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Patho Exam 2 > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Where is the heart located?

A

In the media stinum between the lungs

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2
Q

What is the heart enclosed in?

A

A double walled pericardial sac

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3
Q

How many layers is the heart composed of; names of the layers

A

3 layers:
Endocardium - inner layer
Myocardium - specialized cardiac muscles
Epicardium = visceral pericardium

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4
Q

Epicardium

A

Visceral pericardium

Serous membrane with small amounts of lubricating fluid within the pericardial cavity between the membranes to facilitate heart movements

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5
Q

What are the AV valves; names

A

Valves that separate the atria from the ventricles

  • Tricuspid - right
  • Bicuspid - left
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6
Q

What are the semilunar valves; names

A

Prevent backflow from the arteries

  • Aortic valve
  • Pulmonary valve
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7
Q

What do arteries generally do?

A

Arteries and arterioles transport oxygenated blood away from the heart to the body

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8
Q

Which artery is the exception to normal arterial function? What does it do?

A

Pulmonary artery transports deoxygenated blood from the heart to the lungs to become oxygenated

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9
Q

What do veins generally do ?

A

Veins transport deoxygenated blood back to the heart to receive oxygen

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10
Q

Which vein is the exception to normal vein function? What does it do?

A

Pulmonary vein transports oxygenated blood from the lungs to the heart

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11
Q

Briefly describe pulmonary circulation

A

Exchange of gas in the lungs

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12
Q

Briefly describe systemic circulation

A

Exchange of gases, nutrients, and wastes in the tissues

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13
Q

Pathway of cardiopulmonary circulation

A

deoxygenated blood from the tissue –> returns to the heart through the inferior and superior vena cava –> right atrium –> tricuspid –> right ventricle –> pulmonary artery –> lungs –> pulmonary vein –> left atrium–> bicuspid –> left ventricle –> aorta

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14
Q

Systole

A

Contraction of myocardium

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15
Q

Diastole

A

Relaxation of myocardium

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16
Q

Why does the heart need constant supply of oxygen?

A

Because it has very little storage space

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17
Q

When is the blood flow to the myocardium greatest?

A

During diastole

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18
Q

How does rapid contraction impact oxygen flow?

A

Rapid contractions reduce oxygen flow to the heart since blood flow is greatest during diastole - if the heart is beating rapidly, diastole is reduced, thus lowering oxygen/blood flow to the heart.

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19
Q

The right coronary artery supplies…

A
  • The right side of the heart
  • inferior posterior left ventricle
  • posterior intraventricular septum
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20
Q

The left anterior descending artery supplies..

A
  • anterior wall of the ventricles
  • anterior septum
  • bundle branches
  • circumflex artery
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21
Q

The circumflex artery supplies…

A
  • left atrium

- lateral and posterior ventricles

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22
Q

Baroreceptors

  • location
  • function
A

Location: aortic arch and carotid sinus

Function: sensitive to stretch or pressure within the arterial system and stimulate the basal motor center to initiate a CNS response (sympathetic or parasympathetic)

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23
Q

Chemoreceptors

  • location
  • function
A

Location: aortic body and carotid body

Function: Recognize increased CO2 levels and stimulate the basal motor sensor to increase cardiac activity in response to the hypercapnia

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24
Q

What is the parasympathetic nervous system mediated by?

What is the function of the Parasympathetic Nervous System?

A
  • Mediated by the vagus nerve

- Decreases HR rate (by slowing SA rate and AV conduction rate)

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25
Q

What is the Sympathetic Nervous System regulated by?

What is the function of the Sympathetic Nervous System?

A
  • Regulated by the cardiac accelerator nerve

- Increases HR rate and force of ventricular contraction

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26
Q

What is the S1 sound?

A

“Lubb”

Closure of the AV valves

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27
Q

What is the S2 sound?

A

“Dubb”

Closure of the semilunar valves

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28
Q

What are murmurs caused by

A

Murmurs are caused by incompetent valves

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29
Q

What does a pulse indicate?

A

Pulse indicates heart rate

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30
Q

What is a pulse deficit?

