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562 > Cardiopulmonary System > Flashcards

Cardiopulmonary System Flashcards

1
Q

What are the 2 layers of the pericardium

A 
Epicardium
2nd layer (unnamed)
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2
Q

What does the epicardium do

A

facilitates contraction and relaxation (outer later)

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3
Q

What does the 2nd layer do

A

directly surrounds heart muscle

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4
Q

What is the myocardium

A

middle later of heart

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5
Q

what is the endocardium

A

the inner layer of the heart

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6
Q

What does the endocardium do

A

helps mediate flow

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7
Q

What is the function of heart valves

A

controls blood flow from atria to ventricles and the ventricles into 2 larger arteries

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8
Q

Heart valves

A

Tricuspid
Pulmonary
Mitral
Aortic

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9
Q

Where is the tricuspid valve

A

right side b/t right atrium and the right ventricle

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10
Q

Where is the pulmonary valve

A

right side of the heart b/t right ventricle and the entrance to the pulmonary artery which carries blood to the lungs

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11
Q

Where is the mitral valve

A

left side of heart b/t the left atrium and the left ventricle

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12
Q

Where is the aortic valve

A

left side of the heart b/t the left ventricle and the entrance to the aorta which carries blood to the body

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13
Q

What is the cardiac cycle

A

sequence of events occurring during one complete heartbeat or contraction-relaxation sequence

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14
Q

What is systole

A

contract and eject

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15
Q

what is diastole

A

relax and filling

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16
Q

Order of the cardiac cycle

A
  • Venous blood flows from the R atrium through tricuspid and into the R ventricle during diastole
  • During systole blood from R ventricle is pushed through the pulmonic valve into pulmonary arterial circulation where it’s oxygenated
  • oxygenated blood returns through pulmonary veins to L atrium
  • Then through mitral valve into L ventricle during diastole
  • During systole, L ventricular volume is ejected through the aortic valve into aorta and systemic arterial circulation
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17
Q

What is not in cardiac muscle

A

nerves

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18
Q

What is in cardiac muscle instead of nerves

A

structures that assist the ventricles to contract

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19
Q

Where do conduction pathways originate

A

SA (sinoatrial) node

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20
Q

What is the SA node

A

Hearts natural pacemaker

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21
Q

What does the SA node do

A

generates the 1st impulses initiating the cardiac cycle a basic rate

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22
Q

What is the basic heart rate known as

What is it

A

Sinus rhythm

70 beats/min

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23
Q

What happens upon contraction of the SA node

A

both atria contract forcing blood into the ventricles. Impulses then pass to the AV node

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24
Q

Where does the AV node pass the impulse

A

To the bundle of His. There’s a slight delay to allow ventricles to fill. From the bundle of his fibers branch off into R and L bundles and split into Purkinje fibers

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25
Q

What stimulates the ventricles to contract

A

impulse from the purkinje fibers

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26
Q

What is a ECG/EKG

A

Test electrical activity in the heart

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27
Q

What does depolarization do

A

takes away from the resting membrane potential

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28
Q

What does repolarization do

A

Taking back to resting potential

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29
Q

What is HR and force of contraction controlled by

A

the medulla

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30
Q

What is tachycardia

A

increase in HR caused by sympathetic NS

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31
Q

What is bradycardia

A

Decrease in HR caused by parasympathetic NS or vagus N stimulation

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32
Q

What factors contribute to increased HR

A

increase in body temp, env temp
exercise
smoking
any stimulation of the CNS

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33
Q

What is normal blood pressure

A

Systolic= less than 120

Diastolic=less than 80

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34
Q

What is prehypertension BP range

A 
systolic= 120-139
Diastolic= 80-89
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35
Q

What are the ranges for stage 1 high BP

A 
systolic= 140-159
diastolic= 90-99
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36
Q

What are the BP ranges for stage 2 high BP

A 
systolic= 160 or higher 
diastolic= 100 or higher
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37
Q

What is coronary artery disease secondary to

A

atherosclerosis (narrowing of the coronary arteries due to build up of plaque)

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38
Q

What does coronary artery disease lead to

A

reduced blood flow, reduction of nutrients and oxygen to the heart

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39
Q

What is the leading cause of death in the US

A

Coronary artery disease

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40
Q

What are risk factors for coronary artery disease

A 
genetics/fam hx
obesity
smoking
sedentary lifestyle
diabetes
hypertension
combination of oral contraceptives
smoking
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41
Q

What are the clinical manifestations of coronary artery disease

A 
Angina
Nausea/vomiting
diaphoresis (excessive sweating)
fatigue
pallor
cool extremities
SOB
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42
Q

