CV Part 3 Flashcards

1
Q

What is reentry?

A

Phenomenon of opportunity
Form self sustained electrical current
Multiple depol in multiple regions of myocardium

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2
Q

What is the ventricular rhythm in A fib?

A

Irregularly irregular (AV node fluctuates in conduction frequency)

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3
Q

When is the vulnerable period?

A

Down slope of T wave (end of repol)

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4
Q

What happens during the vulnerable period?

A

Myocytes vary in excitability

Some are easily re-stimulated → reentry possible

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5
Q

What’s an infarct?

A

Area of necrosis due to sudden blood supply loss

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6
Q

Where’s the most common location for an MI?

A

LV → high muscle mass and O2 demand

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7
Q

Changes in ECG for MI (3)

A

Inverted T wave
ST segment elevation
New Q wave

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8
Q

What does new Q waves indicate?

A

Irreversible myocardial death

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9
Q

What does an inverted T wave represent?

A

Ischemia

** not diagnostic for MIs **

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10
Q

What does the ST segment represent?

A

Myocardial injury has occurred

Due to difference between RMPs of the healthy vs ischemic myocardium

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11
Q

Inferior and posterior regions are heart are supplied by

A

Right coronary artery

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12
Q

If inferior myocardium is affected by occlusion in the ________, then electrical changes would be seen in _______ leads such as _______

A

Right coronary artery
Inferior
2, 3, aVF

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13
Q

If posterior myocardium is affected by occlusion in _______, then we would check lead ______

A

Right coronary artery

N/A → posterior does not have a dedicated lead!

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14
Q

Lateral regions of the heart are supplied by the

A

Left circumflex artery

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15
Q

If left lateral myocardium is affected by occlusion in _______, then we would check leads ________

A

Left circumflex artery

1, aVL, V5, V6

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16
Q

Anterior regions of the heart is supplied by

A

Left anterior descending artery

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17
Q

If anterior myocardium is affected by occlusion in ______, then we would check ______

A
Left anterior descending anterior
Precordial leads (V1-V6)
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18
Q

S1

A

Onset of ventricular systole
Closing AV valves

Lub

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19
Q

S2

A

Closing semilunar valves
Split into aortic and pulmonic valve component

Dub

20
Q

Physiologic splitting

A

Aortic valve component and Pulmonic valve component during S2
Can tell difference during inspiration

21
Q

Physiologic splitting occurs due to

A

Decreased thoracic pressure that’s generated during inspiration

22
Q

Which valve closes after the other under normal inspiration?

A

Pulmonic valve closes after Aortic valve

23
Q

What is widened splitting?
What does this mean?
3 Examples

A

Increase the delay between A2 and P2
Delay is pulmonic valve closing → prolonging cardiac cycle in right heart
Right BBB, Pulmonary Hypertension, Pulmonary Stenosis

24
Q

What is paradoxical splitting?
What does this mean?
2 Examples

A

P2 occurs before A2
Aortic valve closes after pulmonic valve → delay aortic valve closure
Aortic Stenosis, Left BBB

25
S3
Occurs after S2 | Heard in elevated left heart filling pressures of adults sometimes
26
S4
Heard in late diastole | Heard if PT has left ventricular hypertrophy
27
Heart sounds are generated by
Valves closing and atrioventricular blood turbulence due to AV pressure
28
Stenosis
Constriction of narrowing
29
Regurgitation
Pressure induced backwash through leaky valve
30
Aortic valve stenosis
LVP >>> aortic pressure Can result in LVH Murmur intensifies at mid-systole
31
Pulmonic valve stenosis
RVP >>> pulmonary arterial pressure Cause RVH Intensity increases during inspiration
32
Mitral stenosis
Left atrial hypertrophy Increased amplitude and duration of leads 1 and V1 High pitched opening snap and then diastolic rumble
33
Mitral regurgitation
Blood leaks back into LA → works harder against higher pressures Notched P wave in ECG
34
Tricuspid regurgitation
Reflux of blood during RV systole → increases jugular venous pressure
35
Aortic valve regurgitation
LV volume and pressure increase | LV dilatation and hypertrophy
36
Acute changes in ________ can induce changes in BP
Intravascular volume
37
Hypovolemia
Low plasma volume
38
Hypervolemia
Elevated plasma volume
39
High pressure baroreceptors are located in
Aortic arch | Carotid sinus
40
Low pressure baroreceptors are found in
RA/vena cava | LA/pulmonary vein
41
Low pressure baroreceptors are sensitive to
Pressure induced stench | Firing rate changes during atrial systole and diastole
42
Chemoceptors are located in
Carotid sinus | Aortic arch
43
Chemoceptors sense
Decreases in PO2 (partial pressure) Elevated PCO2 Decreased pH
44
Chemoceptors are especially sensitive to small changes in
PCO2
45
Baroreceptors and Chemoceptors are designed to correct ________ changes but they can become _______ over time
Acute | Desensitized