Cardiac, Pericardial and Vascular Sx Flashcards
Which is true about vascular surgery?
A Non-textile grafts have more problems than textile grafts, such as thrombogenicity and infectivicity.
B Dacron is a non-textile graft.
C The adventitial surface of an artery has vaso vasorum pattern of perfusing vessels.
D Identifying the gray line during dissection of a vessel indicates that you are in the correct plane.
A (reversed =textile more problems)
B polytetrafluoroethylene
C true
D (white line - occurs when are penetrates the areolar tissues interposed between the adventitia and surrounding tissue)
Which of the following is true?
a. The interventricular grooves are important landmarks for the coronary vein
b. The left coronary artery is normally dominant in cats, whereas the right is normally dominant in dogs
c. The great coronary vein drains into the coronary sinus, which empties into the right atrium just dorsal to the caudal vena cava
d. Waterston’s groove represents the embryologic separation between the left and right atria
D is true
A IV groove- coronary ARTERY
B cats = right and dogs = left
C coronary vein –> coronary sinus –> VENTRAL to caudal VC
Which is true?
A. A mural leaf is part of the mitral valve
B. The septal leaf of the tricuspid valve has 3 parts - A1, A2, A3
C The primary order of chordae tendinae connects edge of leaflets to the papillary muscles
D The right ventricle has 2 prominent papillary muscles
C true
A tricuspid: mural
B Mitral: A1,2,3 for septal and P1,2,3 for parietal
D Left ventricle: papillary m.
Which is false?
A. A normal amount of fluid in the pericardium in a dog is 0.5-2 mL.
B. The parietal pericardium is made of an external fibrous layer and an internal serous layer.
C The visceral pericardium is formed from the internal layer folding in on itself at the level of the heart base.
D The fluid of the pericardium is an ultrafiltrate of plasma that allows for lubrication to facilitate movement between epicardium and pericardium without friction.
A 0.5-1 ml
What is stroke volume?
EDV-ESV
Vascular resistance has a ________ relationship with preload?
Inverse
Which of the following statements is true?
A The AV node delays impulses because of a lack of voltage dependent Ca++ channels
B Automaticity is the slow diastolic depolarization that allows some cardiomyocytes to trigger their own action potential
C Pulse pressure is an inverse function of both stroke volume and compliance of large elastic arteries
D Acepromazine and alpha-2 agonists are recommended pre-medications for cardiac procedures.
A lack voltage Na+ channels
B true
C direct SV and inverse compliance
D no alpha-2 agonists
Which of the following statements is false?
A Pledgets help keep mattress sutures from cutting through cardiac tissues
B Common sutures includes polypropylene, polytetrafluoroethelene (PTFE) and braided polyester
C Pharmacologic manipulation of the heart rate during beating heart surgery is recommended to help with suturing
D For inflow occlusion tourniquets can be placed via right thoracotomy or median sternotomy to access the vena cavae and azygous vein
C false
avoid pharma management of heart beat- not needed or warranted
True or false: With whole body hypothermia (32-34C) circulatory arrest time can be > 4 minutes.
false, up to 4 min
risk of cardiac arrest increases with time
risk cerebral injury and V-fib
what intercostal spaces is the heart located between?
planes of the 3rd and 6th intercostal spaces
Afterload has an ____ relationship with stroke volume
inverse
Contractility has a ___ relationship with stroke volume
direct/ proportional relationship
What electrolyte is involved in excitation-contraction coupling in cardiac myocyte?
entry of Ca++ into the cell during AP
what is pulsus paradoxus and when does it happen?
variations of pressure quality associated with respiratory phase
(NOT pathognomonic: obstructive lung dz, restrictive cardiomyopathy, hypovolemic shock, cardiac tamponade)
Where should you perform pericardiocentesis?
Right 5th/6th ICS
avoids major coronary arteries
describe main points of cardiac tamponade –> cardiogenic shock
decreased diastolic pressure (right then left), decrease SV–> dec. Q –> RAAS activation (without inhibition from ANP) –> increased systemic pressure
Poor myocardial perfusion from compression on coronary A
What is Budd-Chiari syndrome
ascites, hepatomegaly secondary to caudal VC obstruction (e.g. stricture, thrombus)
what are the 3 layers of an artery and what do they contain
adventitia: collagen and CT
Media: Smooth m and elastic tissue
intima: endothelial cells
What tunic of a vein is thinner than and artery and why?
Tunica media: composed mainly of smooth muscle cells, however generally does not act to function in a contractile manner.
most veins the tunica intima contain infoldings, that prevents backflow and pooling of blood from the effects of gravity.
Arteries are NOT located in…(5)
Hair, epidermis, nails, cartilage, cornea
What state is iron in for oxygen binding?
Ferrous Fe2+
True of false: the circumflex coronary artery supplies the largest mass of cardiac muscle, but dogs also have extensive collateral circulation
true
T/F: Hypoxic pulmonary vasoconstriction to regulate oxygen is assisted by most anesthetics drugs
almost true
false: HPV is minimally inhibited
splanchnic circulation receives ___% cardiac output, and contains about ___% of total blood volume
25% Q
20% TBV
which drug severely blunts ability of splanchnic circulation to mobilize blood?
benzodiazepines
what are 5 basic properties for determining cardiac performance?
chronotropy = rate inotropy = contractility lusitropy = relaxation dromotropy = conduction velocity bathmotropy = excitability
Where does ADH come from to cause more sustained changes in cardiopulmonary function?
hypothalamus synthesis, released from pituitary
Where does vasopressin come from?
made in the hypothalamus, released from pituitary
If one artery branches into two arteries concurrently, the combined area of the branching vessels is generally ___ than that of the parent vessel
greater
What approach is best for the caudal VC? The cranial vena cava?
caudal = left thoracotomy Cranial = right thoracotomy or median sternotomy
What approach for a PDA?
left thoracotomy
What approach for a TDL in a cat? in a dog?
cat = left thoracotomy Dog = right thoracotomy
What is the branching pattern of the aortic arch?
brachiocephalic trunk = common carotid + right subclavian
left subclavian
What are indications for sx for ventricular septal defect? hemodynamically significant…want to prevent progressive heart failure or pulmonary hypertension
< 3.5 m/s on doppler-measured shunt flow velocity
Pulmonic ejection velocity > 2.5 m/s
High-flow shunts
Progressive aortic insufficiency
Radiographic evidence of pulmonary vascular enlargement, or left ventricular chamber dilation
which veins carry oxygenated blood?
pulmonary veins
umbilical v
what percent of blood volume is contained in the venous system? arterial system? heart/lungs?
V = 70%
A = 10%
H/L = 15%
capillary exchange = 5%
what is the MOA of defibrillation?
depolarize the whole heart system
What does the area under the volume/pressure curve represent?
Cardiac work; area inside P-V loop represents the external work done by the heart in one cardiac cycle
how do you estimate pulmonary compliance from a pressure volume loop?
slope of P-V curve at any particular point
x = volume
y = pressure
x/y = volume/pressure
what is the equation for ejection fraction
SV/EDV
what is the equation for stroke volume
EDV-ESV
central chemoreceptors are more sensitive to which products?
CO2 and H+
ventral surface of medulla, CO2 diffuses into CSF easily
where are baroreceptors (arterial) and what are they for?
Carotid sinus, aortic arch
Effective for short-term control of blood pressure
