Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Quarter 4 > Cardio Final > Flashcards

Cardio Final Flashcards

1
Q

Levels of Traumatic Brain Injury (TBI)

A

mild (concussion), moderate, and severe (coma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What factors determine intracranial pressure?

A

blood, parenchymal tissue, and CSF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Dose of Mannitol to decrease ICP

A

0.25 - 1 g/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Explain how mannitol affects ICP

A
  • In cerebral circulation:
    • increases osmotic force and causes fluid shift out of tissue compartment into vascular space
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How does vascular smooth muscle respond to brief occlusion?

A

myogenic response

  • following, the vessel reamins vasodilated temporarily
    • post-ischemic hyperemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How does vascular smooth muscle respond to prolonged occlusion

A

maximally dilated and a build-up of CO2 and lactate

  • may lead to reperfusion injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Contraindications for arterial tourniquet

A
  • prosthetic vascular grafts
  • patients at risk for DVT
  • immobilized patients
  • extensive peripheral vascular disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Compartment Syndrome

A

edema and blood accumulate within a confined osseofascial space

  • comprises circulation and tissues
  • more common in tibital and femoral fractures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

(3) Risk factors for developing Compartment syndrome

A
  • long bone fractures or trauma
  • males under 35 yo
  • anticoagulant use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is mainly secreted in pheochromocytomas?

A

norepinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Metryosine

(demser)

A

treatment for pheochromocytoma

  • lowers blood pressure by inhibiting catecholamine production
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Rapid-onset alpha blockers for Pheochromocytoma

A

Phentolamine

(5mg as needed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which drugs should be avoided in cocaine patients?

A
  • Ketamine
  • ephedrine
  • succinylcholine
  • etomidate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Difference between vascular myocyte and cardiac

A

vascular myocytes have longer thin filaments and lack troponin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Baroreceptors

A

sprayed sensory nerve ending found in the adventia of arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Baroreceptor location

A

carotid sinus and aortic arch

(can also be found in the coronary arteries)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

afferent nerves from baroreceptors all terminate in the _____

A

nucleus tractus solitarius

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Baroreceptor response

A

responds to the magnitude (static) and rate of change (dynamic) in pressure

  • alters firing rate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Baroreceptor of the Carotid Sinus

A

origin of internal carotid

  • joings Glossopharyngeal nerve (IX) to petrous ganglion
  • signal mean pressure and pulse pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Baroreceptor of the Aortic arch

A

located at transverse arch of aorta

  • joins vagus nerve (X)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

an increase in MAP causes an _____ in baroreceptor firing

A

increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

A-fibers

A

large diameter, fast conducting, and myelinated

  • low threshold, more sensitive
  • active during normal blood pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

C-fibers

A

abundant, small diameter, slow conducting, and unmyelinated

  • high threshold
  • important for high blood pressures
  • recruitment of C-fibers occurs around 100 mmHg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Baroreflex

A

adjusts cardiac output and peripheral vascular tone to stabilize arterial BP

  • acute pressure elevation triggers depressor reflex
  • hypotension triggers pressor reflex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Depressor Reflex

A

enchances vagal parasympathetic output and inhibits sympathetic

  • bradycardia, decreased contractility, hypotension, and decrease PVR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

depressor reflex example

A

carotid sinus massage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Pressor reflex

A

increases sympathetic outflow and decreases parasympathetic

  • tachycardia, increased contractility, vasoconstriction, and splanchnic venoconstriction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Baroreflex

sensitivity and set point

A
  • sensitivity - “gain”
    • slope of response curve
    • decreased by age and chronic hypertension
  • set point - pressure that reflex tries to maintain
    • higher during exercise
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

(4) Types of Cardiopulmonary Afferents

A
  • myelinated veno-atrial mechanoreceptor
  • non-myelinated cardiac mechanoreceptor
  • coronary artery baroreceptor
  • ventricular chemosensors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Myelinated Veno-Atrial Mechanoreceptors

A

stretch receptors that measure CVP and atrial filling

  • located in great veins and both atria
  • tachycardia and diuresis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Bainbridge Reflex

