Chp 11 Cardiovascular Flashcards
1
Q
delivers oxygen and nutrients to cells of body tissue
A
Cardiovascular system
2
Q
muscular pump
A
heart
3
Q
fuel line and transportation network
A
blood vessels
4
Q
vessels that lead away from the heart
A
arteries
5
Q
have thinner walls than arteries and move deoxygenated blood toward the heart from the tissue
A
Veins
6
Q
smallest vessels, form the point of exchange for oxygen and nutrients into the body cells and waste products coming from body cells
A
capillaries
7
Q
valve between the right atrium and right ventricle
A
tricuspid valve
8
Q
between left atrium and left ventricle
A
mitral valve
9
Q
between right ventricle and pulmonary artery
A
pulmonary valve
10
Q
between left atrium and aorta
A
aortic valve
11
Q
relaxation phase
A
diastole
12
Q
contraction phase
A
systole
13
Q
the diastole-systole cardiac cycle occurs between ______ times per minute
A
70-80 times per minute
14
Q
the heart pumps ____ ounces of blood with each contraction. _____ quarts per minute
A
3 ounces, 5 quarts
15
Q
closure of tricuspid and mitral valves at beginning of systole (sound)
A
lubb
16
Q
closure of aortic and pulmonary valves at end of systole (sound)
A
dubb
17
Q
abnormal heart sound caused by improper valve closure
A
murmur
18
Q
produced by the closure of the AV valves, mitral precedes tricuspid component, fused as one sound
A
S1
19
Q
loudest sound at apex, coincides with carotid pulse
A
S1
20
Q
closure of SL valves, end of systole, aortic precedes pulmonary, loudest at base
A
S2
21
Q
pacemaker of the heart
A
SA node
22
Q
origin of electrical impulse causing walls of atria to contract and force blood into the ventricles
A
Pacemaker
23
Q
sends excitation wave to a bundle of specialized fibers called the atrioventricular bundle or bundle of his
A
AV Node
24
Q
helps from conduction myofibers that extend to ventricle walls and stimulate them to contract, beginning systole, a short rest period follows
A
Bundle of His
25
the record used to detect electrical changes in heart muscle as the heart beats
EKG/ECG
26
spread of excitation wave over the atria just before contraction
P wave
27
spread of excitation wave over the ventricles as the ventricles contract
QRS wave
28
electrical recovery and relaxation of ventricles
T wave
29
ST elevation would indicate
heart attack (STEMI)
30
force that blood exerts on arterial walls
blood pressure
31
how do we measure BP?
sphymomanometer
32
how is BP expressed (whats the fraction)
systolic/diastolic
33
largest artery in body
aorta
34
lower tip of the heart
apex of heart
35
small artery
arteriole
36
largest type of blood vessel; carries blood away from the heart to all parts of the body
artery
37
specialized muscle fibers connecting the atria with the ventricles and transmitting electrical impulse between them
atrioventricular bundle (bundle of His)
38
specialized tissue in the wall between atria, electrical impulses pass fromm pacemaker through AV node and bundle of His toward ventricles
AV node
39
one of two upper chambers of the heart
atrium
40
smallest blood vessel
capillary
41
waste gas released by body cells, transported via veins to the heart, and then to lungs for exhalation
Carbon dioxide
42
blood vessels that branch from the aorta and carry oxygen rich blood to the heart muscle
coronary arteries
43
oxygen poor blood
deoxygenated blood
44
releaxation phase of the heartbeat
diastole
45
record of the electricity flowing through the heart
electrocardiogram
46
inner lining of the heart
endocardium
47
innermost lining of the blood vessels
endothelium
48
valve between the left atrium and left ventricle; bicuspid valve
mitral valve
49
abnormal swishing sound caused by improper closure of heart valves
murmur
50
muscular, middle layer of the heart
myocardium
51
heart rhythm originating in SA node with resting rate 60-100 beats/min
normal sinus rhythm
52
gas carried by the blood from the lungs to the heart to be pumped via arteries to all body cells
oxygen
53
specialized nervous tissue in the right atrium that begins the heartbeat
pacemaker (SA node)
54
double layered membrane surrounding the heart
pericardium
55
artery carrying oxygen-poor blood from the heart to the lungs
pulmonary artery
56
flow of blood from the heart to the lungs and back to the heart
pulmonary circulation
57
valve positioned between the right ventricle and the pulmonary artery
pulmonary valve
58
carries oxygenated blood from the lungs to left atrium of the heart
pulmonary vein
59
the beat of the heart as felt through the walls of the arteries
pulse
60
