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anatomy and physiology > test 3 blood pressure > Flashcards

test 3 blood pressure Flashcards

1
Q

BP

A

blood pressure

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2
Q

blood pressure

A

the pressure blood exerts on the walls of blood vessels

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3
Q

where is blood pressure normally measured

A

in the brachial artery in the arm

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4
Q

blood pressure changes a lot depending whether

A

the heart has just eaten or not

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5
Q

blood pressures are measured with what 2 numbers

A

systolic blood pressure, diastolic blood pressure

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6
Q

systolic blood pressure

A

the pressure at the peak of ventricular contraction

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7
Q

diastolic blood pressure

A

the pressure where ventricles are relaxed

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8
Q

blood pressures are measured in

A

mmHg

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9
Q

what are blood pressures listed as

A

systolic/diastolic

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10
Q

normal blood pressure

A

is around 120/80

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11
Q

what do you use to take blood pressure

A

use a sphygmomanometer

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12
Q

how do you use a sphygmomanometer

A
  • inflate to slightly above expected range(140-160 mmHg)
  • hold u stethoscope or feel for pulse
  • slowly deflate until a pulse is sensed
  • continue deflating until a pulse is no longer sensed
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13
Q

systolic BP

A

systolic is the number at which pulse is sensed

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14
Q

diastolic BP

A

diastolic is the number at which pulse disappears

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15
Q

if blood pressure is too high….

A

cuff totally blocks blood flow

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16
Q

just right blood pressure…

A

cuff blocks blood flow unless heart has just pumped

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17
Q

too low blood pressure

A

cuff does not block blood flow

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18
Q

blood pressure should ideally fall where in adults

A

between 110-140/70-80

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19
Q

hypotension

A

a person with a resting systolic BP under 100

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20
Q

hypertension

A

a person with a resting systolic BP over 130

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21
Q

BP relies on what factors

A
  • how big is the container ( affects vasodilation/vasoconstriction)
  • how much stuff is in the container (how much water in blood)
  • how fast/hard is stuff being pumped (cardiac output)
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22
Q

bigger container

A

lower blood pressure

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23
Q

cardiac output is…

A

heart rate times the stroke volume

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24
Q

cardiac output formula

A

CO=HR x SV

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25
Q

one reading is ________

A

not enough to make diagnosis of hypertension or hypothension

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26
Q

orthostatic hypotension

A

when you stand suddenly, blood falls to the lower portion of the body and decreases flow to the head. quickly vessels contract and increase blood pressure, returning blood flow to the body

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27
Q

another word for orthostatic hypotension

A

head rush

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28
Q

long-term hypertension

A

especially dangerous, hypertension linked to CAD, CHF, and other arterial disease

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29
Q

CAD

A

coronary artery disease

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30
Q

CHF

A

congestive heart failure

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31
Q

hypertension makes the heart

A

work unnecessarily hard and puts extra strain on artery wallas

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32
Q

with hypertension over time….

A

the heart swells to large sizes and artery walls lose their elasticity

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33
Q

generally.. the _____ have a major role

A

kidneys, major role in regulating blood pressure

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34
Q

when BP is low, what does the kidneys do

A

release renin

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35
Q

what does renin do

A

initiates a cascade releasing angiotensin II

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36
Q

angiotensin II functions

A
  • directly causing vasoconstriction ( BP up)

- stimulating release of hormone aldosterone

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37
Q

aldosterone

A

causes kidneys to leave ore sodium in the blood, causing water to enter blood through osmosis ( BP ^)

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38
Q

what is also involved in BP regulations

A

temperature, sympathetic nervous system

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39
Q

how does temperature affect BP

A

the higher is is the higher BP is

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40
Q

sympathetic nervous system

A

epinephrine release increases BP

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41
Q

HOW TO TAKE BLOOD PRESSURE

A
  • wrap sphygmomanometer around upper arm, tubes distal
  • inflate to -140 mmHg
  • place stethoscope on the inside of the elbow
  • slowly deflate until you hear pumps. record this # as systolic Bp
  • continue delating until pump stops. record this number as diastolic BP
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42
Q

final step in the renin cascade

A

ACE turns inactive angiotensin I to active angiotensin II

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43
Q

ACE

A

angiotensin converting enzyme

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44
Q

popular way to treat hypertension

A

ACE inhibitors

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45
Q

normally the heart beats how much

A

60-100 times per minute

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46
Q

skeletal muscle must be

A

stimulated by a nerve to contract

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47
Q

cardiac muscle can…

A

generate its own signal to contract

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48
Q

any one cell along the electrical wiring of the cardiac muscle

A

can fire and will send its signal to the rest of the heart

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49
Q

different parts of the heart contract

A

on their own different intervals

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50
Q

arterial tissue will contract

A

50-60 times a minute

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51
Q

ventricular tissue will contract about

A

20-40 times a minute

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52
Q

how are the lub/dub contractions coordinated

A

the heart has a built in conduction system to pass signals

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53
Q

the conduction pathway is a series of

A

nerve-like, muscle-like fibers called cardiomyocytes

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54
Q

what do cardio myocytes do

A

carry the signal to make cardiac muscle contract

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55
Q

the signal to make cardiac muscle contract is normally generated by what

A

sionoatrial node (SA node) which is located on the right atrium

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56
Q

the signal to make cardiac muscle contract runs across…….

