Cardiopulmonary review Flashcards

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1
Q

network of progressively smaller vessels that carry oxygenated blood to the myocardium

A

coronary arteries

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2
Q

valve between Right atria and Right ventricle

A

tricuspid

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3
Q

valve between Left atria and Left ventricle

A

mitral (bicuspid)

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4
Q

valve between Left ventricle and aorta

A

aortic

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5
Q

valve between Right ventricle and pulmonary artery

A

pulmonary valve

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6
Q

vein that returns blood from lower body and viscera to Right atrium

A

inferior vena cava

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7
Q

veins that carry oxygenated blood from Right and Left lungs to Left atrium

A

pulmonary veins

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8
Q

vein that returns venous blood from head, neck, arms to Right atrium

A

superior vena cava

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9
Q

arteries that carry deoxygenated blood from Right ventricle to Left and Right lungs

A

pulmonary arteries

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10
Q

lowest part of heart formed by inferolateral part of Left ventricle; at level of 5th intercostal space

A

apex

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11
Q

upper border of heart involving Left atrium, part of Right atrium, parts of great vessels; at level of 2nd intercostal space

A

base

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12
Q

thick contractile middle layer of muscle cells; forms bulk of heart wall

A

myocardium

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13
Q

double-walled connective tissue sac that surrounds outside of heart and great vessels

A

pericardium

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14
Q

body’ largest artery; arch, thoracic, abdominal

A

aorta

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15
Q

valve function

A

maintain unidirectional blood flow

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16
Q

normal pacemaker of heart

A

SA node

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17
Q

innervation to heart

A

vagus (parasympathetic), sympathetic nerves

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18
Q

sympathetic effects on heart
Name the neurotransmitters

A

increased rate, increased force of contraction
epinephrine and norepinephrine

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19
Q

parasympathetic influence on heart (via vagus nerve)
Name the neurotransmitter

A

slow HR-through influence on SA node
acetylcholine

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20
Q

closure of mitral and tricuspid valves

A

S1 (lub)

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21
Q

closure of aortic and pulmonary valves (dub)

A

S2

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22
Q

normal in healthy young children; abnormal in adults (may be associated with heart failure)
AKA?

A

S3
ventricular gallop

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23
Q

4th heart sound: may be associated with HTN, stenosis, hypertensive heart disease or MI
AKA?

A

S4
atrial gallop

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24
Q

at least 140 mmHg SBP OR at least 90 mmHg DBP

A

Stage 2 hypertension

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25
Q

130-139 mmHg SBP OR at least 80-89 mmHg DBP

A

Stage 1 hypertension

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26
Q

120-129 mmHg SBP AND <80 mmHg DBP

A

elevated BP

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27
Q

<120 mmHg SBP AND <80 mm Hg DBP

A

Normal BP

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28
Q

greater than 180 mmHg SBP and/or greater than 120 mmHg DBP

A

Hypertensive crisis

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29
Q

refers to tension in ventricular wall at end of diastole; reflects venous filling pressure that fills left ventricle during diastole

A

preload

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30
Q

refers to forces that impede flow of blood out of heart- primarily the pressure in the peripheral vasculature, compliance of the aorta, and mass and viscosity of blood

A

afterload

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31
Q

atrial systole

A

contraction of right and left atria pushing blood into ventricles

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32
Q

atrial diastole

A

period between atrial contractions when atria are repolarizing

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33
Q

ventricular systole

A

contraction of right and left ventricles pushing blood into pulmonary arteries and aorta

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34
Q

ventricular diastole

A

period between ventricular contractions when ventricles are repolarizing

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35
Q

stroke volume

A

refers to volume of blood ejected by each contraction of left ventricle; normal ranges from 60-80 ml–depends on age, sex, activity

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36
Q

cardiac output

A

amount of blood pumped from left or right ventricle per minute; equal to product of stroke volume and heart rate.
normal CO for adult male at rest=4.5-5.0 L/min (your text has slightly wider range), women slightly less
Can increase to 25 L/min during exercise

