Cardio Part 1 Flashcards
3 main organs of the Cardiovascular System
Heart, Blood vessels, Blood
Main function of the heart (supply O2 to body
organs)
Perfusion
carry oxygenated blood
Arteries
carry deoxygenated blood
Veins
Fist-sized, hollow muscular organ that is located at
the center of the thorax
Heart
Heart occupies the space between the lungs
Mediastinum
The weight of the heart
300g
Volume of blooded blood of the ehart
60 ml or 5L/m
enlargement of
the size of the organ, particularly for the heart,
which has thickening walls)
Hypertrophy
backflow of blood
from the lower chamber to the upper
chamber
Regurgitation
● A thin fibrous sac that covers and protects the heart
Pericardium
how many mL of fluid in the pericardial space that lubricates the surface of the heart and reduces friction
20mL
surrounds or envelops the visceral pericardium, tough fibrous tissues, sternum, diaphragm, and vertebral column.
Parietal pericardium
Supports the heart in the mediastinum.
Parietal pericardium
3 Layers of the Heart
Epicardium. myocardium, endocardium
the outermost layer of the heart
Epidicardium
the middle and muscular layer that is
responsible for the pumping action of the heart. the strongest layer of the heart. Composed of muscle fiber.
Myocardium
(inner layer) is the lining in the insides of
the heart and valves.
Endocardium
A muscular wall that separates the heart in 2 halves: left and right
Septum
A muscular wall that separates the heart in 2 halves: left and right
Septum
Condition what the child would be born without a septum
atrial septal defect (ASD) and Ventricular septal defect (VSD).
VSD has ____to ____ shunting, because the left side of the heart is stronger than the right side of the heart.
left to right
Venous blood transfer from the right atrium to right ventricle during ____
diastole
one that receives venous blood from the superior vena cava, inferior vena cava, and coronary sinus returning to the heart
Right atrium
has venous blood from the head, neck, upper extremities, and part of the chest
Superior vena cava
a has venous blood from the
trunk and lower extremities.
Inferior vena cava
has blood from the coronary
circulation (blood that nourishes the heart)
Coronary sinus
a muscular pump located behind the sternum It generates enough pressure to close the
tricuspid valve and open the pulmonic valve to
push the blood to the pulmonary artery
Right ventricle
Is the relaxation phase of all chambers
simultaneously
Diastole
Represented by P wave (atrial depolarization) in ECG and dub
Diastole
the contraction of the atria and the ventricles
Systole
TRUE OR FALSE: Atrial and ventricular systole are simultaneous
FALSE
TRUE OR FALSE: Atrial systole comes first followed by the ventricular contraction
TRUE
Ventricular systole or ventricular depolarization
is indicated by the _____
QRS complex
What condition wherein there is a problem in the QRS complex.
supraventricular tachycardia,
ventricular tachycardia
The valve between the atrium and ventricles
AV valve
The closure of AV valves is maintained by the ___ attached to ventricullar walls
papillary muscles
chordae tendineae
is a 3 leaflet valve found between the right atrium and right ventricles
Tricuspid Valve
also known as bicuspid valve has 2 leaflets that are between the left atrium and left ventricle
Mitral Valve
Composed of 3 leaflets. Expected to be closed during diastole
Semilunar Valves
The valve between the right ventricle and the
pulmonary artery
Pulmonic valve
The valve between the left ventricle and the
aorta
Aortic valve
the specialized cells that form an interconnected network of muscle fibers
Myocytes
Cardiac muscles are connected by junctions called
Intercalated discs
Without a constant supply of oxygen towards the heart, there will be a problem with coronary circulation, _____ may occur.
Myocardial infarction (MI)
The ability to initiate electrical impulses. The heart can initiate electrical impulses through the SA node
Automaticity
The ability to respond to an electrical impulse. By the time the SA node would fire an electrical
impulse, the heart will be able to respond.
Excitability
The ability to transmit electrical impulses from
one cell to another.
Conductibility
The tension developed and the velocity of
shortening of the myocardial fibers.
