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CAL-Jac Paramedic Program > Cardiac > Flashcards

Cardiac Flashcards

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1
Q

Which side of the heart is considered the low pressure system (pulmonary system)?

A

The right side

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2
Q

What side of the heart is considered the high pressure pump (systemic circulation)?

A

The left side

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3
Q

When the left ventricle contracts, it creates an impulse palpable at the apex of the heart called what?

A

apical pulse

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4
Q

The apical pulse is also called ________, because it’s where the heartbeat is most strongly felt.

A

Point of maximal impulse (PMI)

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5
Q

Where is the PMI located?

A

Left anterior chest at fifth intercostal space along the midclavicular line

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6
Q

What is made of thick cardiac muscle tissue and is responsible for contraction and ejection of blood from the heart?

A

Myocardium

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7
Q

The left main coronary arteries divides into what sections?

A

Left anterior descending artery (LAD) and the circumflex artery (Cx)

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8
Q

Where does the LAD supply blood to?

A

Anterior surface of left ventricle
Lateral side of left ventricle
Interventricular septum

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9
Q

Branches of the right coronary artery supply blood to the ….?

A

Walls of right atrium
Walls of the right ventricle
Inferior left ventricle
SA node
Atrioventricular bundle

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10
Q

What are the six parts of the cardiac conduction system?

A

SA node
Atrioventricular node
Bundle of His
Right and Left bundle branches
Purkinje fibers

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11
Q

Stimulation of _______ strengthens the force of contraction and increases the heart rate.

A

sympathetic (accelerator) nerves

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12
Q

Stimulation of the ____________ slows the rate of discharge of the SA node, slows conduction through the atrioventricular nose, weakens the atrial contraction and causes small reduction in the ventricular contraction.

A

Parasympathetic (inhibitory)

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13
Q

What are cardiac conditions caused by an abrupt reduction in blood flow through the coronary artery?

A

Acute coronary syndromes (ACSs)

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14
Q

What are three major ACS’s?

A

unstable angina
Non-ST segment elevation myocardial infarction (NSTEMI)
ST segment elevation myocardial infarction (STEMI)

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15
Q

What are common chief complaints of patients experiencing an ACS?

A

chest pain, dyspnea, fainting, palpitations and fatigue

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16
Q

A pt with multiple symptoms, it’s important to ask …?

A

Which symptom started first and which bothers them the most

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17
Q

What is chest discomfort that occurs when the heart muscle does not receive enough oxygen (myocardial ischemia)?

A

Angina pectoris

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18
Q

What medication do patients with CAD (coronary artery disease) commonly take?

A

NTG - Nitro

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19
Q

Severe ischemia may result in radiation to the _____?

A

right chest, right arm and back

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20
Q

Where does chest discomfort associated with myocardial ischemia usually begin?

A

central or left chest that radiates to the arm (little finger[ulnar] side of left arm), wrist, jaw, epigastrium, left shoulder and between the shoulder blades

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21
Q

What are medications or procedures used to open a blocked coronary artery?

A

reperfusion therapy

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22
Q

How long do anginal symptoms usually last?

A

20 minutes or less

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23
Q

Chest discomfort that lasts for hours may also be seen in patients with ____ & ____?

A

Pericarditis and aortic dissection

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24
Q

Chest discomfort associated with AMI lasts about ?

A

20 minutes to several hours

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25
Q

Dyspnea that occurs on exertion or at rest suggests the presence of?

A

COPD or left ventricular failure

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26
Q

Dyspnea that develops suddenly suggests?

A

pulmonary embolism, pneumothorax, acute pulmonary edema, pneumonia, airway obstruction

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27
Q

In patients who have _____, fluid build up that leads to dyspnea often develops slowly over weeks or months.

A

left ventricular failure

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28
Q

Patients who have dyspnea when resting horizontally may have ________ because blood pools in the lungs when the patient lies down?

A

chronic heart failure

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29
Q

Dyspnea that is relieved by a change in position is called?

A

orthopnea

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30
Q

Paroxysmal nocturnal dyspnea is associated with _____ and usually begins 2-4 hours after on the onset of sleep?

A

left ventricular failure

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31
Q

PND with LVF have what type of symptoms that are improved with sitting or standing up?

A

coughing, wheezing, sweating

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32
Q

Pulmonary edema is usually accompanied by what type of sputum?

A

frothy, pink-tinged sputum

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33
Q

What type of electrolyte disorder is a common cause of generalized weakness and fatigue?

A

high or low potassium levels

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34
Q

What type of medications may also cause fatigue?

A

Beta blockers, diuretics, antihypertensives

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35
Q

What are two types of vasodilators?

