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Cardio AP > Unit 4/ CH 20 > Flashcards

Unit 4/ CH 20 Flashcards

1
Q

Factors controlling cardiac output - cardiac factors

A

CO = SV x HR
Stroke Volume = preload, afterload, contractility

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2
Q

What is cardiac preload?

A

the amount the ventricles stretch at the end of diastole

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3
Q

Frank-Starling Law of the Heart

A

the greater the diastolic volume (preload) - the greater the force of contraction

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4
Q

Increased venous return results in

A

increased preload

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5
Q

increased preload results in

A

increased end diastolic volume

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6
Q

increased force of contraction leads to

A

increased stroke volume

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7
Q

increased SA node firing leads to

A

increased stroke volume

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8
Q

To estimate preload, atrial pressures equal

A

ventricular end diastolic pressures

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9
Q

Explain the effects of heart failure on preload

A

CHF engorges the heart = increased preload

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9
Q

Afterload includes what three factors?

A

-ventricle outflow resistance
-clinical indicators
-factors affecting bp and vessels diameter

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10
Q

What is afterload?

A

ventricular outflow resistance

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11
Q

What are the stroke volume phases?

A

-preload: initial stretching of heart muscles, before contraction such as ventricles filling

-afterload: force heart has to contract against to eject blood

-contractility: strength of cardiac muscle

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12
Q

clinical indicators of afterload

A

mean arterial pressure MAP
mean pulmonary arterial pressure MPAP, pulmonary vascular resistance PVR, systemic vascular resistance SVR

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13
Q

Factors that affect blood pressure and vessel diameter also affect ______________

A

afterload

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14
Q

What is contractility?

A

force of contraction

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15
Q

What is ejection fraction?

A

measure of ventricular contractibility

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16
Q

What is the normal ejection fraction

A

60% of EDV at rest
90% of EDV during exercise

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17
Q

What are inotropic factors?

A

factors affecting contractility

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18
Q

Most important factors in regulating cardiac output

A

vascular factors affecting venous blood return

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19
Q

What factors affect venous return to the heart?

A

vascular resistance
blood volume
Right atrial pressure

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20
Q

What is the vascular function curve?

A

relationship between right atrial pressure and venous return

21
Q

Cardiac function curves (Starling curves) are what?

A

preload versus cardiac output

22
Q

normal blood volume

A

normovolemia

23
Q

What is to high blood volume?

A

Hypervolemia

24
Q

What is too low blood volume?

A

Hypovolemia

25
Q

What is the effect of hypervolemia on the vascular function curve?

A

right shift

26
Q

What is the effect of hypovolemia on the vascular function curve?

A

left shift

27
Q

Pressure gradients between systemic capillaries is ___mmHg & RAP ___mmHg

A

7mmhg, 0mmhg

28
Q

increased contractility causes a ___________ in RAP and ___________ in venous return gradient.

A

decrease, increase

29
Q

increase in blood volume causes an ____________ in pressure and __________ in CO

A

increase
increase

30
Q

increased afterload causes an ______________ in end systolic volume and an _____________ in preload

A

increase, increase

31
Q

How to measure hemodynamics

A

pulmonary artery catheter PAC

32
Q

Pulmonary Artery Catheter (PAC) is inserted where?

A

IJ, subclavian, femoral, basilic, cubital

33
Q

Ports connected to transducers:
Proximal= what two areas?
Distal=what areas?

A

-RA,RV
-pulmonary artery

34
Q

Normal PCWP (pulm capillary wedge pressure)

A

6-12 mmHg

35
Q

Elevated PCWP indicates (>25 mmHg)

A

pulmonary edema

36
Q

Assuming normal blood volume and valve function, what does increased PCWP imply?

A

left ventricle is not pumping efficiently

37
Q

Ventricular function curves - Forrester’s subsets

A

I. Normal or hyperdynamic
II. Fluid overload - normal contractility
III. Hypovolemic
IV. Acute Left Heart Failure - decreased contractility

38
Q

Clinical Management principles - Continuous monitoring:

A

assessment of therapy
modification according to patient response
effect of drugs, fluids, ventilation

39
Q

clinical management - increased preload

A

vasodilators, inotropic drugs, increased ventilation pressures

40
Q

clinical management - decreased preload

A

IV fluid therapy

41
Q

clinical management - abnormal afterload - increased SVR

A

vasodilators
fluid therapy if needed
inotropic drugs with caution
blood or fluids if hypovolemic

42
Q

clinical management - abnormal afterload - decreased SVR

A

vasopressors

43
Q

high CI, low pulmonary capillary wedge pressure

A

Normal or hyperdynamic state

44
Q

high CI, high PCWP

A

fluid overload - normal contractility

45
Q

low CI, low PCWP

A

hypovolemic

46
Q

low CI, high PCWP

A

acute left heart failure

47
Q

arterioles contain only _______% of total blood volume

A

3

48
Q

In what way would an adrenergic drug affect LV afterload?

A

If drug vasoconstricts - increase SVR and afterload
If drug vasodilates - decrease SVR and afterload -

49
Q

Why would a Ca++ blocker affect the ventricular ejection fraction?

A

CA++ blockers diminish the force of contraction - decreased afterload

50
Q

What is the heart’s response to a sudden loss of contratility?

A

acute heart failure

51
Q

Adrenergic Drugs

A

Alpha 1 2 ;Beta 1 2
Increase blood pressure, open airways, constrict blood vessels

Cardio AP (5 decks)

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