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60 Cards in this Set

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  • Back
What is the Carotid Sheath made of?
3 structures
1. Internal Jugular vein(lateral)
2. Common carotid artery(middle)
3. Vagus nerve (posterior)
In the majority of cases what supplies the SA and AV node is supplied by...
RCA (80% of the time)
RCA supplies the inferior part of the left ventricle by the PD artery(rt dominant)
What abt 20% of the time, what supplies the SA and AV node?
the PD arises from the CFX
Where does coronary artery occlusion most commonly occur?
LAD
which supplies the anterior interventricular septum
When do the coronary arteries fill?
Diastole
What is the most posterior part of the heart?
Left atrium
What does the enlargement of the left atrium cause?
Dysphagia
due to compression of the esophageal nerve or hoarseness due to compression of therecurrent laryngeal nerve, a branch of the vagus
What are the two branches of the root of the atria>
Left main and right main
What does the left main branch of into
LAD and the Circumflex
What does the LAD supply?
2/3 of the intervent
ant wall of the LV
ant papillary muscle
What does the circumflex supply?
lat posterior wall of the LV
(10% of the time its PDA)
What does the Right main divide into?
SA and AV node arteries
PDA(85-90% of the time)
What does the PDA supply?
inferior wall of the LV, diaphragmatic part of the heart
What is CO?
the amt of blood pumped out of the heart per minute
How do you calculate CO?
CO- SV x HR
CO=
rate of consumption/arterial O2-venous O2 content
During exercise, CO increases initially bec...
increased SV
After prolonged exercise, CO will remain increased bc of
increased HR
MAP
CO x TPR
IF HR is too high, diastolic filling is...
incomplete and the CO is decreased
(ex-ventric tachy)
MAP
2/3 diastolic P + 1/3 systolic P
Pulse Pressure=
systolic P- diastolic P
Pulse P is proportional to
SV
SV=
CO/HR
SV=
EDV-ESV
What is stroke volume affected by?
contractility,afterload, and preload
When does SV increase?
increased preload
decreased afterload
or
decreased contractility
What 4 circumstances increase contractility(and SV)?
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+)
What does increased sodium do?
stops the Na+ Ca2+ exhange
Contractility( and SV) decreased with...
1. B1 blockade
2. Heart failure
3.acidosis
4. hypoxia/hypercapnea
5.nondihydropyridine Ca2+ channel blockers
What causes SV to increase?
anxiety
exercise
pregnancy
What causes SV to decrease?
a failing heart
myocardial oxygen demand is increased by...
1. increased afterload(analalog to arterial P)
2.increase contractility
3.increased HR
4.increased Heart size(increased wall tension)
Preload=
ventricular EDV
Preload increases with
1. exercise(slightly)
2.increased blood vol(overtransfusion)
3.excitement(sympathetics)
what does Preload do to the heart?
It pumps up the heart
Afterload-
mean arterial pressure(proportional to peripheral resistance)
venodilators=
ex- Nitroglycerin
decreases Preload
vAsodilators=
ex- hydrAlazine
decreases Afterload (Arterial)
Starling curve
force of contraction is proportional to initial length of cardiac muscle fiber(preload)
What increases contractile state of myocardium?
1 circulating catecholamines
2. digitalis
3. sympathetic stimulation
What decreases the contractile state of myocardium?
1.pharmacologic depressants
2.loss of myocardium
change in pressure=
Q x R
similar to Ohm's law
change in V=IR
What is isovolumetric contraction?
period btwn mitral valve closing and the aortic valve opening.

**highest O2 consumption**
What is systolic ejection?
period btwn aortic valve opening and closing
What is isovolumetric relaxation?
period btwn aortic valve closing and mitral valve opening
What is rapid filling?
period just after mitral valve opening
what is reduced filling?
period just before mitral valve closure
what is the S1?
when the mitral and tricuspid valve close.

loudest at the mitral area
Whats is the S2?
aortic and pulmonic valve closure?

loudest at the left sternal border.
What is S3?
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
What is S4?
atrial kick

in late diastole
high atrial P assoc with ventric hypertrophy
left atrium must push bs stiff LV wall
what is the a wave
atrial contraction
what is the C wave?
RV contraction
(tricuspid valve bulging into the atrium)
v wave
increased atrial P due to filling against closed tricuspid valve
what is S2 splitting?
aortic valve closes before pulmonic,
inspiration increases this difference
what is wide splitting?
assoc with pulmonic stenosis or rt bundle branch block2
what is fixed splitting?
assoc with ASD
what is paradoxical splitting?
assoc with aortic stenosis or left bundle branch block
what is normal splitting lungs

a
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