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Breathing and Cir. Exam 1 > Cardiography > Flashcards

Cardiography Flashcards

1
Q

What is the best non-invasive method to evaluate patients with heart disease?

A

Echocardiography

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2
Q

In which echocardiographic modality does the ‘plane’ of the ultrasound cross-section the heart?

A

2D-Mode

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3
Q

In the image above, which depicts a long axis plane and which depicts a short axis plane?
Right: Cut in the middle like a sausage
Left: Cut in the middle like a tomato

A

Right - short axis, left - long axis

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4
Q

Which views in 2D-Mode can you visualize all four chambers of the heart?

A

Long axis and apical

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5
Q

Which axis in 2D-Mode can you best visualize the left ventricle and its papillary muscles?

A

Short axis

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6
Q

What are the advantages of M-Mode or Motion-Mode?

A

Multiple cardiac cycles in single image, ability to compare to established reference values

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7
Q

When using the spectral doppler, what is represented on the Y axis of the graphed output?

A

Flow velocity

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8
Q

When using a spectral doppler, flow towards the probe is ________ (above/below) the baseline while flow away from the probe is __________ (above/below) the baseline.

A

Above, below

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9
Q

What is the gate in relation to pulsed wave doppler?

A

An examiner defined area where the measurements are being taken that appear on the graph

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10
Q

Pulse wave doppler is _________ (good/not good) for spatial resolution while _________ (good/not good) for measuring high velocity areas.

A

Good, not good

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11
Q

Continuous wave doppler is _________ (good/not good) for spatial resolution while _________ (good/not good) for measuring high velocity areas.

A

Not good, good

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12
Q

What does the blue versus red colors in a color doppler image indicate?

A

Blue - flow away from the probe; red - flow towards the probe

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13
Q

What is aliasing in terms of color doppler imaging?

A

When flow is too fast, red and blue mix

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14
Q

If you want to assess the size of the left atrium on a short axis view of the base of the heart, what structure do you compare it to?

A

The aortic diameter

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15
Q

The diameter of the left atrium should be less than how many times larger than the diameter of the aorta?

A

<1.5

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16
Q

What is the equation for fractional shortening?

A

End diastolic diameter minus end systolic diameter, divided by end diastolic diameter, multiplied by 100

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17
Q

What echocardiographic modality do you need to use to get the values needed to calculate fractional shortening?

A

M-Mode

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18
Q

What is the normal range of fractional shortening percentages for a standard breed dog?

A

25-45%

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19
Q

What is the equation for the ejection fraction?

A

End diastolic volume minus end systolic volume, divided by end diastolic volume, multiplied by 100

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20
Q

What is the approximate normal ejection fraction for most animals?

A

70%

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21
Q

What is the equation used to determine blood pressure from blood speed?

A

Delta P is equal to four times the speed squared

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22
Q

What is a clinical syndrome in which impaired emptying or filling of the heart causes clinical signs of exercise intolerance and/or congestion?

A

Heart failure

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23
Q

(T/F) In vet med, heart failure is almost always congestive heart failure.

A

True

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24
Q

Pulmonary edema would indicate congestive heart failure of which side of the heart?

