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Cardiac > Cardiovascular Function and Basic ECGs > Flashcards

Cardiovascular Function and Basic ECGs Flashcards

1
Q

What is the definition of perfusion?

A

The flow of blood through arteries and capillaries delivering nutrients and oxygen to cells.

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2
Q

How is a sarcomere described?

A

it is the functioning unit of the cardiac muscle.

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3
Q

What are the three factors that effect stroke volume?

A

Preload, after load, contractility

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4
Q

What is the definition of preload?

A

The degree of stretch o the cardiac muscle fibers at the end of diastole. (Think volume)

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5
Q

What is the definition of after load?

A

The resistance to ejection of blood from the ventricle; affected by systemic vascular resistance and pulmonary vascular resistance. (Think pressure)

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6
Q

What is the definition of contractility?

A

Cardiac muscles forces Ex) inotropic capability

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7
Q

What increases the preload?

A

Hypervolemia and regurgitation of cardiac valves.

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8
Q

What increases the after load?

A

Hypertension and vasoconstriction

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9
Q

If the after load is increased what also gets increased?

A

the workload

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10
Q

How is hydrostatic pressure described

A

The driving force of the heart tends to push fluid out of the capillaries

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11
Q

How is oncotic pressure described?

A

The pressure exerted by plasma proteins tends to pull fluid into capillaries.

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12
Q

How is filtration pressure described?

A

The net force on fluid

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13
Q

How is filtration pressure determined?

A

By the balance between Hydrostatic Pressure (HP) and Oncotic Pressure (OP)

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14
Q

How is automaticity described?

A

The ability of cardiac cells to initiate an electrical impulse

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15
Q

How is excitability described?

A

The ability to respond to an electrical impulse and generate an action potential

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16
Q

How is conductivity described?

A

Ability to transmit an electrical impulse from one cell to another

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17
Q

How is contractility described?

A

Ability of the cardiac muscle to shorten in response to an electrical impulse

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18
Q

Why does perfusion only discuss the blood flow running through arteries, arterioles, and capillaries?

A

Because there is little oxygen in venous return

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19
Q

What does epicardium refer to?

A

Outer layer of heart including the hearts nerves and blood vessels

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20
Q

What does the myocardium refer to?

A

The middle layer or muscle of the heart

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21
Q

What does endocardium refer to?

A

The inner layer of the heart including the heart valves.

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22
Q

When do the arteries that supply the heart with oxygen fill up with blood?

A

During diastole

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23
Q

What node does the SA node communicate to when stimulating a heart beat?

A

The AV node

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24
Q

When the AV node gets the impulse for the heart to beat where does it send that information to?

A

The Bundle of His

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25
Q

When the Bundle of His gets the impulse for the heart to beat where does it send the information to?

A

The Purkinje fibers

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26
Q

When happens inside the calcium channels during depolarization?

A

Sodium and calcium enter the cell and potassium leaves

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27
Q

What happens inside the calcium channels during repolarization?

A

Sodium and calcium leaves the cell and potassium enters.

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28
Q

What percentage of the total blood volume in the heart gets ejected during each beat?

A

55-65%

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29
Q

What is the equation to find cardiac output or CO?

A

Heart Rate (HR) x Stroke Volume (SV)

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30
Q

How much blood is released from the left ventricle per minute? (in L)

A

4-6 L

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31
Q

How much blood is ejected from the heart during each stoke? (in mL)

A

60-130 mL

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32
Q

What is the equation to find the Ejection Fraction? (EF)

A

Stroke volume (SV)/ End Diastolic Volume (EDV)

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33
Q

What needs to remain the same regardless of how much end diastolic volume here is?

A

The residual left in the heart per stroke needs to remain the same regardless of the amount of volume was placed in the heart.

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34
Q

How is depolarization described?

A

Electrical activation of a cell causes the influx of sodium into the cell while potassium exits the cell

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35
Q

How is repolarization described?

A

Return of the cell to the resting state caused by re-entry of potassium into the cell while sodium exits.

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36
Q

How is the effective refractory period described?

A

Phase in which cells are incapable of depolarizing

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37
Q

How is the relative refractory period described?

