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241 EXAM 1
CHAPTER 12 CARDIO
| Question | Answer |
|---|---|
| what is collateral circulation | Heart muscle compensates and makes its own new blood vessels to perfuse the area of the heart when an obstruction of the heart occurs. |
| disystole | relaxes |
| systole | contracts |
| Cardia output | amount of blood ejected from heart per miniunit |
| Stroke volume | amount of blood pumped with each contraction |
| Preload | voloum of blood in the ventricle at the end of and disystole before heart contracts |
| Afterload | resistance the left ventral must over come to eject blood to the res of the body |
| systolic pressure | Top number pressure by the blood on the arteries during systole |
| Diastolic pressure | lower number pressure of the blood on the arteries during disystole |
| Peripheral vascular resistance | the force opposing blood flow. the amount of friction the vessel walls encounter |
| ADH hormone | reabsorbs fluid increasing BV increasing the BP by cinstricting |
| Aldosterone | hold on sodium and water and excrete potassium. increading BV increasing BP |
| EKG or ECG | show electrical and conduction activity of the heart |
| Echocardiogram | ultrasound of the heart. showing valve abnormalities, congenial defects, and heart structure |
| Chest x ray | shape and size, pulmonary congestion of the heart |
| Coronary angiography | die is injected into the arteries to visualize blood flow through the arteries |
| Troponin test | see if there is damage to the heart tissue by the level of the troponin proteins. detects heart attacks |
| coronary artery disease CAD | angina pectoris or cardiac ischemia or MI leading to heart failure |
| Angina pectoris CAD | chest pain when there is a deficit of oxygen to the heart meaning it has to work harder. usually when there is increases demands of the heart |
| Atherosclerosis | narrowing of coronary arteries from a build up of plaque. can causes MI |
| classic angina | chest pain with activity with exertion |
| Unstable angina | prolong chest pain at rest , Heart attack |
| Arteriosclerosis | ticking and hardening of the arteries |
| Treatment of angina pectoris | rest and something that vasodilates the arteries. nitroglycerin |
| Myocardial infarction - Heart attack CAD | coronary artery is totally obstructed leading to death of myocardial tissue because of ischemia. |
| What does ST elevation MI's or non ST elevation of MI's | When a blood clot completely blocks a coronary artery, needing immediate treatment to restore blood flow |
| How much time does blood have to be restored to not have any irreversible damage from an MI? | 20-30 minuets |
| S/S of MI | chest pain that radiates to the left arm, shoulder, jaw, or neck. indigestion, pallor, diaphoresis, dizzy and weakness, dyspnea, marked anxiety or fear, hypotension causing skock. |
| How to diagnosis a MI? | EKG changes, elevated troponin |
| How to treat MI? | oxygen, morphine, blood thinners, Coronary artery bypass grafting surgery, balloon stent, Cardiac rehab |
| Cardiogenic shock develops when? | pumping capability of the left ventricle is impaired |
| Congestive heart failure CHF happens when? | the contractibility of the ventricle is reduced and stroke volume declines. can happen a few days or later when activity is resumed from a MI |
| Congestive heart failure CHF | when heart is unable to pump sufficient blood to meat metabolic demands of the body. usually chronic. one side of the heart usually fails first then the other side |
| What are the 2 basic effects when the heart cannot maintain its pumping ability? | -Cardiac output or stroke volume decreases meaning less blood is reaching organs and tissues. -Backup congestion the output from the ventricle is less then the inflow of blood |
| Left sided congestive heart failure CHF | left ventricles can not pump all of the blood into the systemic circulation and blood from the lungs can not enter the left side of the heart causing pulmonary congestion |
| What backs up in the lungs during left sided heart failure? | Fluid |
| Right sided congestive heart failure CHF | the right ventricle cannot maintain its output so less blood can proceed to the left side of the heart. Back up in the systemic circulation. increases BV in legs and feet neck, liver Digestive |
| What increases the demands of the heart during CHF? | Hypertension because left ventricle has to work harder. when it over exerts it self it hypertrophies and fails |
| Pulmonary disease comes from what sided of CHF? | right side CHF because it increases the work load of the right ventricle then hypertrophies and fails. known as cor pulmonate |
