Cardiovascular Flashcards
(206 cards)
1
Q
relaxation & filling
A
diastole
2
Q
contraction & ejection of blood
A
systole
3
Q
sounds made by turbulent BF
A
murmur
4
Q
palpable murmur
A
thrill
5
Q
rhythmical throbbing of arteries as BF through
against bony prominence
A
pulse
6
Q
difference in rate between apical & radial/peripheral pulses
A
pulse deficit
7
Q
sound made by closure of atrioventricular valves (mitral, tricuspid)
A
S1
8
Q
S1 occurs when?
A
end of diastole
beginning of systole
9
Q
sound made by closure of semilunar valves (aortic, pulmonic)
A
S2
10
Q
S2 occurs when?
A
end of systole
beginning of diastole
11
Q
explain cardiac cycle including events, valve closure, sounds
A
SYSTOLE
- atria relax
- AV valves close (S1) — SL valves open
- ventricles contract
- blood moves out into pulmonic & aortic arteries
DIASTOLE
- ventricles relax
- SL valves close (S2) — AV valves open
- atria contract
- blood moves into ventricles
12
Q
inflammation/pain from inside joint
A
arthralgia
13
Q
particle moving through vessels
A
embolus
14
Q
blood clot in vessel
A
thrombus
15
Q
moving blood clot
A
thromboembolus
16
Q
cardiac output =
A
stroke volume x HR
17
Q
pathway of electrical conduction through heart (5)
A
Sinoatrial node (SA) → atrioventricular node (AV) → bundle of HIS → L & R bundle branch → Purkinje fibers
18
Q
A normal event becomes audible
A
abnormal heart sounds
19
Q
3 potential causes of a murmur
A
- Increased volume - ex pregnancy
- Abnormal valve
- Abnormal flow b/t structures
20
Q
why can pregnancy cause a murmur?
A
blood volume ↑ 45% during pregnancy
21
Q
“kentucky”
A
S3
Ventricular gallop
22
Q
when does S3 occur
A
early diastole (after S2)
23
Q
etiology of S3
A
impact of incoming blood against a distended ventricle wall
(extra compliant ventricular wall)
24
Q
How to hear S3
A
apex
bell
25
S3 can be normal in…
it is always pathological in…
children; pregnant women; athletes
\>35yo
26
“tennessee”
S4
atrial gallop
27
when does S3 occur
late diastole
before S1
28
etiology of S4
atria contract to force blood into **stiff** ventricle
29
how to hear S4
apex
bell
30
S4 is associated with…
left ventricular hypertrophy
31
when does split S2 occur?
during inspiration
32
split S2 normal in…
most young people
33
how to hear split S2
over SL valves (2nd ICS, sternal borders)
diaphragm
pt semirecumbent, quiet inspiration
34
when is split S2 pathological?
when it is heard as pt holds their breath
35
etiology of split S2 (5)
pulmonary HTN
ASD
conduction disorder
right side HF
vascular disorder
36
Valve leaflets become stiffer, narrowing valve opening
valves neither open nor close well
smaller amt of blood can pass through
valvular stenosis
37
etiology of valvular stenosis (4)
congenital
infection
overuse
Ca+ accumulation
38
congenital condition causing aortic valvular stenosis
bileaflet aortic valves
| (normally there are 3 leaflets)
39
r/f for valvular stenosis
*older age*
renal disease
CV disease
hx infections
IV drug use (infection)
CHD
40
s/s of valvular stenosis (7)
*fatigue*
wt loss
lack of wt gain (children)
palpitations
chest pain
dizziness
murmur
41
a child is not gaining weight and has palpitations…
valvular stenosis
42
complications of valvular stenosis (7)
HF
CVA
emboli
dysrhythmia
bleeding
infection
death
43
BF back through closed/closing valves
regurgitation
44
etiology of regurgitation
congenital
infection
overuse
trauma
45
r/f for regurgitation
older age
infection
congenital
46
s/s of regurgitation (6)
*fatigue; dyspnea; chest pain*
edema
emboli
CVA
47
enlargement of walls of LV
left ventricular hypertrophy
48
LVH etiology
uncontrolled HTN
valvular disease
congenital
**LV has to work harder**
49
s/s of LVH
*dyspnea; chest pain*
S4
palpitations
dizziness
activity intolerance
50
LVH can lead to…
HF
51
Inability to pump enough blood to body
↓ cardiac output
heart failure
52
systolic HF vs diastolic HF
pump failing
filling problem - not enough blood
53
why does infarction increase the heart's workload?
the rest of the heart has to “carry” the dead piece
54
why does HTN lead to hypertrophy of heart?
why does this lead to HF?
