Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NSG 2321 - Theory Exam 2 > CVS > Flashcards

CVS Flashcards

1
Q

What are the three linings of the heart?

A

Endocardium, myocardium, and epicardium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the deoxygenated blood flow route?

A

In through the superior/inferior vena cava, right atrium, tricuspid valves, right ventricle, semilunar valve, out through the pulmonary artery to be oxygenated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the oxygenated blood flow route?

A

In through the pulmonary vein, the right atria, bicuspid valve, right ventricle, aortic valve, out the aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the route of conduction in the heart?

A

SA node -> AV node -> crosses to the bundle of His -> down through purkinje fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Normal rhythm of the heart can also be called?

A

Sinus rhythm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does the P wave signify on an ECG?

A

SA node is firing and depolarization of the atria (contraction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does the QRS complex signify on an ECG?

A

AV node electrical pulse and depolarization of the ventricles (contraction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

At what phase of an ECG does atrial repolarization happen?

A

QRS complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does the T wave signify in an ECG?

A

Repolarization of the ventricles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What do the intervals between ECG segments/waves indicate?

A

They indicate how long it takes for the conduction to travel from one area of the heart to another

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What six factors effect cardiac output?

A

HR, SV, preload, afterload, atrial kick, and cardiac reserve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Define SV

A

Amount of blood ejected by the left ventricle during each systolic contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What effects SV?

A

affected by preload, contractility, and afterload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Define CO

A

amount of blood pumped by the ventricles in one minute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Define preload

A

The volume of blood in the ventricles at the end of diastole, before the next contraction

In addition, the amount of stretch placed on the myocardial fibres

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

The amount of stretch on myocardial fibres may also be classified as?

A

Preload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe Starling’s law

A

The more fibers are stretched (i.e., the greater the preload), the greater is their force of contraction/contractility and recoil, within a physiological range

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Often in HF, the heart becomes overstretched and cannot recoil. This causes risk of?

A

Blood pooling and clotting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is one way to increase preload? One way to decrease it?

A

A fluid bolus would increase preload and diuretics will decrease it due to reduced blood volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Define afterload

A

The peripheral resistance that the left ventricle must pump against (ventricle size, wall tension, and arterial BP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Are enlarged or smaller ventricles more effective for contractility?

A

Enlarged ventricles are ineffective to contractility, we want smaller ventricles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Define atrial kick

A

Occurs in the final phase of atrial systole, where the atria contract and eject a bolus of blood into the ventricles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Define cardiac reserve

A

The CVS may increase its workload/rate by 3-4x to meet demand during heightened/high epinephrine situations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Is the cardiac reserve a sustainable source over time?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Define/briefly describe arteries, arterioles, capillaries, veins, and venules

A

Arteries – thicker, elastic, larger ones have smooth muscle

Arterioles – little elastic tissue and more smooth muscle

Capillaries – thin, endothelial cells, no elastic or muscle tissues

Veins – large diameter, thin walled, larger ones have semi-lunar valves

Venules – small, small amount of muscle and connective tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the two locations of baroreceptors?

A

The aortic arch and carotid sinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are baroreceptors sensitive to and where do they transmit their feedback?

A

They are sensitive to stretch and pressure and they send their feedback to the brainstem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

An increase in CO will ___ (stretch/constrict) the periphery and create a ___ (decrease/increase) in HR due to an (increase/decrease) in blood volume

A

Stretch, decrease, increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Where are chemoreceptors located?

A

aortic arch and carotid bodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are chemoreceptors sensitive to?

A

They create responses based on hypoxia (decreased arterial oxygen), hypercapnia (increased arterial CO2), and acidosis (decreased plasma pH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the formula for BP?

A

BP = CO x SVR (systemic vascular resistance)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the formula for pulse pressure?

A

SBP - DBP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What do the following diagnostic/blood studies indicate? CBC, troponin, creatine kinase

A

CBC - complete blood; indicates counts of WBC, RBC, and platelets

Troponin - measurements of contractile proteins (released after an MI)

Creatine kinase (CK) - measurement of enzyme found in skeletal and heart muscle, and the brain (indicates muscle injury or death)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What do the following diagnostic/blood studies indicate? Serum creatinine, BUN, CRP

A

Serum creatinine - indicates waste product of protein breakdown, approximates GFR

BUN - measurement of nitrogen in the blood from waste product of urea

CRP - measurement of a marker of inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What blood study can be predictive of the risk of cardiac disease, inflammation, and cardiac events?

