Definitions Flashcards
PMI point of maximal impulse
Palpable beat of the heart through the chest in the fifth left intercostal space on the midclavicular line
Epicardium
Same membrane that forms the outermost layer of heart
Pericardium
Tough fibrous sack that protects the heart and provides lubrication. The superficial layer is called the parietal pericardium, The deep layer is call the visceral pericardium. A potential space exists between the two layers
Left main coronary artery LMCA subdivides into…
LAD left anterior descending artery and LCx left circumflex coronary artery
RCA right coronary artery travels between the…
Right ventricle and right atrium by way of the atrioventricular groove
Coronary sulcus
Groove that separates the atria from the ventricles
Name the 2 Atrioventricular valves
Mitral and tricuspid through which blood flows from the atria to the ventricles
Mitral valve is located
Between the left atrium and the left ventricle
Tricuspid valve is located…
Between the right atrium and the right ventricle
Name the 2 Semilunar valves
Pulmonary semilunar valve and aortic semilunar valves
Semilunar valve is located…
Between the right ventricle and pulmonary artery
Aortic semilunar valve is located…
Between the left ventricle and the aorta
Atrial kick
The volume of blood pumped into the ventricles by the aorta
Preload
The volume of blood return to the heart, Also referred to as the pressure of venous return
Afterload
The pressure in aorta against which the left ventricle must pump blood, increasing after load 10 decreased cardiac output
Tunica adventitia
The protective outer layer of vessels to provide strength to withstand high-pressure
Tunica media
The middle layer of elastic fibers of the vessels that gives strength and contractility
Tunica intima
The smooth interlining of vassals that is only one cell thick
Cardiac output CO
The amount of blood that is pumped out by either ventricle normal = 5 to 6 L per minute
Stroke volume SV
Amount of blood pumped out by either ventricle the single contraction. Normal= 60 to 100 mL
Heart rate HR
Number of contractions per minute
Ejection fraction EF
Percentage of blood that leaves the heart after each contraction. Normal = 55 to 70%
Frank starling mechanism
The ability of cardiac muscle when stretched, to contract with greater force. And therefore the more completely empties and the greater the stroke volume
If preload increases what happens according to this Frank starling mechanism
CO will increase
Inotropic
Affecting the contractility of muscle tissue
Chronotropic
Affecting the hearts rate of contraction
Dromotropic
Affecting the hearts rate of electrical conduction
The SA node receives blood from which artery
Right coronary artery. If RCA is occluded, the SA node will become ischemic
Internodal pathways
The three pathways of the electrical conduction system found in the atria that transmit the impulse from the SA node to the AV node. Bachman’s bundle, Wenkebach Tract, Thoral Tract
Where does the blood supply come from for the AV node
RCA
What is the distal portion of the AV node call
Bundle of His
Depolarization
The rapid shifting of electrolytes and cellular charges is the main catalyst for muscle contraction transmission
What are the two phases of the refractory period
Absolute refractory - the heart is completely depolarized and unable to respond to stimulus
Relative refractory -the heart is partially repolarized and only able to partially contract
Acetylcholine
Neurotransmitter that mediates the sympathetic and parasympathetic nervous system
Atropine
Opposes the action of acetylcholine to act as a parasympathetic blocker causing an increase in heart rate
What effect will a Beta agent have on the heart
Positive chronotropic inotropic and dromotropic effect
What affect will a Beta agent have on the vessels
Vasodilation
What effect will an Alpha agent have on the vessels
Vasoconstriction
What affect will a Beta agent have on the bronchioles
Bronchodilation
Beta 1 adrenergic agonist act on…
The heart
Beta 2 adrenergic agonist act on…
The lungs
Norepinephrine primarily acts on alpha receptors to…
Cause vasoconstriction and increase blood pressure due to vasodilation from neurogenic shock
Epinephrine primarily acts beta receptors to…
Increase heart rate, dilate the bronchi, cause peripheral vasoconstriction.
Dopamine is a sympathetic agent used to…
Increase renal perfusion, increased rate and force of myocardial contraction, constrict peripheral blood vessels
Albuterol is a sympathetic beta-2 agent that causes…
Bronchodilation (1 heart, 2 lungs)
What is the first part of patient assessment
Scene size up
What are the four parts of the primary assessment
- Form general impression
- Airway breathing
- Circulation
- Transport decision
What are the main components of the secondary assessment
- OPQRST
- SAMPLE
- Vitals
- Assess all body systems
Paroxysmal nocturnal dyspnea (PND)
An acute episode of shortness of breath that wakes the patient from sleep
Orthopnea
Dyspnea that occurs when recumbent
Digitalis preparations are prescribed for what?
