Cardiovascular

Question 1

Coronary Perfusion Pressure normal range

Answer 1

60-80mmHg

Question 2

Coronary blood flow remains constant when MAP is between…

Answer 2

60-140 (MAP)

Question 3

1. Middle layer of the heart muscle and 2. Muscle type

Answer 3

Myocardium; cardiac muscle

Question 4

1. Innermost layer of the heart and 2. Muscle type

Answer 4

Endocardium; smooth muscle

Question 5

Fluid filled sac around heart

Answer 5

Pericardium

Question 6

Cardiac tamponade is an extreme/potentially fatal presentation of…

Answer 6

Pericardial effusion

Question 7

Coronary arteries stem from where?

Answer 7

First branch off the aorta, closest to the aortic valve

Question 8

AtrioVentricular valves (in order)

Answer 8

TRI-cuspid before you BI-cuspid (Mitral)

Question 9

What is happening when you hear S1, lub?

Answer 9

AV valves closing

Question 10

AV valves close during…

Answer 10

Systole

Question 11

What is happening when you hear S2, dub?

Answer 11

Semilunar valves closing

Question 12

What are the semilunar valves?

Answer 12

Pulmonic and Aortic

Question 13

Semilunar valves close during…

Answer 13

Diastole

Question 14

VO2 refers to…

Answer 14

The actual volume of O2 in mL consumed per minute

Question 15

Gold standard measurement of cardio fitness in athletes?

Answer 15

VO2 max

Question 16

Coronary perfusion primarily occurs during what phase of the heart cycle?

Answer 16

Diastole

Question 17

What artery is commonly referred to as the “widow maker?”

Answer 17

Left Coronary Artery (LCA) or Left main artery

Question 18

What is the dominant supply of the AV node in 90% of the population?

Answer 18

RCA, right coronary artery

Question 19

What is the intrinsic rate of the Purkinje fibers?

Answer 19

20-40 bpm

Question 20

What is the intrinsic rate of the AV node?

Answer 20

40-60 bpm

Question 21

What is the intrinsic rate of the SA node?

Answer 21

60-100 bpm

Question 22

Autonomic nervous system consists of…

Answer 22

Sympathetic and parasympathetic nervous systems

Question 23

Sympathetic NS: Neuro and chemical receptors called “__________” receptors which are stimulated by chemical messengers known as “______________”

Answer 23

Adrenergic; catecholamines

Question 24

2 catecholamines in the Sympathetic NS

Answer 24

ADRENALine/epinephrine (hormone); NORepinephrine (primarily a NEUROtransmitter released in the brain but also released by adrenal* gland)

Question 25

3 types of adrenergic receptors:

Answer 25

Alpha, Beta I, Beta II

Question 26

Where are alpha receptors located?

Answer 26

Primarily on the vessels

Question 27

Sympathomimetic drugs (5) that stimulate alpha receptors (vasoconstriction)

Answer 27

Phenylephrine, norepinephrine, epinephrine, dopamine GREATER than 10mcg/kg/min, angiotensin II (synthetic)

Question 28

Beta I receptors are located primarily...

Answer 28

In the heart (you have 1 heart)

Question 29

Sympathomimetic drugs (3) that stimulate beta I receptors: (inotropic)

Answer 29

Epinephrine, DOPamine LESS than 10mcg/kg/min, DOButamine

Question 30

Beta II receptors are located where?

Answer 30

Bronchial and vascular smooth muscle (2 lungs)

Question 31

Beta II stimulants (4) that produce __________ and ________....

Answer 31

Bronchodilation; vasodilation; Epinephrine, dobutamine, albuterol, isoproterenol

Question 32

Parasympathetic system is controlled by what nerve?

Answer 32

Vagus nerve, cranial nerve 10

Question 33

What node in the heart does the vagus nerve innervate?

Answer 33

SA node

Question 34

What neurotransmitter activates the vagus nerve/parasympathetic system?

Answer 34

Acetylcholine (ACh)

Question 35

5 ways to stimulate the vagal response:

Answer 35

Gagging, holding breath, bearing down, immersing face in ice water, carotid sinus massage

Question 36

Anticholinergic (drug) means...

Answer 36

Inhibiting the parasympathetic system, vagolytic

Question 37

This anticholinergic drug treats what?

Answer 37

Atropine; symptomatic BRADYCARDIA

Question 38

How much atropine is given during ACLS?

Answer 38

0.5mg IVP

Question 39

Pressure =

Answer 39

Flow X resistance

Question 40

BP =

Answer 40

CO X Systemic Vascular Resistance

Question 41

Normal Cardiac Output (CO)

Answer 41

4-8 L/min

Question 42

Preload

Answer 42

Stretch on myofibrils at the end of diastole

Question 43

Right heart Preload is measured as...

Answer 43

CVP or right atrial pressure

Question 44

Left heart preload is measured as...

Answer 44

PAOP (pulmonary artery occlusive pressure) or Wedge pressure

Question 45

Factors that increase PAOP or Wedge pressure

Answer 45

Left heart issues (cardiac tamponade...)

Question 46

PAOP will be inaccurate if the PEEP is greater than...

Answer 46

10

Question 47

Afterload is the pressure that...

