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Physiology > Exam 2 – Cardio Ch 23 > Flashcards

Exam 2 – Cardio Ch 23 Flashcards

1
Q

What is the placenta responsible for?

A

Nutrient and oxygen delivery to the fetal blood

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2
Q

When does the heart start beating?

A

At 18 days

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3
Q

In the fetus, what side of the heart has a higher pressure?

A

The right side, or the two sides could be somewhat equal

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4
Q

What does blood to the fetus come through?

A

Umbilical vessels

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5
Q

What are the different fetal accommodations?

A

Umbilical vessels, urachus
PDA, foramen ovale
Fetal hemoglobin

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6
Q

What is the placenta the site of?

A

Oxygenation

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7
Q

What is the ductus venosus?

A

Bypassing the liver (nonfunctional)–from umbilical vein to inferior vena cava directly

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8
Q

What is the foramen ovale?

A

Shunt from right to left atrium
Oval hole
Highest O2 content to left ventricle to supply carotid and brain

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9
Q

What is the ductus arteriosus?

A

Shunt from pulmonary artery to aorta, also right to left shunt

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10
Q

Look at the organization of the fetal circulation

A

Look at the organization of the fetal circulation

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11
Q

Where do umbilical arteries come off?

A

Close to where the renal arteries come off

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12
Q

What do umbilical arteries do?

A

Pick up nutrients and oxygen then goes to the umbilical vein

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13
Q

What does the umbilical vein carry?

A

Oxygenated blood

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14
Q

Where does the highest oxygenated blood go through?

A

Right atrium

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15
Q

What does 30% of the blood go out of?

A

Pulmonary artery

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16
Q

What does most of the blood bypass?

A

The lungs

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17
Q

What is a very common infection in calves?

A

Umbilicus infections

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18
Q

Where do the 2 umbilical arteries go?

A

Go through the bladder and join the umbilical vein

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19
Q

What happens to blood due to the fact that capillaries have a higher pressure?

A

Blood is forced into the aorta

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20
Q

Which has a higher affinity for oxygen, fetal Hgb or mother Hgb?

A

Fetal Hgb

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21
Q

What does loss of blood flow from the placenta cause?

A

2X increase in vascular resistance
Decreased venous return to right atrium
Increased aortic pressure

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22
Q

When does the ductus venosus close?

A

3-7 days after birth

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23
Q

What does the closing of the ductus venosus cause?

A

Loss of umbilical venous return and low blood flow

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24
Q

What causes pulmonary vascular resistance to decrease?

A

Lung expansion

Lung vasculature vasodilates

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25
Q

After birth, which side of the heart is the high pressure system? Low pressure system?

A

Left side

Right side

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26
Q

What changes at birth?

A

Loss of placenta
First breath decreases vascular resistance in lung
Closure of foramen ovale
Closure of ductus arteriosus

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27
Q

What is the closure of the ductus arteriosus related to?

A

Oxygen content

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28
Q

How long does it take for the ductus arteriosus to fully close?

A

1-8 days

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29
Q

Which has lower O2, fetus or adults?

A

Fetus

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30
Q

What is the most common feature for horses to have?

A

A ductus arteriosus that does not fully close, cuasing there to be a sound similar to a murmur

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31
Q

Describe the 1st heart sound

A

Lub
AV valves close
Luder than the second sound
Low pitch

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32
Q

Describe the second heart sound

A

Dup

Aortic and pulmonary valves close

33
Q

Describe the 3rd heart sound

A

Very low pitch

Caused by inrushing of blood into ventricles

34
Q

Describe the 4th heart sound

A

Atrial contraction late in diastole

Hard to hear with stethoscope except in hypertensive patients with a thick left ventricle

35
Q

What are cardiac sounds?

A

Vibrations

36
Q

What causes more vibrations (cardiac sounds)?

A

Turbulent flow

37
Q

What happens if there is a larger vessel and larger turbulence?

A

The sound is louder

38
Q

What happens if the opening is smaller?

A

The turbulence is greater

39
Q

What are acquired heart defects?

A

Stenosis

Insufficiency

40
Q

What are congenital heart defects?

A

Atrial septal defect
Ventricular septal defect
Tetralogy of fallot

41
Q

Which side will you always be able to hear the heart better?

A

Left

42
Q

What do we listen to on the left side of the heart?

A

Pulmonic, aortic, and mitral valves

43
Q

What do we listen to the right side of the heart?

A

Tricuspid valves

44
Q

What is the grading of heart murmurs based on?

A 
Timing
Loudness
Point of maximal intensity
Cardiac thrill
Acquired vs congenital
45
Q

What are the different timings of murmurs?

A

Systolic/pansystolic or holosystolic
Diastolic/pandiastolic of holodiastolic
Continuous (systole and diastole)
Crescendo-decrescendo

46
Q

How is the loudness of murmurs evaluated?

