Cardio Vascular

Front 1

The ability of the Ventricles to efficiently eject blood out of the Heart and into the Systemic and Pulmonary circulations, is called?

Back 1

Systolic Function

Front 2

Decreased Systolic Function is an indicator of heart diseases, such as? (5)

Back 2

HTN (high blood pressure)

MyoCardial Infarction (heart attack)

Ischemia (lack of oxygen)

Congestive Heart Failure (CHF)

CardioMyopathy (heart muscle disease/abnormality)

Front 3

What are 3 symptoms of a decreased Systolic Function?

Back 3

Chest pain

SOB

DOE (dyspnea upon exertion)

Front 4

The ability of the Ventricles to relax and fill is called?

Back 4

Diastolic Function

Front 5

What indicates whether the Ventricle filling pressure is normal or increased?

Back 5

Ventricular end-diastolic pressure

(RVEDP, LVEDP)

Front 6

__________________ function can precede ____________________ dysfunction.

Back 6

decreased diastolic

systolic

Front 7

Failure of the Ventricle to relax and allow normal filling, is called?

Back 7

decreased diastolic function

Front 8

True/False:

Decreased systolic or diastolic function are indicators of Heart disease and related symptoms.

Back 8

True

Front 9

Regarding Doppler, which wave of the Mitral valve represents the suction into the Heart from the LA into the LV?

Back 9

E-wave (cm/s)

Front 10

What does the E-wave of the Mitral valve in Doppler represent?

Back 10

suction into the Heart from the LA into the LV

Front 11

Which area of the Mitral valve do you place the cursor in order to obtain the sucking effect or early filling during Doppler?

Back 11

leaflet tips

(obtains the E and A wave)

Front 12

Measurement of the E wave of the Mitral valve is used to obtain?

Back 12

early filling of the LV from the LA

sucking effect

Front 13

What is the normal E-wave velocity of the Mitral valve?

Back 13

1.3 cm/s

Front 14

Which wave in Doppler of the Mitral valve represents early filling with active relaxation?

Back 14

E-wave (cm/s)

(want it to be tall)

Front 15

During ________________ the Ventricles of the Heart are at rest.

Back 15

diastole

Front 16

During ______________________ there is passive filling from the Left Atrium into the Left Ventricle.

Back 16

diastole

(75% of filling)

Front 17

Which Doppler wave of the Mitral valve represents Atrial contraction?

Back 17

A-wave

Front 18

What percentage of filling happens during Atrial contraction?

Back 18

10-30%

Front 19

Which 4 factors determine the function/dysfunction of Systole or Diastole?

Back 19

1. How well the Walls are thickening during Systole (is hypertrophy present)
2. Concentric Wall motion
3. Chamber size
4. Ventricular end-diastolic pressure
   

Front 20

True/False:

When there is a large quantity of blood in a chamber, it can stretch the muscle fibers and cause the chamber to lose it's ability to comply.

Back 20

True

Front 21

Which area(s) conduct the emptying of the Ventricles?

Back 21

RVOT

LVOT

Front 22

Narrowing of the _________________ or _________________ would affect the performance of the Ventricles.

Back 22

RVOT

LVOT

Front 23

Normal wall thickening/motion is known as?

Back 23

Contractility

Front 24

An indication of adequate coronary blood flow and oxygenation is?

Back 24

Contractility

(normal wall thickening/motion)

Front 25

Normal viable working Ventricular walls should concentrically thicken and contract during?

Back 25

Systole

Front 26

During systole, the Ventricle walls should concentrically thicken and contract _________% toward the center of the chamber.

Back 26

approx 30%

Front 27

Normal viable working Ventricle walls should ________________ thicken and contract during systole.

Back 27

concentrically

(all walls at the same time)

Front 28

During ______________, normal walls should concentrically thin and relax.

Back 28

diastole

Front 29

During diastole, normal walls should _________________ thin and relax.

Back 29

concentrically

(all walls at the same time)

Front 30

During diastole, normal walls should concentrically _____________ and _____________.

Back 30

thin

relax

Front 31

Indirectly, we can examine _________________________________by evaluation of a chambers wall motion.

Back 31

coronary blood flow

*if the lateral LV wall in an apical 2 is abnormal, something may be wrong with the circumflex vessel

*if the apex of the heart is abnormal, something may be wrong with the LAD vessel

Front 32

Ejection Fraction and __________________________ can be used to determine systolic and diastolic function.