| S/S of congestive heart failure | decrease cardiac output/ blood supply, fatigue weakness, dyspnea, exercise intolerance, dizziness. |
| S/S of Right sided congestive heart failure | edema , ascites, jugular vein destination. |
| S/S of Left sided congestive heart failure | dyspnea, orthopnea, cough, nocturnal dyspnea, pulmonary edema, rales and crackles, low oxygen |
| How to diagnosis CHF? | Chest x ray to see fluid in lungs ABG to measure oxygenation |
| How to treat CHF | Treat the underlying problem, fluid and sodium restriction, antihypertensives, diuretics, vasodilators |
| When do structural congential heart defects develope? | first 8 weeks of embryonic life |
| Congenital heart defects can be? | chromosomal abnormalities such as down syndrome. Environmental factors like infection of rubella, maternal alcoholism, maternal diabetes |
| S/S of Congenital heart defects | small- heart murmur. Large- pallor, cyanosis, tachycardia, dyspnea on exertion, squatting position for comfort bc of blood flow, clubbed fingers, intolerance for exercise and cold weather, delayed growth and development. |
| How to diagnosis Congenital heart defects? | diagnostic imaging, cardiac catheterization, echocardiograms, ECG. usually detected before birth |
| How to treat Congenital heart defects? | surgical repair, oxygen and medications, some septal defects close with time |
| Ventricular septal defect (Congenital heart defects) | Hole in the septum that separates the atriums or ventricles |
| Valve defects Congenital heart defects | valve stenosis restricting forward flow of blood. valvular incompetence failure of a valve to close completely allowing regurgitation |
| Tetralogy of Fallot (Congenital heart defects) | Pulmonary valve stenosis, ventricular septal defect, right ventrical hypertrophy, transposition of aorta |
| Rheumatic fever/ Heart disease (Inflammation and infection in the heart) | inflammation that appears after an abnormal immune reaction a few weeks after untreated infection like group A beta hemolytic streptococcus |
| What becomes inflamed during Rheumatic fever/ Heart disease? | Heart, joints, skin, Pericarditis, myocarditis |
| The most common problem is endocarditis, what is it? Rheumatic fever/ Heart disease | Endocarditis effects the valves that become edematous along the outer edges of the valve cusps. Treatment would be penicillin |
| S/S of Rheumatic fever/ Heart disease | Low fever, leukocytosis, malaise, anorexia, fatigue, tachycardia even at rest, heart murmurs, epistaxis, abdominal pain |
| how to diagnosis endocarditis? (Inflammation and infection in the heart)? | transesophageal echocardiogram. |
| S/S and treatment of endocarditis? | Fever, chills, impaired heart function, osler nodules on fingers. antibiotics |
| Pericarditis (Inflammation and infection in the heart)? | inflammation of the pericardium causing friction rub. could decrease cardiac out put. called cardiac tamponade |
| S/S of pericarditis | Tachycardia, chest pain, dyspnea, cough, friction rub, EKG changes |
| Treatment of pericarditis? | pericardiocentesis- needle used to aspirate or drain fluid from pericardial |
| Hypertension (Vascular disorder) can result it? | renal failure, stroke from hemorrhage, loss of vision, or CHF |
| What areas are more frequently damaged by hypertension? | kidneys, brain, retina |
| S/S of Hypertension? | asymptomatic, fatigue, malaise, headache, consistently elevated BP |
| Treatment of Hypertension? | life style changes like weight loss, stress reduction, sodium restriction, excise, medications |
| Shock (Vascular disorder) | decreased circulating blood volume and decreased tissue perfusion and hypoxia. |
| What happens if shock is not reversed quickley? | organs and tissues will no longer recover resulting in degenerate die, could even be multiple organ failure |
| Hypovolemic shock | loss of blood or plasma from circulating blood |
| Vasogenic or distributive shock | Mass vasodilation causes decreased BP |
| Septic shock | develops in person with a sever infection as bacteria produces endotoxins |
| Anaphylactic shock | rapid vasodilation caused by released histamine in sever allergic reaction |
| S/S of shock | cool, moist, pale skin, tachycardia with weak puls, lethargy, hypoxemia, metabolic acidosis, hypotention |
| Treatment of Shock? | treat underlying problem, fluid replacement, blood transfusion, antihistamines, antibiotics for septic shock, oxygen,, vasoconstriction meds to increase BP |
Created by:
mmarino2