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Pain Control II > Cardio > Flashcards

Cardio Flashcards

1
Q

S1

A

first heart sound

CLOSING of the mitral and tricuspid valves
- hear the mitral more because higher pressure here

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2
Q

S2

A

second heart sound

CLOSING of the pulmonic and aortic valves

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3
Q

systole

A

contraction of ventricls
so valves that have to be open
- aortic valve and pulmonary valves

atrium relaxes
tricuspid (right side)
mitral (left side) should be CLOSED

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4
Q

valves that prevent blood from going from atrium to ventricle

A

tricuspid (right side)

mitral (left side)

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5
Q

S3

A

rapid ventricular filling - seen in CHF - congestive heart failure

will happen in diastole

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6
Q

S4

A

atrial contraction

will happen in diastole

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7
Q

adventitious sounds

A

S3 - rapid ventricular filling seen in CHF
S4 - atrial contraction
Splitting

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8
Q

splitting sound associated with

A

Pulmonic and aortic valves

aortic valve will close first followed by pulmonic valve

occurs during inhalation - more blood coming in so more blood going out

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9
Q

AV node does what

A

slows the impulse down

- give time to fill the right ventricle

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10
Q

P wave is

A

depolarization of the atrium

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11
Q

SA node location

A

atrium

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12
Q

QRS complex

A

depolarization of the ventricles

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13
Q

T wave

A

repolarization ffor ventricles

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14
Q

S1 and S2 when

A

systole

S1 dduring QRS complex

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15
Q

S4 occurs before?

A

S1

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16
Q

cardiac output =

A

stroke volume X heart rate

tries to maintain so if HR drops , stroke volume tries to increase
vise versa
if stroke volume goes down- heart rate will increase

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17
Q

preload is

A

stretch of cardiac muscle prior to contraction

more blood in the heart

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18
Q

afterload is

A

the vascular resistance against which the cardiac muscle must contract

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19
Q

take pulse for ___

A

60 seconds if irregular

normal - radial pulse for 15 seconds and can multiply by 4

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20
Q

bruit

A

murmer like over the blood vessel

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21
Q

thrill

A

feel vibration over pulse

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22
Q

carotid pulse when

A

unconscious prob

CPR situations

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23
Q

brachial pulses important with which population

A

kids - pediatric population

and blood pressure cuffs – stethescope over artyer

24
Q

general breakdown of rhythm

A

regular
irregular
regular irregular (may see with a - fib)

25
Q

normal HR

A

60-100 bpm

bradycardia - less than 60

tachycardia - more than 100 bpm

26
Q

how to measure blood pressure

A

artery occluded

then sounds of turbulent - systolic - see it fluttering then when silence - diasstolic – flow free and inadiuble

27
Q

common mistakes when taking BP with cuff

A

cuff or bladder is too small – false elevated high blood pressure

length = 80% of limb’s circumference

width = to 40% of limbs circumference

28
Q

pulse pressure

A

systolic - diastolic

29
Q

mean arterial pressure

A

SBP + 2(DBP) / 3

if BP = 110/80 : MAP =
110 +2(80)/ 3

270/ 3= 90

MAP - better tells you perfusion of organs

30
Q

minimal palpated sytolic pressure at radial femoral and carotis

A

80 - radial
70 - femoral
60 - carotid

31
Q

heart murmers are?

6 mechanisms

A

turbulant flow

  1. flow acorss a partial obstruciton (stenotic valve)
  2. flow across a valvular or intravascular irregularity without obstruction
  3. increased flow through a normal structures
  4. flow into a dialted chamber
  5. backward or regurgitant flow across an incompetent valve or defect
  6. shunting of clood out of a high presusre chamber or artery through an abnromal range
32
Q

why important to know about heart murmers?

A

in terms of pre-medication patients

also when sedating patients – will valvular conditions drop blood pressure too much

33
Q

failure of the aortic valve to close?

A

causes back flow of blood into the left ventricle

34
Q

aortic valve ethat is leaky

A

unable to close tightly - may cause back flow and this would occur during DIASTOLIC - because these should be closed

35
Q

aortic stenosis would occur in

A

systole – blood unable to freely flow from left ventricle to the aorta

36
Q

location of aortic valve

A

right 2nd interspace 2cm

37
Q

location of pulmonic vlave

A

left 2nd interspace 2cm

38
Q

tricuspid and mitral location

valve locations to listen

A

tricuspid left lower sternal border 2cm

mitral Left interspace 709 cm

39
Q

crescendo and decrescendo

A

sounds going from lower to higher - late murmer pattern

decrescendo - sounds going from higher to lower - early systolic murmer

40
Q

sound classic for aortic stenosis

A

crescendo- decrescendo

41
Q

plateua

A

murmer stays same level all the way through

VSD

42
Q

intensity of heart murmers

A

grade 1-6
1-2 very faint to quiet but heard

3- moderate
4 loud
5 very loud
6 very loud heard w/out stethescope

43
Q

systolic murmers having to do with mitral or tricuspid

A

these are suppose to be closed in systoly so they would be regugitation murmers

44
Q

mitral valve prolapse occurs

A

systolic

45
Q

systolic murmers having to do with pulmonic and aortic

A

these should be open during systol so if hear a murmer in these areas during systol you know these are stenotic

46
Q

ventricular septal defect

A

plateu - so heard all the way across - hear in systolic

47
Q

diastolic murmers

A

regugitation in those that should be closed like aortic (aortic regurgitation or pulmonic regurgitation)
and stenosis in those valves that shuold be open - like mitral stenosis or tricuspid stenosis

48
Q

pansystolic (holosystolic) murmers

A

caused by flow from high pressure chaber to low pressure chamber

  • ventricular septal defect
  • mitral regurgitation
  • tricuspid regurgitaiotn
49
Q

diagnostic test for heart murmers

A

echocardiogram

echo (ultrasound) cardiogram (heart

ultrasound of the heart

provide info about

  1. valves of the heart - calcification
  2. force of contraction of the heart - ejectioon fraction
  3. motion and thickness of the walls of the heart
50
Q

who needs pre medicated

A

only highest risk patients
1. unrepaired cyanotic congenital heart disease, including palliative shunts and conduits

  1. any repaired CHD with residual shunts or valvular regurgitation at the site of or adjacent to the site of a prosthetic patch or a prosthetic device - which can inhibit endothelization
  2. a CHD that is completely repaired with prosthetic material or device, whether placed by surgery or catheter intervention - for the FIRST 6 MONTHS after the repair procedure
  3. prosthetic cardiac valves, including transcatheter- implanted prostheses and homographs
  4. prosthetic material used for cardiac valve repair, such as annuloplasty rings and chords
  5. history of infective endocarditis
  6. cardiac transplant with valve regurgitation due to a structurally abnormal valve
51
Q

pre medication regime

A

amoxillin 2 grams
children 50 mg/ kg or if allergic

clindamycin 600 mg children 20 mg. kg

52
Q

study results from propylaxis

A

results showed when stoped got an increase in IE cases

so the high risk populaton shoul still pre-medicate

53
Q

cardiomegally

A

enlarged heart – may find point of maximum increase may drop further downin anatomy

54
Q

ECG can show you

A

rate
rhythm
ischemic changes / hypertrophy

55
Q

apex heart location and sound location

A

apical pulse
left ventricular area
- by ribs 4-5

Pain Control II (15 decks)

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