Cardiovascular System

Question 1

Function of Cardiovascular System

Answer 1

Delivers O to organs and tissues, removes carbon dioxide and other by-products from body & assists reg of core body temperature

Question 2

Heart Tissue (4 Layers)

Answer 2

Pericardium (outer, fibrous layer enclosing heart), Epicardium (inner layer of peri), Epicardium (heart muscle, major portion of the heart), Endocardium (smooth lining of inner surface and heart cavities)

Question 3

Heart Chambers

Answer 3

R Atrium: Receives blood from systemic circulation during systole (contraction) blood is sent to right vent; R Vent: pumps blood via pulmonary artery to lungs for O; L Artium: receives O blood from lungs and 4 pulmonary veins during systole (contraction) blood sent to left vent; L Vent: pumps blood via aorta thru out entire systemic circulation. *Walls of vent are thicker/stronger than left

Question 4

Flow of Blood

Answer 4

Systemic circulation from R Atrium > R Vent oxygenation > L Atrium > L Vent

Question 5

Atriventricular & Semilunar Valves

Answer 5

A= prevents blood back flow into atria during vent systole - tricuspid= right heart valve/bicuspid= left heart vlalve - S= Prevents blood back flow from aorta & pulmonary arteries

Question 6

Systole vs Diastole

Answer 6

S= period of vent contraction; D= period of vent relax and filling of blood

Question 7

RCA vs LCA

Answer 7

R Coronary Artery: supplies R atrium, most of R vent, inf wall of L vent; Left Coronary Artery: supplies most of L vent & has 2 main divisions

Question 8

Sinoatrial Node

Answer 8

Main pacemaker of heart, indicates sinus rhythm - affects both HR and strength of contraction. Where hear beat begins

Question 9

Arteries

Answer 9

Transport oxygenated blood from areas of high pressure to low in body tissues.

Question 10

Hyperkalemia

Answer 10

Increased K ions; increases rate/force of contraction & produces EKG changes

Question 11

Hypokalemia

Answer 11

Decreased K ions; EKG changes, arrhythmias > may progress to ventricular fib

Question 12

Hypercalcemia vs Hypocalcemia

Answer 12

Increased Ca concentration; increases HR vs Decreased Ca concentration; decreases HR

Question 13

Increased vs Decreased peripheral resistance

Answer 13

I= increases arterial blood vL & pressure while D= decreases arterial blood vL & pressure

Question 14

Coronary Artery Disease (CAD)

Answer 14

Atherosclerotic (plaque build up in arteries) disease process that narrows lumen of coronary arteries resulting in ischemia (decreased blood supply) to myocardium; Lipid-laden plaques affecting mod/large arteries - results in thickening of intimal layer

Question 15

CAD risk factors

Answer 15

Age, gender, race, fam hx, smoking, high BP, hich cholesterol & low density lipoprotein (LDL), elevated homocystine, stress, DM, obesity, sedentary lifestyle

Question 16

Angina Pectoris

Answer 16

Clinical manifestation of ischemia characterized by mild-mod substernal chest discomfort (most commonly pressure/dull ache in chest & L arm>but can be felt anywhere in UE). Usually lasts 20min-increased heart demands

Question 17

Angina Types

Answer 17

Stable: classic, occurring during exercise/activity -relieved w rest and/or subling nitroglycerin; Unstable (preinfarction): coronary insuff at rest w/o any precipitating factor - pain diff to control, can lead to lethal arrhythmia; Variant (Prinzmetal’s): vasospasm of coronary arteries w absence of occlusive disease - responds well w nitroglycerin or Ca channel blocker LT

Question 18

Myocardial Infarction (MI)

Answer 18

Prolonged ischemia, injury and death of an area of myocardium caused by occlusion of one(+) coronary arteries - results in necrosis of heart tissue

Question 19

MI Precipitating Factors and Symptoms

Answer 19

Atherosclerotic heart disease w thrombus formation, coronary vasospasm/embolism; coke toxicity. Severe sternal pain for20(+)min that may radiate up, dyspena, indigestion, pain unrelieved by rest/sibling nitroglycerin

Question 20

3 Infarction Sites

Answer 20

Transmural (Q wave)= full thick of myocardium; Nontransmural (non-Q wave) & Coronary Artery Occlusion= Inf MI: R Vent infarct (R coronary artery); Lat MI: ventricular ectopy (circumflex artery); Ant MI: (L ant descending artery)

Question 21

Heart Failure

Answer 21

Heart is unable to maintain adequate circulation of blood to meet metabolic needs of body; Decreased cardiac output, elevated end diastolic pressure, increased HR, impaired vent contractibility > variety of causes (CAD, congenital heart disease, valvular disease, HTN, infection)

Question 22

L-side HF (CHF)

Answer 22

Blood not adequate pumped into systemic circulation; Characterized by pulmonary congestion, edema, low cardiac output d/t back up of LV to LA and lungs > occurs w insult to LV from myocardial disease, excessive workload of heart, arrhythmias or damage

Question 23

R-Side HF

Answer 23

Blood not adequately returned from systemic circulation to heart. Characterized by increased pressure load on RV > occurs w insult to RV from LV failure, mitral valve disease, chronic lung disease

Question 24

Biventricular Failure

Answer 24

Sever LV pathology producing back up into lungs, increased PA pressure, and RV signs of HF

Question 25

LV Failure: Signs of Pulmonary Congestion

Answer 25

Dyspena, dry cough, orthopena, paraxysmal nocturnal dyspena (PND), pulmonary rales, wheezing

Question 26

LV Failure: Sings of Low Cardiac Output

Answer 26

Lightheaded, dizzy, hypotension, tachycardia, cerebral hypoxia (confusion, restlessness, impaired mem), fatigue, poor exercise tolerance, enlarged heart, murmurs

Question 27

RV Failure: Signs of Pulmonary Congestion

Answer 27

Dependent edema, weight gain, ascites (abdom swelling d/t fluid build up), liver enlargement (hepatomegaly)

Question 28

RV Failure: Sings of Low Cardiac Output

Answer 28

Anorexia, nausea, bloating, cyanosis of nailbeds, R upper quadrant pain, jugular vein distension, murmurs

Question 29

Angioplasty

Answer 29

Relieves obstructed blood flow in acute angina or MI> results in improved coronary blood flow, improved L vent fx and anginal relief

Question 30

Intravascular Stents

Answer 30

Prevents occlusion in coronary or peripheral arteries

Question 31

CABG

Answer 31

Revascularization surgery: multiple grafts may be needed> results in improved coronary blood flow & LV fx, anginal relief, surgery results in deconditioning

Question 32

Transplantation

Answer 32

Used w end stage myocardial disease. Heterotopic involves leaving natural heart and piggybacking donor; Orthotopic replacement heart. (Probs: rejection, infection)