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Cardio Master Notes
Trauma Master Notes
| Question | Answer |
|---|---|
| What is the most come reason people die? When your dealing with someone with chest pain you think they're having a heart attack what is the most common way they are going to die? | From a lethal heart dysrhythmia. |
| Cardiology curriculum is based on what standard curriculum? | U.S. Department of Transportation National Standard Curriculum. |
| What should we perform a cardiac work up? | Pt presents with a pulse and a problem from hips to head. ** 12/15 Lead** |
| Define Anastomosis | The communication between two or more vessels. The connection between one or more vessels. |
| Define Collateral Circulation | The communication between two or more vessels. The connection between one or more vessels. |
| Define Poiseuille's Law | Blood flow through a vessel is directly proportional to the radius of the vessel to the fourth power. |
| What is the first phase of the cardiac cycle. | Diastole |
| Define ventricular Diastole | S1, Lub, When the ventricles fill with blood, first phase of the cardiac cycle, closing of the pulmonic and aortic valve. Heart is filling |
| Define ventricular Systole | S2, Dub, When the myocardium is contracting, second phase of the cardiac cycle. Closing of the tricuspid valve and bicuspid valve, the heart is pumping. |
| Define the cardiac cycle. | Is the sequence of events that occurs between the end of one heart contraction and the end of the the next. |
| Define Ejection Fraction. | Amount of blood pumped out of the ventricles ÷ Total amount of blood in the ventricle **the % of blood that is pumped from the ventricles to how much is remaining at the end of diastole. 100mL - 40mL = 60-70%** <45%=Heart failure |
| Define Proload. | How much volume/ pressure of blood is in the ventricles at the end of diastole. Also called the end diastolic volume. The greater the preload the greater the EF will be. |
| Define Afterload. | The resistance the heart must pump against to open the aortic valve Left or Right. Afterload = Ventricular workload |
| Define Contractility | The ability of the muscle cells to contract, or shorten. |
| What ion is primarily responsible for cardiac contractility. | Calcium. |
| Define Stroke Volume. | The amount of blood pumped out in one contraction. |
| What is the average stroke volume? | Between 70 and 100 mL's average of 70 mL EF 70%. |
| What are three things that affect stroke volume? | Preload- how much blood is filling the heart. Afterload - how much pressure the heart has to pump against. Contractility - how well is the heart is contracting pumping. |
| How do you increase preload | IV fluids |
| How do you increase or decrease afterload | Vasoconstrictors or Vasodilators |
| How do you increase contractility? | Meds |
| Define Cardiac Output. | The volume of blood that is pumped out in one minute. SV x HR |
| Define Starling Law of the Heart. | The rubber band effect. The more the myocardium is stretched the more forceful the subsequent contraction will be the contractility we will have. up to a certain point. |
| What is the function of the Chordae Tendineae? | They anchor the leaflets of the bicuspid and tricuspid valves. |
| Which of the heart valves are called the "semi-lunar" valves? | The Aortic valve and the Pulmonic valve. |
| Blood entering the right atrium arrives via the | Superior / inferior vena cava, & the coronary sinus. |
| The coronary arteries are fed blood during what part of the cardiac cycle. | Diastole, as the heart relaxes the aortic valve closes allowing flood to flow into the coronary arteries |
| Define Chronotropy | Cardiac Heart Rate the speed of electrical impulses from the SA node. |
| Define the term Inotropy | The force of contraction. how hard the heart muscle contracts. |
| Define the term Dromotropy | The conduction velocity of the speed of electrical impulses traveling through the conduction pathways |
| Define ANP Atrial Natriuretic Peptides | Manufactures, stored, and released by the atrial muscle cells in response to such things as atrial distention and stimulation . |
| What is Manufactured, stored, and released by the atrial muscle cells in response to such things as atrial distention and stimulation . | ANP Atrial Natriuretic Peptides. |
| What is secreted by the ventricles of the heart in response to excessive stretching of the ventricle myocytes | BNP Brain natriuretic peptide |
