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Cardiovascular Flashcards

1
Q

Right ventricular failure physiology

A

Fails and dilates; blood backs up into right atrium and to the superior vena cava and inferior vena cava, causing jugular vein distention and hepatic congestion

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2
Q

Causes of Right ventricular failure

A

Right ventricular infarction, pulmonary embolus, elevated pulmonary pressure

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3
Q

Treatment for Right ventricular failure

A

Volume

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4
Q

Goals of Critical care

A

Enhance oxygen delivery; decrease oxygen demand

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5
Q

Diastole

A

Phase of the heart when the heart muscle relaxes and allows the chambers to fill with blood

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6
Q

Systole

A

Phase of the heart where the heart muscle contracts and pumps blood from the chambers into the arteries

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7
Q

Normal ejection fraction range

A

> 60%

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8
Q

Pulse Pressure

A

Difference between systolic and diastolic represents the force that the heart generates each time it contracts

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9
Q

Left Ventricular failure physiology

A

Fails and dilates; blood backs up into the left atrium and to the pulmonary veins, causing increased pulmonary pressures and pulmonary edema

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10
Q

Causes of Left Ventricular failure

A

Acute left ventricular infarction; cardiomyopathies

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11
Q

Treatment for Left Ventricular failure

A

Fluid restriction, diuresis

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12
Q

Right coronary artery

A

Perfuses the right atrium and right ventricle; 90% of people this is the dominant coronary artery and perfuses the inferior left ventricle

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13
Q

Left Coronary Artery

A

Left main artery

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14
Q

Left circumflex

A

Perfuses the left atrium and lateral wall of the left ventricle

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15
Q

Left anterior descending

A

Perfuses the anterior and apex of the left ventricle, as well as two-thirds of the ventricular septum

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16
Q

Coronary Artery Perfusion Pressure

A

Diastolic blood pressure - pulmonary artery wedge pressure

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17
Q

Normal Coronary Artery Perfusion Pressure

A

60-80 mmHg

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18
Q

Determinants of Ventricular Function

A

Supply of oxygen must equal demand of oxygen; heart utilizes approximately 85% of available oxygen at rest; when the myocardium requires more oxygen for proper functioning, the coronary arteries dilate in response to increased demand

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19
Q

Determinants of Ventricular Function

A

Supply of oxygen must equal demand of oxygen; heart utilizes approximately 85% of available oxygen at rest; when the myocardium requires more oxygen for proper functioning, the coronary arteries dilate in response to increased demand

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20
Q

Most likely cause of sudden heart rate rise

A

tissue hypoxia

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21
Q

Most likely cause of sudden respiratory rate rise

A

Tissue hypoxia and metabolic acidosis

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22
Q

Most likely cause of sudden temperature rise

A

Increase in oxygen requirements

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23
Q

Left ventricular end diastolic pressure

A

Important measure of ventricular performance and may identify patients at increased risk for developing late clinical symptoms of heart failure

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24
Q

Cardiac Output

A

Stroke volume X Heart rate

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25
Q

Indicate perfusion to the cells

A

Cardiac Output and Cardiac Index

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26
Q

Stroke Volume

A

Equals the amount of blood ejected with each ventricular contraction

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27
Q

Three things that determine stroke volume

A

Preload; afterload; contractility

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28
Q

Preload

A

The amount of volume returned to the ventricle at the end of diastole

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29
Q

Afterload

A

Impedance of ventricular emptying, resistance to ventricular ejection; workload of the ventricle to pump blood out

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30
Q

Contractility

A

The ability of the ventricular muscle to contract and eject blood

31
Q

Preload consists of:

A

Venous return and intrathoracic pressure

32
Q

Treating ventricular preload if overloaded

A

diuretics and/or vasodilators

33
Q

Treating ventricular preload if low

A

give volume

34
Q

Right ventricle afterload

A

Pulmonary vascular resistance

35
Q

Left Ventricle afterload

A

Systemic vascular resistance and/or aortic stenosis

36
Q

Drugs to reduce afterload

A

Vascular smooth muscle relaxers, decrease the workload of the left ventricle. angiotensin-converting-enzyme inhibitors; angio-receptor blockers; alpha antagonists; all beta blockers; calcium channel blockers

