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Adult Medical Surgical 1 > week 5 > Flashcards

week 5 Flashcards

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USMLE® Step 1 flashcards
1
Q

what are the layers of the heart?

A

Epicardium , Myocardium , Endocardium

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2
Q

what is Stroke Volume ?

A

amount of blood ejected with each heartbeat, ml/beat

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3
Q

what is Cardiac Output?

A

amount of blood pumped by ventricle in liters per minute

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4
Q

what is Contractility ?

A

ability of the heart to contract in response to electrical impulse

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5
Q

what is After Load?

A

resistance to ejection of blood from ventricle

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6
Q

what is Preload?

A

degree of stretch of cardiac muscle fibers at end of diastole

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7
Q

what is Ejection Fraction?

A

percent of end of diastolic volume ejected with each heartbeat

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8
Q

recite the Conduction Pathway

A

1) depolarization begins at SA, 2) Intraatrial and internodal pathway to AV, 3) Delay impulse begins at AV for ventricle filling , 4) Bundle of His, 5) Left and right bundle braches , 6) Punkinje fibers

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9
Q

what is the SA node and where is it located ?

A

It is the primary pacemaker where the depolarization begins (electrical impulse) and its located at the top of the righ atrium

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10
Q

summarize the Cardiac Cycle?

A

1)Depolarization , active electrical activity and systole = contraction , 2) Repolarization, resting electrical activity and diastole = resting or filling phase

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11
Q

True Or False : mechanical activity preceds electrical activity

A

False, electrical activity preceds mechanical activity

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12
Q

what is the formula for Cardiac Output ?

A

CO (ml/min) = SV X HR

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13
Q

what is the average heart rate?

A

70 BPM

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14
Q

what is the average stroke volume ?

A

70-80 ml/beat

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15
Q

what is the average cardiac output ?

A

5000 ml/min

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16
Q

what is Stroke Volume affected by?

A

after load is affected by : systemic vascular resistance , pulmonary vascular resistance
contractility is affected by : catecholamine (increase) , SNS, medications (increase or decrease) , hypoxemia (decrease) , acidosis (decrease)

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17
Q

what does ECG do?

A

records cardiac activity , displays the hearts electrical impulse through the conduction system ,

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18
Q

what is the purpose of EKG?

A

diagnosing a variety of cardiac abnormality

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19
Q

what can an ECG indicate ?

A

electrical conduction , areas of ischemia , myocardial damage , LV hyperatrophy , electrolyte distrubances , drug toxicity

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20
Q

what are the small boxes in the ECG paper represent ?

A

0.04s

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21
Q

what does 5 small boxes represnt in ECG reading?

A

0.20s

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22
Q

what is the P Wave?

A

atrial depolarization , normal , no more than 3 boxes , means the impulse started at SA node

23
Q

what is the QRS complex ?

A

ventricle polarization , Q wave : negative delflection after p wave , R wave : positive delflection after p wave , S wave : negative waveform after r wave , T : ventricle repolarization

24
Q

Do P waves have intervals ?

A

yes , they lost between ventricles and it doesn’t show on the ECG

25
Q

what is U wave ?

A

its between P and T wave

26
Q

how long does PR intervals take ?

A

0.12-0.20s

27
Q

what does short intervals mean ?

A

shorter than 0.12-0.20 , impulse from the AV junction ,

28
Q

what does a longer interval mean?

A

It means it takes longer than 20s, first degree AV block ,

29
Q

how long does a QRS interval take?

A

0.6-0.10 secs

30
Q

what does a wide QRS interval indicate ?

A

a slowed conduction , bundle branch block (BBB) , ventricular rythem

31
Q

what does a ST segment depression indicate ?

A

reciprocal changes , digoxin , ischemia

32
Q

what does an elevated ST segment indicate ?

A

myocardial injury

33
Q

what does inversion of T wave indicate ?

A

myocardial ischemia

34
Q

how do you interpret rythms of on the ECG?

A

by rythmicity , rate (atrial & ventricular) , waveform configuration and location, intervals

35
Q

what is rythmicity?

A

pattern of heart beats

36
Q

when is P-P interval rythem regular?

A

when the distance between P-P intervals is equal

37
Q

True Or Flase : P-P intervals are atrial

A

True.

38
Q

when are R-R intervals regular ?

A

when the distance between the R-R intervals are equal

39
Q

what is a regular rate in ECG?

A

1500 in small blocks , 300 in large blocks

40
Q

what is an irregular rate in ECG?

A

6-second strip

41
Q

what is Atherosclerosis ?

A

Its the accumulation of lipids and fibrous tissue in the atrial walls , it narrows the vessels causing a decreased blood flow to the heart

42
Q

what are the CM of Atherosclerosis ?

A

chest pain, weakness , dyspnea , nausea

43
Q

what is Angina Pectoris ?

A

episodes of paroxysmal pain or pressure in the interior chest by insufficient coronary blood flow

44
Q

what is Stable Angina ?

A

predictable and consistant pain , occurs on exertion , relieved by rest or nitroglycerin

45
Q

what is Unstable Angina (crescendo angina) ?

A

Increase in frequency and severity , may not be relieved by rest & nitroglycerin

46
Q

what is Variant Angina ( Prinzmetal’s Angina) ?

A

pain when resting , with reversible ST-segment elevation , caused by coronary artery vasopasm

47
Q

describe Angina Pain?

A

mild to severe , tightness - choking - heavy sensation , may radiate to : neck , jaw , shoulder , back or arms (usually left) , anxiety accompanies pain

48
Q

what are other symptoms of Angina ?

A

Dyspnea , SOB , dizzines , nausea ,vomiting, typically subsides with rest of NTG ,

49
Q

what is the treatment of Angina

A

it seeks to decreas myocardial oxygen demand and increase oxygen supply ( medications , oxygen, reduce & control risk factors , reperfusion therapy)

50
Q

what are the medications given for Angina?

A

NTG, Beta-adrenergic blocking agent , calcium channel blocking agent (amlodipine) , Aspirin , Clopidogrel and ticlopidine, Heparin , Glycoprotein , antiplatelet

51
Q

what is Myocardial Infraction?

A

an area of the myocardium is permanently destroyed

52
Q

what causes Myocardial Infraction ?

A

by reduced blood flow in a coronary artery ,

53
Q

what are the goals of MI treatment ?

A

minimize myocardial damage , preserve myocardial fucntion , prevent complicatipns

54
Q

what are the medications given for MI ?

A

aspirin , NTG, morphine , beta-blockers , Angiotensin-converting enzyme inhibtors within 24hrs , bedrest , heparin

Adult Medical Surgical 1 (3 decks)

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