Assessment of the Cardiovascular System CHAPTER 30

Question 2

What is afterload?

Answer 2

The pressure or resistance that the ventricles must overcome to eject blood through the semilunar valves and into the peripheral blood vessels.

Question 3

Where is the apical impulse located?

Answer 3

At the left fifth intercostal space in the midclavicular line; also called the point of maximal impulse (PMI).

Question 4

What are baroreceptors?

Answer 4

Sensory receptors in the arch of the aorta and at the origin of the internal carotid arteries that are stimulated when the arterial walls are stretched by increased blood pressure.

Question 5

Define blood pressure (BP).

Answer 5

The force of blood exerted against the vessel walls.

Question 6

What is a bruit?

Answer 6

A swishing sound that may occur from turbulent blood flow in narrowed or atherosclerotic arteries; heard via auscultation or Doppler.

Question 7

What is cardiac catheterization?

Answer 7

The most definitive but most invasive test in the diagnosis of heart disease; involves passing a small catheter into the heart and injecting contrast medium.

Question 8

How is cardiac index calculated?

Answer 8

By dividing the cardiac output by the body surface area.

Question 9

What is cardiac output (CO)?

Answer 9

The volume of blood ejected by the heart each minute.

Question 10

What is cholesterol?

Answer 10

A serum lipid that includes high-density lipoproteins and low-density lipoproteins.

Question 11

Define diastole.

Answer 11

The phase of the cardiac cycle that consists of relaxation and filling of the atria and ventricles; normally about two-thirds of the cardiac cycle.

Question 12

What is diastolic blood pressure?

Answer 12

The amount of pressure or force against the arterial walls during the relaxation phase of the cardiac cycle.

Question 13

What does echocardiography assess?

Answer 13

Cardiac structure and mobility, particularly of the valves, using ultrasound waves.

Question 14

What is an electrophysiologic study (EPS)?

Answer 14

An invasive procedure where programmed electrical stimulation of the heart is used to evaluate dysrhythmias and conduction abnormalities.

Question 15

What does exercise electrocardiography assess?

Answer 15

Cardiovascular response to an increased workload; also called exercise tolerance or stress test.

Question 16

What does heart rate (HR) refer to?

Answer 16

The number of times the ventricles contract each minute.

Question 17

What are high-density lipoproteins (HDLs)?

Answer 17

Part of the total cholesterol value that should be more than 45 mm/dL for men and more than 55 mg/dL for women; ‘good’ cholesterol.

Question 18

What is highly sensitive C-reactive protein (hsCRP)?

Answer 18

A serum marker of inflammation and a critical component of the development of atherosclerosis.

Question 19

What is homocysteine?

Answer 19

An amino acid produced when proteins break down; elevated values may be a risk factor for cardiovascular disease.

Question 20

What are low-density lipoproteins (LDLs)?

Answer 20

Part of the total cholesterol value that should be less than 130 mg/dL; ‘bad’ cholesterol.

Question 21

What is mean arterial pressure (MAP)?

Answer 21

The arterial blood pressure necessary (between 60 and 70 mm Hg) to maintain perfusion of major body organs.

Question 22

What is a murmur?

Answer 22

An abnormal heart sound that reflects turbulent blood flow through normal or abnormal valves.

Question 23

What is myocardial nuclear perfusion imaging (MNPI)?

Answer 23

The use of radionuclide techniques in cardiovascular assessment.

Question 24

What is myocardium?

Answer 24

The heart muscle.

Question 25

Define orthostatic hypotension.

Answer 25

A decrease in blood pressure that occurs when changing from a sitting or lying position to a standing position.

Question 26

What are pack-years?

Answer 26

The number of packs of cigarettes per day multiplied by the number of years the patient has smoked.

Question 27

What are palpitations?

Answer 27

A feeling of fluttering in the chest, an unpleasant awareness of the heartbeat, or an irregular heartbeat.

Question 28

What is paradoxical blood pressure?

Answer 28

An exaggerated decrease in systolic pressure by more than 10 mm Hg during the inspiratory phase of respiration; also known as paradoxical pulse.

Question 29

What is a pericardial friction rub?

Answer 29

An abnormal sound that originates from the pericardial sac and occurs with the movements of the heart.

Question 30

What is preload?

Answer 30

The degree of myocardial fiber stretch at the end of diastole and just before contraction.

Question 31

What is pulse pressure?

Answer 31

The difference between the systolic and diastolic pressures.

