Cardiac Assessment Flashcards

1
Q

What is the pacemaker of the heart?

A

SA Node
At top of R atrium

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2
Q

What is the electrical impulse through the heart called?

A

Action potential

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3
Q

Where is the pulmonic valve?

A

Between R ventricle and pulmonary artery

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4
Q

Where is the tricuspid valve?

A

Between R atrium and R ventricle

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5
Q

Where is the aortic valve?

A

Between L ventricle and aorta

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6
Q

Where is the mitral or bicuspid valve?

A

Between L atrium and ventricle

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7
Q

Which artery that feeds the heart is responsible for most defects in cardiac conduction?

A

Right coronary artery
This feeds the AV node and the bundle of His

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8
Q

What is depolarization/repolarization?

A

Depolarization is movement of Na into heart that causes heart to become excited and ready to beat
Repolarization is when Na moves out and heart relaxes

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9
Q

What part of EKG corresponds to depolarization of atria?

A

P wave
This starts with firing of SA node and pump of atria

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10
Q

What part of EKG corresponds to depolarization of ventricles?

A

QRS
Starts with firing through AV node through pump of ventricles

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11
Q

What part of EKG corresponds to repolarization of ventricles?

A

T wave

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12
Q

What is cardiac output?

A

Amount of blood pumped by each ventricle in 1 min
It is stroke volume x Heart rate

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13
Q

What is stroke volume?

A

Amount of blood ejected from ventricle with each heartbeat

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14
Q

What is a healthy ejection fraction?

A

70%
Ejection fraction is similar to stroke volume except it is a percentage

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15
Q

What is Frank Starling law?

A

The more the heart is stretched, the harder the contraction.

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16
Q

What is preload?

A

The end of diastole before the next contraction

17
Q

What is after load?

A

The resistance the ventricle has to pump against

18
Q

How does HTN lead to atherosclerosis?

A

BP pressure causes damage to endothelium over time. Plaque build up.

19
Q

Where are baroreceptors and what do they detect?

A

Aortic arch
Carotid sinus
They detect stretch or pressure in arteries.
Causes the autonomic NS to adjust

20
Q

What is pulse pressure?

A

Difference between systolic and diastolic. Represents the force of contraction.
Normally about 1/3 of systolic

21
Q

What is MAP?

A

Average pressure within the arterial system.
Represents the pressure felt by organs.
Calculated by
SBP + DBP + DBP divided by 3

22
Q

How should jugular veins be assessed for JVD? What may JVD indicate?

A

With patient moving from lying supine to sitting up. At 30-45 degree angle
Right sided HF

23
Q

What is a bruit?

A

Turbulent blood flow
Sounds like buzzing/humming with bell of stethoscope

24
Q

What is a thrill?

A

Vibration of vessel
This is felt not heard.
Suspect aneurysm or fistula

25
Where is PMI (point of maximal impulse)?
Apical pulse Over apex of heart Midclavicular line 4-5 intercostal space
26
What does S1 sound indicate?
Closure of tricuspid and mitral valves
27
What does S2 indicate?
Closure of aortic and pulmonic valves
28
What does S3 indicate?
Low intensity vibration of ventricular walls. Usually means decreased compliance of ventricles Could indicate Left HF or mitral valve regurgitation. Called ventricular gallop Sounds like Ken-TUCK-ee
29
What does S4 indicate?
Low frequency vibration from atrial contraction. Called atrial gallop CAD, cardiomyopathy
30
How are heart murmurs graded?
Roman numeral 1-6 (So 6/6 is worst, 1/6 is least)
31
What is most definitive lab for suspected MI?
Tropinin
32
What does an elevated BNP indicate?
Heart failure This is used to figure out if dyspnea is respiratory or cardiac cause
33
What is CK-MB lab?
Test for myocardial injury High levels indicate MI Not as helpful as troponin
34
What is CRP lab?
C-reactive protein Marker for inflammation May help predict cardiac disease and events