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37
Q

amount of blood that returns to Right atrium per minute
CV is closed loop, so this amount returning must equal CO when averaged over time

A

venous return

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38
Q

reflexes by which BP is maintained; these detect changes in pressure

A

baroreceptor

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39
Q

forced expiration against a closed glottis; sets off reflexes

A

Valsalva

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40
Q

moderate, bothersome angina

A

2 on anginal pain scale

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41
Q

most severe or intense chest pain ever experienced

A

4 on angina scale

42
Q

mild, barely noticeable chest pain

A

1 on angina pain scale

43
Q

moderately severe, very uncomfortable chest pain

A

3 on angina pain scale

44
Q

normal pH range

A

7.3-7.45 (7.4)

45
Q

indications for arterial blood gas assessment

A

evaluate acid-base status (pH), ventilation PaCO2), oxygenation of arterial blood (SaO2)

46
Q

adult normal range for SaO2

A

95-98%

47
Q

low level of O2 in arterial blood (PaO2<80mmHg)

A

hypoxemia

48
Q

low level of O2 in tissue despite adequate perfusion of tissue

A

hypoxia

49
Q

elevated level of CO2 in arterial blood (PaCO2>45mmHg)

A

hypercapnia

50
Q

low level of CO2 in arterial blood (PaCO2<35mmHg)

A

hypocapnia

51
Q

normal level of CO2 in arterial blood (PaCO2 35-45 mmHg)

A

eucapnia

52
Q

normal hemoglobin in adult males

A

13.3-16.2 gm/dL

53
Q

normal hemoglobin in adult females

A

12.0-15.8 gm/dL

54
Q

desirable total serum cholesterol (mg/dL)

A

<200

55
Q

HDL (“good” cholesterol–helps carry away “bad” cholesterol)

A

high-density lipoprotein

56
Q

LDL (“bad” cholesterol–associated with buildup of fatty plaques within arteries which reduce blood flow)

A

low-density lipoprotein

57
Q

percentage of red blood cells in total blood volume; low number may indicate anemia, blood loss, vitamin/mineral deficiencies

A

hematocrit

58
Q

INR; calculation based on prothrombin time (PT) test results; most often used to see how well warfarin (Coumadin) is working

A

international normalized ratio

59
Q

radiologic examination that injects contrast medium into blood vessels; can show locations of plaques in coronary arteries and extent of occlusion; a cardiac cath procedure

A

angiography

60
Q

used to visualize location, size, shape of heart/lungs/blood vessels/ribs/bones of spine; can revewl fluid in lungs or pleural space

A

chest radiograph

61
Q

thin catheter inserted into artery in arm or leg, advanced to coronary arteries where contrast dye is injected; can evaluate narrowing or occlusion of coronary arteries and measure BP in heart, also O2 in blood; some treatments are performed using this procedure

A

cardiac catheterization

62
Q

procedure for direct visualization of bronchial tree-for diagnostic and therapeutic purposes; can also remove tissue specimens by biopsy or bronchoalveolar lavage

A

bronchoscopy

63
Q

diagnostic test that uses an X-ray that rotates around a patient lying on a table-creates picture of organ and surrounding tissue (slices)

A

computed tomography (CT scan)

64
Q

uses high frequency sound waves non-invasively to evaluate functioning of heart; can provide info on size and function of ventricles, thickness of septums, functions of walls/valves/chambers

A

echocardiogram

65
Q

uses magnetic field and radio waves to create 3D images of heart and blood vessels to assess size and function of chambers, thickness and movement of walls, extent of damage caused by myocardial infarction or heart disease, structural problems in aorta, presence of plaques/blockages in blood vessels; also to image masses in mediastinum

A

magnetic resonance imaging (MRI)

66
Q

placed in pulmonary artery; measures pulmonary artery wedge pressure of left atrium (sensitive indirect measure of left ventricular function) and right atrial pressure
Can estimate left sided heart pressures (left-side measurements are more difficult/risky)

A

Swan-Ganz catheter (balloon catheter, pulmonary artery catheter)

67
Q

measures pressure in vena cava or right atrium

A

CVP line (central venous pressure)

68
Q

SOB in recumbent position

A

orthopnea

69
Q

substernal chest pressure, ofter accompanied by Levine sign (clutching chest over sternum)

A

angina

70
Q

sudden episode of SOB at night

A

paroxysmal nocturnal dyspnea

71
Q

1 MET equivalent

A

3.5 mL O2 /kg/min

72
Q

sternal precautions (general considerations-will vary by physician and possibly patient!)

