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82 Cards in this Set

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