A

the left and right atria, causing them to contract, and then is captured by the atrioventricular node (AV node)

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57
Q

how long are signals held in the atrioventricular node

A

0.12 seconds

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58
Q

what happens after the signal is held by the AV node

A

it passes through a strand of fibers called the bundle of His

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59
Q

what does the bundle of His do

A

breaks into two bundle branches (one for each ventricle), which travel to the apex of the heart and then run back up the outer walls

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60
Q

the bundle branches….

A

break into small strands called Purkinje fibers

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61
Q

what do Purkinje fibers do

A

tell the heart muscle nearby to contract

62
Q

the electrical pathway !!!

A

SA Node»AV Node»Bundle of His»Bundle Branches»Purkinje Fibers

63
Q

who which part of pathway is lub and dub

A

OKK

64
Q

generally cardiomyocytes have a ____ charge compared to their environment

A

negative

65
Q

how do cardiomyocytes transmit signals

A

by briefly changing their charge from a negative charge to a positive charge (DEPOLARIZATION)

66
Q

can depolarization be measured

A

yes

67
Q

EKG can called

A

electrocardiography or ECG

68
Q

EKGs do what

A

detect and record depolarization of cardiac cells under the skin

69
Q

in an EKG usually………

A

10 electrodes are placed around the torso for different looks and are summed up into one signal

70
Q

many leads on EKG lead to…

A

many outputs

71
Q

what are the 3.5 parts of an EKG

A

P wave, QRS complex, T wave, U wave

72
Q

P wave

A

shows the depolarization of atrial cells

73
Q

QRS complex

A

shows the depolarization of ventricular cells

74
Q

T wave

A

shows the depolarization of ventricular cells

75
Q

U wave

A

the enigma of EKGs, cause it unsure but it PROBS a depolarization of other cells in the heart, and it is OFTEN entirely absent

76
Q

why is there a delay between the P wave and the QRS complex

A

there is a delay when the signal sits on the AV node

77
Q

what is a healthy heart’s rhythm called

A

normal sinus rhythm

78
Q

the SA node is supplied w/ nerves by

A

the sympathetic and parasympathetic nervous systems

79
Q

the sympathetic and parasympathetic nervous systems can

A

influence how quickly (SNS) or slowly (PSNS) it generates a siganal

80
Q

tachycardia

A

a heart rate is elevated above 100 beats/ minute (bpm)

81
Q

sinus tachycardia

A

tachycardia that occurs because the SA node is transmitting a signal faster than 100 bpm

82
Q

Bradycardia

A

a heart rate tat is below 60 bpm

83
Q

sinus bradycardia

A

bradycardia that occurs because the SA node is transmitting a signal slower than 60 bpm

84
Q

5 components of rhythm analysis (key features to look for when analyzing EKG)

A 
Regularity
Rate
P wave morphology
PR interval
QRS interval
85
Q

regularity

A

the pulses occur at roughly even intervals, there is some natural fluctuation

86
Q

a fluctuation of more than ___________ when looking at regularity

A

1.5 boxes (.3 seconds) is considered abnormal

87
Q

KNOW the difference between regular contraction and irregular contraction

A

OK STUDY picture on powerpoint

88
Q

Rate

A

how many times the heart beats in one minute , normal rate is between 60-100

89
Q

counting squares between pumps…

A

will help determine bradycardia or tachycardia, but is not precise and can be complicated in cases of arrythmia

90
Q

to calculate regular rate

A

is 1500 rule

91
Q

1500 rule

A

count the number of small boxes between QRS and QRS in regular rhythms to get a precise rate

92
Q

to calculate irregular rate

A

count how many contractions you see in 6 second strip and multiply by 10

93
Q

P wave morphology

A

the shape

94
Q

the P wave is usually

A

short, round, and compact (no more than .1 seconds)

95
Q

usual size of P wave

A

.5-2.5 small squares

96
Q

Common changes to P wave

A

Burial, Inversion, notched waves, Biphasic waves, Flutter waves, After QRS, Multiple

97
Q

Burial

A

P wave is stuck inside T/U wave

98
Q

Inversion

A

P wave is upside down

99
Q

Notched waves

A

P wave has multiple peaks

100
Q

Biphasic waves

A

up and down or down and up

101
Q

Flutter waves

A

P waves happen very quickly

102
Q

After QRS

A

P waves happen after the QRS complex

103
Q

Multiple

A

many types of P waves present

104
Q

PR interval

A

the amount of time that passes between beginning of P wave and beginning of QRS complex

105
Q

the PR interval should be

A

between .12 and .20 second (3-5) small boxes

106
Q

it’s important to measure PR interval …….