a partition or wall diving a cavity, such as that between the right and left atria and the right and left ventricles
septum
61
the pacemaker of the heart
SA node
62
flow of blood from body tissue to the heart and back
systemic circulation
63
strucutre in veins or in the heart that temporarily closes an opening so blood flows in only one direction
valve
64
a thin walled vessel that carries blood from body tissues and lungs back to the heart - contains valves
vein
65
the largest vein in the body superior and inferior returns blood to the right atrium of heart
vena cava
66
one or two lower chambers of the heart
ventricle
67
small vein
venule
68
abnormal heart rhythms
arrhthmias
69
examples of abnormal rhythms
heart block, flutter, fibrillation
70
failure of proper conduction of impulses through the AV node to the Bundle of His
Heart Block
71
rapid but regular contractions of the atria, ventricles do not keep up, sawtooth waves
atrial flutter
72
rapid, random, ineffectual and irregular contraction of the heart
atrial fibrillation
73
what is the most cardiac arrhythmia
a fib
74
due to ineffective atrial contractions, patients can develop an thrombus in the L atria that can dislodge and travel to the brain
a fib
75
Presenting symptoms of A fib (4)
1. palpitations
2. fatigue
3. dyspnea
4. syncope
76
Tx A fib (2)
1. Rate control
2. Anticoagulation
77
rapid, random, ineffectual and irregular contractions of the heart, life-threatening, need defibrillation
Ventricular Fibrillation
78
severe narrowing of descending aorta usually at the junction of the ductus arteriosus and the aortic arch (ligamentum arteriosum)
Coartation of Aorta
79
associated with defects of the aortic valve in 75-80% cases
coartation of aorta
80
upper extremity hypertension, absent/diminished femoral pulses
coartation of aorta
81
systolic murmur @ LSB radiates to back
coartation of aorta
82
failure of the ductus arteriosus to close after birth, 75% occurs as isolated defect
Patent Ductus Arteriosus (PDA)
83
Signs and Symptoms of PDA (10)
1. failure to grow
2. recurrent respiratory infections
3. easy fatigability
4. DOE
5. SOB
6. angina
7. Syncope
8. continuous machinery murmur
9. left upper sternal thrill
10. bounding pulses
84
Tx PDA
surgery, treated with medication as well
85
who is at risk for PDA
premature infants (can resolve on its on within 3mo)
86
a defect or opening in the atrial septum allowing flow of blood between two chambers
atrial septal defect
87
how is shunting in atrial septal defect (directionally)
left to right
88
childhood symptoms of atrial septal defect(3)
minimal, failure to thrive, frequent pulmonary infections
89
adult symptoms atrial septal defect (3)
easy fatiguability, DOE, heart failure
90
when do you repair atrial septal defect?
surgical repair delayed until preschool age
91
congenital or acquired defect of the interventricular septum that allows communications of blood between the left and right ventricles
Ventricular Septal Defect
92
what is the most common congenital defect that can occur after an MI
ventricular septal defect
93
ventricular septal defect symptoms depend on the degree of ______ across the defect
shunting
94
Symptoms of ventricular septal defect (3)
1. Respiratory Distress
2. Tachypnea
3. Holosystolic Murmur
95
includes 4 components: right ventricular outflow stenosis, VSD, Right Ventricular hypertrophy, Overriding Aorta
Tetralogy of Fallot
96
blood does not get _____ in tetralogy of fallot
oxygenated
97
Sounds of tetralogy of fallot
(______, S1 ______, A2 ____, P2 ______)
thrill, S1 normal, loud A2, diminished
98
principal complication of heart disease, produced by abnormality in cardiac pump function. Heart unable to transport blood in a sufficient flow to meet metabolic needs
CHF (ChRoNiC hEaRt FaIlUrE)
99
most common age for CHF diagnoses
65
100
cardinal sign of L sided heart failure
DOE (dyspnea on exertion)
101
Symptoms of CHF (9)
1. Nocturia
2. Deteriorating exercise capacity
3. fatigue
4. weakness
5. tachypnea with mild exertion
6. nocturnal productive cough
7. orthopnea
8. PND (paroxysmal nocturnal dyspnea)
9. wheezing
102
arteriosclerosis characterized by thickening and loss of elasticity of the arterial walls which progressively block the coronary arteries and their branches
coronary artery disease (CAD)
103
chronic, occuring over many years
CAD
104
risk factors for CAD (9)
1. male
2. HTN
3. DM
4. tobacco
5. obesity
6. male
7. physical inactivity
8. increasing age
9. family history
105
disease resulting from infection primarily of the valvular endocardium and occasionally the mural endocardium
endocarditis
106
who is more at risk for endocarditis?
