CARDIO Flashcards
where does the respiratory system begin?
nares and trachea
what is a pnuemothorax? how is it corrected?
when a hole is made in the chest and the lung deflates
chest tube to recreate the neg/ pressure
which way does the diaphragm move during inspiration and expiration?
I-down
E-up
what is external respiration
when you breath in oxygen and release CO2
what is internal respiration
when blood carries oxygen to caillaries where it exchanged for the CO2 and carried back to lungs to exhale
list the common diagnostic tools used for thoracic pathology
chest xray
CT scan
bronch
what is a bleb?
fluid filled sac in the lung
how are chest tubes secured?
silk suture
penduate
list the 3 types of bronch specimens
biopsy
washings
brushings
what is decortication?
removal of fibrinous deposits on the visceral or perietal pleura that interfere with respiratory function
what is thoracic outlet syndrome?
compession of subclavian vessels and brachial plexus nerve complex at the superior aperture of the thorax
the muscle layer of the heart
myocardium
the right side of the heart has ______ chambers, called ____ and ______. They carry ______ blood through the _____ valve
2, atrium, ventricle, deoxygenated, pulmonary
which chamber of the heart is the largest and strongest?
left ventricle
the vessel that carries blood to the lungs from the heart
pulmonary arteries
4 valves of the heart
aortic, mitral, pulmonary, tricuspid
when oxygen and carbon dioxide are exchanged in the capillaries
internal respiration
when arteries are plaque filled
atherosclerosis
invasive test to diagnose atherosclerosis
cardiac catheterization
route of electrical activity of the heart
SA, AV, bundle of his, purkinjee fibers
what is inserted after a needle has been used to find the artery for placement of a catheter?
guide wire
cardiace cath is done under?
local anesthesia and fleuroscopy
blood pressure is monitored with every beat of the heart using?
arterial line
what is the thorax separated from the abd cavity?
diaphragm
how many pairs of ribs and vertebra?
12
the respiratory system divisions
nares and trachea, primary bronchus, secondary bronci, tertiary bronchi
right lung lobes
3
what do lungs do?
exchange carbon dioxide for oxygen
left lung lobes
2
alveoli
exchange of carbon dioxide and oyxgen
surfactant
decreases surface tension on the tissue and keeps it from collapsing
pleural cavity right and left
each contain a lung
what are the lungs lined with?
pleural membrane and separated in the middle by the mediastinum
what is the pleural membrane further divide into?
parietal and visceral pleura
what does pleural fluid do?
lubrication between the 2 membrances
what is needed to keep the lungs inflated?
negative pressure
top of the lung
apex
root of the lung
hilium
inspiration
you breath in and the diaphragm moves down to make room for the expanding lungs
expiration
you breath out and the diaphragm moves up as the lungs deflate
what type of test isn’t done for thoracic pathology?
ultrasound, can’t pass through structures
bronchial arteries
branch off the aorta
what does each bronchus have?
its own pulmonary artery and vein
empyema
infection of the pleural fluid causing pus
postions used most often
lateral, don’t lean on patient
when is a double lumen ET tube used?
when the affected lung will need to be collapsed during the procedure
CVP
central venous pressure monitoring line
swan ganz catheter
monitors heart function, pulmonary artery
thoracostomty
incsion made into the chest wall to provide an opening for the purpose of drainage, then catheter entered to drain fluid
underwater chest drainage sytem
used with chest tube to reestablish negative pressure in chest cavity
mini thoracotomy
no chest tube, just make small incsion to create negative pressure
3 needs for chest tubes to function properly
positive expiratory pressure, gravity, suction
PEEP
maintance of positive pressure within the lungs at the end of expiration
thoracic procedure meds
normally epidural
bronch
inspect inside of the trachea and bronci
biospies
tiny bits of tissue out of biopsy forceps
washings
pap trap to collect
brushings
smear on slide
mediastinoscopy
suprasternal incision
tracheotomy
tube must be ready prior to incision, obturator stays with the patient
what can be accessed with anterior or posterior thoracic incsions?
lung, heart, aorta, esophagus
thoracic incisions
anterior or posterior or thoracoabdominal
pneumonectomy
excision of entire lung, done for cancer
lobectomy
excision of lobe, irreversable dilation of the bronchi
wedge resection
removal of lung wedge for diagnosis
TA 55
bronchus when a pneumonectomy is being done
GIA
used for wedge resection
thoracoscopy
endoscipic view of pleural space looking at the outside of the lung for blebs
how is thoracic outlet syndrome treated?
