Exam 2: Cardio Flashcards
what are the three layers of blood vessels?
tunica intima, tunica media, and tunica adventitia
what constitutes pulmonary circulation?
right ventricle, pulmonary trunk, pulmonary arteries, lungs, pulmonary veins, left atrium
what constitutes the systemic circulation?
left ventricle, aorta, arteries ,capillaries,veins, vena cava, right atrium
what is the volume of blood ejected by the left ventricle per minute
cardiac output
what is the amount of blood ejected with each ventricular contraction?
stroke volume
what are the three layers of the heart? where is the pericardial cavity?
fibrous pericardium, serous pericardium, and pericardial cavity. pericardial cavity is located the potential space between the parietal and visceral serous layers
what is considered the natural pacemaker of the heart?
the SA node
Define the P wave
atrial depolarization
Define the P-R interval
normal conduction time (.12-.20 seconds)
Define the QRS
ventricular depolarization
Define the S-T interval
depolarization-repolarizaation
Define the T wave
ventricular repolarization
what is: the direct relationship between between the strength of contraction and the length of stretch of the cardiac muscle
Frank-Starling Law
What is: the change in HR in response to volume receptors in the atrium; does not affect the contractility
Bainbridge reflex
what is when: pressure receptors in internal carotid arteries and aorta
baroreceptor reflex
what does sympathetic vs. parasympathetic stimulation mean to heart rate, contractility, etc?
Sympathetic- decreased HR, increased Heart Rate, vasoconstriction
Parasympathetic-increased BP, decreased HR, vasodilation
what is the pressure exerted at the end of diastole (frank-Starling law)
preload
what is the resistance to ejection; load the muscle must move when it contracts
afterload
Define coronary artery disease? what is the incidence of CAD among various groups?
CAD is an insidious, progressive disease of vessels of the heart, leading to their narrowing or total occlusion.
- leading cause of death in US
Describe the role of LDL vs. HDL in the development of atheromas and CAD
LDL- low density lipoprotiens,less desirable
-promotes atherosclerosis by depositing cholesterol on artery walls
HDL- more desirable
- removes cholesterol and returns it to liver for breakdown
- inhibits cellular uptake of LDL, prohibiting promotion of CAD
List modifiable vs. nonmodifiable risk factors of CAD?
modifiable- smoking, hypertension, elevated serum, diabetes, obesity, menopause
nonmodifiable- age-over 65 years/ gender-male/ heredity- african americans/ genetics-
list invasive and non-invasive diagnostic tests for CAD and briefly define the use of each
invasive- ECG,EKG, Lab tests, catheterization, transesophogeal echocardiogram
noninvasive- stress test, thallium, transthoracic echocardiogram, dobutamine stress test
define supply vs. demand
supply has to do with the amount of oxygen we take in from breathing to provide the cels and tissues with a source to make ATP whereas demand is the amount of oxygen required by cells and tissues
differentiate between a stable and unstable plaque
stable- fixed, leading to stable angina with a pattern of pain
unstable- unstable angina with unusual pain patterns and MI
what are some causes of plaque disruption?
- size of lipid rich core
- stability and thickness of fibrous cap
- presence of inflammation
- lack of smooth muscle cells
define: acute coronary syndrome
- includes unstable angina and NSTEMI (subtotal or intermitent coronary occlusion_
- STEMI (thrombotic coronary occlusion is complete)
Define NSTEMI, risks, and clinical manifestations
- serum markers present or myocardial damage
- occurs at rest or minimal exertion lasting longer than 20 minutes.
- severe, new onset pain
- more severe than last stable angina
Define STEMI, risk and clincal manifestations
-ischemic death of myocardial tissue determined by coronary artery
-abrupt severe crushing pain, may radiate
- females- atypical ischemic type of discomfort
elderly- SOB main complaint
what are the major types of chronic ischemic heart disease?
stable angina, silent myocardial ischemia, variant/vasoplastic angina
describe or dilineate the primary difference between angina and MI using definition, sighns/symptoms
Angina- burning pain in the substernal or perocardial area that radiates to left arm, neck, jaw, or shoulder blade
-nausea, vomiting, fainting, sweating, commonly occurs after physical exertion
MI- necrosis of myocardial tissue due to lack of blood supply to myocardium
- feeling of impending doom, fatigue, nausea, anxiety, cool extremeties
what is the triad, or zones of infarction?
ischemia- hypoxic tissue, T wave inversion, ST segment depression, reversible
Injury- severe hypoxia, elevated ST segment, reversible
Infarction- Q wave depression
Describe the cardiac enzymes. how are they useful in diagnosis of MI?
Serum enzymes:
SGOT(AST)- level increases 6 to 10 hours after MI
CPK(CK) 3 isoenzymes, CK-MB levels rise after an MI, remains elevated for 72 hours
LDH(LD)-5 isoenzymes
what’s the leading cause of left-sidedheart failure?
coronary artery disease
what’s cor pulmonale
right sided heart failure
