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Cardiopulmonary > Heart and Lung Function and Disease > Flashcards

Heart and Lung Function and Disease Flashcards

1
Q

Pericardium

A

-fibrous sac around heart
-Serous layers: Parietal (outer), visceral (on heart and contains fluid within space)
-Innervated by Phrenic Nerve (sensory)

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2
Q

Diastole

A

-Relaxation
-Filling

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3
Q

Systole

A

-contraction
-ejection

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4
Q

Afterload

A

pressure needed to expel blood from the heart
-synonymous with BP

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5
Q

Myocardium

A

Cardiac muscle fiber
-actin-myosin complex
-Automaticity: contract w/o external stimuli
-Rhythmicity: contract with rhythm
-Conductivity: nerve impulses from one cell to the other due to intercalated discs
-Intercalated disc junctions: Desmosomes (adhesion) and Connexins (conductivity)

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6
Q

Endocardium

A

-Smooth muscle, innermost layer

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7
Q

Pulmonary Artery

A

-only artery to carry deoxygenated blood

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8
Q

Pulmonary vein

A

-only vein to cary oxygenated blood

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9
Q

Right Coronary Artery

A

-Supplies right ventricle, AV node and SA node
-Right posterior descending
-Right marginal

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10
Q

Left Coronary Artery

A

-supplies left ventricle, L atrium, septum, SA node

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11
Q

SA Node

A

-sets heart at pace of >100 without other input
-Susceptible to disease due to pericarditis, occulsion

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12
Q

Sympathetic NS

A

-increase
-norepinephrine

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13
Q

Inotropic

A

-strength of contraction

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14
Q

Chronotropic

A

-speed of contraction

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15
Q

Parasympathetic NS

A

-decrease
-vagus nerve
-acetylcholine
-60-90 bpm

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16
Q

AV Node

A

-receive from SA
-to Bundle of His to bundle branches to perkinjie fibers
-40-60 bpm without exernal stimuli
-0.04s to contract Vs
Susceptible to disease due to RCA occlusion

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17
Q

P Wave

A

atrial depolarization

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18
Q

PR interval

A

-travel of impulse to Vs

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19
Q

QRS Complex

A

ventricular depolarization

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20
Q

T Wave

A

ventricular repolarization

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21
Q

QT Internal

A

Ventricular systole

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22
Q

Low K

A

Harder to depolarize, slower heart rate

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23
Q

High K

A

Easier to depolarize as myocardium is excitable, higher heart rate

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24
Q

Cardiac Output

A

-CO= HR x SV
-5-6L at rest, can increased 4-7x with exercise
-Effects systolic BP

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25
Q

Blood Pressure

A

BP=HR x SV x Total peripheral Resistance
TPR affects diastolic BP

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26
Q

Mean Arterial Blood Pressure

A

-average pressure in the systemic system
MAP= DBP + 1/3 (SBP-DBP)
-Normal: 93 mmHg
-assess peripheral functions of CV
-cautions <60mmHg

Determined By:
-BV, CO, Peripheral resistance, distribution of blood in veins

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27
Q

Pulse Pressure

A

SBP-DBP, difference

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28
Q

Effect of Posture on BP

A

Standing: lower BP, blood pools in legs
Laying: blood evenly in veins, higher BP

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29
Q

BP Normal

A

<120/<80

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30
Q

BP Elevated

A

120-129/<80

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31
Q

High BP Stage 1

A

130-139/80-89

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32
Q

High BP Stage 2

A

> 140/>90

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33
Q

Hypertensive Crisis

A

> 180/>120

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34
Q

HR

A

-Beats per minute

Affected by: Baroreceptors, ANS, endocrine, integrity of the system, temperature, emotions

35
Q

SV

A

-amount of blood pumped out each beat
-Afterload-Preload, heart contractility
-increases 40-60% during exercise

36
Q

Cardiac Preload

A

-End diastolic volume: amount of left ventricular blood volume prior to contraction

