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Accelerated Paramedic > Chapter 18 Cardiology > Flashcards

Chapter 18 Cardiology Flashcards

1
Q

Sudden narrowing or complete blockage of coronary artery causes myocardial tissue death is called what?

A

Acute Myocardial Infarction (AMI)

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2
Q

The cessation of cardiac mechanical activity is called what?

A

Cardiac Arrest

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3
Q

Heart rhythm disturbances

A

Dysrhythmias

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4
Q

The right atrium receives blood from where?

A

Superior vena cava, inferior vena cava, and the coronary sinus.

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5
Q

Which part of the heart receives oxygenated blood from the pulmonary veins?

A

Left Atrium

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6
Q

The ___________________ has much thicker walls than the ______________________.

A

Ventricles have much thicker walls than the atrium.

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7
Q

Which part of the heart pumps deoxygenated blood to the lungs?

A

Right Ventricle

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8
Q

What does the left ventricle pump blood to?

A

The entire body

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9
Q

The L ventricle rotates forward as it contracts. PMI is the POINT OF MAXIMUM IMPULSE, where the heartbeat is most strongly felt. Where on the body can you feel the PMI?

A

Left anterior part of the chest, 5th intercostal space, midclavicular.

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10
Q

What separates the heart into 2 functional pumps?

A

Septa

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11
Q

Which is the “low pressure” side of the heart? Which is the “high pressure” of the heart?

A

Right is low pressure, as it pumps to lungs.
Left is high pressure, as it has to pump blood through the entire system.

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12
Q

What is responsible for cardiac contraction and efficient ejection of blood from the heart?

A

Myocardium

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13
Q

What supplies blood to the tissues of the heart?

A

Coronary arteries

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14
Q

Which artery is the largest in diameter, shortest, and divides off into the LAD (Left Anterior Descending Artery) and the CX (Circumflex Artery)?

A

Left Main Coronary Artery (LMCA)

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15
Q

Where does the LAD supply blood to?

A

L ventricles anterior surface, a portion of the L ventricles lateral surface, and a portion of the inter-ventricular septum.

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16
Q

The Cx artery supplies blood to the what?

A

L atrium & part of the lateral surface of the L ventricle

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17
Q

What supplies blood to the walls of the R Atrium and ventricle, a portion of the inferior part of the L ventricle, and portions of the conduction system (SA node and AV bundle)?

A

Right Coronary Artery (RCA)

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18
Q

Four main components of the Cardiac Cells?

A

Automaticity
Excitability
Conductivity
Contractility

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19
Q

Name the components of the cardiac conduction system.

A

SA Node
AV Node
Bundle of His
R & L Bundle Branches
Purkinje Fibers

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20
Q

A series of cardiac conditions caused by an abrupt reduction in blood flow through a coronary artery is called what?

A

Acute Coronary Syndromes

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21
Q

The 3 major Acute Coronary Syndromes.

A

Unstable Angina
NSTEMI
STEMI

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22
Q

Common chief complaints of someone experiencing ACS.

A

Chest pain/discomfort
Dyspnea
Fainting
Palpitations
Fatigue

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23
Q

Best assessment technique for assessing cardiac related complaints.

A

O - Onset
P - Provocation
Q - Quality
R - Radiation
S - Severity
T - Timing

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24
Q

What cause Angina Pectoris?

A

Ischemia, when the heart muscle does not receive enough O2.

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25
Q

Left Ventricular Failure cause fluid to build up where?

A

Lungs

(Left to Lungs, the rest is from Right)

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26
Q

Sudden onset of difficulty breathing in which the pt is suddenly woken from sleep, often associated with L sided heart failure.

A

Paroxysmal Nocturnal Dyspnea, often accompanied by coughing, wheezing, and sweating. Usually improves within 15-30 mins after sitting upright or standing.

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27
Q

A brief loss of consciousness caused by a temporary decrease in blood flow to the brain.

A

Syncope (fainting)

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28
Q

Common cardiac meds to ask about during assessments.

A

Antidysrhythmics - Digoxin, Amiodarone, Verapamil
Anticoagulants - Lovenox (enoxparin), Coumadin (warfarin), Plavix (clopidogrel)
Angiotensin converting enzyme inhibitors - (PRIL DRUGS) Lisinopril, Enalapril, etc
Beta Blockers - (LOL DRUGS) Atenolol, metoprolol, propranolol
Lipid lowering agents - (STATIN DRUGS) Lovastatin, Pravastatin, Rosuvastatin, etc
Diuretics - Lasix (Furosemide) Hydrochlorothiazide (HCTZ)
Vasodilators - Nitro, Isordil

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29
Q

Specific Diagnoses to inquire about during assessments.

