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CCRN > C2: Cardiovascular: Physiology & Assessment > Flashcards

C2: Cardiovascular: Physiology & Assessment Flashcards

(61 cards)

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0
Q

Where is the base of the heart?

A
  1. Superior, posterior, right

2. 2nd ICS

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1
Q

Where is the apex of the heart?

A
  1. Inferior, anterior, left

2. 5th ICS, MCL

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2
Q

List the layers and sub layers of the cardiac wall.

A

Pericardium

Serous
-parietal
(Pericardial space)
-visceral aka epicardium

Epicardium

Fatty CT

Myocardium

Endocardium

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3
Q

Fxn of pericardium?

A

Keep heart stationary

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4
Q

Layers of the pericardium?

A
  1. Fibrous: protects against infection and neoplasm

2. Serous: parietal, (pericardial space),visceral aka epicardium

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5
Q

Normal amt of fluid in pericardial space?

A

10-30cc

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6
Q

Constituents of myocardium.

A
  1. Specialized conduction fibers

2. Interlacing cardiac muscle fibers

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7
Q

Constituents of endocardium.

A
  1. CT
  2. Elastic fibers
  3. Endothelial cells
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8
Q

Fxn of endothelial cells.

A

Form smooth surface for blood contact .:. Deters clot formation

Lines chambers and valves

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9
Q

Type of tissue and Location of cardiac skeleton?

A

CT at base of the heart and interventricular septum

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10
Q

Describe the atria

A

Thin-walled, LOW pressure chambers

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11
Q

P in R atrium?

A

2-6mm Hg

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12
Q

P in L atrium?

A

8-12 mm Hg

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13
Q

What % of blood fills by passive ventricular filling?

A

70-75%

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14
Q

What % of blood fills by active ventricular filling and what is the mechanism?

A

25-30%

Atrial contraction at the end of ventricular diastole

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15
Q

4 inflow tracts to R atrium?

A
  1. SVC
  2. IVC
  3. Coronary sinus
  4. Thebesian veins
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16
Q

Outflow tract of R atrium?

A

Tricuspid

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17
Q

4 inflow tracts of L atrium?

A

4 OXYGENATED pulmonary veins

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18
Q

Outflow tract of L atrium?

A

Mitral

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19
Q

Which chambers contain trabeculae?

A

Ventricles

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20
Q

Describe the thickness of the RV and LV

A

RV: thin walled
LV: thick walled

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21
Q

RV Pressure

A

Low 25/5

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22
Q

Outflow tract of RV?

A

Pulmonary artery (DEOXYGENATED)

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23
Q

Describe LV position

A

Posterior

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24
Pressure in LV?
LV 120/5
25
Outflow tract of LV
Aorta
26
Purpose of cardiac valves
Maintain unidirectional flow
27
Define stenosis
Narrowing of the valvular orifice preventing normal antegrade flow
28
3 definitions for the inadequate closure of the valvular orifice allowing retrograde flow
1. Regurgitant 2. Incompetent 3. Insufficient
29
Position of AV valves during diastole? Is this active or passive?
Open, passive
30
Position of AV valves during systole? Mechanism?
Closed Active process by contraction of papillary muscles
31
Which heart sound accounts for the closure of the AV valves?
S1 Components: M1 and T1
32
Describe the location of the semi lunar valves
Between the ventricles and the great vessels
33
What are the components of the semi lunar valves
An annulus and three cusps
34
How do the semi lunar valves operate?
Pressure gradients
35
Which heart sound are the semi lunar valves are responsible for?
S2 Components A2 and P2
36
Where are the coronary arteries located?
The first branch off the aorta, immediately after the aortic valve
37
What percentage of cardiac output does the myocardium receive
5% also, it extracts 65 to 80% of oxygen in the blood even at a basal rate
38
How is bloodflow in the coronary artery is regulated
Almost entirely by local auto regulation based on the myocardium's metabolic demands
39
When is the left ventricle perfused
Primarily during diastole due to compression of the musculature (and therefore intramuscular vessels) during systole
40
When is the right ventricle perfused during the cardiac cycle
greater in diastole but throughout the cardiac cycle
41
Define aortic root pressure
The pressure in the aorta immediately outside the aortic valve. This is a significant part of coronary artery filling pressure
42
What is the equation for coronary artery perfusion pressure (CAPP)?
CAPP= DBP - PAOP *PAOP aka PA wedge pressure or pulmonary capillary pressure
43
List the four determinants of myocardial oxygen demand
1. heart rate 2. Preload 3. After load 4. Contractility
44
What are the four determinants of oxygen supply
1. Patent arteries 2. Diastolic pressure 3. Diastolic time 4. Oxygen extraction
45
What parameters affect oxygen extraction
1. hemoglobin | 2. Arterial oxygen saturation (sao2)
46
What are the two main coronary arteries?
The left main coronary artery and the right coronary artery
47
The left main coronary artery bifurcates into which two vessels
1. LAD left anterior descending | 2. LCA Left circumflex artery
48
Which areas of the heart does the LAD supply
1. Anterior LV 2. Anterior 2/3 of IVS 3. Apex of LV 4. Bundle of his and bundle branches
49
Which areas of the heart does the LCA supply
1. LA 2. SA node 45% of hearts 3. AV node 10% of hearts 4. Marginal (obtuse marginal) branch supplies Lateral LV and posterior LV
50
Which areas of the heart do the RCA supply
1. Right atrium 2. SA node (55% of hearts) 3. L posterior hemibundle (dual blood supply from RCA and LAD) 4. Marginal branch
51
Which areas do the marginal branch of the RCA supply
1. Lateral RV | 2. Inferior RV
52
What percentage of hearts are dominated by the RCA
80%
53
In RCA dominant hearts, a branch of RCA referred to as the posterior descending artery PDA supplies what parts of the heart
1. Anterior RV 2. Inferior wall of LV 3. Posterior LV 4. Posterior 1/3 of septum
54
What is collateral circulation
Dear arterial vessels that connects a.k.a. anastomose with each other
55
What factors foster the development of collateral circulation
Anemia, hypoxia, and arteriosclerosis
56
Where do most coronary veins empty
Right atrium
57
The Thebesian veins drain some of the venous blood from the myocardium directly into where
Right atrium, right ventricle, and left ventricle rather then the coronary sinus
58
What is the physiological effect of venous blood emptying directly into the left ventricle
It creates a normal physiologic shunt because it slightly decreases the oxygen saturation
59
Describe the pathway of cardiac lymphatic drainage
Main cardiac channel>pre tracheal node>lymphatic duct
60
What facilitates cardiac lymphatic drainage
Contraction

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