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SRNAanatomy > Cardiovascular Part I > Flashcards

Cardiovascular Part I Flashcards

1
Q

Heart Located in ___________
Base - ____________
Apex - ___________

A
  • mediastinum, between lungs
    -broad superior portion of heart
  • inferior end, tilts to
    the left, tapers to point
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2
Q

Small space between aortic arch and the pulmonary trunk. ________ it contains the ___ ______ and ______ _____ nerve. May occur on its own or with ________.

A

Aorto-pulmonary window
Ligamentum Arteriosum
Recurrent Laryngeal Nerve
heart defects.

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3
Q

Special anesthetics consideration s with mediastinal masses
Hemodynamics
Respiratory compromise
Four Ts

A 
Hemodynamic compromises
Neuro problems (Increased ICP)
Resp comprose
Four Ts : thymoma, teratoma, Thyroid Carcinoma 
and Terrible lymphoma
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4
Q

CARDIOPHRENIC ANGLE MASS: 2 most common and 4 less common

A

Pericardial Fat pad
Pericardial cyst

less common
Morgagni herniation
Lymphadenopathy
Malignant NEOPLASM

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5
Q

Pericardium role:

A

Surrounds, protects and hold heart in place.
allows heart to beat without friction
room to expand

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6
Q

2 types of Pericardium

A

serous pericardium

fibrous pericardium

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7
Q

Ligaments

A

Central tendon ligament
Sternalpericardial ligament
Vertebrol pericardial ligaments

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8
Q

Heart attachments/Ligaments

A

Central tendon ligament
Sternalpericardial ligament
Vertebropericardial ligaments

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9
Q

Chambers of the heart

A

2 atria
2 ventricles
2 auricles

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10
Q

Right atrium received _____blood from 3 veins : ___ _____ _____

A

Deoxygenated
Superior Vena Cava
Inferior Vena Cava
Coronary sinus

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11
Q

Left atrium received _______blood from the ______through _______ veins? How many?

A

Oxygenated; lungs; 4 Pulmonary

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12
Q

Puch like structure on surface of both atria

A

Auricles

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13
Q

Ventricles are

A

2 blood pumping chambers

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14
Q

Right Ventricle

A

Pumps blood out to the pulmonary trunk

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15
Q

___ ____- pumps blood out to the pulmonary trunk. The PT Divides into _____ and __________
• ______distance, _____resistance, ______pressure required

A

Right Ventricle
right and left pulmonary arteries (to lungs)
Short; less; lower

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16
Q

_____ _______- pumps blood out to the Aorta (then systemically)
• ______distance, ______ resistance, requires higher pressure
• It is the thickest chamber - works harder to maintain ____________

A

Left Ventricle
Longer; more; higher
maintain same rate of blood flow as right side

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17
Q

Atrioventricular (AV) valves: prevent __________

pressure in atrium ____ valve; Ventricles contract = pressure in ventricle _____ valve

A

backflow into the 2 atria; open; close

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18
Q
  1. Tricuspid valve (3 cusps) - location ?
A

between right atrium & right ventricle

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19
Q
  1. Bicuspid (mitral) valve -location_________
A

between left atrium & left ventricle

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20
Q

2 Semilunar (SL) valves: prevent_________ _______closes

A

prevent back flow into ventricle

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21
Q

LOCATIONS

  1. Pulmonary semilunar valve - _________
  2. Aortic semilunar valve - ___________
A

between right ventricle and pulmonary trunk
between left ventricle and aorta
Valve Disorders:

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22
Q

Prolapse occurs when ______________

A

AV valve cusp is pushed up into atrium

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23
Q

________ is a narrowing of a heart valve which restricts blood flow.
• repaired by ______ _______, surgical repair, or valve replacement.