resection of the first rib
treatment option for patients with chronic emphysema when other medical management isn’t effective
lung volume reduction
emphysema
destorys the walls of the alveoli and patient suffers dyspnea
lung transplant
can be single or double
single lung transplant
emphysema, pulmonary hypertension
double lung transplant
cystic fibrosis or chronic infection in end stage pulmonary disease
what might a lung transplant be in conjunction with?
heart transplant
what can the donor be for a lung transplant?
cadaver, brain death, living relatives
what is the lung submersed in after transplant?
collins
3 anastomoses are done
bronchus to bronchus pulonary artery to pulmonary artery, recipient pulmonary veins to donor atrial cuff
pectus excavatum
breatbone is sunken into the chest
pectus carinatum
present during chilhood and worsens during adolescence, protrusion deformity
anastomis order for heart
distal then proximal
extremities anastomosis order
proximal then distal
what is the heart?
power pump of the circulatory system
how many chambers does the heart have?
4
what is the heart divided into?
right left halves
pericardial sac
heart is contained in this sac
parietal layer
outer layer
visceral layer
inner layer
pericardial fluid
separates the two layers and serves as a lubricant to prevent friction
epicardium
outer lining
endocardium
inner layer
where is the atrium located?
top
ventricles
larger and more muscular-left being the largest
aortic valve
between the aorta and left ventricle, leaves the heart
pulmonary valve
between the right ventricle and the main pulmonary artery
mitral valve
between the left atrium and the left ventricle
tricuspid valve
between the right atrium and right ventricle
blood supply to the heart
2 arteries that arise from the ascending aorta
what are the blood supplies to the heart called?
right and left coronary arteries
coronary arteries
found in the epicardium and branch off into smaller arteries
complete heart block
caused by MI, beta blockers
left atrium
receives oxygenated blood from the lungs and pumps it through the mitral valve to the left ventricle, which pumps it through the aortic valve into the aorta
right atria
receives deoxygenated blood from the vena cava and pumps it through the tricuspid valve to the right ventricle, which pumps itt through the pulmonary valve into the pulmonary artery
VEAL
veins enter the heart and arteries leave the heart
aorta
main artery of the body
what does the aorta do?
carries oxygenated blood out to the peripheral arteries
sections of the aorta
ascending, arch, descending, thoracic, abdominal
where is the aorta located?
off the heart near the left ventricle
innominate arteries
brachicephalic, left common carotid, left subclavian
what do the innominate arteries do?
carry blood to the head and upper extremities
vena cava
largest veins of the body
where is the vena cava located?
off the heart near the right atrium
tunica advantitia
outer layer of blood vessels
tunica media
middle layer of blood vessels
tunica intima
innermost layer of blood vessels
vasa vasora
network to supply vessels with blood
arterial circulation
powered by the heart
venous circulation
powered by skeletal muscles
what is atherosclerosis also known as?
coronary artery disease
where is the catheter for an cardiac cath normally placed?
femoral artery
why is a cardiac cath done?
check function of the heart valves and coronary arteries are checked
catheterization steps
vessel is entered with a finder needle guid wire is inserted dilator is used to enlarge opening catheter is threaded guide wire removed catheter is secured
most common valves for stenosis
aortic and mitral
septum
wall separating the chambers of the heart
patent ductus
vessel present in utero that shunts blood to the aorta instead of the lungs
tetralogy of fallot
ventricular septal defect
pulmonary stenosis
an aorta that overrrides the ventricluar septal defect
right ventricular hypertrophy
what happens with tetralogy of fallot
decreased blood flow, cyanosis, hypoxia
coarctation of the aorta
congenital defect that may not be discovered until adulhood, localized narrowing of the vessel if not fixed: stroke
aneurysms
weakened wall of an artery
can an aneurysm be congenital?
yes
arterial embolisms
blood clot, fat, air or pieces of tumor that become lodged in a vessel and block the flow
what is an arterial embolism treated with first?
