Cardiology

Front 1

mediastinum

Back 1

location of heart in chest between the lungs that also includes the superior and inferior vena cava, aorta, trachea, mainstem bronchi and part of the esophagus

Front 2

3 tissue layers of the heart

Back 2

endocardium (innermost)
myocardium (middle layer)
pericardium (protective outer sac)

Front 3

ventricles

Back 3

two lower chambers

Front 4

atria

Back 4

two upper chambers

Front 5

mitral valve

Back 5

located between left atrium and ventricle

Front 6

tricuspid valve

Back 6

located between right atrium and ventricle

Front 7

aortic valve

Back 7

located between left ventricle and the aorta

Front 8

pulmonary valve

Back 8

located between right ventricle and pulmonary artery

Front 9

right atrium

Back 9

receives deoxygenated blood from body via superior and inferior vena cavae

Front 10

right ventricle

Back 10

sends deoxygenated blood to the lungs via the pulmonary artery

Front 11

pulmonary veins

Back 11

return oxygenated blood to the left atrium

Front 12

left ventricle

Back 12

pumps oxygenated blood to the body via the aorta

Front 13

arteries

Back 13

pump oxygenated blood from the heart to the tissues

Front 14

veins

Back 14

transport deoxygenated blood from the tissues back to the right atrium

Front 15

coronary arteries

Back 15

originates from the aorta and spread over the heart to supply the heart muscle its nutrients

Front 16

diastole

Back 16

relaxation phase at the end of a cardiac contraction

Front 17

systole

Back 17

the contraction phase

Front 18

stroke volume

Back 18

amount of blood ejected in one contraction (average 70ml)

Front 19

ejection fraction

Back 19

percentage of blood ejected from ventricle in a contraction (normally about 2/3)

Front 20

preload

Back 20

end-diastolic volume that influences the force of the next contraction because of the stretch it exerts. return of blood to the heart

Front 21

afterload

Back 21

resistance against which the heart muscle must pump. (increase in peripheral vascular resistance will increase afterload and decrease stroke volume; a decrease in resistance will increase stroke volume)

Front 22

Starling's Law

Back 22

the more myocardial muscle is stretched, up to a certain amount, the greater its force of contraction will be

Front 23

cardiac output

Back 23

amount of blood ejected in one minute. Cardiac output is the stroke volume times the heart rate

Front 24

catecholamines

Back 24

epinephrine and norepinephrine (raise heart rate and contractile force)

Front 25

sympathetic nervous system

Back 25

part of the autonomic nervous system; fight or flight...raises heart rate and contractile force; epi - Alpha 1 vasoconstriction Beta 1 ino, dromo, and chronotropic; norepi; adrenergic - Beta2 bronchodilation and GI smooth muscle dilation

Front 26

parasympathetic nervous system

Back 26

part of the autonomic nervous system. Works in opposition to sympathetic nervous system to maintain homeostasis. decreases heart rate and contractile force.

Front 27

chronotropic

Back 27

referring to heart rate. epi has a positive chronotropic effect. Acetycholine has a negative chronotropic effect

Front 28

inotropic

Back 28

referring to heart contractile strength

Front 29

dromotropic

Back 29

referring to rate of nervous impulse conduction

Front 30

cardiac electrolytes

Back 30

sodium (Na+), calcium (Ca++), potassium (K+), chloride (Cl-), and magnesium (Mg++)

Front 31

sodium

Back 31

depolarizes the myocardium

Front 32

calcium

Back 32

takes part in myocardial depolarization and contraction

Front 33

potassium

Back 33

influences repolarization

Front 34

capillaries

Back 34

connect arteries and veins

Front 35

intercalated discs

Back 35

connect cardiac muscle fibers and conduct electrical impulse quickly from one muscle fiber to the next.

Front 36

AV bundle

Back 36

conducts impulses from the atria to the ventricles

Front 37

sodium potassium pump

Back 37

expels sodium from the cell leaving the inside of the cell more negatively charged than the outside.

Front 38

myocardial cell stimulation

Back 38

changes the cell membrane to allow positively charged ions to rush into the cell, giving the inside of the cell a greater positive charge than the outside. (also known as the action potential)

Front 39

resting potential

Back 39

when the inside of the cell is more negatively charged than the outside (sodium is expelled)

Front 40

cardiac depolarization

Back 40

change from the resting potential to the action potential, leaving the cell more positively charged. Contraction of the cardiac muscle follows this

Front 41

cardiac conductive system

Back 41

stimulates the ventricles to depolarize in the proper direction

Front 42

excitability

Back 42

allows cells to respond to an electrical stimulus

Front 43

conductivity

Back 43

allows cells to propagate the electrical impulse from cell to cell (conduction)

Front 44

automaticity

Back 44

self-excitation (cells can depolarize without any outside impulse)

Front 45

SA node

Back 45

Sinoatrial node - generally the cell with the fastest rate of discharge and known as the "pacemaker".

