Cardiology I Flashcards
0
Q
What occurs during ventricular systole?
A
Contraction of the ventricles which sends blood to the body and lungs.
1
Q
What controls the opening and closing of the heart valves?
A
Chamber pressure.
2
Q
What occurs during ventricular diastole?
A
Relaxation of the ventricles which allows them to refill
3
Q
What are the two left coronary arteries?
A
Anterior descending and circumflex arteries
4
Q
What part of the heart does the circumflex artery supply?
A
It supplies the left and around the back of the heart
5
Q
What is the right coronary artery?
A
Posterior interventricular artery
6
Q
What vein does the heart empty into (coronary)?
A
The great coronary vein.
7
Q
The vein that filters the heart is called the _____ and it empties into the _______.
A
Great coronary vein; right atrium.
8
Q
What is the blood flow through the heart?
A
Vena cava Right atrium Tricuspid valve Right ventricle Pulmonary valve Pulmonary artery Lungs Pulmonary vein Left atrium Bicuspid valve Left ventricle Aortic valve Aorta Body.
9
Q
______ is the contraction of the ventricles.
A
Systole
10
Q
______ is the period in which the ventricles fill with blood from the atria.
A
Diastole
11
Q
What is the time of one contraction & one relaxation?
A
Cardiac cycle
12
Q
What is the length of one cardiac cycle?
A
Approx. 0.8 seconds
13
Q
What is the length of systole?
A
Approx. 0.2 seconds
14
Q
What is the length of diastole?
A
Approx. 0.52 seconds
15
Q
_____ is the measurement of the amounts of blood pumped out the ventricles.
A
Ejection fraction
16
Q
Ejection fraction is the measurement of the amounts of what?
A
Blood pumped out the ventricles.
17
Q
What is the normal value of ejection fraction?
A
55-70%
18
Q
What part of the cardiac cycle lasts approximately 0.2 seconds?
A
Systole.
19
Q
What part of the cardiac cycle lasts for approximately 0.52 seconds
A
Diastole
20
Q
What lasts approximately 0.8 seconds?
A
One cardiac cycle
21
Q
______ is the amount of blood pumped out of ventricles in a single beat.
A
Stroke volume.
22
Q
___ is the pressure in the ventricles at the end of diastole.
A
Preload
23
Q
What is preload?
A
The amount of pressure at the end of diastole.
24
Preload is directly affected by the volume of blood that what?
Returns to the right atrium
25
_____ is the resistance against which the heart must pump against.
Afterload
26
Afterload is what?
The resistance against which the heart must pump against.
27
What law deals with the stretching of the myocardia?
Sterling's Law
28
What does Sterling's law state?
The myocardium can be stretched and will return to its normal state, but if overworked (stretched too far) it will lose its ability to return to its normal state.
29
What is peripheral vascular resistance?
How much pressure is in the arterioles that the heart must pump against.
30
______ is the amount of pressure in the arterioles that the heart must pump against.
Peripheral vascular resistance
31
Peripheral vascular resistance is determined by what?
Vasoconstriction and vasodilation
32
What is the correlation between the heart rate and the amount of CO2?
⬆️ HR, ⬇️ CO2
33
What is the formula for blood pressure?
Blood pressure = CARDIAC OUTPUT x PERIPHERAL VASCULAR RESISTANCE
34
_____ is the flight or fight response whereas ____ is the rest and digest response
Sympathetic — fight or flight
| Parasympathetic — rest and digest
35
Sympathetic and parasympathetic nervous responses are a part of what,
Autonomic
36
The receptors in the sympathetic nervous system are ___ and ___.
Alpha and beta
37
What chemical neurotransmitters are in the sympathetic nervous system?
Norepinephrine
38
What nerve endings are in the sympathetic nervous system?
Adrenergic
39
Alpha one receptors do what?
vasoconstriction which raises blood pressure
40
Alpha two receptors do what?