Contractility
It corresponds to the repolarization of the heart
or the ability of the heart to rest. This refers to the inability of the cell to respond
to any stimulus.
Refractoriness
is the exchange of ions that
creates a positively charged environment
intracellular ( inside the cell) and a negatively
charged extracellular space.
depolarization
occurs during the repolarization
phase or the resting phase.
Refractory period
Phase in Cardiac Action Potential where Cellular depolarization is initiated as positive ions influx into the cell.
Phase 0
Phase in Cardiac Action Potential where Early cellular repolarization begins
during this phase as potassium exits the
intracellular space.
Phase 1
This phase of Cardia action potential is called the plateau phase because the rate of repolarization slows. Calcium ions enter the intracellular space.
Phase 2
This phase of cardiac action portential marks the completion of repolarization and the return of the cell to its resting state.
Phase 3
This phase of cardiac action potential is considered the resting phase before the next depolarization.
Phase 4
Two Kinds of Refractory Period:
Absolute refractory period
relative refractory period
The cardiac excitability is canceled. The cell is completely unresponsive to any electrical stimulus. It is incapable of initiating an early depolarization
Absolute refractory period
The heart is beginning to recover gradually until it reaches its normal value. corresponds with
the short time at the end of phase 3
Relative refractory period
Will you be able to notice your refractory period?
No: the refractory period would only take milliseconds.
Generates and transmits electrical impulses that stimulate the contraction of the myocardium.
The Conduction System
Primary/Normal pacemaker of the heart. Found between the junction of superior vena cava and right atrium
SA (Sinoatrial Node)
Secondary pacemaker of the heart. Found between the right atrium and ventricle,
near the tricuspid valve
AV node
Transmits impulses from AV node to the
ventricles
Bundle branches/ Bundle of His
The terminal (last) point of the conduction
system of the heart
Purkinje fibers
Simulation of the vagus nerve is under what stimulation. It decreases heart rate
Parasympathetic stimulation
Stimulation that is responsible for Fight or flight response and increases heart rate
Sympathetic stimulation
Triggers the release of epinephrine and
norepinephrine (catecholamines).
Excercise
Enlargement of the heart
Cardiomegaly
any abnormality
on the electrical impulses in the heart
Arrhythmias
the most important electrolyte
Potassium (k)
have a significant role in
your cardiac contractility
Potassium and calcium
Produced by adrenal glands
Catecholamines
is released by the pituitary
TSH
Patients with ______ tends to manifest with tachycardia and palpitations
hyperthyroidism
The amount of blood pumped from the left ventricle each minute
cardiac output
Cardiac output formula
Heart rate x stroke volume
the amount of blood which goes out
of your ventricle every time the heart pumps or
contracts.
stroke volume
The average resting stroke volume is about
60-130mL
Resting cardiac output in mL
4-6mL/min
Number of ventricular contraction in each minute
Heart rate
Heart rate is controlled by the _____ nervous system
autonomic nervous system (ANS): Parasympathetic and sympathetic
Amount of blood ejected by the LV during each
contraction
Stroke volume
Amount or degree of myocardial fiber stretch at
the end of diastole.
Preload
Pressure or resistance that the ventricles must
overcome to eject blood through the semilunar
valve
Afterload
The resistance of the systemic BP to left
ventricular ejection is called systemic vascular
resistance.
Afterload
Contracting power of the heart
Myocardial contractility
slows down the heart rate but it makes the heart pump more effectively
Digoxin
is the amount of blood present in the ventricles at the end of the diastole, also referred to as ventricular and diastolic pressure.
Preload
measures the amount of fluid that enters the heart (right atrium)
Central venous pressure (CVP)
according to this principle the greater the volume of blood entering the heart during diastole, the greater the volume of blood ejected during systole
Frank-Starling Principle
is the amount of pressure the heart needs to
overcome in order to pump blood out of the heart.