A

Aneurysm
Atherosclerotic Heart Disease (MI, HTN, angina, heart failure)
Congenital Anomalies
CAD
DM / Renal Disease
Inflammatory Heart Disease
Previous heart surgeries/grafts/valve replacements
Pacemaker/Defibrillator
Pulmonary Disease
Valvular Disease
Vascular Disease

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30
Q

Bilateral pitting edema is a sign of what?

A

Right Ventricular Failure

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31
Q

Pitting edema to one side of the body is an indication of what?

A

A blockage in a major vein.

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32
Q

What occurs when the SBP drops 10 mm hg or more w/inspiration?

A

Pulses Paradoxus

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33
Q

What conditions could you find Pulses Paradoxus in?

A

AMI, Cardiogenic Shock, Cardiac Tamponade, and Constrictive Pericarditis

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34
Q

A beat-to-beat difference in the strength of a pulse is called what? Could be a sign of severe ventricular failure.

A

Pulsus Alternans

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35
Q

Heart sound on systole, when the tricuspid and mitral valve open.

A

S1

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36
Q

Louder S1 sounds can be heard in pts with what? Due to the valves opening when the ventricles contract.

A

Fever, Anemia, or hyperthyroidism

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37
Q

How many Amps of electricity doe sit take to stop the heart?

A

O.5 amps

38
Q

Treatment for R sided heart failure

A

Fluids - Improve Preload

NO NITRO!! Will kill them!!

39
Q

Treatment for L sided heart failure

A

Nitro

NO FLUID!! Do not want to overload them!!

40
Q

How many joules do you use to cardiovert a ped pt?

A

Start w/2 joules, can go up to 10.

41
Q

Average Adult Stroke Volume

A

70ml

42
Q

Hypothermic CPR Rules

A

CPR, 1 shock, transport, NO DRUGS!!

43
Q

Cold Blood doesn’t…..

A

Clot

44
Q

CPR Pyramid

A

Early Recognition

CPR

AED

Airway

Drugs

45
Q

How to treat SVT, VF, VT, AFib, A Flutter

A

1.) Narrow Complex, Start w/Vagal Maneuver
A.) Shock at 50 Joules, up to 200J as needed
B.) PEDS - 0.5J per kg

2.) Wide Complex, Shock
A.) Shock at 100 Joules, up to 200J as needed
B.) PEDS - 1J per kg

46
Q

Treatment for Sinus brady

A

1.) Atropine (if that doesn’t work)
2.) Dopamine (if that doesn’t work)
3.) Epi (If that doesn’t work)
4.) Pace

47
Q

A “widow maker” is a complete occlusion of which artery?

A

Left Anterior Descending Artery

48
Q

What part of the heart does V1 capture?

A

Septum

49
Q

Which artery supplies blood to the septum and anterior part of the heart?

A

Left Anterior Descending Artery

50
Q

Which artery supplies blood to the lateral part of the heart?

A

Circumflex Coronary Artery

51
Q

Which artery supplies blood to the inferior part of the heart

A

Right Coronary Artery

52
Q

Leads 1 and 2 capture which part of the heart?

A

Septum

53
Q

Leads 3 and 4 capture which part of the heart?

A

Anterior

54
Q

Which part of the heart does lead 5 & 6 capture?

A

Lateral

55
Q

An abnormal whooshing sound that is associated with turbulent blood flow through valves.

A

Murmur

56
Q

A sequence of changes in the membrane potential that occurs when an excitable cell is stimulated.

A

Action potential

57
Q

The process of discharging resting cardiac muscle fibers by means of an electrical impulse that stimulates contraction.

A

Depolarization

58
Q

Cardiac Action Potential Phases

A

Phase 0 - Cardiac muscle receives impulse. The cell depolarizes and contracts. QRS complex on EKG.

Phase 1 - Inward sodium channels close and the cell begins to repolarize.

Phase 2 - Plateau Phase. Corresponds to the ST segment on EKG.

Phase 3 - Final phase of repolarization. Becomes increasingly negative. T wave on EKG.

Phase 4 - Resting Phase. Sodium and Potassium swap out in preparation for the next depolarization.

59
Q

What cells are found in the tissue of the SA node, AV node, bundle of His, and Purkinje Fibers?