A

applying sternal counter pressure (splinting) with cough/laugh/sneeze
limit driving
minimize/avoid UE use with sit to stand and reverse
avoid lifting/pushing/pulling >10pounds
limit shld flex/abd above 90 degrees when weighted
encourage shld pain-free AROM
avoid scap retraction past neutral
avoid trunk flex/rotation with supine to sit

73
Q

hemoglobin level at which caution should be used when exercising (stop or lower intensity)

A

8

74
Q

major complications following MI

A

recurrence of ischemia
LV failure
ventricular arrhythmias

75
Q

chest pain occurs at rest

A

unstable angina Pre-infarction, crescendo)

76
Q

chest pain occurs during exercise or activity

A

stable angina

77
Q

non-ST elevation myocardial infarction

A

NSTEMI

78
Q

ST elevation myocardial infarction

A

STEMI

79
Q

3 common presentations of ACS

A
  1. angina
    2.injury (presence of new acute MI)
  2. infarction (old heart attack with dead tissue that cannot be reversed–irreversible changes start to appear 20 minutes -2 hours from onset of myocardial ischemia)
80
Q

ACS

A

acute coronary syndrome (coronary artery disease or CAD is older term)

81
Q

condition in which blood flow (and thus oxygen) is restricted or reduced in a part of the body

A

ischemia

82
Q

positions to relieve dyspnea

A

forward leaning
forward leaning with arm support
reverse Trendelenberg (decreases weight of abdominal contents on diaphragm)
Semi-Fowlers (esp for CHF, other cardiac)

83
Q

technique to reduce respiratory rate, relieve dyspnea, maintain small positive pressure in bronchioles/prevent airway collapse
What is best position to begin?

A

PLB
Semi-Fowlers

84
Q

PTA applying firm pressure at end of exhalation over area of limited chest wall movement, then ask patient to inhale deeply attempting to expand rib cage under PTA’s hand
Can teach patient to do this!

A

segmental breathing

85
Q

3 phases of Active Cycle of Breathing technique

A
  1. breathing control
  2. thoracic expansion exercises
  3. forced expiratory technique
86
Q

QRS

A

ventricular depolarization

87
Q

P wave

A

atrial depolarization

88
Q

T wave

A

completion of ventricular repolarization

89
Q

9 on original Borg RPE scale

A

very light

90
Q

value that represents 70% max HR on Borg original RPE

A

13-14

91
Q

blood pressure that is consistently elevated at medical practitioner office readings but does not meet diagnostic criteria for hypertension based upon out-of-office home readings

A

White coat hypertension

92
Q

diagnosed when there is no known cause for the elevation in BP values and exists in approximately 90% to 95% of all patients with HTN

A

primary or essential hypertension

93
Q

irreversible changes start to appear how long after onset of ischemia

A

20 minutes to 2 hours from the onset of myocardial ischemia

94
Q

common symptom experienced with left-side heart failure; associated with pulmonary edema

A

dyspnea

95
Q

narrowing of a heart valve limiting the flow of blood through the valve

A

stenosis

96
Q

refers to the forward and backward movement of blood resulting from incomplete valve closure

A

regurgitation

97
Q

A run of four or more PVCs in a row

A

ventricular tachycardia (V tach)

98
Q

characterized by quivering of the ventricles resulting from inadequate electrical stimulation

A

ventricular fibrillation

99
Q

Room or hall ambulation up to 5 min as tolerated 3–4 times/day

A

2-2.5 METS

100
Q

refers to the performance of any activity within the limits or boundaries of that patient’s breathing capacity

A

activity pacing