Cardiac Physiology and Extras Flashcards

1
Q

Cardiac Cycle

A

the sequence of events that make up one heartbeat

0.75-1 sec on length; duration of a cardiac cycle determines heart rate

about 1/3 is spent in systole, and 2/3 is spent in diastole

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2
Q

Stroke Volume

A

the amount of blood ejected from the heart in one contraction (mm)

end diastolic volume minus end systolic volume

measured on an echocardiogram

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3
Q

Cardiac Output

A

stroke volume X heart rate (L/min)

(end diastolic volume minus end systolic volume) X heart rate

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4
Q

Ejection Fraction

A

the percentage of blood ejected from the ventricle in one contraction; measures the amount of blood hat the ventricle can eject compared to what it contains prior to ejection

stroke volume/end-diastolic volume

(end-diastolic volume minus end-systolic volume)/ end-diastolic volume

assesses ventricular function

normal is 55-60%

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5
Q

Diastole

A

relaxation phase; ventricles fill

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6
Q

Frank-Starling Relationship

A

the more that a myocyte is stretched, the more it can contract; therefore, increased ventricle filling (more blood in the ventricle, stretches the ventricle out) leads to increased stroke volume

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7
Q

Diastolic Dysfunction

A

impaired relaxation/stretch caused by thickness or stiffness of the ventricle wall, decreasing ventricular filling

normal compliance (determined by the ability of myocardial cells to stretch) of the ventricle is necessary to achieve optimal filling

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8
Q

Systole

A

ventricle contraction and ejection

work of the heart

begins in isovolumetric contraction, just before the semilunar valves open

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9
Q

Preload

A

the filling pressure of the heart; mechanically it is the initial stretching of myocytes prior to contraction

can be increased by anything that increases the volume of blood delivered to the ventricle

can be decreased by diminished compliance (stiffness) of the ventricle, with impaired relaxation, or by a decrease in volume delivered to the ventricle

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10
Q

Afterload

A

the pressure against which the ventricle contracts; or, as the aortic pressure for the left ventricle

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11
Q

Sympathetic Nervous System Effect on the Heart

A

causes peripheral vasoconstriction

increases peripheral resistance

increases heart rate and cardiac output

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12
Q

Parasympathetic Nervous System Effect on the Heart

A

fibers in the vagus nerve affect the SA and AV nodes (bearing down stimulates vagus and parasympathetic response)

slows heart rate

decreases force of atrial contraction

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13
Q

Eisenmenger Syndrome

A

when a left-to-right shunt switches to ta right-to-left shunt

the left-to-right shunt causes damage to the vasculature of the lungs overtime

non-oxygenated blood moves from the right atrium into the left atrium and is sent to the body

the body does not get enough oxygen, resulting in cyanosis and clubbing

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14
Q

Four Congenital Abnormalities of Tetrology of Fallot

A

ventricular septal defect

RV infundibular stenosis - thickening of the pulmonary valve

a dilated, misplaced aorta (right sided aortic arch 25%, and anomalous left anterior descending coronary artery form right cusp 7-9%)

right ventricular hypertrophy - thickening of right ventricular wall

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15
Q

High levels of hemoglobin and hematocrit are evidence of

A

cyanosis

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16
Q

Regurgitation

A

valve leaflets or cusps don’t close properly, causing blood to leak backward in the heart

caused by failure of papillary muscles, myocardium below papillary muscles, chordae, leaflets, or fibrous annulus (ring around valve)

17
Q

Stenosis

A

valve leaflets or cusps become thick or stiff, and may fuse together causing reduced blood flow though the valve

can result in regurgitation

18
Q

Atresia

A

valve isn’t formed, and a solid sheet of tissue blocks the blood flow between the heart chambers

19
Q

Mechanical Prosthetic Valve

A

prone to thrombosis, require anti-coagulation and daily low-dose aspirin, require endocarditis prophylaxis

20
Q

Bioprosthetic Valves

A

degenerate after 10-15 years

anti-coagulation only needed for first 3 months

21
Q

B-type Natriuretic Peptide (BNP)

A

mainly released when the LV is under stress

useful in the early identification of LV dysfunction

high levels indicate poor prognosis

22
Q

Pectus Excavatum

A

sunken or funnel chest

seen in patients with Mitral Valve Prolapse

23
Q

Pulsus Parvus Et Tardus

A

the carotid arterial pulse typically has a delayed and plateaued peak, decreased amplitude, and gradual downslope

24
Q

Water-Hammer Pulse

A

wide arterial pulse pressure

Aortic Regurgitation

25
Q

Quinke Pulses

A

nailbed capillary pulsations

Aortic Regurgitation

26
Q

Musset Sign

A

head bob with each pulse

Aortic Regurgitation

27
Q

Hill Sign

A

the BP in the leg is over 40 mm Hg higher than in the arm

Aortic Regurgitation

28
Q

Ebstein Anomoly

A

a congenital malformation of the tricuspid valve characterized by apical displacement of the annuler insertion of the septal and posterior leaflets and atrialization of a portion of the ventricular myocardium

tricuspid valve sits abnormally low in the RV

29
Q

CMP

A

tests for abnormal liver function

test in Tricuspid Stenosis and Regurgitation, which can both result in hepatomegaly

30
Q

Levine Sign

A

fist clenched over sternum when describing pain

common in anginas and MIs

31
Q

Myocardial Infarction

A

a rise of cardiac biomarkers (CK-MB, Myoglobin, Troponin) with at least one value above the 99th percentile of the upper reference limit together with evidence of myocardial ischemia with at least one of the following
o symptoms of ischemia
o ECG changes of new ischemia
o new Q waves
o imaging evidence of new loss of viable myocardium or new wall motion abnormality