What is angina

A

pressure, tightness, squeezing in the chest, chest pain can be felt in jaw, neck, left arm

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43
Q

When does angina occur

A

when there is a deficit of oxygen to the heart muscle

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44
Q

What is the tx for angina

A

rest
medication
avoidance of exertion and precipitating events

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45
Q

What are the 2 types of angina

A

Stable

unstable

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46
Q

What is stable angina

A

most common
usually associated with an activity
resolves after a few min of rest/meds

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47
Q

What is unstable angina

A

no pattern
not triggered by an activity
doesn’t resolves
emergent care required (may be signaling a heart attack)

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48
Q

What is atherosclerosis

A

plaque builds up inside the walls of larger arteries (aortic or pulmonary)

49
Q

What is arteriosclerosis

A

build up of plaque in the small blood vessels which feed the heart

50
Q

What is the etiology of athero/arteriosclerosis

A 
age
men
genetics
obesity
smoking
sedentary lifestyle
diabetes
hypertension
oral contraceptives and smoking together
51
Q

What are the clinical signs of athero/arteriosclerosis

A

lead to CAD
peripheral artery disease (narrowing of limbs and pelvis)
CVA
HTN
Aneurysms (thoracic aortic or abdominal aortic)

52
Q

Where does an aortic aneurysm occur

A

upper part of the aorta

53
Q

Where does an abdominal aorta occur

A

lower part of the aorta

54
Q

Med intervention and tx for athero/arteriosclerosis

A

diet/exercise
lifestyle changes
control of diabetes/hypertension
surgery

55
Q

Kinds of surgery for athero/arteriosclerosis

A

Endartectomy
angioplasty
bypass (CABG)

56
Q

What is a endartectomy

A

scraping and cleaning out plaque in artery

57
Q

What is an angioplasty

A

use a balloon to open blockage in artery, then place stent to keep artery open

58
Q

What is bypass

A

use a healthy blood vessel from another part of the body and connect the artery to other arteries in the heart so blood is able to pass around the blocked area

59
Q

What are the 2 most common veins used in bypass

A

saphenous

mammary artery

60
Q

What is myocardial infarction

A

Heart attack

61
Q

When does Myocardial infarction occur

A

when a coronary artery is totally obstructed (due to plaque) leading to prolonged ischemia and cell death

62
Q

Signs and symptoms of myocardial infarction

A

pain (below sternum, chest, left arm, neck, steady and severe)
pallor, sweating, nausea, dizziness, weakness, dyspenea
marked anxiety and fear
hypotension, rapid pulse
low grade fever
enzymes from damaged/dead myocardial cells aer released into blood (one way to dx after it occurred)

63
Q

Prevention and tx of myocardial infarction

A 
modify risk factors
low does aspirin daily
drugs to decrease lipid levels
coronary bypass surgery
immediate coronary angioplasty 
meds (nitrates, beta blockers, calcium channel blockers)
64
Q

What is the prognosis for myocardial infarction

A

of those who die, 60% do in the 1st hour

long term based n preexisting conditions

65
Q

How long can it take to heal heart muscle

A

4-8weeks

66
Q

what should early activity be like after MI

A

Not exceed 1-2 mets

67
Q

What do nitrates do

A

increase o2 to heart

68
Q

what do beta blockers do

A

reduce workload of heart

69
Q

what do calcium channel blockers do

A

decrease BP

70
Q

What are normal resting heart rates

A

60-100 bpm

71
Q

what is the etiology of cardiac arrhythmias

A 
damage to heart
electrolyte abnormalitiesfever
hypoxia
stress
infection
drug toxicity
caffeine
72
Q

What is atrial flutter

how do you treat it

A

HR 250-350 BPM

treat w/ meds, cardioversion (shock heart)

73
Q

What is atrial fibrillation

A

rates over 350 BPM

74
Q

What is the most common sustained arrhythmia

A

atrial fibrillation

75
Q

What is atrial fibrillation associated w/

A

CHF

76
Q

How to tx atrial fibrillation

A

pacemaker
meds
cardioversion
ablation (rake off diseased heart muscle)

