Module 4 Flashcards
Pulmonary circulation
What is the function of the right Atrium and right ventricle
To pump and propel oxygenated blood to the lungs
What is the function of the left a atrium and ventrical?
To pump and propel oxygenated blood throughout the systemic circulation
What Divides the left from this right side of the heart ?
It’s separated by septum - inter
How much does the heart weigh?
200-250 gm
Where is the heart located?
Enclosed in the media steinem in between the 2nd and 5th intercostal space heart rests on the superior surface of the diaphragm anterior to the vertebral column and posterier to the sternum. Approx. Me 2/3 of the heart lies on the Left
What protects, anchors and prevents the heart from over filling?
Pericardium
, it lines the heart’s chambersA thick contractile middle layer of the heart, bulk of the heart characteristic cross striations of muscular tissue.
Myocardium
Inner myocardial surface, glistening white sheet of squamous epithelium that rests on a thin connective tissue. Located in the inner myocardial surface.
Endocardium
What are the layers of the heart, outer most to the inner most layers?
Fibrous Pericardium Parietal Layer of serous pericardium Pericardial cavity Visceral layer of serous pericardium (epicardium) Myocardium Endocardium
Left coronary artery
Supplies blood to the left LV and LA
Right coronary artery?
Supplies blood to RA and RV
What happens when blood flow to the heart muscle is not sufficient enough for the demand?
Heart attack
What are mammary arteries used for?
Replacement vessels for the heart during a heart attack.
What cautions should be taken if mammary arteries are used for a cabg?
Must be careful with by not using too much peep. May rip sutures
Where does the anterior side of the heart empty to?
Anterior side of heart empties into the great cardiac veins
Where does the Posterior side of the heart empty to?
Empties to the middle cardiac veins
- Both cardiac veins converge and empty into
coronary sinus
- Some collected into thebesian veins (RA and LA)
- Contributes to anatomical shunt.
What is the vascular system divided into?
Pulmonary vascular system
Systemic vascular system
Pulmonary Vascular System
Low pressure system diastolic 8
External respiration
What is external respiration
In the lungs, exchange between air and blood
Systemic vascular system
High pressure system diastolic 80
Internal respiration
What is Internal respiration
gas exchange between tissues and blood
Where does gas exchange take place
in the capillaries
What is Systolic pressure
Maximum pressure generated during ventricular contraction
What is sytemic systolic pressure
120 mmhg
What is pulmonary systolic pressure
80mmhg
Diastolic pressure
Lowest pressure in the arteries prior to next ventricular contraction
Systemic diastolic pressure
80 mmhg
Pulmonary diastolic pressure
8 mmhg
systemic MAP
80-100 mmhg
MAP <60mmhg
reduced perfusion to vital organs. Body will attempt to keep vital organs provided with nutrients by vasoconstriction of the extremities.
Calculation of MAP
MAP= SBP + (2XDBP)/3
Why is it important to keep the MAP >60 mmhg
Driving pressure is important to provide nutrients- if not the body may switch from aerobic to anaerobic.
What is MAP determined by
Stroke volume - How much blood flows with every beat
Arterial compliance- recoil
Arterial Resistance-
Normal stroke volume
80-10 mmhg
what is considered hypertention
map > 110
diastole >90
Systole >135-140mmhg
What is normal systemic vascular resistance
900-1440 dynes/sec/cm2
calculate SVR
SVR= (MAP-RAP)/CO X 80
Define vascular resistance, recruitment and distention (engorgement)
Vascular resistance= impedance to blood flow
Vascular resistance = Input pressure - output pressure/ blood flow mean blood pressure/Q 100 mmhg/5L/min 20mmHg/LPM
Pulmonary resistance
Pulm Resistance = Driving pressure/ Q
Mean PA-LAP/Q
10mmhg / 5L/min = 2mmHg/L
Pulmonary Vascular Resistance PVR
Normal is 80-240 dynes/sec/cm-5
PVR = MPAP-LAP/ CO
PVR = MPAP-PCWP/CO
What is Pulmonary Edema?
Accumulation of fluid in the interstitial space between capillary and alveoli
Causes of PUlmonary edema
Increased hydrostatic pressures
Left ventricular failure
Increased capillary permeability
Severe infections, sepsis, ards, o2 toxicity
Decreased Oncotic pressure
Protein starvation, blood dilution, proteinuria (Ascities)
Insufficient lymphatic drainage
Compression of lymphatic vessels (Tumors
Starlings Law of fluid
Qf = Kf (Pc - Pi) - Of (
What is the most narrow part of the upper airway for a child or infant?
Cricoid, more horizontal
What is the most narrow part of adult upper airway?
Epiglottis
In an adult what is the name of an upper airway infection that blocks the airway? What are the symptons? What tests are ordered?
Epiglottis, viral infection. Edema of the supraglottic. Lateral xray should be ordered. Will look like a thumb. Stridor sounds.
In an child what is the name of an upper airway infection that blocks the airway? What are the symptons? What tests are ordered?
Inflammation of the chricoid, subglottic. Lateral neck xray will look like a steeple.
What is a sniffer position?
Neck, chin lift for intubation