A

for every contraction on a strip, even one irregular PR can have a diagnostic potential

107
Q

QRS duration

A

length of QRS complex

108
Q

QRS should be between

A

0.06 and 0.10 seconds

109
Q

how can you describe the QRS complex

A

wide and bizzare, wide and inverted

110
Q

what are the common rhythyms

A
  • sinus rhythms
  • atrial rhythms
  • junctional rhythms
  • ventricular rhythms
  • heart blocks
  • other
111
Q

the SA (sinoatrial) node is supposed to be the ________

A

pacemaker of the heart

112
Q

when the SA is the pacemaker of the heart

A

it is in sinus rhythm

113
Q

normal sinus rhythm

A

all things are normal. heart rate is 60-100, rhythm is regular

114
Q

sinus bradycardia

A

all things normal, heart rate is below 60, rate is regular

115
Q

sinus tachycardia

A

all things normal, heart is above 100, rate is regular, sometimes coupled with a P wave burial

116
Q

how can you check bradycardia

A

more than 5 big boxes, less than 60

117
Q

how to check for sinus tachycardia

A

less than 3 big boxes, over 100

118
Q

sinus arrhythmia

A

P wave, PR interval, QRS are all normal, IRREGULAR CONTRACTIONS

119
Q

Sinus arrest

A

SA node and rest of the heart does not contract for a span of time

120
Q

how are sinus arrests reported

A

reported w/ a duration, such as sinus arrest, 3.5 second delay

121
Q

with each passing second of sinus arrest

A

blood pressure rapidly drops

122
Q

when the SA node fails to function as the pacemaker

A

other cardiomyocytes can take over

123
Q

when other cardiomyocytes take over when the SA node fails to be the pacemakre

A

said to be an escape rhythmn

124
Q

the cells that release the new signal in an escape rhythm

A

called ectopic pacemakers

125
Q

escape rhythms occur in a variety

A

of shapes and sizes

126
Q

sometimes rogue atrial cells will

A

take over as the pacemaker for just one beat

127
Q

when rogue atrial cells take over as the pacemaker for just one beat

A

premature atrial complex

128
Q

how to distinguish a premature arterial complex

A

because there will one early beat w/ a modified P wave morphology that is not inverted

129
Q

wandering atrial pacemaker

A

an escape rhythm where the SA node fails to generate a signal, so different parts of the atria created a signal to compensate

130
Q

WAP

A

wandering atrial pacemaker

131
Q

WAP is defined by

A

3 unique types of P waves across the strip

132
Q

multifocal tachycardia

A

WAP (3 or more P wave morphologies) with heart rate over 100

133
Q

where is multifocal atrial tachycardia

A

typically only seen in elderly patients with COPD

134
Q

atrial flutter

A

when the atria rapidly contract, but the QRS complexes happen normally

135
Q

atrial fibrillation

A

similar to atrial flutter, but the atria just quiver instead of rapidly contracting

136
Q

both A-Fib and A-Flutter

A

happen unknowingly

137
Q

what often happens in atria flutter

A

the electricity in the atria forms a loop an causes continuous contraction. This rhythm is thrombogenic, but not life threatening if the ventricles still readily contract

138
Q

A-Fib and A-Flutter generally

A

affect elderly people and come and go in waves, a primary symptoms are shortness of breath where lying down

139
Q

often the ______ will take over as a pacemaker

A

AV node!!1 not shen the AV node takes over as the pacemaker only the atrial tissues can do this

140
Q

when he AV node takes over as the pacemaker

A

junctional rhythm

141
Q

PJC

A

premature Junctional Complex

142
Q

PJC

A

when the AV node releases one signal quickly above another contraction

143
Q

how to tell if its a junctional rhythm

A

short PR interval, inverted P wave

144
Q

Junctional escape beat

A

like PJC, but not premature, these are usually later than when a bet would occur

145
Q

PJC and junctional escape rhythm can both be identified by

A

inverted P wave

146
Q

junctional escape rhythm

A

when the AV node works as the pacemaker long term, (not just one beat), still an INVERTED P wave

147
Q

junctional escape rhythms are always

A

below 60 bpm (bradycardia)

148
Q

accelerated junctional rhythm

A

like junctional escape rhythm, but from 60-100, still inverted P wave

149
Q

when do atrial usually only create a signal

A

40-60 times a minuet

150
Q

junctional tachycardia

A

like other junctional rhythms, but from 100-180 bpm, still inverted P wave

151
Q

supraventicular tachycardia

A

in tachycardia when the P-wave is buried, you can’t tell if its normal, inverted, flat, buried

152
Q

supraventricular tachycardias

A

all tachycardias whose P wave morphology is buried, the signal s above the ventricles, but we cannot tell where its from

anatomy and physiology (25 decks)

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