A

Pulse deficit is the difference between the apical and radial pulse

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31
Q

Cardiac conduction - Automaticity

A

Automaticity = ability to discharge an electronic impulse spontaneously

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32
Q

Cardiac conduction - Rhythmicity

A

Rhythmicity = ability to generate an electrical impulse in regular intervals (pattern)

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33
Q

Cardiac conduction - Conductivity

A

Conductivity = ability to send an electrical impulse

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34
Q

What is the normal/basic pulse rate?

A

60-100 bpm

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35
Q

Why is there a delay in conduction at the AV node?

A

To allow for complete ventricular filling

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36
Q

Pathway of impulses

A

SA node (pacemaker) –> atrial conduction pathway –> AV node –> bundle of His –> bundle branches –> Purkinje fibers

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37
Q

What does depolarization indicate?

A

Contraction

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38
Q

What does repolarization indiate?

A

Relaxation

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39
Q

What is the P Wave initiated by?

What does the P Wave represent?

A

Initiated by: SA node

P Wave = atrial depolarization

40
Q

What is the QRS Complex initiated by?

What does the QRS Complex represent?

A

Initiated by: AV node

QRS Wave = ventricular repolarization

41
Q

What does the ST Segment represent?

A

Ventricular depolarization

aka “recovery phase”

42
Q

What is the equation for Cardiac Output?

A

CO = HR x SV

43
Q

What is cardiac output?

A

The amount of blood pumped by a ventricle per minute

44
Q

What is heart rate?

A

The number of ventricular contractions per minute

45
Q

What is the stroke volume?

A

The amount of blood ejected from a ventricle with each contraction

46
Q

Would a slower heart rate increase or decrease diastolic filling time?

A

Slower heart rate would increase diastolic filling time.

47
Q

What are some factors that increase HR?

A

Elevated temp (internal and environmental), exercise, stress, smoking, pregnancy, pain

48
Q

Preload

A

The amount of work imposed on the heart before contraction (systole) begins

-It is the volume coming into the ventricles at end of diastolic

49
Q

Would hypervolemia increase or decrease preload?

A

Hypervolemia would increase preload

50
Q

Afterload

A

The force that blood ejected from the ventricle must overcome to circulate

-Determined by peripheral resistance to the semilunar valves

51
Q

Contractility

A

Force of contraction

52
Q

Cardiac Reserve

A

ability of the heart to increase output in response to increased demand

53
Q

What is BP dependent on?

A
  • Peripheral resistance
  • Blood volume
  • Blood viscosity
  • Contraction of left ventricle
54
Q

What is the equation for BP?

A

BP = CO x PR

55
Q

Does sympathetic stimulation increase or decrease BP?

A

Sympathetic stimulation increases BP

-Vasoconstriction increases BP

56
Q

Does local vasoconstriction or vasodilation affect BP?

A

No, only systemic changes affect BP

57
Q

What are the receptors in the heart that are stimulated by SNS?
What do they do?

A

Beta-1 adrenergic receptors in the heart increase HR and force of contraction–> elevate BP

58
Q

What are the receptors in the skin and viscera that are stimulated by the SNS?
What do they do?

A

Alpha-1 Receptors

  • In the arterials in the skin an viscera
  • reduce capacity of the system and increase venous return –> elevate BP
59
Q

What is perfusion?

A

Process of the body delivering blood and oxygen through the vessel into tissue

60
Q

Example of ventilation-perfusion mismatch

A

Pulmonary emoblism

61
Q

Example of Impaired circulation

A

Hemorrhage, third spacing, clot (thrombus)

62
Q

Example of Inadequate cardiac output

A

Structural defects of the heart

63
Q

Example of Excessive perfusion demands

A

Prolonged exertion, hypermetabolic states

64
Q

What is the VQ ratio?

A

Ventilation : Perfusion ratio

V = air that reaches alveoli 
Q = blood that reaches alveoli
65
Q

Example of High VQ ratio

A

pulmonary embolism

-adequate ventilation but poor perfusion

66
Q

Example of Low VQ ratio

A

choking

-poor ventilation but perfusion still happens

67
Q

What are the components of Virchow’s Triad?