Dependent on:
-venous return, BV, LA contraction, Starling law

37
Q

Cardiac Afterload

A

-Amount of resistance encountered by left ventricle

38
Q

Myocardial Contractility

A

-neural and hormonal influences

39
Q

Ejection Fraction

A

Ejection Fraction= SV/EDV
-55-70%
-Low EF indicates systolic heart failure
-EF can be preserved with overall decrease in BV, weak heart increases backflow that increased SV

40
Q

Hypoxia

A

O2 concentration of tissues

41
Q

Hypoxemia

A

O2 concentration of blood

42
Q

ESV

A

End Systolic volume: volume of blood in a ventricle at the end of a contraction

43
Q

Right Shift in O2 Concentration

A

-reduced affinity for for O2, higher po2 will result in lower hemoglobin concentrations

-high temp, high acidity

44
Q

Left Shift in O2 concentration

A

-increased affinity for O2, lower po2 will result in higher hemoglobin concentrations

-low temp, basic environment

45
Q

Fick equation

A

-VO2= HR x SV x (a-vO2 diff)

46
Q

a-vO2 Diff

A

-difference in O2 between arteriole and venule

47
Q

CO Distribution

A

Muscles: 10-15% (80-85% with exercise)
Trunk: 20-30%
Brain and heart: 5%

48
Q

Oxygen Extraction

A

-tissues utilize the same relative amount of o2 in relation to blood o2

49
Q

Pulmonary O2 Exchange Factors

A

-Area of capillary membrane
-Diffusion capacity of alveoli
-Pulmonary Capillary volume
-Ventilation to perfusion ratio

50
Q

Area of Capillary Membrane

A

invaginations increase the surface area

51
Q

Diffusion capacity of alveoli

A

-changes in surface area
-changes in membrane
-gas uptake issues

52
Q

Pulmonary capillary volume

A

-increases with exercise

53
Q

Ventilation to Perfusion Ratio (V/Q)

A

-blood flow to alveoli must match ventilation or =hypoxemia
-changes with posture
-Norm: 0.8

Reduced: decreased ventilation to perfusion, blood shunted to other parts of the lung, vasoconstriction at arterioles to reduce BV, corrected with O2

Increased: increased ventilation to perfusion, vasodilation to increase BV, dead space

54
Q

Arteriole Vasoconstriction

A

-alpha receptors
Shunt blood to muscles, from skin and mesenteric

55
Q

Arteriole Vasodilation

A

-induced by increased vessel stretch
-induced by low O2 or high H+, CO2, metabolites

Beta Receptors
-increased blood flow to Skeletal muscle
-increase ventilation and alveolar perfusion

56
Q

Cardiac Muscle Dysfunction

A

-most common cause of Congestive Heart Failure

Symptoms:
-dyspnea
-fluid buildup
-fatigue at rest

57
Q

Most common cause of pulmonary congestion

A

-heart failure
-mostly right side affected

58
Q

Causes of Cardiac Muscle Disease: Hypertension

A

Increased BP
-increased workload w/o increased blood supply
-decreased BV
-hypertrophy of myocardium that cannot relax well
-BV damage

59
Q

Causes of Cardiac Muscle Disease: Coronary Artery Disease

A

-2nd most common cause of CMD
-supply and demand issue

-lipid deposits: atherosclerosis
-scar formation: decreases contractility

60
Q

Causes of Cardiac Muscle Disease: Myocardial Infarction

A

-irreversible myocardial necrosis
-most commonly affects left ventricle

PT
-Increased Troponin, CK-MB that needs to come down
-ST elevation on ECG “Stimmy”

61
Q

Causes of Cardiac Muscle Disease: Cardiac Arrhythmias

A

-abnormal rate of contractions
-can cause sudden cardiac arrest from SA node
-can lead to decreased CO

