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Academy > Cardiac > Flashcards

Cardiac Flashcards

1
Q

Task management of an arrest call-what order do you perform the tasks?

A

AED, compression, ventillations (steps of the primary assessment are performed simultaneously)

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2
Q

What is a witnessed arrest?

A

Onset seen or heard by EMS

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3
Q

What are the most advantageous rhythms for defibrillations?

A

Ventricular tachycardia

Ventricular fibrillation

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4
Q

Who gets immediate defibrillation?

A

Now all patients get immediate defibrillation no matter who witnessed the arrest

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5
Q

Full COVID atire

A

Gloves, N95, face visor, gown, hair and foot covers

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6
Q

Transport of a medical arrest patient:

A

ROSC
ALS decides it is time to move
Three consecutive no shocks
Nine total shocks

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7
Q

How much blood does a perosn have?

A

70 cc/kg (6-8 L)

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8
Q

What is the liquid component of blood and how much is it by volume?

A

Plasma, 55%

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9
Q

What are the formed elements and percent by volume of blood?

A

Erthrocytes, thrombocytes, leukocytes

45%

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10
Q

RBC’s are anucleated, so are produced in the ___

A

Bone marrow

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11
Q

What carries blood? What is it? What is its active ingredient?

A

Hemoglobin is a protein that has an active ingredient of iron

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12
Q

____ of O2 is carried by RBCs. The rest is dissolved in ___

A

97%

Plasma

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13
Q

___ of CO2 is carried by RBC’s on the hemoglobin, ___% is dissolved in plasma and 70% enters the RBCs (NOT hemoglobin) and undergoes____

A

23%
7%
CO2+H2O->H+ + HCO3-

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14
Q

Two types of leukocytes

A

Lymphocytes->Antigen specific antibody production

Macrophages->destroy foreign invaders, scavenger

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15
Q

Plasma is ___% water and ___% stuff. The stuff is:

A

91%
9%
Glucose, electrolytes, cholesterol, antibodies, proteins

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16
Q

Layers of the artery

A

Tunica intima, tunica medians, tunica adventitia

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17
Q

The tunica intima is made up of a smooth layer of ____ cells

A

Endothelial cells

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18
Q

Due to low blood pressure, the venous system has ____, so if there are any blackflows, this captures blood flow and keeps blood distributed throughout the venous system

A

Semi-lunar valves

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19
Q

Pressure exterted by solutes in the fluid. Often, in an attempt to acheive equilibrium, will pull water out of the circulatory system

A

Oncotic pressure

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20
Q

Examples of oncotoic pressure

A

Salt water drowning, DKA

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21
Q

Junction of the capillaries and arteriole: sphincter

A

Metarteriole

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22
Q

The metarteriole is influenced by three factors:

A

1) Local factures: temperature, hypoxia, hisamine (causes vasodilation)
2) Neural effects: sympathetic versus parasympathetic
3) Hormonal effects: Adrenaline, norepinephrine

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23
Q

Pressure that pushes fluid out of the vessel

A

Hydrostatic fluid

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24
Q

Examples of hydrostatic pressure

A

CHF, peripheral edema, kidneys work this way

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25
Q

Hydrostatic pressure and CHF

A

If reduce the amount of blood able to pump out,the blood coming back from the pulmonary vien (which is not experiencing a back up) begins to exert more hydrostatic pressure on the walls of the vessels than the vessels. Therefore, see blood going out into the aveoli

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26
Q

Location of the apex of the heart

A

Around the 5th intercostal space off to the left, apex is tilted anteriorly

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27
Q

Location of the base of the heart

A

Second intercostals space, base is tilted posteriorly

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28
Q

Business layer of the heart

A

Myocardium

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29
Q

Layers of the heart

A

Fibrous pericardium, parietal pericardium, visceral pericardium/epicardium, myocardium, endocardium

