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Medical Surgical Nursing I > Cardiac A&P > Flashcards

Cardiac A&P Flashcards

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1
Q

What is the function of the valves of the heart?

A

To control the flow of blood between chambers and into the great vessels

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2
Q

When do the mitral and tricuspid valves close?

A

During Ventricular systole

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3
Q

What are the two branches of the Left Main Coronary artery?

A

The Left Anterior descending and the circumflex arteries

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4
Q

What are the three branches of the Left anterior Descending artery

A

Ramus, Diagonals, Septals

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5
Q

The circumflex artery ecentually becomes the ___

A

Obtuse Marginals

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6
Q

What is Automaticity?

A

The ability of the cardiac cells to initiate an electrical stimulus

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7
Q

What is Excitability

A

The ability of the myocardial cells to respond to a stimulus

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8
Q

What is conductivity

A

The ability to transmit the impulse from one cell to another

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9
Q

what is contractility?

A

The ability of myocardial cells to shorten (contract) in response to an electrical stimulus

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10
Q

What is refractoriness?

A

The inability of cells to respond to an electrical impulse if they have not recovered from the previous episode.

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11
Q

What are the two refractory periods?

A

The absolute and the relative

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12
Q

WHat is the absolute refractory period?

A

The period of time when the heart will not respond to stimuli of any magnitude

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13
Q

What is the relative refractory period?

A

The heart can still respond to a strong stimuli

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14
Q

What is stroke Volume?

A

The amount of blood ejected with each contraction of the LV

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15
Q

WHat is heart rate?

A

The number of times the ventricles contract in one minute

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16
Q

What is cardiac output?

A

The volume of blood pumped in one minute

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17
Q

What is the normal range for Cardiac output?

A

4-7 Liters per minute

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18
Q

How is Cardiac Output calculated?

A

Stroke volume X Heart rate

CO= SV X HR

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19
Q

WHat is the Cardiac index?

A

An asjustment made to the CO based on the body size in terms of BSA

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20
Q

What is the normal range for Cardiac INdex?

A

2.7-3.2 L/min/M sq

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21
Q

Why is Cardiac Index important?

A

Because it takes body size into account when calculating Cardiac Output Needs. An obese Person will need more CO to supply their tissues so a normal CO value may still be inadequate for them

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22
Q

How is Cardiac Index calculated?

A

CI= CO/BSA

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23
Q

What is preload?

A

The amount of myocardial stretch at the end of the diastole.

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24
Q

What determines the Pre-load?

A

The Left Ventricular End Diastolic Volume (LVEDV)

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25
Q

Preload is tied to what law

A

Starlings Law

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26
Q

How are LVEDV and SV/CO interrelated

A

When LVEDV increases, the strength of the contractions in the LV are increased causing an increase in SV and CO

27
Q

What is the afterload?

A

The pressure that the LV must overcome to eject blood into the aorta.

28
Q

What are the cardiac risk factors that can not be modified?
4
GAEF

A
  • Gender
  • Age
  • Ethnic Background
  • Family History of CV disease
29
Q

What are the Cardiac risk factors that CAN be modified?
5
CPOTA

A
  • Cigarette Smoking
  • Physical Activity
  • Obesity
  • Type A
  • Stress
30
Q

What is the resting membrane potential of cardiac cells?

A

-90 millivolts

31
Q

At what MV does an action potential occur in cardiac cells?

A

-60 MV

32
Q

What is the threshold potential?

A

The point at which an action potential is triggered

33
Q

Cardiac action potential has _ phases

A

5

34
Q

What are the 5 phases of cardiac potential?

A 
0-Depolarization
1-Early repolarization
2-Plateau
3-Rapid Repolarization
4-Resting Membrane potential
35
Q

What occurs during the depolarization phase of cardiac potential?

A
  • Shown as a vertical line moving away from the resting membrane potential
  • Occurs when the membrane is stimulated
  • When stimulated, sodium channels open up.
  • Sodium is positively charged and thus causes a sharp positive spike in membrane potential from -90 to +20MV
36
Q

What occurs during phase 1 (early Repolarization) of cardiac potential?

