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30 Cards in this Set
- Front
- Back
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Whatdoes each layer of the heart consist of? Understand the structure of the pericardium. |
•Epicardium:outerlayer of connective tissue•Coronaryarteries•Coveredby visceral pericardium Myocardium: middle layer, muscular, thickestlayer, workhorse of the heart •Endocardium:innermostlayer•Smoothlayer continuous with the endothelium that line chambers and heart valves •Pericardium •Double-walledsac that surrounds the heart |
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Differentiatebetween the right and left sides (pulmonary and systemic circulations) of theheart. |
•Right half (right atrium, RA and rightventricle, RV)•Pulmonarypump, circulates blood into pulmonary artery, lungs •Left half (left atrium, LA and leftventricle, LV)•Systemicpump, circulates blood into aorta, organs and tissues |
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1. Whatare the locations and functions of the heart valves? |
•Atrioventricularor AV valves: flap-likevalves between atria and ventricles; Tricuspid valve: threeflexible flaps; directs blood flow from RA to RV, Bicuspid valve or mitral valve: directsblood flow from LA to LV •Semilunarvalves •Preventbackflow of blood into ventricles during diastole•Pulmonaryvalve: directsblood flow from RV to pulmonary trunk•Aorticvalve: directsblood flow from LV to aorta |
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1. Describethe blood flow through the heart including valves that are encountered. |
•Oxygen-poorblood enters RA → RV through tricuspid valve → pulmonary artery → lungs•Freshlyoxygenated blood leave lungs through pulmonary veins → LA → LV through mitralvalve → aorta → rest of the body |
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1. Whatis the purpose of the coronary circulation? |
main blood supply to heart |
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1. Howdoes the cardiac conduction system work? In what order does current flow through this system? |
•Right coronary artery, RCA, Suppliesposterior wall and posterior part of interventricular septum•Left coronary artery, LCA and branches•Left anterior descending artery,LAD, Suppliesanterior wall, anterior part of interventricular septum•Left circumflex artery, LCA, Supplieslateral wall |
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1. Whathappens at each phase of the cardiac cycle? |
•Atrial systole•ventricles contract → atrial diastole Chambersrelaxed → ventricular systole •ventricles contract →ventricular diastole •chambers relax and a new cyclebegins |
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1. Whatare the different types of blood vessels? |
•Largeelastic arteries – conductthe blood to various locations throughout the body. •Arterioles– smallervessels with muscular walls that regulate flow from the large arteries into thecapillaries. •Capillaries– thinendothelium-lined channels that deliver nutrients to cells and remove wasteproducts. •Veins– returnblood to the heart under low pressure and usually travel with the arteries. |
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1. Differentiatesystolic and diastolic blood pressure. |
•Pressureis highest when ventricles contract systolicpressure •Pressureis lowest when ventricles relax diastolicpressure |
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1. Whatis an electrocardiogram used for? Whatdoes each wave of the tracing represent? |
•Measures electrical activity ofheart; diagnostic tool, Detectsdisturbances in rate, rhythm, conduction, muscle injury, extent of muscledamage P- atrial depolarization QRS apex- ventricle depolarization QRS- atrial re-polarization T-ventricular re-polarization |
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1. Whatare the signs/symptoms and etiology of arrhythmias? |
•Symptoms•Palpitations•Tachycardia•Bradycardia•Skippedheartbeats•Syncope•Fatigue •Etiology•Resultswhen there is interference within the conduction system of the heart•Ischemiaand drugs cause many arrhythmias |
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1. Whatis the difference between a normalsinus rhythm, sinus bradycardia, and sinus tachycardia? |
•Normalsinus rhythm•ECGthat is within normal limits with a heart rate between 60-100 bpm •Sinusbradycardia•Aregular rhythm with a heart rate of <60 bpm•Thismay be normal in an athlete •SinustachycardiaA regular rhythm with a heart rateof >100 bpm |
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1. Whatis atrial fibrillation? What does it look like on an ECG? Who is prone to it? How is it treated? |
