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Cards A&P and Exam
Cardiology
| Question | Answer |
|---|---|
| CHF effect on risk of sudden heart failure death: | increases risk x8 |
| lifetime risk devt of A-fib | 1 in 4 |
| Most common causes of heart failure: | Ischemic cardiomyopathy; Valvular cardiomyopathy; Hypertensive cardiomyopathy (diastolic non-compliant CHF more common in hypertension than Systolic (end stage hypertensive dz)) |
| Structural causes of heart dz | myocardial dz; pericardial dz |
| Types of myocardial dz | Cardiomyopathy; myocarditis |
| 3 functional categories of cardiomyopathy | dilated; hypertrophic; restrictive |
| 3 types of myocarditis | infectious; toxic; idiopathic |
| 3 types of pericardial dz | Pericarditis; Pericardial effusion / tamponade; Pericardial constriction |
| CHF risk factors | Age; Hypertension; Tobacco abuse; Diabetes mellitus; Obesity; ETOH/Substance abuse |
| CHF precipitators | Coronary artery dz/MI; Valvular or congenital heart dz; Hypertension….diastolic dysfn; ETOH/substance abuse; Viral Infxns; PG; Idiopathic |
| Most common causes of heart failure: | Ischemic cardiomyopathy; Valvular cardiomyopathy; Hypertensive cardiomyopathy |
| Which type of non-compliant CHF is more common in HTN? | Diastolic more than Systolic (end stage hypertensive dz) |
| What precipitates conduction system problems? | Coronary artery dz/MI (ischemia induced); congenital; anything that causes CHF |
| Deoxygenated blood draining from the heart itself enters the right atrium via: | the coronary sinus & thebesian veins |
| Second most common cause of sudden death in young adults | Anomalous coronary arteries (4-15% of young people with sudden cardiac death); 1-2% of population |
| Which valves do/do not have chordae/papillary mx? | AV valves do; semilunar valves do not |
| period of ventricular contraction | systole |
| period of ventricular relaxation | diastole |
| the load that stretches the cardiac muscle prior to contraction | preload |
| the resistance against which the left ventricle must contract | afterload |
| ability of cardiac muscle to shorten, when given a load | myocardial contractility |
| myocardial contractility is increased by: | sympathetic stimulation/action |
| myocardial contractility is decreased by: | myocardial injury |
| afterload comprises: | blood volume/viscosity; resistance in aorta & other peripheral vessels |
| Preload is increased by: | inspiration or increasing venous return to right heart) |
| Amount of blood remaining after ejection: | end systolic volume |
| In diastole, _____% of ventricular filling occurs before atrial contraction | 80 |
| SV= | EDV (end diastolic volume) – ESV (end systolic volume) |
| CO = | HR x SV (normal about 5 L/min) |
| Adult normal cardiac blood volumes: | SV=70ml, EDV=135ml, ESV=65ml, CO=5L total blood |
| volume of blood ejected from each ventricle during one minute | Cardiac output |
| volume of blood ejected with each heartbeat | Stroke volume |
| Starling’s Law: | SV increases as the EDV increases |
| Ejection Fraction formula: | EF% = SV/EDV |
| A quantitative measure of contractility | Ejection Fraction |
| Normal EF | 67% (at DUMC: >55%) |
| Annulus: | fibrous ring surrounding each of the 4 cardiac valves; fn: to provide structural support to the heart |
| narrowing or obstruction to forward flow while valve is open | Stenosis |
| backward leakage during time when valve is closed | Regurgitation / Insufficiency |
| S1 = _____ valve closing | Mitral (Systole) |
| S2 = _____ valve closing | Aortic valve closing (diastole) |
| S3 may indicate: | CHF (sounds like: Ken-Tuc-Key) |
| S4 may indicate: | HTN or CAD (sounds like: Tenn-es-see) |
| Which heart sound is always pathological? | S4 |
| Left & right coronary arteries arise from what part of the aortic root? | Sinuses of Valsalva |
| Branches off the left main coronary artery | LAD; Left circumflex |
| Right Dominant: Septum supplied by: | Distal branches from RCA (supply the septum 70%) |
| Left Dominant: Septum supplied by: | Distal branches from LCx (supply the septum 20%) |
| SA Node is supplied by: | RCA 60% of the time & by LCX 40% of the time |
| AV node supplied by: | dominant artery (RCA or LCx) |
| small vascular channels that interconnect the normal coronary arteries | Collateral Vessels |
| Function of collateral vessels in normal myocardium | Nonfunctional because no pressure gradient is present |
| S/S of conduction problems | palpitations; dizziness; presyncope/ syncope |
| Myocardial dz categories | Cardiomyopathy; Myocarditis |
| DM increases risk/incidence of: | Diffuse dz; small vessel dz; CHF & death rates post MI; death or MI post CABG & PCI |
| Recommended for sedentary lifestyle | Devoted exercise 30 min/day, 5 d/wk; initially under med supervision |
| Causes of noncardiac CP | Pericarditis; myocarditis; MVP; chostocondritis; C- or T-spine dz/thoracic outlet; GI/gall bladder; PE; pneumonia; pneumothorax |
| Pericardium anatomy | complex = outer fibrous layer (flask-shaped tough outer sac connected at diaphragm, sternum, and costal cartilage) and inner serous layer |
| Pericardial friction rub is pathognomonic for: | acute pericarditis |
| Coronary artery at left lateral wall | left marginal |
| Coronary artery at posterolateral surface | left circumflex |
| Coronary artery at posterior heart, AV node | right coronary |
| Coronary artery at anterior wall of LV, anterior2/3 of intraventricular septum | LAD |
| RCA supplies: | sinus node, AV node, bundle of His |
Created by:
Abarnard
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