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82 Cards in this Set
- Front
- Back
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Which portion of the heart lies directly beneath the sternum?
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Right ventricle
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All the valves of the heart have 3 cusps except...
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Mitral valve
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The mitral valve is located...
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between the left ventricle and left atrium
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Pulmonary veins contain oxygenated or deoxygenated blood?
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Oxygenated blood
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What is the structure located above the aortic valve containing orifices of the left and right arteries that drain there?
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Sinuses of Valsalva
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A patient is admitted that had a massive MI on the anterior wall of the left ventricle. What is the probable cause?
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Coronary artery occluded is in the left anterior descending (LAD)
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Are the valves open or closed in the isovolumetric contraction of the ventricles?
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Closed
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What happens primarily during diastole?
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Coronary perfusion
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What is automaticity?
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The ability to generate impulses spontaneously
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What is conductivity?
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Ability to transmit impulses
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What is excitability?
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Ability to respond to a stimulus
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What is rhythmicity?
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ability to keep regularity of impulses
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Why is there a .08-.1 second delay of conduction in the AV node?
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Because the ventricles are filling during this time
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An EKG strip shows you...
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electrical activity of the heart
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If someone develops atherosclerosis, the earliest pathological change is...
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Fatty streaks
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What is protective cholesterol?
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HDL
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Formula for cardiac output?
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CO=HRXstroke volume
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Starlings law of the heart, stretching of myocardial tissue...increases force of contraction during...
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Systole (relaxes during diastole)
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Mean arterial pressure formula
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systolic + (2Xdiastolic) all divided by 3
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Pulmonary capillary wedge pressure will read _______ if a patient with left ventricular heart failure
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High
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HTN in an adult is defined as BP greater than ...
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140/90
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PND (Paroxysmal nocturnal dyspnea) is a symptom of...
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CHF (left side)
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Normal QRS interval
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.06-.10 seconds
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Normal rate for the SA node?
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60-100
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Normal rate for the AV node?
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40-60
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A deep Q wave on an EKG indicates...
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and old MI
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Tenting of T waves of an EKG indicates...
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Hyperkalemia
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A prolonged PR interval indicates...
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Slow conduction through the AV node
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Elevation of the ST segment indicates...
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An MI is happening right now (fresh MI)
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A depressed ST segment indicates...
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injury (ischemia)
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Ventricular function curve of a failing heart looks?
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Depressed/flattened
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Rales are a sign of
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Left ventricular failure
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Peripheral dependent edema is a sing of
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right ventricular failure
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Pulmonary edema is a sign of
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left ventricular failure
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S3 heart sounds are a sign of
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left ventricular failure
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JVD is a sign of
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right ventricular failure
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Ascites/hepatomegaly is a sign of
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Right ventricular failure
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What is the effect of placing a patient on digitalis for a positive inotropic effect?
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Increased contractility of the heart
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Why would a CHF patient be put on salt and water restrictions...
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to reduce edema and preload on the heart
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What is the color of sputum of pneumococcal pneumonia?
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Rust
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What is it called when pleural fluid collects in the pleural space?
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Pleural effusion
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What is involved in tension pneumothorax?
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Air is entering the lung and collects (it doesn't escape)
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Signs of cyanosis...
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Blue...not a reliable sign of hypoxia...depends on how much Hb a patient has
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Clinical signs of a hypoxic patient...
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restless, apprehension, headache, tachycardia, fear, flared nostrils
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What part of blood gases is going to be best indicator of alveolar ventilatory adequacy?
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PaCO2
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Absorption atelectasis in post op patient is prevented by...
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NPO, cough and deep breathing, providing collateral circulation in the pores of Kohn
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Conditions putting people at high risk for pulmonary emboli?
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History of DVT, hip surgery, immobillity, age, obesity, malignant neoplasms, CHF
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Classic S & S with moderate sized pulmonary embolism
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dyspnea, tachycardia, anxiety, tachypnea, loss of consciousness (if really severe)
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PND and CHF is due to an _____ hydrostatic pressure
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Increase
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HTN is a pre rec. for _____ to exist?
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Cor pulmonale
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What is the best definition of acute respiratory failure?