Back 32

Fractional Shortening

Front 33

Cardiac walls that do not thicken and contract properly are considered to have?

Back 33

Wall Motion Abnormality (WMA)

Front 34

Wall Motion Abnormality (WMA) could be an indication of localized or global?

Back 34

Ischemia (lack of oxygen from the coronary vessels)

Front 35

Excessive wall motion is called?

Back 35

Hyperkinetic

Front 36

Decreased wall motion is called?

Back 36

Hypokinetic

Front 37

No wall movement or thickening of the Myocardium, is known as?

Back 37

Akinetic

Front 38

Wall movement away from the center of the cavity, is known as?

Back 38

Dyskinetic

Front 39

Normal viable chambers should concentrically ________________ in size during systole.

Back 39

decrease

Front 40

Normal viable chambers should concentrically ________________ in size during diastole.

Back 40

increase

Front 41

What corresponds to the degree of muscle fiber stretch in the ventricles?

Back 41

LV end-diastolic pressure (LVEDP)

RV end-diastolic pressure (RVEDP)

Front 42

RV end-diastolic pressure (RVEDP) is equivalent to?

Back 42

Mean RA pressure

Front 43

LV end-diastolic pressure (LVEDP) is equivalent to?

Back 43

Mean LA pressure

Front 44

The degree of ___________________ depends on the quantity of blood in the chamber prior to contraction.

Back 44

muscle fiber stretch

Front 45

The degree of muscle fiber stretch depends on the quantity of blood in the chamber prior to ____________________.

Back 45

contraction

Front 46

The degree of muscle fiber strength depends on the _________________________ in the chamber prior to contraction.

Back 46

quantity of blood

Front 47

The greater the amount of blood entering the chamber, the __________________ the contraction required to expel the blood.

Back 47

greater

Front 48

The __________________ the amount of blood entering the chamber, the greater the contraction required to expel the blood.

Back 48

greater

Front 49

What can be determined by Doppler examination of the blood flow through the TV, PV, MV, AoV?

Back 49

RVEDP

LVEDP

Front 50

The quantity of blood filling a chamber is also responsible for the amount of ____________________that is applied to the chamber walls.

Back 50

pressure

Front 51

Equation:

LVEDP =

Back 51

LVEDP = diastolic pressure - AoV press. gradient

*AoV pressure gradient = 4V sqd

(V is the velocity of aortic regurge jet)

Front 52

The greater the amount of blood entering a chamber the greater the amount of ______________ that is applied.

Back 52

contraction

Front 53

What is the Bernoulli equation?

Back 53

4V sqd.

Front 54

Equation:

AoV pressure gradient =

Back 54

AoV PG = 4V sqd

(Bernoulli equation)

*V is the velocity of the aortic regurge jet

Front 55

Equation:

RVEDP =

Back 55

RVEDP= 4V sqd + RAP

*V is the velocity of the pulmonary regurge jet

*right atrial pressure (RAP) = 10mmHg

Front 56

True/False:

RAP = 10 mmHg in the presence of Tricuspid regurge.

Back 56

False

*RAP = 10 mmHg in the ABSENCE of TR

Front 57

During ________________, the body's demand for oxygen will increase dramatically.

Back 57

exercise

Front 58

During exercise, the heart increases the supply of _____________________ blood to the body.

Back 58

oxygenated

Front 59

What is the normal range for heart beats per minute?

Back 59

60-100 bpm

Front 60

During exercise, there is a(n)_______________ in heart rate, and a(n) ________________ in stroke volume.

Back 60

increase

increase

Front 61

Name the 4 LV function indicators.

Back 61

Stroke volume

Doppler stroke volume

Ejection fraction

Cardiac output

Front 62

The volume of blood ejected with each contraction (heart beat), is called?

Back 62

Stroke volume

Front 63

What 3 factors of a patient is Stroke volume dependent upon?

Back 63

Body habitus (size)

HR

LV end-diastolic volume (LVEDV)

Front 64

What is the normal range for a resting Stroke volume?

Back 64

70-110 ml

Front 65

True/False:

Women usually have a higher Stroke volume than Men.

Back 65

False

*Men have a higher stroke volume than women

Front 66

The Heart rate represents the blood flow entering the ______________________.