A

CRP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What do the following diagnostic/blood studies indicate? BNP, triglycerides, cholesterol, HDL, LDL

A

BNP - measurement of a peptide that causes natriuresis (sodium in the urine)

Triglycerides - measurement of mixture of fatty acids

Chol - measurement of blood lipid

HDL - measurement of a form of cholesterol that helps remove other forms

LDL - measurement of the form of the bodies of major cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What diagnostic/blood study indicates the presence of HF and may help distinguish cardiac vs respirator related dyspnea?

A

BNP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

BNP is released when the ___ swell?

A

Ventricles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is Holter monitoring?

A

recording of an ECG rhythm over a 24-48 hour period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is a cardiac stress test?

A

Studies the effect of exercise tolerance on the CVS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is cardiac angiography?

A

Procedure that assesses the coronary circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

How do baroreceptors respond to an increased blood pressure?

A

Respond to stretch due to increased BP and blood volume, send an inhibitory impulse to the brainstem which results in decreased HR, force of contraction, and vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

How do baroreceptors respond/adjust to continuous hypertension?

A

Baroreceptors adjust to the higher rates of BP and recognize these levels as normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the vascular endothelium? What can happen to it to cause issues with BP?

A

A single cell layer that lines the blood vessels

It can be potentially narrowed from deposits of lipids and cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

How does the body compensate for deposits of lipids and cholesterol lining the vascular endothelium?

A

The body will add fibrin around the deposits to try and wall them off

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

How does the RAAS system affect blood pressure?

A

It determines whether to conserve or excrete water, which will modify the blood volume - an increase of sodium will increase water intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What enzyme do the kidneys release when they require greater amounts of fluid and blood?

A

Renin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What three hormones are released by the endocrine system to increase BP?

A

ADH - increased of ADH increase ECF, which in turn increases blood vol. and BP

Epinephrine - increases CO, HR, and myocardial contraction

Aldosterone - stimulates the kidneys to retain sodium and water, which increases BP and CO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What does RAAS stand for?

A

Renin angiotensin-aldosterone system

50
Q

What value is considered hypertensive? What is stage one and stage two values?

A

140/90 mmHg

Stage one - 140-159/90-99
Stage two - 160/100

51
Q

What is isolated systolic hypertension?

A

A medical emergency of sustained elevated SBP equal to or greater than 140

52
Q

What is the difference between primary and secondary hypertension?

A

Primary - we do not know the cause

Secondary - we can determine the cause (i.e., tumour)

53
Q

What is a stepped approach with primary hypertension?

A

When administering medications, we always want to start low and work our way up

54
Q

Can primary hypertension be inherited?

A

Yes, and we do not know the direct cause

55
Q

What 7 pathophysiological factors can lead to primary hypertension?

A
  1. Gene
  2. Sodium and water retention (diet and exercise are fundamental)
  3. Altered RAAS (kidneys are excreting high amounts of renin)
  4. stress and increased SNS
  5. insulin resistance and hyperinsulinemia
  6. endothelial cell dysfunction (may result in deposits of cholesterol)
  7. obesity
56
Q

What are 5 concerning complications of chronic hypertension?

A
  1. Hypertensive heart disease (CAD, cardiac hypertrophy, HF)
  2. Cerebrovascular disease (arteriosclerosis)
  3. Peripheral arterial disease
  4. Nephrosclerosis (hardening of kidneys)
  5. Retinal blood vessel damage
57
Q

What is ambulatory blood pressure monitoring?

A

Recording blood pressure over 24 hours, where the machine goes off at random times of the day - pt should continue normal routine and ADLs

58
Q

What are 6 lifestyle modifications that can be made for hypertension management?

A
  1. Nutrition (specifically, reduce sodium)
  2. Weight reduction
  3. Modify alcohol consumption
  4. Physical activity
  5. Avoidance of tobacco
  6. Stress management
59
Q

What are the three levels/steps of medications for medication management of hypertension?

A

Begin with diuretics, then antihypertensives, and lastly move to cholesterol-lowering agents

60
Q

What will hypertensive lab work show for triglycerides, HDLs, and LDLs

A

Labs will show high triglycerides, low HDLs, or high LDL

61
Q

What does the PR segment indicate on an ECG?