-Sick Sinus node syndrome
-Suprasventricular tachycardia
-V fib

62
Q

Lab Values: Sodium

A

Increased
-dehydration

Decreased
-overhydration

63
Q

Lab Values: Potassium

A

Increased
-Renal retention, decreased insulin

Decreased
-Excess renal secretion, aldosterone, burns

64
Q

Lab Values: Calcium

A

Increased:
-hyperparathyroidism, hyperthyroidism

Decreased: hypoparathyroidism, renal failure

65
Q

Causes of Cardiac Muscle Disease: Renal Insufficiency

A

-contributes to CMD due to increased fluid triggered by low BP or low BV
-RAAS
-maintains Na and K balance

66
Q

Causes of Cardiac Muscle Disease: Cardiomyopathy

A

-disease of heart muscle leading to heart failure
-impaired contractility
-HTN, MI, metabolic disorders, heart valve issues

67
Q

Causes of Cardiac Muscle Disease: Dilated Cardiomyopathy

A

Heart failure with reduced ejection fraction (<40)
-systolic dysfunction: less effective pump
-mitochondrial dysfunction
-increased LV EDV
-lead to electrical issues

68
Q

Causes of Cardiac Muscle Disease: Hypertrophic Cardiomyopathy

A

-enlarged heart that cannot relax
-diastolic dysfunction: less compliant
-increases left EDP
-Heart failure with preserved EF
-rapid ventricular emptying
-muscle cells disorganized

-common cause for sudden cardiac arrest in young athletes

69
Q

Causes of Cardiac Muscle Disease: Restrictive Cardiomyopathy

A

-cannot relax
-EF preserved
-diastolic dysfunction
-scar tissue (sarcoidosis/radiation) OR defect in myocardial relaxation
-hypertrophy

70
Q

Heart Valve Abnormalities

A

-contracts more forcefully
-induces myocardial hypertrophy
-deceases ventricular distensibility
-decreases CO and BP

71
Q

Pericardial Effusion

A

-buildup of fluid compress the heart

Cardiac Tamponade
-pressure on heart leads to decreased heart function
-worse when lying down
-relieved when standing

72
Q

Pulmonary Embolism

A

-lung infarction due to decreased BV
-increased pulmonary hypertension
-increases load to right side of heart
-presence of ascities, bilateral LE edema and jugular vein distension
-increases V/Q ratio

73
Q

Pulmonary Hypertension

A

-risk for cardiac disease
->20mmHg
-increased R ventricle work (Swangan’s Catheter)

74
Q

Heart Disease Vitals

A

-pO2: hypoxia (92-96%)
-RR: tachypnea
-HR: tachycardia
-BP: orthostatic hypotension

75
Q

Congestive Heart Failure

A

-decreased CO
-LV failure
-increased BNP (stretch protein in heart)
-attempts compensatory strategies (sympathetic, RAAS, heart receptors, EPO)

76
Q

Pulmonary System and CHF

A

-pulmonary edema
-decreased o2 concentration

77
Q

Skeletal Muscle Function and CHF

A

-decreased type 1 fibers
-less contraction strength

78
Q

Pancreas and CHF

A

-impairs blood flow
-impairs insulin release

79
Q

Hematologic function and BHF

A

-polycythemia (thick blood)
-thrombocytopenia (low platelets)

Anemia
-can cause CHF
-can harm or help
-shifts curve to right; more o2 needed

80
Q

Neurohumoral Function and CHF

A

-SNS overstimulation and downreg of B1 receptors

B1: myocardial inotrophy and chronotrophy
B2: vasodilation and bronchodilation
a1: vasoconstriction
a2: arterial vasodilation (constriction of coronary)

81
Q

Renal Function and CHF

A

-RAAS
-a receptor activity
-decreased renal activity

82
Q

MAP

A

-mean arterial pressure
-total pressure of the system

83
Q

Pulse Pressure

A

-how hard the heart is working
40-60

84
Q

Rate Pressure Product

A

SBP*HR
-cardiac function

Cardiopulmonary (23 decks)

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