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45 Cards in this Set

  • Front
  • Back
vascular system:
-consist of arterial system, venous system and capillaries
-delivers O2 and nutrients
-removes waste from the tissues
arterial system:
-high pressure system that delivers blood to the tissues
venous system:
-low pressure system that collects blood from the capillaries
Layers of the heart:
1. epicardium (outer)
2. myocardium (muscle)
3. endocardium (inner)
Layers of pericardium and heart wall:
1. parietal pericardium (fibrous/serous)
2. parietal cavity
3. visceral pericardium (epicardium)
4. myocardium
5. endocardium
What coronary artery feeds the right side of the heart?
posterior descending branch
What 2 coronary arteries feed the left side of the heart?
anterior descending branch and the circumflex
How do the veins of the body enter the heart?
thru the coronary sinus which goes into the right atrium
What 2 conditions are caused by valvular stenosis or blockage?
left pulmonary edema and right peripheral edema (less severe)
Causes of myocardial ischemia:
1. decrease in aortic pressure or RV pressure
2. reduced vessel diameter (blockage)
3. reduced perfusion time
4. increased metabolic demands (fever, sepsis)
What can cause reduced perfusion time of vessels?
fast heart rate
arrhythmias
What molecule is necessary for muscle contraction?
Calcium ions
What happens during a contraction?
-all cells shorten simultaneously to produce a forceful contraction
-action potential travels down the conduction system
What is the fastest way to determine myocardial damage?
-enzymes leak into extracellular fluid
-test cardiac enzymes (CK levels are elevated)
List the ECG pathway.
1. SA node
2. AV node
3. Bundle of His (intra-atrial septum)
4. Bundle branches (septum)
5. Purkinje fibers (from apex upward)
SA node:
-pacemaker of the RA
-impulses sent to atria
AV node:
-posterior spetal wall of RA
-pacemaker if SA node fails
-delay here to complete atria contraction
Electrocardiography components:
-P-wave (atrial depolarization)
-QRS (ventricular depolarization)
-T wave (repolarization of ventricles)
Components of QRS:
Q=depolarization from left septum to right
R=down septum to apex
S=depolarization of base
cardiac output:
= SV x HR
-amount of blood pumped in one minute
-norm: 5-6 lpm (70 ml/min)
-one factor may offset the other
List the 8 determinants of heart rate.
1. sympthetics
2. parasympathetics
3. baroreceptors
4. chemoreceptors
5. sensory receptors in heart chambers
6. drugs
7. CNS (anxiety, fear)
8. excess tachycardia
How does excess tachycardia affect heart rate?
decreases cardiac output
How do sympathetics affect HR?
-causes inadequate BP, lack of O2 and buildup of metabolic end products
baroreceptors:
Ex: aortic and carotid SINUSES
-found in the wall of the artery
-if stretched too much, CV center vasodilates to compensate
chemorecptors:
Ex: aortic and carotid BODIES and hypothalamus
-monitors O2 levels (mostly), CO2 levels and pH
3 Determinants of stroke volume:
1. venous return (BV in the heart)
2. contractility
3. ventricular ejection
positive ionotropes:
-increases Ca levels for contractility
Exs: epiepherine, norepinepherine, thyroid hormone, caffeine, digitalis
Bad conditions in the body cause the blood to become more ___.
acidic
digitalis:
-increases contractility and better utilization of O2
-given to pts with heart conditions
negative inotropes:
-decreases Ca levels
Exs: calcium channel blockers, parasympathomimetics, sympathetic blockers
List the 3 contractile capabilities of the heart.
1. positive inotropes
2. negative inotropes
3. baroreceptor reflex
What valvular condition is most common?
aortic
Who mainly has aortic valve trouble?
more common in older people
atrial natriuretic factor:
-diuretic reaction
-released from atrial stretch
-causes an increase in excretion of Na and water
-decreases BV and BP
Which heart valve is the most dangerous to have damaged?
tricuspid valve
Which heart valve is the least dangerous to have damaged?
pulmonary valve
4 tests of cardiac function:
1. ECG
2. Echocardiogram (ultrasound)
3. nucluear cardiography
4. cardiac catheterization
6 ECG leads:
1 (btn RA and LA)
2 (btn RA and LL)
3 (btn LA and LL)
AVR (btn RA and heart)
AVL (btn LA and heart)
AVF (btn LL and heart)
holter monitoring:
24 hr EKG used on pts with premature beats or irregularities
3 measurements of ECG:
1. heart enlargement
2. conduction (rate and rhythm)
3. damage
3 measurements of echocardiogram:
1. valve function
2. heart size
3. contractility
3 Reasons for cardiac catheterizations:
1. pressures in vessels and chambers
2. coronary patency
3. O2 content in various areas
Tx for pts needing a cardiac cath:
thrombolytics, balloon angioplasty or stents
stents:
-vessels that do not remain dilated
-can also be used with stenosis of the ureter
thrombolytics:
-dissolves clots
-used within 2 hrs of incident
-expensive