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Health Status > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Where is the heart located?

A

Mediastinum of thoracic cavity
Top at 3rd costal cartilage
Apex between 4th and 5th rib

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2
Q

What is the outer layer of the heart?

A

Epicardium (visceral layer of serous pericardium)
Contains nerves, vessels and fat for protection

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3
Q

What is the middle layer of the heart?

A

Myocardium
Thickest layer
Specialised interconnected muscle cells perform contraction

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4
Q

What is the inner layer of the heart?

A

Endocardium
Lines the chambers
Smooth surface for blood flow

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5
Q

What is the pericardium?

A

Protective sac around heart
Together with pericardial cavity (gap between pericardium and epicardium) allows it to beat without friction or injury

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6
Q

What are the layers of the pericardium?

A

Fibrous pericardium: dense connective tissue to protect, support and anchor to sternum and diaphragm

Serous pericardium: has two layers - parietal (lines fibrous layer) and visceral (continual with epicardium)

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7
Q

What is automaticity?

A

Heart cells ability to generate an impulse without stimulation

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8
Q

What are cardiac fibroblasts?

A

Cells that support structure and aide in transmitting impulses

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9
Q

What are cardiac myocytes?

A

Specialised interconnected cells which create heart contraction and relaxation

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10
Q

What are cardiac endothelial cells?

A

Form endocardium to line chambers and regulate substance exchange

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11
Q

What are cardiac conducting cells?

A

Specialised cells generate impulses

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12
Q

What valves separate atria from ventricles?

A

Atrioventricular valves
Tricuspid on the right
Mitral (bicuspid) on the left

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13
Q

What valves separate ventricles from large vessels?

A

Semilunar
Pulmonary valve and aortic valve

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14
Q

What is the pulmonary circulatory system?

A

DeO2 blood enters vena cavas, RA, through tricuspid valve, RV, pulmonary valve, PA, lungs, PV
Blood is now O2

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15
Q

What is the systemic circulatory system?

A

O2 blood enters LA, through mitral valve, LV, aortic valve, aorta to whole body

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16
Q

What is the function of heart valves?

A

Prevent back flow of blood during systole
Chordae tendinae and papillary muscles help reinforce valves

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17
Q

Define cardiac output

A

Amount of blood pumped by heart per minute

CO = SV x HR

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18
Q

What is SV?

A

Stroke volume
Amount of blood pumped by the LV per beat (ml)

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19
Q

What 3 factors influence SV?

A

Preload - amount of blood returned to the heart influences stretch/recoil ability
Contractile force - strength of contraction influenced by calcium
After load - amount of resistance LV has to overcome to eject blood out

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20
Q

What is blood pressure?

A

The force exerted on the walls of vessels

BP = CO x total vascular resistance

Also influenced by blood volume, vessel elasticity and vessel diameter

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21
Q

How do you manually measure BP?

A

Sphygmomanometer and stethoscope over brachial artery
Inflate cuff until all sounds gone then start letting down slowly
First sound to return called korotkoff sounds and is systolic
When sound disappears again that is diastolic

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22
Q

What are the 3 stages of hypertension?

A

1: >140
2: >160
3: >180

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23
Q

What is the pathway of electrical impulse through the heart?

A

SA node depolarises causing atrial contraction
AV node delays signal to allow atrium to empty
Signal reaches Bundle of His, L and R branches and purkinje fibres causing ventricles to contract

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24
Q

What happens at each part of the ecg?

A

P: atrial depolarisation/contract
QRS: ventricular depolarisation/contract
T: ventricular repolarisation/relax

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25
Q

What intrinsic factors affect cardiac cycle?

A

Automaticity of cardiac cells (fail safe if no impulse received)
Highest intrinsic rate at SA and decreases at each point thereafter

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26
Q

What extrinsic factors affect cardiac cycle?

A

ANS
Baroreceptors
Endocrine hormones
Atrial natriuretic peptide (released from atrial cells to reduce CO if blood volume or stretch too high)

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27
Q

Describe arteries

A

Carry oxygenated blood away from heart
Muscular and elastic
Branch into arterioles and capillaries

28
Q

Describe veins

A

Carry deoxygenated blood back to the heart
Contain valves to prevent back flow
Connect to capillaries via venules

29
Q

Describe capillaries

A

Site of gas exchange
Single endothelial cell layer wall for maximum exchange

Basement membrane surrounds for structural support
Pericytes are contractile cells to contract and relax

30
Q

What are the layers of vessels?

A

Tunica intima: smooth internal layer for flow
Tunica media: muscular middle layer to change diameter and give strength/support
Tunica adventitia: fibrous outer layer for protection

31
Q

What are the four sections of the aorta?

A

Ascending
Arch
Thoracic
Abdominal (bifurcates into L/R femoral arteries)

32
Q

What 3 factors aide in blood flow through veins?

A

Valves
Skeletal muscle pump action
Thoracic pump action via breathing creating pressure changes in the chest

33
Q

What is an abdominal aortic aneurysm?

A

Bulge in the wall of the abdominal aorta
SX: back/abdo pain, pulsating feeling in abdomen, unequal BP on each side

34
Q

What is a DVT?

A

Thrombus in a deep vein caused by disruption of flow, injury or increased clotting
May lead to PE and post thrombotic syndrome

SX: swell, pain, red, warm

35
Q

How much blood do adults have?

A

70ml/kg

36
Q

What is the ratio of cells comprising blood?

A

55% plasma
45% RBC
<1% WBC and platelet

37
Q

What are erythrocytes?

A

RBC
Contain haemoglobin to transport O2

38
Q

What are leukocytes?