A

Stenosis; balloon valvuloplasty

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24
Q

AORTIC location

A

2ND-3RD R IC SPACE

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25
Q

PULMONIC location

A

2ND-3RD L IC SPACE

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26
Q

TRICUSPID location

A

LLSB

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27
Q

MITRAL location

A

APEX

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28
Q

Aortic Valve Stenosis can produce:

3 results of AV stenosis

A

Decreased C.O.
Increased Pulmonary vascular resistance
Ventricular hypertrophy –> R sided HF

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29
Q

*****AV valves are anchored inside heart by what? and what are they ?

A

Chordae tendinea cords between valve cusps and papillary muscles

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30
Q

Papillary muscles: cone shaped raised bundles of cardiac muscle ?

A

valve flaps from moving backward into atria (Mitral valve prolapse)

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31
Q

SL valves are not anchored why ? vs _______ pressure in the ventricles.

A

because they are subject to

in the aorta and pulmonary trunk lower pressure (20-80 mmHg) ; 120mmHg.

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32
Q

Fossa ovalis

A

Remnant of the foramen ovale. - opening through the atrial septum.

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33
Q

Higher pressure is in the

Lower pressure is in the

A

left side of the heart.

right side of the heart

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34
Q

Meaty rideges

A

Bundles of cardiac muscle within chambers

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35
Q

***Firbrous skeleton of the Heart

A

Dense Connective Tissue

Form ring structure of the valves

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36
Q

COARCTATION Of the Aorta

A

Ducturs arteriosus extends to the aorta.

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37
Q

The path of Blood Flow (PULMONARY CIRCULATION)

A 
Right side of heart pumps to the lungs and back
Right Atrium(1) receives de-oxygenated blood from vena cava & coronary sinus Through Tricuspid valve(2) and into Right Ventricle(3)
Pumps through pulmonary semilunar valve(4) to pulmonary trunk(5); then into pulmonary arteries/arterioles(6)
Within Lungs gas exchange occurs at pulmonary capillaries(7)
Oxygenated blood now into pulmonary venules/veins(8) to left atrium(9)
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38
Q

The Path of Blood flow (Systemic circulation)

A

Left side of heart pumps to organs of the body
Left atrium through Bicuspid(10) valve and into Left Ventricle(11)
Left ventricle pumps through aortic semilunar valve(12) to aorta(13)
Aorta branches to many systemic arteries(14) that branch into arterioles(15)
then to systemic capillaries(16) found in all organs of the body (Exchange occurs)
De-oxygenated blood returns via systemic venules(17), veins(18), vena cava(19),
into Right atrium(1)

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39
Q

Aorta Coronary arteries coronary capillaries coronary veins coronary sinus Right atrium

A

Aorta –> Coronary arteries –> coronary capillaries (exchange)–>coronary veins –> coronary sinus –>Right atrium

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40
Q

The 3 major Coronary Veins that deliver to the Coronary Sinus:

A

Great Cardiac Vein (within the anterior interventricular sulcus)
Middle Cardiac Vein (within the posterior interventricular sulcus)
Small Cardiac Vein (within the coronary sulcus – posterior right side)

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41
Q

Distinguishes R sided CHF from L sided CHF

A

Peripheral Edema.

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42
Q

Right sided HF shows

Tx

A

Peripheral Edema.

Diuretics

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43
Q

Unstable angina– _____________

A

prolonged pain at rest

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44
Q 
Agina Pectoris (3 types) and their symptoms
Pt present with \_\_\_\_\_ and\_\_\_\_\_\_
A

SOB and chest pain:

a) Exertional – pain with activity, relieved with rest
b) Variant: pain at rest
c) unstable: Prolonged pain at rest.

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45
Q

Glycosilated hemoglobin

A

Endothelial cells sticks to hgb

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46
Q

Glycosilated hemoglobin

A

Endothelial cells sticks to glucose

47
Q

Turbulent blood flow in the carotids, what does it do to some cells?

A

From plaques built up, irritates endothelial cells.

48
Q

also the _______ ________ term can be used to describe a fistula between aorta and pulmonary trunk

A

AortoPulmonary window

49
Q

Hemodynamic compromise with Mediastinal tumors.

A

pulmonary artery & cardiac compression

50
Q

Neurologic problems with Mediastinal masses : _____ ____ ______ from __________ in the upper thorax (___ syndrome)

A

↑ ICP, HA, altered mental status) from obstructed venous drainage in
the upper thorax (ex. superior vena cava syndrome

51
Q

What is the serous pericardium?

