Intro to Perfusion Flashcards
Cardiac Cycle
-Systole
- Ventricular contraction and atrial filling (Systole)
Cardiac Cycle
-Diastole
- Atrial Contraction causes ventricular filling (Diastole)
2. Relaxation of ventricle (Diastole)
Stroke Volume
- Amount of blood ejected per beat
Cardiac Output
- Amount of blood ejected per minute
Ejection Fraction
- Percentage of blood ejected in systole
Cardiac Index
- CO / Bod Surface Area
- More specific indicator of circulation ** Best indication of perfusion **
- Takes height & Weight into consideration
Cardiac Output
-Influenced by
- Activity level & metabolic rate
- Physiologic & Psychologic stress
- Age
- Body size
Cardiac Output
-Involves interaction of
- HR
- Preload & After-load
- Contractility
Cardiac Reserve
- Ability to respond to body’s changing needs
Base of the Heart
-Location?
- The base of the heart it the top
- 2nd intercostal space
Apex of the Heart
-Location
- Bottom - 5th intercostal space, midclavicular line
Coronary Circulation
-Aorta: Filling of Coronary Arteries?
- Coronary arteries fill during DIASTOLE
Coronary Circulation
-Right Coronary Artery
- Feeds inferior and posterior portions of heart (R side of heart)
Coronary Circulation
-Left Main Coronary Artery
- Left anterior descending
- Feeds anterior and septal portion (Left ventricle) - Left Circumflex
- Feeds lateral and posterior
Preload
- Volume of blood in the ventricles at the end of diastole
2. Influenced by venous return and compliance of ventricles
Preload
-Starling’s Law
- The greater the volume, the greater the force, the greater the fibers contract to accomplish emptying
Drugs that Increase Preload
- Vasopressors
2. Fluid
Drugs that decrease Preload
- Vasodilators
2. Diuretics
After-load
- The amount of force needed to eject blood from the ventricles (open the semilunar valves)
After-load
-Right Ventricle
- Must overcome Pulmonary Vascular resistance
After-Load
-Left Ventricle
- Must overcome Systemic Vascular Resistance
Cardiac Output
-Visual Clues of Low Output?
- Decreased:
- BP
- LOC
- UOP
- Bowel sounds
Cardiac Output
-Visual Clues of High output?
- Septic - fever
- High HR
- High or low BP
Heart Sounds
-S1
- Lub
- Onset of ventricular contraction (SYSTOLE)
- CLosure of AV valves
Heart Sounds
-S2
- Dub
- Onset of ventricular relaxation (DIASTOLE)
- Closure of semilunar valves
Apical Impulse
- Visible pulsation at the point of maximal impulse (PMI)
2. Seen in half of adults
Point of Maximal Impulse (PMI)
-Where is it Palpated?
- Normally palpated at the:
- 5th intercostal space
- midclavicular line
PMI
-Displaced Laterally?
- If the PMI is displaced laterally it indicates an ENLARGED HEART
Extra Heart Sounds
-S3 (Ventricular Gallop)
- Immediately after S2
- Myocardial failure
- CHF, Mitral Regurgitation, Tricuspid Regurgitation
Extra Heart Sounds
-S4 (Atrial Gallop)
- Immediately before S1
- Resistance to ventricular filling
- HTN, CAD, Aortic stenosis
Extra Heart Sounds
-Summation Gallop
- Combination S3 & S4
- Severe CHF
Diagnostics
-Serum Cholesterol/Triglycerides/Lipids
- Normal Total Cholesterol <110
- If Pt has high cholesterol:
- Assess current diet
- Reduce animal products
Extra Heart Sounds
-Pericardial Friction Rub
- Pericarditis
Calculating Mean Arterial Pressure (MAP) TEST
- SBP + 2(DBP) / 3 = MAP