CABS CHF, HF, Shock

Question 1

Phrenic nerve assists with sensory signalling from the

Answer 1

pericardium

Question 2

Phrenic nerve innervates the

Answer 2

diaphragm to help with respiration

Question 3

Cardiac innervation: _____ nerve innervates the efferent and afferent parasympathetic

Answer 3

vagus

Question 4

Cardiac innervation: _____ and _____ ganglia innervates with efferent and afferent sympathetic

Answer 4

cervical and thoracic

Question 5

Heart Failure is

Answer 5

syndrome of decreased cardiac output
(failure to meet its obligations)

Question 6

Heart Failure presents with

Answer 6

fluid overload (large edematous legs/ pulm edema)

Question 7

Classifications of HF

Answer 7

acute vs chronic
compensated vs decompensated
right sided vs left sided
systolic vs diastolic

Question 8

Acute HF is

Answer 8

abrupt onset, more sudden/ severe sx
associated with acute heart disease

Question 9

Chronic HF is

Answer 9

develops over months to years
more common
associated with cardiomegaly
hallmarked by fluid overload (peripheral edema, pulm edema)

Question 10

Left sided HF is

Answer 10

most common type
left ventricular failure - decreased CO
leading to HTN, tissue ischemia, pulmonary edema (backing up into the right side)

Question 11

Right sided HF is

Answer 11

right ventricular failure
primary causes: pulm HTN, pulm valve stenosis, increased preload, decreased contractility
secondary: m/c cause Left sided heart failure

Question 12

Compensated HF

Answer 12

body is able to compensate for the underlying heart disfunction - typically decribes someone’s chronic state

Question 13

Compensatory mechanisms during HF

Answer 13

body will try and fix the strain on the heart and decrease CO, in turn leading to the renin-angiotensin-aldosterone system being activated (thus making it worse)

Question 14

Systolic HF is

Answer 14

left ventricle can’t squeeze effectively (HFrEF)

Question 15

Diastolic HF is

Answer 15

cant dilate/ relax enough for the heart to properly fill (HFpEF)

Question 16

How to measure EF?

Answer 16

ECHO

Question 17

Causes of systolic HF

Answer 17

MI (m/c)
Dilated cardiomyopathy
tachyarrhythmia

Question 18

Causes of diastolic HF

Answer 18

decreased preload
restrictive cardiomyopathy
pericarditis
increased afterload

Question 19

Preload is

Answer 19

volume of blood in the ventricles at the end of diastole (end diastolic pressure)

Question 20

Afterload is

Answer 20

resistance the left ventricle must overcome to circulate blood
increase afterload = increased cardiac workload

Question 21

Presentation of HF includes

Answer 21

S3 heart sound
crackles (pulm edema)
elevated JVD
hepatojugular reflux
peripheral edema
SOB, orthopnea, PND
Ascites

Question 22

Edema is

Answer 22

excess interstitial fluid volume, increased Na+ retention typically increases in edema
m/c in LE

Question 23

Anasarca is

Answer 23

diffuse edema (everywhere)

Question 24

Pitting vs non pitting edema

Answer 24

pitting - more common, typical underlying pathophysiology
non pitting - more reflective of lymphatic obstruction

Question 25

Shock is

Answer 25

a life-threatening condition characterized by inadequate delivery of oxygen and nutrients to vital organs relative to their metabolic demand (inadequate O2 delivery/ nutrient supply) - resulting in end-organ dysfunction

Question 26

Shock index =

Answer 26

HR / systolic BP

Question 27

If shock index is greater than ___ this indicates

Answer 27

1 LV dysfunction, higher mortality rate

Question 28

shock =

Answer 28

hypoprofusion

Question 29

Cardiogenic shock results from

Answer 29

decreased cardiac function, typically LV resulting in decreased perfusion to peripheral tissues

Question 30

Cardiogenic shock is associated with

Answer 30

MI, arrhythmia, HF, valve dysfunction

Question 31

Positive inotropic medications cause

Answer 31

increase muscular contraction

Question 32

Positive chronotropic medications cause

Answer 32

increases HR

Question 33

Vasopressors cause

Answer 33

vasoconstriction

Question 34

If the IV infiltrates when giving vasopressors what can happen

Answer 34

leaks out into the tissues from the vein and can cause necrosis of the limb

Question 35

Hypovolemic shock results from

Answer 35

decreased intravascular volume marked by decreased preload, increased vascular resistance and decreased CO seen with hemorrhage, capillary leak, GI losses, thermal burns

Question 36

Distributive shock results from

Answer 36

redistribution of blood volume systemic vasodilation - decreased preload marked by decreased preload, increased systemic vascular resistance, mixed CO think septic shock**, neurogenic shock, anaphylactic shock

Question 37

Neurogenic shock results from

Answer 37

disruption of the autonomic pathway (this includes parasympathetic and sympathetic) most commonly seen in thoracic level trauma

Question 38

Neurogenic shock presents with

Answer 38

hypotension, bradycardia, flushing below (LE)

Question 39

Obstructive shock results from

Answer 39

decreased venous return or decreased cardiac compliance (squeezed and obstructed)

Question 40

obstructive shock is associated with

Answer 40

PE