Question 32

What is stroke volume (SV)?

Answer 32

The amount of blood ejected by the left ventricle during each contraction.

Question 33

Define systole.

Answer 33

The phase of the cardiac cycle that consists of the contraction and emptying of the atria and ventricles.

Question 34

What is systolic blood pressure?

Answer 34

The amount of pressure generated by the left ventricle to distribute blood into the aorta with each contraction.

Question 35

What is transesophageal echocardiography (TEE)?

Answer 35

A form of echocardiography performed through the esophagus that examines cardiac structure and function.

Question 36

What are triglycerides?

Answer 36

Serum lipids that include the measurement of cholesterol and lipoproteins.

Question 37

What is troponin?

Answer 37

A myocardial muscle protein released into the bloodstream with injury to myocardial muscle.

Question 38

What does the right atrium (RA) receive?

Answer 38

Deoxygenated venous blood from the body through the superior and inferior vena cava and blood from the heart muscle through the coronary sinus

Question 39

How does blood flow from the right atrium to the right ventricle during diastole?

Answer 39

Passively through the opened tricuspid valve

Question 40

What is the function of the right ventricle (RV)?

Answer 40

Acts as a muscular pump to propel blood into the pulmonary artery and the lungs

Question 41

Where does blood go after being reoxygenated in the lungs?

Answer 41

Flows into the left atrium via the four pulmonary veins

Question 42

What happens to the mitral valve during ventricular diastole?

Answer 42

It opens to allow blood flow from the left atrium to the left ventricle

Question 43

What is the pressure range in the aorta of a young adult?

Answer 43

100 to 120 mm Hg

Question 44

What is the average pressure in the right atrium (RA)?

Answer 44

0 to 5 mm Hg

Question 45

What are the two types of cardiac valves?

Answer 45

* Atrioventricular (AV) valves * Semilunar valves

Question 46

Which valves separate the atria from the ventricles?

Answer 46

* Tricuspid valve * Mitral (bicuspid) valve

Question 47

What prevents backflow of blood into the atria during systole?

Answer 47

The closure of the atrioventricular (AV) valves

Question 48

What are the two semilunar valves?

Answer 48

* Pulmonic valve * Aortic valve

Question 49

How does the coronary arterial system supply blood to the heart muscle?

Answer 49

Coronary arteries originate from the aorta just beyond the aortic valve

Question 50

What is the primary time for coronary artery blood flow to the myocardium?

Answer 50

During diastole

Question 51

What is the normal range for cardiac output (CO) in adults?

Answer 51

3 to 6 L/min

Question 52

What does stroke volume (SV) refer to?

Answer 52

The amount of blood ejected by the left ventricle during each contraction

Question 53

What factors influence stroke volume (SV)?

Answer 53

* Heart rate (HR) * Preload * Afterload * Contractility

Question 54

What is preload?

Answer 54

The degree of myocardial fiber stretch at the end of diastole before contraction

Question 55

What is afterload?

Answer 55

The pressure or resistance that the ventricles must overcome to eject blood

Question 56

What is Starling’s law of the heart?

Answer 56

The more the heart is filled during diastole, the more forcefully it contracts

Question 57

What is cardiac contractility?

Answer 57

The force of cardiac contraction independent of preload

Question 58

What can decrease myocardial contractility?

Answer 58

* Hypoxia * Acidemia

Question 59

What are the characteristics of cardiac muscle cells?

Answer 59

* Automaticity * Excitability * Conductivity * Contractility * Refractoriness

Question 60

What regulates heart rate (HR)?

Answer 60

The autonomic nervous system (ANS)

Question 61

What is the normal resting heart rate for an adult?

Answer 61

60 to 100 beats/min

Question 62

What is the effect of sympathetic stimulation on heart rate?

Answer 62

Increases the heart rate

Question 63

What is the role of the parasympathetic system on heart rate?

Answer 63

Slows the heart rate

Question 64

What is mean arterial pressure (MAP) necessary for coronary perfusion?

Answer 64

At least 60 mm Hg

Question 65

What does cardiac index adjust for?

Answer 65

Differences in body size

Question 66

What is the cardiac index range?

Answer 66

2.8 to 4.2 L/min/m2

Question 67

What happens to the heart muscle during relaxation?

Answer 67

Calcium ions are pumped back into the sarcoplasmic reticulum

Question 68

What is myocardial contraction primarily caused by?

Answer 68

The release of calcium ions from the sarcoplasmic reticulum and blood