A
  • Membrane potential charge goes from +20 to around 0

- Occurs when sodium channels are closing and some chloride (neg) enters the cell

37
Q

What occurs during phase 2 (plateau) phase of cardiac potential?

A
  • Charge stays around 0 mv

- Calcium channels open and calcium enters the cell

38
Q

What occurs during phase 3 (rapid repolarization) of cardiac potential

A
  • When action potential returns to resting membrane potential
  • Occurs because potassium rushes out of the cell
39
Q

What occurs during phase 4 (Resting potential) of cardiac potential?

A
  • Cell is at resting membrane potential
  • Absolute refractory due to cell charge being opposite
  • Sodium potassium pump returns to restore proper balance to cell
40
Q

What is the SA node?

A

The sino-atrial node

  • The normal (primary) pacemaker of the heart
  • Depolarized at 60-100 time per minute
  • Located near where the Superior vena cava enters the right atrium
41
Q

What is the function of the internodal pathway?

A

Delivers the impulse to the RA from the SA node

42
Q

What is the finction of bachmann’s bundle?

A

Delivers impulse to the LA from the SA node

43
Q

What is the AV node?

A
  • Located at the junction between the Ventricles and the atria
  • Slows the Impulse as it moves through the conduction system
  • If the SA node fails, the AV node will take over at 40-60 BPM
44
Q

What is the function of the bundle of his

A
  • Slows the impulse in conjunction with the AV node

- Delivers impulse to the ventricles

45
Q

What are the bundle Branches?

A
  • Two main branches. Left bundle branch (LBB) and Right bundle branch (RBB)
  • IMpulse moves through them to the purkinje fibers
46
Q

What are the purkinje fibers?

A
  • Deliver the impulse rapidly to the ventricular myocardium
  • Impulse is delivered almost instantly throughout all cells to ensure a coordinated, effective contraction
  • Can take over in both SA and AV nodes fail. Will impulse at 20-40 times per second
47
Q

On EKG paper, the amount of time between two vertical lines is?

A

0.04 seconds

48
Q

On EKG paper, the amount of time between two darker vertical lines is?

A

.2 seconds

49
Q

What does the vertical axis on EKG paper measure?

A

Voltage

50
Q

On EKG paper, What is the voltage between two horizontal lines?

A

.1 mv

51
Q

On EKG paper, what is the voltage between two darker horizontal lines?

A

0.5 mv

52
Q

What does the P way signify?

A

-Signifies Atrial Depolarization

53
Q

What is the mechanical action associated with the P wave?

A

Atrial contraction

54
Q

What is the general, normal appearance of the P wave?

A

Small, round positive deflections from the baseline

55
Q

What does the PR interval (PRI) signify?

A

The period of time between the beginning of the P wave and the beginning of the QRS complex.
-Start of Atrial depolarization to the start of Ventricular depolarization

56
Q

What is the normal range of the PRI?

A

0.14 to 0.2 seconds

57
Q

What does the QRS complex represent?

A

Ventricular depolarization.

58
Q

What is the mechanical action associated with the QRS complex?

A

Ventricular Contraction

59
Q

What is the normal duration range for the QRS complex?

A

0.04 seconds to 0.1 second

60
Q

What does the T wave represent?

A

Ventricular Re-polarization

-Generally upright

61
Q

What are the five questions when assessing EKG strips?

A
  1. Are there P waves
  2. Is there a P wave in front of each QRS complex?
  3. What is the duration of the PRI
  4. What is the duration of the QRS complex
  5. What is the Ventricular Rate/Rhythm?
62
Q

When asking “are there P waves?” What additional things need to be considered?

A

a. is the morphology consistant?

b. What is the rate/rhythm?

63
Q

When asking “Is there a P wave in front of each QRS complex?” What is an additional/alternative question to ask?

A

Or, is every P wave followed by a QRS complex?

Medical Surgical Nursing I (11 decks)

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