A

Hypercoagulability, endothelial injury, circulatory stasis

68
Q

What are the general manifestations of altered perfusion? (10)

A
  • Cyanosis - bluish discoloration from hypoxia
  • Pain
  • Pallor
  • Coolness
  • Edema
  • SOB
  • Tachychardia
  • Tachypnea
  • Fatigue
  • Heart murmur
69
Q

What is an ECG or EKG?

A

Records electrical activity of the heart

70
Q

What does auscultation help detect?

A

Auscultation helps detect abnormalities of blood flow that cause murmurs, and checks blood pressure

71
Q

What is an echocardiography?

A

Sonogram of the heart

-Records heart valve movement, blood flow, cardiac ouput

72
Q

Exercise Stress Test

A

Measures heart’s response to external stress

73
Q

How do chest x-rays help?

A

Provides imaging of the chest to help diagnose conditions

74
Q

What is cardiac catherization?

A

Insertion of a catheter into the heart to measure pressure and assess heart function

75
Q

What is an angiography?

A

Imaging of the blood vessels, arteries, veins, and heart chambers
-Radio-opque contrast agents are inserted to blood vessels for imaging of blood flow in the coronary arteries

76
Q

Doppler Studies

A

Probes on the skin enable you to see peripheral vessels

77
Q

What is Percutaenous Transluminal Coronary Angioplastic?

A

Procedure during cardiac catheterization that compresses fatty deposits in the coronary arteries and alleviates occlusion

78
Q

What procedure enables bypassing of the obstructed artery?

A

Coronary byspass grafting

79
Q

What procedure vaporizes fatty deposits with a hot-tip laser device?

A

Laser Angioplasty

80
Q

What kind of medication is a vasodilator?

A

Nitroglycerin

81
Q

What kind of medication is a beta-blocker (slows HR)

A

Metroprolol

82
Q

What kind of medication is a diuretic?

A

Lasix

83
Q

What medications help with anti-coagulation?

A

ASA (aspirin), heparin, coumadin

84
Q

In older adults, ____ increases and _____ decreases, causing heart valves and vessels to become thick and stiff

A

Collagen increases and elastin decreases

85
Q

In older adults, cardiac output and stroke volume ____

A

Cardiac output and stroke volume decrease

86
Q

In older adults, the # of pacemaker cells increases or decreases?

A

of pacemaker cells decrease

87
Q

How does the number and function of beta-adrenergic cells change in older adults?

A

of beta-adrenergic cells decrease, leading to decrease response to emotional stress

88
Q

Arteries of older adults become more sensitive to what hormone?
How does this gerontologic change affect BP?

A

Arteries become more sensitive to ADH

  • Leads to progressive increase in systolic blood pressure
  • But none/decrease in diastolic
89
Q

What is shock?

A

A syndrome of decreased or impaired tissue perfusion

90
Q

What is low flow shock?

What are 2 types of low flow shock?

A

Low flow shock = decreased CO

Hypovolemic, cardiogeneic

91
Q

What is distributive shock?

What are 3 types of distributive shock?

A

Distributive shock = normal/increased CO

Anaphylactic, septic, neurogenic

92
Q

What are the main, common manifestations of shock? (3)

A
  • Vital organs are not being perfused –> lethargy and weakness
  • Ischemia of vital organs
  • Not enough O2 for aerobic respiration –> anaerobic respiration –> lactic acid buildup –> metabolic acidosis
93
Q

What are the early manifestations of shock?

A

SNS stimulation –> anxiety and restlessness

  • tachycardia
  • cool, pale, diaphoretic skin
  • oliguria
  • thirst
  • tachypnea
94
Q

What are progressive manifestations of shock?

A

Metabolic acidosis –> lethargy, weakness, faintness

-Production of bicarbonate decreases glomerular filtration rate and renal excretion of acids

95
Q

What are the decompensated manifestations of shock?

A 
Stupor
Confusion 
Arrhythmias
Weak pulse 
Metabolic acidosis 
Acute respiratory distress syndrome 
Multiple thrombi
Acute liver failure
Acute renal failure
Paralytic ileus 
GI hemorrhage

Patho Exam 2 (4 decks)

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