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CARDIO EXAM 1 > CARDIO EXAM 1 > Flashcards

CARDIO EXAM 1 Flashcards

1
Q

Arteries rely on pressure and contain _______ which is responsible for vasodilation and vasoconstriction.

A

Smooth Muscle

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2
Q

Veins rely on ________to send blood back to the heart.

A

Muscle Pump

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3
Q

Explain the pathway of blood

A

Heart–> arteries–> arterioles–>capillaries (gas exchange)–> venules–>veins (muscle pump)–>Heart

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4
Q

What vessel has the highest pressure?

A

Aorta, coronary arteries rely on the pressure in the aorta, because coronary arteries fill with blood during diastole.

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5
Q

What is considered Pre-Hypertension?

A

120-139/80-89

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6
Q

Stage 1 HTN

A

140-159/90-99 at this stage want to get the patient on medication

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7
Q

Stage 2 HTN

A

> 159/>99
High BP increases the risk of stroke/MI/HF because it makes the heart work harder, BP wears the endothelial layer of the artery allowing plaque to build up in the walls.

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8
Q

What is the function of the Lympthmatic System? And relies on what to function?

A

Removes waste from tissue. Relies on muscle pump, edema will form if lymphatic system is blocked.

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9
Q

What two system relies on muscle pump?

A

venous and lymph

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10
Q

Grading Pitting Edema

A

1+: Barely perceptible pit
2+: Skin rebounds in less or equal to 15s
3+: Skin rebound in 15-30 s

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11
Q

Where are Baroreceptors found and what do they do?

A

Found in Aortic Arch/Carotid Sinus

When Baroreceptors sense a decrease in BP, there is an increase in sympathetic input increasing HR. Involves CNs 9/10

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12
Q

Narrowing of the aorta or aortic valve block, can decrease cardiac output and is normally diagnosed via Heart Catheter. Name the heart condition.

A

Aortic Stenosis

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13
Q

When blood leaks back down into the L ventricle which can lead to decrease in cardiac output and can eventually back up into the L VENTRICLE, causing it to expand leading to ventricular problems. Name the heart condition.

A

Aortic Regurgitation

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14
Q

What heart condition can happen when the valve doesn’t open fully thus restricting blood flow into the L ventricle. The restricting flow causes extra blood to stay in the L atrium, leading to blood backing up into the lungs. Decreasing blood and leading to Pulmonary Edema. Name this Heart condition.

A

Mitral Valve Stenosis

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15
Q

Describes what occurs to the heart when a patient presents with a LEFT Myocardial Infarction near a valve.

A

Muscle tissue death occurs in an MI, and turns into scar tissue leading to poor contractility and decreases CO. If the MI occurred near a valve or papillary muscles in which hold the valve open this can lead to mitral valve dysfunction.

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16
Q

What two valves are most prone to dysfunction?

A

Mitral and Aortic

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17
Q

Blockage of the Circumflex artery can result in what type of disorder? And what will the examiner hear upon palpation?

A

Damage to Circumflex artery suppilies lateral wall and papillary muscles that hold the valve open and can cause a dysfucntion in the valve itself. If the papillary muscles can’t function the mitral vlave may cause leakage during contraction of the L ventricle causing blood to travel in reverse.

Diagnostically we can assess this condition by auscultating patient’s heart sound. Examiner would hear ‘LUSH DUB” after S1

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18
Q

Heart Sound: S1

A

Closing of the tricuspid and mitral valve corresponds with systole, ventricular contraction. S1 is heard louder at the APEX of the heart

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19
Q

Heart Sound: S2

A

Closing of the Aortic and Pulmonic Valves, corresponds with Diastole or ventricular filling, DUB at the 2nd intercostal space

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20
Q

Heart Sound: S3

A

Extra Heart sound after the lub-dub (indicative of HF)

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21
Q

Where are the SA and AV node found and note the importance of the location?

A

R atrium, so problems with atria will most likely produce an arrhythmia

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22
Q

RCA (Posterior Descending and R Marginal A) supplies what part of the heart?

A

RA, Both ventricles (more RV) and back of the septum

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23
Q

Leads II, III and aVF correspond with

A

RCA

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24
Q

Blockage of the RCA can lead to?

A

Increase risk of AV block or arrythmias, 50% of patients have a R ventricle infract

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25
Q

Left Main Coronary Artery Supplies what part of the heart?

A

Anterior and Lateral

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26
Q

LAD supplies

A

70% of left ventricle and anterior portion of the heart

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27
Q

Circumflex supplies

A

the lateral portion of the heart (papillary muscles)

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28
Q

Leads V1-V6, I, aVL correspond with

A

Left Main Coronary Artery

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29
Q

Leads V5,V6, aVL, I

A

Circumflex artery

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30
Q

Leads V1-4

A

LAD

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31
Q

Which arteries if damaged can lead to pump dysfunction or failure?

A

Left main coronary artery/LAD

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32
Q

Which artery if damaged can lead to mitral valve regurgitation?

