CV Flashcards
Cause of transposition of great vessels
failure of truncus arteriosis to spiral
cause of tertology of fallot
skewed AP septum development
cause of persisant trunctus arteriosis
partial AP Septum development
eisnmenger’s syndrome
initial left to right shunt reversing to right to left due to onset of pulmonary hypertension
foreamen primum is on the ____ of the atrial septum
bottom
foramen ovale develops from the
foramen secundum
fetal hemoglobin chains
a2g2
when bone marrow starts erythopoesis
22 wks development on
erythropesis organs during early development
liver and spleen
helps close the PDA
indomethacin
keep the PDA open
prostaglandins E1 and E2
path of fetal circulation
umbilical vein –> ductus venosus –> foramen ovale, ductus –> aorta –> systemic baby circulation/umbilical arteries
RCA supplies
SA and AV nodes
most common coronary artery to be occluded
LAD
coronary arteries fill during
diastole
supplies lateral and posterier walls of LV
L circumflex
LAD supplies
anterior 2/3 of interventricular septum, anterior surface of LV
supplies RV
acute marginal artery
Posterior decending supplies
posterior 1/3 of interventricular septum and posterior walls of ventricles
CO =
SV x HR
Fick principle
CO = rate of O2 consumption /(arterial o2 content-venous o2 content)
mean arterial pressure (MAP) =
CO x total peripheral resistance or
2/3 diastolic pressure + 1/2 systolic pressure
Pulse pressure =
systolic pressure- diastolic pressure
sx of left atrium enlargement
dysphagia (pressure on esophagus)
hoarseness (pressure on left laryngeal nerve)
effects stroke volume
contractility (direct effect)
afterload (indirect effect)
preload (direct effect)
venodilators lower
preload
vasodilators lower
afterload
starling’s law
force of contraction is proportional to end diastolic lenght of cardiac muscle fiber (preload)
ejection fraction =
SV/EDV = (EDV-ESV)/EDV
normal EF
greater than 54% (lower is systolic HF)
total resistance in series
additive
total resistance in parrell
1/TR = 1/r1+1/r2……
can raise blood viscosity
polycythemia, hyperprotenemia, hereditay spherocytosis
at S3 the…
Mitral valve opens
S1 is the sound of
mitral valve/Tricuspid valve closing
S2 is the sound of
Aortic/pulmonic valve closing
highest pressure in the cardiac cycle
S2/Aortic vavle closure/ESV
time of the lowest presssure in the cardiac cycle
from when the mitral valve opens to when it closes
period of highest cardiac O2 consuption
isovolumetric contraction - from when mitral valve closes and aortic valve opens
rapid filling
period just after mitral vavle opening
When an S3 is heard
during rapid ventricular filling
conditions where an S3 might be heard
mitral regurg, CHF, dilated ventricles
when an S4 might be heard
late diastole
conditions where an S4 might be heard
ventricular hypertrophy
valve timing in cardiac cycle (LV)
mitral valve closes, aortic valve clses, aortic vavlve closes, mitral valve closes
dicrotic notch
at time of aortic vavle closure (S2)
QRS complex coresponds to what valve movement
mitral vavle closes
can cause wide splitting
anything that delays RV emptying
can cause fixed splitting
ASD,
can cause paradoxical splitting
anything that delays LV emptying
murmurs in Aortic area
(all systolic murmers) aortic stenosis
disastolic murmurs in left sternal border
aortic regurg, pulmonic regerg,
systolic murmurs in left sternal border
hypertrophic cardiomyopathy
systolic murmurs in pulmonic area
pulmonic stenosis
pansystolic murmurs in tricuspid area
tricuspid area, VSD
diastolic murmurs in tricuspid area
ASD, tricuspid stenosis
systolic murmur in mitral area
systolic murmur
diastolic mumur in mitral area
diastolic murmur
holosystolic blowing murmur
mitral - MVP
tricuspid - RV dialation
crecendo-decrescendo systolic ejection murmor after click
Aortic stenosis
harsh, holosystolic murmur
VSD
late systolic crecendo murmur with midsystololic click
MVP
blowing diastolic decrescendo murmur
AR
delayed rumbling late diastolic murmur
MS
continuous machine-like murmur
PDA
Ventricular Phase 0
rapid upstroke - Na channels open
Ventricular Phase 1
initial repolarazation - inactivation of Na channels, opening of K channels
Ventricular Phase 2
plateau - Ca influx balances K efflux
Ventricular phase 3
rapid repolarization, massive K influx and closure of Ca channels
Ventricular phase 4
resting potential - high K permeability through channals
pacemaker phase 2
not present
pacemaker phase 3
inactiviation of the Ca channels and activation of the K channels (K efflux)
pacemaker phase 0
upstroke - opening of voltage gated Ca channels
P wave represents
Atrial depolarization
PR interval represents
conduction delay through AV node
QRS complex represents
ventricular depolarization
QT interval represents
mechanical contraction of the ventricles
ST segment represents
isoelectric, ventricles depolarized
U wave caused by
hypokalemia, bradycardia
causes congenital long QT
defects in cardiac sodium or potassium channels
treatment for long QT
magnesum sulfate
tx for A fib
rate control, anticoag, possible cardioversion
tx for a flutter
IA, IC, III antiarrithmycs/Beta blocker or CCB
tx for V fib
CPR and defib
ANP function
released by atrial myocytes in resoponse to high BP and atrial pressure. causes generalized vascula relaxation and decreased Na reabsorption at kidneys
good approximation of LA pressure
pulmonary wedge pressure
