Cardiovascular Panopto Flashcards (Part 1)
1
Q
The heart is a-
A
Muscle
2
Q
Where specifically is the heart located?
A
In the Thorax, in the Mediastinal Space
3
Q
What is the Mediastinum (or Mediastinal Space)?
A
It is the space between the lungs
4
Q
What separates the left and right pleural cavities?
A
The Mediastinal Space
5
Q
What divides the heart vertically?
A
The Septum
6
Q
What are the 3 cardiac layers in order of the outer-most to inner-most layers of the heart?
A
The outer-most is the Epicardium.
The middle layer is the Myocardium.
Then inner-most layer is the Endocardium.
7
Q
What is the heart covered by?
A
The Pericardium
8
Q
The Pericardium is a sac that covers the heart.
How many layers does it have?
What are they called?
A
2.
The Visceral Pericardium & The Parietal Pericardium
9
Q
What should you always think of whenever you hear the word “Visceral”?
A
Organs
10
Q
How thick is the Endocardium?
A
It is thin
11
Q
What is the outer-layer of pericardium called?
What is the inner-layer called?
A
The Parietal Pericardium
The Visceral Pericardium
12
Q
The visceral pericardium can also be called the-
A
Endocardium
13
Q
How many mL of Pericardial Fluid does the Pericardial Space contain?
A
10-15 mL
14
Q
What does Pericardial Fluid do?
A
Prevents friction between the surfaces of the heart whenever it contracts
15
Q
There are how many chambers of the heart? What are they called?
A
4.
The right atrium, right ventricle, left atrium, left ventricle
16
Q
There are how many valves of the heart? What are they called?
A
4.
The Tricuspid Valve
The Pulmonic Valve
The Mitral Valve
The Aortic Valve
17
Q
The left ventricular wall is how much thicker than the right?
A
2-3 Times Thicker
18
Q
Which is thicker, the atria or the ventricles?
A
The Ventricles
19
Q
Which chamber of the heart has the thickest walls?
A
The left ventricle
20
Q
What does AV stand for?
Where are the AV valves found?
A
AV stands for Atrioventricular Valves.
They are found between the atria and ventricles.
21
Q
List all of the AV:
A
The Tricuspid Valve + The Mitral Valve
22
Q
What do the valves prevent?
A
Regurgitation (When the blood in the heart goes backwards instead of being propelled forwards properly after a ventricular contraction)
23
Q
The type of valves that allow blood to enter the great vessels =
A
The Semilunar Valves
24
Q
List the Semilunar Valves (SV):
A
Pulmonic Valve + Aortic Valve
25
You’re assessing the Aortic Area, where should your stethoscope be?
2nd Intercostal Space, Right Side, Parallel to the Pulmonic Area
26
You’re assessing the Pulmonic Area, where should your stethoscope be?
2nd Intercostal Space, Left Side, Parallel to the Aortic Area
27
You’re assessing the Erb’s Point, where should your stethoscope be?
Directly below the Pulmonic Area, Third Intercostal Space
28
You’re assessing the Tricuspid Area, where should your stethoscope be?
Fifth Intercostal Space, directly below the Erb’s Point & Pulmonic Areas
29
What is the area of the heart called that the Apex of the heart and the Point of Mass Impulse (PMI) is located?
The Mitral Area
30
You’re assessing the Mitral Area, where should your stethoscope be?
Fifth Intercostal Space, at the Mid-Clavicular Line (MCL)
31
What is Pericarditis?
When the pericardium gets inflamed. This causes there to be excess pericardial fluid
32
The heart is what kind of pump?
A Myocardial Pump (A Muscular Pump)
33
Where does the right ventricle pump blood into?
The pulmonic valve opens up and it goes into the pulmonary arteries and to the lungs
34
Where does the left ventricle pump blood into?
The Aortic Valve opens up and it goes into the Aorta and into the body’s systemic circulation
35
The heart is used as a major transport system in the body, it also picks up waste and carries that to different sites for-
Metabolism and for Disposal
36
Which side of the heart pushes blood to the pulmonary circulation (to go to the lungs)
Which side of the heart pushes blood to the systemic circulation (to go to the organs, tissues, etc.)
The Right Side
The Left Side
37
When do the chambers of the heart fill with blood?
Diastole
38
When do the chambers of the heart empty their blood?
Systole
39
What are Arteries?
Vessels that carry oxygenated blood away from the heart and to other tissues
40
What is the only artery called that carries deoxygenated blood?
The Pulmonary Artery
41
What do Arterioles do?
They control blood flow into the capillaries
42
What do the Capillaries do?
They allow for the exchange of fluid and nutrients between the blood and the interstitial spaces
(To try to simplify, capillaries let the blood into the organs and tissues so that they can give away their oxygen and nutrients. At the same time, they also take the waste products, like deoxygenated blood, out of the tissues)
43
What do Venules do?