A

circumflex

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33
Q

P wave corresponds with

A

Atrial Contraction

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34
Q

QRS wave corresponds with

A

Ventricular contraction/Atrial Repolarization

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35
Q

T wave corresponds with

A

Ventricular Repolarizaiton

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36
Q

What % of blood fills the heart during passive filling?

A

80% and 20% of blood comes into the heart during atrial contraction

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37
Q

Cardiac output is defined as how much blood the heart pumps tot he body per heart beat, what is normal resting CO?

A

5L/min

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38
Q

Cardiac output is defined as how much blood the heart pumps to the body per heart beat, what is CO with exercise?

A

25-30 L/min

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39
Q

End volumetric pressure that stretches the R/L ventricle. Amount of blood sitting in the heart right before it contracts is defined as

A

Preload

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40
Q

An increase in preload will do what to SV and CO? Decrease blood volume will do what to preload?

A

increase, decrease

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41
Q

What is the Rate Pressure Product and what does it determine?

A

SBPxHR, determines the myocardial oxygen demand on the heart. If patient can’t meet the work load demands then they can develop ischemic pain.

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42
Q

Name that factors that affect stroke volume?

A

Change in position because blood rushes towards the legs, fluid intake, dehydration, strength of pump

43
Q

Alpha 1 receptors are located in

A

the vasculature

44
Q

Beta 1 Receptors are located in

A

the heart

45
Q

Beta 2 Receptors are located in

A

the lungs, stimulation causes bronchodilation

46
Q

What value do we want to keep total cholesterol under?

A

under 200

47
Q

What is the optimal LDL value?

A

less than 100, above 190 is very high

48
Q

What leads to plaque formation because they stick to the walls of the vasculature, causing blockages.

A

LDL

49
Q

Known as the “Pac-man” What helps clean up plaque and debri in the arterial walls and then carries it to the liver. And if low levels are found in the patient’s blood can lead to greater plaque formation?

A

HDL

50
Q

Increased levels of this lipid can lead to increased deposits on arterial walls forming plaque like lesions that can occulde the lumen?

A

Triglycerides

51
Q

Increased levels of glucose can be indicative of what two problems?

A

diabetes or acute MI, can lead to plaque formation

52
Q

This lab value is indicative of Myocardial Damage

A

CK-MB

53
Q

What are considered the 2 cardiac enzymes?

A

Ck-MB, Troponin

54
Q

Which of the 2 cardiac enzymes is the fastest indicator that there is heart damage?

A

troponin Shows up quicker in the blood around 15 minutes

55
Q

Percent of red blood cells in the blood important for oxygen transport to the tissues.

A

Hct

56
Q

Oxygen-transport protein in the blood, if low hinders oxygen transport

A

Hb

57
Q

This lab value is known as the chemical purines found in substances like alcohol, most is dissolved in the blood and travels to the kidneys to be passed through the urine, if high indicative of kidney failure? And in what condition is this usually high?

A

Uric Acid

58
Q

Low Na/K are indicative of what?

A

low electrolyte imbalance. Note water follows sodium so if there is a decrease in sodium there is most likely a decrease in blood volume and in turn a decrease in BP. Body wants to maintain H20 in order to maintain adequate blood volume levels.

59
Q

High BUN indicates

A

Descreased kidney function

60
Q

What is considered the “gold standard of HF” specific to the ventricles also can be released in CAD where there is ischemia.

A

BNP

61
Q

What level of BNP is considered decompensated heart failure?

A

700

62
Q

PT/PTT if increase what does that mean

A

the time it takes for blood to clot, common increase in blood clotting time due to patients taking anti-congualnts.

63
Q

What lab value if increased is indicative of liver damage?

A

Bilirubin

64
Q

What lab value if decreased is indicative of a liver issue, malnutrition, or decreased absorption in the GI?

A

Albumin

65
Q

Restriction of blood supply to the myocardium resulting in decreased oxygen to the tissue is defined as ?

A

Ischemia

66
Q

Cardiac cell death is defined as?

A

Myocardial Infarct

67
Q

The heart is unable to provide the sufficient pump action to maintain blood flow to meet the demands of the body is defined as?

A

congestive heart failure

68
Q

List the common ischemia symptoms for MEN?

A
  • ->Left or R arm pain, Numbness
  • ->Jaw pain
  • –>chest tightness (angina)
69
Q

Pain above the chest that doesn’t go away is known as an

A

infarct

70
Q

Pain above the chest that goes away with rest

A

ischemia

71
Q

Ischemia symptoms for Women?

A

Number 1 symptom is fatigue (that is not specific)
Pain between the scapulas
Unexplained weakness
GI issues

72
Q

Ischemia symptoms for Diabetics?

A

SOB (due to decreased sensation diabetics don’t report chest pain)

73
Q

STEMI (Segment Elevation Myocardial Infarction) what is it and what is noted?

A

Due to complete occlusion of coronary artery, full thickness damage.