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30
Q

____ are located in the middle of the heart vessels and attached to the cordae tendonea

A

Papillary muscles

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31
Q

Heart strings

A

Cordae tendonea

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32
Q

Purpose of the papillary muscles

A

Prevents prolapse

Assists in opening the valves during relaxation

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33
Q

Inflammation causes excess fluid between the heart and the sac surrounding the heart

A

Pericardial effusion

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34
Q

Issue due to faulty valve, it may be prolapsed or inverted

A

Heart mummer

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35
Q

Cardiac muscle is ____ because of the interlocking of the cells

A

Syncytium

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36
Q

Blood flow in the myocardium

A

Left Ventricle-> aorta->Left and Right coronary arteries->smaller arteries (LCA:left anterior descending coronay artery and circumflex)->arterioles->capillary beds->coronary venules->small veins->larger veins->coronary sinueses->right atrium

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37
Q

Where does the blood flow from the coronary viens before entering into the right atrium

A

Coronary sinus-small chamber in atrial septum

38
Q

Calcium into smooth muscles/hardening of vessles. Soft tissue stiffens so less elastic. Natural consequence of aging

A

Arteriosclerosis

39
Q

Deposting of plaque along the tunica intima, walls thicken/lumen narrows, resistance increses

A

Atheroscleorsis

40
Q

Intrinisic rates of the nodes

A

SA node=60-100
AV node=40-60
Bundle of His=40-60
Pujinke fibers=20-40

41
Q

Rate of SA node firing

A

Chronotropy

42
Q

Intensity of the contraction

A

Inotropy

43
Q

Duration of contraction which is related to the speed of conduction

A

Dromotropy

44
Q

In an EKG, region between S and T (i.e. the ST segment) where there is an elevated segment

A

STEMI

45
Q

Region between S and the end of the T wave

A

Refractory period

46
Q

Reion between the S and beginning of the T wave

A

ST segment

47
Q

Perfusion

A

Adequate: Bloodfloow, oxygen, nutrients and waste removal

48
Q

LV Ejection fraction

A

Fraction of the blood in your ventricles you push out. Stroke volume/End diastolic volume

49
Q

End systolic volume

A

End diastolic volume-stroke volume

50
Q

Increased stretch results in increased contractility

A

Starlings law

51
Q

Starling’s Law and cardiac ouput path

A

Venous return->increased pre-load->increased stretch->increased contractility->increased stroke volume->increased cardiac output

52
Q

Venous return to the heart-how can it impact preload

A 
Right sided heart failure can drop cardiac output (i.e. atrial fibrillation)
Hypovolemia
Tension pneumothorax
Pericardial tamponade
Supine hypotension syndrom
53
Q

Filling time and how it can impact stretch/Starling’s Law

A

Profound tachycardia (HR over 160), not enough time to fill heart for adequate strech and preload

54
Q

Two things that can impact pre-load/Starling’s Law

A

Venous return to the heart

Filling time

55
Q

Afterload

A

Systemic vascular resistance, the greater the resistance the more difficult it is to press against resistance and generate enough pressure to overcome resistance

56
Q

Circuation to the tissue that normally is not open

A

Collateral circulation

57
Q

Two ways collateral circulation happens:

A

1) Small collapsed vessels open up

2) Neovascularization

58
Q

Vessels can develop a vessle that connects them. Creates redundancy

A

Anastomosis

59
Q

Modifiable risk factors for coronary artery disease (CAD)

A

Smoking-single biggest modifiable factor
Diet
Exercise

60
Q

Non-Modifiable risk factors for coronary artery disease (CAD

A

Age

Genetics

61
Q

Semi-Modifiable risk factors for coronary artery disease (CAD

A

Hypertension
Stress
Diabetes

62
Q

Treatment of CAD

A

Thombolystics
Angioplasty
Cabg

63
Q

Part of the brainstrem involved in rate and contractility

A

Cardiac Center

64
Q

The cardiac center is involved in ___ and ____

A

rate, contractility

65
Q

Part of the brainstem that varies the size of vessels, based upon pressure

A

Vasomotor center

66
Q

The vasomotor center ____

A

Varies the size of the vessels

67
Q

What two hormones control blood pressure and heart rate

A

Adrenaline and catecholomines

68
Q

Where are the baroreceptors and what do they do?

