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Goulds Ch 12
Goulds Cardiac
| Question | Answer |
|---|---|
| Normally the conduction pathway originates at the | sinoatrial (SA) node |
| The atrial contraction is represented by the depolarization in the EKG by | P wave |
| the ventricular contraction is shown by the large wave of depolarization in the ventricles as the | the QRS wave |
| T wave represents | repolarization of the ventricles |
| Heart rate and force of contraction are controlled by | medulla of the brain. |
| The baroreceptors are located in | the walls of the aorta and internal carotid arteries |
| Factors that increase heart rate include the following | Elevated body temperature, Increased environmental temperatures ,Exertion or exercise, Smoking, Stress response, Dehydration |
| interference with the blood supply to the left coronary artery will most likely impair the pumping capability of the | left ventricle |
| A pulse deficit is | a difference in rate between the apical pulse and the radial pulse. |
| Cardiac output | the volume of blood ejected by a ventricle in 1 minute and depends on heart rate and stroke volume, the volume pumped from one ventricle in one contraction |
| Preload refers to | the mechanical state of the heart at the end of diastole with the ventricles at their maximum volume |
| Afterload is the | force required to eject blood from the ventricles and is determined by the peripheral resistance |
| Peripheral resistance is | the force opposing blood flow |
| Antidiuretic hormone (ADH) | increases water reabsorption through the kidney, thus increasing blood volume. |
| Aldosterone | increases blood volume by increasing reabsorption of sodium ions and water. |
| The renin-angiotensin-aldosterone system in the kidneys | an important control and compensation mechanism that is initiated when there is any decrease in renal blood |
| Angina, or chest pain, occurs when | there is a deficit of oxygen to the heart muscle |
| Etiology of angina | Insufficient myocardial blood supply is associated with atherosclerosis, arteriosclerosis, and myocardial hypertrophy |
| Precipitating factors of angina attacks are related to | activities that increase the demands on the heart, such as running up stairs, getting angry, having a respiratory infection with fever, being exposed to weather extremes or pollution, or eating a large meal |
| Signs and Symptoms of Angina | recurrent, intermittent brief episodes of substernal chest pain, usually triggered by a physical or emotional stress that increases the demand by the heart for oxygen, Pallor, Diaphoresis, Nausea |
| Myocardial Infarction involves | the death of myocardial tissue because of ischemia |
| Manifestations of MI | Sudden substernal chest pain that radiates to the left arm, shoulder, jaw, or neck is the hallmark of MI, Pallor, Diaphoresis, Nausea, Dizziness and weakness, Dyspnea |
| Cardiac Dysrhythmias (Arrhythmias) | Deviations from normal cardiac rate or rhythm |
| Cardiac Dysrhythmias (Arrhythmias) may result from | damage to the heart’s conduction system or systemic causes such as electrolyte abnormalities , fever, hypoxia, stress, infection, or drug toxicity |
| Dysrhythmias reduce the efficiency of | the heart’s pumping cycle |
| Cardiac arrest is | the cessation of all activity in the heart |
| Congestive Heart Failure occurs when | the heart is unable to pump sufficient blood to meet the metabolic needs of the body |
| There are two basic effects when the heart cannot maintain its pumping capability | 1. Cardiac output or stroke volume decreases, resulting in less blood reaching the various organs and tissues, a “forward” effect 2. “Backup” congestion develops in the circulation behind the affected ventricle |
| Etiology of Congestive heart failure | Infarction that impairs the pumping ability or efficiency of the conducting system, valvular changes, or congenital heart defects may cause failure of the affected side. |
| Signs and Symptoms of CHF | With failure of either side, the forward effects are similar: Decreased blood supply to the tissues and general hypoxia, Fatigue and weakness, Dyspnea , Exercise intolerance, Cold intolerance, Dizziness, tachycardia, pallor, and daytime oliguria |
| The backup effects of left-sided failure are related to pulmonary congestion and include the following | Dyspnea and orthopnea, or difficulty in breathing when lying down, develop as increased fluid accumulates in the lungs in the recumbent position, Cough is commonly associated with the fluid irritating the respiratory passages, hemoptysis |
| Signs of right-sided failure and systemic backup include the following: | Dependent edema in the feet or legs, Hepatomegaly and splenomegaly, |
| Congenital heart defects | structural defects in the heart that develop during the first 8 weeks of embryonic life. A structure such as a valve may be altered or missing. |