anticoagulants
intermittent claudication or arterial insufficiency
not enough blood flow to keep up with oxygen demands
anemia
not enough healthy RBC to carry adequate oxygen to tissues
DIC
disseminated intravascular coagulation
prevents blood from clotting normally
hemophilia
disorder of blood clotting system causeing prolonged bleeding
marfans syndrome
affects musculosketetal system and cause cardiovascular abnormalities
disease that is progressive, irreversible condition resulting in diminshed lung capacity
COPD
chest tubes must be connected to an open drainage system that is kept above chest level
false
lung scans are useful in identifying all of the following except
hypoxia
what isnt a hemostatic agent used in thoracic surgery?
heparin
may be taken upon completion of thoracic procedure to assess lung reexpansion
PA and later xrays
the rigid bronchoscope is used to?
remove foreign object
what postion is used to provide access to anterior lung surfaces and mediastinal structures
supine
prognosis of patient who had thoracic surgery because of cancer depends on?
type, location, stage
for lung transplant the patient may be directly transported to PACU to be closely monitored?
true
many thoracic procedures require the patient to be placed in what position?
lateral
which is a post op complciation of thoracic surgery
pe, hemorrhage, mediastinal shift
most thoracic procedure sare performed under local anesthesia
false
positioning for posterolateral thoracotomy approcach
lateral
position used for median sternotomy approach
supine
what is not a change in pressure of bluid in the respiratory system?
emphysema
foley catheter
measures kidney function
cardiopulmonary bypass machine
oxygenates and pumps the blood
cannulas for bypass machine
right atrium and aortic
insitu
devalve
defibrillator
reestablish AV node operation of the heart
heparin
thins blood, decreases clot forming, allow 3 minutes placed prior to entering a vessel
protamine sulfate
counteract effect of heparin
papaverine
keep arterial grafts from spasming
epi
raise BP, stimulates heart
cooling the CV pt
increase warmth, cool with slush
characteristics of grafts
nonreactive to the body
types of grafts
straight and bifurcated, cortex and woven
prolene
monofilament
ethibond
braided nonabsorbable, reinforce areas, sew in valves
pledget
small piece of teflon patch, reinforce
doppler probe
assess arterial flow
coronary angioplasty
balloon used to dilate the artery and flatten arteriosclerosis to open the artery
when is coronary angioplasty done?
when blockage doens’t warrant CABG
factors of coronary artery disease
diet, exercise, age, heredity
arteriotomy
opening of an artery
grafts for CABG
saphenous, mammary, radial artery or vein
MID CABG
heart not stopped, no bypass machine
robotic CABG
chest isn’t opened, without bypass machine
aortic or mitral valve replacement
valve removed with pituitary ronguer
artifical replacement
soaked in antibiotics prior to use
porcine replacement
rinsed 3 times with saline and saline from last basin is cultured
descending aortic aneurysm
use bypass to protect lower half of body
aortic coarctation
occurs in aorta, after the arch
what is the pacemaker of the heart?
sa nose
what happens when the sa node or the av node don’t work?
need artifical pacemaker
pacemaker insertion
continuous ECG monitoring, could cause cardiac dysrhythmias
pericardiectomy
excsion of adhered pericardium to relieve constriction of compressed heart, caused by TB NO BYPASS
is a pericardiectomy a cure?
no just palliative measure
ventricular remodeling/ventricular aneurysm repair
batista, for cardiomyopthy or aneurysm
goal of ventricular remodeling/ventricular aneurysm repair
improve cardiac function and output, heart transplant is altern.
ventricular remodeling/ventricular aneurysm repair suture
purse string around dead area
transmyocardial revascularization
relieve severe angina in pts who arn’t cand. for bypass surgery due to advanced disease *uses laser
angiography
flow through vessel
angioscopy
visulalization of inside of artery to assess pathology and function
vena cava filter insertion
pt with history of emboli in pelvis, catches emboli
when is a vena cava filter used?
heparin is contraindicated or ineffective
where is vena cava filter most often placed?
right femoral vein
AAA location
below the renal arteries
endovascular AAA repair
endograft introduced through expose femoral artery
intermittent claudication
pain with exercise of extremity, really serious if it happens at rest
embolectomy
blood clot post op is most common embolus
carotid endarterectomy
plaque build up, removal with freer and repair of artery
AV fistula/shunt
joining of artery and vein to dilate vein, kidney failure for dialysis
av fistula location
radial artery and cephalic vein
VAD implantation common veins
subclavian and internal jugular
venous closure
treat venous reflux or venous insufficiency that lead to varicose veins
tumescent
numb area, protect surrounding tissue
what is attached at the end of a webster vessel cannula?