A

Left

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25
Right sided congestive heart failure is associated with what abnormalities of the body?
Ascites +/- pleural effusion
26
Volume overload leads to eccentric hypertrophy which is the _________ (in-series/parallel) replication of sarcomeres resulting in hypertrophy _________ (with/without) dilation.
In-series, with
27
Volume overload and related eccentric hypertrophy shows a ___________ (preserved/increased) ratio of wall thickness to lumen.
Preserved
28
Concentric hypertrophy is associated with overload of what?
Pressure
29
Pressure overload leads to concentric hypertrophy which is the ___________ (in-series/parallel) replication of sarcomeres resulting in hypertrophy _________ (with/without) dilation.
Parallel, without
30
Pressure overload and related concentric hypertrophy shows a ___________ (preserved/increased) ratio of wall thickness to lumen.
Increased
31
What causes impaired emptying of the ventricles and may be caused by primary myocardial diseases or be a sequela of other diseases?
Contractile dysfunction
32
What causes impaired filling of the ventricles and is very difficult to assess non-invasively?
Diastolic dysfunction
33
What causes both impared filling and emptying of the ventricles?
Arrhythmias
34
Excitation is when specialized cardiomyocytes initiate and propagate a wave of cellular depolarization that starts at which node in the heart?
Sinus node
35
What type of myocytes then contract in response to the wave of cellular depolarization in the contraction phase of excitation-contraction coupling?
Working myocytes
36
(T/F) The depolarization that occurs at the sinus node is spontaneous and the overall action potential has a plateau phase.
F, no plateau phase
37
(T/F) Ventricular myocyte depolarization does not occur spontaneously and has a plateau phase.
True
38
Of the five phases of a general action potential, which two do sinus node action potential not have?
Plateau and overshoot
39
Besides the sodium potassium pump and the selective permeability of the membrane in its resting state, what is another reason that cardiomyocytes are polarized at rest?
Donnan effect
40
What electrolyte is used to trigger depolarization in working myocytes?
Sodium
41
What is the threshold for working myocytes?
-70mV
42
The depolarization phase of working myocytes occurs due to what type of channels?
43
What electrolyte is used to trigger depolarization in the sinus node?
Calcium
44
The depolarization phase of the sinus node occurs due to what types of channels?
Transient and lasting calcium channels
45
What is the plateau phase, found only in working myocytes and not the sinus node, largely due to?
Voltage gated ‘slow’ calcium channels
46
What two things are the plateau phase important for?
Phases of contraction and to avoid arrhythmias
47
(T/F) The repolarization phase is the same in both working myocytes and the sinus node, both utilizing potassium to return to their resting membrane potential.
True
48
The sympathetic nervous system has what effect on the action potentials of the sinus node?
Makes phase 4, resting membrane potential reaching the depolarization threshold, faster by affecting the funny sodium channels and the calcium channels
49
(T/F) The only way electrical activity is conveyed from the atria to the ventricles is via the AV node
True
50
What is the normal firing rate range for dogs versus cats for the SA node?
Dogs:70-160bpm, cats: 140-220bpm
51
What is the purpose of the interventricular conduction system?
To quickly pass the electrical activity from the AV node to the entirety of the ventricular system so everything contracts at the same time
52
What forms the connection between the conduction system and working myocardium?
Purkinje fibers
53
What about a vector on a surface electrocardiogram depends on the angle of intersection between the recording sites, the direction of the vector, and the amount of myocardial mass crossed?
Magnitude of the vector
54
What three things does the magnitude of a vector detected depend on?
Angle of intersection between the recording sites, the direction of the vector, and the amount of myocardial mass crossed
55
(T/F) A lead is a singular electrode.
F, pair
56
What is the standard electrode placement when an animal is in right lateral recumbency?
White on right front, black on left front, green on right back, and red on left back
57
(T/F) The waveforms seen on an ECG read out indicate the electrical pulse running through the conduction system.
F, through the muscle
58
(T/F) If conduction through the His bundle is intact, any impulse originating above the bifurcation of the His bundle will generate a normal looking QRS wave.
True
59
How does a larger mass of cells or slow conduction time change an ECG waves’ deflection and waveform?
Larger deflection and wider waveform
60
A wave of depolarization moving toward a positive electrode would give a wave _______ (above/below) baseline?
Above
61
A wave of depolarization moving parallel with the electrode pair results in a __________ (smaller/larger) wave deflection.
Larger
62
What is the normal range of heart rate in adult dogs?
60-120bpm
63
What is the normal range of heart rate in puppies?
60-220bpm
64
What is the normal range of heart rate in cats?
140-220bpm
65
If your ECG machine prints paper at 25mm/s and you count 8 heart beats in a 15cm portion, what is the patient's heart rate?
80bpm
66
If your ECG machine prints paper at 50mm/s and you count 6 heart beats in a 15cm portion, what is the patient’s heart rate?
120bpm
67
