Surg 105--Chapter 33 Flashcards
A slow heart rate (usually under 60 beats per minute).
bradycardia
Intentional stopping of the heart during cardiac surgery.
cardioplegia
A solution that most often contains a mixture of potassium chloride, lidocaine, dextrose, insulin, albumin, tromethamine, and Plasmanate.
cardioplegic solution
The phase of the cardiac cycle when the ventricles contract.
diastole
Uncoordinated muscular activity in the heart muscle, which results in “quivering” rather than pumping action; results in pooling of blood.
fibrillation
Reduced blood supply to tissue. May be a result of obstruction within the blood vessels or external pressure, which acts as a tourniquet.
ischemia
The narrowing of a hollow structure such as a blood vessel or duct.
stenosis
An incision made into the sternum.
sternotomy
The relaxation phase of the cardiac cycle when the ventricles are filling with blood.
systole
A fast heart rate (usually over 120 beats per minute).
tachycardia
What are the two upper chambers of the heart?
left and right atrium
What are the two lower chambers of the heart.
left and right ventricle
The heart is contained within a _____ cavity called the _____.
closed
mediastinum
The heart is located between the two _____, _____ to the sternum, and _____ to the vertebrae and esophagus.
lungs
posterior
anterior
The walls of the heart have three layers, what are they?
- epicardium (outer layer)
- myocardium (middle layer)
- endocardium (inner layer)
A double-layered membrane that encloses the heart is the _____.
pericardium
What test is done that demonstrates the movement of blood through valves?
ventricular angiography
A short length of rubber tubing either commercially prepared or cut from a straight (Robinson) urinary catheter.
Rumel tourniquet
How is the Rumel tourniquet held in place?
Threaded over cannulation sutures.
Used when large vessels are occluded or isolated with a vessel loop or umbilical tape.
Rumel tourniquet
What is a pacemaker and what does it do?
A device that produces electrical impulses that stimulate the heart muscle
Are pacing batteries permanent or temporary or both?
Both, temporary (external) and permanent (internal)
What is a defibrillator?
Required to convert fibrillation into a functional rhythm.
Also described as ineffectual quivering of the ventricles.
fibrillation
What is the most common incision used in cardiac surgery?
median sternotomy
What is cardioplegic solution used?
To stop the heart; this reduces the energy required by the cardiac muscle by eliminating the energy requirements of contraction. Protects the cardiac muscle from damage while the aorta is occluded and the blood supply is interrupted.
What are the most common methods of infusion of a cardioplegic solution?
Direct coronary artery infusion and the transatrial retrograde method.
During coronary artery bypass grafting metal rings or opaque material can be placed around each vein graft on the aorta, why are they sometimes used?
They mark the veins in the event cardiac catheterization is performed in the postop period.
A series of small-bore, transmural channels are created with the carbon dioxide or holmiun-yttrium-aluminum-garnet laser to perfuse the myocardium.
transmyocardial revascularization
What is the goal of transmyocardial revascularization?
Increase blood flow to the heart in patients in whom bypass surgery or medical management is not feasible.
What does the aortic valve do?
Maintains one-way blood flow from the left ventricle to the aorta.
During an aortic valve replacement, what type of incision does the surgeon use to open the aorta?
a transverse incision, or occasionally, a vertical incision
What causes mitral valve disease?
May be caused by rheumatic heart disease, dilation of the annulus, ischemic heart disease, trauma, or changes in the tissue that produces regurgitation.
What are the 2 classifications of aneurysms?
saccular or fusiform
A ballooning out of a localized area in the artery.
saccular aneurysm
Involves the entire circumference of the artery.
fusiform aneurysm
Implanted into the body to correct cardiac arrhythmia caused by disease of the conduction system.
insertion of an artificial cardiac pacemaker
A heart rate over 120 beats per minute.
tachycardia
A heart rate of 240-450 beats per minute.
atrial flutter
Chaotic, disorganized stimulation of one or both ventricles that does not pump the blood.
ventricular fibrillation
Chaotic, disorganized stimulation of one or both atria that prevents atrial contraction.
atrial fibrillation
A heart rate below 40-60 beats per minute.
bradycardia
When is an implantable cardioverter defribillator used?
Used in patients susceptible to ventricular fibrillation or ventricular tachycardia.
What incisions can be used to insert an implantable cardioverter defribillator?
thoracotomy, subxyphoid, median sternotomy incision
How are most implantable cardioverter defribillators implanted?
transvenously with the leads placed in the right ventricle
Remove accumulated blood or fluid from the pericardium.
pericardial window
Used to ween patients from the cardiopulmonary bypass when other means are ineffective.
ventricular assist device (VAD)
Maintains perfusion through cannulas placed in the chambers of the heart and the great vessels.
ventricular assist device (VAD)
What patients are candidates for ventricular assist device (VAD)?
patients awaiting heart transplantation
Which patients are suitable for heart transplant?
- coronary artery disease
- congenital heart disease
- valve disease
- coronary artery disease
- rejection of previously transplanted heart