Back 66

Left Ventricle

Front 67

The greater the LV end-diastolic volume, the ________________ the Stroke volume.

Back 67

greater

Front 68

The greater the Heart rate, the ________________ the Stroke volume.

Back 68

greater

Front 69

Equation:

Stroke volume =

Back 69

SV = EDV - ESV

*end-diastolic volume

*end-systolic volume

Front 70

What are the 4 ways to calculate the Ejection Fraction?

Back 70

BiPlane Simpson Rule

2D echo M-Mode

Cardiac Angio

Cardiac Nuclear Study (stress test)

Front 71

What is the normal Ejection Fraction range?

Back 71

> 55%

*previous test stated 55% - 65%

Front 72

Equation:

Ejection Fraction =

Back 72

EF = SV / EDV x 100

*end-diastolic volume (EDV)

*stroke volume (SV) = EDV - ESV

Front 73

*Boards

Equation:

Doppler Stroke volume =

Back 73

Doppler SV = VTI x CSA

*velocity time integral

*cross sectional area

**VTI = FVI (flow velocity integral)**

VTI or FVI trace Doppler spectral

CSA = 3.14(d/2) sqd. or 0.785(d) sqd.

*d=diameter

Front 74

How do you calculate the Velocity Time Integral (VTI) or Flow Velocity Integral (FVI)?

Back 74

tracing the Doppler Spectral display

Front 75

What does the Velocity Time Integral (VTI) and Flow Velocity Integral (FVI) represent?

Back 75

how far the blood travels in cm with each ejection

Front 76

What is a normal Mitral valve VTI or FVI?

Back 76

12 cm

Front 77

What is a normal Aortic Valve VTI or FVI?

Back 77

20 cm

Front 78

Equation(s):

Cross Sectional Area (CSA) (cm sqd)=

Back 78

either...

CSA = 3.14(D/2) sqd

CSA = 0.785(D) sqd

*D is for diameter

*3.14 = Pi

Front 79

Term for the volume of blood being pumped from the Left Ventricle each minute is?

Back 79

Cardiac Output

*combination of SV and HR

Front 80

What is the normal range of Cardiac Output?

Back 80

4 - 8 L/min

*varies w/ BSA

Front 81

What is Cardiac Output dependent upon?

Back 81

Body Surface Area (BSA)

Front 82

Volume of blood ejected each minute is called?

Back 82

Cardiac output

Front 83

Equation:

Cardiac output (L/min) =

Back 83

CO = (SV x HR) / 1000

*SV = EDV - ESV

Front 84

The Heart's ability to increase the Cardiac output is dependent upon which 4 factors of the overall cardiac function?

Back 84

Preload

Afterload

Inotropic force

Chronotropic force

Front 85

The Volume exerted on the Ventricle at end-diastole, is called?

Back 85

Preload

*volume is equivalent to load

Front 86

What determines the force of contraction?

Back 86

Preload (volume)

Front 87

What is the Frank-Starling Law?

Back 87

the greater the load, the greater the force of contraction (contractility)

Front 88

The greater the load (volume), the greater the force of contractility (contraction) needed, is known as?

Back 88

Frank-Starling Law

Front 89

During Preload (volume) the chambers will be ______________ and the walls will be ____________.

Back 89

dilated

thin

Front 90

What are 3 main causes of an increase in Preload?

Back 90

Regurgitation (MR,TR,AR,PR)

Fluid overload

Septal defects (VSD, ASD)

Front 91

As the Heart fills with more blood than usual, the force of the muscular contractions will increase, this is known as?

Back 91

Frank-Starling Law

Front 92

What is the result of an increase in load experienced by each muscle fiber due to the extraneous blood entering the Heart?

Back 92

Frank-Starling Law

*the force of the muscular contractions will increase

Front 93

The stretching of the chambers muscle fibers due to extraneous blood entering the Heart causes?

Back 93

increased contractile force of the cardiac muscle

*Frank-Starling Law

Front 94

In Frank-Starling's Law, the force that any single muscle fiber generates, is proportional to?

Back 94

initial length (aka Preload)

Front 95

In Frank-Starling's Law, the stretch on the individual muscle fibers, is related to?

Back 95

Ventricular End-Diastolic Volume

(LVEDV or RVEDV)

Front 96

If there is an increase in volume (preload), then there will be a _______________ in contractility.

Back 96

increase

*length-tension relationship

Front 97

If there is an increase in myocardial fiber length, then there will be ________________ tension.

