Chapter 30 Assessment of the Cardiovascular System Flashcards
Exam 1
Layers of the heart
epicardium, myocardium, endocardium + pericardial fluid/ sack
Heart Chambers & Great Vessels
Right and Left Atria; Right and Left Ventricles; Pulmonary artery; Aorta; Inferior Vena Cava; Pulmonary Veins
What divides the Right ventricle from the Left Ventricle?
Septum
How much blood does the heart pump per min?
5L
Atrioventricular Valves (AV)
Tricuspid and Mitral Valves
Semilunar Valves (SV)
Pulmonic and Aortic Valves
Left Anterior Descending (LAD)
aka: Widow maker
Coronary Vessel Circulation
Left Anterior Descending (LAD); Circumflex; Right Coronary Artery (RCA)
The is the what between the systemic circulation and pulmonary circulation?
connection
The ability to generate an electrical impulse independently of stimulation by the nervous system or any other source is called what? (pacemaker cells)
automaticity
The ability of the cells to respond to electrical stimulation is what? (muscle and nerve cells of the heart)
excitability
The ability to pass or propagate an electrical impulse from cell to cell through the heart.
conductivity
mechanical activity of the heart (not an electrical activity)
contractility
Conduction System Sequence from fastest to slowest
SA Node - AV Node- Bundle of His - Bundle Branches - Purkinje Fibers
What is the primary pacemaker at a rate of 60-100?
SA Node
What rate is the AV node?
40- 60 (bradycardic)
Resting state or what? of the heart
polarized
electrical stimulation changes __________
permeability
conductivity moves ________ rapidly from cell to cell
depolarization (milliseconds)
the heart must return to ________ ________ of internal negativity for further depolarization to occur
resting state
Mechanical Properties of the Heart
Cardiac Output; Heart Rate; Stroke Volume; Preload; Resistance; Myocardial Contractility
the amount of blood pumped out by each ventricle in 1 minute
Cardiac output
Cardiac Output =
Stroke Volume x Heart Rate
Blood pumped through the heart at an estimated _____mL per Heart beat?
60mL
the number of times the ventricles contract each minute
heart rate
determined by the autonomic nervous system
heart rate
autonomic nervous system is composed of what 2 systems
parasympathetic and sympathetic
amount of blood ejected by the left ventricle during each contraction
stroke volume
4 factors affecting cardiac output are?
preload, afterload, contractility and heart rate
volume of blood in ventricles at end of diastole (degree of myocardial stretch)
preload
SV of the heart increases in response to an increase in volume if blood filling the heart
Starling’s Law
resistance the ventricles must pump against in order to circulate blood
afterload
afterload is greater on which ventricle?
left is greater than the right
the force of contraction
contractility
controls all components of the heart
sympathetic nervous system
releases Norepinephrine
sympathetic nervous system
positive chronotropic
increases HR
positive inotropic
increases contractility
positive chronotropic/ positive inotropic
sympathetic nervous system
controls the SA node and AV node
parasympathetic nervous system
releases Acetylcholine
parasympathetic nervous system
negative chronotropic
decreases HR
has little effect on contractility
parasympathetic nervous system
Cardiovascular changes with age
*decreased vessel elasticity
*increased calcification of vessels
*impaired valve function
*decrease in muscle tone (including heart)
*decrease in baroreceptor response to BP changes
*decreased conduction ability of the heart
purpose of taking patient history during the assessment
to obtain info about risk factors and symptoms of CV disease
what is the best indicator of fluid balance?
weight
1 liter of fluid =
2.2 lb/ 1 kg
precordium
sternal/ 5th costal space
What are the 5 areas for listening to the heart?
All People Enjoy Time Magazine
A-Aorta P-Pulmonic E- Erb’s Point T- Tricuspid M- Mitral
train your ears to what you are seeing
telemetry/ stethoscope
Triad of symptoms for women (heart disease)
weakness/ fatigue, indigestion, strangling
Serum markers for myocardial damage
troponin, creatine kinase (CK), myoglobin, serum lipids
cardiac lab tests
blood coagulation studies, ABGs, CBC, cardiac markers
measurement of pressure, flow, and oxygenation of blood within the CV system
hemodynamic monitoring
to identify abnormal physiology and intervene before complications, including organ failure and death, occur
the purpose of hemodynamic monitoring
cardiac diagnostic testing
ECG (electrocardiography), EPS (electrophysiologic study), Stress Test (excercise electrocardiography), Echocardiography (Pharmacologic stress echocardiogram and transesphopaheal echocardiogram (TEE), Lexiscan
