Cardiovascular Flashcards

Question

Right coronary artery branches

Answer 1

Right marginal artery Posterior interventricular artery

Answer 2

Relaxation of myocardium required for filling chambers

Answer 3

Contraction of the myocardium provides an increase in pressure to eject blood. The right side of the heart to the lungs. The left side of the heart out the aorta to the body.

Answer 4

1. Right atrium Deoxygenated blood enters the heart through the superior vena cava and inferior vena cava, and flows into the right atrium. 2. Tricuspid valve The tricuspid valve opens, allowing blood to flow from the right atrium to the right ventricle. 3. Right ventricle When the right ventricle is full, it contracts and closes the tricuspid valve. 4. Pulmonary valve The pulmonary valve opens, allowing blood to flow from the right ventricle to the pulmonary artery. 5. Lungs Blood travels to the lungs, where it releases carbon dioxide and becomes oxygenated. 6. Pulmonary veins Oxygenated blood returns to the heart through the pulmonary veins and into the left atrium. 7. Mitral valve The mitral valve opens, allowing blood to flow from the left atrium to the left ventricle. 8. Left ventricle When the left ventricle is full, it contracts and closes the mitral valve. 9. Aortic valve The aortic valve opens, allowing blood to flow from the left ventricle to the aorta and the rest of the body.

Answer 5

“Lubb”—closure of AV valves “Dub”—closure of semilunar valves Murmurs(Caused by incompetent valves) Pulse (Indicates heart rate) Pulse deficit (Difference in rate between apical and radial pulses). Should be no more than 2 beats. It would indicate the heart is beating , but blood is not moving.

Answer 6

Blood ejected by a ventricle in 1 minute CO = SV × HR (heart rate)

Answer 7

Volume of blood pumped out of ventricle—contraction

Answer 8

Amount of blood delivered to heart by venous return

Answer 9

Force required to eject blood from ventricles Determined by peripheral resistance in arteries

Answer 10

Systolic pressure Exerted when blood is ejected from ventricles (high) Diastolic pressure Sustained pressure when ventricles relax (lower) Blood pressure (BP) is altered by cardiac output, blood volume, and peripheral resistance to blood flow.

Answer 11

Sympathetic branch of ANS Increased output → vasoconstriction and increased BP Decreased output → vasodilation and decreased BP BP is directly proportional to blood volume. Hormones Antidiuretic hormone (↑ BP); aldosterone (↑ blood volume, ↑ BP); renin-angiotensin-aldosterone (vasoconstriction; ↑ BP)

Answer 12

Electrocardiography- Useful in the initial diagnosis and monitoring of dysrhythmias, myocardial infarction, infection, pericarditis

Answer 13

Determination of valvular abnormalities or abnormal shunts of blood that cause murmurs Detected by listening through a stethoscope

Answer 14

Used to record heart valve movements, blood flow, and cardiac output

Answer 15

Used to assess general cardiovascular function

Answer 16

Used to show shape and size of the heart Nuclear imaging Tomographic studies

Answer 17

Measures pressure and assesses valve and heart function Determines central venous pressure and pulmonary capillary wedge pressure

Answer 18

Visualization of blood flow in the coronary arteries

Answer 19

Assess blood flow in peripheral vessels Record sounds of blood flow or obstruction

Answer 20

Assess levels of serum triglycerides, cholesterol, sodium, potassium, calcium, other electrolytes

Answer 21

Checks the current oxygen level and acid-base balance

Answer 22

1)Dietary modifications To decrease total fat intake General weight reduction Reduce salt intake 2)Regular exercise program Increases high-density lipoprotein levels Lowers serum lipid levels Reduces stress levels 3)Cessation of smoking Decreases risk of coronary disease 4)Vasodilators Reduction of peripheral resistance 5)Beta blockers Treatment of hypertension and dysrhythmias Reduction of angina attacks 6)Calcium channel blockers Decrease cardiac contractility Antihypertensives and vasodilators Prophylactic against angina 7)Digoxin Treatment for heart failure Antidysrhythmic drug for atrial dysrhythmias 8)Antihypertensive drugs Used to lower blood pressure 9)Adrenergic blocking drugs Act on SNS centrally or on the periphery 10)Angiotensin-converting enzyme (ACE) inhibitors Block conversion of angiotensin I to angiotensin II 11)Diuretics Remove excess sodium and/or water. Treat high BP and congestive heart failure. 12)Anticoagulants Reduce risk of blood clot formation 13)Cholesterol-lowering drugs Reduce low-density lipoprotein and cholesterol levels