A

Aorta/carotid artery-stretch receptors

69
Q

Where are the chemo receptors and what do they do?

A

Aorta/carotid artery-measure the concentration of O2

70
Q

The vascular component of the ____ is very sensitive to O2. Small drop in O2 will trigger significant sympathetic response to increase HR and BP

A

Chemo receptors

71
Q

Shock is

A

poor perfusion. Maintain perfusion by maintainign cardiac output. Maintain cardiac output by maintaining BP and HR

72
Q

There is a ____CO2 effect on BP and HR

A

Minimal

73
Q

What things impact stroke volume

A

Preload (venous return, ventricular filling time, volume)
Contractility (nervous control, hormones)
Afterload
A afib

74
Q

Non-Reproducible chest pain

A

1) No change upon palpation
2) No change upon movement
3) No change upon deep respiration

75
Q

Reproducible chest pain

A

Changes with deep respiration (pleuritic)

Changes with palpation and movement (muscular skeletal)

76
Q

Thoracic aortic aneurysm

A 
"Tearing" pain
Sudden onset (maximal pain at onset)
Constant
Radiates posteriorly between scapulae
Unequal radial pulses 
Disparate blood pressure in both arms (>20 is significant)
77
Q

Tunica intima develops a tear and separates from the medians. Creates a “false passage”

A

Dissection

78
Q

Weakened arterial wall, “balloons out”

A

Thoracic aortic aneurysm

79
Q

Dissections are more likely in the ___ while ruptured aneurysms are more prevalent in the ____

A

Chest, abdomen

80
Q

With a dissection at the base of the aorta, see signs and symptoms similar to _____

A

Pericardial tamponade, because impinging the pericardium and coronary artery

81
Q

Predispositions for thoracic aortic aneurysm

A

Hypertension-biggest indicator
Age
Marfansim, because generally do not have the same amount of collagen in the aorta

82
Q

Acute Coronary Syndrome

A

Develop a “pit” in artery which triggers the release of chemicals (tissue mediator) to the site to try to effect repair
Thesese chemicals attract platlets and white blood cells (macrophages)
The tunia medians expands into the injured site, trying to fill the injured space
Now have an uneven surface which attracts more platlets and fatty streaks (i.e. lipoprotein deposits)-cholesteral
Eventually develop a fibrous encapsulation. This provides substrates for future clots

83
Q

Unstable angina

A

Event that is aytpical for the patient
Qualitative (radiates further out, SOB that never happened before)
Quantitative (discomfortable is higher, 3 nitros instead of 1)

84
Q

Different signs and symptoms for agina versus MI

A

Diaphoretic-MI
Time <15 for angina, >20 MI
Angina-onset due to exertion/stress. MI can be sedentary

85
Q

Cardiogenic shock

A

Cardiac output drops to the point where you are no longer perfusing adequately

86
Q

S/S due to decrease in stroke volume which leads to a left ventricular event

A 
HR increases
BP decreases
Hydrostatic pressure increases in the capillary beds in lungs because blood flow from lungs is still the same-pulmonary edema, rales
RR increases
WOB increases
Pink frothy sputum
Sycope? Due to low BP
87
Q

Issue that results from a decrease in stroke volume which leads to a left ventricular event

A

CHF

88
Q

S/S HR issue, conduction issue

A 
HR decreases
Adrenaline dump=pale, cool, diaphoretic
Normotensive or increased BP (because left ventricle is pushing fine)
Clear and equal breath sounds
Syncope due to bradycardia
89
Q

HR issue, conduction issue is affecting what parts of the heart?

A

Right coronary event

Impacting SA node

90
Q

Why are we worried about giving O2 to a person experiencing an MI?

A

Re-perfusion injury

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