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Cardio A & P/Assess
Hartley PP 1
| Question | Answer |
|---|---|
| What are 3 layer of cardiac tissue | endocardium Myocardium Epicardium |
| Where is tricuspid valve | between right atria and right ventricle |
| Where is mitral valve | between left atria and left ventricle |
| Where is pulmonic valve | connects right ventricle to pulmonary artery |
| Where is aortic valve | connects left ventricle to aorta |
| Which valve closures produces lub sound | mitral and tricuspid |
| Which valve closures produce dub sound | pulmonic and aortic |
| Which side of the heart has a thinner myocardium | Atrial |
| Which chamber is myocardium 3 times thicker than the others | Left Ventricle |
| Why are cardiac patients always put on oxygen | the myocardium uses 80% of oxygen delivered to the heart |
| What areas of the heart does the Right coronary artery feed | Right atrium, Right ventricle and some of the posterior wall of left ventricle |
| What heart problems occur as a result of Right Coronary artery blockage | Conduction of impulses and rhythm disturbances |
| Whar areas of the heart does the left coronary artery feed | front(anterior), left ventricle, and apex |
| Where is circumflex artery | branched off Left medial coronary artery |
| What happens to coronary circulation during tachycardia | coronary perfusion time is shortened and myocardial oxygen demand is increased |
| What does P wave represent | Atrial depolarization |
| What does P-R interval represent | Atrial depolarization and delay at AV junction |
| What does QRS wave represent | Ventricular depolarization |
| What does S-T segment represent | period between ventricular depolarization and repolarization |
| What does T wave represent | Repolarization |
| What does R-R wave represent | Time between 2 ventricular contractions |
| What is phase 4 of action potential | resting phase |
| What electrolytes are outside the cell during resting phase of action potential | Na+ (positive charge) |
| What electrolytes are inside the cell during resting phase of action potential | K+ (negative cell interior) |
| What happens during phase 0 of action potential | sodium enters the cell and some calcium enters to make cell interior positve |
| How do you know if a contraction has occured | you have a pulse |
| What is preload | volume of blood in the ventricles at the end of diastole |
| What is afterload | peripheral resistance in which left ventricle must pump |
| What does preload determine | the amount of strech of myocardial fibers |
| What affects after load | size of ventricle, ventricle wall tension, and arterial blood pressure |
| What is MAP | mean arterial pressure |
| How is MAP calculated | SBP + 2(DBP) divided by 3 |
| What is Cardiac output | amount of blood pumped by each ventricle in one minute |
| What is Cardiac Index | cardiac output divided by body surface area |
| What is cardiac reserve | The ability to respond to altering demand by altering cardiac output X 3 or 4 |
| What is ejection fraction | The % of blood ejected with each contraction in relation to volume of blood available from the left ventricle |
| What is a normal ejection fraction | 55-65% |
| What is diastolic blood pressure | residual pressure in the arterial system during ventricular relaxation |
| What is systolic blood pressure | The pressure in the arterial system during ventricular contraction |
| What does starlings curve represent | preload vs stroke volume |
| What is stroke volume | volume of blood ejected from Left ventricle during systole |
| What is a normal stroke volume | 60-100 ml per beat |
| What regulates stroke volume | preload, afterload and contractility |
| What is a normal cardiac output | 4-8 liters/minute |
| What does cardiac output measure | mechanical efficiency of heart |
| What heart rhythm reduces CO by 30% | Atrial Fib |
| What is the normal range for Cardiac Index | 2.5-4.2 L/min/meter squared |
| How is ejection fraction obtained | by echocardiogram |
| What EF is diagnostic for heart failure | less than 40% |
| What is pulse deficit | The difference between heart rate and palpable pulse |
| What is paroxysmal Nocturnal dyspnea | shortness of breath that occurs repeatedly and without warning during sleep |
| What is orthopnea | labored breathing that occurs when lying flat |
| What is jugular vein distention | a sympton of cardiac decompression usually reflects right heart failure and approximates central venous pressure |
| What is point of maximal impuse | pulsation at the apex of the heart usually found medial to the mid clavicular line in the 4th or 5th intercostal space |
| What is the absoulute refractory period | time during repolarization of action potential that cannot react to a stimulus |
| %period | time during repolarization of action potential that can only react to a strong stimulus |
| What is atrial kick | the contraction of the atrium which consist of 5-30% of cardiac output |
| When is preload decreased | during hemorrhage,diuresis, vomiting, diarrhea, third spacing and profound diaphoresis |
| What is systemic vascular resistance | afterload in l ventricle |
| When does afterload increase | aortic/pulmonic stenosis, HTN, classic shock, hypothermia |
| When is preload decreased | during hemorrhage,diuresis, vomiting, diarrhea, third spacing and profound diaphoresis |
| What drugs decrease preload | vasodilators |
| What is systemic vascular resistance | afterload in l ventricle |
| What drugs decrease afterload | calcium channel blockers, beta blockers, narcotics, and antidepressants |