Answer 23

Occurs when there is a deficit of oxygen to meet myocardial needs Chest pain may occur in different patterns. Classic or exertional angina Variant angina Vasospasm occurs at rest. Unstable angina Prolonged pain at rest—may precede myocardial infarction

Answer 24

Recurrent, intermittent brief episodes of substernal chest pain Triggered by physical or emotional stress Attacks vary in severity and duration but become more frequent and longer as disease progresses. Relieved by rest and administration of coronary vasodilators Example: nitroglycerin Primarily acts by reducing systemic resistance, decreasing the demand for oxygen

Answer 25

Pallor Diaphoresis (excessive sweating) Nausea

Answer 26

Rest, stop activity Patient seated in upright position Administration of nitroglycerin—sublingual Check pulse and respiration. Administer oxygen, if necessary. Patient known to have angina Second dose of nitroglycerin Patient without history of angina Emergency medical aid

Answer 27

A feeling of pressure , heaviness, or burning in chest-especially with increased activity. Sudden shortness of breath weakness, fatigue, nausea, Indigestion, Anxiety, and Fear. Pain may occur and, if present usually (Substernal, Crushing, Radiating)

Answer 28

Changes in ECG Serum levels of myosin & (troponin) are elevated within 6 hours Serum enzyme and isoenzyme levels Leukocytosis, elevated CRP and ESR common Arterial blood gas measurements may be altered in severe cases Pulmonary artery pressure measurements helpful

Answer 29

Occurs when coronary artery is totally obstructed Atherosclerosis is most common cause Thrombus from atheroma may obstruct artery Vasospasm is cause in a small percentage. Size and location of the infarct determine the damage.

Answer 30

Type 1 is primarily associated with atherosclerosis and the destruction of cardiac muscle

Answer 31

characterized by a mismatch in myocardial oxygen supply

Answer 32

involves only fatal MIs

Answer 33

are attributed to MIs that occur as a result of a medical procedure(s)

Answer 34

Reduce cardiac demand. Oxygen therapy Analgesics Anticoagulants Thrombolytic agents may be used. Tissue plasminogen activator Medication to treat: Dysrhythmias, hypertension, congestive heart failure Cardiac rehabilitation begins immediately.

Answer 35

Sudden death Cardiogenic shock Congestive heart failure Rupture of necrotic heart tissue/cardiac tamponade Thromboembolism causing cerebrovascular accident (CVA; with left ventricular MI)

Answer 36

Deviations from normal cardiac rate or rhythm Caused by electrolyte abnormalities, fever, hypoxia, stress, infection, drug toxicity Electrocardiography—for monitoring the conduction system Detects abnormalities Reduction of the efficiency of the heart’s pumping cycle Many types of abnormal conduction patterns exist.

Answer 37

Determine cause i.e. drugs Change of drug dose might eliminate dysrhythmia Antiarrhythmic drugs Beta-adrenergic blockers Calcium channel blockers Digoxin Pacemaker

Answer 38

SA node Pacemaker of the heart; rate can be altered. Bradycardia Regular but slow heart rate Tachycardia Regular rapid heart rate Sick sinus syndrome Marked by altering bradycardia and tachycardia Often requires mechanical pacemaker

Answer 39

Premature atrial contractions or beats (PACs, PABs) Extra contraction or ectopic beats Irritable atrial muscle cells outside conduction pathway Atrial flutter Atrial heart rate of 160 to 350 beats/min AV node delays conduction—ventricular rate slower Atrial fibrillation Rate over 350 beats/min Causes pooling of blood in the atria Thrombus formation is a risk.

