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ASDOH Cardiopulmonary System > Test 1 > Flashcards

Test 1 Flashcards

1
Q

Adult heart approximately

A

The size of a fist

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2
Q

Right ventricle = moves venous blood to the

A

Pulmonary Circulation

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3
Q

Left ventricle = moves arterial blood to the

A

Systemic Circulation

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4
Q

separates right and left atria

A

Interatrial septum

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5
Q

depression in the interatrial septum; remnants of foramen ovale

A

Fossa ovalis

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6
Q

is the term used to describe an interatrial septum that fails to develop properly

A

Atrial Septal Defect

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7
Q

separates right and left ventricles

A

Interventricular septum

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8
Q

are the most common CONGENITAL cardiac abnormalities ; they are found in 30-60% of all newborns with a congenital heart defect, or about 2-6 per 1000 births

A

Ventricular septal defects

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9
Q

In order to pump blood…

A

Right and Left Ventricles of the Heart

Must contract forcefully and overcome aortic and pulmonary pressures

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10
Q

end diastolic volume is usually about

A

150 mL

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11
Q

How much blood dos the heart eject with each stroke?

A

About 50% the volume ejected is about 70-80mL

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12
Q

What are the 3 Layers of the heart

A

Epicardium
Myocardium
Endocardium

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13
Q

Lines inner chambers,valves, chordae tendineae, and papillary muscles.

A

Endocardium

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14
Q

The different things cardiac muscle has compared to skeletal muscle…

A 
Single central nucleus
Intercalated discs (help contraction)
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15
Q

Also called the

visceral pericardium

A

Epicardium

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16
Q

Includes blood capillaries, lymph capillaries, nerve fibers, and epicardial fat

A

Epicardium

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17
Q

covers approx. 60- 80% of the heart’s surface and constitutes 20% of total heart weight

A

Epicardial fat

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18
Q

The pericardial space usually contains…

What is this used for?

A

Normally contains approximately 10 mL of fluid

Acts as a lubricant, preventing friction as the heart beats

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19
Q

Primary function of the heart valves

A

Ensure blood flow in one direction through

heart chambers and Prevent regurgitation

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20
Q 
• Lies between right
atrium and right ventricle
• Consists of three
separate leaflets
• Larger in diameter
and thinner than mitral valve
A

TRICUSPID VALVE

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21
Q

• Has only two cusps
• Lies between left
atrium and left
ventricle

A

MITRAL (BICUSPID) VALVE

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22
Q

What are the distinct features of AV valves?

A

Cusps of AV valves are attached to chordae tendineae (“heart strings”): papillary muscles contract when the ventricular walls contract preventing bulging too far backward.

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23
Q

have three cusps shaped like half-moons

A

Semilunar valves
• Pulmonic valve (Right Ventricle)
• Aortic valve (Left Ventricle)

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24
Q

Function of the “ventricular valves”

A

Prevent backflow of blood from the aorta and pulmonary arteries into the ventricles during ventricular diastole

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25
Q

Associated with closure of tricuspid and mitral

(AV) valves

A

First Heart Sound (Lub)

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26
Q

Associated with closure of pulmonic and aortic

(semilunar) valves

A

Second Heart sound (Dub)

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27
Q

receives blood from: Superior vena cava, Inferior vena cava, and Coronary sinus.

A

Receives blood from: Superior vena cava, Inferior vena cava, and Coronary sinus.

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28
Q

Order of blood flow through RIGHT SIDE of heart

A 
Right Atrium
Tricuspid Valve
Right Ventricle
Semilunar pulmonic valve
Pulmonary trunk
Pulmonary arteries
Lungs (pulmonary
capillaries)
Pulmonary veins
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29
Q

Blood flow starting in the LEFT SIDE of the heart

A 
Left atrium 
Mitral Valve
Left Ventricle
Semilunar Aortic valve
Aorta
Systemic Circulation
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30
Q

Acute Pericarditis Manifestations

A

Chest Pain
Friction rub
ECG changes

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31
Q

Acute Pericarditis Causes

A

Infections: viral, bacterial or fungal
autoimmune: RA, SLE
Trauma
Drug toxicity

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32
Q

This Pericarditis is associated with systemic lupus erythematosus (SLE), rheumatic fever, and a variety of viral infections.

A

SEROUS PERICARDITIS

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33
Q

This Pericarditis is characterized by production of a clear, straw-colored, protein-rich exudate containing small numbers of inflammatory cells.

A

SEROUS PERICARDITIS

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34
Q

This Pericarditis is characterized by a fibrin-rich exudate. It may be caused by uremia, myocardial infarction, or acute rheumatic f e v e r.

