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EBCM Lab > Cardiovascular Lecture and Lab > Flashcards

Cardiovascular Lecture and Lab Flashcards

1
Q

How does blood flow through the heart?

A

In superior vena cava, to right atrium, through the tricuspid valve, into the right ventricle, through the pulmonic vavle into pulmonary artery, to lung, to pulmonary vein, to left atrium, through mitral valve, to left ventricle, through aortic valve to the aorta and systemic circulation

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2
Q

What are the AV valves?

A

Atrioventricular
-Tricuspid and Mitral

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3
Q

What are the semilunar valves?

A

Pulmonary and aortic

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4
Q

Which side of the heart is high pressure versus low?

A

High is left, low is right

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5
Q

How does electricity flow though the heart?

A

SA node (sinus) (Depolarize atrium) -> AV node ->through septum and spirals back up and around (Depolarize ventricle)

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6
Q

What does each part of the P-QRS-T wave represent?

A

P - Atrial Depolarization
QRS - Ventricle Depolarization
T- Ventricle Repolarization

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7
Q

What does each heart phase and sound line up with?

A

S1: Lub: Closure of AV valves (Tricuspid and Mitral) - end diastole beginning of systole

S2: Dub: Closure of Semilunar (Pulmonary and Aorta) - end of systole beginning of diastole

S3: ventricular filling

S4: Atrial Contribution to ventricular filling

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8
Q

What occurs electrically and physically during cycle?

A

Early Systole: Ventricles depolarize, S1-AV valve snap shut and ventricular presure rises (Make QRS)

Systole: Ventricle contract, push blood through semilunar valves into pulmonary artery and aorta, ventricle repolarize (T)

Late Systole: Pressure in ventricle drop, S2 -semilunar valve snap shut

Early Diastole: S3 - Passive ventricular filling

Mid-Late Diastole: Atrial Depolarization S4 - atrial contributing to ventricular filling
(would not hear in afib)

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9
Q

What should be part of your cardiac examination?

A

Normal PE
BCS
Cardiopulmonary auscultation on both sides of chest
Palpation and observation - jug vein, peripheral arteries and distal limb (Feel mandibular and facial)

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10
Q

When listening to the heart is systole or diastole the longer or shorter pause?

A

Systole: short pause
Diastole: long pause

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11
Q

What should you observe and palpate during your cardio exam?

A

RR rate and effort
Jug vein pulsation
-Tell pressure RA and RV - extend 2/3 up neck in heart failure
-Hyperdynamic
-Palpate peripheral pulse and chest

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12
Q

What occurs when there is cardiovascular disease?

A

Incidence valvular regurgitation and arrythmias
-Murmur - physiologic, AOR, MR, TR
-Arrhythmia - 2 AV, AF
-Fatal low

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13
Q

What is heart failure?

A

Impaired emptying or filling
-Chronic or acute valvular regurgitation
-Myocarditis
-large Vessel rupture
-Congenital anomalies
-Pericarditis
-Severe lung disease

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14
Q

What signs might you see based on heart failure location?

A

Right: Peripheral edema, cavitary effusion

Left Sided: Cough, pulmonary edema

Subclinical heart disease, exercise intolerance, cyanosis, failure to thrive, syncope and sudden death

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15
Q

What is pathognomonic for Pulmonary Edema?

A

Foam out of the nostrils

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16
Q

When are additional diagnostics needed?

A

Loud murmur (3/6 or higher) - athlete
Unexplained exercise intolerance
Irregular Rythm
Sustained tachycardia >60bpm
Muffled heart sound
Sign CHF

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17
Q

What can radiographs be used to ascess?

A

Size of heart, pulmonary vessels and lung parenchyma

18
Q

When performing a base-apex ECG, where do you want your leads for a negative QRS?

A

White- Right point of shoulder (base)
Black - Left axilla (apex)
Red - anywhere on right (Right jug furrow)

19
Q

What is your ECG checklist of things to evaluate?