77
Q

What is ventricular flutter and fibrillation

A

rapid rhythm 250 r more bpm

originating in ventricles

78
Q

What is ventricular flutter and fibrillation associated with

A

MI

79
Q

How to treat ventricular flutter and fibrillation

A 
CPR
defibrillation (aed)
80
Q

What is flutter

A

still some blood being ejected from heart

81
Q

what is fibrillation

A

no blood being ejected leading to cardiac death

82
Q

What is tachycardia

A

abnormal rapid rhythm

sinus rhythm exceeding 100 beat/min

83
Q

What causes tachycardia

A

response to stress
excessive caffeine and tobacco use
heart disease

84
Q

What are the clinical manifestations of tachycardia

A 
palpitations
lightheaded
dizzy
chest pain 
fatigue
85
Q

Tx fro tachycardia

A 
stress management
decrease tobacco caffeine use 
sedation
vagal stim (slows hr through implanted device)
meds
86
Q

what is the prognosis of tachycardia

A

good in absence of heart disease

87
Q

What is bradycardia

A

hr of less that 60 beats/min

88
Q

when does badycardia occur

A

naturally duing rest and sleep

89
Q

signs and symptoms of bradycardia

A

usually asymptomatic
confusion
hypotension

90
Q

When does congestive heart failure occur

A

when cardiac output isn’t sufficient to meet the metabolic demands of the body
secondary to another condition

91
Q

CHF is what kind of condition

A

Chronic

92
Q

Risk factors for CHF

A

aging
disorders of heart and other organs
abnormal congenital anatomy

93
Q

clinical manifestations of CHF

A 
Fatigue and weakness
dyspenea (SOB)
exercise intolerance
cold intolerance
tachycardia
pallor
daytime oliguria (decreased urine output)
cough
edema in feet and legs
hepatomegaly (enlarged liver)
splenomegaly (enlarged spleen)
headaches
flushed face
paroxysmal nocturnal  dyspnea (frothey blood stained sputum)
94
Q

etiology of CHF

A

increased pre-load
decreased pre-load
increased after loading
decreased contractibility

95
Q

What is increased pre-load

A

fluid backs up into lungs (edema may be present in ankles and feet)

96
Q

what is decreased pre-laod

A

fluid continues to back u causing the ehart to pump out less fluid and heart starts to enlarge. L ventricle pumps out less fluid and theres more back up into the body and heart

97
Q

What is increased after loading

A

heart unable to eject fluid comlpetely which results in decreased o2 to heart, enlargement of heart. (LEFT VENTRICLE BECOMES WEAKER FORCE)

98
Q

What are causes of decreased contractibility

A

atherosclerosis
degenerative changes of aging
necrosis of myocarium due to MI

99
Q

What is a result of CHF

A

increased metabolic demands

affects kidneys ability to dispose of sodium and water which leads to furhter edema

100
Q

Tests for CHF

A

radiographs (chest xray)

arterial blood gases

101
Q

What do arterial blood gases do

A

used to determine how well your lungs move o2 into the blood and remove CO2 from the blood

102
Q

Tx for CHF

A 
tx underlying problems as able
meds
counseling and edu regarding lifestle 
life style changes (diet/exercise)
ronary artery bypass graft, angioplasty
103
Q

What is cardiomyopathy

A

impairment of cardiac contraction due to primary diesease of myocardium
weakened and enlarged heart muscle

104
Q

What causes cardiomyopathy

A 
virus 
alcohol consumption
pregnancy (last trimester, proteins leak from uterine muscles)
long standing HTN 
infection
105
Q

Clinical manifestations of Cardiomyopathy

A

same as CHF

often asymptomatic

106
Q

Prevention and tx for cardiomyopathy

A

lifestlye changes

tx underlying problems

107
Q

What is hypertension

A

BP consistently over 140/90

108
Q

Three categories of hypertension

A

primary or essential
secondary
malignant

109
Q

What causes primar hypertension

A

idiopathic

110
Q

what causes secondary hypertension

A

from renal or endocrine disease, pregnanc

111
Q

What causes malignant hypertension

A

uncoontrollable
severe
progressive

112
Q

What causes hypertension

A 
age 60+
men
african american
excessive alcohol intake
obesity
prolonged or recurrent stroke
genetic
113
Q

Signs and symptoms of hypertension

A 
asymptomatic
fatigue
malaise
headache
elevated BP
high risk for CVA, PVD
114
Q

What is rate of perceived exertion

A

allows pt to self monitor how they tolerate activities or exercise
ordinal scale from 6-20

115
Q

What is the most widely used RPE scles

A

Borgs

116
Q

What to do for OT

A 
eval and analyze pt occupations
psychosocial adjustment (may have depression, fear, anxiety)
edu/lifestye changes
work simplification
energy conservation
raelaxation/stress mngmt
edu/prevention
home program 9strength and endurance)
monitor BP, HR, vitals
117
Q

Cardiac rehab phases

A

Phase 1- in pt
phase 2- formal out pt rehab
phase 3- ongoing more independent exercise

118
Q

What are the layers of the heart

A

Pericardium
Myocardium
Endocardium

562 (14 decks)

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