A

an increase in heart rate due to an increase in CVP

  • detected by Veno-Atrial mechanoreceptors
  • shifts blood from venous to arterial
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Non-myelinated Cardiac Mechanoreceptors

A

cause bradycardia and vasodilation

  • located in atria and left ventricle
  • signal over-distension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Coronary Artery Baroreceptors

A

similar to other baroreceptors but with greater potency

  • Bezold-Jarisch Reflex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Bezold-Jarisch Reflex

A

increased pressure in coronary arteries causes bradycardia and hypotension

  • mediated by Coronary Artery Baroreceptors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Ventricular Chemosensors

A

vagal fibers that mediate ischemic heart pain in the left ventricle

  • increases sympathetic activity in response to:
    • adenosine, bradykinin, prostaglandin, histamine, thromboxane, lactic acid, K+, and ROS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Cushing’s Reflex

A

increased ICP causes an increase in peripheral sympathetic activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Cushing’s Triad

A

hypertension, reflex bradycardia, and abnormal breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Oculocardiac Reflex

A

pressure on eye or extraocular muscles

  • increase parasympathetic tone
  • bradycardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Renin - Angiotensin - Aldosterone

A

promotes salt and water retention when blood pressure is low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Addison’s Disease

A

low Aldosterone

  • causes hypotension
  • chronic adrenal insufficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Anti-Diuretic Hormone

(vasopressin)

A

promotes water retention to restore extracellular volume

  • stimulated by low blood volume
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Atrial Natriuretic Peptide

A

promotes salt excretion and diuresis

  • reelased in response to atrial distension
  • directly affects central blood volume
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

RAAS response to decreased BP

A
  • increase renin increases:
    • angiotensin II
    • aldosterone
    • Na+ absorption
    • fluid absorption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Mechanoreceptors

A

inhibit cardiac vagal tone

  • stimulated by local pressure and muscle contraction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Metaboreceptors

A

stimulated by substances released during exercise

  • more active during isometric exercise due to less blood flow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Somatic Pain response

A

increase HR and BP

(opposite for visceral pain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Asphyxia

A

hypoxemia with hypercapnia

  • stimulates increase BP, cerebral perfusion, and oxygen delivery
48
Q

Clinical Shock

A

hypotension, hypovolemic, and cardiac shock

  • causes rapid breathing and increases peripheral resistance
49
Q

What regulates alveolar ventilation and BP during asphyxia and clinical shock?

A

arterial chemoreflex

50
Q

Nucleus Tractus Solitarus

A

integrates virtually all cardiovascular afferents and relays them to the hypothalamus, cerebellum, and medulla

51
Q

Destruction of the nucleus tractus solitarus causes a sustained _____

A

hypertension

52
Q

Rostral Ventrolateral Medulla (RVLM)

A

tonically active vasopressor

  • regulated by the CVLM
  • primary regulator of the sympathetic nervous system
53
Q

Paraventricular Nucleus

A

regulates sympathetic activity

  • recieves information from NTS
  • project into RVLM and SC to influence sympathetic outflow
  • located in hypothalamus
54
Q

Magnocellular Neurons

A

secrete oxytocin and vasopressin

  • located in PVN of the hypothalamus
55
Q

Alerting Response

A

tachycardia, increased CO, vasodilation, and increased BP

  • generated by amygdala, hypothalamus, and preiaqueductal grey matter
56
Q

“playing dead” response

A

bradycardia and hypotension

  • originates in cingulate gyrus of limbic system
57
Q

Valsalva Maneuver

A

forced expiration against a closed or narrow glottis that creates high intrathroacic pressure

  • ultimately increases stroke volume and pulse pressure while decreasing HR
58
Q

Oxygen uptake

(equation)

A

VO2 = Q * (CaO2 - CvO2)