A

Nitro (Nitrostat) and Isosorbide (Isordil)

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36
Q

What is another word for hypoperfusion?

A

shock

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37
Q

Where does the right atrium receive blood low in oxygen from?

A

superior vena cava, inferior vena cava and coronary sinus

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38
Q

Where does the left atrium receive oxygenated blood from?

A

lungs via the right and left pulmonary veins

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39
Q

What does the right ventricle pump?

A

Deoxygenated blood to the lungs

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40
Q

Where does the left ventricle pump?

A

Oxygenated blood throughout the body

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41
Q

Bilateral pitting edema may be a sign of what?

A

Right Ventricle Failure (RVF)

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42
Q

What are the BP vitals in Stage 2 hypertension?

A

SBP 140mm Hg or higher
DBP 90mm Hg

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43
Q

Are widened pulse pressures an early or late signs of shock?

A

late sign

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44
Q

S1 heart sounds occur when…?

A

Tricuspid and mitral valve closes

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45
Q

Decreased S1 sounds indicate?

A

fibrotic and calcified mitral valve, obesity, emphysema, cardiac tamponade

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46
Q

Decreased S2 heart sounds occur when…?

A

pulmonary and aortic valves close

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47
Q

Decreased S2 heart sounds indicate?

A

loud: HTN or pulmonary HTN
decreased: hypotension
split: right bundle branch

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48
Q

S3 heard sounds are caused by…?

A

ventricular wall vibrations

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49
Q

Decreased S3 heart sounds can indicate?

A

heart failure

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50
Q

Which heart sound is heard just before S1 and is caused by turbulent filling of a stiff ventricle?

A

S4

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51
Q

What can be heard from turbulent blood flow through the valves?

A

heart murmurs

52
Q

What happens to the muscle fibers during depolarization?

A

They are stimulated to contract through changes in concentrations of electrolytes

53
Q

When does repolarization begin?

A

Closing of sodium and calcium channels

54
Q

What cardiac action potential phase does the cell depolarize and begin to contract?

A

Phase 0

55
Q

What cardiac action potential phase is the resting phase?

A

Phase 4

56
Q

What cardiac action potential phase do the cells begin to repolarize?

A

Phase 1

57
Q

What cardiac action potential phase completes repolarization?

A

Phase 3

58
Q

What cardiac action potential phase does the Na+ and Ca++ enter the cell and Potassium flow out?

A

Phase 2

59
Q

What phases consist of the absolute refractory period? (have not sufficiently repolarized to enable another depolarization)

A

Phase 0 to the middle of Phase 3

60
Q

What phases represent the relative refractory period? (some cells have repolarized sufficiently to depolarize again)

A

(middle of phase 3 to the beginning of phase 4)

61
Q

Where is the SA node located?

A

right atrium

62
Q

Where does the SA node receive blood from?

A

RCA

63
Q

What is the most common cause of sudden cardiac arrest?

A

V-fib

64
Q

Impulses generated on the SA node spread across the atria and internodal pathways: what are those pathways?

A

anterior internodal
middle internodal
thorel tract

65
Q

What type of breath sounds will you hear with pt’s with CHF?

A

crackles

66
Q

Where is the AV node located?

A

floor of the right atrium behind the tricuspid valve

67
Q

What is dependent edema?

A

swelling of the feet and ankles

68
Q

When an SA impulse enters the AV node, it is delayed by how many seconds?

A

0.12 seconds

69
Q

What does the delay between the nodes allow?

A

Allows the atria to empty blood into the ventricles

70
Q

What medications can be given for the treatment of CHF?

A

ACE inhibitors, beta blockers, and diuretics

71
Q

What position would be used to treat CHF

A

upright/Fowlers

72
Q

What can be used to treat respiratory distress with CHF?

A

CPAP

73
Q

What happens when an atrial rate becomes rapid?

A

fewer impulses reach the ventricle

74
Q

unequal radial or femoral pulses are a good indication of what type of cardiac emergency?

A

Aortic Aneurysm

75
Q

Commotio Cordis is what type of Ventricular dysrhythmia?

A

V-Fib

76
Q

What systolic BP is considered as a hypertensive emergency?

A

180 mmHG

77
Q

When a cell is at rest, what leaks out?

A

Potassium

78
Q

When the inside of the cell is more negative than the outside, it is?

A

polarized

79
Q

The P wave on an EKG signifies?

A

atrial depolarization

80
Q

What is another word for the middle internodal tract?

A

Wenckebach

81
Q

What is the ability of the pacemaker cells to initiate an electrical impulse without being stimulated from another source

A

automaticity

82
Q

Decreased concentrations of Potassium and calcium in the blood causes the automaticity to increase or decrease?

