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A&P II Exam 1 > Slide set 3 > Flashcards

Slide set 3 Flashcards

1
Q

Lack of sympathetic tone or heart failure would do what to a CO curve?

A

Right shift and decreased plateau

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2
Q

Increase in sympathetic stimulation or increased pumping effectiveness will cause what in a CO curve?

A

Left shift and increased plateau

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3
Q

An increase in SVR also causes an increase in

A

RVR

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4
Q

SVR is also

A

Afterload

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5
Q

An increased preload will show what variables on the PV loop

A

Increased SV and EDV; ESV stays the same

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6
Q

A decreased preload will show what variables on the PV loop

A

Decreased SV and EDV; ESV stays the same

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7
Q

Increased afterload will show what variables on the PV loop

A

Decreased ejection time and SV; increased time spent in phase II; increased ESV; EDV remains the same

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8
Q

Decrease afterload will show what variables on the PV loop

A

More time spent in ejection; Increased SV and reduced ESV

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9
Q

Contractility is denoted by what on the PV loop

A

Upper left hand corner

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10
Q

Increased contractility will show what on the PV loop

A

Steeper slope with leftward loop shift; increased SV and decreased ESV

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11
Q

Decreased contractility will show what on the PV loop

A

Reduced slope; reduced SV and increased ESV

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12
Q

What is happening during mitral regurgitation

A

Any time the pressure is higher in the ventricle than the left atria, blood is backflowing

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13
Q

Why is EF not a good diagnostic for MR

A

SV is increased

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14
Q

A temporary enhanced filling will eventually cause ______ in MR

A

eccentric hypertrophy over time

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15
Q

Mild MR

A

<30 mL backflow

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16
Q

Moderate MR

A

30-60 mL regurg flow

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17
Q

Severe MR

A

> 60 mL regurg flow

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18
Q

IABP inflates during

A

Diastole to help push blood down the atria and perfuse the CAs

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19
Q

IABP deflates during

A

Systole to create an artificially low afterload

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20
Q

What medications might we give to someone with MR and what considerations should we have

A

Afterload reducers; caution in patients with CAD and they may have trouble perfusing the CAs

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21
Q

We want to decrease the ________ to reduce regurgitant flow in MR

A

Delta P

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22
Q

Time spent in ______ can increase mitral regurgitant flow. To combat this we would allow

A

Systole; permissive slight tacycardia

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23
Q

Mitral regurgitation will show what on a PV loop

A

Increased SV and EDV; decreased ESV; longer ejection time

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24
Q

Mitral stenosis will show what on a PV loop

A

Lower SV, EDV, and ESV; left shift - similar to decreased preload

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25
Q

The body compensates for mitral stenosis by

A

Increasing filing pressures and CVP

26
Q

Increasing filling pressures of the right heart for MS can cause

A

Increase in pulmonary pressures, prolonged P wave and a right axis deviation

27
Q

Mitral stenosis does not have a big effect on

A

the left ventricle

28
Q

We want to avoid what intraoperatively with mitral stenosis? Why?

A

Tachycardia; need as much time in diastole as possible

29
Q

MS was attributed to rheumatic fever years ago - what might cause it now?

A

A bad strep infection

30
Q

Why do we want to avoid a fib in patients with MS

A

Loss of atrial kick to help filling

31
Q

What happens during aortic regurgitation

A

Blood backflows in LV anytime the pressure is higher in the aorta

32
Q

Compensation for aortic regurg

A

Fill the heart with more blood

33
Q

What compensation for aortic regurg may make the backflow even worse

A

Constricting of vessels to maintain ABP; increased SVR and afterload will further increase delta P

34
Q

What will you see on a PV loop in AR

A

Increased SV, EDV, and ESV

35
Q

What kind of hypertrophy would you find in someone with AR

A

Eccentric

36
Q

What medications would we consider in someone with AR

A

afterload reducers

37
Q

Pulse pressure is _____ in aortic stenosis

A

Reduced

38
Q

What is happening during aortic stenosis

A

the heart is having to pump against a non compliant valve

39
Q

Compensation for AS

A

Increase in filling pressures or an increase in HR

40
Q

What would see on a PV loop for aortic stenosis

A

Decreased SV; increased preload and ejection pressures; increased EDV and ESV

41
Q

Concentric hypertrophy is

A

Thickening of the heart wall via addition of parallel sarcomeres

42
Q

Why is preload increased in AS

A

Thicker heart wall is less compliant to filling

43
Q

Tachycardia is bad for someone with AS because

A

Less time spent in diastole; therefore less time perfusing CA

44
Q

Why is aortic stenosis resistant to CPR

A

The sequence has been taken out of the contraction; pushing on everything at once

45
Q

In someone with bad CO and contractility how might we help them out?

A

Afterload reducer

46
Q

During early inspiration, what occurs

A

R heart CO increases 2 fold, L heart CO decreases, PAP decreases due to pulm vessels being pulled open, MAP decreases

47
Q

PPV affects thoracic pressure and hemodynamics by

A

Increasing thoracic pressure causing a temporary increase in R and L CO, MAP, and PAP; over time, this decreases VR

48
Q

Coronary blood flow is equivalent to

A

70mL/min/100 grams of heart muscle

49
Q

Normal coronary blood flow rate

A

225 mL/min

50
Q

Delta P of aortic pressure and ventricular wall pressure tells us

A

Coronary blood flow

51
Q

Temporary retrograde flow of the LCA is caused by

A

the beginning of systole

52
Q

X descent

A

occurs after A wave; drop in pressure during atrial relaxation of mid systole

53
Q

Y descent

A

occurs after V wave; drop in pressure d/t ventricular filling at the start of diastole

54
Q

H plateau

A

Immediately before A wave; occurs during the middle third of diastole

55
Q

Overdampening of an A line may be due to

A

Occlusion or partial occlusion

56
Q

Underdampening of an A line may be due to

A

Artifact

57
Q

When we place a spinal block we are at risk for causing

A

sympathetic block and knocking out the nerves that pace the heart

58
Q

The “shortcut” from an AV fistula will cause a decrease in

A

RVR

59
Q

At what percentage of blood loss is our CO affected

A

15%

60
Q

At what percent of blood loss is our ABP affected

A

20%

61
Q

At percent of blood loss would cause fatality if the SNS was knocked out

A

10-15%

A&P II Exam 1 (5 decks)

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