Cardiac Lecture 6 Flashcards

1
Q

What percent of people have a PDA that branches off the RCA aka right coronary dominance?

A

75%

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2
Q

What percent of people have a PDA that branches off the LCA aka left coronary dominance?

A

15%

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3
Q

Is it a higher risk for the PDA to descend from the RCA or LCA?

A

LCA

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4
Q

Positive pressure ventilation would result in a _______ filling pressure and _______ CO

A

higher filling pressure- need more volume and/or venous constriction

Higher CO initially, but with prolonged positive pressure ventilation will result in lower CO

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5
Q

Aortic stenosis would result in what change to the heart walls? What is the downside?

A

hypertrophy, thick heart wall - harder to fill ventricles (reduced compliance) need to inc Psf to accommodate
- inc slope of phase I

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6
Q

Dilated cardiomyopathy (aortic valve regurgitation) would result in what change to the heart walls?

A

stretched out ventricle, thinner heart wall - high compliance, dec Psf
- dec slope of phase I

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7
Q

How are kid ventricles different from adults?

A

less compliant ventricle - can’t accommodate inc venous return so have to inc HR instead
- be careful with volume

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8
Q

What causes the first heart sound?

A

AV valves closing (ventricular pressure > atrial) vibration, systole

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9
Q

Which heart sound is the longest? What is the pitch?

A

1st (0.14 s) - low pitch

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10
Q

How long is the second heart sound? Pitch?

A

0.11 sec, higher pitch

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11
Q

What is the cause of the 2nd heart sound? What is unique about S2?

A

pulmonary and aortic valves closing, diastole
- can have splitting during deep inspiration and pulmonic valve stays open longer and closes after aortic valve

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12
Q

When is the 4th heart sound heard?

A

when the atrium is doing more work/fuller than normal (mitral stenosis) - unhealthy heart

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13
Q

When can the 3rd heart sound be heard?

A

kids and heart failure - low compliance ventricle; walls not stretching enough - turbulence

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14
Q

What heart sounds are expected in aortic stenosis?

A

loud murmur during systole

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15
Q

What heart sounds are expected in mitral stenosis?

A

murmur during diastole, loudest at the end (atrial contraction)

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16
Q

What heart sounds are expected in aortic regurgitation?

A

murmur during diastole - loudest in the beginning and dec

17
Q

What heart sounds are expected in mitral regurgitation?

A

backward flow during systole - systolic murmur loudest at the beginning

18
Q

Where can valves be auscultated?

A

aortic valve - R 2nd ICS
pulmonic valve - L 2nd ICS
tricuspid - L 5th ICS
bicuspid - lateral L 5th ICS

19
Q

What is the acronym for valve auscultation?

A

APTM - all physicians take money

20
Q

What instrument is used to identify heart murmur frequencies that are too low to hear?

A

Phonocardiogram

21
Q

How low can the ear hear?

22
Q

What are the divisions of the mediastinum?

A

Superior
Inferior:
- Anterior
- Middle
- Posterior

23
Q

What do the pericardiacophrenic nerves sense?

A

responsible for sensory perception in the pericardium and diaphragm

24
Q

What is included in the posterior mediastinum?

A

esophagus, thoracic aorta and ducts, vagus nerves, azygos and hemizygous veins

25
What is included in the middle mediastinum?
heart, pericardium, ascending aorta, SVC, pulmonary trunk and veins, pericardiacophrenic and nerves, arteries and veins
26
What is a good art line waveform called?
defined dicrotic notch
27
A spring (bubble or clot) in the circuit of an art line would cause an _______-dampened waveform
over - can also be caused by the gain/amplifier not being turned up enough
28
If the amplifier/gain is turned up too high in the circuit of an art line would cause an _______-dampened waveform
under - artifact
29
A connection between the circumflex (LCA) and PDA (RCA) is called an ________
anastomosis
30
Coronary blood vessels on the surface of the heart are ______, while the deeper vessels are called _______
epicardial - LAD and PDA (sub)endocardial
31
epicardial blood vessels have _____ pressure than endocardial blood vessels
lower
32
Which blood vessels in the heart are the most likely to have ischemia?
subendocardial, left ventricle - blood can move retrograde
33
What could help reduce the amount of backward blood flow during mitral regurgitation?
reduce afterload
34
A dilated left ventricle can also be called _________
eccentric LVH
35
A hypertrophied left ventricle can also be called _________
concentric LVH
36
What are the causes of eccentric LVH?
- aortic/mitral valve regurg - ventricular septal defect - systolic dysfunction
37
What are the causes of concentric LVH?
- aortic valve stenosis - chronic HTN - diastolic dysfunction
38
ACE inhibitors are given to
slow down scar tissue deposition in ischemic heart tissue
39
Dead heart tissue resulting in nonfunctional muscle and systolic stretch would cause a decrease in ____
EF