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Unit XI Circulation

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Question
Answer
Cardiac Output   Amount of blood ejected from the heart each minute (CO = HR x SV)  
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Systole   Contraction of the heart. When the heart ejects the blood into pulmonary and systemic circulation.  
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Diastole   Relaxation of the heart. When the hearts ventricles fill with blood. This phase is twice as long.  
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S1 (lub)   First sound. Beginning of ventricular systole; caused by closure of the atrioventricular valves (loudest at the apex of the heart)  
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Atrioventricular valves   Tricuspid and mitral  
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S2 (dub)   Second sound. Beginning of ventricular diastole; caused by closure of the semilunar valves (loudest at the base of the heart)  
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Semilunar valves   Aortic and pulmonic  
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Purpose of heart valves   Keep blood moving forward and prevent regurgitation.  
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Arteries   Carry oxygenated blood away from the heart to the tissues.  
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Pulmonary arteries   Carry oxygenated blood toward the heart from the lungs.  
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Veins   Carry unoxygenated blood toward the heart from the tissues.  
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Pulmonary veins   Carry unoxygenated blood away from the heart into the lungs.  
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Stroke Volume   Amount of blood ejected from the heart with each beat (SV)  
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Heart Rate   Number of beats in each minute (HR)  
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Preload   Volume of blood in ventricles at the end of the diastolic period (end diastolic pressure)  
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Afterload   Resistance the ventricles must overcome to circulate blood. Ventricles must generate sufficient pressure to overcome vascular resistance.  
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Best way to listen for S3 and S4   Have patient roll partially onto their left side.  
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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.  
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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.  
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Heart failure   When the heart cannot pump enough blood to meet the metabolic needs of the body.  
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Brain Natriuretic Peptide (BNP)   A hormone produced mainly by the left ventricle of the heart in response to increased ventricular volume pressure.  
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Normal BNP   Below 100 pg/mL (100 - 300 pg/mL indicates heart failure)  
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Left sided heart failure causes this   Pulmonary vessel congestion  
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Right sided heart failure causes this   Systemic vessel problems such as: JVD, hepatosplenomegaly, right upper quadrant pain, edema, weight gain, anorexia, nausea.  
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Types of treatments for heart failure   Treat underlying cause, beta blockers, nitrates, Digoxin, Ace Inhibitors, Oxygen, morphine.  
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Signs and symptoms of Impaired Tissue Perfusion   5 P's: Pulse, Pallor, Pain/Parethesia, Paralysis, Polar (cool extremities)  
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Fully saturated hemoglobin requires this   All four heme groups are bound to oxygen.  
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Sinus Arrhythmia   A normal variation in heart rate. Common in infants and young children, often increasing and decreasing with each breath.  
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Atherosclerosis   Build up of fatty plaques within the arteries  
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Primary contributor to Cardio Vascular Disease (CVD) and cause of impaired blood flow to organs and tissues?   Atherosclerosis  
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Leading cause of death in North America   CVD  
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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  
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Peripheral Vascular Resistance (PVR)   Impedes or opposes blood flow to the tissues.  
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Nonmodifiable Traditional Risk Factors of CVD   Heredity, Age, Gender  
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Modifiable Traditional Risk Factors of CVD   Elevated serum lipid level, Hypertension, Cigarette smoking, Diabetes, Obesity, Sedentary lifestyle  
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Myocardial infarction (MI)   Heart attack  
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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.  
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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.  
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Ischemia   Lack of blood supply due to obstructed circulation.  
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Cause of myocardial ischemia   Partial obstruction of coronary arteries  
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Complete obstruction of coronary artery causes this.   Results in MI (heart attach)  
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Cause of Transient Ischemic Attach (TIA)   Partial obstruction of cerebral vessels  
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Cause of a Stroke (Cerebralvascular Accident)   Complete obstruction of cerebral vessels  
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Peripheral Vascular Disease leads to what?   Ischemia of distal tissues such as the legs and feet. Gangrene and amputation may result.  
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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  
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Pulmonary Embolism (PE)   An embolism that gets trapped in small pulmonary vessels, occludes blood supply to the capillary membrane so no gas exchange occurs.  
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Enzymes released in blood during an MI   Creatine kinase (CK) and troponin. Elevated levels of these can help differentiate the source of the pain.  
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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.  
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