A

FIBRINOUS PERICARDITIS

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35
Q

This Pericarditis is characterized by a grossly cloudy exudate. It is almost always caused by bacterial infection.

A

PURULENT PERICARIDITIS

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36
Q

This Pericarditis is characterized by a bloody exudate. It usually results from tumor invasion of the pericardium, but can also result from tuberculosis or other bacterial infections.

A

HEMORRHAGIC PERICARDITIS

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37
Q

Define CARDIAC TAMPONADE

A

Represents an increase in pericardial sac pressure caused by an accumulation of fluid or blood in the pericardial sac

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38
Q

Define Myocardial Disease

A

Disorders originating from within the
myocardium, but not from cardiovascular
disease

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39
Q

Inflammation of the heart muscle (and conduction system) without evidence of myocardial infarction

A

Myocarditis

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40
Q

Causes of Myocarditis

A

viral (#1 cause), drug toxicity (e.g., cocaine), autoimmune diseases

41
Q

Most often presents as biventricular heart failure in young persons who do not have valvular, rheumatic, or congenital heart disease

A

Myocarditis

42
Q

Diseases of the heart muscle that are non-inflammatory and are not associated with hypertension, congenital heart disease, valvular disease, or coronary artery disease

A

Primary Cardiomyopathies

43
Q

most common form of Cardiomyopathy Progressive cardiac hypertrophy and dilation & impaired pumping ability in one or both ventricles

A

Dilated Cardiomyopathy

44
Q

are common during Dilated Cardiomyopathy and may be a source of thromboemboli

A

Mural thrombi

45
Q

Causes: Dilated Cardiomyopathy

A

idiopathic, infectious myocarditis, alcohol

46
Q

Characterized by ventricular hypertrophy and impaired diastolic ventricular filling. Is often inherited as an autosomal dominant characteristic; several genes have been implicated in the genesis of this disorder. Sudden death may occur if left ventricular outflow obstruction continues.

A

Hypertrophic Cardiomyopathy

47
Q

Least common of the primary cardiomyopathies
Ventricular filling is restricted because of excessive rigidity and stiffness of the ventricular walls
Causes is unknown

A

Restrictive Cardiomyopathy

48
Q

Relatively uncommon, life-threatening condition of the endocardial surface of the heart, including the heart valves

A

Infective Endocarditis (Bacterial Endocarditis)

49
Q

The primary antibiotic regimen for select patients is_________, 2g orally 30-60 min before the procedure.

A

AMOXICILLIN

50
Q

Patients who are allergic to penicillins can be treated with…

A

cephalexin (2g) or azithromycin or clarithromycin

51
Q

Because cardiac fibers are electrically coupled by the gap junctions, the entire myocardium behaves as a…

A

coordinated unit or FUNCTIONAL SYNCYTIUM.

52
Q

The cardiac troponin complex consists of three proteins, What are they?

A
  • cardiac troponin C (cTnC)
  • cardiac troponin I (cTnI)
  • cardiac troponin T (cTnT)
53
Q

cardiac troponin T (cTnT): T is for…

A

“tropomyosin binding”

54
Q

cardiac troponin I (cTnI): I is for…

A

“inhibitory”

55
Q

cardiac troponin C (cTnC): C is for…

A

“calcium binding”

56
Q

What is the Clinical Application of Troponin

A

Cardiac troponins are the prefered markers for detecting myocardial cell injury

57
Q

The two Tracts of the SA node…

A 
Internodal Tracts (continues on)
Interatrial Tracts
58
Q

What is the path of a signal from the SA node traveling down the Internodal tract?

A

SA NODE»Internodal Tract»AV Node»AV Bundle»R/L Bundle Branches»Purkinje Fibers

59
Q

Describe Non-Pacemaker or “Fast Response” Action Potentials

A

• Occur in the atria,
ventricles and Purkinje fibers
• Undergo “rapid”
depolarization

60
Q

Describe Pacemaker or “Slow Response”

Action Potentials

A

• Occur in the SA node
and AV node
• Undergo “slow” depolarization

61
Q

What happens in Phase 0 (Rapid Depolarization) Fast Response Cardiac Action Potentials?

A
  • Upstroke of the AP
  • “Fast” Na+-channels open
  • Several types of K+- channels closed
62
Q

What happens in Phase 1 (Early/Initial Repolarization) Fast Response Cardiac Action Potentials?

A
  • Transient outward current as K+ channels open

* “Fast” Na+-channels are closed

63
Q

What happens in Phase 2 (Plateau Phase) Fast Response Cardiac Action Potentials?

