Chapter 21 Flashcards
The heart is encased in a thin fibrous sac called what?
Pericardium
What is the inner layer of the heart?
Endocardium
What is the middle layer of the heart?
Made up of muscle fibers that is responsible for the pumping action
Myocardium
What is the exterior portion of the heart?
Epicardium
What are the 2 top chambers of the heart?
Atria
What are the 2 bottom chambers of the heart
Ventricles
Relaxation phase is what?
Diastole
What is referred to as ventricular filling?
Diastole
Contraction phase is called?
Systole
What is the only artery in the body that carries deoxygenated blood?
Pulmonary artery
What are the 2 types of heart valves?
AV valves
Semilunar valves
What generates and transmits electrical impulses, that stimulate contraction of the myocardium?
Cardiac conduction system
What is the primary pacemaker of the heart?
SA node
What is the secondary pacemaker of the heart?
AV node
A normal cardiac output has how many liters per minute
4-8 L/min
A normal, cardiac output has how many liters per minute
4 to 8 L per minute
Amount of blood pumped out of the ventricle with each beat or contraction
Stroke volume
Force/strength of contraction of the heart muscle
Contractility 
Percent of blood expelled from the left ventricle with every contraction
Ejection fraction(EF)
Normal EF is 50 to 70%
Amount of blood return to the right side of the heart at the end of diastole
Preload
Pressure that the left ventricle has to pump against
Afterload
What carries oxygenated blood to tissues?
Arteries
(Think Away from the heart)
What carries deoxygenated blood back to the heart
Veins
What is the Order of the electrical conduction of the heart
SA node
AV node
Bundle of His
Bundle, branches
Purkinje fibers
Pneumonic (Send A Big Bounding Pulse)
When you have an S3 sound of the heart what to diseases may you have?
Heart failure
Cardiomyopathy
When you have an extra heart sound, S4 what to diseases may you have?
Myocardial ischemia
Hypertension
Heart sound where the AV valve closes
S1 Lub
Heart sound where the semi lunar valve closes?
S2 Dub
A slower than normal rate <60
Sinus Brady
Caused by lower metabolic needs
-Sleep
-Athletic training
-hypothyroidism
Meds
-calcium channel blockers
-beta blockers
-Amiodarone
Sinus Brady
Faster than normal heart rate >100
Sinus tachy
Caused by
Blood loss
Fever
Exercise
Dehydration
HF
Cardiac tamponade
Hyperthyroidism
Sinus tachy
Type of EKG reading that looks like tomb stones. Irregular course wave forms of different shapes there’s no contractions or cardiac output, which may be fatal.
A rate of 100-250
No P-wave
Ventricular tachycardia (VT)
Causes of what?
MI
Electrolyte imbalance
Digoxin toxicity
Stimulants
Ventricular Tachycardia
Type of EKG reading with rapid disorganized patterns of electrical activity in the ventricle, in which electrical impulses, arise from many different foci.
Rate unknown
Rhythm, chaotic
PQRST complex not visible
Ventricular fibrillation (V-Fib)
What may lead to v-fib?
Untreated, ventricular tachycardia
What drug may you give for V fib?
Amiodaraon
Type of EKG, reading, uncoordinated, electrical activity in the atria that causes rapid and disorganized fibbing of the muscles in the atrium.
The atria is quivering
Rate usually over 100
Due to low oxygen
Atrial fibrillation (A-Fib)
What is an early conduction of the QRS complex?
Premature ventricular contractions (PVCS)
EKG with a Saw tooth appearance
Rate at 75 to 150
Atrial flutter
What are symptoms of left sided heart failure?
Dyspnea
Rales (crackles)
Orthopnea
Weakness, fatigue
Increased heart rate
Frothy blood tinged sputum
Gaining weight
Type of heart failure we’re fluid is backing up into the lungs
Left sided heart failure
Type of heart failure we’re fluid is backing up into the venous system
Right sided heart failure
What are symptoms of right sided heart failure?
Swelling of the legs and hands
Weight gain
Edema
JVD
Ascites
Irregular heart rate 
How would you diagnose heart failure?
Increase in BNP
Chest X-Ray
Echocardiogram
What diet modifications would you do with heart failure?
Fluid restrictions
Decreased sodium, fat and cholesterol
What is the bad cholesterol?
LDL (keep <100)
What is the happy cholesterol?
HDL (keep at >60)
What EKG changes would there be with CAD?
Changes in ST segment or T waves
The disease where deoxygenated blood cannot get back into the heart pulling of oxygenated blood into the extremities
Peripheral venous disease
Narrow artery, where oxygenated blood can’t get to the distal extremities like the hands of the feet ischemia and necrosis of the extremities
Peripheral arterial disease 
How would you diagnose peripheral vascular diseases?
A Doppler ultrasound or a ankle brachial index
What medication decreases the workload of the heart and decreases pain. Given with suspected MI
Morphine
What does elevated when a person is going through an MI
Troponin level
120-139
80-89
Pre-hypertension
140-159
90-99
Stage one hypertension
> 160
100
Stage two hypertension
> 180
120
Hypertensive crisis
What are examples of secondary hypertension?
Pre-existing conditions like chronic kidney disease, thyroid diseases, pregnancy, and certain drugs (oral contraceptives)
What is hypertension also called
Silent killer, usually because of lack of symptoms
Suffix’s of HTN meds
-pril
-olol
-pine
-amil
What type of anti-hyperlipidemic drug?
-statins