•AtrialFibrillation (A-fib)•Seenin older persons; those with CVD, COPD, hyperthyroidism; occasionally in normalindividuals •Characterizedby extremely rapid, incomplete atrial contractions of 400-500 bpm•Atriaquiver versus contracting normally •ECG•Resultsin small, irregular, and uncoordinated P waves that cannot be distinguished•Ventricularcontraction also occurs at an irregularly irregular at interval TREATMENT- •Restorenormal rhythm by terminating fibrillation through electrical cardioversion or pharmacologic therapy•Anticoagulationto prevent thombus formation |
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1. Whatare premature ventricularcontractions? What causes them? What do they look like on an ECG? Are they harmful? |
•Oneof the most common and least harmful arrhythmias •Caused by •Lackof Sleep•Caffeine•Nicotine•Alcohol•Anxiety/Stress •Characterizedby a beat that comes early in the cycle, has no P wave, a wide QRS complex, anda different T wave•ThePVC is followed by a pause before the occurrence of the next normal cycle |
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1. Whatis ventricular tachycardia? What type of patients is it often seen in? What does it look like on an ECG? Is it harmful? |
•Seenin patients with cardiac disease•Characterizedby 3 or more PVCs that occur at a rate of 150-250 bpm•Thereare no P waves and the QRS complexes are distorted•V-tach islife threatening and can rapidly deteriorate into ventricular fibrillation andcardiac arrest |
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1. Whatis ventricular fibrillation? What does it look like on an ECG? Is it harmful? |
•Oneof the more serious arrhythmias•Rapidand uncoordinated ventricular beat•Heartcells are contracting spontaneously and the heart just quivers•Itis totally ineffective for pumping blood and will quickly lead to death if notcorrected |
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1. What is cardiac arrest? What are the signs/symptoms? What is the etiology? What is the treatment? |
Sudden, unexpected cessation of cardiac activity Signs/Symptoms- patient is unresponsive, with no respiratory effort and no palpable pulse Etiology- Results from anoxia or interruption of the electrical stimuli to the heart Treatment- CPR within 4-6 minutes, defibrillation, epinephrine or dobutamine to stimulate the heart, antiarrhythmic drugs |
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1. Whatare the various treatments for arrhythmias? How do they work? |
-Antiarrhythmic drugs- drug induced arrhythmias usually resolve with the stoppage of the drug -Anticoagulants are given to prevent thromboembolism -Ischemia should respond to oxygen and increased blood flow to the myocardium -Cardioversion (defibrillation) for serious arrhythmias- Electrical device that appiles countershock to heart through electrodes placed on chest |
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1. Whatare the 2 types of valvular malfunction? What are some causes? |
1. Stenosis- hardening of cusps valves that prevents complete opening of valves, impedes blood flow into next chamber. Common Causes- rheumatic heart disease, infective endocarditis, congenital malformations, calcification of valve cusps 2. Insufficiency (incompetence, regurgitation)- failure of valves to close completely, exerts pressure on chamber and overloads heart |
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1. Whatis rheumatic fever? What causes it? What are the signs/symptoms? What are possible clinical outcomes? How is it treated? |
Commonly seen in children, NOT a bacterial infection but immunologic reaction. Caused by- complication of group A beta hemolytic streptococcal infection( sore throat and scarlet fever), anti-streptococcal antibodies against strep antigens cross react with similar antigens in tissues, antigen-antibody reaction injuries connective tissue and causes fever Signs/Symptoms- fever, inflammation of connective tissue throughout the body especially heart and joints, acute arthritis, inflammation of heart Clinical Outcomes- Death from severe inflammation and acute heart failure, healing with scarring of tissues (heart valves), can reoccur if strep infection reactivates Treatment- after diagnosis of strep throat treatment complete course of antibodies after diagnosis with rheumatic fever, antibodies, anti-inflammatory agents (NSAIDs and steroids) antipyretic (fever reducers) |
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1. Whatis rheumatic heart disease? What causesit? How is it prevented? |
Complication of rheumatic fever, primarily affects mitral and aortic valves Causes- in acute disease valve becomes red, thickened and swollen -inflammatory damage produces scarring causing stenosis Prevented- treat beta strep infection promptly prophylactic penicillin to prevent strep infections, reduce risk of recurrent rheumatic fever and further heart valve damage |
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1. Whatis mitral stenosis, what causes it, and how is it treated? |
-Most common of all valve disease -impairs the passage of blood from the left atrium to the left ventricle Cause- rheumatic heart disease is the cause of most cases Treatment- diuretics help reduce workload of heart, anticoagulants prevent formation of thrombi, surgical intervention includes commissurotomy balloon valvuloplasty, valve replacement |
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1. Whatare the types of non-rheumatic aorticstenosis? Clinical outcomes? Prevention? Treatment? |
Occurs in 2% population 1. Aortic stenosis secondary to bicuspid aortic valve: functions then becomes thickened, calcified, rigid from increased strain on valve leads to heart failure 2. Calcific aortic stenosis: Leaflets undergo connective tissue degenerative changes to fibrotic, calcifed, rigid to restricts valve mobility Clinical Outcome- increase strain to left ventricular hypertrophy to heart failure Prevention- control risk factors (high cholesterol, diabetes, hypertension, smoking) Treatment- digitalis can be used as inotropic agent, anticoagulants prevent the formation of thrombi, balloon valvuloplasty and valve replacement |
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Whatis mitral valve prolapsed? What causes it? Is it dangerous? |
One or more of mitral valve protrudes back into left atrium, blood leaks back into left atrium Cause- Abnormally long or short chordae tendineae may not allow valve to close properly, malfunctioning papillary muscles, usually benign, asymptomatic condition does not require treatment |
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1. Whatis infective endocarditis? What can itcause? |
-bacterial endocarditis most common -build up of large, easily fragmented infective masses Can cause- erosion of valve leaflets, seeding of the blood with infective agent, embollization |
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1. Whatis subacute infective endocarditis? What are the symptoms? |
-causes by organisms of low virulence, affects abnormal or damaged valves Symptoms- mild of an infection Prophylactic antibodies given prior to dental or surgical procedures to prevent transient bacteremia and resulting endocarditis |
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1. Whatis acute infective endocarditis? What are the symptoms? Who is at risk? |
-caused by highly pathogenic organisms, commonly staphylococci- affects normal heart valves -severe symptoms of infection and valve destruction -At risk groups- intravenous drug users, unsterile materials or contaminants enter right side of heart |
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1. Howis infective endocarditis treated and prevented? |
Treatment- IV anti-infective therapy, antipyretics, anticoagulants, damaged cardiac valves may need surgical repair or replacement Prevention- prophylactic antibodies given prior to dental or surgical procedures |
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1. Whatis hypertension and how does it develop? What are the current recommendations defining hypertension,pre-hypertension, and an ideal blood pressure? What are the signs/symptoms and risk factors? |
-excessive vasoconstriction of small arterioles -Elevated blood hydrostatic pressure in systemic arterial system - latest recommendation- Ideal BP- <120/80, Pre-hypertensive- 120-140/80-90, hypertensive- >140/90 -<140/90 for younger than 60 or anyone with diabetes or chronic kidney disease -<150/90 for those 60 or older without diabetes or kidney disease -Usually asymptomatic -Risk Factors- genetics, race, increased age, smoking, obesity, stress, sedentary lifestyle |
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1. Whatis the difference between primary and secondary hypertension? |
-Primary Hypertension (essential hypertension) - no specific cause can be identified, occur 90-95% of cases, thought to be due to some defect in blood pressure control mechanism, has insidious onset, with few if any symptoms until permanent damage has occurred -Secondary Hypertension (systemic)- some other specific disorder can be identified as the cause of elevated BP- kidneys, excessive levels of various hormones |