| Etiology of congenital heart defects | Most defects appear to be multifactorial and reflect a combination of genetic and environmental influences. |
| Signs and Symptoms of congenital heart defects | small defects are asymptomatic other than the presence of a heart murmur. Large defects lead to the following: Pallor and cyanosis, Tachycardia, Dyspnea on exertion and tachypnea, A squatting position, Clubbed fingers , Delayed growth and development |
| Ventricular septal defect (VSD) is | the most common congenital heart defect and is commonly called a “hole in the heart” |
| Tetralogy of Fallot | the most common cyanotic congenital heart condition |
| The four defects of Tetrology of Fallot are | pulmonary valve stenosis, VSD, dextroposition of the aorta (to the right over the VSD), and right ventricular hypertrophy |
| Rheumatic fever is | an acute systemic inflammatory condition that appears to result from an abnormal immune reaction occurring a few weeks after an untreated infection, usually caused by certain strains of group A beta-hemolytic Streptococcus. |
| Pathophysiology of Rheumatic Fever | The preceding infection appears as an upper respiratory infection, tonsillitis, pharyngitis, or strep. Antibodies to the streptococcus organisms form and react with connective tissue in the skin, joints, brain, and heart, causing inflammation. |
| The general indications in acute rheumatic fever | Low-grade fever, Leukocytosis, Malaise, Anorexia and fatigue, Tachycardia, even at rest, is common |
| Infective endocarditis | Microorganisms in the general circulation attach to the endocardium and invade the heart valves, causing inflammation and formation of vegetations on the cusps. |
| Etiology of infective endocarditis | A combination of factors predisposes to infection: the presence of abnormal tissue in the heart, the presence of microbes in the blood, and reduced host defenses. |
| Signs and Symptoms of infective endocarditis | frequently insidious in onset, manifesting only as an intermittent low-grade fever or fatigue. Other manifestations may include the following: Anorexia, Splenomegaly, CHF develops in severe cases |
| Pericarditis Pathophysiology | Pericarditis may be acute or chronic and is usually secondary to another condition in either the heart or the surrounding |
| Hypertension, | high blood pressure, in both its primary and secondary forms is a common problem. Hypertension is often undiagnosed until complications arise, and has been called the “silent killer.” |
| Causes of primary or essential hypertension | idiopathic and is the form of hypertension discussed in this section. |
| Secondary hypertension results from | renal (e.g., nephrosclerosis) or endocrine (e.g., hyperaldosteronism) disease, or pheochromocytoma, or SNS chain of ganglia. In this type of hypertension, the underlying problem must be treated to reduce the blood pressure. |
| Malignant or resistant hypertension | is a hypertensive emergency with extremely high blood pressure |
| Essential hypertension develops when | the blood pressure is consistently above 140/90 mm Hg |
| Etiology of hypertension | Even in idiopathic hypertension, the form discussed here, many factors appear to predispose to the condition: genetic factors, high sodium intake, excessive alcohol intake obesity, and prolonged or recurrent stress. |
| Signs and Symptoms of Hypertension | frequently asymptomatic in the early stages, and the initial signs are often vague and nonspecific Fatigue, Malaise, Morning headache |
| Shock or hypotension results from | a decreased circulating blood volume, leading to decreased tissue perfusion and general hypoxia. |
| Shock caused by a loss of circulating blood volume | (hypovolemic shock) |
| Shock caused by inability of the heart to pump the blood through the circulation | (cardiogenic shock) |
| A shock caused by changes in peripheral resistance leading to pooling of blood in the periphery | (distributive, vasogenic, neurogenic, septic, or anaphylactic shock) |
| Hypovolemic shock results from | loss of blood |
| Cardiogenic shock | associated with cardiac impairment, such as acute infarction of the left ventricle, or arrhythmias |
| Neurogenic or vasogenic shock | may develop from pain, fear, drugs, or loss of SNS stimuli with spinal cord injury |
| Anaphylactic shock results from | rapid general vasodilation caused by the release of large amounts of histamine in a severe allergic reaction |
| Septic shock may develop in | persons with severe infection |
| Signs and Symptoms of shock | thirst and agitation or restlessness followed by Cool, moist, pale skin, Tachycardia, vasoconstriction shunts blood from the viscera and skin to the vital areas, Lethargy, Weakness, Dizziness, A weak, thready pulse |
Created by:
doctorwho1