| When does afterload increase | aortic/pulmonic stenosis, HTN, classic shock, hypothermia |
| What is systemic circulation | ability of the right side of the heart to supply blood to the body, perfusion |
| What drugs decrease afterload | Dopamine and norepinephrine |
| What is pulmonic circulation | ability of the right side of the heart to move blood through the capillary bed surrounding the lungs |
| What drugs decrease preload | vasodilators |
| What is the effect of sympathetic nervous system on cardiac circulation | increases discharge rate from SA node, decreases the refratory period through AV node |
| What drugs decrease afterload | calcium channel blockers, beta blockers, narcotics, and antidepressants |
| What is systemic circulation | ability of the right side of the heart to supply blood to the body, perfusion |
| What is pulmonic circulation | ability of the right side of the heart to move blood through the capillary bed surrounding the lungs |
| What is the effect of sympathetic nervous system on cardiac circulation | increases discharge rate from SA node, decreases the refratory period through AV node |
| What is the effect of sympathetic nervous system on the vascular system | vasoconstriction |
| What is the major controller of blood pressuure | arterioles |
| Where is the clotting cascade initiated | endothelium |
| What do baroceptors respond to | pressure within the arterial system |
| What do chemoreceptors respond to | pH and increased pCO2 pressure |
| What is the minimum MAP to perfuse organs | 60 mm Hg |
| What effect does the parasympathetic nervous system have on cardiac system | decreases HR, slows conduction, lessens the force of contractions (Atria only) |
| What mediates the parasympathetic nervous system | Vagus nerve |
| What is one vagolytic drug | Atropine |
| What are the 4 phases of assessment | Pre-arrival, arrival quick check, comprehensive initial assessment, and ongoing assessment |
| What are the steps of pre-arrival assessment | Report from medical personnel, determine necessary resouces, and prepare the environment |
| What are the steps of arrival quick check | Airway (A), Breathing (B), Circulation (C), Drugs (D), and Equipment (E) |
| When in a baseline obtained | during arrival quick check |
| What are the five major systems in a comprehensive cardiac assessment | MS, Neuro, Pulmonary, GI/GU, Integument |
| What are common complaints that are indicative of a cardiac problem | SOB, Fatigue, weight gain, edema, chest pain, cough, N/V, weakness, nocturia, palpatations |
| What is claudication | cramping in the lower leg while waling or exercising |
| What are the 5 sites of arterial pulses | Carotid, Radial, femoral, Dorsalis pedis, and posterior tibial |
| What are the 4 description of a pulse | rate, rhythm, quality and strength |
| What does jugular vein distention reflect | right heart failure, estimates central venous pressure |
| What are the 5 cardiac auscultatory areas | Pulmonic, tricuspid, mitral, left ventricle, and aortic arch |
| What does the S1 sound signal | the beginning of systole, closure of tricupid and mitral valves |
| What does the S2 sound signal | The beggining of diastole, closure of pulmonic and aortic valves |
| What is S3 | heart failure |
| What is S4 | Hypertension |
| What are the cardiac enzyme tests | CK-MB, Troponin, and myoglobin |
| What is CK-MB | isoenzyme released with myocardial tissue injury >4-6% of total CK is positive |
| What is Troponin I | contractile protein released during an MI 0.5-2.3 ng/ml |
| What is Troponin T | contractile protein released during an MI >2.3 ng/ml |
| What is C reactive protein | marker of inflammation that predicts risk of MI >3mg/L |
| What is the range of myoglobin values for a male | 15.2-91.2 mcg/L, LMW protein that is 99% sensitive to myocardial injury |
| What is the range of myoglobin values for a female | 11.1-57.5 mcg/L |
| What is homocysteine | Amino acid produced during protein catabolism that predicts CVD, male 5.2-12.9 umol/L females 3.7-10.4 umol/L |
| What is BNP | value used to distiguish between cardiac or respiratory dyspnea >100pg/ml is cardiac |
| What is cholesterol | blood lipid <200mg/dL |
| What are triglycerides | mixtures of fatty acids, <150 mg/dL |
| What are HDL and LDL levels that indicate risk for CVD | <40 mg/dL HDL, >160 mg/dL LDL |
| What is a chest x-ray show in CVD | size and placement in chest |
| What is an echocardiogram done to assess | cardiac valve function |
| What doe changes mean in a stress test | ischemia |
| What blood test generally means heart failure | BNP |
| What blood test generally means MI | Troponin |
| What Liver function tests levels are related to heart disease | SGOT(AST) elevated SGPT(ast) elevated |
| What are normal SGOT(AST) and SGPT(AST) values | 5-40 U/L 5-40 U/L 7-56 U/L |
| What is normal potassium and what is associated with low potassium | 3.5-5.0 mEQ/L Cardiac arrythmias |
| What is normal chloride and what does it indicate | 118-132 mEq/L acisosis |
| What is normal sodium and what does it indicate | 125-135 mEq/L acid base balance |
| What is normal Ca and what does it indicate | 8.4-10.2 cardiac function |
| What is normal Mg levels and what does it indicate | 1.5-2.5 mEq/L cardiac arrythmias |
| What is normal BUN and what does it indicate | 6-8-21-24 mg/dL poor circulation |
| What is normal creatnine and what does it indicate | .6-1.2 mg/dL HTN |
Created by:
garrisonl
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