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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
Q

cardiac tamponade

A

fluid accumulates in the pericardial cavity to the point that it compresses the heart decreasing cardiac output

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26
Q

pericarditis manifestations

A

dyspnea and anterior chest pain (sharp); may hear friction rub upon auscultation

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27
Q

becks triad

A

low blood pressure, jugular vein distention, muffled heart sounds (can be signs of sudden acute tamponade)

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28
Q

myocarditis

A

inflammation of the myocardium d/t either infections or non-infectious agents

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29
Q

stenosis

A

narrowing of a structure; heart valves in cardiology

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30
Q

regurgitation

A

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

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31
Q

cardiomyopathy

A

diseases that can lead to several types of structural and functional changes

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32
Q

dilated cardiomyopathy

A

ventricles become enlarged causing systolic dysfunction

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33
Q

hypertrophic cardiomyopathy

A

ventricular wall is enlarged and becomes stiff; unable to relax during ventricular filling affecting diastolic function

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34
Q

restrictive cardiomyopathy

A

rigidity of myocardium and diastolic function; does not allow for proper filling

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35
Q

QRS greater than or equal to 0.12 sec

A

longer depolarization time of QRS can be indicative of a bundle block and an alternative electrical route is followed

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36
Q

PR interval

A

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

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37
Q

PR interval typical time

A

0.12-0.2 seconds

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38
Q

QRS wave

A

depolarization of ventricles

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39
Q

ST segment

A

flat, isoelectric section of ECG; represents early portion of ventricular repolarization

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40
Q

QT interval

A

represents total time for ventricular depolarization and repolarization; typically shorter in individuals with faster heart rates

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41
Q

prolongation of QT

A

increased risk of arrythmias

42
Q

T wave

A

repolarization of ventricular myocardium

43
Q

RR interval

A

distance between 2 consecutive R waves on ECG; represents duration of 1 cardiac cycle

44
Q

systole

A

heart squeezing left ventricle and right ventricle; left is sending out oxygenated blood to circulation

45
Q

diastole

A

filling of the left and right chambers during relaxation; heat is at rest

46
Q

MAP

A

average pressure in one systole-diastole cycle; provides information for overall tissue perfusion

47
Q

pulse pressure

A

difference between systolic and diastolic; represent pressure created from each heart contraction

48
Q

Ventricular septal defect (VSD)

A

opening between ventricles

49
Q

Atrial septal defect (ASD)

A

opening between atria; failure of closure of normal fetal channel between right atrium and left atrium

50
Q

Patent ductus arteriosus

A

failure of closure of normal fetal channel between pulmonary artery and aorta

51
Q

pulmonary stenosis

A

narrowing of a valve

52
Q

Transposition of great vessels

A

abnormal attachment of the aorta to the right ventricle and pulmonary artery to the left ventricle (backwards)

53
Q
A
54
Q

Tetralogy of fallot

A

four abnormalities are VSD, Pulmonary Stenosis, right ventricle hypertrophy, aorta overriding VSD

55
Q

coarctation of aorta

A

narrow aorta

56
Q

atrioventricular canal defect

A

can be complete, partial, or transitional

57
Q

aortic stenosis

A

narrow valve

58
Q

causes for CHDs

A

maternal smoking, certain maternal medications, maternal health status (obesity or preexisting diabetes)

59
Q

Manifestations of CHDs

A

alterations in blood flow in heart, abnormal shunting of blood

60
Q

Coronary Artery Disease (CAD)

A

atherosclerosis of the coronary artery; leading cause of death

61
Q

metabolic syndrome

A

abdominal obesity, fasting BG >100, systolic BP > 130, HDL <50 in women, Triglycerides >150

62
Q

non-modifiable risk factors of CAD

A

men > 45 & women >55 (or menopause), family history in first degree family

63
Q

modifiable risk factors of CAD

A

tobacco, obesity, inactivity, stress, diabetes mellitus, HLD, HTN

64
Q

negative risk factors of CAD

A

high HDL, cholesterol

65
Q

emerging risk factors for cardiovascular disease

A

elevated C-reaction protein and homocysteine levels

66
Q

CAD can cause

A

heart failure, dysrhythmias, sudden death, MI, ischemia; worsens when body needs more blood and O2 during activities such as shoveling

