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EMT-B > Test 3 Cardiac/Neuro > Flashcards

Test 3 Cardiac/Neuro Flashcards

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1
Q

What are the four properties of cardiac cells?

A

Automaticity
conductivity
contractility
excitability

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2
Q

What is Ability of some cells to initiate their own electrical impulse?

A

Automaticity

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3
Q

What is Ability of the myocardial cells & fibers to contract and stretch in response to an electrical stimulus?

A

Contractility

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4
Q

What is Ability of a cell to transmit an electrical impulse somewhere else?

A

Conductivity

When a muscle cell has been stimulated, it will conduct the stimulus to adjacent cells

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5
Q

What is the ability to respond to an electrical stimulus?

A

Excitability

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6
Q

What is the electrical conduction order of the heart?

A

SA node to the AV node to the ventricles

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7
Q

This function sends a signal across the atria stimulating them to contract simultaneously?

A

SA node (primary pacemaker)

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8
Q

This is a bridge of special electrical tissue between the atria and ventricles where the signal is slowed (one-two tenths of a second) to allow for blood to pass from the atria to the ventricles?

A

AV node (secondary pacemaker)

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9
Q

This impulse then exits the AV node and spread throughout both the ventricles through the bundle of His, the right and left bundle branches, and the purkinje fibers, causing the muscles cells of the ventricles to contract?

A

Ventricles (final pacemaker)

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10
Q

What is the firing rate of the SA node?

A

60-100

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11
Q

What is the firing rate of the AV node?

A

40-60

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12
Q

What is the firing rate of the ventricles?

A

20-40

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13
Q

What causes vasodilation systemically. It results in reduced preload, afterload, and cardiac workload?

A

Nitroglycerin

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14
Q

What is the blood flow through the heart?

A

Vena cava -> R atrium -> tricuspid valve -> R ventricle -> pulmonic valve -> pulmonary arteries -> lungs -> pulmonary veins -> L atrium -> bicuspid (mitral) valve -> L ventricles -> aortic valve -> aorta -> body

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15
Q

What is Progressive narrowing of the heart blood vessels caused by atherosclerosis that leads to decreased oxygen to the heart muscle?

A

Acute coronary syndrome (ACS)

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16
Q

What is the term for when supply of oxygen does not meet the demand of the muscle, usually during exertion and pain with activity?

A

Angina

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17
Q

What occurs during angina?

A

Flow to the heart is reduced and heart muscle becomes hypoxic

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18
Q

What is the term for when blood flow is obstructed in an area of the heart muscle and actual cell death occurs do to hypoxia?

A

Acute myocardial infarction (AMI)

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19
Q

What is the term for disease involving a decrease in blood flow to one or more portions of the heart muscle?

A

ischemic heart disease

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20
Q

What is a Localized abnormal dilation of a vessel caused by a congenital defect or weakness in the wall of the vessel?

A

Aneurysm

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21
Q

What restores normal heart rhythm by analyzing electrical signals from the heart and delivery of a shock after analysis of a cardiac rhythm when appropriate?

A

AED

Automated external defibrillator

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22
Q

What is the inability to understand and /or produce speech?

A

Aphagia

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23
Q

What kind of stroke occurs when plaque forms inside of the walls of the blood vessels and maybe obstruct blood flow, eventually causes complete occlusion of the artery?

A

ischemic stroke

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24
Q

What type of stroke results from bleeding inside the brain, often fatal, increased risk with high stress, exertion and very high blood pressure?

A

hemorrhagic stroke

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25
Q

where does the spinal cord exit?

A

The spinal cord exits the skull at the foramen magnum

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26
Q

What does the brain stem control?

A 
Basic functions
breathing
blood pressure 
swallowing
pupil constriction
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27
Q

How does the brain receive its oxygenated blood?

A

Internal carotid arteries

Vertebral arteries

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28
Q

What is a measurement of the volume of blood circulated by the heart in 1 minute, calculated by multiplying the stroke volume by the heart rate?

A

Cardiac output

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29
Q

How do you calculate cardiac output?