Back 97

increased

*length-tension relationship

Front 98

True/False:

Stretching of the Heart fibers loses their ability to do work.

Back 98

True

Front 99

During exercise, blood rushes towards the Heart from the __________________ muscles.

Back 99

peripheral

Front 100

True/False:

During exercise, the increased venous flow fills the atria and then the ventricles to a greater extent than which occurs at rest.

Back 100

True

Front 101

Increased filling stretches individual muscle fibers of the ventricles causing the Heart to produce ______________________ to pump the blood?

Back 101

more forceful contractions

Front 102

The Heart has to pump more blood in response to a(n) ____________________ venous inflow.

Back 102

increased

Front 103

Electrically, what causes early emptying of the Left Ventricle into the Aorta?

Back 103

Premature Ventricular Contraction (PVC)

*diastole sets up systole

Front 104

Due to a Premature Ventricular Contraction, the following contraction comes at it's regular timing so the filling time of the Left Ventricle increases causing an?

Back 104

increased LVEDV

Front 105

Because of the Frank-Starling Law, the ventricular contraction following a PVC will be?

Back 105

more forceful

Front 106

Because of the Frank-Starling Law, the ventricular contraction following a PVC will be more forceful, causing an ejection of the larger volume from the LV and bringing the LVESV?

Back 106

back to the baseline

Front 107

In regards to the Frank-Starling Law, ________________ Aortic Insufficiency is hyperdynamic and hypercontractile.

Back 107

Acute AI

*hyper = increase

*shifts UP the curve (graph)

Front 108

In regards to the Frank-Starling Law, _____________________ Aortic Insufficiency is hypocontractile and can result in heart failure.

Back 108

Chronic AI

*hypo = decrease

*shifts downward on the curve (graph)

Front 109

_________________ Aortic Insufficiency damages the myocardium.

Back 109

Chronic AI

Front 110

_________________ Aortic Insufficiency stretches the muscle fibers resulting in heart failure.

Back 110

Chronic AI

Front 111

An enlarged Left Ventricle will have a _______________ Ejection Fraction.

Back 111

low

*wall contraction will have very little compliance

Front 112

If a patient has Dilated Cardio Myopathy, their Ejection Fraction will be?

Back 112

low

*wall contraction will have very little compliance

Front 113

Abnormally increased muscular activity, is called?

Back 113

Hyperdynamics

Front 114

Abnormally decreased muscular activity, is called?

Back 114

Hypodynamics

Front 115

Abnormal increase in contraction force, is called?

Back 115

Hypercontractile

Front 116

____________________ dilates the chamber and causes thin walls.

Back 116

Preload (volume)

*large volume

Front 117

Resistance against which the ventricle must pump, is called?

Back 117

Afterload (pressure)

Front 118

Anything that increases Left Ventricle pressure will __________________ the afterload.

Back 118

increase

Front 119

What determines the tension that the Myocardium must generate?

Back 119

Afterload (pressure)

Front 120

_________________ causes hypertrophy (enlarge muscle).

Back 120

Afterload (pressure)

Front 121

An increase in force will __________________ the velocity.

Back 121

decrease

*force-velocity relationship

Front 122

As the force generated by the heart muscle increases, there is a(n) _________________ in the velocity of muscle fiber shortening.

Back 122

decrease

Front 123

What are 3 main causes of an increase in afterload (pressure)?

Back 123

Hypertension (high blood pressure)

AS

PS

Front 124

If the Heart rate increases, contractions will __________________.

Back 124

increase

*interval-strength relationship

Front 125

The strength of a beat is related to the ___________________________ preceding that beat.

Back 125

diastolic interval

Front 126

The strength of a beat is related to the diastolic interval ______________ that beat.

Back 126

preceding

Front 127

The longer the diastolic interval of a heart beat, the _________________ the contraction.

Back 127

longer

Front 128

The ___________________ the diastolic interval of a heart beat, the longer the contraction.

Back 128

longer

Front 129

True/False:

Diastole sets up Systole.

Back 129

True

Front 130

The beat following a PVC is forceful due to the _____________________ following the PVC.

Back 130

long diastolic interval

*compensatory pause

Front 131

The beat following a PVC is forceful due to the compensatory pause following the PVC. This is known as?

Back 131

Post-Extra-Systolic Potentiation