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Cardiovascular Flashcards

1
Q

Coronary Perfusion Pressure normal range

A

60-80mmHg

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2
Q

Coronary blood flow remains constant when MAP is between…

A

60-140 (MAP)

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3
Q
  1. Middle layer of the heart muscle and 2. Muscle type
A

Myocardium; cardiac muscle

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4
Q
  1. Innermost layer of the heart and 2. Muscle type
A

Endocardium; smooth muscle

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5
Q

Fluid filled sac around heart

A

Pericardium

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6
Q

Cardiac tamponade is an extreme/potentially fatal presentation of…

A

Pericardial effusion

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7
Q

Coronary arteries stem from where?

A

First branch off the aorta, closest to the aortic valve

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8
Q

AtrioVentricular valves (in order)

A

TRI-cuspid before you BI-cuspid (Mitral)

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9
Q

What is happening when you hear S1, lub?

A

AV valves closing

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10
Q

AV valves close during…

A

Systole

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11
Q

What is happening when you hear S2, dub?

A

Semilunar valves closing

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12
Q

What are the semilunar valves?

A

Pulmonic and Aortic

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13
Q

Semilunar valves close during…

A

Diastole

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14
Q

VO2 refers to…

A

The actual volume of O2 in mL consumed per minute

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15
Q

Gold standard measurement of cardio fitness in athletes?

A

VO2 max

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16
Q

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

A

Diastole

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17
Q

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

A

Left Coronary Artery (LCA) or Left main artery

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18
Q

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

A

RCA, right coronary artery

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19
Q

What is the intrinsic rate of the Purkinje fibers?

A

20-40 bpm

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20
Q

What is the intrinsic rate of the AV node?

A

40-60 bpm

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21
Q

What is the intrinsic rate of the SA node?

A

60-100 bpm

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22
Q

Autonomic nervous system consists of…

A

Sympathetic and parasympathetic nervous systems

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23
Q

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

A

Adrenergic; catecholamines

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24
Q

2 catecholamines in the Sympathetic NS

A

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

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25
Q

3 types of adrenergic receptors:

A

Alpha, Beta I, Beta II

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26
Q

Where are alpha receptors located?

A

Primarily on the vessels

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27
Q

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

A

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

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28
Q

Beta I receptors are located primarily…

A

In the heart (you have 1 heart)

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29
Q

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

A

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

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30
Q

Beta II receptors are located where?

A

Bronchial and vascular smooth muscle (2 lungs)

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31
Q

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

A

Bronchodilation; vasodilation; Epinephrine, dobutamine, albuterol, isoproterenol

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32
Q

Parasympathetic system is controlled by what nerve?

A

Vagus nerve, cranial nerve 10

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33
Q

What node in the heart does the vagus nerve innervate?

A

SA node

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34
Q

What neurotransmitter activates the vagus nerve/parasympathetic system?

A

Acetylcholine (ACh)

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35
Q

5 ways to stimulate the vagal response:

A

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

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36
Q

Anticholinergic (drug) means…

A

Inhibiting the parasympathetic system, vagolytic

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37
Q

This anticholinergic drug treats what?

A

Atropine; symptomatic BRADYCARDIA

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38
Q

How much atropine is given during ACLS?

A

0.5mg IVP

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39
Q

Pressure =

A

Flow X resistance

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40
Q

BP =

A

CO X Systemic Vascular Resistance

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41
Q

Normal Cardiac Output (CO)

42
Q

Preload

A

Stretch on myofibrils at the end of diastole

43
Q

Right heart Preload is measured as…

A

CVP or right atrial pressure

44
Q

Left heart preload is measured as…

A

PAOP (pulmonary artery occlusive pressure) or Wedge pressure

45
Q

Factors that increase PAOP or Wedge pressure

A

Left heart issues (cardiac tamponade…)

46
Q

PAOP will be inaccurate if the PEEP is greater than…

47
Q

Afterload is the pressure that…

A

The ventricles must push against to open the semilunar valves

48
Q

Surprising pulmonary vasodilator:

