Cardiopulm Flashcards
bainbridge reflex
increased venous return leads to increased HR through inhibiting vagus
what is normal blood volume?
4.5-5.0L
thrombocytopenia vs. thromobocythemia
decreased number of platelets vs too many; increased risk of bleeding vs. increased risk of thrombus: normal = 150-450; <20 AROM/ADLs only, 20-30 light exercise only, 30-50 moderate exercise
leukocytosis
abnormally high white blood cells - can indicate infection or leukemia
netrophils
protect against infection by ingesting bacteria/debris
tricuspid vs. mitral valve
R AV valve (try again) vs. L AV valve (my turn)
Conduction of the heart
SA node > AV node (junction of R/L atrium)> bundle of His >purkinje fibers
in what order is the fastest/slowest conductors of the heart
SA = 60-100bpm(pacemaker) > AV node = 40-60bpm > Purkinje 20-40bpm
normal ejection fractions
> 55%, the lower it is the more impaired the LV
hyperkalemia
increased concentration of K+ in blood - widens the PR interval and QRS
hypokalemia
decreased K+ causes flattened T waves, prolonged PR and QT intervals - arrhythmias, ventricular fibrillation
Hypercalcemia
increased calcium concentration - increases hearts actions
hypocalcemia
depresses hearts actions
hyper vs hypomagnesemia
hyper = calcium blocker, can lead to arrhythmias or cardiac arrest; hypo = ventricular arrhythmias, coronary artery vasospasm, and sudden death
Grading scale for pulse (0-4+)
0 = no pulse, not palpable; 1+ = diminished; 2+ = easily palpable; 3+ = full pulse/increased strength; 4+ = bounding pulse
Normal heart rate: adults, peds, infants
adults = 60-100bpm; peds = 60-140bpm; infants; 90-164bpm
Postural tachycardia syndrome (POTS)
Sustained heart rate increased of >30 bpm within 10min of standing
Auscultation landmarks: AorticV valve, Pulmonic valve, tricupsid valve, mitral valve
AorticV = 2nd R intercostal space; PV = 2nd L intercostal space; Tricupsid = 4th L intercostal space; Mitral = 5th L intercostal space midclavicular line
Heart sounds: S1 vs. S2
S1 = lub - closure of mitral & tricupid = systole; S2 = dub - closure of aortic & pulmonary = end of systole (beginning of diastole) - diastole falls between S2 and S1
thrill
abnormal tremor accompanied by a vascular or cardiac murmur - can feel on palpation
S3 vs. S4 sounds
S3 = soon after S2 during ventricular filling = indicative of LV heart failure (heart bumping against the chest wall); S4 = before S1 with ventricular filling - indicative of coronary artery disease (CAD), MI, or aortic stenosis
EEG Cardiac cycle - go!
P wave = atrial depolarization; P-R interval = SA node> purjikne fibers; QRS complex = ventricular depolarization; ST segment = ventricular repolarization; (QT interval = electrical systole)
How to calculate HR on a strip
count number of intervals between QRS complex in 6 sec strip
Premature ventricular contraction (PVC)
premature beat from the ventricle > EKG: no p wave, wide & bizzare QRS complex followed by a pause; bad = more than 6/minute
Ventricular tachycardia
Run of 3 or more PVCs in a row at a rapid rate of 150-200bpm; usually as a result of ventricular ischemia; nonsustained = stops in 30sec, sustained = doesn’t stop in 30 sec
Ventricular fibrillation
dude you got no pulse; no QRS complex
Atrial arrhythmia
P waves abnormal due to ectopic foci on the atria; atrial tachycardia = 140-250bpm; atrial flutter =250-350bpm; fibrillation >300bpm
how much ST segment elevation is considered abnormal
> 1mm
Digitalis & affect on ST segment
depresses ST, flattens T & shortens QT
beta blocker
decreases HR, blunts heart rate response to exercise; i.e Indera, lopressor
Nitrates
increase heart rate
anti-arrhythmic agents
prolong QRS and QT intervals
Orthostatic hypotension
drop in systolic >20, diastolic >10
Pediatric BP
<2yo: 106-110/59-63; 3-5yo: 113-116/67-74
Respiratory rate: adult, ped, infant
12-20; ped = 20-30; infant = 30-40
in general; ped BP and RR is 10 more than adult
Stages of hypertension
normal 120/80; pre: 120-139/80-89; stage 1: 140-159/90-99; stage 2: >160/>100; crisis: >180/>110; increases by 20’s for systolic & 10’s for diastolic
Anginal scale
1+ to 4+; 1+ = light, 2+ = moderate/bothersome; 3+; severe/uncomfortable; 4+ = most severe pain ever
Dyspnea Borg scale (NOT Borg RPE)
0-10; 3= moderate, severe starting at 5-6
Scale for Edema
1+ to 4+; 1+ = 30sec or more
Ankle Brachial Index Values
1.0-1.3 = normal; 0.80.99 = mild blockage; 0.4-0.79 = moderate blockage; <0.4 = severe PAD may have claudication ; >1.3 = non compliant arteries
Hemoglobin numbers (M/F)
M=13-18; F = 12-16
Hematocrit
M=45-52%; F = 37-48%
ACE inhibitors
decrease Na rentetion and peripheral vasoconstriction to decrease BP; captopril, enalopril, lisinopril
calcium channel blocking agents
inhibit flow of calcium ions, decrease HR, decrease contractility, dilate coronary arteries and reduce BP, control arthymmias
compression depth CPR adults, peds, infants
adults = >2in; peds = 1/3AP depth ~2in/5cm; infants = at least 1/3 AP depth, ~1.5in/4cm
compression: ventilation ratio for CPR
30:2, ventilate until visible chest rise
Phase of Korotkoff sounds correspond to what?
Phase I = SBP (clear tapping); Phase V = diastolic (sound disappears)
crackles are heard with which type of lung disease?
restrictive - atelectasis, pneumonia, brochietasis