Front 46

contractility

Back 46

allows the cells to contract or constrict

Front 47

cardiac causes of jvd

Back 47

cardiac tamponade or pump failure

Front 48

bruits

Back 48

murmurs in the carotid arteries which are a sign of turbulent blood flow through a vessel, indicates partial blockage of the vessel (atherosclerosis)

Front 49

ECG paper - 1 small box

Back 49

represents 0.04 sec

Front 50

ECG paper - 1 large box

Back 50

represents 0.20 sec

Front 51

ECG paper - 15 large boxes

Back 51

3 seconds

Front 52

P wave

Back 52

represents atrial depolarization

Front 53

QRS complex

Back 53

represents ventricular depolarization

Front 54

T wave

Back 54

represents repolarization of the ventricles

Front 55

U wave

Back 55

only occur occasionally; represent electrolyte abnormalities

Front 56

PR interval

Back 56

represents time the impulse takes to travel from the atria to the ventricles (should be 0.12 - 0.20 sec)

Front 57

QRS interval

Back 57

represents the time necessary for ventricular depolarization (should be 0.04 - 0.12 sec)

Front 58

normal sinus rhythm

Back 58

hr 60-100; rhythm regular;p waves normal; PR interval lasts 0.12 to 0.20 sec; QRS complex has normal morphology and a duration of <0.12 sec

Front 59

dysrhythmia

Back 59

any deviation from the heart's normal electrical rhythm

Front 60

arrhythmia

Back 60

absence of cardiac electrical activity

Front 61

sinus bradycardia

Back 61

slowing of the SA node

Front 62

sinus tachycardia

Back 62

increased rate of the SA node discharge

Front 63

ventricular tachycardia

Back 63

VT; three or more ventricular complexes in succession at a rate of 100 beats per min or higher

Front 64

ventricular fibrillation

Back 64

chaotic ventricular rhythm resulting from presence of many reentry circuits within the ventricles; there is no ventricular depolarization or contraction; a lethal dysrhythmia

Front 65

asystole

Back 65

cardiac standstill; the absence of all cardiac electrical activity; usually associated with myocardial infarction and is often the final outcome of ventricular fibrillation

Front 66

pulseless electrical activity

Back 66

PEA; electrical activity is present and identifiable on the cardiac monitor but with no accompanying mechanical contractions of the heart; monitor may show perfect normal sinus rhythm but patient will be pulseless

Front 67

defribrillation

Back 67

process of passing a current through a fibrillating heart to depolarize the cells and allow them to repolarize uniformally, restoring an organized cardiac rhythm

Front 68

angina pectoris

Back 68

pain in the chest; coronary arteries cannot deliver an adequate amount of blood to the myocardium during periods of increased oxygen demand; causes myocardial ischemia and chest pain

Front 69

atherosclerosis

Back 69

plaque that develops within the coronary arteries and decreases blood flow to the heart.

Front 70

ischemia

Back 70

decreased supply of oxygenated blood to a body part or organ

Front 71

stable angina

Back 71

occurs during activity when the heart's oxygen demands are increased and stops when activity is ceased

Front 72

unstable angina

Back 72

occurs at rest; also called preinfarction angina as the patient's disease process is worsening and the risk of myocardial infarction is significant

Front 73

myocardial infarction

Back 73

death of a portion of the heart muscle from prolonged deprivation of oxygenated arterial blood

Front 74

heart failure

Back 74

clinical syndrome in which the heart's mechanical performance is compromised so that cardiac output cannot meet the body's needs

Front 75

left ventricular failure

Back 75

causes back pressure of blood into the pulmonary circulation resulting in pulmonary edema

Front 76

right ventricular failure

Back 76

causes back pressure of blood into the systemic venous circulation and venous congestion (JVD)

Front 77

pulmonary embolism

Back 77

PE; blood clot in oneof the pulmonary arteries; can cause right heart failure

Front 78

congestive heart failure

Back 78

heart's reduced stroke volume causes an overload of fluid in the body's other tissues presenting as edema

Front 79

paroxysmal nocturnal dyspnea

Back 79

(PND) acute or progresive shortness of breath at night caused by pulmonary edema

Front 80

cardiogenic shock

Back 80

most severe form of pump failure; the inability of the heart to meet the metabolic needs of the body resulting in inadequate tissue perfusion

