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Flashcards in Cardiopulmonary System Deck (118):
1

What are the 2 layers of the pericardium

Epicardium
2nd layer (unnamed)

2

What does the epicardium do

facilitates contraction and relaxation (outer later)

3

What does the 2nd layer do

directly surrounds heart muscle

4

What is the myocardium

middle later of heart

5

what is the endocardium

the inner layer of the heart

6

What does the endocardium do

helps mediate flow

7

What is the function of heart valves

controls blood flow from atria to ventricles and the ventricles into 2 larger arteries

8

Heart valves

Tricuspid
Pulmonary
Mitral
Aortic

9

Where is the tricuspid valve

right side b/t right atrium and the right ventricle

10

Where is the pulmonary valve

right side of the heart b/t right ventricle and the entrance to the pulmonary artery which carries blood to the lungs

11

Where is the mitral valve

left side of heart b/t the left atrium and the left ventricle

12

Where is the aortic valve

left side of the heart b/t the left ventricle and the entrance to the aorta which carries blood to the body

13

What is the cardiac cycle

sequence of events occurring during one complete heartbeat or contraction-relaxation sequence

14

What is systole

contract and eject

15

what is diastole

relax and filling

16

Order of the cardiac cycle

-Venous blood flows from the R atrium through tricuspid and into the R ventricle during diastole
-During systole blood from R ventricle is pushed through the pulmonic valve into pulmonary arterial circulation where it's oxygenated
-oxygenated blood returns through pulmonary veins to L atrium
-Then through mitral valve into L ventricle during diastole
-During systole, L ventricular volume is ejected through the aortic valve into aorta and systemic arterial circulation

17

What is not in cardiac muscle

nerves

18

What is in cardiac muscle instead of nerves

structures that assist the ventricles to contract

19

Where do conduction pathways originate

SA (sinoatrial) node

20

What is the SA node

Hearts natural pacemaker

21

What does the SA node do

generates the 1st impulses initiating the cardiac cycle a basic rate

22

What is the basic heart rate known as
What is it

Sinus rhythm
70 beats/min

23

What happens upon contraction of the SA node

both atria contract forcing blood into the ventricles. Impulses then pass to the AV node

24

Where does the AV node pass the impulse

To the bundle of His. There's a slight delay to allow ventricles to fill. From the bundle of his fibers branch off into R and L bundles and split into Purkinje fibers

25

What stimulates the ventricles to contract

impulse from the purkinje fibers

26

What is a ECG/EKG

Test electrical activity in the heart

27

What does depolarization do

takes away from the resting membrane potential

28

What does repolarization do

Taking back to resting potential

29

What is HR and force of contraction controlled by

the medulla

30

What is tachycardia

increase in HR caused by sympathetic NS

31

What is bradycardia

Decrease in HR caused by parasympathetic NS or vagus N stimulation

32

What factors contribute to increased HR

increase in body temp, env temp
exercise
smoking
any stimulation of the CNS

33

What is normal blood pressure

Systolic= less than 120
Diastolic=less than 80

34

What is prehypertension BP range

systolic= 120-139
Diastolic= 80-89

35

What are the ranges for stage 1 high BP

systolic= 140-159
diastolic= 90-99

36

What are the BP ranges for stage 2 high BP

systolic= 160 or higher
diastolic= 100 or higher

37

What is coronary artery disease secondary to

atherosclerosis (narrowing of the coronary arteries due to build up of plaque)

38

What does coronary artery disease lead to

reduced blood flow, reduction of nutrients and oxygen to the heart

39

What is the leading cause of death in the US

Coronary artery disease

40

What are risk factors for coronary artery disease

genetics/fam hx
obesity
smoking
sedentary lifestyle
diabetes
hypertension
combination of oral contraceptives
smoking

41

What are the clinical manifestations of coronary artery disease

Angina
Nausea/vomiting
diaphoresis (excessive sweating)
fatigue
pallor
cool extremities
SOB

42

What is angina

pressure, tightness, squeezing in the chest, chest pain can be felt in jaw, neck, left arm

