Cardiovascular/Lymphatic Flashcards
What is preload?
The amount of blood in the LV at the end of diastole.
How many milliliters is the stroke volume usually?
55-100ml
What is frank-starling’s law?
The greater the preload the greater quantity of blood pumped
What is the normal cardiac output for an adult at rest?
4-5 L per minute
What is the ejection fraction EF?
The percentage of blood emptied from the ventricle during systole.
What is the normal EF
60-70%
The lower the more impaired the ventricle
Cholinergic stimulation is also know as?
Parasympathetic
Parasympathetic stimulation comes from what nerve and releases what substance?
CN X vagus. Releases Acetylcholine (slows rate and force of myocardial contraction) & (coronary artery vasoconstriction)
Adrenergic AKA?
Sympathetic stimulation
What nerve causes sympathetic stimulation and releases what substance?
Cord segments T1-T4, upper thoracic to superior cervical chain. Releases epinephrine and norepinephrine (increases rate & for of heart)
Hyperkalemia causes what to your heart?
- Decreases rate and force of contraction
- Widened PR & QRS interval
- Flattens P wave
- T wave becomes peaked
Hypokalemia causes what to your heart?
- Flattened T waves
- Prolonged PR & QT intervals
- Arrhythmias and Vfib
Hypercalcemia causes what to the heart?
Increases heart actions
Hypocalcemia causes what to the heart?
Depresses heart actions
What are some positive risk factors for MI?
- Age : >45 male, >55 female
- Cigarette smoking
- Sedentary lifestyle
- Obesity
- Hypertension
- Dyslipidemia: LDL >130, HDL 200
- Prediabetes: IFG >100
Name all locations to examine heart sounds
- Aortic valve: 2nd R intercostal space at sternal border
- Pulmonic valve: 2nd L intercostal space at sternal border
- Tricuspid valve: 4th L intercostal space at sternal border
- Mitral valve: 5th L intercostal space at midclavical area
P wave signifies what?
Atrial depolarization
P-R interval signifies what?
Time required for impulse to travel from atria through conduction system to purkinje fibers
QRS signifies what?
Ventricular depolarization
ST segment signifies what?
Beginning of ventricular repolarization
T wave signifies what?
Ventrical repolarization
QT interval signifies what?
Time for electrical systole
How do you calculate HR using EKG?
Count QRS complexes in a 6 second strip and multiply by ten
ST segment depression or elevation >? Is considered abnormal
> 1mm
Hypothermia causes what on ECG?
Elevates ST segment, slows rhythm
Digitalis does what to ECG?
Depresses ST segment
Flattens T wave (or inverts)
QT shortens
Quinidine does what to your ECG?
- QT Lengthens
- T wave flattens (or inverts)
- QRS lengthens
Beta blockers do what to heart? (Propranolol, etc)
Decreases HR, Blunts HR response to exercise
Nitrates (nitroglycerin) does what to heart?
Increases HR
Primary hypertension means what?
No identifiable cause
Secondary hypertension means?
Cause can be identified
In regards to OHT, a drop of > ? mmHg or standing BP <? Should be reported?
Drop of 20mmHg, standing BP of <100mmHg
What are signs an symptoms of an MI?
- Sudden onset
- Pain lasts >30 min
- May not have precipitating factors
- Not relieved my rest/medications
What are s/s of angina?
- Sudden or gradual onset
- Precipitated by emotional/physical factors
- Hot or cold temperatures
- Relieved by rest or medication
What is 1+ on dyspnea scale?
Mild, noticeable to pt but not to observer
What is 2+ on dyspnea scale?
Mild, some difficulty, noticeable to observer
What is 3+ on dyspnea scale?
Moderate difficulty, but pt can continue
What is 4+ on dyspnea scale?
Severe difficulty, patient cannot continue
What is 1+ on Anginal scale?
Light, barely noticeable
What is 2+ on Anginal scale?
Moderate, bothersome
What is 3+ on Anginal scale?
Severe, very uncomfortable
What is 4+ on Anginal scale?
Most severe pain ever experienced
What is Stemmer’s sign?
Dorsal skin folds of toes or fingers resistant to lifting; indicating fibrotic changes and lymphedema
If the patient has an ST elevated MI a couple days ago under what circumstances can they be given an exercise test?
HR equal to 70% age predicted maximum. (Very little demand on the healing myocardium tissue)
What’s the exercise to rest ratio for cardiac rehabilitation inpatient Tx?
1:1
What’s the exercise to rest ratio when beginning an outpatient cardiac rehabilitation Tx?
2: 1
5: 1 can be used towards the end