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Theory Test IV

Unit XI Circulation

Cardiac Output Amount of blood ejected from the heart each minute (CO = HR x SV)
Systole Contraction of the heart. When the heart ejects the blood into pulmonary and systemic circulation.
Diastole Relaxation of the heart. When the hearts ventricles fill with blood. This phase is twice as long.
S1 (lub) First sound. Beginning of ventricular systole; caused by closure of the atrioventricular valves (loudest at the apex of the heart)
Atrioventricular valves Tricuspid and mitral
S2 (dub) Second sound. Beginning of ventricular diastole; caused by closure of the semilunar valves (loudest at the base of the heart)
Semilunar valves Aortic and pulmonic
Purpose of heart valves Keep blood moving forward and prevent regurgitation.
Arteries Carry oxygenated blood away from the heart to the tissues.
Pulmonary arteries Carry oxygenated blood toward the heart from the lungs.
Veins Carry unoxygenated blood toward the heart from the tissues.
Pulmonary veins Carry unoxygenated blood away from the heart into the lungs.
Stroke Volume Amount of blood ejected from the heart with each beat (SV)
Heart Rate Number of beats in each minute (HR)
Preload Volume of blood in ventricles at the end of the diastolic period (end diastolic pressure)
Afterload Resistance the ventricles must overcome to circulate blood. Ventricles must generate sufficient pressure to overcome vascular resistance.
Best way to listen for S3 and S4 Have patient roll partially onto their left side.
S3 Occurs early is diastole right after the S2 sound. (S1, S2, S3) Best heard with patient laying on their left side and will usually disappear when they sit up. "lub-dub-ee". May indicate heart failure.
S4 "Ventricular gallop". Occurs near the very end of diastole just before the S1 sound (S4, S1, S2) sounds like "dee-lub-dub". Sign of hypertension.
Heart failure When the heart cannot pump enough blood to meet the metabolic needs of the body.
Brain Natriuretic Peptide (BNP) A hormone produced mainly by the left ventricle of the heart in response to increased ventricular volume pressure.
Normal BNP Below 100 pg/mL (100 - 300 pg/mL indicates heart failure)
Left sided heart failure causes this Pulmonary vessel congestion
Right sided heart failure causes this Systemic vessel problems such as: JVD, hepatosplenomegaly, right upper quadrant pain, edema, weight gain, anorexia, nausea.
Types of treatments for heart failure Treat underlying cause, beta blockers, nitrates, Digoxin, Ace Inhibitors, Oxygen, morphine.
Signs and symptoms of Impaired Tissue Perfusion 5 P's: Pulse, Pallor, Pain/Parethesia, Paralysis, Polar (cool extremities)
Fully saturated hemoglobin requires this All four heme groups are bound to oxygen.
Sinus Arrhythmia A normal variation in heart rate. Common in infants and young children, often increasing and decreasing with each breath.
Atherosclerosis Build up of fatty plaques within the arteries
Primary contributor to Cardio Vascular Disease (CVD) and cause of impaired blood flow to organs and tissues? Atherosclerosis
Leading cause of death in North America CVD
Mean Arterial Pressure (MAP) Maintains blood flow to the tissues throughout the cardiac cycle. Product of Cardiac Output x Peripheral Vascular Resistance. CO x PVR = MAP
Peripheral Vascular Resistance (PVR) Impedes or opposes blood flow to the tissues.
Nonmodifiable Traditional Risk Factors of CVD Heredity, Age, Gender
Modifiable Traditional Risk Factors of CVD Elevated serum lipid level, Hypertension, Cigarette smoking, Diabetes, Obesity, Sedentary lifestyle
Myocardial infarction (MI) Heart attack
Cause of MI Atherosclerosis or blood clot in vessels that supply blood to the heart, shutting of blood supply to a portion of the myocardium, resulting in necrotic tissue.
Signs and symptoms of MI They vary, but may include: Chest pain (substernal and/or radiating to the left arm, jaw), Nausea, Shortness of breath, Diaphoresis.
Ischemia Lack of blood supply due to obstructed circulation.
Cause of myocardial ischemia Partial obstruction of coronary arteries
Complete obstruction of coronary artery causes this. Results in MI (heart attach)
Cause of Transient Ischemic Attach (TIA) Partial obstruction of cerebral vessels
Cause of a Stroke (Cerebralvascular Accident) Complete obstruction of cerebral vessels
Peripheral Vascular Disease leads to what? Ischemia of distal tissues such as the legs and feet. Gangrene and amputation may result.
Incompetent valves in veins Allow blood to pool in veins, causing edema and decreasing venous return to the heart. Increases the risk for thrombi formation and PE
Pulmonary Embolism (PE) An embolism that gets trapped in small pulmonary vessels, occludes blood supply to the capillary membrane so no gas exchange occurs.
Enzymes released in blood during an MI Creatine kinase (CK) and troponin. Elevated levels of these can help differentiate the source of the pain.
Risks associated with Venous Stasis May allow clots to develop in deep vein, often in the thigh or calf (DVT). If the thrombus breaks free, it can become a PE.
Created by: Jnford15