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PARAMEDIC SCHOOL > CHP 18: CARDIAC > Flashcards

CHP 18: CARDIAC Flashcards

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1
Q

group of disorders of the heart and blood vessels

A

cardiovascular disease

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2
Q

what the left ventricle produce when it contracts

A

apical impulse

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3
Q

the apical impulse is also called the ____

A

point of maximal impulse

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4
Q

the right side of the heart is a ___-pressure system aka ___ circulation

A

low, pulmonary

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5
Q

the left side of the heart is a ___-pressure system aka ____ circulation

A

high, systemic

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6
Q

what is the largest diameter but shortest coronary artery

A

left main

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7
Q

what does the LMCA divide into

A

left anterior descending artery and the circumflex artery

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8
Q

what parts of the heart does the LAD supply

A

left ventricle, portion of interventricular septum

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9
Q

what parts of the heart does the Cx artery supply

A

left atrium

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10
Q

what parts of the heart does the branches of the RCA supply

A

right atrium and ventricle, SA node, AV bundle

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11
Q

4 properties of cardiac cells

A

automaticity, excitability, conductivity, contractility

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12
Q

what does stimulation of the parasympathetic nerve fibers do in the heart

A

slows rate of SA node, slows conduction of AV node, weakens atrial and ventricular contraction

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13
Q

3 major ACS’s

A

unstable angina, NSTEMI, STEMI

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14
Q

chest discomfort that occurs when the heart muscle does not receive enough oxygen is called what

A

angina pectoris

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15
Q

what is inflammation of the pericardial sac

A

pericarditis

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16
Q

where will patient experience pain with pericarditis

A

similar to MI pain

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17
Q

pain that beings in the center of the chest and radiates to the back can be indicative of what 2 things

A

aortic dissection or enlargement of aortic aneurysm

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18
Q

anginal symptoms usually last less than how long

A

20 mins

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19
Q

AMI symptoms can last how long

A

20 mins to several hours

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20
Q

dyspnea that develops suddenly suggests what

A

pulmonary embolism, pneumothorax, acute pulmonary edema

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21
Q

dyspnea that occurs on exertion or at rest suggests what

A

COPD or left ventricular failure

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22
Q

sudden onset of difficulty of breathing in which the patient suddenly awakens from sleep is what? what is it usually associated with?

A

paroxysmal nocturnal dyspnea, associated with left ventricular failure

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23
Q

pulmonary edema often produces what type of sputum

A

pink-tinged

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24
Q

what condition may cause chest pain form inflammation of cartilage and bones in chest well

A

costochondritis

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25
Q

crackles or wheezes in lung sounds can suggest what

A

left ventricular failure with pulmonary edema

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26
Q

strong pulsations in the epigastric area may be a sign of what

A

abdominal aortic aneurysm

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27
Q

bilateral pitting edema may be a sign of what

A

right ventricular failure

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28
Q

weak, thready pulse or pallor suggests what

A

reduction in cardiac output

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29
Q

how to test for pulse deficit

A

stethoscope of apical pulse and hand over peripheral pulse to compare

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30
Q

what is pulsus paradoxus

A

systolic BP falls more than 10mmHg with inspiration

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31
Q

what cardiac conditions can cause pulsus paradoxus

A

AMI, cardiogenic shock, cardiac tamponade, constrictive pericarditis

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32
Q

what is pulsus alternans and what is it indicative of

A

beat-to-beat difference in strength of pulse
severe ventricular failure

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33
Q

normal pulse pressure range

A

30-40mmHg

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33
Q

stage 2 hypertension criteria

A

systolic BP 140 or higher and diastolic BP of 90 or higher

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34
Q

what does pulse pressure reflect

A

stroke volume and elasticity of arterial walls

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35
Q

widened pulse pressure is indicative of what

A

later stages of shock

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36
Q

narrowed pulse pressure is indicative of what

A

tachycardia and cardiac tamponade

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37
Q

what conditions may cause BP to vary from right to left side

A

stroke or aortic aneurysm

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38
Q

when do S1 sounds occur and what causes the sound

A

beginning of ventricular systole
tricuspid and mitral valves close (AV valves)

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39
Q

when do S2 sounds occur and what causes the sound

A

end of ventricular systole
pulmonary and aortic valves close (SL valves)

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40
Q

what is a gallop rhythm

A

S3 in ventricular diastole

41
Q

what is S4

A

rare heart sound before S1 caused by turbulent filling of stiff ventricle

42
Q

what is an abnormal whooshing sound

A

murmur

43
Q

phase 0 of cardiac action potential

A

sodium rapidly moves into cell, calcium slowly moves in, cell depolarizes

44
Q

phase 1 of cardiac action potential

A

potassium leaving cell, cell begins to repolarize

QRS complex

45
Q

phase 2 of cardiac action potential

A

plateau phase, sodium and calcium slowly enter, potassium leaves

ST segment

46
Q

phase 3 of cardiac action potential

A

repolarization finishes, calcium and potassium leaves cell

T wave

47
Q

phase 4 of cardiac action potential

A

resting phase

48
Q

what phases of the cardiac cycle is the absolute refractory period

A

0-3

49
Q

what phases of the cardiac cycle is the relative refractory period

A

middle of 3 to beginning of phase 4

50
Q

what is the interatrial pathway connecting SA and AV nodes

A

Bachmann bundle

51
Q

what is the middle internodal tract

A

Wenckeback

52
Q

what is the last internodal pathway

A

Thorel tract

53
Q

how long does the AV node delay the SA node’s impulse

A

0.12secs

54
Q

what is the only electrical connection between the atria and the ventricles and what does it consist of