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Not being able to maintain normal ABGs under resting conditions
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In acute respiratory failure, what is the terminology for oxygen content in the blood?
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Hypoxemia
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In acute respiratory failure, what is the terminology for the CO2 levels?
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Hypercapnia
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ABG for O2 failure?
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PaO2 less than 50 and PaCO2 can be normal
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ABG for ventillatory failure?
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PaO2 less than 50 and PaCO2 greater than 50
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Treatment for respiratory failure?
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Make sure hypoxemia, hypercapnia and acidosis do not reach hazardous levels
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Patient with hypoxemia and hypercapnia. If this were a COPD patient the treatment would include?
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Low flow of O2 via ventia mask for irregular rate (dont want to use nasal cannula unless they have a regular rate)
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Tissue hypoxia (decreased perfusion) is caused by _____ if O2 is normal
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low cardiac output, hemoglobin, vasoconstriction, and oxyhemoglobin dissociation curve (shifted to left)
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Most important cause of lung cancer..
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chain smoking
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S & S of lung cancer
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coughing, SOB, bloody sputum (hemoptosis), clubbing, pneumonia
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Intrinsic rate of impulse generation of Perkinje cells
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20-40
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Phase 4 of action potential of cardiac cell
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Resting Phase: inside of cell negative with respect to outside. More permeable to K+
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Phase 0 of action potential of cardiac cell
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Rapid depolarization: increase permeability to Na+. Action potential generated with rush of sodium. Membrane potential is positive.
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Phase 1 of action potential of cardiac cell
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Partial repolarization: caused by abrupt inactivation of fast Na+ channels. Inside of cell becomes slightly less positive.
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Phase 2 of action potential of cardiac cell
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Sustained plateau: slow inward flow of Ca++. Balance between flow of K+ and Na+. Corresponds to the absolute refractory period.
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Phase 3 of action potential of cardiac cell
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Rapid Repolarization: increased permeability of CM to K+. K+ moves out of cell. Resting potential restored by further action of Na-K pump.
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Order of A.P. phases
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4, 0, 1, 2, 3
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Normal PR interval
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.12-.20 seconds
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Normal QT interval
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depends on HR (< .44)
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According to the revised Jones criteria, manifestations of rheumatic fever include...
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2 major signs OR 1 major and 2 minor signs. Major signs: carditis, migratory polyarthritis, sydenham's chorea, subcutaneous nodules, erythema marginatum. Minor: fever, arthraigia, increased ESR, increased CRP, prolonged PR interval.
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Increased cardiac volume work is a characteristic of regurgitation or stenosis?
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Regurgitation
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Resistance to forward flow is a characteristic of regurgitation or stenosis?
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Stenosis
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Muscle hypertrophy is a characteristic of regurgitation or stenosis?
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Stenosis
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Chamber dilation is a characteristic of regurgitation or stenosis?
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Regurgitation?
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In cardiomyopathy, is there SEVERE hypertrophy?
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No no no no noooooooooo!!!
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What is cor pulmonale?
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Right ventricular hypertrophy
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Gold standard for diagnosis of pulmonary embolism?
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Angiogram
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300 Rule
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Count the # of big boxes between 2 R waves. 1 big box=300, 2 big boxes=150, 3 big boxes=100 etc. (1 big box=.2 sec; 300=60sec) pg. 18 in notes
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Sinus bradycardia
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HR under 60 bpm. Results in lightheadedness, syncope, dizziness, hypotension and vertigo. Rx: IV atropine or pacemaker only if pt has Sx
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Atrial fibrillation
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Atrial rate: 350-600. Ventricular rate: 100-180. irregular, no P wave Pg. 22. Rx. Restore NS or decrease ventricular response, synchronized cardioversion; digoxin,, verapamil or propanolol; prevent stroke; anticoagulant
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PVC
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Premature ventricular contraction: may be a compensatory pause after each PVC. may have an inverted QRS wave. Rx: some do not need to be treated. If >5/min, multifocal, bigeminy, fall on T wave, associated with acute MI are all dangerous.
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V-tach
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4 or more PVCs in a row. usually rapid rate (140-400) ventricles are directly stimulated by an ectopic ventricular focus firing repeatedly or through a re-entry process. Wide and bizzare QRS. Rx: may turn into V-fib
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