricle
left atrium
left ventricle

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20
Q

normal axis deviation

A

-30-+90

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21
Q

causes of Extreme right axis deviation

A

vtac
severe hyper k
pvc
severe rvh

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22
Q

causes of right axis deviation

A

right ventricular hypertrophy
copd
pulmonary embolism
lateral MI
hyperk
wpw

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23
Q

Left axis deviation causes

A

Left ventricular hypertropy
left bbb
rbbb
inferior MI
wpw

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24
Q

parasympathetic (cholinergic) function
neurotransmitter
major nerve

A

feed and breed
acetylcholine
vagus nerve

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25
sympathetic nervous system (adrenergic) function neurotransmitter
fight or flight norepi
26
parasympatholytic
blocks parasympathetic nervous system
27
sympathomimetic
mimics sympathetic nervous system epi
28
alpha 1 receptor jobs
vasoconstriction pupil dilation decreased renin secretion
29
beta 1
hr chronotropy contractilty ino conduction dromo
30
beta blocker ending
olol
31
renin function
released by kidneys in response to low blood pressure and decreased perfusion
32
explain renin angiotensin aldosteron system
angiotensinogen is secreted by liver and put into circulation renin is released by kidneys angiotensin is converted by renin to angiotensin 1 which is then converted by lungs to using ACE to angiotensin 2 this takes 20 min and causes vasoconstriction
33
baroreceptors function
detect low bp
34
baroreceptors location
carotid sinus and aortic arch
35
most prevalent extracellular cation
sodium
36
sodium function
plays role in depolarization
37
calcium function
myocardial depolarization and contraction
38
potassium function
influences repolarization
39
most prevalent intracellular cation
potassium
40
what does atp do
fuel for cell
41
explain cardiac action cycle
resting potential -> polarization-> K in Na out action potential-> depolarization -> influx of Na recovery -> repolarization-> k returns into cell, Na exits
42
intercalated disc function
allow simultaneous contraction
43
s1 sound
lub closure of AV valves
44
s2
dub closure of semilunar valve
45
s3
chf or fluid sounds like kentuky
46
s4
sounds like tenesse, increased atrial contraction
47
SA intrinsic rate
60-100
48
AV intrinsic rate
40-60
49
purkinje intrinsic rate
15-40
50
what is coronary artery disease
diseases that affect arteries of heart
51
thrombus
clot formed of blood and plaque
52
embolus
blockage of vessle by clot
53
atherosclerosis
calcium and cholesterol build up inside walls of blood vessels leading to ischemia
54
arteriosclerosis
hardening of arterial walls preventing adequate vasocaonstriction and dilation
55
what is angina
"pain in the chest" from hearts demand for o2 exceeding supply. commonly caused by atherosclerosis and cad
56
stable angina time of onset, length, persistence
sudden onset with activity lasts 3-5 min, subsides with nitro and rest
57
unstable angina, time of onset, duration, persistnece
sudden onset during rest, lasts more than 20 min, wont resolve with nitro
58
variant angina (prinzmetal)
caused by coronary vessle vasospasm, can occur at rest, may go away with rest or meds
59
Subendocardial MI
mi extends partially through thickness of myocardium. may or may not produce pathological q wave
60
transmural MI
MI goes through full thickness of myocardium
61
Stemi requirements
1mm or more of elevation in contigous or consecutive
62
atypical MI can present in who
elderly, female, chronic hypertensive, diabetics
63
causes of right heart failue
#1 left heart failure cor pulmonale (right ventricular hypertrophy) right ventricualr infarct, tricuspid or pulmonic valve damage, PE
64
causes of left heart failure
pulmonary edema htn left ventricular infarct mitral valve damage aortic valve damage cardiomyopathy MI #1 cause
65
ss of R heart failure
JVD peripheral edema ascites sacral/scrotal edema orthopnea hepato jugular reflex
66
ss of left heart failure
anxiety tachycardia htn pale sweaty skin paroxysmal nocturnal dyspnea orhtopnea rales/crackles pink frothy sputum pulsus paradoxus pulsus alterans
67
right heart failure treatment
o2, 12 lead, fluid administration
68
left heart failure treatment
o2 , 12 lead, nitro, cpap, furosemide
69
becks triad
jvd muffled heart sounds hypotension
70
what type of shock is cardiac tamponade
obstructive and cardiac
71
ss of cardiac tamponade
becks triad cp dyspnea orthopnea narrowing pulse pressure electrical alternaans pulsus paradoxus
72
cardiac tamponade managemnt
o2 fluid bolus 20 ml/kg pressor
73
cardiogenic shock causes
impaired contractility due to mi impared ventricular emptying (left sided heart failure) tension pneumothorax cardiac tamponade trauma
74
cardiogenic shock ss
sbp less than 80 respiratory distress cp weakness altered mental status hypotension tachycardia
75
cardiogenic shock treatment
o2, identify underlying problems, fluid, vasopressor 1-200 ml fluid boluses
76
dissecting aortic aneurysm signs and symptoms
syncope absent or reduced pulses unequal bp heart failure tearing sensation in back flank pain scapular pain pain radiating in legs
77
hypertensive crisis definiton
uncontrolled htn that flucuates and is above 180/120
78
1 small box on ekg
.04 seconds
79
1 big box
.2 seconds
80
how fast does paper move
25 mm/ second
81
lead 1 shows what axis
0
82
lead 2 shows what axis
60
83
lead 3 shows what axis
120
84
avr shows what view
right arm
85
avl shows what view
left arm
86
afv shows what view
left foot
87
p wave means what
atrial depolarization
88
pr interval shows what
time it takes for impulse to travel from sa node to ventricles normal is .12-.20 measured from beginning of p wave
89
qrs complex shows what
depolarization of ventricles normal is .04-.12
90
t wave means what
repolarization of ventricles
91
Lateral Leads artery
LCX
92
Inferior leads artery
RCA
93
septal and anterior leads artery
LAD
94
digitalis effect on 12 lead
st segment "sag"
95
WPW wave
delta wave, slurred upstroke
96
osborne wave
J wave, Hump on back of qrs

NREMT Review (12 decks)

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