A

Pacemaker Cells

60
Q

Depolarization of Atria. Normal duration is 0.08-0.11 secs (2-3 small boxes) and less than 2.5mm tall.

A

P wave

61
Q

Distance from a P wave to the beginning of a QRS complex, indicates the amount of time it took for the impulse to traverse the atria and AV junction. Normal range is 0.12-0.20 secs (3-5 small boxes). Prolonged ones can indicate a heart block.

A

PR Interval

62
Q

Represents ventricular depolarization. Should be narrow w/a duration of 0.08-0.11 secs.

A

QRS wave

63
Q

1st negative deflection, indicates conduction through the interventricular septum. Should last no more than 0.04 secs.

A

Q wave

64
Q

Wave that represents depolarization of the R & L ventricles (squeeze of heart).

A

R & S wave

65
Q

Begins at J point, ends at T wave. Represents early ventricular repolarization. Period between ventricular depolarization and beginning of repolarization.

A

ST Segment

66
Q

Represents ventricular repolarization. Upright, flat, or inverted wave following the QRS complex. Should be asymmetric and half the overall height of the QRS complex.

A

T wave

67
Q

Time between 2 successful ventricular depolarizations.

A

R-R Interval

68
Q

Represents all electrical activity of one complete ventricular cycle. Generally measures 0.40 & 0.44 secs.

A

QT Interval

Considered prolonged if longer than 0.47 in men and 0.48 in woman.

69
Q

Elevated T wave indicates what?

A

Hyperkalemia

70
Q

Decreased T wave indicates what?

A

Hypokalemia

71
Q

Lead 1 provides tracing between what?

A

LA & RA

72
Q

R Arm lead is always…..

A

Negative

73
Q

L leg is always……

A

Positive

74
Q

L Arm can be ______________ or _______________, depending on what?

A

Negative or Positive, depending on the lead and which part of the heart its trying to capture.

Lead 1: Tracing between RA & LA, L arm is positive, because R arm is always negative.

Lead 2: Tracing between RA & LL, L leg is positive, because R arm is always negative.

Lead 3: Tracing between LA & LL, L arm is negative, because L leg is always positive.

75
Q

4 Leads Placement

A

R arm/Shoulder is white

R torso/leg is green

L arm/shoulder is black

R torso/leg is red

76
Q

R arm is referenced against combination of L arm and L leg.

A

AVR

77
Q

L arm referenced against combination of R arm and R leg.

A

AVL

78
Q

Combination of L arm and R arm

A

AVF

79
Q

1,500 method of determining HR

A

Count # of small boxes between any 2 QRS complexes. Then divide 1,500 by that number = HR

80
Q

Sequence Rate Method of determining HR

A

R wave to R wave. R wave on line, next big box is 300, next big box is 150, next big box is 100, next is 75, next 60, next 50. Wherever the next R wave is, is where you get your HR.

81
Q

Rules that determine a NSR

A

Rate: 60-100BPM
Regularity: Regular
P Wave: Present
P:QRS ratio: 1:1
PRI: Normal/Regular
QRS width: Normal
Grouping: None
Dropped Beats: None

82
Q

This rhythm has all the normal qualifications of NSR, except it may be irregular d/t respirations.

A

Sinus Arrythmia

83
Q

This rhythm has all the normal rules for NSR, except it has a rate of less than 60BPM.

A

Sinus Bradycardia

84
Q

Rhythm that presents with 100BPM or higher, other rules fall within sinus rhythm.

A

Sinus Tachycardia

85
Q

Varied Rate
Irregular
P wave, except in areas of pause/dropped beats
P:QRS ratio 1:1
Normal PRI
Normal QRS width

A

Sinus Pause/Sinoatrial Block

86
Q

Approx 100bpm
Irregularly irregular
3 different morphologies of P waves
PRI varies

A

Wandering Atrial Pacemaker

87
Q

Greater than 100bpm
Irregularly Irregular
At least 3 different morphologies of P waves
PRI varies

A

Multifocal Atrial Trachycardia

88
Q

Commonly 250-350bpm (ventricle rate 125-175)
Usually regular
“Saw tooth” appearanced P waves
P:QRS ratio 2:1

A

Atrial Flutter

89
Q

Rate: Variable, can be slow or fast
Irregularly Irregular
P Wave: none or chaotic activity
PRI: None

A

Atrial Fibrillation

90
Q

Rate depends on underlying rhythm
Irregular
Variable; P waves on regular beat, none on early beat
PRI: None or shortened

A

Premature Junctional Contraction

Accelerated Paramedic (16 decks)

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