| What muscles in the ventricles attach to the chordae tendineae? | Papillary muscles. |
| Blood entering the left atrium arrives via the? | Pulmonary Veins. |
| Blood is pushed to the pulmonary circuit from the heart by the? | Right ventricle. |
| What is the equation for blood pressure? | HR x SV s Systemic vascular resistance. |
| Which coronary artery feeds the anterior wall of the left ventricle? | LAD the left anterior descending artery. AKA the widow maker |
| Which coronary artery feeds the inferior wall of the heart? | RCA Right Coronary Artery |
| Which coronary artery feeds the left lateral wall of the heart? | LCX Left Circumflex |
| A blockage of which of the following would result in the entire left ventricle not receiving blood supply? | LMCA Left Main Coronary Artery |
| Define Pectinate Muscles. | Comb-like muscle found in the right atrium |
| Parallel ridges of muscle that are found in the anterior part of the right atrium that help to increase the power of contraction without adding extra weight to the heart? | Pectinate Muscles AKA musculi pectinate. |
| What is the Foramen Ovale? | A whole in the atrial septum that is part of the fetal blood circulation. |
| Normal heart sounds are known as ___&___. | S1 lub closing of the atrioventricular valves & S2 Dub closing of the semilunar valves. |
| The best place to auscultate normal heart tones is at ____. This is located at the 3rd ICS just to the left of the sternum. | Erbs Point |
| The amount of blood pumped by the ventricles with one contraction, versus the amount of blood that was in the ventricles at the end of diastole is termed the? | Ejection Fraction ** The % of blood pumped out of the ventricles with each beat divide the SV by the end diastolic volume ** |
| What are the three direct factors that influence the stroke volume of the ventricles? | Influencing the filling of the heart, the strength of the squeeze or the resistance it faces all impact the stroke volume ** preload, afterload, contractility. ** |
| What ion causes the autorhythmic cell to depolarize? | Calcium |
| A normal P wave should be nice and round and have an amplitude no higher than ____mm in the limb leads. | 2.5 millimeters or 0.25 millivolts 2.5 small boxes |
| A normal P wave should no higher than ____mm in the precordial leads. | 3mm 3 small boxes |
| Depolarization of the cardiac contractile cell occurs during Phase ___ of the cardiac action potential. | Phase 0 |
| Repolarization of the cardiac contractile cell occurs during phase ___ of the cardiac action potential. | Phase 3 |
| A normal PRI has a duration between ___to___ seconds/ | 0.12-0.20 seconds |
| Resting potential of the cardiac contractile cell occurs at __mV? | -90mV |
| On ECG paper, one small vertical box represents ____mm. | 1mm |
| A normal QRS has a duration between___to___ seconds. | 0.04 to 0.12 seconds 1-3 SB |
| Action potential of the cardiac contractile cell occurs at? | -85mV |
| What ion causes the autorhythmic cell to repolarize. | potassium |
| A normal P wave should be nice and round and have an amplitude no higher than ___mm in the precordial leads? | 0.15 mV |
| The health care surveillance process, put in place for trauma systems, is called the? | Registry |
| What is the Health Care Surveillance Process | -Data Collection -Data Analysis - Data Interpretation - Dissemination |
| The Health Care Surveillance process, put in place for trauma systems, is called the? | Registry |
| The collection of data to identify the existence, significance, and characteristics of a disease or disease process is called? | Surveillance |
| Penetrating trauma refers to an injury in which? | Object enters the body and exchanuges energy directly eith human tissue. |
| ____ are standards established by your systems medical direction to assist you in determining which patients require urgent transportation to a trauma center. | Trauma triage criteria |
| Definitive trauma care is only available at facilities with rapid access to... | Surgery |
| Medical facility that commits resources to address the most common trauma emergencies with surgical capability availed 24/7 is classified as... | Level 2 |
| The mental summation of anticipated injuries based on your event analysis is called...? | Index of suspicion |
| What are the three main elements of the transport decision tree are what? | - Glasgow coma scale - Anatomy of injury - Physical findings |
| Recreating the incident from evidence available at the scene will help you determine the...? | MOI |