A

Increase

83
Q

Increased concentrations of K+, Na+, Ca+++, decreases or increases automaticity?

A

decreases

84
Q

The ability of cardiac cells to shorten causing cardiac muscle contraction in response to an electrical stimulus?

A

contractility

85
Q

Geographically similar areas of the myocardium which help localize areas of ischemia, injury or infarction are called what type of leads?

A

contiguous leads

86
Q

Very large (hyperacute) T waves may indicate?

A

myocardial ischemia, injury and infarction

87
Q

Tall, pointed (peaked) T waves indicate?

A

hyperkalemia

88
Q

A clot that develops in a vein near the surface of the skin

A

Superficial thrombophlebitis

88
Q

The development of a blood clot in an inflamed or damaged vein

A

Thrombophlebitis

88
Q

What are two examples of coronary heart disease?

A

angina pectoris and AMI (acute myocardial infarction)

88
Q

Counting the number of QRS complexes in a 6 second strip and multiplying it by 10 can help you measure what?

A

heart rate

89
Q

What does SCD stand for?

A

Sudden cardiac death

90
Q

Where do most out of hospital cardiac deaths occur?

A

homes- public settings - nursing homes

91
Q

What are the three roles of the cardiovascular system?

A

To deliver oxygenated blood and nutrients to the cells, deliver chemical messengers(hormones) and transport waste products to appropriate sites.

92
Q

Where does the atrium receive blood low in oxygen?

A

superior vena cava, inferior vena cava and coronary sinus

93
Q

What is the coronary sinus?

A

It is a large vein that on the posterior side of the heart that collects blood from the great cardiac vein, small coronary veins and drains it into the right atrium.

94
Q

Where does the left atrium receive fresh oxygenated blood from?

A

right and left pulmonary veins

95
Q

Where does the right ventricle pump deoxygenated blood to?

A

the lungs

96
Q

Where does the left ventricle pump oxygenated blood to?

A

the rest of the body

97
Q

What valve do the atria pump blood through?

A

AV valve (atrioventricular)

98
Q

What does the interatrial septum separate?

A

right and left atrium

99
Q

What layer of the heart is the middle layer that is responsible for cardiac contraction and efficient ejection of blood from the heart?

A

myocardium

100
Q

Which coronary artery is the largest in diameter and the shortest myocardial blood vessels?

A

left main coronary artery (LMCA)

101
Q

Is the baseline, the isoelectric (TP segment, isometric line) line, positive, negative or neutral?

A

electrically neutral

102
Q

An electrical impulse moving in the direction of a negative electrode produces what type of deflection?

A

deflection below the baseline

103
Q

Perpendicular movement of an impulse toward a positive electrode produces what type of waveforms?

A

biphasics waves

104
Q

What is the amplitude of a p wave?

A

less than 2.5mm tall

105
Q

what is the duration of a p wave?

A

0.11 seconds or less

106
Q

what does a p wave represent?

A

atrial depolarization

107
Q

What does a calibration box inform you of?

A

The paper speed and amplitude

108
Q

What is the length of a normal PR interval?

A

0.12-0.20 seconds (3-5 small boxes)

109
Q

What does the PR interval represent?

A

time required for an impulse to traverse the atria and AV junction

110
Q

What does the PR segment represent?

A

amount of time the AV node delays transmission of atrial activity to the ventricles

111
Q

When does atrial repolarization take place?

A

During the PR segment

112
Q

What does the QRS segment represent?

A

ventricular depolarization

113
Q

What condition is alleviated when sitting forward?

A

perocarditis

114
Q

What are the signs and symptoms of pericarditis?

A

-positional chest pain
-SOB
-recent infection or fever
-diffused concave ST elevation ( no more than 5mm), depressed or down sloping PR segments, absence of reciprocal ST depression

115
Q

True or False: Reciprocal ST depression is never seen with pericarditis?

A

True

116
Q

What is the most common cause of accelerated idioventricular rhythms?

A

AMI- acute myocardial infarction

117
Q

What is the pattern for stable angina?

A

chest pain, pressure, discomfort induced by exertion

118
Q

Unstable is not relieved by what?

A

rest and/or nitroglycerin

119
Q

If a pt is experiencing angina, what should you expect to see on the 12-lead?

A

ST segment depression or T wave inversion

120
Q

How does right-sided heart failure manifest?

A

JVD and peripheral edema

121
Q

What is the normal duration of a QRS complex?

A

011 seconds or less

122
Q
A

CAL-Jac Paramedic Program (8 decks)

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