67
Q

4 types of angina

A

stable, unstable, prinzmetal, microvascular

68
Q

diagnosis of angina

A

12 lead, H&P, lipid/metabolic panel, cardiac biomarkers

69
Q

angina treatment

A

prevent modifiable risks, meds (nitrates, beta-adrenergic blockers, calcium channel blockers)

70
Q

stable angina

A

ischemia with increased workload, pain relieved when increased work is stopped, <5 min, arise from cold, sex, stress, stimulants

71
Q

unstable angina

A

unpredictable, can occur while resting or increased workload, >20 min, pre-infarction states, is reversible until myocardial tissue death

72
Q

Prinzmetal angina

A

vasospastic or variant, d/t vasospasm in coronary artery, rare and more common in younger population, usually happens at night/rest

73
Q

microvascular angina

A

dysfunction in coronary microvasculature, younger patients and women, increased vasoconstriction and decreased vasodilation

74
Q

peripheral vascular disease (PVD)

A

if upper and lower extremities then likely peripheral arterial disease

75
Q

6 P’s emergency

A

pallor, pulselessness, paresthesia, paralysis, poikilothermia, pain

76
Q

venous thrombus characteristics

A

pulse is present, rubor (red) skin color, warm temp., edema present

77
Q

arterial thrombus characteristics

A

weak/ absent pulse, cyanotic skin color, cool temp., minimal/absent edema

78
Q

threatened limb

A

limb without pulse

79
Q

BP equation

A

cardiovascular resistance (CVR) x systemic vascular resistance (SVR)

80
Q

Cardiac output (CO)

A

amount of blood pumped in 1 minute; CO = CVR x HR

81
Q

preload

A

amount of blood into the heart

82
Q

afterload

A

pressure or resistance the ventricle must overcome to pump blood out

83
Q

alterations in CO

A

can cause immediate or delayed side effects

84
Q

conditions altering CO and perfusion

A

infective myocarditis, hypertrophic cardiomyopathy, dilated cardiomyopathy, restrictive cardiomyopathy

85
Q

hypertrophic cardiomyopathy

A

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
Q

dilated cardiomyopathy

A

cardiac hypertrophy and thinning (depending on area); dilation; impaired pumping to lungs and body

87
Q

HTN range

A

130-140 systolic (depends on source)

88
Q

cardiac tamponade

A

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
Q

how to treat cardiac tamponade

A

remove fluid from pericardial sac

90
Q

shock

A

inadequate tissue perfusion

91
Q

distributive shock

A

enough blood flow but in the wrong spaces; ex: septic or anaphylaxis

92
Q

cardiogenic shock

A

heart cannot pump correctly; ex: MI

93
Q

hypovolemic shock

A

not enough fluid or blood; ex: hemorrhage

94
Q

neurogenic shock

A

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
Q

stages of shock

A

compensatory (pre-shock; increased HR and increased BP), progressive (decompensated; tachycardic and low BP), irreversible (refractory; high mortality)

96
Q

congestive heart failure (CHF or HF)

A

inability for heart to pump adequate amount of blood to meet bodies needs; decreased pre-load, CO, afterload, myocardial contractility, and stroke volume

97
Q

manifestations of CHF

A

occur when issue with ventricular filling or ejection leading to decreased CO and inadequate tissue perfusion

98
Q

L sided heart failure causes

A

infarction of left ventricle, aortic valve stenosis, HTN, hyperthyroidism

99
Q

L sided HF effects

A

build up of fluid in lungs, dyspnea, decreased CO, activity intolerance

100
Q

R sided heart failure causes

A

infarction of right ventricle, pulmonary valve stenosis, pulmonary disease (cor pulmonale)

101
Q

R sided HF effects

A

build up of fluid systemically, decreased CO, edema, weight gain

Pathophysiology (11 decks)

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