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55 Cards in this Set
- Front
- Back
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Describe the lining of the right ventricle compared to that of the left ventricle. Why?
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The muscle lining on the right is thinner than on the left because pressure difference and distance of blood traveling differs. Righ thas low pressure because the blood only has to travel to the lungs. Blood from the left has to go to all the other body cells.
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Describe activity in the arteries.
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Carry oxygenated blood from heart to the body, except for the pulmonary artery.
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Describe activity in the veins.
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Carry deoxygenated blood except for pulmonary veins.
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What is the pericardium?
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Double-layered sac that surrounds the heart.
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What is the function of the pericardium?
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It reduces friction between the heart and other organs that it meets when the heart moves/beats.
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What happens if the there is fluid in the pericardial cavity, for example because of infection?
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Chest pain occurs because it is difficult for the hart to move due to friction.
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What do the capillaries function in/.
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Gas exchange
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Explain what ischemic heart disease is.
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A lack of oxygen to the heart which leads to the formation of scar tissue which prevents the heart from contracting.
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What are the 3 coronary arteries?
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Right coronary artery
Left coronary artery branches into 2: - circumflex artery - left anterior descending artery |
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What are the 4 coronary valves?
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Tricuspid
Pulmonary Aortic Mitral |
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Explain the cardiac conduction system.
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Impulse starts at SA node in the right atrium
Spreads through right and left atria Comes to the AV node Travels through HIS bundle and divides into right and left bundles. Left bundle then divides into 2 bundles: posterior and anterior branch |
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Why is it important for the electric impulse to pass through the AV node?
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It is the only way to pass the impulse to the ventricles.
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What does the 1st P-wave of the EKG represent?
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The activation of the right and left atria by the SA node.
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What does the Q wave correspond to in the EKG?
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The septum is activated from left to right: left is activated a little faster than right- it is negative because the current is moving away from the lead.
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What does the R wave correspond to?
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Activation of the Left ventricle.
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What does the S wave correspond to?
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The activation of the right ventricle, which occurs slightly slower than the left ventricle
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What does the QRS complex correspond to?
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Activation of both ventricles
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What does the T wave correspond to?
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Relaxation or repolarization of the ventricles.
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What does the interval between the P wave and the beginning of the QRS complex correspond to?
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The time it takes for signal to travel from SA node to activate ventricles through AV node.
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If the QRS sequence is too wide, what can be the problem?
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HIS bundle and conduction through it to the ventricles.
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Where does one see ischemia/myocardial infarctions?
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in the ST segment.
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What does st-elevation signify?
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A very severe myocardial infarction.
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What does st-depression signify?
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A myocardial infacrtion, less severe than in st-elevation: usually a smaller part of the heart is affected.
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What can a prolonged QT segment signify?
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Arrhythmia: can be caused by medicines, can lead to cardiac arrest.
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What is the normal value for heart rate?
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50-100 bpm
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what is the regular value for PQ?
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0.12-0.22 (3-5 small squares)
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What is the regular value for QRS?
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<0.12 sec
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What is the regular value for QT with a HR of 60?
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<0.44 sec
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WHat is a normal P-wave?
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<0.12 sec and <0.3 mm
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How can you deduce the HR from an EKG?
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300/ 3 of small squares between 2 R waves (bpm)
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What is a sinus rhythm?
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When there is 1 P wave in front of each QRS sequence
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What are risk factors for ischemic heart disease?
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Hyperlipadaemia
smoking gender hypertension diabetes family history former myocardial infarctions other minor: male, age, obesity, inactivity |
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What are clinical presentations of ischemic heart disease?
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Angina: typically after exercise (stable angina pectoris)
fainting: should take an ECG (syncopy) breathlessness |
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What is stable angina pectoris?
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Chest pain that occurs when patient needs extra oxygen, such as during exercise, eating, emotional stress, etc.
Not life threatening at this point |
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What is unstable angina pectoris?
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Chespt pain that occurs during rest: precursor to myocaridal infarction
Myocardial cells are not dying yet, but crying out for oxygen. |
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Explain Acute Coronary Syndrome (ACS)
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Involves unstable angina pectoris which then can lead to a myocardial infarction in which myocardial cells are dying
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What are the 2 types of myocardial infarction?
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non-ST-elevation (NSTEMI): ST-depression: only portion of ventricular wall is affected
ST-elevation (STEMI): most serious, the whole ventricular wall |
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What is needed for a myocardial infarction to be diagnosed?
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-chest pain
-ECG signs *Biomarkers (ex. Troponins elevated) 2 out of 3 are needed for a diagnosis |
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What are some non-invasive tests to evaluate non-ACS chest pain?
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Functional Tests:
-bicycle/treadmill -myocardial perfusion imaging -MR perfusion -stress echocardiography Anatomic Tests: -cardiac CT: look for plaques |
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What are some invasive tests to evaluate non-ACS chest pain?
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CATH: coronary angiography
*Only if pretest risk is very high or if there is a positive non-invasive test |
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What is the treatment for ACS?
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MONA
-morphine: relieves pain and reduces afterload -aspirin: bloodthinning -nitrates: relieves pain, dilates arteries, reduces pre and after load -oxygen Also: statins, Beta-blockers, and Clopidogrel and Heparin |
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What is cardiac output?
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stroke volume x heart rate
Is the amount of blood being pumped from the heart every minute |
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What happens if stroke volume decreases in the heart?
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The cardiac output also decreases, so the heart rate has to increase to compensate and pump out sufficient blood from the heart to the body: puts more pressure and strain on the heart.
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What are the symptoms of heart failure?
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Shortness of breath
chest pain swollen ankles fatigue: due to lack of O2 in the muscles dizziness/fainting (syncope) |
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Name the different types of fractures.
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Greenstick
sprial transverse comminuted compund compression |
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What are the 2 divisions of bone fractures?
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Close (simple)
Open (compound) |
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What is the Evans classification of bone fractures?
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Petrochanteric fractures
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What is the Gardens classification for bone fractures?
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Collum femoris fractures
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What are the 3 signs of a hip/femur fracture?
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- patient has pain in hip and groin that can radiate to the knee
- lower extremity typically tucked up/shortened and rotated outwards - patient cannot perform a straight leg lift |
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Which part of the femur does a Garden classification deal with. How many gradings are there?
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4 gradings, neck of femur.
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Which part of the femur does an Evans classification deal with. How many gradings are there>
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5 gradings, lower region of the femur, below the neck.
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Why are open fractures so dangerous and often more difficult to treat?
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Infection can easily get into the system and into the bone
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How are comminuted fractures caused?
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High energy/trauma: mostly occur in lower limbs and ankles
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What is the most common fracture in children and why?
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Greenstick fracture: an incomplete fracture in which the bone is bent. Due to the fact that children's bones have not completely calcified yet, making them more pliable
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What is the difference between a complete and incomplete fracture?
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Complete: bones have separated completely at the break
Incomplete: still attached |