They revive deoxygenated blood from the capillaries and move that blood into the veins
44
What do the Veins do?
They carry deoxygenated blood back to the right side of the heart and then to the lungs for reoxygenation
45
What helps return blood to the heart against the force of gravity?
Veins
46
What do Lymphatics do?
They drain the tissues and return the tissue fluid to the blood
47
What makes up the Vascular System?
Arteries + Arterioles + Capillaries + Venules + Veins + Valves + Lymphatics
48
When does the blood officially enter the systemic circulation?
When it enters the Aorta
49
The Coronary Circulation establishes a blood supply to the -
Myocardium
50
What do your coronary arteries connect? Why?
They connect the Myocardium with the Aorta. This is done to keep a blood supply established for the Myocardium
51
What are the two types of Coronary Arteries?
Left Coronary Artery
Right Coronary Artery
52
Which Coronary Artery allows blood to flow to the Anterior (Front) heart wall?
Left Coronary Artery
53
Which Coronary Artery allows blood to flow to the Posterior (Inferior) heart wall?
Right Coronary Artery
54
What are some factors that can cause decreased coronary blood flow?
Blood Clotting
Atherosclerosis
55
What is Ischemia caused by?
Temporary blood loss to the tissues of the heart
56
What does Ischemia cause?
Angina
57
What is Angina?
A type of chest pain that’s caused by reduced blood flow to the heart
58
What’s a Myocardial Infarction?
It’s the same thing as a heart attack and it caused tissue death (Necrosis)
59
So what’s the difference between Ischemia and Infarction?
Ischemia just means you have a reduced blood flow to the tissues of the heart.
Infarction is whenever you aren’t getting any blood flow at all to the tissues of the heart.
60
When does the blood flow into the Coronary Arteries?
During Diastole
61
A client with a Tricuspid Valve Disorder has impaired blood flow to which area?
A.) Vena Cava and Right Atrium
B.) Left Atrium and Left Ventricle
C.) Right Atrium and Right Ventricle
D.) Right Ventricle and Pulmonary Artery
C
62
The Sinus Node and the SA Node is the same thing as-
The Sinoatrial Node
63
What is the Sinoatrial Node? What’s its function?
The pacemaker of the heart. It’s function is to send out electrical signals to the AV node to make the heart contract
64
Where’s the SA Node located?
At the junction of the Superior Vena Cava and the Right Atrium
65
At what rate should the SA Node fire impulses to the AV Node?
60 - 100 times a minute
66
The SA Node has-
What does this mean?
Automatic Firing.
It doesn’t have anything telling it when to send impulses, it just does it on its own automatically.
67
What is the SA Node controlled by?
The Sympathetic and Parasympathetic Nervous System
68
What is the Cardiac Conduction System composed of?
The SA Node
The AV Node
The Bundle of HIS
The Right and Left Bundle Branch
The Purkinje Fibers
69
Where does the SA Node fire its electrical impulse to?
The AV Node
70
Where does the AV Node take electrical impulses to?
The Bundle of HIS
71
Where does the Bundle of HIS take electrical impulses to?
It separates the electrical impulses into the Right and Left Bundle Branch
72
Where does the Right Bundle Branch take electrical impulses to?
The Purkinje Fibers
73
Where does the Left Bundle Branch take electrical impulses to?
The Purkinje Fibers
74
Whenever the heart contracts, what is contracting?
A.) The Atria Only
B.) The Ventricles Only
C.) Both, the Atria and Ventricles
D.) The Right Ventricle and Right Atrium
C
75
What does an EKG/ECG show?
The Electrical Pathway of the Conduction System
76
What is an Etopic Beat?
When the electrical impulses are stimulated from areas other than the SA Node
77
What can an Etopic Beat interfere with?
The Contraction of the Heart & Proper Circulation
78
How do you typically treat an Etopic Beat?
You go in and do what’s called an Ablation
79
What is an Ablation?
You go in and you make small burns or freezes to cause come scarring on the inside of the heart.
This scarring helps break up the electrical signals that cause the arrhythmia.
80
Where is the AV Node located?
The lower aspect of the Atrial Septum
81
How many Septum’s are there?
What do they do?
The Ventricular Septum
The Atrial Septum
These separate the Ventricles and the Atria vertically.
82
If the SA Node fails, what can the AV Node do to compensate for it?
It can initiate and sustain a heart rate of 40 - 60 BPM
83
When do you have to have an artificial pacemaker?
Whenever the SA Node stops functioning properly
84
Whenever the higher pacemakers fail (SV & AV Nodes), the Purkinje Fibers can act as the pacemaker.
The Purkinje Fibers can initiate and maintain a heart rate of-
20 - 40 BPM
85
When does the right atrium relax and allow for more blood to enter it?