A

stroke volume x heart rate

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30
Q

What is the type of shock results when build up causes fluid to be forced out of the capillary beds that surround the alveoli leading to pulmonary edema?

A

Cardiogenic shock

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31
Q

What kind of shock is caused by the inadequate function of the heart or pump failure?

A

Cardiogenic shock

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32
Q

What type of shock results from a severe bacterial infections that cause toxins to be produced?

A

Septic shock

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33
Q

In this type of shock toxins that are produced by the bacterial damage the vessel walls, which causes increased cellular permeability (Access to the cell), the vessel walls leak and don’t constrict the way they should, causing widespread dilation of vessels in combination with plasma loss through the injured vessel walls resulting in shock?

A

Septic shock

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34
Q

What is the pathophysiological process of septic shock?

A

Septic shock starts with insufficient volume of fluid, then the leaked fluid collects in the alveoli interfering with respiration, then the vasodilation leads to larger than normal vascular volume, this increasing space combined with smaller than normal volume of intervascular fluid leads to shock.

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35
Q

What type of shock is caused by damage to the spinal cord usually at the upper cervical levels (high spinal) that causes loss of control to the musculature and vessels below the injury site?

A

Neurogenic shock

36
Q

What are the signs and sx of septic shock?

A

warm skin
fever
low BP
tachycardia

37
Q

What type of shock is usually caused by brain conditions, pressure on the spinal cord, tumors, and spina bifida?

A

Neurogenic shock

38
Q

What are the signs and sx of neurogenic shock?A

A

Bradycardia
low blood pressure
signs of a spinal injury

39
Q

What type of shock results from a quick reaction to a substance to which she or he has been sensitized?

A

Anaphylactic shock

40
Q

What is the physiological process of anaphylactic shock?

A

wide spread vascular dilation, increased permeability and bronchoconstriction.

41
Q

What are the signs and sx of anaphylactic shock?

A

Signs and symptoms include itching or rash, burning skin, vascular dilation, generalized edema, coma or rapid death. The cause of anaphylactic shock is severe allergic reaction.

42
Q

What type of shock results from inadequate amount of fluid in the circulatory system?

A

Hypovolemic shock

43
Q

What are the causes of hypovolemic shock?

A

Diarrhea
burns
vomiting
bleeding

44
Q

How does hypovolemic shock occur from burns?

A

the intravascular plasma loss is caused when fluid leaks from the capillaries into the surrounding tissue Crushing injuries can also result in hypovolemic shock from loss of plasma and damaged vessels into injured tissues.

45
Q

What are the signs and sx of hypovolemic shock?D

A

Signs and symptoms of hypovolemic shock include rapid weak pulse, low blood pressure, change in mental status, cyanosis, cool clammy skin, and increased respiratory rate.

46
Q

What is it called when shock progresses too far and becomes irreversible, the body is no longer working to make up for the blood loss (perfusion deficit)?

A

Decompensated shock

47
Q

What are the signs and sx of decompensated shock?

A

The signs and symptoms of decompensated shock include falling blood pressure (systolic less than 90 mm Hg), declining mental status, altered level of consciousness, labored or irregular breathing, ashen, mottled or cyanotic skin, thready or absent peripheral pulses, dilated pupils, and poor urinary output.

48
Q

How does the brain stem stimulates breathing?

A

The medulla oblongata is the primary respiratory control center. Its main function is to send signals to the muscles that control respiration to cause breathing to occur.

49
Q

What group stimulates expiratory movement?

A

The ventral respiratory group

50
Q

What is the trade name for nitroglycerin?

A

Nitrostat

51
Q

What is the medication class of nitroglycerin?

A

Anti-anginal

vasodilator

52
Q

What causes vasodilation systemically, reducing preload, afterload, and cardiac workload?

A

Nitroglycerin

53
Q

What is the pharmacological action of nitroglycerin?

A

Causes vasodilation systemically, This results in reduced preload, afterload, and cardiac work load

54
Q

What is the indication to administer nitroglycerin?

A

Chest pain determined to be cardiac origin

55
Q

What are the requirements for assisting the patient with nitroglycerin?

