Perfusion Flashcards
Afterload
The force the ventricles must overcome to eject their blood volume. R Ventricle must generate enough tension to open the pulmonary valve & eject it’s vol. into the low-pressure pulmonary arteries. R Ventricle Afterload is measured as pulmonary vascular resistance. L Ventricular ejects its load by overcoming the pressure behind the aortic valve. L Ventricular Afterload is measured as systemic vascular resistance.
Action Potential
Electrical impulse that stimulates muscle contraction, and produces the waveforms represented on electrocardiogram (EEG) strips
____________ pressures are much higher than ______________ pressures; thus the _______ ventricle has to work much harder than the _______ ventricle. ~Alterations in vascular tone affect afterload & ventricular work.
Arterial/Pulmonary Left/Right
Cardiac output adjusted for the client’s body surface area (BSA), _____________provides beneficial data regarding the heart’s ability to perfuse the tissues. ___________is also an accurate indicator of the effectiveness of the circulation. *same answer for both blanks
Cardiac Index
The process that returns the cell to it’s resting, polarized state.
Repolarization
Stroke Volume / end-diastolic volume and represents the fraction of percent of the diastolic volume that is ejected from the heart during systole. Normal range: 50%-70%
Ejection Fraction
Average adult Cardiac Output range
4-8 L/min
HR x SV =
Cardiac Output
Central perfusion
*Generated by cardiac output *Propels blood to organs in their tissues *Clinical manifestations are systematic when impaired (meaning the entire body is affected)
Tissue perfusion
*volume of blood that flows through the tissues *supplied by blood flow from arteries to capillaries *Poor central perfusion or a problem within the organ itself can cause impaired tissue perfusion
What happens with impaired central perfusion?
Hypotension, tachycardia, change in mental status, shortness of breath, change in heart rhythm, peripheral edema, and S1, S2, S3, S4, or murmurs
What happens with impaired tissue perfusion?
Lower extremities: pale, cool skin, less hair on legs, diminished dorsalis pedal and posterior Tibial pulses, slowed capillary refill Kidneys: decreased urine output Brain: depends on the extent of ischemia and areas affected
First heart sound (S1) the “lub”
Produced by closure of the AV valves, start of systole (phase of ventricular contraction)
Closure of the semilunar valves when the ventricles empty their blood into the aorta and pulmonary arteries. Start of diastole (ventricular relaxation)
Second heart sound (S2) the “dub” sound
Closure of the Aortic Valve (AV) produces _________ that is characterized by the syllable “lub.”
Auscultation Site _________
Side of stethoscope used during assesment_______
3 answers
- First Heart Sound (S1 )
- Auscultation site: Apex
- using the disphram of Stethoscope
~ Cardiac Cycle: Start of Systole, high-pitched, patients positioning does not affect sound.
Sound produced by the closure of the Semilunar Valves amd characterized by the syllable “dub”__________ with an ausculatating site of __________ using the ___________?
- Second heart sound (S2 )
- Both in Second Intercostal space (ICS), with the pulmonary component best at left sternal boarder (LSB) and aortic component at right sternal border (RSB)
- Heard best with diaphram
~Cardiac Cycle Timing: End of systole, positioning: sitting or supine, high-pitched
Phase of ventricular contraction that begins with the closure of AV Valves.
- Systole
~In Systolic Phase ventricles are filled then contract to expel blood into the aorta & pulmonary arteries.
The phase of ventricular relaxation begins with the closure of semilunar valve(S2 ) and ends at the closure of AV valves (S1 ).
Diastole
Most commonly heard in children & pregnant women in the third trimester.
- Third Heart Sound (S3 )
~Heard after S2 using the bell at apex and termed ventricular gallop, When AV valves open the blood flow into vemtricles causes vibrations which produce the S3 sound during diastole.
May be heard in children, well-conditioned athletes, & healthy older adults without cardiac disease.
- Fourth Heart Sound S4
~caused by atrial contraction & ejection of blood during late diastole and is termed atrial gallop
~Heard best at apex with bell during early diastole right after S2 Low-pitched
- *
Heard in pt. with Valvular disease in early systole
Clicks & Snaps
May be heard in mitral stenosis in early systole
Opening Snap
Occur in damaged pulmonary & aortic valves (SL Valves)
Ejection Clicks
Heard in prolapse of mitral valve
Nonejection Clicks
Results from inflamation of the pericadial sac, the surfaces of the parietal & visceral layers of pericadium can’t slide smoothly producing a rubbing or grating sound.
Friction Rubs
Harsh blowing sounds, caused by disruptive blood flow into the heart, into the chambers, or from heart to pulmonary or aortic systems.
Heart Murmur
Left & Right coronary arteries originate at the base of the __________ and branch out to encircle the ____________.
AORTA & MYOCARDIUM
JUST NOTES: Volume of Murmurs are on a scale of 1-6
- Grade 1: Barely audible with stethscope; often considered physiological
- Grade 2: Very soft but distinctly audible
- Grade 3: Moderatly loud; no thrill or thrushing motion is associated
- Grade 4: Distinctly loud, in addition to a palpable thrill.
- Grade 5: Very loud, can hear with diaphram off the chest; palpable thrust & thrill are present.
- Grade 6: Loudest, can hear w/ dialhram off chest; visible thrill & thrust.
During diastole, the volume in the ventricles increases to approximatley 120 mL (____________), and at the end of systole the volume in the vemtricles decreases to approximatly 50 mL (_____________).
- End-diastolic Volume
- End-systolic Volume
Difference between End-diastolic Volume and End-systolic Volume is the ____________?
Stroke Volume
~Ranges from 60-100 mL/beat with an aversge of 70mL/beat in an adult.
The amount of blood pummped by the ventricles into the pulmonary & systemic circulstions in 1 minute.
Cardiac Output
Average adult CO?
- Ranges from 4-8 L/min
- CO is and indicator of the hearts ability to function as a pump.
- If the heart can’t pump effectivley, CO & tissue perfussion are decreased leading to ischmic tissues, ultimatly causing necrosis in cells.
CO influencing factors
- 4 Most Important Factors of CO
- Heart rate
- Preload
- Afterload
- Contractility
~with activity level, metabolic rate, physiological & psychological stress responses, age, & body size all influencing CO as well.
The hearts ability to respond to an increase of strenuous activity & adjust it’s CO is called_________?
Cardiac Reserve
The ability of the arteris to contract & expand is called?
Compliance
Factors affecting Pulse
- Age: As age ⬆ pulse rate gradually ⬇ overall
- Gender: After puberty, the average males PR is slightly lower than the average female’s.
- Excercise: The PR normally ⬆ with activity. The rate of increase in a prof. athleteis often less than in the average individual bc of greater cardiac size, strength, & efficiency.