As soon the deoxygenated blood enters the pulmonary arteries and the pulmonic valve closes
86
What carries oxygenated blood to the left atrium?
The Pulmonary Veins
87
What are the only veins in your body that carry oxygenated blood?
Pulmonary Veins
88
The valves are made up of 2-3 small but strong flaps of tissue called-
Leaflets
89
How many Leaflets does your Tricuspid Valve have? What about your Bicuspid Valve?
Tricuspid Valve = 3 Leaflets
Bicuspid Valve = 2 Leaflets
(Hence the names.)
“Tri” = 3
“Bi” = 2
90
The Pulmonic Valve and Aortic Valve both have how many Leaflets?
3
91
When does Coronary Disease occur?
What does this cause?
Whenever there is a build up of Cholesterol Plaque in the Coronary Arteries.
Myocardial Infarction / Heart Attack OR Ischemia.
92
How can you tell whenever a heart cycle ends?
The ‘Lubb-Dupp’ Cycle
93
The Lubb sound is your-
S1 Sound
94
The S1 sound is caused by the closure of which valves?
The AV Valves
95
The Dupp sound is your-
S2 Sound
96
The S2 sound is caused by the closure of which valves?
The Semilunar Valves
97
S1 is the start of-
And it’s the end of-
Systole.
Diastole.
98
S2 is the start of-
And it’s the end of-
Diastole.
Systole.
99
Is there an S3 heart sound?
Yes, and it can be an abnormal finding. It is also called a “Ventricular Gallop”.
100
When will you hear an S3 heart sound?
Whenever the ventricular wall compliance is decreased and the structures in the ventricular wall vibrate
101
What conditions can cause an S3 sound?
Heart Failure
A Valve Regurgitation
102
An S3 sound can be normal if you are how old?
Under 30 Years Old
103
Is there an S4 sound?
Yup, it is also called an “Atrial Gallop”
104
Is an S4 sound always an abnormal finding?
No, it can be an expected finding in the Elderly, Children, and Athletic Patients
105
When can an S4 sound be heard?
It can be heard during Atrial systole if there’s resistance to ventricular filling
106
What are some causes of the S4 sound?
Cardiac Hypertrophy.
Disease or Injury to the ventricular wall.
107
S3 and S4 are low pitch, and so they should be heard with what part of the stethoscope?
The bell of the stethoscope
108
What should you hear if you assess someone’s heart sounds and you hear S1, S2, and S3?
Lubb Dubb Dubb
109
What should you hear if you assess someone’s heart sounds and you hear S1, S2, and S4?
Dubb Lubb Dubb
110
The S3 and S4 sound are both heard during-
Diastole
111
When is the S3 sound heard?
EARLY in Diastole
112
When is the S4 sound heard?
LATE in Diastole
113
Where is the Angle of Louis?
The Second Rib
114
What can you use the Angle of Louis for?
For finding where the cardiac landmarks are
115
If your HR is fast, the heart will have less time for what?
What will this result in?
Filling.
This is will result in a decreased cardiac output.
116
What do you call a normal heart rate without an abnormalities?
A Normal Sinus Rhythm
117
You have a patient with a heart rate of 110 BPM, but they aren’t showing any signs or symptoms of anything and everything else is otherwise normal. What is this called?
Sinus Tachycardia
118
You have a patient with a heart rate of 50 BPM, but they aren’t showing any signs or symptoms of anything and everything else is otherwise normal. What is this called?
Sinus Bradycardia
119
Specialized nerve endings affected by changes in the arterial BP =
Baroreceptors
120
Baroreceptors are also called-
Pressoreceptors
121
What are Baroreceptors located?
In the walls of the aortic arch and carotid sinuses
122
What stimulates Baroreceptors?
Increases in arterial pressure
123
What happens whenever the Baroreceptors are stimulated?
The HR and Arterial Pressure should decrease
124
What causes a reduced stimulation of Baroreceptors?
Decreases in arterial pressure
125
What happens if the stimulation of Baroreceptors is decreased?
Vasoconstriction Occurs + HR Increases
126
Where are Stretch Receptors located?
The Vena Cava & Right Atrium
127
What do Stretch Receptors respond to?
Pressure changes that affect circulatory blood volume
128
When you have too much fluid volume in your body =
Hypervolemia
129
When you don’t have enough fluid volume in your body =
Hypovolemia
130
What does Hypovolemia do to your BP?
Decreases it
131
What does Hypervolemia do to your BP?
Increases it
132
When the BP decreases as a result of hypovolemia, what occurs?
A Sympathetic Response
133
Whenever a sympathetic response occurs as a result of Hypovolemia, what does this cause?
Increased HR + Vasoconstriction
134
Whenever a sympathetic response occurs as a result of Hypervolemia, what does this cause?