A
  • Long-lasting (L-type) Ca+2 channels open leading to inward calcium movement
  • Efflux of K+ through several types of K+- channels
64
Q

Cardiac contraction has an absolute requirement for Ca+2 influx through these channels…

A

L-type Ca+2 channels

65
Q

The influx of calcium during an action potential serves as a trigger to induce calcium release from the sarcoplasmic reticulum (calcium-induced calcium release = CICR), which then promotes actin-myosin interaction and hence contraction; occurs via…

A

ryanodine receptors (RyR2)

66
Q

What happens in Fast Response Cardiac Action Potentials Phase 3 (Late or Final Repolarization)?

A
  • Continual efflux of K+ through several types of K+-channels
  • L-type Ca+2-channels eventually close
67
Q

What happens in Fast Response Cardiac Action Potentials Phase 4 (RMP)

A
  • K+-channels remain open

* Calcium extrusion mechanisms become highly active

68
Q

The electrical and mechanical events in cardiac muscle overlap, this prevents…

A

Tetany

69
Q

What happens in Phase 0 Slow Response Cardiac Action Potentials?

A

Is the upstroke of the AP

Is caused by an increase in Ca+2 conductance

70
Q

What happens in Phase 3 Slow Response Cardiac Action Potentials?

A

repolarization Is caused by an increase in K+ conductance

71
Q

What happens in Phase 4 Slow Response Cardiac Action Potentials?

A

slow depolarization

Is caused by an increase in Na+ conductance, which results in an inward current called I_f

72
Q

I_f is “turned on” by

A

repolarization of the membrane potential during the preceding action potential

73
Q

reflects the time required for excitation to spread throughout cardiac tissue.

A

Conduction Velocity (CV)

74
Q

CV is fastest in the______ and Slowest in the ______

A

CV is fastest in the Purkinje system

CV is slowest in the AV node

75
Q

produce changes in heart rate

A

Chronotropic effects

76
Q

changes in HR are reflected on the ECG by changes

in the

A

R-R intervals

77
Q

produce changes in conduction velocity, primarily in the

AV node

A

Dromotropic effects

78
Q

cetylcholine (ACh), acts at…

A

muscarinic receptors

79
Q

norepinephrine (NE), acts at…

A

β1-receptors

80
Q

quantity of blood remaining in either ventricle at the end of ventricular diastole

A

End Diastolic Volume (EDV)

average 130ml

81
Q

quantity of blood remaining in either ventricle at the end of ventricular systole

A

End Systolic Volume (ESV)

82
Q

Three distinct phases of ventricular filling

A
  1. Rapid Passive Filling
  2. Slow passive filling (Diastasis, no one contracts)
  3. Atrial Systole
83
Q

The third heart sound is associated with

A

The end of rapid passive filling of the ventricles.

84
Q

occurs when a valve does not open properly.

A

VALVULAR STENOSIS

85
Q

The_______ valve is the valve that is most frequently involved in rheumatic heart disease.

A

mitral

86
Q

Most frequent heart valve problem, occurring in approximately 7% of the population, most often in young women…

A

Mitral valve prolapse

87
Q 
is the  most common
cause of calcific aortic
stenosis in persons
older than 60 years of
age.
A

degenerative

calcific aortic stenosis,

88
Q 
is the  most common
cause of calcific aortic
stenosis in persons
older than 60 years of
age.
A

degenerative calcific aortic stenosis,

89
Q

The greater the preload, the greater the force of contractiond

A

HETEROMETRIC REGULATION (Pre-load)

Frank-Starling Law of the Heart

90
Q

Enhanced contractility results in more complete ejection of blood from the heart,

A

HOMOMETRIC REGULATION

91
Q

The BACK PRESSURE exerted on the aortic & pulmonary semilunar valves by arterial blood in the aorta and pulmonary trunk respectively

A

Afterload

92
Q

Cardiac Contractility is also called…

A

Inotropism or Inotropy

93
Q

cardiac output or performance is enhanced by:

A

↑ Preload ↑ Inotropy ↑ Heart rate ↓ Afterload

94
Q

This type of Angina is associated with atherosclerotic disease that produces fixed obstruction of the coronary arteries.

A

Classic angina or exertional angina

95
Q

This type of Angina is caused by spasms of the coronary arteries.

A

Variant angina or Prinzmetal’s angina

also referred to as vasospastic angina.

96
Q

is considered to be a clinical syndrome of myocardial ischemia that falls between stable angina and myocardial infarction

A

Unstable angina

97
Q

Myocardial Infarctions that traverses the entire ventricular wall from the endocardium to the epicardium.

A

Transmural infarction

98
Q

Myocardial Infarctions that is limited to the interior one-third of the wall of the ventricle.

A

Subendocardial infarction

ASDOH Cardiopulmonary System (3 decks)

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