Afterload
is the ability of the heart to contract, for the
cardiac muscles to contract as initiated by the SA node
Contractility
is a cardiac glycoside that decreases the heart rate however, it makes each contraction to be more effective thus, increasing the strength of every contraction which results in increased contractility
Digoxin
% of the end-diastolic blood volume ejected with each heartbeat; ; used as a measure of cardiac contractility
Ejection fraction
Normal ejection fraction
Normal value = 55 – 65%
An ejection fraction of less than 40% is already an indication of
Heart failure
Three Major Sequential Events
Diastole
Atrial systole
Ventricular systole
Atrial systole augments ventricular
blood volume by 15% to 25% and is sometimes
referred to as
atrial kick
Supplies blood to the right atrium (RA) and
anterior of the right ventricle (Anterior RV)
Right coronary artery
Supplies also the posterior aspect of the septum, posterior papillary muscle, SA and AV node, and inferior aspect of the left ventricle
Right coronary artery
Left coronary artery: The artery from the point of origin to the first major branch is called the
Left main coronary artery
Two branches arise from the left main coronary artery:
left anterior descending
circumflex artery
supply the anterior left ventricular wall, anterior interventricular septum, anterior papillary muscles, and left ventricular aspect
Left Anterior Descending
supply the anterior left ventricular wall, anterior interventricular septum, anterior papillary muscles, and left ventricular aspect
Circumflex artery
Whenever you encounter a patient with chest
pain or discomfort, you need to ask for the
COLDSPA (character, onset, location, duration,
severity, precipitating, aggravating factors of
the pain experience of the patient.
the tendency of the pain is to be diffused throughout the
chest.
Myocardial Infarction (MI)
Pain or discomfort in other areas of the body
including arms, back, neck, jaw, and stomach. If
there is chest pain radiating in these body parts,
this might indicate that the patient is having the
Acute coronary syndrome
an early symptom of heart failure and heart symptom that is only experienced by women
Shortness of Breathing (SOB) or Dyspnea on
Exertion (DOB)
Blood problem caused by dyspnea on exertion
Anemia
Whenever there is a change in LOC, you’ll be
suspecting
Shock
causes syncopal episode and dizziness
Decrease cerebral blood (cerebral hypoxia) flow
is a major risk factor for CVD, coronary artery disease (CAD), peripheral vascular disease (PVD).
Cigarette use
Two components in smoking that have been
implicated to coronary artery disease:
Tar
Nicotine
A substance with cumulative effect that
can be found in smoke from a burning
tobacco
Tar
Causes blood vessels to constrict
or narrow which limits the flow of the blood
to different organs
Nicotine
Worst class of obesity
Class III
Best time to take statins
at night (9 PM)
time of fat metabolism occurs
10 AM-2 AM
tissue that develops on the leaflet of
the bulb of the heart
vegetation
Patients with diabetes are given hbA1C
diagnostic tests, at least every______, to
detect if sugar control is very good or not.
6 months
the substance produced by
kidneys which leads to the blood to make
RBCs.
Erythropoietin
common vein used as alternative route in CABG
Saphenous vein and IMA (Internal Mammary
Artery)
TRUE OR FALSE: Beta-blockers (-olol) and calcium channel blockers (-ine) decrease blood pressure and slow HR
TRUE
used to treat blood vessel vasospasm
Calcium channel blockers
increase the risk for thromboembolic disease
such as DVT which can develop into an embolus
Contraceptive pill
Commonly used for depression
St. John’s Wort
For the brain, _____ is the first sign
of hypoxia.
rritability or restlessness
Aorta is found in the ______, in the right
2nd ICS
Erb’s point can be located at the
3rd ICS
is a common finding in patients with HF and peripheral vascular diseases, such as deep vein thrombosis or chronic venous insufficiency
Peripheral edema
Apical pulse is present in the ______ of the left
midclavicular line.
5th ICS
If the apical pulse is palpated in two distinct areas and pulsations are paradoxical (not spontaneous or not simultaneous) you may suspect a
ventricular aneurysm.
If you have your broad and forceful apical impulse this may indicate
left ventricular heave or lift
a vibration or purring sensation, this could be caused by valvular heart disease, atrial or ventricular septal defect, stenosis, or a large artery such as a carotid artery.
