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ECCC Block 1 > Block 1 Unit 3 Cardiovascular System > Flashcards

Block 1 Unit 3 Cardiovascular System Flashcards

1
Q

What is the Pericardium?

A

A double walled membranous sac that encapsulates the heart

(Peri-around)

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2
Q

What layer is the Epicardium and what does it provide?

A

2nd layer, provides a smooth surface for the heart to contract and relax within the pericardium with minimal friction

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3
Q

What layer is the myocardium and what is it composed of?

A

It is the 3rd layer and the thickest layer of the heart, composed of cardiac muscles ( cardiomyocytes )

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4
Q

What is the cardiomyocyte responsible for?

A

It is the cell responsible for the contraction of the heart

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5
Q

What layer is the endocardium and it’s responsibility?

A

Internal lining of the myocardium; continuous endothelium that lines all the arteries, veins and capillaries of the body creating a continuous, closed circulatory system

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6
Q

How many layers does the pericardium have?

A

It is a double walled membranous sac that encapsulates the heart

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7
Q

What does the pericardium prevent?

A

Prevents displacement of the heart during acceleration and deceleration and acts as physical barrier that protects the heart from infection and inflammation from the lungs and pleural space.

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8
Q

The pericardium contains ______\ and _____ that causes changes in BP and HR

A

Pain receptors, mechano receptors

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9
Q

How much fluid is in the Pericardial space?

A

20mL of pericardial fluid

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10
Q

What’s the purpose of pericardial fluid?

A

Lubricates the membranes that allows them to slide smoothly over one another with minimal friction as the heart beats

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11
Q

What is Automaticity?

A

Ability to spontaneously depolarize/ initiate impulses regularly

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12
Q

What is excitability?

A

Ability to depolarize in response to a stimulus

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13
Q

What is conductivity?

A

Ability to transmit impulses from cell to cell

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14
Q

What is Rhythmicity?

A

The regular generation of an action potential by the hearts conduction system

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15
Q

What is contractility?

A

Ability to respond to a stimulus by shortening

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16
Q

What is the SA node BPM rate?

A

60-100 bpm

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17
Q

What is the AV node BPM rate?

A

40-60 BPM

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18
Q

What is the bundle of his BPM rate?

A

30-40 BPM

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19
Q

What is the Purkinje fibers BPM rate?

A

15-40 BPM

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20
Q

What are some Cardiac disease Hx you should look out for?

A

-Rheumatic fever
-Cardiac murmurs
-HLD
-Congenital heart disease
-HTN

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21
Q

What are some risk factors for cardiac issues

A

-Tobacco use
-Alcohol
-Nutrition
-Exercise
-illicit drug use

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22
Q

What does a full set of vitals entail?

A

-BP on both arms
-Pulse pressure ( SBP-DBP= mmHg)
-Temp
-HR
-RR
-O2 saturation

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23
Q

What is a pulse pressure?

A

The difference between the SBP and the DBP ( SBP-DBP= PP)

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24
Q

What does pulse pressure reflects?

A

-Stroke volume
-Ejection velocity
-Systemic vascular resistance

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25
Q

What causes a widened pulse pressure?

A

Usually related to Vascular stiffening evident in..

-Sinus bradycardia
-Complete heart block
-Aortic regurgitation
-Anxiety
-Catecholamine infusion ( dobutamine, dopamine, epinephrine)
-Age
-Atherosclerosis
-HTN
-Fever
-Hot environnement
-Exercise

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26
Q

What causes a narrow pulse pressure?

A

Insufficient preload leading to decreased cardiac output. E.g.
-Aortic valve stenosis
-Cardiac tamponade
-Hypovolemic shock

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27
Q

What does a high pulse pressure, bradycardia, and irregular breathing indicate?

A

Increased ICP ( Cushing triad)

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28
Q

What is the function of the coronary arteries?

A

Vessels that supply the heart structures with oxygenated blood and then return the blood to the general circulation via coronary veins.

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29
Q

Where does the coronary arteries being at?

A

Begins at base of aorta, openings are called Ostia

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30
Q

What 2 branches does the LCA divide into?

A

LAD and the Circumflex artery

31
Q

What areas of the heart does the LAD supplies oxygenated blood to?

A

The septum, anterior, and inferior wall of the L ventricle

32
Q

Who’s nickname is the “widow maker” and why?

A

LAD artery due to the large amount of cardiac tissue receiving blood supply from this vessel

33
Q

What area of the heart does the Circumflex artery supplies to?

A

L atrium and L arterial ventricular wall

34
Q

What area of the heart does the RCA perfuses to?

A

R atrium, SA and AV nodes

35
Q

What are the 3 branches that branches off the RCA ?

A

-Conus
-R marginal branch
-Posterior descending branch

36
Q

What area of the heart does the Conus perfuses?

A

Upper R ventricle

37
Q

What area of the heart does the R marginal branch perfuses?