A

Time taken for the impulse to spread through the atria, AV node, bundle of His, bundle of branches, and Purkinje fibres

62
Q

What does the ST segment indicate on an ECG?

A

Time between ventricle depolarization and depolarization, should be flat

63
Q

Should the ST segment be peaked or flat in normal sinus rhythm?

A

Flat

64
Q

What is normal sinus bradycardia?

A

Conduction pathway is the same as sinus rhythm, but the SA node fires at a slower rate (i.e., slower HR)

65
Q

What are some normal/non disease clinical associations of sinus bradycardia?

A

Athlete, sleeping, valsalva maneuver, medications

66
Q

How would a patient present if symptomatic with sinus bradycardia?

A

Pallor, low BP, cold skin, weakness, angina, syncope (dizziness), confusion, and SOB

67
Q

What is syncope?

A

Sudden, brief loss of consciousness

68
Q

What medication would you administer to someone in sinus bradycardia in an emergency?

A

Atropine - an anticholinergic to rapidly increase the HR

69
Q

What surgical intervention could be administered to someone who is sinus bradycardic?

A

Insertion of a pacemaker

70
Q

What is normal sinus tachycardia?

A

The conduction pathway is the same as that in sinus rhythm, but rate from SA node is increased (i.e., increased HR)

71
Q

What are some clinical associations of sinus tachycardia?

A

Stress, panic attack, exercise, fever, infection, acute pain, anemia, caffeine

72
Q

Hypovolemia would lead to sinus bradycardia or tachycardia? Why?

A

Hypovolemia (loss of water, blood, and electrolytes) will lead to tachycardia due to the body wanting to compensate

73
Q

Low BP, hypoxia, hypoglycaemia will all lead to sinus tachycardia or bradycardia?

A

Sinus tach

74
Q

What are the three main symptoms of sinus tachycardia?

A

Dizziness, headache, and SOB

75
Q

How do we treat sinus tachycardia?

A

Entirely dependent on the cause - increase sugar, reduce pain, vagal maneuvers, cardioversion

76
Q

What is reduced ejection fraction r/t HF?

A

The pushing/contraction from atria and ventricles is reduced, causing lowered blood volume

77
Q

What is the difference between reduced and preserved ejection fraction?

A

Reduced - caused by impaired contractile function, leaving the left ventricle with inability to generate enough pressure to eject blood through aorta

Preserved - inability of the ventricles to relax and fill during diastole

78
Q

List the 4 compensatory mechanisms the heart uses in HF

A
  1. SNS
  2. Neurohormonal
  3. Ventricular dilation
  4. Ventricular hypertrophy
79
Q

How does the SNS compensate in HF?

A

Epinephrine release, which increases BP, HR, contractility, and vasoconstriction

80
Q

Does epinephrine have an effect on ejection fraction?

A

No

81
Q

Which compensatory mechanism in HF is the least effective of the 4?

A

SNS

82
Q

How does the neurohormonal system compensate in HF?

A

The RAAS system is activated (aldosterone and ADH are released) to absorb more sodium and water, which in turn increases blood volume and BP

83
Q

How does ventricular dilation compensate in HF?

A

Ventricles enlarge, which leads to overstretched muscle that ineffectively contract

84
Q

How does ventricular hypertrophy compensate in HF?

A

Increases in muscle mass and cardiac wall thickness in response to overwork and strain - eventually they need more oxygen and increase CO

85
Q

How do natriuretic peptides (BNP) effect HF?

A

BNP is released from the ventricles in response to increased blood volume in the heart, which helps to counter the adverse effects of the SNS and RAAS system

86
Q

What are the two types of HF? Briefly explain each

A

Right-sided - Backward blood flow to the right atrium and venous circulation, we see peripheral edema, JVD, and poor circulation to the lungs

Left-sided - Left ventricular dysfunction causes blood to back up through the left atrium and into the pulmonary veins, we see pulmonary congestion, pink/frothy sputum, cyanotic extremities, cold skin, and poor circulation to the body

87
Q

What are the 9 clinical manifestations of HF?

A

Fatigue, dyspnea, tachycardia, edema, nocturna, skin changes (dry, cracked, pallor), behavioural changes (agitation, depression, frustration), chest pain, weight changes

88
Q

What is the most common form of initial HF?

A

Left-sided HF

89
Q

What is one of the earliest symptoms of HF?

A

Fatigue

90
Q

What is brawny edema?