59
Q

Dynamic exercise

A

cycles of contraction and relaxation

  • increased CO balanced by decreased PVR
60
Q

Static exercise

A

isometric contraction

  • stimulation of mechanoreceptors
  • increase HR, CO, and SVR
61
Q

endurance is dependent on the maximum rate of ______

A

O2 transport from lungs to mitochondria

62
Q

Endurance atheletes

A

increased CO and SV

eccentric hypertrophy

63
Q

Eccentric Hypertrophy

A

increases myocyte length (not width)

  • found in endurance atheletes
  • increased number of capillaries
  • bigger chamber in proportion to increase in wall thickness
64
Q

Concentric Hypertrophy

A

increase in wall thickness > chamber size

  • found in strength training
  • similar to chronic HTN
65
Q

Diving Response

A

apenea, bradycardia, and peripheral vasoconstriction

66
Q

Arterial Oxygen Content

(equation)

A

CaO2 = (1.31 * Hb * SaO2) + (0.003 * PaO2)

67
Q

All forms of shock have a decrease in ____ and an increase in _____

A

decrease in MAP

increase in lactic acid

68
Q

distributive shock

A

systemic hypotension, sepsis, anaphylaxis, or neurogenic shock

  • decrease
    • PAWP, SVR
  • increase
    • CO, SvO2
69
Q

Obstructive Shock

A

PE, cardiac tamponade, VAE, or tension pneumothorax

  • decrease
    • CO, SvO2
  • increase
    • PAWP, SVR
70
Q

Hypovolemic shock

A
  • increase
    • SVR
  • decrease
    • PAWP, CO, and SvO2
71
Q

Cardiogenic Shock

A
  • increase
    • PAWP, SVR
  • decrease
    • CO, SvO2
72
Q

_____% of blood loss may produce hypovolemic shock

A

20-30%

73
Q

Hemorrhagic Shock

A
  • cardiopulmonary stretch receptors and arterial baroreceptors decline
    • chemoreceptor activity increases
  • equal MAP, but decreased pulse pressure
74
Q

Hemorrhagic Shock

(long term responses)

A
  • reduced renal excretion and increased fluid intake
  • albumin synthesis
  • RBC production
75
Q

Blood loss ultimately results in increased ____ (4)

A

HR, contractility, venous tone, and SVR

76
Q

Framingham Risk Score

A

determines risk of developing IHD or CVA

  • age, gender, cholesterol, smoker, systolic BP, and anti-hypertensive medication
  • low risk < 10%
  • high risk > 20%
77
Q

Metabolic Syndrome

A

group of risk factors that occur together and increase risk for IHD and stroke

  • 3 or more:
    • waise > 40 or 35
    • TG > 150
    • HDL < 40 or 50
    • fasting glucose > 100
    • BP > 130/85
78
Q

Syndrome X

A

group of risk factors that indicate predisposition to diabetes

  • glucose intolerance, high triglycerides, obesity, and hypertension
79
Q

Transesophageal echo (TEE)

contraindications

A
  • pharyngeal or esophageal obstruction
  • active upper GI bleed
  • suspected perforated viscus
  • instability of cervical spine
  • uncooperative patient
80
Q

Why should class III patients not recieve a treadmill stress test?

A

baseline ECG abnormalities

  • WPW, paced rhythm, ST depression, or complete LBBB
81
Q

Treadmill Stress Test

contraindications

A
  • acute MI
  • angina
  • aortic stenosis
  • PE
  • aortic dissection
  • psychosis
82
Q

Treadmill stress test is best used in evaluation of a patient with _____

A

intermediate risk with atypical history or a low risk with typical history

83
Q

imaging for myocardial ischemia

A

nuclear imaging or PET

84
Q

imaging for systolic/diastolic dysfunction

A

stress echo

85
Q

imaging for chest pain

A

history

86
Q

Pharmocologic stressors in Nuclear Stress Testing

A
  • Dipyridamole (persantine)
  • Adenosine
  • Regadenoson (lexiscan)
87
Q

Nuclear stress testing effects _____ receptors

A

adenosine receptors

A2A - coronary artery vasodilation

88
Q

Nuclear Stress Test imaging agents

A
  • Thallium
  • Tecnhitium
    • Sestamibi (cardiolite)
    • Tetrofosmin (myoview)
    • Teboroxime (cardiotec)
89
Q

Contraindications for Nuclear Stress Testing

A
  • I-131 therapy within 12 weeks
  • Tc-99m studies
  • caffeine
  • allergies to diphyridamole or aminophylline
  • active asthma
90
Q

What test is the gold standard to find blockages?