Stop vasoconstriction.
41
Beta one receptors are located where?
In the heart
42
Beta two receptors are located where?
In the lungs.
43
Beta two receptors cause what?
Bronchodilation and Vasodilation
44
What are the neurotransmitters for the parasympathetic nervous system?
Acetylcholine
45
Acetylcholine nerve endings are called what?
Cholinergic.
46
Cholinergic nerve endings are what?
Parasympathetic nerve fibers that use acetylcholine as neurotransmitters.
47
Adrenergic nerve endings are what?
Sympathetic nerve fibers that use epinephrine as neurotransmitters.
48
Myocardial working cells do what?
Generate the PHYSICAL contraction of heart cells.
49
What generates blood flow?
Physical contractions of myocardial working cells
50
What do pacemaker cells control?
Rate and rhythm by coordinating regular depolarization
51
Depolarization is…
Contractions of the heart.
52
What is the primers function of pacemaker cells?
To generate and conduct electrical impulses
53
A ____ is the point at which a stimulus will produce a cell response.
Threshold
54
What are the four cardiac cell characteristics?
Contractibility (mechanical)
Automaticity (electrical)
Excitability (electrical)
Conductivity (electrical)
55
_____ is the ability of the cardiac cells to shorten and cause muscle contraction.
Contractility
56
____ is the ability of the cardiac pacemaker cells to spontaneously generate electrical impulses w/o external stimulation.
Automaticity
57
____ is the ability of cardiac cells to respond to an electrical stimulus.
Excitability
58
_____ is the ability of cardiac cells to receive/transmit stimulus to other cardiac cells.
Conductivity
59
Where is the location of automaticity?
SA NODE, AV JUNCTION, PURKINJE FIBERS
60
_____ is a substance or compound whose molecules dissociate into charged components (ions)
Electrolytes.
61
_____ performs a vital part in depolarization of myocardium
Sodium
62
What occurs during cardiac depolarization?
Sodium ions rush into cell changing interio charge to positive after cell is stimulated.
63
What happens during cardiac repolarization?
Sodium ions returns to outside of the cell and potassium ions return to inside.
64
What is the charge of the inside and outside of the cell during resting membrane potential?
Negative inside
| Positive outside
65
What occurs during action potential?
Changes in polarity produces change in cells.
66
____ are attempts to ensure muscle is totally relaxed before another depolarization can be initiated.
Refractory period
67
What is the refractory period for the atrial muscle?
0.15 seconds
68
What is the refractory period for the ventricular muscle?
0.25-0.3 seconds
69
Period of rest is called ____.
Cardiac repolarization
70
The ____ is the primary pacemaker of the heart.
SA node
71
What cardiac wave is caused by the SA node?
The P-Wave
72
What is the firing rate of the SA node?
60-100 BPM
73
What receives the impulse as it exits the SA node?
The internodal pathways
74
The internodal pathways deliver the impulse where?
From the SA node, throughout the atria, and to the AV node
75
What delivers the impulse from the left atrium to the right atrium?
Bachmann's bundle (wenckebach's bundle)
76
At the AV node electrical activity delays _____
0.05 seconds
77
Why does the impulse delay at the AV node?
To allow for complete filling of the ventricles
78
What is the firing rate of the AV node?
40-60 BPM
79
What is the secondary pacemaker?
AV node
80
Where is the bundle of his located?
The top of the interventricular septum
81
What is the firing rate of the bundle of his?
20-40 BPM
82
What is the firing rate of the purkinje network?
20-40 BPM
83
Where does the impulse go from the purkinje network?
To the ventricular muscle cells.
84
What is the pathway of electrical conduction in the heart?
```
SA node
Interventricular pathways
bachmann's bundle
AV node
Bundle of his
Left and right branches
Purkinje fibers
Ventricular muscle cells
```
85
EKG is the graphing of what activity in the heart?