A

R vertical to the apex

38
Q

What is the posterior descending branch?

A

Smaller coronary branches to both ventricles

39
Q

What is the mnemonic to help remember the order of heart sounds?

A

APEs To Man

40
Q

Where can you listen to listen to the Aotric sound?

A

2nd intercostal space R sternal border

41
Q

Where can you listen to listen to the pulmonic sound?

A

2nd Intercostal space L sternal border

42
Q

Where can you listen to listen to the erb’s point?

A

3rd intercostal space L sternal border

43
Q

Where can you listen to listen to the tricuspid?

A

4th intercostal space L sternal border

44
Q

Where can you listen to listen to the mitral?

A

5th intercostal space at midclavicular line

45
Q

What is troponin?

A

Regulatory proteins in cardiac muscles released with damage

46
Q

What is the initial elevation of Troponin after a MI

A

3-6 hrs

47
Q

When is the peak elevation of Troponin after a MI?

A

12-47 hrs

48
Q

How many days can a person Troponin be elevated for?

A

5-10 days

49
Q

What cardiac biomarker is the most clinically accurate marker of a MI?

A

Troponin

50
Q

What cardiac biomarkers is used to to determine damage to the heart?

A

Troponin and Creatinine Kinase Myocardial Band (CKMB)

51
Q

What cardiac biomarker shows the protein found in the cardiac and skeletal muscle?

A

CKMB

52
Q

What cardiac biomarker rises 4 to 8 hrs after a MI?

A

CKMB

53
Q

What cardiac biomarker peaks 15-24 hrs after a MI?

A

CKMB

54
Q

What cardiac biomarker can be elevated for 2-3 days after a MI?

A

CKMB

55
Q

What cardiac biomarker usually gets 3 samples at the 6 or 8 hour intervals?

A

CKMB

56
Q

What cardiac biomarker shows the peptide secreted by ventricle in response to excessive stretching by heart muscle?

A

B-type Natriuretic Peptide (BNP)

57
Q

What cardiac biomarker is going to be higher in pts with renal failure?

A

BNP

58
Q

What cardiac biomarker used to assist in determining CHF severity?

A

BNP

59
Q

What can be used to dx cardiac tamponade and assess coronary circulation?

A

CT scan

60
Q

A chest X-ray can show you what?

A

Cardiomegaly and fluid in places it shouldn’t be e.g. empyema and pleural effusions

61
Q

What is a EP study?

A

A test used to evaluate the heart’s electrical system and to check for abnormal heart rhythms.

62
Q

How is a EP study performed?

A

Wire electrodes are threaded into the heart via a vein in the groin, wrist, or neck. Electrical signals are sent through said wires to stimulate the heart in order to find the cause of the abnormal rhythm.

63
Q

What types of pts would you anticipate needing an Echo?

A

-New murmurs/ valve status
-New arrhythmias/ heart pumping status
-HF
-Heart valve disease
-cardiomyopathy/ EF
-Pericardial effusion/ tamponade

64
Q

What is a bubble study used for?

A

It can identify potential blood flow issues inside the heart.

65
Q

You are doing a bubble test and you see your bubbles appear on the L side of the heart, what does this entail?

A

This is a positive test and indicates the presence of a hole in the heart

66
Q

What is a cardiac catheterization?

A

A catheter inserted into the radial or femoral arty.

67
Q

cardiac catheterization can aid in the dx of what?

A

-Heart disease
- EF

68
Q

What’s the purpose of a PAC?

A

Diagnostic, used to…
-detect HF or sepsis
-monitor therapy
-evaluate effects of drugs
-blood flow and pressures in and around the heart

69
Q

Pt is presenting to the ED w/ sudden excruciating pain located at the posterior chest between their scapula, Dypnea, extremity weakness and episodes of syncope. When taking vitals you noticed a 23mmHg difference between the right and left arm. Provider orders a chest X-Ray and the image reveals a widening of the mediastinum. What would the Dx be?

A

Aortic Dissection

70
Q

When does a Aortic Dissection occur?

A

When the intimai aortic wall is disrupted and blood extends into the aortic vessel.

71
Q

What are some of the causes of Aortic Dissection?

A

-Trauma
-Atherosclerosis
-Hx of thoracic or abdominal aneurysms
-Marfan’s syndrome ( inherited disorder that affects connective tissue)
-FHx
-HTN

72
Q

What’s the difference between Type A and Type B Aortic Dissection?

A

Type A-doesn’t involve ascending aorta

Type B- involves ascending aorta

73
Q

What’s the Tx for Type B Aortic Dissection?

A

Typically managed by controlling the pts BP with a beta blocker

74
Q

What’s the Tx for Type A Aortic Dissection?

A

Will require a graft ( graft is inserted to reinforce the walls of the artery Andy prevent them from stretching further and possibly popping)

ECCC Block 1 (4 decks)

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