Answer 40

Heart blocks Conduction excessively delayed or stopped at AV node or bundle of His First-degree block Conduction delay between atrial and ventricular contractions Second-degree block Every second to third atrial beat dropped at AV node Third-degree block No transmission from atria to ventricles

Answer 41

Bundle branch block Interference with conduction in one of the bundle branches Ventricular tachycardia Likely to reduce cardiac output as reduced diastole occurs Ventricular fibrillation Muscle fibers contract independently and rapidly Cardiac standstill occurs if not treated immediately! Premature ventricular contractions (PVCs) Additional beats from ventricular muscle cell or ectopic pacemaker; may lead to ventricular fibrillation

Answer 42

Cause needs to be determined and treated. Antidysrhythmic drugs are effective in many cases. SA nodal problems or total heart block require pacemaker Defibrillator may be implanted for conversion of ventricular fibrillation.

Answer 43

Cessation of all heart activity No conduction of impulses Flat ECG Many reasons Excessive vagal nerve stimulation Potassium imbalance Cardiogenic shock Drug toxicity Insufficient oxygen Respiratory arrest Blow to heart

Answer 44

When heart cannot maintain pumping capability Cardiac output or stroke volume decreases. Less blood reaches the various organs. Decreased cell function Fatigue and lethargy Mild acidosis develops. Backup and congestion develop as coronary demands for oxygen and glucose are not met. Output from ventricle is less than the inflow of blood. Congestion in venous circulation draining into the affected side of the heart

Answer 45

Related to pulmonary congestion Dyspnea and orthopnea Develop as fluid accumulates in the lungs Cough Associated with fluid irritating the respiratory passages Paroxysmal nocturnal dyspnea Indicates the presence of acute pulmonary edema Usually develops during sleep Excess fluid in lungs frequently leads to infections such as pneumonia.

Answer 46

Dependent edema in feet, legs, or buttocks Increased pressure in jugular veins leads to distention. Hepatomegaly and splenomegaly Digestive disturbances Ascites Complication when fluid accumulates in peritoneal cavity Marked abdominal distention Acute right-sided failure Flushed face, distended neck veins, headache, visual disturbances

Answer 47

Often secondary to congenital heart disease Feeding difficulties often first sign Failure to gain weight or meet developmental guidelines Short sleep periods Tripod position to play Cough, rapid grunting respirations, flared nostrils, wheezing Radiographs show cardiomegaly. Arterial blood gases used to measure hypoxia

Answer 48

cardiac anomalies Structural defects in the heart that develop during the first 8 weeks of embryonic life Congenital heart disease Valvular defects Septal defects Detected by the presence of heart murmurs If untreated, child may develop heart failure. May be cyanotic or acyanotic, depending on direction of shunting

Answer 49

Large defects Pallor Tachycardia Occurs with very rapid sleeping pulse and frequent pulse deficit Dyspnea on exertion Squatting position—toddlers and older children Appears to modify blood flow, more comfortable Clubbed fingers Intolerance for exercise and exposure to cold weather Delayed growth and development

Answer 50

Severe defects are often diagnosed at birth. Others may not be detected for some time. Examination techniques Radiography Diagnostic imaging Cardiac catheterization Echocardiography Electrocardiography Surgical repair

Answer 51

VSD is the most common congenital heart defect. Opening in the interventricular septum May vary in size and location Untreated VSD Pressure usually higher in left ventricle. Shunt from left → right Acyanotic condition unless respiratory condition increases pressure in right ventricle

Answer 52

Treatment usually involves both surgical and medical Surgical Open heart surgery Catheter procedure Hybrid procedure Medical used to: Increase strength of contractions Decrease amount of fluid in circulation Keep a regular heartbeat.

