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Pathophysiology > Cardiovascular function > Flashcards

Cardiovascular function Flashcards

1
Q

Sinoatrial Node

A

primary pacemaker (60-100 bpm); located in right atrium

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2
Q

Atrioventricular NOde

A

back up pacemaker (40-40 bpm); located in right atrium

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3
Q

Bundle of his

A

3rd pacemaker (20-40 bpm); located in the interventricular septum

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4
Q

organized depolarization

A

increase in electrical charge through exchange of ions across cell membrane (depolarization stimulates the contraction of cardiac muscles)

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5
Q

P Wave depolarization

A

atrial contraction

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6
Q

QRS complex depolarization

A

ventricle contraction

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7
Q

Why is QRS complex higher than the P wave?

A

the height of the wave is directly correlated to the force necessary for the contraction; since QRS represents ventricle contraction, a much larger contraction is necessary to pump blood to the body compared to the atrial contraction which only pumps blood to the ventricles

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8
Q

T wave repolarization

A

recovery of ventricles (atrial repolarization occurs but is not seen on EKG)

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9
Q

Blood supply to the heart

A

LCA, RCA

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10
Q

left coronary artery division 1

A

becomes anterior descending artery supplying front of heart, left and right ventricles, and interventricular septum

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11
Q

left coronary artery division 2

A

circumflex artery supplying left atrium and lateral left ventricle wall

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12
Q

right coronary artery

A

supplies right atrium and right ventricle, posterior heart, back of interventricular septum

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13
Q

Generally arteries carry

A

oxygenated blood away from the heart to tissues

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14
Q

generally veins carry

A

deoxygenate blood from the body back to the heart

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15
Q

exception to artery carrying ox blood away and vein carrying de-ox blood to

A

pulmonary arteries carry deoxygenated blood from right side of heart to lungs where they become oxygenated; pulmonary veins carry oxygenated blood from the lungs to the left side of the heart

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16
Q

3 layers of vessel

A

tunica intima (endothelium), tunica media, tunica adventitia

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17
Q

tunica intima

A

smooth, thin, inner layer of blood vessels

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18
Q

tunica media

A

middle layer, smooth muscle responsible for changing diameter

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19
Q

tunica adventitia

A

elastic and fibrous connective tissues that provide necessary elasticity to accommodate increase of blood flow from cardiac contraction

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20
Q

frank starling law

A

the more the cardiac muscle stretches, the greater the contraction

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21
Q

ADH (antidiuretic hormone)

A

vasopressin; increases water reabsorption in kidney which increases blood volume; also vasoconstrictor

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22
Q

RAAS (renin-angiotensin-aldosterone system)

A

becomes activated when hypotensive; low blood volume causes renin to be released from kidneys, activating angiotensin I, then converted to angiotensin II through enzyme in lungs, aldosterone secretion stimulated increasing reabsorption of Na+ and Cl- in kidneys which draws in water to increase blood volume

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23
Q

pericarditis

A

inflammation of the pericardium (sac that surrounds, protects, and supports the heart)