49
Q

Hyperthermia temperature threshold

A

> 38.5 degrees (101.3F)

50
Q

Normal EF range

51
Q

Normal MAP

A

70-105 (>65 goal)

52
Q

Pulse pressure =

A

Difference between systolic and diastolic pressure

53
Q

Normal pulse pressure range

54
Q

Example of an event causing narrowed pulse pressure

A

Cardiac tamponade

55
Q

What happens during the P wave

A

SA node fires, atrial depolarization, atrial contraction

56
Q

What happens during QRS

A

AV node fires, ventricular depolarization and systole/contraction

57
Q

What happens during T wave

A

Ventricular REpolarization, relaxation, diastolic filling

58
Q

ST segment is time from…

A

Ventricular depolarization to complete repolarization

59
Q

ST elevation indicates

A

Myocardial injury

60
Q

ST depression indicates

A

Myocardial ischemia

61
Q

Rewatch which video

A

electrocardiography

62
Q

S3 sound, ventricular gallop

A

Lub-dup-da (slo-shing IN)

63
Q

S3 happens when…

A

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

64
Q

S4 sound, atrial gallop

A

Da- lub dup (A stiff-wall)

65
Q

S4 happens when…

A

Blood is being forced into a stiff hypertrophic ventricle

66
Q

Order of murmur locations

A

A, P, T, M (upardonme)

67
Q

Lub - Murmur - Dup

A

Systolic murmur

68
Q

Lub - Dup - Murmur

A

Diastolic murmur

69
Q

Normal CVP values

70
Q

PA waves

71
Q

PA A wave indicates

A

Left atrial contraction

72
Q

PA C wave indicates

A

Closure of mitral valve

73
Q

PA V wave indicates

A

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

74
Q

Elevated V wave indicates

A

Mitral regurgitation (pressure in left atrium)

75
Q

PAOP measures pressure in what chamber of the heart

A

Left atrium

76
Q

CVP money

77
Q

RVP money

A

Quarter / nickel

78
Q

PAP money

A

Quarter / dime

79
Q

PAOP money

80
Q

LVP money

A

1 dollar / dime

81
Q

What is the fifth vital sign?

A

SvO2 (mixed venous oxygen saturation)

82
Q

SvO2 is drawn off of what line?

A

PA catheter

83
Q

Normal SvO2 range

84
Q

High SvO2 values (>80%) indicate what?

A

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

85
Q

4 causes of decreased oxygen extraction at tissue level

A

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

86
Q

High pH makes blood ______ for ______

A

Sticky; oxygen

87
Q

IABP both augments ____________, and improves ________ blood flow

A

Diastolic BP; coronary

88
Q

2 types of pulmonary edema

A

Cardiogenic; non cardiogenic

89
Q

PAP, MPAP, or PAOP >__mmHg are HIGH

90
Q

Cardiac related causes of pulmonary edema

A

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

91
Q

After carotid endarterectomy, BP should stay below:

A

160mmHg (between 100 and 150)

92
Q

Hallmark signs of cardiac tamponade (“______ triad”)

A

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

93
Q

Pulsus paradoxus (seen in cardiac tamponade)

A

DECREASE in SBP (>10mmHg) during INSPIRATION

94
Q

Normal Cardiac index:

A

2.5-4.o L/min/m2

95
Q

Wedge pressure greater than ___ indicates a degree of _______________________

A

> 15mmHg; left sided heart failure

96
Q

Normal level of BNP

97
Q

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

A

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

98
Q

BNP serves as a counter-regulatory system for the ____

A

RAAS (renin angiotensin aldosterone system)

99
Q

Avoid _________ with HOCM (hypertrophic obstructive cardiomyopathy)

100
Q

Main 3 ways to manage heart failure

A

Reduce preload, reduce afterload, improve contractility

CCRN (4 decks)

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