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1
Q

What does ECMO stand for

A

Extra corporeal membrane oxygenation

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2
Q

What does extracorporeal mean?

A

Occurring outside the body

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3
Q

When you look at an ECMO machine what do you see

A

A pair of lungs

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4
Q

What does the ECMO machine do

A

When blood is pushed into the ECMO machine oxygen is placed into the blood and carbon dioxide is removed

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5
Q

What are the two types of ECMO and which is most common

A

Venous Venous (VV), and Veno arterial (VA)

VV ecmo is most common

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6
Q

Describe how a VV ECMO works

A

A Venous Venous ECMO works by taking blood out of the vein, oxygenating it, and then putting it back into the vein

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7
Q

Describe how a VA ECMO works

A

Blood will be taken out of the vein, passed through the echo machine and then funnelled through an artery back to The Body

Vein > machine > artery > body

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8
Q

What does ARDS stand for

A

Acute respiratory distress syndrome

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9
Q

What is ARDS

A

Type of respiratory failure that occurs when the capillary membrane that surrounds the alveoli sac leaks fluid into the sack

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10
Q

What occurs in the alveoli Sac

A

Gas exchange

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11
Q

What occurs when fluid enters the alveolar sacs? In other words what happens when ARDS occurs in a patient?

A

There will be a decreased gas exchange, collapse of sac, and hypoxemia (low o2 in blood) which will result in suffering organs

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12
Q

Hypoxaemia

A

Low oxygen in blood

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13
Q

Hypoxia

A

Reduced level of tissue oxygenation

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14
Q

What is atrial kick

A

Atrial kick signifies the contraction of the atria and adds 10 to 30% more blood to the ventricles

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15
Q

What is the pericardium

A

Fluid filled sac around the heart

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16
Q

Epicardium

A

Outer visceral layer of heart, flexible outer layer

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17
Q

Describe myocardium

A

Middle muscular layer

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18
Q

Endocardium

A

Inner layer of heart, connective tissue

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19
Q

What are the two main coronary arteries

A

The left coronary artery and the right coronary artery

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20
Q

What does the left coronary artery branch into

A

The left coronary artery branches into the left anterior descending artery and the circumflex artery

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21
Q

What does the location of the coronary artery determine

A

Location of the artery determines what area of the heart it provides oxygen to

22
Q

Coronary arteries break off into smaller what

A

Collaterals

23
Q

What are collaterals

A

Coronary collaterals are tiny specialized blood vessels that connect the larger vessels in the heart

24
Q

What are the two types of cardiac cells

A

Electrical cells and mechanical cells

25
Q

What is the role of electrical cells

A

Impulse formation and conduction

26
Q

What is the role of mechanical cells

A

Muscle contraction

27
Q

Describe S1

A
  • lub
  • closure of AV valves (mitral and tricuspid)
  • end of diastole / beginning of ventricular systole
28
Q

Describe S2

A
  • dub
  • closure of semilunar valves (pulmonic and aortic valves)
  • end of ventricular systole, beginning of diastole
29
Q

What is a murmur

A

Turbulent blood flow

30
Q

What is cardiac output, normal range, and why do we need it

A

Cardiac output is the amount of blood pumped into the aorta each minute, normal range is 4 to 8 L per minute, and it is necessary for adequate tissue oxygenation and normal organ function

31
Q

What are the determinants of cardiac output

A

Cardiac output is equal to heart rate time stroke volume.

32
Q

What does stroke volume refer to And what is it influenced by

A

Stroke volume is the amount of blood ejected from the left ventricle per beat. Stroke volume is influenced by pre-load, after load, and contractility. Normal is 50 to 70 mL per beat

33
Q

Describe preload and what is it affected by

A

Reload is the amount of blood volume in the ventricles (End diastolic volume)

Preload is affected by blood volume, venous return, atrial kick, filling time (increased heart rate equals decreased filling time), Amount of myocardial fibre stretch at the end of diastole

34
Q

Describe afterload and what it is determined by

A

After load is resistance or pressure the ventricle must overcome to eject it’s blood volume

Determined by size of the vessel (dilation versus constriction) compliance of vessels (stenosis) size and thickness of ventricle walls, (contractility) and volume of blood ejected

35
Q

Contractility and what is it influenced by

A

Hearts ability to contract when required
Contractility is influenced by starlings mechanism, sympathetic stimulation, metabolic changes, changes in intracellular calcium, drug therapy

36
Q

Inotropy

A

Ability of the myocardial muscle fibres to shorten during systole

37
Q

Heart failure

A

Failure of heart to contract effectively as a result of a long-term failure such as untreated valve disfunction or hypertension or short term event such as MI

38
Q

Angina

A

Transient inability for the body to meet oxygen demand of the heart. May resolve, may progress

39
Q

Myocardial infarction

A

Inability for the body to meet oxygen demand of the heart resulting in damage to cardiac tissue

40
Q

What kind of valves are anchored to the wall of the ventricle by Cordae tendonae which is attached to papillary muscle

A

AV valves (mitral and tricuspid valves)

41
Q

What are the semi lunar valve’s

A

Aortic and pulmonary valves

42
Q

What are the AV valves

A

Mitral and tricuspid valve

43
Q

The Semi lunar valve’s differ from the AV valves as the semi lunar valve’s have no

A

Chordae tendonae

44
Q

What does stenosis mean

A

Narrowing

45
Q

Stenotic valves restrict the forward flow of blood because

A

They are unable to open fully

46
Q

Why does stenosis impact the heart function over time

A
  • increase cardiac workload to pump against the high afterload (Increased afterload of a tree out or ventricles due to narrowing)
  • obstruction of blood flow results in backup of blood and increased pressure in the affected chambers - Eventual hypertrophy of the atria or ventricles
47
Q

Regurgitation

A

Valves do not close properly resulting in the backward flow of blood

48
Q

Why is regurgitation bad

A

Increased volume and pressure behind the valve

Increased cardiac workload in an effort to maintain adequate cardiac output

49
Q

Ebstein’s anomaly

A

Congenital heart defect in which tricuspid valve has malformed and displaced causing regurgitation

50
Q

Atresia

A

Absence or closure of valve orifice, often tricuspid valve

Cardiology (5 decks)

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