Electricak
86
What is placed on the skin to sense electrical activity?
Electrodes
87
How is EKG recorded?
Electrocardiogram
88
The ____ are the pads that go on the patients skin whereas the ____ connect to the cardiac monitor.
Electrodes - skin
| Leads - machine
89
Three leads are named because they must have what?
A positive, a negative and a ground
90
What is einthoven's triangle?
And imaginary inverted triangle formed around heart by proper positioning oft the bipolar leads.
91
Lead one goes where?
Left & right arm
92
Lead two goes where?
Left leg and right arm
93
Lead 3 goes where?
Left leg and arm
94
Time is measured on the ____ line of the ekg graph.
Horizontal.
95
Voltage is measured on the ___ line of the ekg paper
Vertical
96
One small box meaures ___ seconds
0.04 seconds.
97
PRI is how long ?
0.12-0.20 seconds
98
One large box is equal to how long?
0.20 seconds
99
QRS is how long?
Less than 0.12 seconds
100
The ____ is the beginning and ending of all waves
Isoelectric line
101
A _____ is above the isoelectric line.
Positive deflection
102
A ____ is below the isoelectric line.
Negative deflection.
103
The P wave is how long
10 seconds
104
What is the P wave
depolarization of the left and right atria
105
What is the PR interval
Start of the P wave to the start of the QRS complex
106
How long is the PRI?
0.12-0.20 seconds
107
The QRS complex represents what?
Ventricular depolarization
108
The S wave is how long?
Less than 0.12 seconds
109
The ST segment is what?
Ventricles are depolarizes and repolarization begins
110
Elevation and/or depression of the ST segment is indicative of what?
An acute myocardial infarction
111
STEMI is what?
An elevated ST segment
112
Angina is what?
A depressed ST segment
113
The T wave represents what?
Ventricular repolarization
114
The T wave is what phase of the cardiac cycle?
Resting phase
115
The P wave is what?
Atrial depolarization
116
The QRS complex is what?
Atrial repolarization/ventricular depolarization
117
The T wave is what?
Ventricular repolarization
118
What are causes of sinus arrhythmia?
MI
Sick Sinus Syndrome
Medications
119
What are causes of sinister arrest?
```
Hypoxia
Ischemia
Damage to SA node
Acute MI
digitalis & salicylates
```
120
What are causes of atrial dysrrhythmia?
COPD
Digitontoxitity
Electrolyte imbalances
121
What are the 5 steps to interpret EKGs?
```
HR
Heart Rhythm
P wave
PRI
QRS Complex
```
122
What are causes of PACs?
```
Increased sympathetic tone
Digitalis toxicity
Hypoxia
Stimulants
Caffeine
```
123
How many PACs must happen for they to be called frequent?
More than 6
124
Two sequential PACs is called a…
Couplet
125
When every other beat is a PAC that is called…
Atrial bigemity
126
Every third beat being a PAC is called what?
Atrial trigemity
127
What is the reactivation of myocardial tissue for a second or subsequent time by the same impulse?
ReEntry dysrrhythmia
128
What causes the short circuit of electrical conduction?
A delay or block
129
What are causes of reentry dysrhythmias?
Hyperkalemia
Myocardial ischemia
Certain antidysrhythmia meds
130
What type of rhythms are reentry dysrhythmias?
```
A-flutter
A-fibrillation
PAC
PSVT
SVT
```
131
What are 3 characteristics of A-Fibrillation
There are no p waves
F waves replace p waves
Ventricle response is irregularly irregular
132
What are causes of Atrial fibrillation?
```
Heart disease
CHF
Rheumatic heart disease
Hypoxia
Digitalis toxicity
Electrolyte imbalance
```
133
When your patient is in A-fibrillation and their heart rate is greater than 100 they are considered ______ if their heart rate is less than 100 they are considered _______.
Unstable; stable
134
When you cardiovert a patient you use how many J?
50
