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60 Cards in this Set
- Front
- Back
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What is the Carotid Sheath made of?
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3 structures
1. Internal Jugular vein(lateral) 2. Common carotid artery(middle) 3. Vagus nerve (posterior) |
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In the majority of cases what supplies the SA and AV node is supplied by...
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RCA (80% of the time)
RCA supplies the inferior part of the left ventricle by the PD artery(rt dominant) |
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What abt 20% of the time, what supplies the SA and AV node?
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the PD arises from the CFX
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Where does coronary artery occlusion most commonly occur?
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LAD
which supplies the anterior interventricular septum |
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When do the coronary arteries fill?
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Diastole
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What is the most posterior part of the heart?
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Left atrium
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What does the enlargement of the left atrium cause?
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Dysphagia
due to compression of the esophageal nerve or hoarseness due to compression of therecurrent laryngeal nerve, a branch of the vagus |
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What are the two branches of the root of the atria>
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Left main and right main
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What does the left main branch of into
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LAD and the Circumflex
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What does the LAD supply?
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2/3 of the intervent
ant wall of the LV ant papillary muscle |
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What does the circumflex supply?
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lat posterior wall of the LV
(10% of the time its PDA) |
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What does the Right main divide into?
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SA and AV node arteries
PDA(85-90% of the time) |
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What does the PDA supply?
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inferior wall of the LV, diaphragmatic part of the heart
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What is CO?
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the amt of blood pumped out of the heart per minute
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How do you calculate CO?
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CO- SV x HR
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CO=
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rate of consumption/arterial O2-venous O2 content
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During exercise, CO increases initially bec...
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increased SV
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After prolonged exercise, CO will remain increased bc of
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increased HR
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MAP
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CO x TPR
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IF HR is too high, diastolic filling is...
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incomplete and the CO is decreased
(ex-ventric tachy) |
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MAP
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2/3 diastolic P + 1/3 systolic P
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Pulse Pressure=
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systolic P- diastolic P
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Pulse P is proportional to
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SV
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SV=
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CO/HR
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SV=
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EDV-ESV
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What is stroke volume affected by?
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contractility,afterload, and preload
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When does SV increase?
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increased preload
decreased afterload or decreased contractility |
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What 4 circumstances increase contractility(and SV)?
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1. catecholamines(increased activity of Ca2+ pump in sarcoplasmic reticulm)
2. increased intracellular calcium 3. decreased extracellular sodium (decreased activity of Na+/Ca2+ exchanger) 4. Digitalis(increased intracellular Na+ resulting in increased Ca2+) |
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What does increased sodium do?
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stops the Na+ Ca2+ exhange
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Contractility( and SV) decreased with...
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1. B1 blockade
2. Heart failure 3.acidosis 4. hypoxia/hypercapnea 5.nondihydropyridine Ca2+ channel blockers |
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What causes SV to increase?
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anxiety
exercise pregnancy |
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What causes SV to decrease?
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a failing heart
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myocardial oxygen demand is increased by...
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1. increased afterload(analalog to arterial P)
2.increase contractility 3.increased HR 4.increased Heart size(increased wall tension) |
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Preload=
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ventricular EDV
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Preload increases with
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1. exercise(slightly)
2.increased blood vol(overtransfusion) 3.excitement(sympathetics) |
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what does Preload do to the heart?
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It pumps up the heart
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Afterload-
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mean arterial pressure(proportional to peripheral resistance)
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venodilators=
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ex- Nitroglycerin
decreases Preload |
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vAsodilators=
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ex- hydrAlazine
decreases Afterload (Arterial) |
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Starling curve
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force of contraction is proportional to initial length of cardiac muscle fiber(preload)
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What increases contractile state of myocardium?
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1 circulating catecholamines
2. digitalis 3. sympathetic stimulation |
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What decreases the contractile state of myocardium?
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1.pharmacologic depressants
2.loss of myocardium |
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change in pressure=
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Q x R
similar to Ohm's law change in V=IR |
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What is isovolumetric contraction?
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period btwn mitral valve closing and the aortic valve opening.
**highest O2 consumption** |
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What is systolic ejection?
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period btwn aortic valve opening and closing
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What is isovolumetric relaxation?
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period btwn aortic valve closing and mitral valve opening
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What is rapid filling?
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period just after mitral valve opening
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what is reduced filling?
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period just before mitral valve closure
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what is the S1?
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when the mitral and tricuspid valve close.
loudest at the mitral area |
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Whats is the S2?
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aortic and pulmonic valve closure?
loudest at the left sternal border. |
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What is S3?
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in early diastole, during rapid ventricular filling phase
assoc with increased filling pressures and more common in dilated ventricles but normal in kids and preggos |
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What is S4?
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atrial kick
in late diastole high atrial P assoc with ventric hypertrophy left atrium must push bs stiff LV wall |
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what is the a wave
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atrial contraction
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what is the C wave?
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RV contraction
(tricuspid valve bulging into the atrium) |
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v wave
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increased atrial P due to filling against closed tricuspid valve
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what is S2 splitting?
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aortic valve closes before pulmonic,
inspiration increases this difference |
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what is wide splitting?
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assoc with pulmonic stenosis or rt bundle branch block2
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what is fixed splitting?
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assoc with ASD
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what is paradoxical splitting?
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assoc with aortic stenosis or left bundle branch block
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what is normal splitting lungs
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inspiration leads to a drop in intrathoracic pressire which increases capacity of pulm circulation
pulm valve closes to later accomodate more blood entering lungs. Aortic valve |