male
107
Symptoms of Endocarditis (7)
1. fever
2. night sweats
3. anorexia
4. heart murmur
5. CP
6. SOB
7. cough
108
Tx endocarditis
IV antibiotics
109
endocarditis special node / lesions
osler node, janeway lesion
110
prolonged elevation of blood pressure
hypertensive heart disease
111
prolonged BP elevation leads to changes in: (3)
1. myocardial structure
2. coronary vasculature
3. conduction system of the heart
112
what area of heart hypertrophies during hypertensive heart disease and what disease could this lead to?
left ventricular hypertrophy and CHF
113
what two disorders could be caused by coronary artery disease as a result of HTN
Angina
MI
114
what conduction system diseases are affected by HTN
cardiac arrhythmias (esp A fib)
115
valve is competent in systole but prolapses into atrium later in systole
mitral valve prolapse
116
sounds heard in mitral valve prolapse
1. late systolic murmur
2. mid-systolic clicks
117
where to listen for mitral valve prolapse
apex/left sternal border, easily missed in supine pos so need to listen in upright position too
118
blood circulating through normal cardiac chambers and valves usually makes no noise
murmur
119
some conditions create turbulent blood flow and collision currents
murmur
120
blowing, swooshing sound
murmur
121
conditions that result in a murmur include (3)
1. velocity of blood increases (flow murmur)
2. viscosity of blood decreases
3. structural defects - in valves of unusual opening in chambers
122
disease process involving the pericardial sac surrounding the heart
pericarditis
123
thickenign and adherence of the pericardium to the heart after chronic inflammation
constrictive pericarditis
124
S/S Pericarditis
1. CP (sharp, retrosternal w radiation to trapezial ridge)
2. pain (sudden onset and reduced by tripod pos)
3. splinted breathing
4. fever
5. Myalgia
6. Pericardial friction rub
125
inflammatory, preceding infection of the upper respiratory tract with group A streptococcus
rheumatic heart disease
126
major cardiac manifestation =
carditis
127
65% patients with rheumatic fever have (3)
1. pericarditis
2. myocarditis
3. valvular insufficiency
128
permanent localized dilation of the abdominal aorta having at least 50% increase in diameter compared to the expected diameter of the artery
aneurysm (aortic)
129
blood clot in a large vein usually lower limb, common in pts with prolonged bed rest/chronic debilitating disease & malignancies
DVT
130
S/S DVT
Red, hot, pain/tenderness in area, unilateral. Can be asymptomatic with PE as primary presentation
131
Tx DVT
Anticoagulation
132
Diagnostic Evaluation
Venous Doppler, D-Dimer
133
top number of blood pressure measurement, pressure generated when the heart beats
Systolic
134
bottom number of blood pressure measurement, represents the pressure in vessels when the heart is at rest
Diastolic
135
______ is determined by the amount of blood pumped by the heart and size and condition of the arteries
blood pressure
136
essential hypertension has no _______ cause
identifiable
137
secondary hypertension is high BP caused by another ________
disorder
138
blockage arteries in lower extremities due to atherosclerosis,
peripheral arterial disease
139
140
symptoms of peripheral arterial disease
asymptomatic, can be present with claudication or ulcers
141
physical exam of peripheral arterial disease (4)
1. decreased distal pulse
2. decreased hair distribution
3. shiny legs
4. non-healing ulcers
142
Tx Peripheral arterial disease (3)
1. control underlying disease (HTN, DM, etc)
2. Avoid nicotine
3. surgery
143
bilaterally occurring vasospastic disorder manifested by intermittent attack of extreme pallor, then cyanosis of fingers brought on by cold. when warmed they get extremely red with swelling/throbbing/paresthesias
Raynaud phenomenon
144
are thumbs involved in Raynaud phenomenon
no
145
does raynaud occur more in men/women
female
146
elongated, dilated, tortuous superficial veins with congenitally absent valves or valves have become incompetent
varicose veins
147
affects legs where reverse flow occurs when dependent, 20% adults, more in female
varicose veins
148
S/S Varicose veins (7)
1. asymptomatic
2. leg crmaps
3. tortuosity of superficial veins
4. edema of limb
5. leg ache
6. fatigue
7. pain
149
blood test that differentiates cardiac from pulmonary cause of dyspnea
brain natriuretic peptide (BNP)
150
elevated levels of BNP would indicate what two diseases?