A
  • Patients script
  • Not expired
  • No contraindications found
  • MCEP consult and approval
56
Q

What are the contraindications to giving nitroglycerin?

A
  • Severe hypotension ( SBP must be at least 100mg Hg)
  • Extreme bradycardia (HR less than 50)
  • Tachycardia in the absence of heart failure (greater than 120bmp)
57
Q

What is the primary medication reaction with nitroglycerin and why?

A

Because it can lead to a lethal drop in BP do not assist if the patient has taken a sexual performance/erectile dysfunction (SPED) medication or other phosphodiesterase-5 inhibitors within the past 24-48.

58
Q

What are the erectile dysfunction drugs that you should hold nitroglycerin for?

A 
Sildenafil citrate (viagra)
Tadalafil (Cialis)
59
Q

How long should you wait to give nitroglycerin if viagra was taken?

A

24 hours

60
Q

How long should you wait to give nitroglycerin if cialis was taken?

A

48 hours

61
Q

What is the adult dose of nitroglycerin?

A

0.4 SL (Sublingual), tab or spray every 3-5 minutes up to 3 doses

62
Q

What are the routes of administration of nitroglycerin?

A

Sublingual
tab
spray

63
Q

How many doses of nitroglycerin can you give?

A

3 doses

64
Q

How often is nitroglycerin given?

A

every 3-5 minutes

65
Q

Can you give nitroglycerin or can you only assist with it?

A

assist with it

66
Q

What is the dose for pediatric patients for nitroglycerin?

A

Its not recommended

67
Q

What are the side effects of nitroglycerin?

A 
Throbbing headache
flushing
dizziness
burning under the tongue
Less common severe hypotension
68
Q

If the patient has side effects when given nitroglycerin what does that assure?

A

The pills are potent

69
Q

What is the half life of nitroglycerin?

A

8-10 minutes

70
Q

What is the duration of action of nitroglycerin?

A

30-60 minutes

71
Q

What are the trade names for acetylsalicylic acid?

A

Aspirin

Bayer

72
Q

What is the medication class of acetylsalicylic acid (aspirin)?

A

Antiplatelet agent

73
Q

What is the pharmacological process of acetylsalicylic acid (aspirin)?

A

Interferes with platelet aggregation (makes platelets less sticky and prevents clumping, prevents clots from getting bigger)

74
Q

What medication interferes with platelet aggregation making platelets less sticky and prevents clumping, keeping formed clots from getting bigger?

A

acetylsalicylic acid (aspirin)

75
Q

What is the indication of administration of acetylsalicylic acid (aspirin)?

A

Chest pain to be determined of cardiac origin (any patient suspected of AMI regardless of pain presence or absence and no contraindications)

76
Q

What are the contraindications to giving acetylsalicylic acid (aspirin)?

A 
Bleeding disorders (recent severe trauma/GI bleeds)
Aspirin-intolerant asthma
77
Q

What are the medication interactions of acetylsalicylic acid (aspirin)?

A

none

78
Q

What is the adult dose of acetylsalicylic acid (aspirin)?

A

324mg, orally (PO) preferably chewed

79
Q

What is the pediatric dose of acetylsalicylic acid (aspirin)?

A

It should not given

80
Q

What medication should all patients suspected to having an AMI without contraindications recieve?

A 
acetylsalicylic acid (aspirin) 
ASA
81
Q

After giving acetylsalicylic acid (aspirin) will patients have a relief in pain?

A

NO its not given for pain relief

82
Q

How long does iut take acetylsalicylic acid (aspirin) to absorb and take full effect?

A

25-30 minutes

83
Q

What should you take caution of when giving acetylsalicylic acid (aspirin) to patients in reference of other medications?

A

Many OTC medications contain aspirin, be sure not to overdose the patient.

84
Q

What is the half life of acetylsalicylic acid (aspirin)?

A

15-20 minutes

85
Q

What is the duration of action for acetylsalicylic acid (aspirin)?

A

1-4 hours

86
Q

What is swelling or enlargement of the wall of an artery resulting from a defect or weakening of the arterial wall

A

Aneurysm

EMT-B (7 decks)

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