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Ch 26 - Cardio

Nursing

QuestionAnswer
The three layers of the heart? Endocardium, myocardium, epicardium.
What compses the two layers of the pericardium and how much fluid can be located? The visceral pericardium & parietal pericardium. There is 30mL of fluid.
What is the only artery in the body that does not contain oxygenated blood? Left pulmonary artery.
What are the thin fibrous bands that close the leaflet valves? Chordae Tendineae.
When does the coronary arteries receive blood from the heart? The coronary arteries receive blood during diastole of the heart from.
How much of the oxygen from the lung is used by the heart? 70 - 80%
Why can an increase in heart rate cause a myocardial ischemia? An increase in heart rate shorten diastole and can decrease myocardial perfusion.
What is the coronary sinus? There area where the majority of venous blood of the heart is returned.
The myocardium is composed of specialized cells called myocytes. What shape does this structure take and what is it purpose? a figure eight pattern, which allows a twisting and compressive movement of the heart.
What are the two specialized cells of the cardiac conduction system? Nodal Cells and the Purkinje cells.
What are the three characteristics of the nodal and purkinje cells that provide synchronization? Automaticity, Excitability, Conductivity.
The SA and AV nodes are both composed of what type of specialized cell? Node cells
What is the SA (sinoatrial node) firing rate of a normal resting adult? 60 - 100 impulses per min.
The electrical signal initiated byt he SA nodes are conducted though specialized tracts called? Internodal pathways.
Where can one locate the AV node? In the right atrial wall near the tricuspid vale.
What myocardial cell determine heart rate? The one with the fastest inhert firing rate.
Compare the impulses of the SA, AV nodes, and Ventricular pacemaker (bundle of hiss). SA node 60-100 AV node 40-60 Ventricular pacemakes 30-40
Of the three ions that stimulate the cardiac working cells which moves the fastest and which moves the slowest? Sodium is the fastest. Calcium is the slowest.
What is the cardiac action potential? The repeated cycles of depolarization and repolarization.
What occurs to begin phase 0? Cellular depolarization.
How does calcium channel blockers (CCB) slow heart rate? Both the SA and AV nodes are depolarized by the movement of Ca through the calcium channel. CCB slows this movement and thereby slows the conductive impulse.
What characterize Phase 1? Early cellular repolarization, as the K exits the intracellular space.
What phase is called the plateau phase and what occurs during that phase? Phase 2 is called the plateaus phase b/c the reate of repolarization slows. Ca ions enter the intracellular space.
What happens in Phase 3? Completion of repolarization.
What happens in Phase 4? The resting phase before the next depolarization.
What drugs would you administer to suppress dysrhythmia formation and how do they function? Class I antiarrhythmic, which block the influx of Na. The drugs are Lidocaine (Xylocaine), Quinidine (Quinalan), and propafenone (Rythmol).
What class would you find Metoprolol (Lopressor), sotalol (Betapace)? What do they do and what condition would you give them? The are class II (beta-blockers). They are given to help slow tachycardia by decreasing automaticity.
What drug would you give to suppress atrial or ventricular dysrhythmias? How do they function? Class III amiodarone (cordarone), which prolong repolariztion.
What are Verapamil (Calan), diltiazem (Cardizemi) and what condition do you them to tx? Class IV (CCB), used to treat tachycardia.
What is the refractory period and what is it's importance? It is a period where the cell is incapable of being stimulated, as it wait to be complete repolarized.
What are the two phase of the refractory period? Effective (absolute) refractory period and relative refractory period.
During the relative refractory period the cell my depolarize prematurely if a stronger than normal electrical stimulus is given. What Cardiac action phases would this occur in and how would this effect the pt? The relative refractory period can occur a short time after phase 3 and it increases the pt risk for dysrhythmias.
Created by: 100000119407075