For the following questions, you just received a patient’s ECG and are staring at it right now. - What is the first thing you want to determine?
Heart rate and if it is normal or not
68
For the following questions, you just received a patient’s ECG and are staring at it right now. - The second question you ask yourself is about rhythm, what are you looking for?
If it is regular or irregular
69
For the following questions, you just received a patient’s ECG and are staring at it right now. - For the third question you ask yourself, what do you want to evaluate for normalcy?
Waveform
70
For the following questions, you just received a patient’s ECG and are staring at it right now. - What would you look for if asking yourself ‘is a heartbeat originating from the sinus node’?
P wave
71
For the following questions, you just received a patient’s ECG and are staring at it right now. - What is the fifth and final question you should ask when evaluating an ECG?
Is there a QRS for every P
72
What is bradycardia?
Heartbeat that is slower than reference interval
73
(T/F) Sinus bradycardia is associated with an entirely normal waveform for every heart beat.
True
74
(T/F) An owner counts their horse's heart beat as 20 bpm while creeping on it when the horse is sleeping, this would be cause for concern for clinical significant bradycardia.
F, tell them to stop creeping
75
Besides sleep, what else can cause sinus bradycardia?
Drugs and increased vagal tone
76
What is sinus arrhythmia?
Normal variation in the firing of the sinus node causes variation in heart rate. If you want to see it for yourself, start taking your heart rate and then take a deep breath in and hold it, although very slight, your heart rate should increase on inhalation and then decrease as you hold your breath
77
What signalment is overrepresented for third degree AV blocks?
Old cocker spaniels
78
What is the treatment for asymptomatic patients with a third degree AV block? What about symptomatic patients?
Asymptomatic - monitor; symptomatic - pacemaker
79
(T/F) Prognosis for a patient with a third degree AV block is excellent if a pacemaker is put in
True
80
Listed below are the different degrees of AV blocks, describe the appearance of their ECG waves. - First degree aka ‘mild’ - Second degree aka ‘moderate' - Third degree aka ‘severe’
- First degree aka ‘mild’ (Prolonged PR interval otherwise normal) - Second degree aka ‘moderate’ (Some P waves not followed by QRS wave) - Third degree aka ‘severe’ (No P waves are followed by QRS, QRS observed originate from the ventricles)
81
(T/F) Most third degree AV blocks are due to structural AV node disease (such as AV fibrosis, neoplastic infiltration, infarction).
True
82
(T/F) Increased vagal tone (can be due to drug effect and/or diseases of the respiratory, GI, CNA or ocular systems) usually only causes second or third degree AV blocks.
F, 1st or 2nd
83
Atropine is typically used to resolve AV node blocks caused by increased vagal tone but is not used in horses, how are they treated in horses?
Resolved with exercise → increased sympathetic tone
84
What pathologic process is indicated in the above ECG (Description:Three beats with normal p and qrs waves, pause in sinus rhythm, beats resume with no p wave) ?
Sick sinus syndrome
85
What is the typical signalment of dogs with the above ECG (Description: Sick sinus syndrome) ?
Older schnauzers, dachshund, and terriers
86
Sometimes patients with the sick sinus syndrome faint, in what period of their abnormal heart rhythm do they typically faint?
During bradycardic periods
87
What are the two forms of atrial standstill?
Hyperkalemic and myocardial
88
Describe the abnormal waveform associated with hyperkalemia atrial standstill?
No P wave, QRS wave normal to wide, T wave bizarre and tall/tented
89
What is the treatment for hyperkalemia atrial standstill?
Correct what is causing the hyperkalemia
90
(T/F) Wide tachycardia is ventricular in origin while narrow tachycardia is supraventricular in origin.
True
91
What do the waveforms typically look like for ventricular tachyarrhythmias?
Wide and bizarre QRS with no associated P wave
92
You are performing an ECG on a patient with hx of a systemic disease and you notice a run of bizarre QRS waves with no associated P wave so you check the heart rate and find it is completely normal. - Would this patient typically be treated with anything? - What does this patient have?
- Would this patient typically be treated with anything? (Not necessary) - What does this patient have? (Slow ventricular tachycardia aka accelerated idioventricular rhythm)
93
What are P waves replaced by in ECGs for patients with atrial fibrillation, though they may not always be visible?
Fibrillation waves
94
What is the treatment for atrial fibrillation?
Slow down AV conduction with drugs
95
With premature atrial contractions, which wave is abnormal?
P wave
96
What causes the noncompensatory pause seen in an APC ECG?
The APC triggers the resetting of the sinus node which causes the pause after the T wave
97
Why will P waves continue to look normal and occur at a normal rate on a VPC ECG?
The wave of abnormal current triggered somewhere in the ventricles cannot make it past the ‘skeleton’ of the heart so the P wave is clueless to the ventricular drama
98
(T/F) APCs are more common than VPCs and will be more likely to occur if an animal has an atrial disease of some sort
True
99
What do the waveforms usually look like for APCs/atrial tachycardia?
Narrow/normal QRS, abnormal or buried P waves

Breathing and Cir. Exam 1 (8 decks)

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