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24
Q

pericardial effusion

A

fluid accumulating in pericardial cavity

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25
cardiac tamponade
fluid accumulates in the pericardial cavity to the point that it compresses the heart decreasing cardiac output
26
pericarditis manifestations
dyspnea and anterior chest pain (sharp); may hear friction rub upon auscultation
27
becks triad
low blood pressure, jugular vein distention, muffled heart sounds (can be signs of sudden acute tamponade)
28
myocarditis
inflammation of the myocardium d/t either infections or non-infectious agents
29
stenosis
narrowing of a structure; heart valves in cardiology
30
regurgitation
insufficiency or incompetence; valve leaflets do not close completely allowing blood to leak; normal heart valves allow blood to flow in one direction but this allows for backflow as well
31
cardiomyopathy
diseases that can lead to several types of structural and functional changes
32
dilated cardiomyopathy
ventricles become enlarged causing systolic dysfunction
33
hypertrophic cardiomyopathy
ventricular wall is enlarged and becomes stiff; unable to relax during ventricular filling affecting diastolic function
34
restrictive cardiomyopathy
rigidity of myocardium and diastolic function; does not allow for proper filling
35
QRS greater than or equal to 0.12 sec
longer depolarization time of QRS can be indicative of a bundle block and an alternative electrical route is followed
36
PR interval
time it takes for electrical signal to travel from atria to ventricles; begins at P wave which is atrial depolarization and ends at QRS complex which is ventricular depolarization
37
PR interval typical time
0.12-0.2 seconds
38
QRS wave
depolarization of ventricles
39
ST segment
flat, isoelectric section of ECG; represents early portion of ventricular repolarization
40
QT interval
represents total time for ventricular depolarization and repolarization; typically shorter in individuals with faster heart rates
41
prolongation of QT
increased risk of arrythmias
42
T wave
repolarization of ventricular myocardium
43
RR interval
distance between 2 consecutive R waves on ECG; represents duration of 1 cardiac cycle
44
systole
heart squeezing left ventricle and right ventricle; left is sending out oxygenated blood to circulation
45
diastole
filling of the left and right chambers during relaxation; heat is at rest
46
MAP
average pressure in one systole-diastole cycle; provides information for overall tissue perfusion
47
pulse pressure
difference between systolic and diastolic; represent pressure created from each heart contraction
48
Ventricular septal defect (VSD)
opening between ventricles
49
Atrial septal defect (ASD)
opening between atria; failure of closure of normal fetal channel between right atrium and left atrium
50
Patent ductus arteriosus
failure of closure of normal fetal channel between pulmonary artery and aorta
51
pulmonary stenosis
narrowing of a valve
52
Transposition of great vessels
abnormal attachment of the aorta to the right ventricle and pulmonary artery to the left ventricle (backwards)
53
54
Tetralogy of fallot
four abnormalities are VSD, Pulmonary Stenosis, right ventricle hypertrophy, aorta overriding VSD
55
coarctation of aorta
narrow aorta
56
atrioventricular canal defect
can be complete, partial, or transitional
57
aortic stenosis
narrow valve
58
causes for CHDs
maternal smoking, certain maternal medications, maternal health status (obesity or preexisting diabetes)
59
Manifestations of CHDs
alterations in blood flow in heart, abnormal shunting of blood
60
Coronary Artery Disease (CAD)
atherosclerosis of the coronary artery; leading cause of death
61
metabolic syndrome
abdominal obesity, fasting BG >100, systolic BP > 130, HDL <50 in women, Triglycerides >150
62
non-modifiable risk factors of CAD
men > 45 & women >55 (or menopause), family history in first degree family
63
modifiable risk factors of CAD
tobacco, obesity, inactivity, stress, diabetes mellitus, HLD, HTN
64
negative risk factors of CAD
high HDL, cholesterol
65
emerging risk factors for cardiovascular disease
elevated C-reaction protein and homocysteine levels
66
CAD can cause
heart failure, dysrhythmias, sudden death, MI, ischemia; worsens when body needs more blood and O2 during activities such as shoveling
67
4 types of angina
stable, unstable, prinzmetal, microvascular
68
diagnosis of angina
12 lead, H&P, lipid/metabolic panel, cardiac biomarkers
69
angina treatment
prevent modifiable risks, meds (nitrates, beta-adrenergic blockers, calcium channel blockers)
70
stable angina
ischemia with increased workload, pain relieved when increased work is stopped, <5 min, arise from cold, sex, stress, stimulants
71
unstable angina
unpredictable, can occur while resting or increased workload, >20 min, pre-infarction states, is reversible until myocardial tissue death
72
Prinzmetal angina
vasospastic or variant, d/t vasospasm in coronary artery, rare and more common in younger population, usually happens at night/rest
73
microvascular angina
dysfunction in coronary microvasculature, younger patients and women, increased vasoconstriction and decreased vasodilation
74
peripheral vascular disease (PVD)
if upper and lower extremities then likely peripheral arterial disease
75
6 P's emergency
pallor, pulselessness, paresthesia, paralysis, poikilothermia, pain
76
venous thrombus characteristics
pulse is present, rubor (red) skin color, warm temp., edema present
77
arterial thrombus characteristics
weak/ absent pulse, cyanotic skin color, cool temp., minimal/absent edema
78
threatened limb
limb without pulse
79
BP equation
cardiovascular resistance (CVR) x systemic vascular resistance (SVR)
80
Cardiac output (CO)
amount of blood pumped in 1 minute; CO = CVR x HR
81
preload
amount of blood into the heart
82
afterload
pressure or resistance the ventricle must overcome to pump blood out
83
alterations in CO
can cause immediate or delayed side effects
84
conditions altering CO and perfusion
infective myocarditis, hypertrophic cardiomyopathy, dilated cardiomyopathy, restrictive cardiomyopathy
85
hypertrophic cardiomyopathy
increased cell size causing decrease in blood volume and ventricular wall becomes stiff and unable to relax; mainly impacts systolic function in men and sedentary people; can affect young athletes
86
dilated cardiomyopathy
cardiac hypertrophy and thinning (depending on area); dilation; impaired pumping to lungs and body
87
HTN range
130-140 systolic (depends on source)
88
cardiac tamponade
fluid fills pericardial sac around heart inhibiting heart from beating properly; muffled heart sounds, heart failure, cardiogenic shock; arterial pressure falls d/t decreased CO and venous pressure increases d/t blood accumulating
89
how to treat cardiac tamponade
remove fluid from pericardial sac
90
shock
inadequate tissue perfusion
91
distributive shock
enough blood flow but in the wrong spaces; ex: septic or anaphylaxis
92
cardiogenic shock
heart cannot pump correctly; ex: MI
93
hypovolemic shock
not enough fluid or blood; ex: hemorrhage
94
neurogenic shock
spinal cord impaired causing disruption of blood flow to peripheral d/t unstable BP, HR, and temp.; ex: car crash with spinal cord injury
95
stages of shock
compensatory (pre-shock; increased HR and increased BP), progressive (decompensated; tachycardic and low BP), irreversible (refractory; high mortality)
96
congestive heart failure (CHF or HF)
inability for heart to pump adequate amount of blood to meet bodies needs; decreased pre-load, CO, afterload, myocardial contractility, and stroke volume
97
manifestations of CHF
occur when issue with ventricular filling or ejection leading to decreased CO and inadequate tissue perfusion
98
L sided heart failure causes
infarction of left ventricle, aortic valve stenosis, HTN, hyperthyroidism
99
L sided HF effects
build up of fluid in lungs, dyspnea, decreased CO, activity intolerance
100
R sided heart failure causes
infarction of right ventricle, pulmonary valve stenosis, pulmonary disease (cor pulmonale)
101
R sided HF effects
build up of fluid systemically, decreased CO, edema, weight gain

Pathophysiology (11 decks)

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