Trill
Marks onset of systole and closure of the
atrioventricular valves
S1 (lub)
s1 is best heard in
Apex
marks the onset of diastole and closure of
semilunar valves
s2 (dub)
S2 is best heard at the
base of the heart (upper portion).
Occurs when it is possible to distinguish
between the closure of the aortic and pulmonic
valves.
Abnormal splitting of S2 (Paradoxical Splitting)
May occur with heart disease but they can also occur in some healthy people.
Gallop and Murmur (s3 and S4)
The presence of both S3 and S4 called
Summation or a Quadruple Gallop
The presence of both S3 and S4 called Summation or a Quadruple Gallop is an indication of
Severe Heart Failure.
Reflect turbulent blood flow through normal
or abnormal valves. Harsh, blowing, whistling, rumbling, or squeaking
Murmurs
Originates from the pericardial sac and
occurs with the movements of the heart
during the cardiac cycle.
PERICARDIAL FRICTION RUB
Can be used to visualize the heart.
Chest X-ray
It can help determine the size, contour, and position of the heart
Chest X-Ray
uses sound waves to produce an
image of the heart.
Echocardiogram
used to measure the ejection fraction
(percentage of the blood that goes out of the heart every time it pumps). It is also used to check the size, shape, and motion of
the heart.
Echocardiogram
Used to determine regurgitation through sound.
Echocardiogram
Determines the size and structure of the heart
MRI
Can give a detailed image of the heart, including
cardiac wall thickness, chamber dilation, valve and ventricular function, and blood movement into the great vessels
MRI
Displays the electrical activity of the heart, through the analysis of waveforms.
ECG
atrial depolarization
P wave
ventricular depolarization
QRS complex
ventricular repolarization
T wave
early ventricular repolarization
ST segment
ST-segment elevation (chair-like appearance) has evidence of
evolving MI
ST segment depression may identify the presence of
myocardial ischemia or injury
Recording of audible vibration coming from the
heart and great vessels.
● Phonocardiography
Valuable tool for detecting and evaluating CAD.
Stress test
determines the working
nature of the heart when it is made to go under
pressure.
Treadmill stress test
Done to determine which dysrhythmias may
cause clinical signs and symptoms that may not
occur during a routine ECG.
Holter monitoring
Referred to as Cardiac Biomarkers because their increase is specific to the cardiac muscle
Cardiac enzyme
a myocardial protein that is released
into the bloodstream with the injury of your
myocardial muscle.
Troponin I
Everytime Troponin I or T is released in the
bloodstream, it means that there is
injury to the cardiac muscle.
specific to MI and shows a predictable rise and fall during three days and the peak levels occur about 24 hours after the onset of chest pain.
CK-MB activity
Low molecular weight protein found in the cardiac and skeletal muscle
Myoglobin
Sedimentation rate which is an indication of
inflammation.
ESR
Neuro hormone regulates your blood pressure and fluid volume. useful for prompt diagnosis of heart failure
BNP (B-type Natriuretic Peptide)
A BNP level greater than 100 pg/mL is suggestive of
Heart failure
A test using a special camera and a small amount of radioactive substance injected into the bloodstream to make an image of the blood flow to the heart.
Thallium scanning
Catheter is introduced into the heart and selected blood vessels to measure pressure and O2 sat.
Cardiac Catheritization
mapping the blood vessels of the heart to find out if there are any blockage in any part of blood vessels
Coronary angiography
Done through cardiac catheterization
Coronary angiography
Injecting contrast medium into the vascular system to outline the heart and blood vessels
Coronary angiography
Invasive procedures of monitoring the pressure in our body specifically in the heart.
Hemodynamic monitoring
Pressure at your superior vena cava and right atrium
CVP (Central Venous Pressure)
Normal CVP:
2-6 mmHg
Pressure is monitored through arteries. A probe is inserted towards the arteries and the probe
is attached to a catheter going towards the cardiac monitor wherein the blood pressure inside the body could be read.
Intra-arterial Blood Pressure Monitoring
