Cardio Flashcards
What are the four chmbers of the heart? What is the blood flow pattern?
R and L atrium
R and L ventricle
system/body > R atrium
> Left vent > pulmonary system/oxygenated > L atrium > L ventricle > system/body
What is systole and diastole?
systole = ventricle contraction
diastole - ventricle relaxation and filling of blood
What are the arteries of the heart?
R coronary - R atrium and vent, AV node L coronary (L ant descending and circumflex) - left vent and atrium, SA node
What is normal conduction of the heart?
origin at SA node, atrium contract togehter, stimulates AV node, transmits to bundle of His and Purkinje fibers, ventricles contract (atrial kick)
What are symptoms of caridac conditions?
chest pain, palpitations, SOB
fatigue
dizzieness, syncope
edema - usually in dependent body parts/ LE, sudden wt gain
What is normal HR?
Tachy?
Brady?
60-100bpm
>100 Tachy
Where do you auscultate for the aortic valve? pulmonic valve? tricuspid? bicuspid?
Aortic valve – 2nd R intercostal space
Pulmonic valve – 2nd L intercostal space
Tricuspid – 4th L intercostal space at sternal border
Bicuspid – 5th intercostal space at midclavical area
What are the S1, S2 sounds?
S1 ‘lub’ - closure of bicuspid and tricspid valves
S2 ‘dub’ - closure of aortic and pulmonary valves
What is the normal cardiac cycles on an ECG?
P wave – atrial depolarization/contraction
PR interval – impulse from SA to AV node
QRS wave – ventricular depolarization/contraction; atrial repolarization
ST segment – beginning of ventricular repolarization/relax
T wave – ventricular repolarization/relax
QT interval – time for electrical systole
What is normal BP?
120/80
How do calculate MAP?
sum of systolic + twice diastolic / 3
What is normal RR for an adult, child, infant?
What is tachy? brady?
hyperpnea? dyspnea?
adult 12-20
child 20-30
infant 30-40
tachy >22
brady
What is normal SpO2?
98-100%
What is normal PaO2?
90-100mmHg
What is normal PaCO2?
35-45 mmHg
what is normal pH?
7.35-7.45
>7.45 alkalotic
What are normal WBC levels?
4300-10800
indicitive of status of immune system
increases in infection
decreases in aplastic anemia
What are normal RBC levels?
4.2-6.2
increase in polycynthemia
decrease in anemia
What are normal hemoglobin levels?
male 13-18
female 12-16
increase polycythemia, dehydration, shock
decrease in anemias, prolonged hemorrhage, RBC destruction
What is normal platelet count?
150,000-450,000
increase in chronic leukemia, hemoconcentration
decrease with thrombocytopenia, acute leukemia, aplastic anemia, cancer chemo
increased risk of bleeding with low levels
What are SandS of left heart failure?
Dyspnea, dry cough Orthopnea Paroxysmal nocturnal dyspnea Pulmonary rales, wheezing Hypotension Tachycardia Lightheadedness, dizziness Cerebral hypoxia: irritability, restlessness, confusion, impaired memory, sleep disturbances Fatigue, weakness Poor exs tolerance Enlarged heart on x ray S3 sounds, maybe S4 Murmurs of mitral and tricuspid
What are SandS of right heart failure?
Hallmark signs of jugular vein distention and peripheral edema
Dependent edema Weight gain Ascites Liver engorgement Anorexia, nausea, bloating Cyanosis R upper quad pain Jugular vein distension R sided S3 sounds Murmurs of pulmonary or tricuspid insufficiency
What are the activity restrictions for acute MI?acute HF?
MI - limited to 5 METS or 70% of age HRmax 4-6 weeks post MI
HF - O2 demand should not be increased
once medically managed, activity grandually increased
What is the function of beta blockers?
lols
reduces myocardial demand by reducing HR, decrease contractility, control arrythmias
reduces chest pain and BP
What do ACE inhibitors do?
prils
decrease BP
What do angiotension II receptor blockers do?
tans
decrease BP
What do nitrates/nitroglycerin do?
decrease preload through peripheral vasodilation, reduce myocardial O2 demand, reduce chest pain, may dilate coronary arteries and improve coronary blood flow
What do calcium channel blockers do?
inhibit flow of calcium ions, decrease HR, decrease contractility, dilate coronoary arteries, reduce BP, control arrythmias, reduce chest pain
How do you calculate ABI?
What is normal?
What is abnormal?
systolic pressure of LE divided by systolic pressure of UE
Normal 1-1.4
1.5 = fibrotic/not compressible
What are characteristics of arterial disease?
intermittent claudication pain worse with exs usually pain in calf no edema decreased/absent pulse pale, shiny, dry skin - trophic changes deep ulcers on lateral malleolus
What are characteristics of venous disease?
minimal pain aching in LE in sitting (dependent) edema! dark thickened brown skin cellulitis ulcer at medial mall, shallow, EXUDATE!, irregular borders
What is primary and secondary lymphodema?
primary - congential
secondary - acquired
What is respiratory acidosis and its symptoms?
CO2 not exhaled enough
Decreased PCO2
hypoventilation, COPD
anxiety, restlessness, dyspnea, HA, confusion, coma
What is respiratory alkalosis and its symptoms?
CO2 is exhaled too much
increased PCO2 >45
hyperventilation, liver disease, sepsis
dizziness, syncope, tingling, numbness, early tetany
What is metabolic acidosis?
decreased bicarb HCO3
What is metabolic alkalosis?
increased bicarb HCO3 >26
vomiting, potassium depletion, diuretics, adrenal disease
vague symptoms, weakness, mental dullness, early tetany
What is hyperkalemia?
increased potassium ions
decreases rate and force of contraction
What is hypokalemia?
decreased potassium ions
arrhythmias, ventricular fibrilation
What is hypercalcemia?
increased calcium ions
increased heart actions
What is hypocalcemia?
decreased calcium ions
decreased heart actions
What is hypermagnesemia?
increased magnesium is a calcium channel blocker
arrhythmias, cardiac arrest
What is hypomagnesemia?
decreased magnesium
ventricular arrythmias, coronary artery vasospasm, sudden death
What is the AHA blood pressure definitions?
normal 160/100
hypertensive crisis >180/110
