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Anesthesia Principles II > Cardiac test stuff to memorize > Flashcards

Cardiac test stuff to memorize Flashcards

(50 cards)

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1
Q

Three meds that increase Calcium by preventing Ca brakdown?

A

PDE inhibitors
glucagon
digitalis

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2
Q

drugs/states that slow ca channels and decrease Ca entry into cardiac cells?

A

acidosis
volatiles
N2O

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3
Q

SNS innervation of the heart?

A

T1-T4 and stellate ganglion

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4
Q

what makes up SV?

A

preload after load and contractility

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5
Q

75% of blood volume resides in?

A

veins

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6
Q

Bainbridge reflex?

A

increased volume in RA causes increased HR by 10-20%

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7
Q

what establishes length of myocyte immediately before isovolumetric contraction?

A

preload

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8
Q

what is the law for wall tension? what is the formula?

A

Law of laplace

T(wall tension)=P (pressure) x (radius)

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9
Q

formula for SVR

A

SVR=80 (MAP-CVP/CO)

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10
Q

normal SVR range?

A

900-1500

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11
Q

normal PVR range?

A

50-150

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12
Q

PNS innervates what in the heart?

A

atria and conduction tissue

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13
Q

what aspects of chemical enviroment affect contractility? what is the most important?

A

Ca, Mg, O2, pH

Ca is the most important

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14
Q

normal EF?

A

68%

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15
Q

Left main coronary artery divides into what?

A

LAD and circumflex

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16
Q

LAD has what branches? what do they supply?

A

1-3 diagonals anterolateral LV

septal branches: septum, bundle branches, purkinje fibers

LAD supplies 45-55% of the LV, runs in inter-ventricular groove

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17
Q

Circumflex supplies what and has what branches that supply what?

A

1-3 obtuse marginals: lateral wall of LV and part of SA node

in 15% of people gives rise of PDA

runs in the AV groove

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18
Q

what does RCA supply and branch into?

A

divides into acute marginal branches

supplies RV, right anterior wall, SA node

gives rise to PDA in 85% of people

SA node in 60% of people

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19
Q

normal CPP?

A

60-80

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20
Q

CPP formula? autoregulated in what range?

A

CPP = AoDBP-LVEDP

50-150

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21
Q

normal O2 content in the blood?

22
Q

primary determinant of O2 level in the blood?

23
Q

MVO2 formula?

Study These Flashcards
A

MVO2=CBF-(CaO2-Cvo2)

24
Q

3 main determinants of myocardial oxygen consumption? What is most important?

Study These Flashcards
A

HR, contractility, and wall stress

HR is the most important one. Doubling HR more than doubles O2 demand, so non linear relationship

25
how to calculate wall stress?
Wall stress (tension) = (pressure x radius) / (2 x wall thickness)
26
MAP correlates with, ______ not ______
MVO2, not SBP
27
doubling pressure in the heart _____ O2 demand
doubles
28
increased pre load increases MVO2 to a _____ ______
lesser extent
29
formula for CBP?
CPP/CVR
30
normal CBF?
225-250ml/min
31
What will increase CVR?
increased O2 decreased CO2 decreased H+ increased alpha 1 increased cholinergic tone increased vasopression antiogensin thromboxane
32
what causes decreased CVR?
decreased O2 increased CO2 increased H+ increased Beta 1 tone prostacyclin NO endothelial derived hyperpolarizing factor prostaglandin I2
33
what does alpha 1 stimulation do?
constriction, mainly epicardial arteries
34
what does beta 1 stimulation do?
dilation, mainly intramuscular arteries
35
how do benzos affect hemodynamics?
limited hemodynamic effects
36
why do bad hearts love opioids?
decreased O2 demand without decreased contractility
37
what opiod will increase HR and contractility?
meperidine (Demerol)
38
CV effects of opioids?
decrease SVR (worse with benozs) decrease Preload (worse with histamine release) decreased SNS stimulation
39
what are alpha 2 agonists used for in cardiac surgery?
decrease HR and BP, used intra-op and post op to decrease opioid requirement, and therefore less resp depression
40
Volatiles effects on on hemdynamics?
all decrease contractility and all decrease afterload Sevoiso>sevo
41
Nitrous Oxide effects on hemodynamics?
decreased contractility, increased PVR
42
what to watch for with Succ?
bradycardia, espeically with repeat doses
43
how does pancuronium affect hemodynamics?
increase HR by 20%, attenuated by high dose narcotic admin
44
how do vec and roc affect hemodynamics?
minimal CV effects, possible bradycardia
45
cisatricurium effects on hemodynamics?
no effect
46
how soon do you see ST changes?
1-2min after ischemia ocurs
47
where do you look for ST chagnes?
0.08 seconds after j point
48
which leads are the most sensitive for ischemia? what percentage of ischemia do they detect?
2,3, aVF and especially V5 detect 90% of ischemia
49
new onset V wave on PCWP indicates what?
papillary muscle dysfunction
50
downstroke on a-line represents what?
PVR

Anesthesia Principles II (14 decks)

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