A

Edema that is so full that it cannot be displaced

91
Q

What would a HF patient’s BP and O2 sats be?

A

Hypotensive and low O2 sats

92
Q

What are 8 complications associated with HF?

A
  1. Pleural effusion (accumulation of fluid in the pleura)
  2. Conduction abnormalities
  3. Left ventricular thrombus (LVT)
  4. Stroke
  5. Pulmonary thrombosis
  6. Ascites
  7. Enlarged liver
  8. Renal failure
93
Q

What is the underlying goal in all HF patients?

A

Preserve and manage current cardiac function

94
Q

Would a pacemaker be an effective intervention for a HF patient?

A

Yes, it would

95
Q

What is peripheral artery disease (PAD)?

A

The thickening of artery walls from increased deposits of cholesterol and lipids in vessels, which results in the narrowing of upper and lower arteries

96
Q

What is the greatest risk factor for PAD?

A

Aging, specifically greater than 70 years

97
Q

What are seven other related risk factors for PAD?

A

Diabetes (excess glucose and thicker blood), smoking, uncontrolled hypertension, family history, diet, stress, and PA

98
Q

When do symptoms of PAD begin to present?

A

See symptoms when vessels are 60-75% blocked

99
Q

What is collateral circulation?

A

In PAD patients, the blocked vessels will develop alternate pathways for circulation

100
Q

What are six complications associated with PAD?

A
  1. Intermittent claudication
  2. Paresthesia
  3. Pallor
  4. Reactive hyperaemia
  5. Pain at rest
  6. Critical limb ischemia
101
Q

What is intermittent claudication in PAD?

A

Aching precipitated by exercise, which resolves with rest

Exercise could be walking or ADLs

102
Q

What is paresthesia in PAD?

A

Numbness and tingling in the toes or feet due to nerve tissue suffering from ischemia

103
Q

What is pallor in PAD?

A

Blanching of the foot with elevation

104
Q

What is reactive hyperaemia in PAD?

A

Redness of the foot in dependent position (below the level of the heart)

105
Q

Does pain in lower limbs worsen at night in PAD patients?

A

Yes, intense leg pain due to the them being at the level of the heart and reduced CO

106
Q

What is critical limb ischemia in PAD?

A

Limbs are not receiving blood flow that they need - can lead to rest pain greater than 2 weeks, leg ulcers, and gangrene

107
Q

What are four diagnostic tools for PAD?

A
  1. Doppler ultrasound
  2. Segmental BP
  3. Ankle-brachial index
  4. Computed tomographic angiogram
108
Q

What does a doppler ultrasound test in PAD?

A

Measures the diameter of the vessel and highlights area of obstruction

109
Q

What does a segmental BP test in PAD?

A

Blood pressure cuffs attached to various areas, observing BP as it moves through cuffs

110
Q

What does an ankle-brachial index test in PAD?

A

BP taken on the ankle and foot

111
Q

What does a computed tomographic angiogram test in PAD?

A

Detects any areas of decreased or no perfusion

112
Q

What are six risk modifications that are important to PAD?

A

Healthy weight, regular PA program, diet, smoking cessation, BP control, and blood sugar control

113
Q

What lifestyle behaviour is pertinent to manage in PAD patients?

A

Smoking cessation

114
Q

What type of medication is necessary and preventative for PAD patients?

A

Anti-platelets to reduce blood clots from sluggish blood

115
Q

What is the recommended exercise program for PAD patients?

A

Walking 30 to 40 mins per day, 3-5x per day

116
Q

What type of diet/nutrition is recommended for PAD patients?

A

High in fruits and grains, low in cholesterol, fats, and sodium

117
Q

Interventional radiological catheter-based procedures are useful for what in PAD patients?

A

Stents keep the vessels open

118
Q

What is peripheral vascular disease (PVD)?

A

Similar to PAD, but is of concern with diabetic patients

119
Q

How is PVD preventable?

A

It is preventable through tight management of diabetes

120
Q

Describe good foot care in diabetics and why it is important

A
  1. Check their feet every day
  2. Ensure appropriate sock wear (NO SEAMS)
  3. Appropriate footwear
  4. Nail trimming
121
Q

What type of socks should diabetics wear?

A

No seams

122
Q

What is appropriate nail trimming for diabetics?

A

Straight across or seek professional

NSG 2321 - Theory Exam 2 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions