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60 Cards in this Set

  • Front
  • Back
Through what mechanisms is blood oxygenated?
ventilation, perfusion, and transport of ABG.
What controls the rate and depth of respiration in response to o2 demands?
Neural and Chemical regulators
What is the functional purpose of the cardiac system?
Delivers oxygen, nutrients, and other substances to tissues and removes waste products of cellular metabolism through respiratory, digestive, and renal systems.
What is stroke volume?
Blood ejected from the ventricles.
What is Cardiac output?
Amount of blood that is ejected from the left ventricle each minute.
Does Cardiac output change?
Yes it can change in times of exercise, pregnancy and fever. Normal amount of blood that is pumped through the body in a minute at rest for 150lb person is 4-6L. A formula to calculate Cardiac output is the stroke volume x heart rate.
What is preload?
It is the end-diastolic volume
What is the conduction system?
The cardiac conduction system generates and transmits impulses needed to initiate the electrical chain of events for a normal heartbeat. It origniates with the SA node or pacemaker of the heart.
What test reflects the electrical activity of the conduction system in the heart?
An electrocardiogram or ECG
What is diffusion?
Diffusion: movement of oxygen and Co2 across alveolar capillary membranes by diffusion from a higher area of concentration to a lower concentration. Diffusion continues until equilibrium is reached.
What is perfusion?
Perfusion: Oxygen diffuses from the alveoli into the pulmonary blood most of the oxygen attaches to hemoglobin molecules in the red blood cells. Red blood cells carry the oxygenated hemoglobin molecules through the left side of the heart and out to the peripheral capillaries where the oxygen detaches depending on the needs of the tissues.
Diffusion and Perfusion can be checked how?
Capillary refill
What are the several ways the body can have heat loss?
1) Conduction: direct heat like pan on a stove, 2)Convection: heat lost or transferred away like a fan blowing across you to blow away heat by air movement. 3) Radiation: heat loss without contact. Example we lose 85% of our body heat to the environment. Blood is hot and carries heat to the skin and it is lost to the environment.
Behavioral controls: put on a sweater!
What is the circadian rhythm for temperature?
At 6pm we are hottest, and 4 am we are coldest
Who are likely candidates for hypothermia?
skiiers, mountain climbers, swimmers, water skiiers and burn victims.
What are some common alterations in cardiac functioning?
Mycardial ischemia (lack of 02 in heart) shows up in pulses and temp, Disturbances of conductions because of sa or av nodes, altered cardiac output, impaired valvular function,
Indicators of Hypertension:
More common than hypotension
Thickening of walls,Loss of elasticity
Family history
Risk factors, high salt diet...
What are some indicators of hypotension?
Hypotension:Less than 90/60 mm Hg
Dilation of arteries,Loss of blood volume: could have problems with kidneys, not enough for glomerular filtration rate because not enough blood pressure.Decrease of blood flow to vital organs. Orthostatic/postural: take bp in different positions, which means I could educate people on orthostatics.
What controls the rate and depth of respiration?
There are neural and chemical regulators.
What physical functions oxygenate blood?
Blood is oxygenated through ventilation, perfusion, and transport of respiratory gases.
What is the big picture function of the cardiac system?
Cardiovascular System: moves nutrient gasses and wastes to and from cells, fights disease, stabilizes body temp and the ph form homeostasis, and has a closed system,
When does most of the blood go through the heart?
In the diastolic period.
In its simplest definition what is systole and what is diastole?
Systole is contraction of the heart muscle that ejects blood out of the ventricles and into the lungs and/or vascular system. Diastole is the relaxation of the myocardium and filling of the ventricles before the next contraction.
What is cardiac reserve?
Cardiac reserve is the heart's response to higher demands of 3 or 4fold like exercise, fever, ...You will see an increase of HR or SV that will make the heart increase to 180/min for short amounts of time.
What do the letters for the electrocardiogram mean. PQRSTU
P= depolarization from the SA node.
Q R S= depolarization of the AV node throughout the Ventricles. The delay from the P end of the P wave to the start of the QRS wave is the time it takes impulse from the sa node to make it to the av node.
T= repolarization of the ventricles
U=Repolarization of the Perkinje fibers or can mean hypokalemia. Intervals between each wave is the time it is taking for the impulse to travel. The time intervals are measured on the ECG.
How does the Nervous system get the idea that it should raise blood pressure or lower blood pressure?
1) Baroreceptors: on the carotic sinus aortic arch, and interpret pressure or stress. A message is sent to the brain to either turn on sympathetic or parasympathetic response by either vasoconstriction or vasodilation.
2) Chemoreceptors: in the carotid body and aortic arch, decreased O2, and increase CO2. Response to O2, CO2, or pH levels and will stimulate the vasomotor center to increase cardiac activity depending on acid/base balance.
In order to perfuse the body adequately with blood what must the MAP be?
60 bpm, if not you could become hypoxic because not enough o2 would be getting to the tissues adequately.
What are some of the gerentologic complications of the cardiac system:
1) CAD: coronary artery disease is most common problem. 2) Myo cardium wall /elastin, calcification, collagen starts to decrease, making contraction less distensible. 3)Heart valves become stiffer and thicker. 4) SA node pacemaker cells decrease and AV node cells decrease, making conduction less effective. 5) hyptertension. 6) Kyphosis, is giving less room for chest expansion
What is intermittant claudication?
It is pain felt in the muscles (usually the legs) due to poor vascularity. It is precipitated with excercise and relieved with rest.
What is clubbing of the fingers from?
Poor oxygen perfusion over a long period of time.
What are the 9 places to take the pulse?
Temporal, carotid, brachial, ulnar, radial, femoral, popliteal, posterior tibial, and dorsalis pedis.
What is the s1 sound?
Closure of the 2 atrial ventricular valves, which are the tricuspid and bicuspid valves.
What is the s2 sound
Closure of the semilunar valves after blood leaves the ventricles. Semilunar valves are the pulmonary and aortic valves that carry blood either to the lungs or to the body.
Where do hear the s1 sound best, the s2 sound best and the split s2 best?
The s1 sound is heard best at the apex. It sounds like BUUH duh, BUUH,duh. The s2 sound is heard best at the base. It sounds like
buh DUH, buh DUH. The split s2 sound is heard best at the pulmonic area. It is a normal sound if it's heard on inspiration, but an abnormal sound if heard on expiration.
What are some noninvasive, (meaning no surgery),diagnostic cadiac tests that can be done? Explain the procedures.
1) Blood studies: labs: Testing partial pressures of pao2, paco2, CRP, homocysteine, BNP, cholesterol, triglycerides, lipoproteins: ldl, hdl,
2) Chest x-ray, 3)Electrocardiogram: 12 leads, …4) Exercise or stress testing: treadmill test, 5) holter readings, 6) Echocardiogram: soundwaves by ultrasound. 7)Nuclear cardiology: Radioisotopes w/ IV 8) Magnetic resonance imaging: 9) MRI: 3d view of heart and 10) Computed tomography: ct: calcium deposits pg 758-759 in lewis.
Which cardiac diagnostic tests are considered invasive?
All 4 of the following tests involve catheters into the coranary arteries or into the heart. In addition, cardioangiography and cardiac catherterization involve dye. Must get consent,
1) Cardiac catheterization & 2) Coronary angiography
3) Intracoronary ultrasound
4) Electrophysiology study. These tests read blood flow and pressure measurements: put probes in with catheter to measure flow of blood: The dye shows how the blood is flowing are not through the heart.
What parts are included in the upper respiratory system and the lower respiratory system?
The upper includes: nose, pharynx, adenoids, tonsils, epiglottis, larynx, and trachea. The lower includes: bronchi, bronchioles, alveolar ducts, and alveoli.
What is the name of the lipoprotein that lowers the surface tension in the alveoli, and reduces the amount of pressure needed ot inflate the alveoli and decreases the tendency of the alveoli to collapse.
Surfactanct
How easy it is to breathe or expand our lungs is called:
Compliance
Is Expiration or inspiration the functional problem for COPD patients?
Expiration
What is gas exchange called in the alveoli?
Diffusion
What does a left shift mean on the oxy/hemo disassociation curve mean?
The dissociation curve is all about perfusion of oxygen to the TISSUES. so it is all about the affinity hemoglobin has for oxygen. Different factors can effect this affinity. If a person has alkalosis, meaning high ph, low co2, then there is a left shift in curve indicating that blood is easily picked up in the lungs, but not in the tissues. If a person has high co2, low pH, a right shift will happen and blood is less rapidly picked up in lungs,but will be delivered more efficiently in the tissues.
What are the chemoreceptors and the mechanical receptors in respiration?
Chemoreceptors are pH, or CO2. Mechanical are coughing, muscle stretching,...etc. Both kinds of receptors will increase respirations.
What are the body's 5 natural respiratory defense mechanisms?
1) Filtration of air: Nose
2) Mucociliary clearance system: mucous and cilia
3) Cough reflex: high pressure
4) Reflex bronchio constriction: to keep it from getting in, and then hopefully you cough it out
5) Alveolar macrophages: have them in alveoli to eat bacteria and move them out to the cilia to get it out
What are some less invasive diagnostic tests that are performed in respiratory?
1) Chest x-ray
2) Computed tomography: ct scan
3) Magnetic resonance imaging
4)Ventilation-perfusion scan: give radioactive dye in a gas no prep needs to be done, can see an embolism.
5)Pulmonary angiography: catheter into pulmonary artery, invasive.
6) Positron emission tomography: radiography, used to malignancies.
What are some invasive resp diagnostic tests?
Endoscopic examinations
1) Bronchoscopy:
2) Mediastinoscopy: inspection and biopsy of lymphnodes in the mediastinum area. 3) Lung biopsy: take out a piece of lung 4) Thoracentesis: put in a needle and pull out pleural fluid for testing.
What can be the problem with analgesics in respiratory?
Analgesics: can get tachypnea, or pulmonary edema or collapse
What is the breathlessness scale?
0 nothing at all
0.5 very very slight
3 moderate: stairs wipes them out
7 very severe
9 very very severe: asthma
10 maximal
What is diastolic pressure?
It is the minimal pressure exerted against arterial walls at all times.
What are the acceptable ranges of respirations related to age levels?
newborn 30-60, infant 30-50, toddler 25-32, child 2-30, adolesc. 16-19, and adult 12-20
What is perfusion?
Distribution of RBC to and form pulmonary capillaries.
What is diffusion in respiration?
Movement of O2 & Co2 between alvoli and redblood cells.
What will the inspiratory and residual air volumes be in the elderly compared to the adult?
Inspiratory volume will be less, but the residual volume will be more.
Where are the chemo recepters located in respiration?
They are located in the medulla of the brain, responding to changes in H+
T/F Intracoronary Ultrasound is noninvasive cardiac procedure.
False. It is an invasive procedure because the ultrasound is taken place in conjunction with coronary angiography. 2 or 3D ultrasound images provide a cross-sectional view of the arterial walls of the coronary arteries. A small catheter is introduced through a peripheral artery and advanced to the artery to be studied.
When a person sighs, they are stretching the alveoli to promote what?
The secretion of surfactant. Without sufficient surfactant the alveoli collapse called atelectasis. People who aren't breathing normal becuase of pain or anesthesia run the risk of atelectasis because surfactant is not being stimulated.
What does a right shift on the dissociation curve indicate?
Indicates acidosis or hyperthermia when PaCO2 is increased. Blood is picked up less readily in the lungs, but can deliver o2 more readily to the peripheral tissues.
T/F Coughing, muscle stretching, changes in pH, and PaCO2 are all able to have an effect on respirations.
True. Coughing and muscle stretching are Mechanoreceptors and pH and PaCO2 are Chemoreceptors that can all have an influence on respirations.
Important table for test:
Pg 524 and 525 in Lewis.
What are the important indicators of hypoxia?
In both early and late stages there is anxiety and restlessness that increases, but in early there is tachycardia and in late there is bradycardia, and in early there is tachypnea-dyspnea, but in late there is decreased respirations-dyspnea. Start w/ decreased LOC and increase to a stupor and somnolence (drowsiness).