A

Grade I-VI/VI

47
Q

What is the modulation for systolic murmurs?

A

Crescendo-decrescendo

48
Q

What are the association with a systolic murmur?

A 
Congenital pulmonic stenosis
Congenital aortic stenosis
Innocent murmurs
Mitral regurgitation
Tricuspid regurgitation
Ventricular septal defect
49
Q

What is the modulation of diastolic murmurs?

A

Decrescendo

50
Q

What are the associations with diastolic murmurs?

A

Aortic regurgitation
Aortic valve bacterial endocarditis
Secondary to chronic aortic stenosis
Secondary to a high ventricular septal defect

51
Q

What is the modulation of continuous murmurs?

A

Machinery

52
Q

What are the associations with diastolic murmurs?

A

Patent ductus arteriosis

Tetraology of fallot

53
Q

What is stenosis?

A

Narrowing/scarring–systolic

54
Q

What is insufficiency?

A

Not sealing, leaky–diastolic

Regurgitation

55
Q

What are the valves most commonly affected by a murmur?

A 
Mitral valves (most common in dogs)
Tricuspid valves (most common in cattle, horses, and pigs)
Aortic valve (second most common in dogs)
56
Q

What are results of heart valve damage?

A

Stenosis

Destruction of valve –regurgitation or insufficiency

57
Q

Describe mitral stenosis

A

Murmur heard in last 3rd of diastole
Thrill over apex of heart
Low rumbling murmur

58
Q

What are the hemodynamics of mitral stenosis?

A

Cardiac output and mean arterial pressure do not decrease nearly as much as in aortic stenosis
Atrial volume leads to atrial fibrillation
Right ventricle pressure could lead to right ventricle failure
Left atrial pressure could cause pulmonary edema
Left ventricle is normal

59
Q

What is mitral regurgitation?

A

Idiopathic myxomatous degeneration
Blowing murmur head throughout systole–high pitch
Best heard over left thorax

60
Q

When does regurgitation occur?

A

During systole

61
Q

What are the hemodynamics of mitral regurgitation?

A

Left atrial pressure can lead to pulmonary edema
Cardiac output falls more if right heart fails
Left atrial volume can lead to atrial fibrillation

62
Q

Describe aortic stenosis (narrowed)

A

Diamond shaped– or crescendo and decrescendo
Pressure in ventricle causes ventricular hypertrophy
Very loud (can be felt if severe)
Fairly common

63
Q

What are the hemodynamics of aortic stenosis?

A

Left ventricle hypertrophy

Chronic increase in blood volume

64
Q

When does leaking/regurgitation occur?

A

Diastole

65
Q

Describe aortic regurgitation

A

Blowing murmur–high pitch
Listen over left ventricle for best sound
Short murmur means blood flows back rapidly and is more severe

66
Q

What are the hemodynamics of aortic regurgitation?

A

Aortic diastolic pressure decreases rapidly
Filling of ventricle can compress inner parts of heart and coronary artery
Left ventricular hypertrophy

67
Q

How can a diagnosis of murmurs be done?

A

Stethoscope or phonocardiogram
Echocardiogram
X-ray
Catheterization

68
Q

What are congenital murmurs?

A

Failure of heart formation during gestation

69
Q

Look at patent ductus arteriosus

A

Look at patent ductus arteriosus

70
Q

What can patent ductus arteriosus be treated with?

A

Prostaglandin blocker, indomethacin

71
Q

What happens to blood with patent ductus arteriosus?

A

It recirculates through the lungs

72
Q

What happens to blood volume with a decreased net cardiac output in patent ductus arteriosus?

A

It is increased to bring CO back to normal

73
Q

What happens to cardiac reserve with patent ductus arteriosus?

A

Decreased

74
Q

What can patent ductus arteriosus develop?

A

Pulmonary edema

75
Q

What are the hemodynamics of patent ductus arteriosus?

A

Left ventricular hypertrophy

Right ventricular hypertrophy

76
Q

What happens with interventricular septal defect?

A

Pan systolic murmur unless hole closes during contraction

The larger the hole the quieter the murmur

77
Q

Describe interventricular septal defect

A

Foramen ovale may not fuse closed
May not have normal fibrotic closure of foramen ovale, but left atrial pressure causes it to functionally close
If right atrial pressure becomes greater than left atrial pressure, flowery be reversed

78
Q

What is tetraology of fallot?

A

4 abnormalities that results in insufficiently oxygenated blood pumped to the body

79
Q

What are the 4 abnormalities of tetraology of fallot

A

Ventrical septal defect (opening between the left and right ventricles)
Displacement of aorta over ventricular septal defect
Narrowing of pulmonary valve
Thickening of wall of right ventricle

Physiology (70 decks)

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