43

When does angina occur

when there is a deficit of oxygen to the heart muscle

44

What is the tx for angina

rest
medication
avoidance of exertion and precipitating events

45

What are the 2 types of angina

Stable
unstable

46

What is stable angina

most common
usually associated with an activity
resolves after a few min of rest/meds

47

What is unstable angina

no pattern
not triggered by an activity
doesn't resolves
emergent care required (may be signaling a heart attack)

48

What is atherosclerosis

plaque builds up inside the walls of larger arteries (aortic or pulmonary)

49

What is arteriosclerosis

build up of plaque in the small blood vessels which feed the heart

50

What is the etiology of athero/arteriosclerosis

age
men
genetics
obesity
smoking
sedentary lifestyle
diabetes
hypertension
oral contraceptives and smoking together

51

What are the clinical signs of athero/arteriosclerosis

lead to CAD
peripheral artery disease (narrowing of limbs and pelvis)
CVA
HTN
Aneurysms (thoracic aortic or abdominal aortic)

52

Where does an aortic aneurysm occur

upper part of the aorta

53

Where does an abdominal aorta occur

lower part of the aorta

54

Med intervention and tx for athero/arteriosclerosis

diet/exercise
lifestyle changes
control of diabetes/hypertension
surgery

55

Kinds of surgery for athero/arteriosclerosis

Endartectomy
angioplasty
bypass (CABG)

56

What is a endartectomy

scraping and cleaning out plaque in artery

57

What is an angioplasty

use a balloon to open blockage in artery, then place stent to keep artery open

58

What is bypass

use a healthy blood vessel from another part of the body and connect the artery to other arteries in the heart so blood is able to pass around the blocked area

59

What are the 2 most common veins used in bypass

saphenous
mammary artery

60

What is myocardial infarction

Heart attack

61

When does Myocardial infarction occur

when a coronary artery is totally obstructed (due to plaque) leading to prolonged ischemia and cell death

62

Signs and symptoms of myocardial infarction

pain (below sternum, chest, left arm, neck, steady and severe)
pallor, sweating, nausea, dizziness, weakness, dyspenea
marked anxiety and fear
hypotension, rapid pulse
low grade fever
enzymes from damaged/dead myocardial cells aer released into blood (one way to dx after it occurred)

63

Prevention and tx of myocardial infarction

modify risk factors
low does aspirin daily
drugs to decrease lipid levels
coronary bypass surgery
immediate coronary angioplasty
meds (nitrates, beta blockers, calcium channel blockers)

64

What is the prognosis for myocardial infarction

of those who die, 60% do in the 1st hour
long term based n preexisting conditions

65

How long can it take to heal heart muscle

4-8weeks

66

what should early activity be like after MI

Not exceed 1-2 mets

67

What do nitrates do

increase o2 to heart

68

what do beta blockers do

reduce workload of heart

69

what do calcium channel blockers do

decrease BP

70

What are normal resting heart rates

60-100 bpm

71

what is the etiology of cardiac arrhythmias

damage to heart
electrolyte abnormalitiesfever
hypoxia
stress
infection
drug toxicity
caffeine

72

What is atrial flutter
how do you treat it

HR 250-350 BPM
treat w/ meds, cardioversion (shock heart)

73

What is atrial fibrillation

rates over 350 BPM

74

What is the most common sustained arrhythmia

atrial fibrillation

75

What is atrial fibrillation associated w/

CHF

76

How to tx atrial fibrillation

pacemaker
meds
cardioversion
ablation (rake off diseased heart muscle)

77

What is ventricular flutter and fibrillation

rapid rhythm 250 r more bpm
originating in ventricles

78

What is ventricular flutter and fibrillation associated with

MI

79

How to treat ventricular flutter and fibrillation

CPR
defibrillation (aed)