Answer 53

Most common cyanotic (R → L shunt) congenital heart condition Cyanosis occurs because shunt bypasses the pulmonary circulation. Alters pressures in heart and alters blood flow Includes four abnormalities Involves heart as well as joints VSD Dextroposition of the aorta Right ventricular hypertrophy

Answer 54

Rheumatic fever Acute systemic inflammatory condition May result from an abnormal immune reaction Can occur a few weeks after an untreated infection (usually group A β-hemolytic Streptococcus) Involves heart as well as joints Usually occurs in children ages 5 to 15 years Long-term effects Rheumatic heart disease May be complicated by infective endocarditis and heart failure in older adults

Answer 55

Acute stage—inflammation of the heart Pericarditis Myocarditis Endocarditis and incompetent heart valves Other sites of inflammation Large joints Erythema marginatum Nontender subcutaneous nodules Involuntary jerky movement of the face, arms, legs

Answer 56

Low-grade fever Leukocytosis Malaise Anorexia, and fatigue Tachycardia Heart murmurs Epistaxis and abdominal pain may be present

Answer 57

Subacute Streptococcus viridans Acute Staphylococcus aureus Basic effects Same regardless of organism Factors that predispose to infection Presence of abnormal valves in heart Bacteremia Reduced host defenses

Answer 58

Low-grade fever or fatigue Anorexia, splenomegaly, congestive heart failure in severe cases Acute endocarditis Sudden, marked onset—spiking fever, chills, drowsiness Subacute endocarditis Insidious onset—increasing fatigue, anorexia, cough, and dyspnea Blood culture to identify causative agent Antimicrobial drugs for several weeks, often IV

Answer 59

Usually secondary to another condition Classified by cause or type of exudate Acute pericarditis May involve simple inflammation of the pericardium May be secondary to: Open heart surgery, myocardial infarction, rheumatic fever, systemic lupus erythematosus, cancer, renal failure, trauma, viral infection Effusion may develop. Large volume of fluid accumulates in pericardial sac Leads to distended neck veins, faint heart sounds, pulsus paradoxus

Answer 60

Results in formation of adhesions between the pericardial membranes Fibrous tissue often results from tuberculosis or radiation to the mediastinum. Limiting movement of the heart during diastole and systole → reduced cardiac output Inflammation or infection may develop from adjacent structures. Causes fatigue, weakness, abdominal discomfort Caused by systemic venous congestion

Answer 61

Results from renal or endocrine disease, pheochromocytoma (benign tumor of the adrenal medulla) Underlying problem must be treated to reduce blood pressure.

Answer 62

Uncontrollable, severe, and rapidly progressive form with many complications Diastolic pressure is extremely high.

Answer 63

Essential hypertension Blood pressure consistently above 140/90 mm Hg May be adjusted for age Increase in arteriolar vasoconstriction Over long period of time—damage to arterial walls Blood supply to involved area is reduced. Ischemia and necrosis of tissues, with loss of function

Answer 64

Kidneys Heart Brain Retina

Answer 65

Incidence increases with age. Men affected more frequently and more severely Incidence in women increases after middle age. Genetic factors Sodium intake, excessive alcohol intake, obesity, smoking, prolonged or recurrent stress

Answer 66

Frequently asymptomatic in early stages Initial signs vague and nonspecific Fatigue, malaise, sometimes morning occipital headache Essential hypertension treated in steps Lifestyle changes Reduction of sodium intake Weight reduction Reduction of stress Drugs Diuretics, ACE inhibitors, drug combinations

Answer 67

Hypovolemic shock Loss of circulating blood volume Cardiogenic shock Inability of heart to maintain cardiac output to circulation Distributive, vasogenic, neurogenic, septic, anaphylactic shock Changes in peripheral resistance leading to pooling of blood in the periphery

Answer 68

Anxiety Tachycardia Pallor Light-headedness Syncope Sweating Oliguria

Answer 69

SNS and adrenal medulla stimulated—increase heart rate, force of contraction, systemic vasoconstriction Renin secretion increases. Increased ADH secretion Secretion of glucocorticoids Acidosis stimulates increased respiration. With prolonged shock, cell metabolism is diminished, waste not removed—leads to lower pH

Answer 70

Acute renal failure Shock lung, or adult respiratory distress syndrome Hepatic failure Paralytic ileus, stress or hemorrhagic ulcers Infection or septicemia Disseminated intravascular coagulation Depression of cardiac function

Answer 71

formation of a blood clot in a vein that is not inflamed.