A

WBC
Identify and destroy invaders; produce antibodies

39
Q

What are thrombocytes?

A

Platelets
Small fragments derived from megakaryocytes produce plug to stop bleeding

40
Q

How do RBC transport O2?

A

Haemoglobin molecule has 4 subunits (Heme group) each with an Fe molecule where oxygen binds
Disk shape and no nucleus improves surface area for better gas exchange

41
Q

What is carbaminohaemoglobin?

A

Product of CO2 bound to haemoglobin

42
Q

What controls production and maintenance of RBC?

A

Process called erythropoiesis regulated by kidney hormone erythropoietin
Occurs in marrow
RBC lasts 120 days then recycled by liver/spleen

43
Q

What is anaemia?

A

Low number of RBC or haemoglobin
Caused by blood loss, RBC destruction (autoimmune, infection) or reduced production (low iron, disease)
SX: fatigue, dizzy, palpitation, SOB

44
Q

What are the 6 functions of blood?

A

Oxygen and nutrient transport
CO2 and waste removal
Immune defence
Clotting
Regulation of temperature
Transport hormones etc

45
Q

How do blood groups work?

A

Determined by what antigens are present on surface of RBC: A, B, AB or none (O)
Antibodies opposite to antigens are present in the plasma

Rh antigen is either present + or not -

46
Q

How does paediatric CVS differ?

A

Higher BSA leads to greater blood loss
Reduced contract-ability means they can’t change SV so increase HR instead
High metabolic rate = heart works heart and more O2 needed
Higher blood volume (newborn 90ml/kg)
Can compensate well but then deteriorate quickly

47
Q

How does geriatric CVS differ?

A

Reduced vessel elasticity (arteriosis) so higher BP
SA node tired so lower intrinsic HR
Capillary walls thicken = less exchange
Reduced RBC production = minor anaemia
Reduced heart valve function

48
Q

What is artherosclerosis?

A

Chronic disease of hardened and narrowed arteries from the build up of plaque on artery walls

49
Q

What is the disease process of artherosclerosis?

A

Damage to endothelium
Lipids penetrate and accumulate at injury site
LDL oxidises and triggers inflammatory response attracting WBC to area
These become macrophages and engulf LDL forming foam cells
Foam cells and smooth muscle cells form fatty streaks which progress into plaque over time

50
Q

What issues can artherosclerosis cause?

A

Plaque can break off and cause clots resulting in angina, MI, TIA, stroke etc

51
Q

What is angina pectoris?

A

The temporary reduction of blood flow to heart muscle often due to coronary artery artherosclerosis

52
Q

What is the disease process of angina?

A

Reduced blood flow causes a lack of oxygen resulting in ischemic tissue
Ischemic tissue does not receive energy to function and waste products build up including adenosine, bradykinin and lactic acid
These stimulate cardiac nociceptors signalling pain to the brain

53
Q

What are the symptoms of angina and MI

A

Pain - squeeze, pressure, tight chest which may refer to left jaw/shoulder/arm
SOB or high RR
High BP and HR
Fatigue
Sweaty/clammy
Nausea
Dizzy

(MI has sudden onset, not improved with rest and ECG changes)

54
Q

What is stable and unstable angina?

A

Stable occurs predictably under physical or emotional stress. Improves with rest

Unstable occurs unpredictably, even at rest

55
Q

What are the risk factors of angina and MI?

A

Age >45
Male more common
Family hx
Smoking, hypertension, obesity, poor diet, low exercise, smoking, stress, DM, high cholesterol

56
Q

What medicines are used by EMT to treat angina?

A

Nitrates for vessel dilation
Morphine for pain
Aspirin to reduce clot

57
Q

What is a myocardial infarction?

A

Blocked flow to part of cardiac muscle resulting in tissue damage

(Usually from thrombus from artherosclerosis)

58
Q

What is a STEMI and NSTEMI MI?

A

STEMI is when coronary artery is completely blocked and has raised ST segments on ECG

NSTEMI is when coronary artery is partially/temporarily blocked and ST segment may be depressed, inverted or not change at all

59
Q

What is the difference between angina and an MI?

A

Angina is a temporary reduction in blood flow usually from narrowed arteries, which is short lasting and improves with rest.

MI is a disruption to blood flow usually from a blocked artery that results in tissue damage.

60
Q

What is a cardiac arrest?

A

Heart stops beating effectively and therefore the body is starved of blood/O2

Asystole, VF and VT

61
Q

What is acute cardiogenic pulmonary oedema?

A

Fluid in the lungs caused by heart dysfunction
LV cannot pump effectively so blood remains after contraction causing a back pressure in pulmonary circulation causing fluid to be forced into lung tissue.
Fluid in lungs reduces surface area for gas exchange

62
Q

What are the symptoms of ACPO?

A

Crackles/rales on auscultation
SOB - fast and shallow with strained accessory muscles
Wheeze/cough
Pink sputum
Anxious
Cold/clammy
Cyanosis
High HR

63
Q

What causes rales on auscultation?

A

Surfactant that lines alveoli to keep them open during exhalation gets washed out by fluid. This causes the alveoli to ‘pop’ open and closed during breathing.

64
Q

What else can cause fluid in the lungs?

A

Toxic inhalation
ARDS
Kidney issues causing circulatory overload
High altitude
PE

65
Q

What are other causes of fluid in the lungs?

A

ARDS
Toxic inhalation
Kidney disease causing circulatory overload
High altitude
PE

66
Q

How does cardiovascular system differ in pregnancy?

A

Higher blood volume
Anaemia
Higher HR
Reduced ability to compensate
Higher metabolic demand

Health Status (15 decks)

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