| What concept is made to remind EMS to hasten care and delivery to the ED? | The golden period |
| What is the role of sodium in autorhythmic cells? | Gets the cell from resting potential to action potential |
| What is the role of sodium in contractile cells? | It gets the cell to depolarize |
| What is the role of Calcium in autorhythmic cells? | If makes the cells depolarize |
| What is the role of Calcium in contractile cells? | It makes the cell contract |
| What muscle is found in the upper right atrium. | Pectinate muscle AKA cone muscle |
| What is the most common heart problem that everyone will eventually get? | Atrial fibrillation. |
| In any limb lead a normal P wave should be nice and round and have a maximum amplitude of...? | 0.25 mV |
| In any chest lead, a normal P wave should have a maximum amplitude of...? | 0.15 mV |
| A normal T wave in any limb lead should have a maximum amplitude of...? | 5 mm |
| A normal T wave in any chest lead should have a maximum amplitude of...? | 10 mm |
| An ECG rhythm in which the SA node fails to initiate an impulse, there is multiple dropped beats, and the cadence is thrown off when it starts back up again is known as...? | Sinus Arrest |
| An ECG rhythm in which the SA node fails to initiate an impulse , there is only one dropped beat, and the cadence is thrown off when starts back up gain is known as...? | Sinus Pause |
| An ECG rhythm is which the electrical impulse fails to leave the SA node, there are multiple dropped beats, but the cadence is right on track when it starts back up again is known as...? | Sinus Block |
| If thw PRI is longer than 0.20 seconds, what is occurring in the electrical conduction system of the heart? | The impulse is being held for too long at the AV node. |
| A normal PRI should be between____ seconds. | 0.12 & 0.20 |
| A normal QRS duration should be between ___ seconds. | 0.04 & 0.12 |
| The rapid influx of what ion causes an autorhythmic call to depolarize? | Calcium |
| The rapid influx of what ion causes a cardiac contractile call to depolarize? | Sodium |
| The efflux of what ion causes both types of cardiac cells to repolarize? | Potassium |
| What is the method of measuring a regular heart rate when coulting small boxes between R intervals | HR = (#sb / 1500) |
| The pressure within the ventricles at the end of diastole is referred as? | Preload |
| Define Coagulopathy | A condition in which the blood's ability to clot is impaired |
| Pericardial Tamponade Presents with | -Distended jugular veins, -Tachycardia, -Hypotension and - Muffled Heart Tones |
| During stage 2 hemorrhage, the patients pulse pressure will: | Be noticeably narrower start to narrow |
| The blood vessels that are called the "capacitance system" are the...? | Veins |
| True Or False Cardiogenic shock has a high mortality rate? | True |
| Your Pt has lost about 20 of his total blood Vol. He is anxious, restless, and has cool / clammy skin. In which stage of hemorrhage is he? | Stage 2 |
| What are the three steps in the clotting process? | 1) Vascular phase, smooth muscle contracts 2) Platelet phase, Platelets, Collagen aggregate 3) Coagulation phase, Fibrin blood clot |
| What does the CUPS acronym stand for? | Critical - Cardiac/Respiratory arrest Unstable - Life issues Potentially unstable - Hi risk of deteriorating Stable - no immediate threat to life |
| Venous bleeding is usually | Dark red, and blowing |
| Define Beck's Triad | Distended Jugular Veins Distant Heart Sounds Decreased arterial blood pressure |
| Remember that using a tourniquet can cause? | The accumulation of lactic acid, potassium, and anaerobic metabolites can occur with its use. |
| The Measurement of peripheral vascular resistance is the | Wrong Diastolic pressure Wrong pulse pressure Wrond Systolic Pressure Correct Mean arterial pressure |
| Stroke volume is predicated by...? | Preload, afterload, and contractility? |
| Cutaneous vasoconstriction in shock victim contributes to..? | Hypothermia |
| What are the 4 classes of Hemorrhage? | Class 1 - Initial 15% (750mL) Class 2 - Compensated 15-30% (750mL-1500mL) Class 3 - Decompensated 30 - 40% (1500mL-2000mL) Class 4 - Irreversible >40% (>2000 mL) |
| What are the three layers of the artery | Tunica - Adventitia Extera Tunica - Media constrictor Tunica - Intima |
| Tenison pneumothorax and pulmonary emboli can cause which type of shock? | Obstructive |