A

Phase in which cells require a stronger-than-normal stimulus to depolarize

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38
Q

What are the two most common reported clinical symptoms in terms of issues of the heart?

A

Chest pain and dyspnea

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39
Q

What does JVD stand for?

A

Jugular Vein Distention

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40
Q

How can you tell if a patient has JVD?

A

They have a very large and rebounding jugular vein. You can see it pulsating.

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41
Q

What causes JVD?

A

hypervolemia

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42
Q

Where on the body can you hear the aortic valve?

A

On the right side, 2nd intercostal space, against the sternal boarder.

43
Q

Where on the body can you hear the pulmonic valve?

A

On the left side, 2nd intercostal space, against the sternal boarder.

44
Q

Where on the body can you hear Erb’s point?

A

On the left side, 3rd intercostal space, against the sternal boarder.

45
Q

Where on the body can you hear the tricuspid valve?

A

On the right side, 4th intercostal space, against the sternal boarder.

46
Q

Where on the body can you hear the mitral valve?

A

On the left side, 5th intercostal space, midclavicular line.

47
Q

How is the S1 sound described?

A

The closing of the AV valves (tricuspid and mitral) “lub”

48
Q

When do you hear the S1 sound?

A

At the beginning of ventricular systole.

49
Q

Where is the S1 sound best heard?

A

At the apex aka the mitral valve

50
Q

How is the S2 sound described?

A

The closing of the semi-lunar valves (aortic and pulmonic) “dub”

51
Q

When do you hear the S2 sound?

A

The end of systole and the beginning of ventricular diastole

52
Q

Where is the S2 sound best heard?

A

At the aortic or pulmonic area.

53
Q

How are murmurs described?

A

A turbulent flow caused by the stenosis or regurgitation of a valve.

54
Q

What do you need to document when describing a murmur?

A

Timing Location Loudness Pitch Quality

55
Q

What type of creatine kinase is specific to the heart?

A

Creatine MB (CK-MB)

56
Q

How is Holter Monitoring described?

A

A 5-lead EKG over 24 hours.

57
Q

Why would a patient need to be on Holter Monitoring?

A

Because they are experiencing angina and the doctor is trying to pinpoint why.

58
Q

What does a patient who is on Holter Monitoring need to tell the doctor?

A

When they experienced the angina pain and what activity they were doing.

59
Q

Where do you assess the pulses on a patient who underwent a heart catheterization?

A

The pulse that is distal to the incision site.

60
Q

How long should your patient lay flat after a heart catheterization?

A

2-6 hours

61
Q

When the heart rate decreases what happens to the hearts work load?

A

It increases

62
Q

How is dysrhythmias described?

A

Disorders of the formation or condition (of both) of the electrical impulses in the heart

63
Q

What can cause disturbances of the heart?

A

Rate, rhythm or both

64
Q

How are dysrhythmias diagnosed?

A

By analysis of ECG waveform

65
Q

What do dysrhythmias have the potential to do?

A

Alter blood flow and cause hemodynamic changes

66
Q

When the SA node is in charge: how many beats per minute does the heart conduct?

A

60-100 bpm

67
Q

When the AV node is in charge: how many beats per minute does the heart conduct?

A

40-60 bpm

68
Q

When the bundle branch and/or purkinje fibers are in charge: how many beats per minute does the heart conduct?

A

20-40 bpm

69
Q

On a 5 lead EKG where do you place the white colored lead?

A

Upper right part on the chest. *Remember: white = right!

70
Q

On a 5 lead EKG where do you place the green colored lead?

A

Lower right part on the chest. *Remember: Snow over trees or clouds on grass

71
Q

On a 5 lead EKG where do you place the black colored lead?

A

Upper left part on the chest

72
Q

On a 5 lead EKG where do you place the red colored lead?

A

Lower left part on the chest *Remember: Smoke over fire!

73
Q

On a 5 lead EKG where do you place the brown colored lead?

A

On the center of the chest- centered between the four other leads.

74
Q

What part of the heart is responsible for the P-wave?

A

The electric communication between the SA and AV nodes causing the atrial contraction

75
Q

What part of the heart is responsible for the QRS complex?