must work harder to overcome pressure in peripheral system
less space in the LV, lower stroke volume
55
HF r/f (5)
*HTN*
CAD
valvular dysfunction
MI
medications
56
A-stage HF
_at risk_ — pt with HTN, CAD, DM, family hx
57
B-stage HF
ejection fraction
_asymptomatic HF_ — pt with previous MI, LV systolic dysfunction, asymptomatic valvular disease
ejection fraction \<55%
58
C-stage HF
_symptomatic HF_ — pt with known structural heart defect, SOB, fatigue, activity intolerance, orthopnea, LVH, enlargement
59
D-stage HF
_refractory end-stage HF_ — pt with marked sx at rest despite maximal medical therapy - hospitalized & cannot be discharged w/o specialized interventions
60
New York Heart Association stages of HF
* _Class I_ — no physical activity limitation
* _Class II_ — slight limitation of physical activity; comfortable at rest
* _Class III_ — marked limitation of physical activity; normal activity causes sx; comfortable at rest
* _Class IV_ — severe limitation & discomfort with physical activity; sx even at rest
61
most common form of HF
left side
62
left sided HF vs right sided HF
where does blood back up into?
left - pulmonary circulation
right - body circulation
63
left side HF etiology (4)
HTN
CM
CAD
MI
64
complications of left side HF (2)
right side HF
pulmonary edema
65
“cor pulmonale”
right side HF
66
right side HF etiology (2)
etiology of _isolated_ right side HF
left side HF
CAD
isolated: pulmonary disease
67
complication of right side HF
ascites/3rd spacing
68
t/f most patients have sx of either left side or right side HF
false
most pts have sx of both
69
Impulses that coordinate heart do not work properly
dysrhythmias/arrhythmias
70
etiology of dysrhthmias (5)
disruption of normal conduction system
misfiring of action potential
damage to nodes
excitation of myocardial cells
genetic
71
r/f for dysrhythmias (7)
*HTN; DM; obesity*
CAD
high fat diet/high cholesterol
stimulant drug use
excessive alcohol
72
s/s of dysrhythmias (5)
palpitations
dizziness
weakness
loss of consciousness
pulse deficit
73
complications of dysrhythmias (2)
thrombi formation
CVA
74
atrium acts weird
atrial fibrillation
75
complications of a-fib
CVA - blood sloshing around in atria causes thrombus formation
76
Cessation of electrical activity of heart
cardiac arrest
77
s/s of cardiac arrest (3)
asystole
pulselessness
sudden loss of consciousness
78
tx for cardiac arrest
CPR
AED
79
Arteries supplying heart harden & narrow due to plaque buildup
coronary artery disease (CAD)
80
most common form of heart disease
CAD
81
etiology of CAD
atherosclerosis
blood components stick to plaque
82
why does smoking ↑ risk for all kinds of CV problems?
increases blood viscosity
plaque deposits in vessels
83
r/f for CAD (8)
*older age; family hx; smoking; DM; HLD; HTN; obesity*
male
84
population most affected by CAD
older males
85
s/s of CAD (4)
*dyspnea*
angina (especially with activity)
numbness in jaw/arm
other referred pain
86
complication of CAD
progression to MI
87
populations an S3 may be normal in
pregnant women
athletes
children
88
population a split S2 may be normal in
younger people
89
populations most affected by valvular stenosis
older
IV drug users
90
cardiac-related chest pain
angina
91
etiology of angina
ischemia to heart muscle
| (not yet infarction)
92
3 types of angina
* _Stable_ - predictable - with activity
* _Unstable_ - unpredictable
* _Variant_ - even less predictable
93
r/f for angina (9)
*older age; family hx; DM; HTN; HLD; obesity; smoking*
lack of cardio exercise
stress
94
locations for referred angina
jaw
arm
abdomen
95
complication of angina
MI
96
interventions & tx for if a patient is having/thinks they are having a heart attack (5)
try to calm their anxiety & slow their breathing
O2
chewable sublingual aspirin 325 mg
morphine for anxiety
PO nitroglycerine (massive vasodilator)
97
EKG indication of MI
labs indication of MI
ST elevation
T & I troponins elevated
98
muscle cells die due to hypoxia
myocardial infarction
99
etiology of MI
coronary artery blockage
100
if someone has MI, they probably have….
(same disease process)
peripheral artery disease
101
r/f for MI (8)
*older age; family hx; HTN; HLD; obesity; smoking; DM*
male
102
populations most affected by MI
older males
103
s/s of MI (7)
angina
jaw pain, arm pain
diaphoresis
dyspnea
pallor
anxiety
n/v
104
3 infectious/inflammatory disease process related to cardio
rheumatic heart disease
infective endocarditis
pericarditis
105
Valves permanently damaged by rheumatic fever
rheumatic heart disease
106
what cardio condition can strep throat lead to if untreated?
rheumatic heart disease
107
etiology of rheumatic heart disease
untreated strep throat
108
r/f for rheumatic heart disease (4)
incomplete antibiotic (stopping prematurely)
poverty
overcrowding
↓ access to medical care
109
s/s of rheumatic heart disease
*fever; dyspnea*
arthralgia
rash
nodules
uncontrolled arm/leg movement
weakness
110
SX
fever
dyspnea
arthralgia
rash
nodules
uncontrolled arm/leg movement
rheumatic heart disease
111
complications of rheumatic heart disease (3)
HF
bacterial endocarditis
damaged valves
112
Infection in heart lining, valve, or vessel of heart
infective endocarditis
113
populations most affected by infective endocarditis
immunocompromised
IV drug users
artificial valves
114
r/f for infective endocarditis (5)
IV drug use
artificial valves
damaged valve
congenital defect
hx endocarditis
115
s/s of infective endocarditis (10)
*fever; dyspnea*
new murmur
myalgia
angina
night sweats
wt loss
hematuria
Osler’s nodes (raised red lesions on hands or feet)
petechial rash
116
Osler's nodes indicate…
infective endocarditis
117
when a person has a new murmur, always do a(n) _________ assessment
integumentary
118
how to dx infective endocarditis
echocardiogram
ultrasound
119
tx for infective endocarditis
long term antibiotics
sometimes surgery
120
complications of infective endocarditis (6)
endocardial vegetations in right valves leading to emboli
abscess
HF
valvular dysfunction
seizure
aneurysm w/i heart
121
Inflammation of pericardium
third-spacing of fluid into pericardium
pericarditis
122
etiologies of pericarditis
idiopathic
viral
chronic
123
r/f for pericarditis (4)
infection
recent MI
trauma
autoimmune disorders
124
EKG indicator of pericarditis
ST elevation through all 12 leads
125
s/s of pericarditis (7)
*fever; cough*
chest pain on inspiration
orthopnea
palpitations
edema
flu-like sx
126
complications of pericarditis (2)
constrictive pericarditis
cardiac tamponade
127
permanent thickening, scarring, contraction of pericardium
constrictive pericarditis
128
pressure on heart when blood/fluid accumulates in pericardium, impairing ability to pump
cardiac tamponade
129
Beck's triad
indicates…?
_indicates cardiac tamponade_
low arterial BP
distended neck veins
distant muffled heart sounds
130
cellular & tissue hypoxia due to _↓ O2 delivery_, _↑ O2 consumption_, _inadequate O2 utilization_, or combo
shock
131
3 etiologies of shock (with regards to O2)
↓ O2 delivery
↑ O2 consumption
inadequate O2 utilization
132
6 types of shock
distributive/vasogenic
cardiogenic
hypovolemic
obstructive
septic
anaphylactic
133
**vasodilation** secondary to loss of sympathetic/vasomotor tone resulting in shock
caused by pain and fear, spinal cord injury, hypoglycemia
distributive/vasogenic shock
134
decreased pumping capability resulting in shock
caused by MI of LV, arrhythmia, PE, cardiac tamponade
cardiogenic shock
135
loss of blood/plasma resulting in shock
caused by hemorrhage, burns, dehydration, peritonitis, pancreatitis
hypovolemic shock
136
3 stages of shock
* _Pre-shock_ - compensation for ↓ tissue perfusion
* _Shock_ - compensation overwhelmed
* _End-stage shock_ - irreversible multiorgan failure
137
s/s of pre-shock (3)
tachycardia
modest BP change
mild to moderate hyperlactatemia
138
s/s of shock (middle stage between pre- and end-stage)
tachycardia
dyspnea
restlessness
diaphoresis
metabolic acidosis
hypotension
oliguria
cool/clammy skin
139
how does shock affect pH balance?
metabolic acidosis
140
s/s of end stage shock (7)
anuria/acute renal failure
acidemia
severe hypotension
hyperlactatemia worsens
restlessness
coma
death
141
Swollen, twisted, visible veins
varicose veins
142
etiology of varicose veins (2)
↑ BP in vein
weakened/damaged valves in veins
143
r/f for varicose veins (6)
*obesity; family hx; older age*
female
pregnancy
standing or sitting for long periods
144
populations most affected by varicose veins & chronic venous insufficiency
older women
pregnant women
145
s/s of varicose veins (4)
large, raised, swollen, blue/purple vein
achy heavy feeling
itching
palpable twisted, swollen vein
146
Blood in legs not able to return to heart effectively
chronic venous insufficiency
147
etiology of chronic venous insufficiency
damaged venous valves
148
r/f of chronic venous insufficiency
*older age; family hx; obesity*
female
pregnancy
standing or sitting for long periods
tallness
hx DVT
149
intervention for chronic venous insufficiency
ambulate pt
150
s/s of chronic venous insufficiency (4)
bilateral edema in legs, feet
itchy
intermittent claudication
skin changes (shinyness, loss of hair, darkening color)
151
chronic venous insufficiency uni/bilateral?
bilateral
152
why can chronic venous insufficiency lead to ulceration?
inability to carry waste products away
153
inflammation of vein wall
thrombophlebitis
154
DVT uni/bilateral?
unilateral
155
Blood clot in deep vein - usually in legs
deep vein thrombosis
156
r/f for DVT (10)
*obesity; smoking*
injury to vein
**surgery**
**immobility**/decreased mvmt/prolonged disuse
**pregnancy & postpartum period**
**oral contraceptives**
clotting disorder
cancer
HF
157
populations most affected by DVT
postsurgical pts
truckers/others who sit constantly
pregnant women/postpartum
158
s/s of DVT (4)
pain
erythema
warmth
unilateral edema in leg
159
effect of DVT on pulses
none
160
complications of DVT
PE
postphlebitic syndrome
161
how to dx a DVT
ultrasound
162
tx for DVT
meds to prevent other DVTs and enlargment of current clot
do not dissolve current clot
163
Elevated force of blood against walls of vessels
hypertension
164
normal BP
\<120/80
165
HTN range
130/\>80
166
stage 2 HTN range
\>140/90
167
most common form of HTN
essential HTN
168
\_\_% of blood goes to kidneys
45
169
decreased blood flow to kidney causes continuous stimulation of RAAS system
causes HTN
renal artery stenosis
170
how does an adrenal tumor cause HTN?
stimulates sympathetic NS
171
r/f for HTN (11)
*older age; obesity; smoking; family hx; DM*
too much alcohol
sedentary
OSA
stress
excessive Na
deficient K
172
electrolyte r/f for HTN
high Na+
low K+
173
“silent killer”
HTN
174
s/s of HTN
usually none
dyspnea
h/a
175
complications of HTN (6)
MI
HF
CVA
kidney damage
aneurysm
dementia
176
screenings for HTN
recommended for everybody
adults should have BP taken at least 1x/year
177
Narrowed arteries (due to plaque) - ↓ BF to limbs
peripheral artery disease
178
etiology of PAD
atherosclerosis
179
r/f for PAD (7)
*older age; smoking; DM; HTN; HLD; obesity; family hx*
180
s/s of PAD (9)
intermittent claudication
coldness
numbness
paleness
sores on toes
no hair
thin shiny skin
weak/absent pulse
ED
181
leg pain aggravated by activity & relieved by rest, associated with vascular diseases
intermittent claudication
182
Vessels become thick, stiff, hardened
restrict BF to organs, tissues
atherosclerosis
183
etiology of atherosclerosis
excessive lipids in bloodstream (especially LDL)
inner layer of vessel becomes injured
_plaque_ (fatty cholesterol substance) builds up at injury site & hardens
narrows vessel
impedes vessel’s ability to stretch
184
r/f for atherosclerosis (6)
*HTN; HLD; DM; smoking; family hx*
fatty diet
185
tx for atherosclerosis
statins
186
Part of vessel wall becomes weak and balloons out
aneurysm
187
r/f for aneurysm (6)
*older age; family hx; HTN; smoking*
men
trauma
188
populations most affected by aneurysms
older men
189
dissection
small hole in AAA → rupture
empties blood volume quickly into peritoneum
low survival rate
190
Anything lodged in vessels
causes ischemia & death of tissue
embolism
191
LEFT OR RIGHT SIDE HF
air hunger
left
192
LEFT OR RIGHT SIDE HF
pulmonary congestion
left
193
LEFT OR RIGHT SIDE HF
paroxysmal nocturnal dyspnea
left
194
LEFT OR RIGHT SIDE HF
orthopnea
left
195
LEFT OR RIGHT SIDE HF
tachycardia
left
196
LEFT OR RIGHT SIDE HF
exertional dyspnea
left
197
LEFT OR RIGHT SIDE HF
cyanosis
left
198
LEFT OR RIGHT SIDE HF
rales
left
199
LEFT OR RIGHT SIDE HF
raised peripheral venous pressure
right
200
LEFT OR RIGHT SIDE HF
hepatosplenomegaly
right
201
LEFT OR RIGHT SIDE HF
DJV
right
202
LEFT OR RIGHT SIDE HF
anorexia
right
203
LEFT OR RIGHT SIDE HF
dependent edema
right
204
LEFT OR RIGHT SIDE HF
weight gain
right
204
LEFT OR RIGHT SIDE HF
weight gain
right
205
ejection fraction
systolic vs diastolic HF
systolic - low EF
diastolic - normal EF