syringe and vessel
when sweing in a graft, the ___ end is usally attached first and then ____
proximal, de aired then distal
what will be handed after right angle
ties, umbilical tape, vessel loops
limb with poor blood flow
pale, no pulse, cold
used to pull a clot out of an arteriotomy
fogary cath
AAA tips
long instruments, 4-0 prolene
used to daignose carotid artery disease
angiogram
3 common meds on vascular cases
hep saline, thrombin, antibiotic irrigation
how is heart protected during CPB?
cardioplegia
how can a rubber catheter tournique be made?
placced over each suture
how does atherosclerosis form?
artery is injured by cholesterol
what are complications of MI?
rupture, aneurysm
cardiac tamponade and tx
compression of heart due to collection of blood, pericardial window
repeat sternotomy
use oscillating saw
how is IMA prepared?
papervine soaked to prevent vasospams
procedure to treat mitral valve?
CMC
risks for peds surgery?
blood loss, monitor irrigation
patent ductus arteriosus
doesn’t close after birth, clamp clamp cut tie
if cyanosis severe what can be done until full repair?
shunt placed
where does atherosclerosis involvement tend to begin?
aortic bifurcations
what is primary indication for a carotid endar.?
TIA’s
cause of TIA’s
small pieces of plaque
how is a vein prepared for used?
valves striped away
types of graft that must be preclotted?
dacron
what is used to strip valves?
cardio valvulotome
tx for varicose veins
recurrent, external bleeding
vessels responsible for exchange of oxygen and metablic waste
capillaries
part of the artery responsbile for vasoconstriction and vasodilation
tunica media
what is only found in veins?
valves
how far should the ballon go past?
1-2cm
what are urokinase and streptokinase used for?
lysis of emobolus
used to sture a graft to an artery tech.
running 5-0 or 6-0 non absorbable
hemorrhage, ulceration, cellutis complications
varicose veins
prep for vein stripping
toes to groin circum.
what is balloon angioplasty performed for?
atherosclerotic thicking
what is the stent not made of?
ceramic
double lumened vascular device for admin. of chemo
groshong
core removed for the carotid artery
plaue
mortality for ruptured AAA?
more than 80 percent
diagnostic test for AAA repair
aortogram
specimen for AAA
thrombus and plaque
what chamber is responsible for pumping blood into the pulm. artery?
rt ventricle
where does the coronary arteries originate?
ascending aorta
what isn’t a component of the bypass machine
defibrillator
what is freq. used to repair septal defect in peds?
dacron patch
tiny vessels that nourish the cells of arterial walls
vasa vasorum
portion of the aorta that descends but is above the diaphragm
thoracic
portion of aorta that runs between diaphragm and bifurcation of iliac arteries
abd
arteries that become femoral arteries as they exit the pelvis
external iliac
artery that serves the head and neck
left common carotid
number of true ribs
7
what isn’t found in the mediastinum
diaphragm
lung reduction surgery is performed to patients with emphysema
true
lung tissue is friable
true
the apex of the lung is located superiorly and just above the clavicle
true
what does the chest trube rely on?
water seal to reestablish neg. pressure
what are the manubrium, body and xiphoid parts of?
sternum
saphenous vein for coronary art. graft
reversed for anstomsosis
the ventricles of the heart has thinner myocaridum than the atria
false
thymomas, neurogenic tumors and pleuropericardial cysts can be biopsied during what?
medistinoscopy
does a VAT used CO2?
no
lifescan for heart valves
10-15 years
is cardiomyopathy curable?
no, tx is heart transplant
condition on heart muscle dies from ischemia
MI
device attached to suction for collection of mucous
lukens tube
lung decortication is perfomed to release constriction of the lungs by fibrin layers
true
atelectasis
collapsed lung
a heart murmur is usally heard with ausculation over the mitral valve
true
used to aspirate secretions and check for leaks
bronch
glass syringes cause less accum. of bubbles
true
what is ejection fraction
% blood pumped out of the heart
heartblock would require a pacemaker
true
control BP, o2 and co2
aortic bodies
superior mesenterie artery
supplies inferior upper abd organs
controls force and rate of contraction heart
medulla oblongata
epidural with VATS
yes
50% of occlusive coronary lesions occur in?
left anterior descending
used for pts awaiting heart transplant
VAD