Treatment of chronic CHF, atrial fibrillation, atrial flutter, SVT
Pulse deficit
Situation in which the palpated radial pulse rate is less than the apical pulse rate: reported numerically as the difference between the two
Pulses alternans
Impulse that alternates between strong and weak beats, characteristic of left ventricular systolic damage
Pulsus paradoxes
Weakening or loss of the probable pulse during inhalation, equivalent to a drop in the systolic blood pressure of 10 mm or more common in pericardial tamponade or severe asthma
Bipolar leads
Contain A positive and negative pole. I,II,III
Augmented unipolar leads
Contain one true pole, while the other end of the lead is referenced against a combination of other leads. aVL, aVF, aVR
Sinus dysrhythmia
Slight variation of the sinus rhythm that is usually > .12 sec between the longest and shortest cycles
First degree heart block
The impulse reaching the AV node is delayed slightly longer than is expected and results in the PR interval of greater than .20 seconds
Idioventricular rate occurs when…
The ventricles are responsible for producing the rhythm due to SA and AV node failure
Axis deviation
A component of an ECG looks at the direction of travel for the electricity going through the heart as it depolarizes
Bundle branch block
QRS complex of long-duration that signifies some abnormality in conduction through the ventricles
Bifascicular block
Blockage in any combination of two of the fascicles or conduction pathways: RBBB and anterior hemiblock, or BBB and posterior hemlock, or anterior hemiblock and posterior hemiblock
Trifascicular block
Blockage of all three components of the ventricular conduction system, with one working occasionally to provide AV conduction
Preexcitation
Early depolarization of venricular tissue due to the presence of an accessory pathway between the atria and ventricles
WPW and Lown-Ganong-Levine syndrome
WPW - characterized by short PR intervals, Delta waves, nonspecific ST-T wave changes, indicating the presence of an accessory pathway
LGL - characterized by a short PRI and normal QRS is a disorder that causes preexcitation ventricular tissue
What causes right atrial enlargement
And elevation in the returning venous pressure or high pulmonary pressure
What causes left atrial enlargement
Systemic hypertension, mitral or aortic valve stenosis or an athletic heart
What are the contiguous leads
Leads that view geographically similar areas Hoopers trick Lateral View = I, aVL, V5, V6 Anterior View = V3, V4 Inferior View = II, III, aVF Septal View = V1, V2
Fibrinolysis
The process of dissolving blood clots
Benign early repolarization
Early repolarization thought to be a normal variant, characterized by ST segment elevation, 80 fishhook appearance at the J point and concave ST segment morphology
Pulmonary Embolism
A blood clot or foreign matter trapped within the pulmonary circulation
Hypertrophic cardiomyopathy
Condition in which the myocardial walls become very thick. Causes SOB, Chest pain, syncope
Brugada syndrome
Genetic disorder involving sodium channels in the heart; characterized by incomplete RBBB and ST segment elevation that aggressively returns to baseline
Long QT syndrome
QT interval exceeding .45 s (12 boxes)
Ischemia
Tissue deprived of oxygen
Infarction
Dead tissue
Atherosclerosis
Cholesterol and calcium buildup inside deciles forming plaque which leads to blockage of bloodflow
Arteriosclerosis
Arterial walls become thickened and inelastic
Claudication
Severe pain in the calf caused by narrowing arteries
Thromboembolism
Blood clot that has formed with in the blood vessel and is floating within the bloodstream
Prinzmetal angina
Chest pain that occurs while at rest
Unstable angina
Characterized by changing unpredictable pattern of pain
Stable angina
Characterized by a pattern of predictable pain
Transmural myocardial infarction
When an infarct extends through the entire wall of the ventricle
Subendocardial myocardial infarction
When the ischemic process affects only the inner layer of muscle
Percutaneous coronary intervention PCI
And alternative to fibrinolysis that involves peripheral artery recanalization to keep blocked coronary arteries open with balloons or stents
Left sided heart failure
A condition in which the left ventricle cannot effectively pump leading to a backup of blood behind the left ventricle and eventually serum is forced out of the pulmonary capillaries and into the aveoli
Right sided heart failure
Condition in which the right side has to work increasingly harder to pump blood into engorged pulmonary vessels which leads to an inability to keep up with the increased workload
Becks triad
Combination of narrowing pulse pressure, Muffled heart tones, and JVD associated with cardiac Tampa not usually results from penetrating chest trauma
Hypertensive emergency
Acute elevation of BP with evidence of end organ damage
Hypertensive encephalopathy
Condition that may complicate any form of hypertension, which is usually signaled by a sudden marked prize in BP greater then 200/130. A.k.a. Acute hypertensive crisis
Endocarditis
Inflammation of the endocardium
Myocarditis
Inflammation of the myocardium
