Cardio Review PP Flashcards
Blood Flow Through the Heart: What kind of blood and from where does the right side of the heart receive blood?
Right side of the heart receives deoxygenated venous blood from all over the body.
Blood Flow Through the Heart: What anatomical structure does blood pass to enter the right atrium?
Enters through inferior and superior vena cava.
Blood Flow Through the Heart: What valve is between the right atrium and right ventricle?
Atrial contraction forces blood through tricuspid valve into right ventricle.
Blood Flow Through the Heart: What valve does blood pass through when the right ventricle contracts?
Right ventricle contracts, forcing blood through pulmonary valve.
Blood Flow Through the Heart: After leaving the right ventricle, what structure does it enter and where does it go?
Blood enters pulmonary artery and into the lungs.
Blood Flow Through the Heart: Where is blood oxygenated? How does it return to the heart?
Blood is oxygenated in lungs and returned to heart through pulmonary veins. (Left Atrium)
Blood Flow Through the Heart: What valve separates the left atrium and left ventricle?
Left atrium contracts forcing oxygenated blood through the mitral valve into left ventricle.
Blood Flow Through the Heart: Where does blood go after the left ventricle contracts? (Valve and anatomical structure)
Muscular left ventricle contract, forcing blood through the aortic valve into the aorta.
Anatomy of the Heart: What is the outer layer of the heart and what is its role?
Epicardium (outer layer): prevents excess expansion or movement of the heart
Anatomy of the Heart: What is the middle layer of the heart and what is its role?
Myocardium (middle layer): initiates contractions driving the cardiac cycle
Anatomy of the Heart: What is the inner layer of the heart and what is its role?
Endocardium (inner layer): lines the cavities and valves
Heart sounds: Describe the S1 sound
S1: Closure of the atrioventricular (mitral and tricuspid) valves.
-Normal; “lub”
Heart sounds: Describe the S2 sound
S2: Closure of semilunar (aortic and pulmonary) valves
-Normal; “dub”
Heart sounds: Describe the S3 sound
S3: Extra beat heard after S2
- Ventricular gallop
- Typically caused by congestive heart failure
- May be normal in young children, pregnancy, and well-trained athletes
Heart sounds: Describe the S4 sound
S4: Extr beat heard prior to S1
- Atrial gallop
- Typically caused by atrial enlargement
Start of EKGs: Who experimented with zinc and copper connected to a frog’s leg?
Luigi Galvani
Start of EKGs: Who found the frog legs kicked when connected to heart?
Kollicker and Mueller
Start of EKGs: What does an EKG provide us with?
EKG provides us with a record of cardiac electrical activity and valuable information about the heart’s function and structure.
Start of EKGs: What does an EKG record?
Records electrical activity of contraction of the heart muscle (myocardium)
Start of EKGs: What has to be electrically stimulated for the heart to contract?
When myocardium is electrically stimulated, it contracts
Basics of EKGs: What type of charge is polarized?
Polarized: negative charge
Basics of EKGs: What type of charge is depolarized?
Depolarized: positive charge
Basics of EKGs: Are the myocytes (heart muscle cells) Polarized or Depolarized while in a resting state?
Polarized
Basics of EKGs: How do myocytes become depolarized?
Become depolarized when their interiors become positive, and cells contract.
Basics of EKGs: What happens when a wave of depolarization progresses through the heart?
A wave of depolarization progresses through the heart, causing contraction of the myocardium
Basics of EKGs: Where does the wave of depolarization begin?
Begins in right atrium, spreading quickly to left atrium
Basics of EKGs: After the wave of depolarization happens in the right and left atrium, where does it go next?
Proceeds through the AV Valves
Basics of EKGs: What is repolarization?
Cell interiors return to negative
Basics of EKGs: What does “late” repolarization look like on EKG?
Broad hump on EKG is most active phase of “late” repolarization
Basics of EKGs: Dealing with depolarization, what type of electrode produces a upward deflection?
A depolarization wave moving towards a positive (+) electrode produces a (+) upward deflection
Basics of EKGs: What is the heart’s dominant pacemaker? What is this activity called?
Sinoatrial Node (SA Node) is the heart’s dominant pacemaker. -Activity is known as "sinus rhythm"
Basics of EKGs: What is automaticity?
The ability to initiate an electrical impulse without outside nervous system stimulation.
Basics of EKGs: What has automaticity to generate pacemaking stimuli?
SA Node
Basics of EKGs: What happens when depolarization moves through both atria?
-As a wave of depolarization moves through both atria, there is a simultaneous wave of atrial contraction.
Basics of EKGs: What is a P wave represent on an EKG? (2)
- Atrial depolarization is recorded as a P wave on an EKG.
- Represents the depolarization and contraction of both atria that forces blood through the Atrio-Ventricular Node (AV Node).
Basics of EKGs: What is the role of the Atrio-Ventricular valve? (2)
- Atrio-Ventricular valves prevent ventricle-to-atrium blood backflow
- Electrically insulate the ventricles from the atria
Basics of EKGs: What lies between the atria and ventricles? What side is each on?
- Mitral valve and tricuspid valve lie between the atria and ventricles
- MitraL = Left
- TRIcuspid = Right
Basics of EKGs: How does the pause after the P wave happen? What does that produce?
- When wave of atrial depolarization enters the AV node, depolarization slows
- This produces a brief pause to allow blood to enter ventricles
Basics of EKGs: What causes this slow conduction through the AV node when depolarization slows after p wave?
Ca++
Basics of EKGs: What does the AV node conduct?
Atrioventricular node (AV Node) is the sole pathway to conduct the depolarization stimulus through the AV valves and to ventricles.
Basics of EKGs: Where is the AV node located?
Located just above, but continuous with, a specialized “ventricular conduction system.”
Basics of EKGs: What shoots through the ventricular conduction system and where does it begin?
Depolarization shoots rapidly through the ventricular conduction system beginning at the His Bundle
Basics of EKGs: What does the His Bundle divide into? Name them.
His Bundle divides into 2 in the interventricular septum
- Right Bundle Branch (RBB)
- Left Bundle Branch (LBB)
Basics of EKGs: What are contained inside the His Bundle and Bundle branches?
His “Bundle” and “Bundle” Branches are “bundles” of rapidly conducting Purkinje fibers.
Basics of EKGs: What is the role of the Purkinje fibers?
Terminal filaments of Purkinje fibers rapidly distribute depolarization to the ventricular myocytes
Basics of EKGs: What produces the QRS complex on the EKG? What does it initiate?
Depolarization of the ventricular myocytes produces a QRS complex on and EKG; initiates the contraction of ventricles.
Basics of EKGs: What is the definition of deflection?
Deflection: direction in which EKG records
Basics of EKGs: What does the Q wave look like?
Q wave: first downward deflection of the complex.
-Not always seen on the EKG
Basics of EKGs: What does the R wave look like?
R wave: upward deflection following Q wave
Basics of EKGs: What does the S wave look like?
S wave: downward deflection following an R wave
Basics of EKGs: What is the ST segment? What does it represent? What level is it at?
ST segment: horizontal baseline following QRS complex.
- Represents initial phase of ventricular repolarization
- Should be level with other areas of baseline.
Basics of EKGs: What does the T wave look like? What does it represent?
T wave: broad hump following ST segment
-Represents the final “rapid” phase of ventricular repolarization
Basics of EKGs: why does repolarization occur? (2). How is it accomplished?
- Repolarization occurs so that the ventricular myocytes can recover their interior, resting negative charge.
- Allows for the myocyte to be depolarized again
- Accomplished by potassium (K+) ion leaving myocytes
Basics of EKGs: What does the QT interval represent?
QT interval: represents the duration of ventricular systole
Basics of EKGs: How is the QT interval measured?
Measured from beginning of QRS to end of the T wave
Basics of EKGs: What is the QT interval an indicator for?
Good indicator of repolarization as it compromises most of the interval
Basics of EKGs: What is a paramedic tip for interval and segment?
Interval: contains at least one wave
Segment: portion of baseline
Basics of EKGs: What is the role of Ca++? How does it achieve this?
Ca++ causes myocardial contraction.
-Binds with troponin to achieve
Basics of EKGs: What is the role of of K+?
Causes repolarization
Basics of EKGs: What does Na+ produce? What is the exception?
Na+ ions produce cell-to-cell conduction in the heart
-Except the AV node, which depends on the movement of Ca++ ions