A

Heart Rate
Rhythm - RR interval (regular or irregular)
Relationship between P and QRS
Morphology complexes

20
Q

How should you calculate the HR on ECG?

A

Count small boxes (MM) between R-R complex and divide by paper speed. Then do 60 over your answer to get BPM.

21
Q

Why do we perform echocardiogram?

A

Allows us to assess chamber size, vascular architecture and competency and cardiac function

22
Q

What are some general rules for Echocardiogram?

A

Adult heart should fit on 30cm screen

L atrium 11-14cm depend on breed

RH should be 1/3 LH

Valve leaflets should be clean and crisp with synchronous motion

23
Q

How do you determine cardiac function on echo?

A

Fractional shortening - % decrease left ventricle when comparing diastole to systole

24
Q

What is color doppler used for on echo?

A

Intensity and shade color vary to depict velocity and direction of blood flow
-M mode allow timing of regurgitation

Blue - away
Red - toward
Green - laminar flow turbulent

25
Q

What are the most common forms of cardiac disease in the equine?

A

Cardiac malformations, acquired valvular disease and arrythmias

26
Q

What is left sided heart failure?

A

pulmonary edema due to heart disease

27
Q

What is right sided heart failure?

A

Peripheral edema, ascites, pleural effusion

28
Q

What are signs of heart disease?

A

Exercise Intolerance
Cough (left sided)
Tachypnea, Hyperpnea, respiratory
Ventral Edema (right sided)
Syncope
Failure to thrive

29
Q

What should be included in a PE for suspect heart disease patient?

A

Exam in quiet area
BCS
RR rate and character assessed
Color, CRT and hydration status
Examine Jug vein (1/3 up neck normal)
Arterial Pulse
Precordial Palpation (PMI)
Auscultation

30
Q

If the jugular vein fills higher than 1/3 way up the neck what may be the issue in the sense of heart physiology?

A

Increase in right ventricular diastolic pressure (filling)

31
Q

What is felt when you are feeling an arterial pulse?

A

ventricular ejection
(influenced by stroke volume)

32
Q

What 2 things can be evaluated from the pulse?

A

Amplitude - strength of pulse (difference between systolic and diastolic)

Character - subtle shape of arterial pressure pulse - rate it rises and falls

33
Q

When is there a right ventricular heave?

A

Substantial right ventricular hypertrophy

34
Q

When does a hyperdynamic precordium result?

A

When there is ventricular enlargement and preserved systolic function

35
Q

When does a precordium thrill occur?

A

Palpable vibration of chest wall that occurs when kinetic energy from high intensity murmurs are communicated through teh chest wall

36
Q

What are the normal heart sounds and what is occurring during them?

A

S1 - Lub - AV valves closing (Start of systole)
S2 - Dub - Semilunar closing (End of Systole)
S3 - Whoosh - Ventricular Filling (diastole)
S4 - Atrial contraction (diastole)

37
Q

What does the radiograph provide diagnostically?

A

Global cardiac size
Indirect assessment of performance - see pulmonary vessels and parynchema

38
Q

What is an electrocardiography?

A

record of electrical activity of heart and primary means by which to clarify a physical finding of arrythmia

-Cant evaluate side in horse - why we don’t need so many leads

39
Q

How is the single bipolar lead base-apex applied to the horse?

A

White - right point of shoulder
Black - behind left shoulder
Red - right side jugular

40
Q

What does each letter of the P QRS T wave represent?

A

P - Right atrium depolarize
QRS - Ventricles depolarize
T - Ventricle Repolarization
R-R Interval - Evaluate Rhythm

41
Q

What is echocardiography?

A

Use of medical ultrasound to provide information regarding cardiac structure and function
-No sedation needed
-M mode and 2D
-Tell size, myocardial function and pericardial space
-See individual chambers and measure them
-Doppler - see colors

42
Q

What do the colors represent on a doppler echocardiogram?

A

Blue - away
Red - toward
Green - turbulence

EBCM Lab (4 decks)

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