A

Thin, delicate membrane; forms a double layer parietal & visceral (epicardium)

52
Q

What does the fibrous pericardium do?

A

Prevents overstretching, provides protection,

anchors heart

53
Q

Pericardial cavity filled with pericardial fluid ______ml

A

5-30ml.

54
Q

Serous pericardium has 2 layers

Which layer is the epicardium?

A

parietal and visceral layer (epicardium)

55
Q

______pouch-like structure on surface of both _____

A

atria , Auricles

56
Q

What is the function of the auricles?

A

Increases Capacity

57
Q

Pressure in atrium ______valve; Ventricles contract = pressure in ventricle ____valve

A

opens valve; closes valve

58
Q

For the semilunar valves the pressure in ventricle______ valve; pressure outside _____ valve

A

opens valve; closes

59
Q

What is stenosis ? How is it repaired (3)

A

Stenosis is a narrowing of a heart valve which restricts blood flow.
• repaired by balloon valvuloplasty, surgical repair, or valve replacement.

60
Q

What is insufficiency or incompetence for valve?

A

Insufficiency or incompetence is a failure of a valve to close completely.

61
Q

What is a prolapse of a valve?

A

Prolapse occurs when AV valve cusp is pushed up into atrium

62
Q

What is the papillary muscle role?

A

Prevent valve flaps from moving backward into atria

63
Q

Explain the pathophysiology of how blood flow through the SL valves during contraction and relaxation?

A

As the ventricles contract, the intra-ventricular pressure rises, and blood is pushed up against the SL valve forcing it to open..
As the ventricle relax, the intra-ventricular pressure falls, blood flows back

64
Q

What are the 3 factors that regulates stroke volume

A

Preload
Contractility
Afterload

65
Q

Preload is proportional to ______ and supports the ______law, which states the ______ , the ________. Ex is a ________

A

EDV; Frank-Starling Law
The greater the stretch, the greater the contraction.
rubberband

66
Q

Contractility
Positive Inotropic Agents _______ contractility ex: ________
Negative Inotropic Agents _______ contractility
ex: ___________

A

increase; Epi, Norepi
Ca++ channel blockers
Decrease: Ca++ channel blockers

67
Q

Afterload = the pressure that must be overcome before SL valves open
_____ mmHg pressure in Aorta
____ mmHg pressure in Pulmonary Trunk

A

the pressure that must be overcome before SL valves open; 80; 20

68
Q

LV ejects about _____ml in the Aorta. This is the _____RV ejects ______

A

70; EF; same

69
Q

Cardiac output (CO) =

A

HR x SV

70
Q

When ventricular pressure ____ _____ atrial pressure, AV valves open and passive ventricular filling begins again.

A

drops below

71
Q

At the end of the relaxation period, the ventricles are about

A

three-quarters full (~ 105 ml)

72
Q

Explain the procedure of Heart Transplant

2 Indications and procedures.

A

End-stage heart failure or severe coronary artery disease
Heart-lung bypass machine oxygenates & circulates patient’s blood during procedure
Donor heart sutured into position
Reinitiate blood flow
Immunosuppressant drugs

73
Q

CABG

A

“grafted” blood vessel between the aorta and unblocked portion of the coronary artery

74
Q

Balloon catheter is inserted into an artery of an arm or leg and guided into a coronary artery

A

Coronary angioplasty.

75
Q

Myocardial infarction is a loss of ________ as a result of __________.

A

Loss of living heart muscle as a result of prolonged or severe ischemia
Tissue dies and is replaced by scar tissue

76
Q

Reperfusion is

A

Restoration of blood flow.

77
Q

Collateral arteries;
Function ?
Formed by (2) :

A
  • Are connections, or anastomoses, between the branches of the coronary circulation.
  • Protects the heart from ischemia.
  • Are formed by arteriogenesis or -angiogenesis.
78
Q

Heart size

Weight?

