Cardiac Phys (Rita)

Question 1

What % EF is considered cardiovascular pump dysfxn/failure?

Answer 1

< 40%

Question 2

What BNP value is considered cardiovascular pump dysfxn/failure?

Answer 2

BNP > normal (age dependent)

Question 3

What measurement tells us about onset of ventricular ectopy with inc. workload?

Answer 3

> 7 PVCs/min with hemodynamic compromise

PVC = premature ventricular contractions/min

Question 4

What measurement of ST elevation/depression is considered cardiovascular pump dysfxn/failure?

Answer 4

> 2mm

Question 5

Peripheral ischemia can be measures by what value? What symptoms?

Answer 5

ABI < 0.5

claudication with ambulation

Question 6

Deconditioning begins with how many hours of bed rest?

Answer 6

24-48 hours

Question 7

What are abnormal vital sign changes in response to activity?

Answer 7

flat response

dec. in HR and/or BP with inc. workload

Question 8

3 major fxns of cardiovascular system?

Answer 8

1. consists of heart and blood vessels
2. transports necessary substances to tissues throughout body
3. removes waste products from cells

Question 9

What 3 factors assist the heart to drive blood through the system?

Answer 9

1. Elastic recoil of arteries during diastole
2. Skeletal muscle compression of veins during activity
3. Negative thoracic pressure during inspiration

Question 10

What is the fxn of the chord tendinae?

Answer 10

anchor support for the AV valves

–> can degenerate… leads to regurgitation

Question 11

Which coronary artery infarction(s) may lead to CO dysfxn?

Answer 11

LCA, LAD, L Circumflex, PDA

ie: all except RCA

Question 12

Which coronary artery infarction(s) may lead to electrical system dysfxn

Answer 12

RCA

Question 13

_____-sided heart failure leads to systemic edema.

Answer 13

right

Question 14

_____-sided heart failure leads to pulmonary edema.

Answer 14

left

Question 15

Atrial kick refers to atrial contraction and corresponds to what LV volume?

Answer 15

20% LV or LVEDV (left ventricular end diastolic volume)

Question 16

What sound is heard when the mitral valve closes?

Answer 16

S1

Question 17

What sound is heard when aortic valve is closed at end of systole?

Answer 17

S2

Question 18

impaired venous return would affect which component of SV?

Answer 18

preload

Question 19

arterial sclerosis or vavlular stenosis would effect which component of SV?

Answer 19

afterload

Question 20

DM and myocardial ischemia may effect which component of SV?

Answer 20

contractility

Question 21

How does DM influence stroke volume?

Answer 21

ANS changes due to neuropathy impair heart contractility

Question 22

What is normal CO?

Answer 22

4-8 L/min

Question 23

What are the 3 major influences of the left ventricular pump?

Answer 23

muscle mechanics
myocardial perfusion
electrical activity

Question 24

Heart sounds are caused by?

Answer 24

turbulent flow

Question 25

What is the term for marked turbulence/murmur that is palpable?

Answer 25

thrill

Question 26

S1 corresponds to

Answer 26

closing of mitral valve start of ventricular systole LUB

Question 27

S2 corresponds to

Answer 27

closing of aortic valve start of ventricular diastole DUB

Question 28

S3 corresponds to

Answer 28

heart failure | LUB

Question 29

S4 corresponds to

Answer 29

opening of AV valves | DUB

Question 30

Where is the site for auscultation of aortic valve?

Answer 30

2nd/3rd R interspace

Question 31

Where is the site for auscultation of pulmonic valve?

Answer 31

2nd/3rd L interspace

Question 32

Where is the site for auscultation of tricuspid valve?

Answer 32

L sternal border

Question 33

Where is the site for auscultation of mitral valve?

Answer 33

apex

Question 34

normal SA node rate?

Answer 34

60-100 bpm

Question 35

normal AV node rate?

Answer 35

40-60 bpm

Question 36

normal ventricle heart rate?

Answer 36

20-40 bpm

Question 37

Describe normal conduction in 3 steps:

Answer 37

1. Electrical impulse starts in sinoatrial node (SA) 2. Travels to atrioventricular node (AV) 3. Proceeds through left & right bundle branches of the Purkinje fibers

Question 38

What are 3 Parasympathetic Neurohormonal Influences on Cardiac Function?

Answer 38

1. Reduces HR 2. Decrease speed of conduction thru AV node 3. Decrease force of atrial contraction

Question 39

What are 2 Sympathetic Neurohormonal Influences on Cardiac Function?

Answer 39

1. Myocardium: increases contractility (inotropy) | 2. Sinus node: increases rate of contraction (chronotropy)

Question 40

P wave (or PR interval) corresponds to:

Answer 40

atrial depolarization (contract)

Question 41

QRS complex corresponds to:

Answer 41

``` ventricular depolarization (contraction) atria repolarize ```

Question 42

T wave (or ST segment) corresponds to:

Answer 42

ventricular repolarization (relaxation)

Question 43

QT interval corresponds to:

Answer 43

ventricular depolarization and repolization

Question 44

ST elevation/depression

Answer 44

the segment above or below the isokinetic line (only visible from 12 lead EKG)

Question 45

Name the parasympathetic cardiac receptor(s):

Answer 45

PNS Receptors 1. SA node 2. atrial muscle 3. AV node

Question 46

Name the sympathetic cardiac receptor(s) and example of neurohormones involved:

Answer 46

SNS: Beta 1 adrenergic receptors | Eg epinephrine and norepinephrine

Question 47

What is inotropy?

Answer 47

increased contractility (due to SNS stimulation of myocardium)

Question 48

| What is chrontropy?

Answer 48

| increased rate of contraction (due to SNS stimulation of sinus node)