Cardiac

Question 1

Cardiac cycle

Answer 1

begins in Vent diastole (muscle relaxes) = 70% of blood flow
- remaining 30% left in atria is pumped into vents in atria systole (closure of AV valves)
- Pressure builds in vents then 55-70% ejected to pul and systemic systems

Question 2

What makes S1

Answer 2

closure of AV valves; mitral and tricuspid

Question 3

what makes S2

Answer 3

closure of semilunar (AV and PV) valves

Question 4

Stroke volume

Answer 4

volume of blood ejected by each vent perisitnelty Approx 70 ml

Question 5

EF

Answer 5

SV/EDV (amount of blood in the ventricles before systole) 55-70%

Question 6

Cardiac Output

Answer 6

HR X SV

Question 7

SV

Answer 7

Preload, afterload and contractility

Question 8

Preload

Answer 8

Volume / stretch / loading the heart

Question 9

Afterload

Answer 9

pressure / resistance
opens semi-lunar valves

Question 10

Frank starling law

Answer 10

stretching cardiac muscle fibers during diastole will result in a stronger contraction

Question 11

Causes of increased afterload

Answer 11

COPD, Systemic HTN, pul HTN, aortic valve stenosis

Question 12

Decreased afterload causes

Answer 12

hypotension or vasodilation (shock)

Question 13

Most immediate effect on afterload

Answer 13

HTN

Question 14

Laplace’s Law

Answer 14

heart must work harder (increase tension or force) when the muscle is weak

Question 15

Contractility

Answer 15

determined by calcium ion available and its interaction with actin and myosin. (inotropic state)

Question 16

Causes of Decreased contractility

Answer 16

Acidosis, ischemia and cardiomyopathy

Question 17

Heart failure

Answer 17

Less CO to meet body’s demands. dec contractility and SV and increased LVEDP and increased preload

Question 18

Heart failure causes

Answer 18

Decreased contractility, SV, and increased LVEDF = heart dilation and increased preload

Question 19

Major risk factor for developing HF

Answer 19

HTN

Question 20

left Sided Heart Failure

Answer 20

HFrEF

Question 21

Cause of HFrEF

Answer 21

HTN - inc afterload- inc preload (unable to eject normal amount of blood) -inc blood volume and pressure in pul veins - forced fluid out of vessels into tissues.

Question 22

Unresolved Left HF causes

Answer 22

pressure/build up to right side of heart causing right sided heart failure

Question 23

Right sided Heart failure

Answer 23

HFpEF

Question 24

Patho of Right HF

Answer 24

inability of the right ventricle to provide adequate blood flow into pulmonary circulation. pul HTN, COPD, Left HF

Question 25

high output (bi-V) failure

Answer 25

unresolved right heart failure results in left HF

Question 26

Causes of High-out-put failure

Answer 26

severe anemia, nutritional deficiencies (berry-Berry), hyperthyroidism, sepsis (inc metabolic rate), extreme febrile states

Question 27

Stages of heart failure

Answer 27

A : no symptoms /has risk factors B: no symptoms/structure defects like MI C: has symptoms (classifications come into play) D: end stage / failure treatment needs pacer /transplant

Question 28

Classifications of HF

Answer 28

Classified level of severity/damage starts are stage C

Question 29

Class 1 HF

Answer 29

Mild; no physical limitations.

Question 30

Class 2 HF

Answer 30

mild; slight limitation to physical activity. comfortable at rest

Question 31

Class 3 HF

Answer 31

moderate; marked decreased with physical activity. marked limited physical activity. Comfortable at rest

Question 32

Class 4 HF

Answer 32

sever. cant complete physical activities without discomfort. no comfortable at rest.

Question 33

Aortic Stenosis

Answer 33

Mid systolic cresendo decresendo murmur heard loudest at base

Question 34

S 4 gallop present, fainting, sustained laterally placed apical pulse

Answer 34

Aortic stenosis

Question 35

Aortic Regurgitation

Answer 35

early, high-pitched diastolic murmur heard at the left lower sternal border.

Question 36

HTN, SOB that progressively worsens, cardiomegaly and pul edema on CXR

Answer 36

Aortic Regurgitation

Question 37

Mitral stenosis

Answer 37

Rumbling, decrescendo (low pitched) diastolic murmur heard at apex of the heart

Question 38

SOB with activity, pounding racing heart, JVD, Crackles,

Answer 38

Mitral stenosis

Question 39

history of rheumatic heart disease associated with

Answer 39

Mitral stenosis

Question 40

mitral regurgitation

Answer 40

blowing pansystolic/holosystolic murmur best at the heart's apex

Question 41

SOB, JVD, crackles in bases

Answer 41

Mital regurgitation

Question 42

4+ pulses, HTN, pul edema and cardiomegaly

Answer 42

Aortic regurgitation

Question 43

modifiable risk factor for Coronary Artery Disease (CAD)?

Answer 43

Obesity

Question 44

Coronary artery disease (CAD) is mainly the result of

Answer 44

Longstanding atherosclerosis.

Question 45

In CAD pumping ability of the heart can be impaired due to the deprivation of oxygen Ture or false

Answer 45

True

Question 46

major risk factor for the development of CAD is

Answer 46

Family history

Question 47

Cor Pulmonale is

Answer 47

Right ventricular failure secondary to pulmonary hypertension

Question 48

Most common cause of right heart failure is

Answer 48

Pulmonary HTN

Question 49

In the healthy heart, the response to an increase in preload is for the stroke volume to

Answer 49

Increase

Question 50

Hypertension has its most immediate effect on

Answer 50

Afterload

Question 51

JVD, Hepatosplenomegaly, peripheral edema, cor polmonale, tricuspid valve damage

Answer 51

Right sided heart failure

Question 52

Decreased EF, increased LV preload, pulmonary edema and dyspnea

Answer 52

Left sided heart failure

Question 53

LVEDP

Answer 53

left vent end diastolic volume and if increased in HR = increased preload