Front 81

cardiac arrest

Back 81

the absence of ventricular contractions

Front 82

sudden death

Back 82

death within 1 hour after the onset of symptom

Front 83

down time

Back 83

duration from the beginning of the cardiac arrest until effective cpr is established

Front 84

total down time

Back 84

duration from the beginning of arrest until the patient's delivery to the ER

Front 85

resuscitation

Back 85

provision of efforts to return a spontaneous pulse and breathing

Front 86

return of spontaneous circulation

Back 86

ROSC the return of a spontaneous pulse after a period of full cardiac arrest

Front 87

survival

Back 87

when a patient is resuscitated and survives to be discharged from the hospital

Front 88

aneurysm

Back 88

the ballooning of an arterial wall resulting from a defect or weakness in the wall

Front 89

abdominal aortic aneurysm

Back 89

rupture of the abdominal aorta; commonly the result of atherosclerosis; most frequently below the renal arteries and above the bifurcation of the common iliac arteries; ten times more common in men than in women and most prevalent between ages of 60 and 70

Front 90

dissecting aortic aneurysm

Back 90

aneurysm caused when blood gets between and separates the layers of the aortic wall

Front 91

cystic medial necrosis

Back 91

a death or degeneration of a part of the wall of an artery

Front 92

acute pulmonary embolism

Back 92

blockage that occurs when a blood clot or other particle lodges in a pulmonary artery

Front 93

endocardium

Back 93

innermost layer of the heart that lines the chambers

Front 94

myocardium

Back 94

heart muscle; middle layer that generates and conducts electrical impulses, causing the heart to contract

Front 95

pericardium

Back 95

protective sac surrounding the heart that anchors it in the mediastinum and prevents overdistention of the heart

Front 96

sodium

Back 96

plays the most major role in cardiac depolarization

Front 97

starlings law

Back 97

more myocardium is stretched, to a certain point, the stronger the next contraction will be. The preload affects the next beat.

Front 98

blood pressure

Back 98

cardiac output times systemic vascular resistance

Front 99

electrical property of cardiac cells

Back 99

excitability, conductivity, contractility, automaticity

Front 100

automaticity

Back 100

ability of cardiac cells to generate it own electric impulse

Front 101

order of electrical conduction of heart

Back 101

SA node = 60-100 bpm
AV node = 45-50 bpm
bundle of his = 40-45 bpm
left and right bundle branches = 40-45 bpm
purkinje fibers = 35-40 bpm
myocardial cells = 30-35 bpm

Front 102

depolarization

Back 102

myocardial cell receives a stimulus from the conduction system and sodium rushes into the cell and calcium enters it more slowly, causing it to become more positively charged and causing contraction as conduction moves along the muscle. This process is also known as excitation-contraction coupling.

Front 103

repolarization

Back 103

electrolyte change utilizing the sodium potassium pump. pumps out potassium, and sodium entry slows and then is pumped out as potassium is pumped back in. calcium is returned to storage sites in the cells and the cells become negatively charged again returning to the polarized state. heart is ready to go; gets charge and is at rest.

Front 104

ecg

Back 104

graph of the electrical activity of the heart. Does NOT show mechanical activity....can have electrical activity without any mechanical activity (contractions) i.e. PEA

Front 105

PEA

Back 105

pulseless electrical activity; electrical activity without any contractions (no mechanical activity)

Front 106

isoelectric line

Back 106

asystole; absence of electrical activity

Front 107

ecg upward curve

Back 107

positive deflection

Front 108

ecg downward curve

Back 108

negative deflection

Front 109

systole

Back 109

contraction of the ventricular mass and the pumping of blood into the systemic circulation

Front 110

t wave represents?

Back 110

resting, diastolic pressure

Front 111

jvd in trauma

Back 111

left heart failure

Front 112

CABG

Back 112

coronary artery bypass graft

Front 113

extrinsic risk factor

Back 113

smoking, diet, excercise, lifestyle

Front 114

intrinsic risk factor

Back 114

hereditary,

Front 115

tricuspid valve

Back 115

separates right atrium from the right ventricle

Front 116

bicuspid valve

Back 116

(mitral valve) separates the left atrium from the left ventricle

Front 117

pulmonic valve

Back 117

semilunar valve that regulates blood flow between the right ventricle and the pulmonary artery

Front 118

aortic valve

Back 118

semilunar valve that regulates blood flow from the left ventricle to the aorta

Front 119

pulmonary vein

Back 119

only vein that carries oxygenated blood

Front 120

pulmonary artery

Back 120

only vein that carries deoxygenated blood

Front 121

S1

Back 121

AV valves closing ("lub")