37
Q

Drugs to increase afterload

A

Increase arterial tone, vasoconstrictors. Norepinephrine, Vasopressin, Phenylephrine injection, Dopamine

38
Q

Drugs that improve contractility

A

Digoxin, Dobutamine, Milrinone, Dopamine

39
Q

S1 heart sounds

A

Marks the end of diastole, beginning of systole; known as lub

40
Q

S2 heart sounds

A

Marks the end of systole, beginning of diastole; known as Dub

41
Q

S3 heart sounds

A

Always pathological; fluid overload

42
Q

S4 heart sounds

A

Always pathological; decreased compliance, only in sinus rhythm

43
Q

Hemodynamics

A

The flow of blood as it travels through the heart and great vessels

44
Q

Normal Central Venous Pressure (CVP)

45
Q

Normal Right Ventricular Pressure (RV)

A

25/3-5 mmHg

46
Q

Normal Pulmonary Artery Pressure (PAP)

A

25/8-12 mmHg

47
Q

Normal Pulmonary Capillary Wedge Pressure (PCWP)(

48
Q

Normal LA

49
Q

Normal LV

A

120/4-12 mmHg

50
Q

Normal Cardiac Output

A

4.8 liters/min

51
Q

Normal Cardiac Index

A

2.4 - 4.2 liters/min/m2

52
Q

Normal Pulmonary Vascular Resistance (PVR)

A

37-250 dynes/sec/cm2

53
Q

Normal Systemic Vascular Resistance (SVR)

A

800-1200 dynes/sec/cm2

54
Q

Mean Arterial Pressure (MAP)

A

Reflects changes in the relationship between cardiac output and systemic vascular resistance and reflects the arterial pressure in the vessels perfusing the organs

55
Q

Ejection Fraction

A

is a measurement of how well the left ventricle, or the heart’s main pumping chamber, works. It is expressed as a percentage of blood that leaves the heart with each beat

56
Q

End Diastolic Volume (EDV)

A

Volume of blood in the right or left ventricle at the end of diastole

57
Q

End Systolic Volume (ESV)

A

Volume of blood in the right or left ventricle at the end of systole

58
Q

Valves that close during S1

A

AV (mitral and tricuspid) valves

59
Q

S1 is loudest when listening….

A

at Apex of the heart (midclavicular, 5th intercostal space)

60
Q

Valves that close during S2

A

Semilunar (aortic and pulmonic) valves

61
Q

S2 is loudest when listening…

A

at the base (right sternal border, 2nd intercostal space)

62
Q

S2 is louder when…

A

With pulmonary embolism

63
Q

S2 splits on inspiration when…

A

wide, fixed splitting of S2 caused by right bundle branch block

64
Q

Base of the Heart

A

Aortic area, where S2 is loudest. It is at the 2nd intercostal space, right sternal border

65
Q

Apex of the Heart

A

Mitral area, where S1 is loudest. It is at the 5th intercostal space, midclavicular

66
Q

S3 heart sound caused by…

A

rapid rush of blood into a dilated ventricle

67
Q

S3 occurs…

A

Early in diastole, right after S2

68
Q

S3 is best heard…

A

at the apex of the heart with the bell of the stethoscope

69
Q

S3 is associated with…

A

heart failure, may occur before crackles

70
Q

S3 has this sound…

A

ventricular gallop “Kentucky”

71
Q

S3 is also caused by…

A

pulmonary hypertension and cor pulmonale; mitral, aortic, or tricuspid insufficiency

72
Q

S4 heart sound is caused by….

A

atrial contraction of blood into a noncompliant ventricle

73
Q

S4 occurs….

A

right before S1

74
Q

S4 is best heard….

A

at the apex of the heart with the bell of the stethoscope

CCRN (1 decks)

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