| Which of the following medical conditions will not cause a pt to experience distributive shock? Anaphylaxis/cardiac tamponade/sepsis/Neurogenic | Cardiac Tamponade |
| The ultimate killer of all trauma victims is? | Shock? |
| Expiratory CO2 levels in the head-injured patient who is intubated, should not drop below..? | 30? |
| The blood volume of an infant or young child is proportionally .. | 20% greater than an adult |
| The blood vessels that are called the ":capacitance system" are the..? | Veins? |
| The vascular system consists of three types of vessels. Which of the following statements is true regarding arteries? | Correct: Arteries carry blood from the heart to the body tissues Wrong: Arteris contain about 64 percent of the total blood volume. Wrong: Arteries carry only oxygenated blood Wrong: Arteries are relatively large, twice the size of veins. |
| A rapid influx of which ion is responsible for the repolarization of the cardiac autorhythmic cells | Calcium |
| Waddels triad consists of which of the following | Ankle injuries Abdominal chest injuries Head injury Pelvis/ Femer injury |
| The rapid influx of which ion is responisble for the depolarization of the crdiac contractile cells | sodium |
| A rapid trauma assessment should be performed on..? | Ant Pt with a significant MOI. |
| When treating a pt with obvious signs of crush syndrome & hyperkalemia, what is your first line IV medication and why? | Calcium Chloride Rhabdomyolysis= high potassium calcium chloride temporarily blocks potassium to prevent arrythmias. |
| Crush syndrome usually occurs when a body part has been trapped/crushed for longer than how many hours? | 4 hrs |
| The skin comprises what percentage of total body weight? | 16% |
| What is the most common location for compartment syndrome to occur? | Distal leg, anterior compartment. |
| What is the correct dose of calcium chloride for the treatment of hyperkalemia? | 500-1000 mg slow IV over 3 min. |
| What is considered the first P of compartment syndrome? What are the P's of compartment Syndrome | 1. Pain 2. Pins and needle 3. Pallor 4. Paralysis 5. Pulselessness 6. Pretty cold |
| Which of the following layers of skin is the most important in insulating the body against heat loss? | Subcutaneous Layer |
| What ECG change would you see for a patient suffering from hyperkalemia? | From crush injury Peaked T waves |
| Rhabdomyolysis = Elevated potassium levels S&S 6P's | Compartment syndrome |
| Hyperkalemia S&S pain firm and tense limb, loss of muscle function, swelling, low BP, Dark bloody urine, | Crush syndrome |
| What medication would you give for a Pt suspected of having hyperkalemia? | Sodium Bicarbonate |
| Sinus Bradycardia | |
| Sinus Tachycardia | |
| Sinus Arrhythmia | |
| Sinus Block | |
| Sinus Pause | |
| Sinus Arrest | |
| Sick Sinus Syndrome | |
| Wandering Atrial Pacemaker | |
| Premature Atrial Contraction | |
| Multifocal Atrial Contraction | |
| Supraventricular Tachycardia | |
| Paroxysmal Supraventricular Tachycardia | |
| Wolff-Parkinson-White Syndrome | |
| Atrial Flutter | |
| Atrial Fibrillation | |
| AVNRT | |
| AVRT | |
| Compensatory | |
| Non-Compensatory | |
| 2-1 , 3-1 block | |
| Leads V1 and V2 look at what part of the heart? | Septal the middle of the heart. |
| Leads V3 and V4 loo at what part of the heart? | Anterior. |
| Leads II, III and aVF look at what part of the heart? | Inferior. |
| Leads I and aVL look at what part of the heart? | Higher left Lateral |
| Leads V5 and V6 look at what part of the heart? | Lower Left Lateral |
| Cardioversion or pharmacological intervention is only usually required for patients that present in A-Fib at what ventricular rate? | Above 150 bpm |
| In cardiac contractile cell action potential in what phase is the cell repolarizing? | Phase 3 |
| In cardiac contractile cell action potential in what phase are fast sodium channels open causing the cell to depolarize? | Phase 0 |
| In cardiac contractile cell action potential in what phase are sodium/potassium pumps actively moving ions back to where they belong? | Phase 4 |
| In cardiac contractile cell action potential in what phase is calcium entering the cell? | Phase 2 |
| In autorhythmic cell action potential what phase is potassium leaving the cell and causing repolarization? | Phase 3 |
| In autorhythmic cell action potential what phase is calcium rushing into the cell causing depolarization? | Phase 0 |
Created by:
ejarami4
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