Front 122

S2

Back 122

semilunar valves closing (aortic and pulmonic valves)

Front 123

S3

Back 123

murmur

Front 124

chordae tendinae cordis

Back 124

small muscular strands that attach the ventricles and the valves preventing regurgitation of blood through the valves from the ventricles to the atria

Front 125

tunica intima

Back 125

the endothelium (smooth, thin inner lining of vessel)

Front 126

tunica media

Back 126

middle layer of vessel comprised of elastic tissue and smooth muscle cells that allow the vessels to contract or expand in response to body demands. Arterial vessels have a thicker middle layer in order to have stronger contractability

Front 127

Dyspnea on exertion

Back 127

shortness of breath during activity which is relieved from inactivity

Front 128

tunica adventitia

Back 128

the outer layer of a vessel that consists of elastic and fibrous connective tissue

Front 129

baroreceptors

Back 129

located in brain, kidneys, blood vessels, and aortic arch that monitor the pressure in the heart and main arteries

Front 130

chemoreceptors

Back 130

located in blood vessels, kidneys, brain, and heart that respond to changes in the chemical composition of the blood

Front 131

alpha effects

Back 131

vasoconstriction

Front 132

beta 1 effects

Back 132

Beta1 = increased heart rate (chronotropic), conductivity (dromotropic), and contractility (inotropic)

Front 133

beta 2 effects

Back 133

bronchodilation and GI smooth muscle dilation

Front 134

chain of survival

Back 134

1. recognition of early warning signs and immediate activation of EMS
2. immediate bystander CPR
3. early defribrillation
4. early advanced cardiac life support.

Front 135

three portions of the aorta

Back 135

1. ascending - coronary arteries
2. aortic arch - left carotid, left subclavian, and brachio-cephalic
3. descending - thoracic/abdominal

Front 136

arteriosclerosis

Back 136

thickening of arterial walls that results in a loss of elasticity and reduction in blood flow

Front 137

coronary arteries

Back 137

supply blood to the heart muscle and work differently than other arteries in that they get their blood flow in the resting phase of the heart. Blood leaves aorta and backflows into the openings of the coronary arteries during diastole

Front 138

visceral layer of pericardium

Back 138

lies closest to heart (epicardium)

Front 139

parietal layer of pericardium

Back 139

outer layer that separates visceral pericardium by a small amount of fluid (pericardial fluid)

Front 140

interatrial septum

Back 140

membrane that separates the two atria

Front 141

interventricular septum

Back 141

separates the right and left ventricles

Front 142

atrium

Back 142

upper chamber of heart that receives blood from other parts of the body (right - from body, left - from lungs)

Front 143

ventricles

Back 143

pump blood out of heart to the body (right - to lungs, left - to body)

Front 144

fossa ovalis

Back 144

former location of the foramen ovale which was an opening between the atria present in a fetus that closes immediately after birth

Front 145

vena cava

Back 145

two large veins, inferior(largest) and superior which return deoxygenated blood from the body to the heart. Inferior - lower body and superior - upper body

Front 146

aorta

Back 146

body's largest artery that sends blood throughout the body

Front 147

left ventricle

Back 147

strongest and largest part of the four cardiac chambers as it is responsible for pumping blood throughout the body

Front 148

heart sounds

Back 148

closing of valves. S1 is the sudden closure of the mitral and tricuspid valves; S2 is the closure of both the pulmonary and aortic valves at the end of the ventricular contraction; S3 is typically a murmur

Front 149

six parts of the cardiac conduction system

Back 149

SA node, AV node, bundle of His, right and left bundle branches, and the Purkinje fibers

Front 150

catecholamines

Back 150

epi and norepi (Sympathetic Nervous System) endogenous hormones. Epi - beta receptors (inotropic, dromotropic, chronotropic) norepi - alpha receptors - vasoconstriction

Front 151

cholinergic fiber

Back 151

secretes acetylcholine; parasympathetic nervous system response

Front 152

adrenergic fiber

Back 152

secretes norepinephrine; sympathetic nervous system response

Front 153

ECG lead placement

Back 153

white on right upper chest, red over left lower chest, black on left upper chest

Front 154

STEMI

Back 154

This more severe type of heart attack is usually recognized by characteristic changes it produces on the ECG. One of those ECG changes is a characteristic elevation in what is called the "ST segment." The elevated ST segment indicates that a relatively large amount of heart muscle damage is occurring (because the coronary artery is totally occluded), and is what gives this type of heart attack its name. ST elevated Myocardial Infarction (STEMI)