Decreased HR + Decreased Arterial Pressure
135
What hormone influences BP indirectly by regulating vascular volume?
Antidiuretic Hormone
136
Antidiuretic Hormone is also called-
Vasopressin
137
What do increases in blood volume result in?
Decreased releasing of ADH.
Increased Diuresis.
Decreasing Blood Volume + BP.
138
What do decreases in blood volume result in?
Increased releasing of ADH.
This causes an increase of blood volume + BP.
139
What is Diuresis?
Increased or Excessive Production of Urine
140
What is Renin?
A potent vasoconstrictor that causes BP to increase
141
Renin is responsible for converting what into what?
Angiotensinogen into Angiotensin I
142
What is Angiotensin I converted into?
Angiotensin II
143
Where is Angiotensin I converted into Angiotensin II?
In the lungs
144
What does Angiotensin II stimulate?
The release of Aldosterone
145
What does Aldosterone do?
Promotes water + sodium retention by the kidneys. This increases Blood Volume & BP.
146
What does the stimulation of Sympathetic Nerve Fibers release?
Norepinephrine
147
What is Norepinephrine?
A Neurotransmitter
148
Whenever the stimulation of Sympathetic Nerve Fibers releases the neurotransmitter Norepinephrine, what does this cause?
Increased HR + Increased Conduction Speed through the AV Node + Increased Atrial & Ventricular Contractility + Peripheral Vasoconstriction
149
When does the stimulation of Sympathetic Nerve Fibers occur?
Whenever a decrease in pressure is detected
150
When does the stimulation of the Parasympathetic Nerve Fibers occur?
When an increase in pressure is detected
151
What does the stimulation of Parasympathetic Nerve Fibers release?
Acetylcholine
152
What is Acetylcholine?
A Neurotransmitter
153
Whenever the stimulation of Parasympathetic Nerve Fibers releases the neurotransmitter Acetylcholine, what does this cause?
Decreased HR.
Lessens Atrial & Ventricular Contractility + Conductivity.
154
What is your Cardiac Output equal to?
Stroke Volume (SV) x HR
155
What things affect Stroke Volume and Heart Rate?
Preload
Afterload
Vascular System
156
What is Preload?
The volume of blood in the ventricles at the end of diastole
157
What is Afterload?
The amount of resistance that the left ventricle has to overcome to eject the blood
158
What causes an increased Preload?
Hypervolemia
Regurgitation of Cardiac Valves
Heart Failure
159
What causes an increased Afterload?
Hypertension
Vasoconstriction
160
What is the Cardiac Output?
The amount of blood pumped by the ventricles in 1 minute
161
What is the normal Cardiac Output at rest?
4 - 8 L
162
What is the SV?
The amount of blood pumped by the ventricles with each contraction
163
With each heartbeat, the average SV is-
70 mL per beat
164
Where is the blood being ejected to by the ventricles?
The Right Ventricle pumps blood to the Pulmonary Artery + Pulmonary Vessels.
The Left Ventricle pumps blood to the aorta for systemic circulation.
165
It’s important to remember that if the exam doesn’t specify what the patient’s stroke volume is, then the SV is by default, how many mL?
70 mL
166
How many can the SV increase with exercise?
Up to 80 mL
167
What should the total blood volume in your body be?
~ 5 L
168
About how long does it take for the entirety of your blood volume to circulate through your heart?
~1 Minute
169
If the HR increases then the CO -
Also Increases (If the SV is normal and unchanged)
170
If the HR decreases then the CO -
Also Decreases (If the SV is normal and unchanged)
171
How many BPM can your HR reach up to for short periods without any harmful effects?
What is this an example of?
180 BPM.
Sinus Tachycardia.
172
A HR greater than or equal to 180 BPM will cause you to have a very short diastole. What does this mean for your ventricles?
They won’t have enough time to fill properly
173
If Tachycardia goes on for a prolonged period of time, then it will-
Decrease Stroke Volume + Cardiac Output
174
What can cause Tachycardia?
Increased Metabolism (Exercise, Fever, Increased Thyroid Hormone, Young Age).
Stress Response.
Meds (Caffeine, Nicotine, Epinephrine).
175
What can cause Bradycardia?
Decreased Metabolism (Decreased Thyroid Hormone, Age).
Vagus Nerve Stimulation or Carotid Massage.
Meds (Digoxin).
176
What does the medication Digoxin do?
Increase the strength of the heart’s contractions + Slow the HR
177
What are some early symptoms of Tachycardia?
Dizziness, Light-Headedness, SOB
178
What are some early symptoms of Bradycardia?
Dizziness, Fatigue, Near Fainting (Syncope)
179
What about Bradycardia causes Syncope?
The Decreased Cardiac Output = Not Enough Blood Getting to the Brain