A

The electrical signal going through from the AV node through the Bundle of His and Purkinje Fibers. Causing contraction of the ventricles.

76
Q

What is occurring in the heart during the T-wave?

A

Ventricle repolarization

77
Q

What are the 5 portions of a heart beat when represented on an EKG?

A

P-wave P-R interval QRS complex S-T segment T-wave

78
Q

What are the 5 questions you need to answer in reference to the p-wave?

A
  1. Is it present? 2. Are they occurring regularly? 3. Is there a p-wave for every QRS complex? 4. Are they smooth, rounded and upright or are they inverted? 5. Do all the p-waves look similar?
79
Q

How many seconds are in a PR interval?

A

0.12-0.2 seconds

80
Q

How many seconds are in a QRS complex?

A

less than 0.12 seconds

81
Q

What is the time significance between each QRS complex on EKG strip?

A

It is how you can tell if the patient has a normal heart rate

82
Q

What are the components of a normal sinus rhythm?

A

-The measure of time between each R and R is constant. -Uniform P waves -60-100 BPM -One P-wave for each QRS -P-R Interval: 0.12-0.20 seconds and is constant -QRS: less than 0.12 seconds

83
Q

What is the criteria for sinus bradycardia?

A

Meets all criteria for normal sinus rhythm EXCEPT: less than 60 BPM

84
Q

If the sinus bradycardia is asymptomatic what treatment should be done?

A

None

85
Q

If the sinus bradycardia is symptomatic what treatment should be done?

A

Treat the underlying cause

86
Q

What may a patient need if they have sinus bradycardia?

A

A pacemaker

87
Q

What medications do you need to check for if a patient has bradycardia?

A

Digoxin Beta blockers Calcium channel blockers

88
Q

What are the criteria for sinus tachycardia?

A

Meets all criteria for normal sinus rhythm: EXCEPT: Greater than 100 BPM *Usually between 100 - 160

89
Q

If a patient has sinus tachycardia what may it be secondary to?

A

Exercise Heightened emotions Caffeine Nicotine ETOH Cocaine Amphetamines

90
Q

If a patient has sinus tachycardia what may this signal?

A

Massive heart damage Impending heart failure Shock

91
Q

What underlying causes may there be if a patient has sinus tachycardia?

A

Blood or fluid loss MI Pulmonary Edema

92
Q

What medication do you need to check for in a patient with sinus tachycardia?

A

Beta blockers Calcium channel blockers

93
Q

What criteria does an EKG reading need to have in order for it to be labeled as a dysrhythmia?

A

-R to R varies: may change with respirations -Uniform P wave for each Q wave -Normal heart rates: 60-100 bpm -PR interval constant: 0.12-0.20 seconds -QRS complex: less than .12

94
Q

Based on this EKG strip:
What would the patients diagnosis be?

A

Sinus Tachycardia

95
Q

Based on this EKG: What would this patient be diagnosed with?

A

Dysrhythmia

96
Q

Based on this EKG strip: What would this patient be diagnosed with?

A

Sinus Bradycardia

97
Q

Based on this EKG strip: What would this patient be diagnosed wtih?

A

Normal Sinus Rhythm

98
Q

Based on this EKG strip: What would this patient be diagnosed with?

A

Premature Atrial Contraction (PAC)

99
Q

How many seconds do you need to look at an EKG strip to diagnose a patient with an abnormality?

A

6 seconds

100
Q

In a Premature Atrial Contraction (PAC) what happens to the P-wave?

A

It is not rounded- it is spiky

101
Q

What happens to the P and T waves during Premature Atrial Contraction (PAC)?

A

They almost connect. The p-wave starts directly after the t-wave

102
Q

What is the heart not doing properly during Premature Atrial Contaction?

A

Repolarizing

103
Q

What is happening to the PR interval and QRS complex during a Premature Atrial Contraction (PAC)?

A

Nothing- both of them are within normal limits

104
Q

Why can pulmonary edema occur in a patient who has sinus tachycardia?

A

The heart is not pumping enough blood out of the heart so it is backing up in the lungs

Cardiac (13 decks)

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