80

What is flutter

still some blood being ejected from heart

81

what is fibrillation

no blood being ejected leading to cardiac death

82

What is tachycardia

abnormal rapid rhythm
sinus rhythm exceeding 100 beat/min

83

What causes tachycardia

response to stress
excessive caffeine and tobacco use
heart disease

84

What are the clinical manifestations of tachycardia

palpitations
lightheaded
dizzy
chest pain
fatigue

85

Tx fro tachycardia

stress management
decrease tobacco caffeine use
sedation
vagal stim (slows hr through implanted device)
meds

86

what is the prognosis of tachycardia

good in absence of heart disease

87

What is bradycardia

hr of less that 60 beats/min

88

when does badycardia occur

naturally duing rest and sleep

89

signs and symptoms of bradycardia

usually asymptomatic
confusion
hypotension

90

When does congestive heart failure occur

when cardiac output isn't sufficient to meet the metabolic demands of the body
secondary to another condition

91

CHF is what kind of condition

Chronic

92

Risk factors for CHF

aging
disorders of heart and other organs
abnormal congenital anatomy

93

clinical manifestations of CHF

Fatigue and weakness
dyspenea (SOB)
exercise intolerance
cold intolerance
tachycardia
pallor
daytime oliguria (decreased urine output)
cough
edema in feet and legs
hepatomegaly (enlarged liver)
splenomegaly (enlarged spleen)
headaches
flushed face
paroxysmal nocturnal dyspnea (frothey blood stained sputum)

94

etiology of CHF

increased pre-load
decreased pre-load
increased after loading
decreased contractibility

95

What is increased pre-load

fluid backs up into lungs (edema may be present in ankles and feet)

96

what is decreased pre-laod

fluid continues to back u causing the ehart to pump out less fluid and heart starts to enlarge. L ventricle pumps out less fluid and theres more back up into the body and heart

97

What is increased after loading

heart unable to eject fluid comlpetely which results in decreased o2 to heart, enlargement of heart. (LEFT VENTRICLE BECOMES WEAKER FORCE)

98

What are causes of decreased contractibility

atherosclerosis
degenerative changes of aging
necrosis of myocarium due to MI

99

What is a result of CHF

increased metabolic demands
affects kidneys ability to dispose of sodium and water which leads to furhter edema

100

Tests for CHF

radiographs (chest xray)
arterial blood gases

101

What do arterial blood gases do

used to determine how well your lungs move o2 into the blood and remove CO2 from the blood

102

Tx for CHF

tx underlying problems as able
meds
counseling and edu regarding lifestle
life style changes (diet/exercise)
ronary artery bypass graft, angioplasty

103

What is cardiomyopathy

impairment of cardiac contraction due to primary diesease of myocardium
weakened and enlarged heart muscle

104

What causes cardiomyopathy

virus
alcohol consumption
pregnancy (last trimester, proteins leak from uterine muscles)
long standing HTN
infection

105

Clinical manifestations of Cardiomyopathy

same as CHF
often asymptomatic

106

Prevention and tx for cardiomyopathy

lifestlye changes
tx underlying problems

107

What is hypertension

BP consistently over 140/90

108

Three categories of hypertension

primary or essential
secondary
malignant

109

What causes primar hypertension

idiopathic

110

what causes secondary hypertension

from renal or endocrine disease, pregnanc

111

What causes malignant hypertension

uncoontrollable
severe
progressive

112

What causes hypertension

age 60+
men
african american
excessive alcohol intake
obesity
prolonged or recurrent stroke
genetic

113

Signs and symptoms of hypertension

asymptomatic
fatigue
malaise
headache
elevated BP
high risk for CVA, PVD

114

What is rate of perceived exertion

allows pt to self monitor how they tolerate activities or exercise
ordinal scale from 6-20

115

What is the most widely used RPE scles

Borgs

116

What to do for OT

eval and analyze pt occupations
psychosocial adjustment (may have depression, fear, anxiety)
edu/lifestye changes
work simplification
energy conservation
raelaxation/stress mngmt
edu/prevention
home program 9strength and endurance)
monitor BP, HR, vitals

117

Cardiac rehab phases

Phase 1- in pt
phase 2- formal out pt rehab
phase 3- ongoing more independent exercise

118

What are the layers of the heart

Pericardium
Myocardium
Endocardium