A

3.5 in. wide at base, 5 in. from base to apex and 2.5 in. anterior to posterior; weighs 10 oz

79
Q

Fibrous skeleton of the heart: made up of__________
Function?
Forms what?

A

Dense connective tissue

Forms ring structure of the valves (prevents over-stretching of valves)

80
Q

Coarctation of the AORTA? How it’s detected? what is it?

A

Can be detercted by checking BP in arms and legs.

Is a narrowing of the aorta.

81
Q

Patent Ductus Arteriosus (PDA)

A

Ductus arteriosus remains open

82
Q

Atrial Septal Defect (ASD)

A

Foramen Ovale fails to close

83
Q

Ventricular Septal Defect (VSD)

A

Opening in the Interventricular septum

84
Q

Tetralogy of Fallot (4 defects)

A

Ventricular septal defect (VSD)
Pulmonary valve stenosis
Misplaced aorta
Right ventricular hypertrophy

85
Q

Left sided HF shows

Tx

A

Pulmonary Edema.

86
Q

How are venules formed?

A

Merged capillaries.

87
Q

Veins are under_____pressure’ and the blood contained in the veins is called _____volume; they have _______ receptors

A

Low ; unstressed; ALPHA 1

88
Q

Arteries are under_____pressure’ and the blood contained in the arteries is called _____volume; they have _____, which is found in skin, splanchnic and renal circulation. and have _______ which is found is skeletal muscles

A

HIGH ; stressed; Alpha 1; beta 2

89
Q

Capillaries are made up of

A

single layer of endothelial cells surrounded by basal lamina.
Largest total cross sectional and surface area.

90
Q

From capillaries to vena cava

A

Capillaries merge to form venules
Venules to veins
Veins merge to form larger vein
Largest vein –> Vena Cava

91
Q

The marginal branch and the posterior interventricular are branches of the

A

RCA

92
Q

What are 2 branches of the RCA?

A

Marginal branch

Posterior interventricular branch

93
Q

Heart beats approximately_______per day

A

100

94
Q

The circumflex branch and the Anterior Interventricular artery are branches of the

A

LCA

95
Q

LCA branches

A

Circumflex

anterior interventricular

96
Q

The AV valve permit blood flow in

A

one direction only

97
Q

The cusps of the AV valves attach directly to the

A

Chordae tendinae.

98
Q

Contraction of the papillary muscles

A

Prevent AV valves from reversing into the atria.

99
Q

Earlike extension of the atria

A

Auricles

100
Q

How many pulmonary veins

A

4

101
Q

In a procedure known as ________, an inflatable balloon at the end of a catheter is used to press plaque back against the vessel wall.

A

balloon angioplasty

102
Q

A procedure in which a length of the patient’s vein or artery is used to create a detour around an obstruction in a coronary artery is called

A

CABG

103
Q

A fine tubular wire mesh called a ________ may be inserted into a coronary vessel, holding it open.

A

stent

104
Q

The coronary sinus drains the ________ into the ________.

A

cardiac veins; right atrium

105
Q

The ________ is a remnant of an important fetal blood vessel that once linked the pulmonary and systemic circuits.

A

ligamentum arteriosum

106
Q

The efficiency of the right ventricle is increased by the left ventricle because _______

A

the wall of the left ventricle pushes into the right ventricle.

107
Q

The endocardium consists of this type of tissue.

A

simple squamous tissue

108
Q

The principle that increasing the end-diastolic volume results in a corresponding increase in the stroke volume is known as

A

Frank Starling

109
Q

Which factor directly influences preload?

A

PRELOAD

110
Q

Which ion’s entry causes rapid depolarization? Which ion’s entry causes the plateau? Which ion’s exit causes repolarization?

A

Sodium; Calcium; Potassium

111
Q

Normal resting CO

A

5-7.5L

112
Q

A prolonged PR indicates

A

Slow AV conduction possible due to decrease blood flow (ischemia)

113
Q

What forms the ring structures of the valves in the heart

A

Fibrous Skeleton of the heart

SRNAanatomy (25 decks)

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