1. Heart Failure
2. Cardiomyopathy
151
chemicals measured in blood as evidence of myocardial infarction (what are the tests called)
Serum Enzyme test
152
what is included in a serum enzyme test (5)
1. Myoglobin (elevated w/in 1 hr)
2. Creatinine Phosphokinase (elevated w/in 4-8 hrs)
3. CK MB isoenzyme (4-12 hrs)
4. Troponin T or I (sensitive, w/in 4 hrs)
5. High sensitivity cardiac troponin (new!)
153
what serum enzyme test is very sensitive and can remain elevated for 4 hours - more than a week?
Troponin T or I
154
measure of cholesterol and triglycerides
lipid test
155
high frenquency sound waves and echoes produce heart image. performed transthoracic or transesophageal
echocardiography
156
what is the main dx tool to dx CAD
coronary angiography
157
thin flexible tube guided into the heart's coronary arteries via vein or artery, stents can be placed
cardiac catheterization
158
which area of the heart is evaluated during stress using atrial pacing, exercise, or drugs
left ventricular function (assessing)
159
monitor worn for 24 hours to detect arrhythmia
holter monitor
160
vitals and EKG rhythms monitored during test. Can use physical activity or pharmacologic agents. (name the two types too)
stress test
1. Exercise tolerance test (ETT)
2. Radionuclide stress myocardial perfusion imaging (MPI): thallium stress test
161
162
process of restoring hearts normal rhythm from an abnormal one
cardioversion
163
electrical activity applied across chest, reset rhythm control to pacemaker cells. DOES NOT TREAT ASYSTOLE OR PULSELESS ELECTRICAL ACTIVITY (PEA)
Defibrillation
164
what is an ICD
implantable cardioverterdefibrillator (for pts with high risk of sudden ventricular death)
165
principal surgery method for treatment of CAD by bypassing blockages in coronary arteries with a blood vessel taken from another area of the body.
Coronary Artery Bypass Grafting (surgery) or CABG
166
surgical removal of plaque from artery that becomes narrowed or blocked, commonly in carotid arteries
Endarterectomy
167
keeps blood moving through the body and blood gasses exchange in balance
Extracorporeal membrane oxygenation (ECMO)
168
surgical transplant for patients with end stage heart failure or severe coronary artery disease
heart transplant
169
heterotrophic heart transplant would indicate
leaving the patients diseased heart to support the new heart
170
patients placed on booster pump when waiting for heart transplant
LVAD
171
performed by threading a slender balloon catheter from artery in groin to trouble area of artery (heart). Balloon gets inflated and compresses any plaque so the blood can flow more easily - often place stent afterwards
Percutaneous coronary intervention (PCI)
172
medication that can dissolve a clot - time sensitive for MI or CVA
thrombolytic therapy
173
where damaged valve is removed and replaced with artificial valve - requires sternotomy incision
conventional open heart surgery
174
what is a minimally invasive procedure that uses catheters in blood vessels to replace the aortic valve
transcatheter aortic valve replacement (TAVR)
