module 5 quiz questions

Question 1

What is a disrhythmia / arrhythmia?

Answer 1

A change in the normal rhythm of the heart beat

Range from occasional “missed”, more rapid or slower beats, to serious disturbances that impair the pumping ability of the heart

Question 2

What are the two general causes for disrhythmias?

Answer 2

Abnormal rate of impulse generation from the SA node or other pacemaker

Abnormal conduction of impulses through the heart’s conduction system

Question 3

Define sinus rhythm

Answer 3

Normal heartbeat

Question 4

define brachycardia,

Answer 4

Slow heartbeat

Question 5

define tachycardia

Answer 5

Fast heartbeat

Question 6

define sinus arrhythmia.

Answer 6

Irregular heartbeat (during respiration)

Question 7

Describe atrial fibrillation.

Answer 7

Completely disorganized and irregular atrial rhythm accompanied by completely irregular ventricular rhythm. Causes pooling of blood in atria

Question 8

Why can atrial fibrillation be sometimes asymptomatic?

Answer 8

Ventricular filling is not totally dependent on atrial contraction, so these arrhythmias may be asymptomatic

Question 9

What is the greatest danger of atrial fibrillation

Answer 9

blood clots which will lead to stroke

Question 10

Describe atrioventricular node abnormalities (heart block)

Answer 10

Occurs when conduction is excessively delayed or stopped at the AV node or bundle of His

Partial heart block (slower conduction – leads to first, second degree) to total heart block (no transmission – leads to third degree, where ventricles contract on their own, but cardiac output is greatly reduced)

Not all atrial beats getting through to the ventricles

Question 11

Describe ventricular fibrillation

Answer 11

Ventricles quiver but do not contract – ineffective in ejecting blood (no cardiac output, so death within minutes if not corrected)

Disorganized electrical signals: ventricles quiver instead of contract. Patient unconscious as blood is not pumped to the brain. Immediate defibrillation is indicated. May occur in MI

Question 12

describe asystole

Answer 12

No electrical activity in the heart / absence of a heartbeat (“flatline”)

Question 13

Describe the purpose of cardiopulmonary resuscitation (CPR)

Answer 13

Purpose is to “massage” the heart with sufficient force to circulate sufficient blood throughout the body and throughout the heart muscle to maintain life. Performed when heart has stopped beating (asystole). (it is possible (but unlikely) that, with the heart muscle receiving sufficient oxygen, it may begin to beat spontaneously)

Question 14

Describe the purpose defibrillation

Answer 14

Purpose is to interrupt the irregular electrical signals that are causing the ventricles to vibrate and not produce sufficient cardiac output. Once these signals have been stopped, it is possible for the heart to begin beating in a rhythmic fashion. Performed when the ventricles are fibrillating

Question 15

Define diastolic heart failure.

Answer 15

A decrease in cardiac output caused by decreased filling of the left ventricle during diastole caused by reduced chamber size (left side only)

Question 16

Identify (and understand the example for each) three causes for diastolic heart failure.

Answer 16

Decrease expansion of the ventricle (pericardial effusion)

Increase wall thickness and reduce chamber size (hypertrophic cardiomyopathy)

Delay diastolic relaxation (myocardial ischemia) (decreased energy for calcium pumps)

Remember that calcium must be removed from cytosol in order for myosin to detach from actin, allowing relaxation to occur

Question 17

Describe the condition of cardiogenic shock and its effect on the heart

Answer 17

Enough blood volume, but decreased cardiac output due to decreased contractility, increased preload and increased afterload

Decrease in blood pressure causes responses (increase in epinephrine, RAAS) that increase oxygen/nutrient demand of the heart which puts further strain on the heart, resulting in it becoming incapable of pumping an adequate volume

Question 18

Describe the condition of hypovolemic shock and its causes (3).

Answer 18

Not enough blood volume, caused by loss of whole blood (hemorrhage), plasma (burns) or interstitial fluid (diarrhea or diuresis) in large amounts

Question 19

Describe the condition of distributive shock.

Answer 19

Result of massive vasodilation such that, although the volume of the blood has not changed, the amount of space containing the blood has increased, resulting in a decrease in BP below the required to drive nutrients across capillary membranes to the cells

Question 20

Describe the condition of neurogenic shock. Be familiar with the causes.

Answer 20

Result of massive vasodilation resulting from overstimulation of the parasympathetic NS and under stimulation of the sympathetic NS

Trauma to the spinal cord or medulla, anaesthetic agents, severe pain

Question 21

Describe the condition of anaphylactic shock, its cause and its treatment.

Answer 21

Release of histamine and other compounds by mast cells as a result of a type I hypersensitivity results in vasodilation and vascular permeability to the point of peripheral pooling and tissue edema

Results from widespread hypersensitivity reaction, known as anaphylaxis

Smooth muscle constriction can result in laryngospasm, bronchospasm and diarrhea

Treatment involves intramuscular administration of epinephrine to cause vasoconstriction and reverse airway constriction

Question 22

Define the condition of septic shock.

Answer 22

Severe infection with a microorganism has 2 possible effects: the microorganism releases toxins that stimulate an overwhelming inflammatory response, and/or there is an overwhelming inflammatory response to the microorganism itself

Common type of vasodilatory shock

Question 23

What manifestation differs between vasodilatory (distributive) shock and other categories of shock?

Answer 23

Manifestation differs from types of non-vasodilatory shock in that the skin is warm and flushed (non-vasodilatory types of shock constrict blood vessels, thus decreasing blood flow to skin (skin becomes cool and pale) while distributive types of shock produce dilation of blood vessels)

Question 24

.Describe the condition of obstructive shock, and its most common cause.

Answer 24

Results from mechanical obstruction of the flow of blood through the central circulation

Most common cause is pulmonary embolism (other causes include cardiac tamponade, pneumothorax)

Elevated right heart pressure occurs

Significant decrease in cardiac output