Seen:
ST Elevation
Q wave
Tissue damage through entire thickness of muscle tissue, results in complete occlusion of artery

74
Q

Non STEMI Transmural (MI) what is it and what’s noted?

A

ST depression, T wave inversion, No Q wave

75
Q

Patient walks into your clinic complaining of generalized “heavy pain” that is rarely sharp in shoulder and jaw region. He also complains of chest tightness and pressure? What type of pain is this?

A

Cardiac pain

76
Q

Patient walks into your clinic and tells you they have pain when taking deep breaths in. What type of pain is this?

A

Lung pain

77
Q

Pain that is localized and is usually increased with palpation over the chest wall is

A

musculoskeletal in nature

78
Q

What is the difference between unstable angina and stable angina?

A

unstable angina patient has pain at rest and stable angia just has pain with exertion

79
Q

Can you mobilize patient’s with decompensated HF?

A

no, because they are symptomatic at rest! (compensated HF they are asymptomatic at rest)

80
Q

Positive Iontotrope

A

Improves Heart Contractility (caffeine)

81
Q

Positive Chronotrope

A

Increases HR

82
Q

Peripheral Edema is a sign of what type of HF?

A

Right HF

83
Q

Pulmonary Edema is a sign of what type of HF?

A

LEFT

84
Q

What are the 3 Anti-Angina Meds?

A

Beta Blockers (allows more time for ventricles to fill)
Nitrates
Ca Channel Blockers

85
Q

Cardiac Failure Cocktail of Drugs?

A

Diuretics
Ace Inhibitors
Beta Blockers/glycosides

86
Q

Diagnosing an MI (name 3 things you want to look for)

A
  • symptoms greater than 20 minutes
  • Changes in ECG
  • Heart Enzymes released (seen in lab values)
87
Q

List 5 main signs of Heart Failure

A
  1. Rapid Breathing at rest
  2. Rales with pulmonary EDEMA (L)
  3. S3 Heart sounds (heard after S2)
  4. Jugular venous Distension with R HF
  5. Weight gain greater than 3 pounds in a day due to peripheral edema (R HF)
88
Q

Patient presents with irregular beats, palpable skipped beats and is symtompatic. The PT is concerned and would like to assess the patient’s arrhythmias during a 24 hour period. What is the best assessment tool?

A

Holter Monitor (portable device for continous moonitoring of electrical activity of the CV system)

89
Q

Examiner has patient walk on a treadmill for 3 minutes then has the patient walk faster on an incline and use ECG and BP to note the response what test is he performing?

A

Exercise Stress test

90
Q

A non-invasive procedure that looks at the size of ventricles, valve function and Ejection fraction?

A

Echo

91
Q

What type of diagnostic test is considered a routine procedure upon hospital admission?

A

Chest -XRay (heart should be 1/3 the width of the chest) also note shape of diaphragm, costodiaphragmatic angle to assess fluid in the lungs or hyperinflation of the lungs.

92
Q

This diagnostic test is used to look at the hearts electrical activity currently or to not what past events affected the conductivity?

A

12-lead ECG

93
Q

This test looks at blockages of the arteries directly and id done usually after an abnormal stress test or abnormal ECG as it is more invasive

A

Coronary Catheritization (can also put a camera or US on top of a cath to view vessel blockage)

94
Q

This test is used for lung assessment during inspiration?

A

Incentive Spirometry

95
Q

CABG surgery is usually done by grafting what type of vessel into the damaged artery?

A

Radial Artery has 92% patency after sx, note when PTs work with these patient and you are moblizing them they may have wrist pain due to the sx so becareful when using a walker.

96
Q

What is the most Common complication after CABG sx besides infection?

A

Plueral Effusion, the sternal incision makes it harder for patient to take deep breathes.

97
Q

ON PUMP vs. OFF PUMP procedure

A

On PUMP: Stop heart, use machine to circulate major complication is blood flow to the brain. Want to assess cognitive condition of these patient’s

OFF-PUMP: Heart is still beating, can’t do on everyone because it depends on where the patient needs the bypass surgery. This procedure needs to be done in a certain about of time.

98
Q

Catheter with balloon attached to flatten plaque build up along the arterial walls

A

Angioplasty

99
Q

Wire/Mesh structures that keep arteries open after angioplasty

A

STENT

100
Q

Allows for pressure to stay up in aorta, inflates during diastole. The increased pressure in the aorta and increasing blood flow back into the coronary arteries which increases oxygen profusion to the myocardium. Can’t mobilize if placed in LE

A

IABP

101
Q

Name 4 Sternal Percautions

A
  1. No ABD/Flex greater than 90
  2. No lifting 5-10 lbs
  3. No driving
  4. Everything bilateral use
    * *refer to recommendations of surgeon
102
Q

Used with patients that have life threatening arrhtymias

A

AICD (implantable internal defib)

103
Q

For DVTs what 2 main assessments or tests would help you determine if the patient has a DVT.

A

Doppler/US and RISK ASSESSMENT!

CARDIO EXAM 1 (1 decks)

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