Answer 47

The ventricles must push against to open the semilunar valves

Question 48

Surprising pulmonary vasodilator:

Answer 48

Oxygen

Question 49

Hyperthermia temperature threshold

Answer 49

>38.5 degrees (101.3F)

Question 50

Normal EF range

Answer 50

55%-75%

Question 51

Normal MAP

Answer 51

70-105 (>65 goal)

Question 52

Pulse pressure =

Answer 52

Difference between systolic and diastolic pressure

Question 53

Normal pulse pressure range

Answer 53

30-50

Question 54

Example of an event causing narrowed pulse pressure

Answer 54

Cardiac tamponade

Question 55

What happens during the P wave

Answer 55

SA node fires, atrial depolarization, atrial contraction

Question 56

What happens during QRS

Answer 56

AV node fires, ventricular depolarization and systole/contraction

Question 57

What happens during T wave

Answer 57

Ventricular REpolarization, relaxation, diastolic filling

Question 58

ST segment is time from...

Answer 58

Ventricular depolarization to complete repolarization

Question 59

ST elevation indicates

Answer 59

Myocardial injury

Question 60

ST depression indicates

Answer 60

Myocardial ischemia

Question 61

Rewatch which video

Answer 61

electrocardiography

Question 62

S3 sound, ventricular gallop

Answer 62

Lub-dup-da (slo-shing IN)

Question 63

S3 happens when...

Answer 63

Blood is being forced into a distended ventricle, suggests fluid overload, CHF

Question 64

S4 sound, atrial gallop

Answer 64

Da- lub dup (A stiff-wall)

Question 65

S4 happens when...

Answer 65

Blood is being forced into a stiff hypertrophic ventricle

Question 66

Order of murmur locations

Answer 66

A, P, T, M (upardonme)

Question 67

Lub - Murmur - Dup

Answer 67

Systolic murmur

Question 68

Lub - Dup - Murmur

Answer 68

Diastolic murmur

Question 69

Normal CVP values

Answer 69

2-8 mmHg

Question 70

PA waves

Answer 70

A, C, V

Question 71

PA A wave indicates

Answer 71

Left atrial contraction

Question 72

PA C wave indicates

Answer 72

Closure of mitral valve

Question 73

PA V wave indicates

Answer 73

Left ventricular systole, passive filling of left atrium during atrial diastole

Question 74

Elevated V wave indicates

Answer 74

Mitral regurgitation (pressure in left atrium)

Question 75

PAOP measures pressure in what chamber of the heart

Answer 75

Left atrium

Question 76

CVP money

Answer 76

Nickel

Question 77

RVP money

Answer 77

Quarter / nickel

Question 78

PAP money

Answer 78

Quarter / dime

Question 79

PAOP money

Answer 79

Dime

Question 80

LVP money

Answer 80

1 dollar / dime

Question 81

What is the fifth vital sign?

Answer 81

SvO2 (mixed venous oxygen saturation)

Question 82

SvO2 is drawn off of what line?

Answer 82

PA catheter

Question 83

Normal SvO2 range

Answer 83

60-80%

Question 84

High SvO2 values (>80%) indicate what?

Answer 84

Body is not consuming enough oxygen or it is receiving too much

Question 85

4 causes of decreased oxygen extraction at tissue level

Answer 85

Early sepsis, cyanide toxicity, left shift/high PH, hypothermia

Question 86

High pH makes blood ______ for ______

Answer 86

Sticky; oxygen

Question 87

IABP both augments ____________, and improves ________ blood flow

Answer 87

Diastolic BP; coronary

Question 88

2 types of pulmonary edema

Answer 88

Cardiogenic; non cardiogenic

Question 89

PAP, MPAP, or PAOP >__mmHg are HIGH

Answer 89

>30

Question 90

Cardiac related causes of pulmonary edema

Answer 90

LV dysfunction; hypertensive crisis (huge after-load impedes forward flow)

Question 91

After carotid endarterectomy, BP should stay below:

Answer 91

160mmHg (between 100 and 150)

Question 92

Hallmark signs of cardiac tamponade ("______ triad")

Answer 92

Beck's triad; elevated CVP/JVD, HoTn, Muffled heart sounds

Question 93

Pulsus paradoxus (seen in cardiac tamponade)

Answer 93

DECREASE in SBP (>10mmHg) during INSPIRATION

Question 94

Normal Cardiac index:

Answer 94

2.5-4.o L/min/m2

Question 95

Wedge pressure greater than ___ indicates a degree of _______________________

Answer 95

>15mmHg; left sided heart failure

Question 96

Normal level of BNP

Answer 96

125

Question 97

Aldosterone is excreted by the Renal ______ and causes the renal tubules to retain ___ and ______

Answer 97

Cortex; sodium and water (And excrete potassium to maintain electrolyte balance)

Question 98

BNP serves as a counter-regulatory system for the ____

Answer 98

RAAS (renin angiotensin aldosterone system)

Question 99

Avoid _________ with HOCM (hypertrophic obstructive cardiomyopathy)

Answer 99

Inotropes

Question 100

Main 3 ways to manage heart failure

Answer 100

Reduce preload, reduce afterload, improve contractility