A

AV junction - AV node and nonbranching portion of bundle of His

55
Q

what causes a delta wave

A

the bundle of Kent depolarizes to bypass AV and trigger early depolarization of ventricles

56
Q

what nerve is responsible for decreasing heart rate

A

vagus nerve or cranial nerve X

57
Q

what is straining or forced exhalation against a closed glottis

A

Valsalva maneuver

58
Q

what drug is a parasympathetic blocker that opposes ACh

A

atropine

59
Q

where are baroreceptors located and what do they do

A

carotid arteries and aortic arch
detect BP changes

60
Q

sodium’s role in cardiac function

A

initiates depolarization

61
Q

potassium’s role in cardiac function

A

initiates repolarization

62
Q

calcium’s role in cardiac function

A

depolarization of pacemaker cells and myocardial contractility

63
Q

magnesium’s role in cardiac function

A

stabilizes cell membrane, works with potassium and against calcium

64
Q

limb leads:

precordial leads:

augmented leads:

A

I, II, III

V1-V6

aVR, aVL, aVF

65
Q

an imaginary line joining the positive and negative poles of a lead

A

lead axis

66
Q

left leg electrode is ___ charged
right arm electrode is ____ charged
left arm electrode is ___ charged

A

always positive
always negative
positive to RA, negative to LL

67
Q

one small ECG paper box is __ seconds
one large box is ___ seconds

A

0.04

0.2

68
Q

what does the P wave represent and what are its parameters

A

atrial depolarization
less than 0.11 seconds

69
Q

what is the PRI interval and what are its parameters

A

beginning of P wave to beginning of QRS, AV node delaying transmission
0.12-0.2 seconds

70
Q

what does the QRS represent and what are its parameters

A

ventricular depolarization
less than 0.11 secs

71
Q

parameters for Q wave

A

first negative deflection in QRS
less than 0.04 seconds, less than 1/3 of QRS complex’s height

72
Q

what is the R wave

A

first upward deflection of QRS complex

73
Q

what is the S wave

A

any downward deflection after R wave

74
Q

hat is a second upward deflection in QRS complex called

A

R-prime wave

75
Q

R wave is depolarization of __ ventricle
S wave is depolarization of __ ventricle

A

right
left

76
Q

what is the J point

A

QRS complex ends and ST segment begins
end of depolarization and beginning of repolarization

77
Q

what is the ST segment

A

begins at J point and ends at T wave
period between ventricular depolarization of repolarization

78
Q

elevated ST segment indicates ___,
depressed ST segment indicates ___

A

myocardial injury
myocardial ischemia

79
Q

what does the T wave represent

A

ventricular repolarization

80
Q

peaked T waves are indicative of

A

hyperkalemia

81
Q

a tall U wave can be indicative of what

A

hypokalemia

82
Q

QT interval parameters

A

beginning of QRS to end of T wave
0.4-0.44secs

83
Q

what is the R-R interval

A

period between QRS complexes, interval between two ventricular depolarizations

84
Q

5 step method for ECG interpretation

A
  1. identify waves
  2. measure PRI
  3. measure QRS duration
  4. determine rhythm regularity
  5. measure heart rate
85
Q

two classes of dysrhythmias

A

disturbances of automaticity or disturbances of conduction

86
Q

an impulse or rhythm originating from a site other than SA node

A

ectopic

87
Q

how to calculate the upper limit of sinus tachycardia

A

220bpm - patient’s age

88
Q

what is sick sinus syndrome

A

variety of rhythms from poorly functioning SA node
alternating patterns of extreme brady and tachycardia

89
Q

most common type of SVT

A

AV nodal reentrant tachycardia

90
Q

what is “occurring in spasms”

A

paroxysmal

91
Q

what are cannon A waves and what physical sign can be found

A

dissociation between atria and ventricles
depression of jugular veins forming an “a” during wave

92
Q

early depolarization of ventricular tissue through an accessory pathway between atria and ventricles

A

preexcitation

93
Q

most common preexcitation disorder

A

Wolff-Parkinson-White syndrome

94
Q

what disorder causes preexcitation of ventricular tissue and is characterized by short PRI and normal QRS

A

Lown-Ganong-Levine syndrome

95
Q

what disorder causes preexcitation and is characterized by short PRI and widened QRS delta wave

A

WPW

96
Q

what rhythm increases risk for emboli and strokes

A

afib

97
Q

rhythm in which atria quiver instead of contract

A

afib

98
Q

rhythm in which atrial impulse fire too rapid for ventricles

A

aflutter

99
Q

rhythm in which P wave shape varies

A

wandering atrial pacemaker

100
Q

rhythm in which multiple ectopic sites within atria depolarize at rapid rates

A

multifocal atrial tachycardia

101
Q
A

PARAMEDIC SCHOOL (74 decks)

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