Exam 2: Cardio

Question 1

what are the three layers of blood vessels?

Answer 1

tunica intima, tunica media, and tunica adventitia

Question 2

what constitutes pulmonary circulation?

Answer 2

right ventricle, pulmonary trunk, pulmonary arteries, lungs, pulmonary veins, left atrium

Question 3

what constitutes the systemic circulation?

Answer 3

left ventricle, aorta, arteries ,capillaries,veins, vena cava, right atrium

Question 4

what is the volume of blood ejected by the left ventricle per minute

Answer 4

cardiac output

Question 5

what is the amount of blood ejected with each ventricular contraction?

Answer 5

stroke volume

Question 6

what are the three layers of the heart? where is the pericardial cavity?

Answer 6

fibrous pericardium, serous pericardium, and pericardial cavity. pericardial cavity is located the potential space between the parietal and visceral serous layers

Question 7

what is considered the natural pacemaker of the heart?

Answer 7

the SA node

Question 8

Define the P wave

Answer 8

atrial depolarization

Question 9

Define the P-R interval

Answer 9

normal conduction time (.12-.20 seconds)

Question 10

Define the QRS

Answer 10

ventricular depolarization

Question 11

Define the S-T interval

Answer 11

depolarization-repolarizaation

Question 12

Define the T wave

Answer 12

ventricular repolarization

Question 13

what is: the direct relationship between between the strength of contraction and the length of stretch of the cardiac muscle

Answer 13

Frank-Starling Law

Question 14

What is: the change in HR in response to volume receptors in the atrium; does not affect the contractility

Answer 14

Bainbridge reflex

Question 15

what is when: pressure receptors in internal carotid arteries and aorta

Answer 15

baroreceptor reflex

Question 16

what does sympathetic vs. parasympathetic stimulation mean to heart rate, contractility, etc?

Answer 16

Sympathetic- decreased HR, increased Heart Rate, vasoconstriction

Parasympathetic-increased BP, decreased HR, vasodilation

Question 17

what is the pressure exerted at the end of diastole (frank-Starling law)

Answer 17

preload

Question 18

what is the resistance to ejection; load the muscle must move when it contracts

Answer 18

afterload

Question 19

Define coronary artery disease? what is the incidence of CAD among various groups?

Answer 19

CAD is an insidious, progressive disease of vessels of the heart, leading to their narrowing or total occlusion.

• leading cause of death in US

Question 20

Describe the role of LDL vs. HDL in the development of atheromas and CAD

Answer 20

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

Question 21

List modifiable vs. nonmodifiable risk factors of CAD?

Answer 21

modifiable- smoking, hypertension, elevated serum, diabetes, obesity, menopause

nonmodifiable- age-over 65 years/ gender-male/ heredity- african americans/ genetics-

Question 22

list invasive and non-invasive diagnostic tests for CAD and briefly define the use of each

Answer 22

invasive- ECG,EKG, Lab tests, catheterization, transesophogeal echocardiogram

noninvasive- stress test, thallium, transthoracic echocardiogram, dobutamine stress test

Question 23

define supply vs. demand

Answer 23

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

Question 24

differentiate between a stable and unstable plaque

Answer 24

stable- fixed, leading to stable angina with a pattern of pain

unstable- unstable angina with unusual pain patterns and MI

Question 25

what are some causes of plaque disruption?

Answer 25

• size of lipid rich core
• stability and thickness of fibrous cap
• presence of inflammation
• lack of smooth muscle cells

Question 26

define: acute coronary syndrome

Answer 26

• includes unstable angina and NSTEMI (subtotal or intermitent coronary occlusion_
• STEMI (thrombotic coronary occlusion is complete)

Question 27

Define NSTEMI, risks, and clinical manifestations

Answer 27

• 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

Question 28

Define STEMI, risk and clincal manifestations

Answer 28

-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

Question 29

what are the major types of chronic ischemic heart disease?

Answer 29

stable angina, silent myocardial ischemia, variant/vasoplastic angina

Question 30

describe or dilineate the primary difference between angina and MI using definition, sighns/symptoms

Answer 30

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

Question 31

what is the triad, or zones of infarction?

Answer 31

ischemia- hypoxic tissue, T wave inversion, ST segment depression, reversible

Injury- severe hypoxia, elevated ST segment, reversible

Infarction- Q wave depression

Question 32

Describe the cardiac enzymes. how are they useful in diagnosis of MI?

Answer 32

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

Question 33

what’s the leading cause of left-sidedheart failure?

Answer 33

coronary artery disease

Question 34

what’s cor pulmonale

Answer 34

right sided heart failure