Cardiovascular Flashcards
——— is the most posterior part of the heart
LA
Enlargement of the LA (eg, in ———) can lead to compression of the ——— (causing ———) and/or the ———, a branch of the ———, causing ——— (I.e., ——— syndrome)
- mitral stenosis
- esophagus
- dysphagia
- left recurrent laryngeal nerve
- vagus nerve
- hoarseness
- Ortner
——— is the most anterior part of the heart and most commonly ———
- RV
- injured in trauma
——— is about 2/3 and ———— is about 1/3 of the inferior (diaphragmatic) cardiac surface
- LV
- RV
Pericardium consists of what 3 layers (from outer to inner):
Fibrous pericardium
Parietal pericardium
Epicardium (visceral pericardium)
Pericardial space lies between ——— and ———
parietal pericardium and epicardium
Pericardium innervated by ———; thus, pericarditis can cause referred pain to the ———
- phrenic nerve
- neck, arms, or one or both shoulders (often left)
LAD and its branches supply what 3 areas:
- anterior 2/3 of interventricular septum
- anterolateral papillary muscle
- anterior surface of LV
PDA supplies what 3 areas:
- posterior 1/3 of interventricular septum
- posterior 2/3 walls of ventricles
- posteromedial papillary muscle
——— supplies AV node and SA node; thus, infarct may cause ——— (I.e., ——— or ———)
- RCA
- nodal dysfunction
- bradycardia or heart block
——— supplies RV
Right (acute) marginal artery
——— is the most commonly occluded coronary artery
LAD
Define right-dominant circulation (most common):
PDA arises from RCA
Define left-dominant circulation:
PDA arises from LCX
Define codominant circulation:
PDA arises from both LCX and RCA
Coronary blood flow to LV and interventricular septum peaks in ———
early diastole
Coronary sinus runs in the ——— and drains into the ———
- left AV groove
- RA
S1 is ——— and is loudest at ———area
- mitral and tricuspid valve closure
- mitral
S2 is ——— and is loudest at ———
- aortic and pulmonary valve closure
- left upper sternal border
S3 is ———, is associated with ——— (eg, as seen in conditions like ———), is caused by turbulence from ———, and is best heard at ———. S3 is more common in ——— (but can be normal in ———).
- in early diastole during rapid ventricular filling phase
- increased filling pressures
- MR, AR, HF, thyrotoxicosis
- blood from LA mixing with increased ESV
- apex with patient in left lateral decubitus position
- dilated ventricles
- children, young adults, athletes, and pregnancy
S4 is in ———, is from turbulence caused by ———, and is best heard ———. S4 associated with ——— in atria and ——— in ventricle (eg, ———). S4 ——— if palpable. S4 common in ———.
- late diastole (“atrial kick”)
- blood entering stiffened LV
- at apex with patient in left lateral decubitus position
- high pressure
- noncompliance
- hypertrophy
- considered abnormal
- older adults
Kussmaul sign refers to ——— (normally, inspiration results in ———pressure yielding increased ——— and decreased ———)
- Paradoxical increase in JVP on inspiration
- negative intrathoracic
- venous return
- JVP
Kussmaul sign due to impaired ——— (I.e., cannot accommodate increased ——— during ———; thus, blood backs up into ———
- RV filling
- venous return
- inspiration
- vena cava
List 5 conditions associated with Kussmaul sign:
- constrictive pericarditis
- restrictive cardiomyopathy
- right HF
- massive pulmonary embolism
- right atrial or ventricular tumors
List the 7 parts of cardiac conduction pathway:
- SA node
- atria
- AV node
-bundle of His
- right and left bundle branches (left bundle branch divides into left anterior and posterior fascicles)
- Purkinje fibers
- ventricles
List in order speed of conduction of cardiac conduction system (fastest to slowest):
His-Purkinje > Atria > Ventricles > AV node
(He Parks At Ventura AVenue)
Bundle branch block is an interruption of ———, which results in affected ventricle ———
- conduction of normal left or right bundle branches
- depolarizes via slower myocyte-to-myocyte conduction from the unaffected ventricle, which depolarizes via the faster His-Purkinje system
Bundle branch block commonly due to ——— (eg, ——— or ———).
- degenerative changes
- cardiomyopathy or infiltrative disease
Normally, ——— closure occurs just before ——— closure, and the combination of these sounds make up S2. A physiologic split S2 occurs when the ——— by a great enough distance to allow both sounds to be heard separately, which occurs during ——— when increased ——— delays the closure of the ———
- AV
- PV
- AV sound precedes PV sound
- inspiration
- venous return to the right side of the heart
- pulmonic valve
In physiologic splitting of S2, ——— results in a drop in ——— leading to increased ———, increased ———, increased ———, and increased ——— ; thus, there is delayed ———
- Inspiration
- intrathoracic pressure
- venous return
- RV filling
- RV stroke volume
- RV ejection time
- closure of pulmonic valve
Along with main cause physiologic splitting of S2, this phenomenon is also related to decreased pulmonary ——— (I.e., increased capacity of the ———) which also occurs during ———, and contributes to delayed closure of ———
- impedance
- pulmonary circulation
- inspiration
- pulmonic valve
Wide splitting of S2 is seen in conditions that delay ——— (eg, ——— and ———), which causes delayed ——— (especially ———), with an exaggeration of normal splitting
- RV emptying
- pulmonic stenosis and right bundle branch block
- pulmonic sound
- on pulmonic sound
Fixed splitting of S2 is heard in ——— because there is a ——— resulting in increased ——— volumes leading to increased flow through ——— and delayed ——— (notably this is independent of ———)
- ASD
- left-to-right shunt
- RA and RV
- pulmonic valve
- pulmonic valve closure
- respiration
Paradoxical splitting of S2 is heard in conditions that ——— (eg, ——— and ———)
- delay aortic valve closure
- aortic stenosis and left bundle branch block
In paradoxical splitting of S2, the normal order of ——— is reversed: in paradoxical splitting ——— occurs before ———
- semilunar valve closure
- P2
- A2