A

cardiac catheterization

coronary angiography or left ventirculography

91
Q

Cardiac Catheterization contraindications

A
  • coagulopathy
  • renal failure
  • dye allergy
  • active infection
  • CHF
  • severe hypertension
92
Q

Acute Coronary Syndrome

A

blood supply to myocardium is suddenly blocked

  • umbrella term including:
    • STEMI, non-STEMI, and unstable angina
93
Q

Fondaparinux

(arixtra)

A

factor Xa inhibitor

antithrombin

94
Q

most sensitive and specific cardiac enzyme to test for myocardial damage

A

Troponin

95
Q

right-to-left shunt

A

systemic venous into systemic arterial

96
Q

left-to-right shunt

A

pulmonary venous into pulmonary arterial

97
Q

o reduce right to left shunt flow through a VSD, which should be avoided?

A

hypoxemia

98
Q

Atrial Septal Defect

A

defect in interatrial septum allowing left-to-right shunt

  • dyspnea, SVT, right heart failure, and paradoxical embolism
  • 2 cm
99
Q

Patent Foramen Ovale

A

hole between upper atria

  • NOT an atrial septal defect
  • venous blood leaks into left atrium
100
Q

ventricular septal defect

A

hole between the ventricles

  • volume overload to right ventricle
    • early pulmonary hypertension
  • may develop PVOD
  • most common CHD
    • 50% sponatenously resolve
101
Q

Patent Ductus Arteriosus

A

hole between pulmonary artery and aorta

  • mixed blood goes from aorta into pulmonary artery
  • treated with ligation using Pancuronium and ketamine
102
Q

Coarctation of the Aorta

A

narrowing of descending thoracic aorta

  • often appears with Turner syndrome
    • mostly post-ductal
  • associated with aortic stenosis, bicuspid valve, and VSD
  • increases resistance to left ventricular outflow
103
Q

Tetralogy of Fallot

A

combination of four defects:

(VSD, pulmonary stenosis, overriding aora, and RVH)

  • most common cyanotic leasion
104
Q

Treatment of TET spells

A
  • 100% oxygen
  • compression of femoral arteries
  • morphine
  • fluid bolus (15-30 mL/kg)
  • NaHCO3 to correct acidosis
  • Phenylephrine to increase SVR
105
Q

what should not be given during TET spells?

A

beta agonists

(worsens RVOT obstruction)

106
Q

Hypoplastic Left Heart Syndrome

A

underdeveloped left heart

  • systemic perfusion is dependent on PDA flow
107
Q

Transposition of Great Arteries

A

inappropriate orientation of vessels and cardiac chambers

  • two circulations in parallel (not series)
  • PDA and FO must remain open
108
Q

Eisenmenger Syndrome

A

large L-to-R shunt

  • develops pulmonary vascular disease and hypertension
109
Q

classic triad of symptoms with Aortic Stenosis

A

angina, dyspnea, and syncope

110
Q

Most common type of aortic stenosis

A

valvular

111
Q

Normal arotic valve area

A

3 - 4 cm2

critical aortic stenosis is AVA < 0.7 cm2

112
Q

Physical findings of Aortic Stenosis

A
  • pulsus parvus et tardus
  • systolic ejection murmur
  • paradoxically split S2
113
Q

paradoxically split S2 causes ____

A
  • severe aortic stenosis
  • LBBB
  • hypertrophic cardiomyopathy
114
Q

most common cause of aortic stenosis

A

age-related calcific degeneration

115
Q

most common causes of acute mitral regurge

A

ischemic heart disease, endocarditis, and rupture of chordae tendinae

116
Q

Primary cause for mitral stenosis

A

rheumatic heart disease

Quarter 4 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions