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Hemodynamics > Ch. 10 Egans > Flashcards

Ch. 10 Egans Flashcards

1
Q

Approx 2-3rds of the heart lies to the left of the ______ between the _______?

A

Midline of the sternum ; between the 2nd and 6th rib

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2
Q

The apex of the heart is located where?

A

The tip of the left ventricle and lies above the diaphragm at 5th intercostal space

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3
Q

The base of the heart is located where?

A

Lying below the second rib (formed by the atria).

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4
Q

The heart is enclosed in a sac called the _____?

A

Pericardium

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5
Q

What is the fibrous pericardium?

A

Tough loose fitting and inelastic sac surrounding the heart.

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6
Q

What is serous pericardium?

A

Consist of 2 layers:
Parietal layer: inner lining of the fibrous pericardium
Visceral layer: covering the outer surface of the heart and great vessels

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7
Q

What is pericardial fluid?

A

A thin layer of fluid that separates the two layers of the serous pericardium

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8
Q

What is pericarditis?

A

Inflammation of the pericardium

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9
Q

What is pericardial effusion?

A

An abnormal amount of fluid that accumulates between the layers

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10
Q

What is cardiac tamponade?

A

A large pericardial effusion that lessens the pumping function of the heart, which compresses the heart muscle, leading to a serious decrease in blood flow to the body

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11
Q

What are the three layers of the heart wall?

A

• The outer epicardium
• Middle myocardium
• Inner endocardium

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12
Q

The ________ composes the bulk of the heart muscle and consist of bands of involuntary striated muscle fibers.

A

Myocardium

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13
Q

Where are the AV valves located?

A

Between the atria and ventricles

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14
Q

The valve on the right is called the….?

A

Tricuspid valve

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15
Q

The valve on the left is called the….?

A

Bicuspid or mitral valve

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16
Q

When do the AV valves close?

A

During systolic contraction of the ventricles, preventing backflow of blood into the atria

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17
Q

What is regurgitation?

A

The back flow of blood through a malfunctioning leaky valve.

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18
Q

What is stenosis?

A

Narrowing or constriction of valve outlet, which causes blood to back up and increased pressure in the proximal chamber and vessels.

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19
Q

What happens in mitral stenosis?

A

High pressures in the left atrium back up into the pulmonary circulation and these high pressures can cause pulmonary edema and diastolic murmur.

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20
Q

What are the semilunar valves?

A

They separate the ventricles from their arterial outflow tracts, the pulmonary artery (in the right) and the aorta (in the left).

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21
Q

What do the semilunar valves do?

A
  • Consist of 3 half moon shaped cusps
  • These valves prevent back flow of blood into the ventricles during diastole (or when the the chambers of the heart fill with blood).
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22
Q

Partial obstruction of the coronary artery may lead to what?

A

Tissue ischemia or angina pectoris

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23
Q

Complete obstruction of the coronary artery may cause what?

A

Tissue death or myocardial infarction

24
Q

What are the three types of CAD?

A
  1. Angina pectoris
  2. non-ST segment elevation myocardial infarction
  3. ST segment elevation myocardial infarction
25
Q

What are the 4 key properties that the myocardial tissue possesses?

A
  1. Excitability
  2. Inherit rhythmicity or automaticity
  3. Conductivity
  4. Contractility
26
Q

The period during which the myocardium cannot be stimulated is called the ______ and lasts approx ______ nearly as long as the heart contraction or systole.

A

Refractory period ; 250ms

27
Q

What are the 2 major subdivisions of the heart?

A

Systemic circulation & pulmonary circulation

28
Q

What does the systemic circulation begin with?

A

The aorta on the left ventricle and ends with the right atrium

29
Q

Rule of thumb pg. 207

A

A cardiac tamponade should be suspected in patient presenting with hypotension, JVD, pulses paradoxus, tachycardia, tachypnea, narrowing pulse pressures, and/or severe dyspnea.

30
Q

What are the three major components of systemic circulation?

A
  1. The arterial system
  2. The capillary system
  3. The venous system
31
Q

What does the arterial system consist of?

A

Large, highly elastic, low resistance, arteries and small, muscular arterioles of varying resistance.

32
Q

Together the large arteries are called what?

A

Conductance vessels

33
Q

What is another name for arterioles?

A

Resistance vessels

34
Q

The ______ maintains a constant exchange of nutrients and waste products for the tissues of the body.

A

Capillary system

35
Q

What does the venous system consist of?

A

Small expandable venules, veins, and larger more elastic veins
acts as a reservoir for circulation

36
Q

What are the four mechanisms that aid the venous return to the heart?

A
  1. Sympathetic venous tone
  2. Skeletal muscle pumping or milking
  3. Cardiac suction
  4. Thoracic pressure difference is caused by respiratory efforts.
    # 4 is most important for RTs
37
Q

Although the heart is a single organ it functions as ______ separate pumps

A

2

38
Q

The right side of the heart generates a systolic pressure of approximately _______ to drive blood through the low resistance, low pressure pulmonary circulation.

A

25mmHg

39
Q

The left side of the heart generates systolic pressure at approximately _________ to propel blood through the higher pressure, high resistance, systemic circulation

A

120mmHg

40
Q

The sum of all frictional forces opposing blood flow through the systemic circulation is called?

A

Systemic vascular resistance (SVR)

41
Q

What must SVR equal?

A

The difference in pressure between the beginning, and the end of the circuit divided by the flow

42
Q

What is the formula for SVR?

A
43
Q

What is PVR?

A

Resistance in pulmonary circulation

44
Q

What is the formula for MAP?

A

MAP= (COxSVR)+CVP OR Volume/capacity

45
Q

What is the normal range for MAP?

A

80-100mmHg

46
Q

What can happen if MAP decreases below 60 mmHg?

A

untreated shock, perfusion to the brain and kidney is severely compromised and organ failure may occur in minutes.

47
Q

Contractions have to be ______

A

Synchronized

48
Q

What does positive inotropic mean? What meds are used?

A

Increased contractility
digoxin and dopamine

49
Q

What does negative inotropic mean? What meds are used?

A

Decreased contractility
Verapamil & procainamide

50
Q

Systemic venous blood returns to_______?

A

RA via SVC & IVC

51
Q

Pulmonary vasculature begins with______?

A

Pulmonary artery out of the RV to RA

52
Q

What is a sound you can hear with pulmonary edema?

A

Diastolic murmur

53
Q

What is the formula for cardiac output?

A

CO=HRxSV

54
Q

What is cardiac output?

A

Total amount of blood pumped in one minute

55
Q

What are the 3 factors that SV is affected by?

A
  1. Preload
  2. Afterload
  3. Contractility
56
Q

What is the formula for PVR?

A

PVR = MPAP-LAP/CO

Hemodynamics (14 decks)

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