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PARAMEDIC SCHOOL > CHP 18: CARDIAC > Flashcards

CHP 18: CARDIAC Flashcards

(102 cards)

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1
Q

group of disorders of the heart and blood vessels

A

cardiovascular disease

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2
Q

what the left ventricle produce when it contracts

A

apical impulse

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3
Q

the apical impulse is also called the ____

A

point of maximal impulse

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4
Q

the right side of the heart is a ___-pressure system aka ___ circulation

A

low, pulmonary

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5
Q

the left side of the heart is a ___-pressure system aka ____ circulation

A

high, systemic

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6
Q

what is the largest diameter but shortest coronary artery

A

left main

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7
Q

what does the LMCA divide into

A

left anterior descending artery and the circumflex artery

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8
Q

what parts of the heart does the LAD supply

A

left ventricle, portion of interventricular septum

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9
Q

what parts of the heart does the Cx artery supply

A

left atrium

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10
Q

what parts of the heart does the branches of the RCA supply

A

right atrium and ventricle, SA node, AV bundle

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11
Q

4 properties of cardiac cells

A

automaticity, excitability, conductivity, contractility

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12
Q

what does stimulation of the parasympathetic nerve fibers do in the heart

A

slows rate of SA node, slows conduction of AV node, weakens atrial and ventricular contraction

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13
Q

3 major ACS’s

A

unstable angina, NSTEMI, STEMI

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14
Q

chest discomfort that occurs when the heart muscle does not receive enough oxygen is called what

A

angina pectoris

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15
Q

what is inflammation of the pericardial sac

A

pericarditis

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16
Q

where will patient experience pain with pericarditis

A

similar to MI pain

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17
Q

pain that beings in the center of the chest and radiates to the back can be indicative of what 2 things

A

aortic dissection or enlargement of aortic aneurysm

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18
Q

anginal symptoms usually last less than how long

A

20 mins

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19
Q

AMI symptoms can last how long

A

20 mins to several hours

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20
Q

dyspnea that develops suddenly suggests what

A

pulmonary embolism, pneumothorax, acute pulmonary edema

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21
Q

dyspnea that occurs on exertion or at rest suggests what

A

COPD or left ventricular failure

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22
Q

sudden onset of difficulty of breathing in which the patient suddenly awakens from sleep is what? what is it usually associated with?

A

paroxysmal nocturnal dyspnea, associated with left ventricular failure

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23
Q

pulmonary edema often produces what type of sputum

A

pink-tinged

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24
Q

what condition may cause chest pain form inflammation of cartilage and bones in chest well

A

costochondritis

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25
crackles or wheezes in lung sounds can suggest what
left ventricular failure with pulmonary edema
26
strong pulsations in the epigastric area may be a sign of what
abdominal aortic aneurysm
27
bilateral pitting edema may be a sign of what
right ventricular failure
28
weak, thready pulse or pallor suggests what
reduction in cardiac output
29
how to test for pulse deficit
stethoscope of apical pulse and hand over peripheral pulse to compare
30
what is pulsus paradoxus
systolic BP falls more than 10mmHg with inspiration
31
what cardiac conditions can cause pulsus paradoxus
AMI, cardiogenic shock, cardiac tamponade, constrictive pericarditis
32
what is pulsus alternans and what is it indicative of
beat-to-beat difference in strength of pulse severe ventricular failure
33
normal pulse pressure range
30-40mmHg
33
stage 2 hypertension criteria
systolic BP 140 or higher and diastolic BP of 90 or higher
34
what does pulse pressure reflect
stroke volume and elasticity of arterial walls
35
widened pulse pressure is indicative of what
later stages of shock
36
narrowed pulse pressure is indicative of what
tachycardia and cardiac tamponade
37
what conditions may cause BP to vary from right to left side
stroke or aortic aneurysm
38
when do S1 sounds occur and what causes the sound
beginning of ventricular systole tricuspid and mitral valves close (AV valves)
39
when do S2 sounds occur and what causes the sound
end of ventricular systole pulmonary and aortic valves close (SL valves)
40
what is a gallop rhythm
S3 in ventricular diastole
41
what is S4
rare heart sound before S1 caused by turbulent filling of stiff ventricle
42
what is an abnormal whooshing sound
murmur
43
phase 0 of cardiac action potential
sodium rapidly moves into cell, calcium slowly moves in, cell depolarizes
44
phase 1 of cardiac action potential
potassium leaving cell, cell begins to repolarize QRS complex
45
phase 2 of cardiac action potential
plateau phase, sodium and calcium slowly enter, potassium leaves ST segment
46
phase 3 of cardiac action potential
repolarization finishes, calcium and potassium leaves cell T wave
47
phase 4 of cardiac action potential
resting phase
48
what phases of the cardiac cycle is the absolute refractory period
0-3
49
what phases of the cardiac cycle is the relative refractory period
middle of 3 to beginning of phase 4
50
what is the interatrial pathway connecting SA and AV nodes
Bachmann bundle
51
what is the middle internodal tract
Wenckeback
52
what is the last internodal pathway
Thorel tract
53
how long does the AV node delay the SA node's impulse
0.12secs
54
what is the only electrical connection between the atria and the ventricles and what does it consist of
AV junction - AV node and nonbranching portion of bundle of His
55
what causes a delta wave
the bundle of Kent depolarizes to bypass AV and trigger early depolarization of ventricles
56
what nerve is responsible for decreasing heart rate
vagus nerve or cranial nerve X
57
what is straining or forced exhalation against a closed glottis
Valsalva maneuver
58
what drug is a parasympathetic blocker that opposes ACh
atropine
59
where are baroreceptors located and what do they do
carotid arteries and aortic arch detect BP changes
60
sodium's role in cardiac function
initiates depolarization
61
potassium's role in cardiac function
initiates repolarization
62
calcium's role in cardiac function
depolarization of pacemaker cells and myocardial contractility
63
magnesium's role in cardiac function
stabilizes cell membrane, works with potassium and against calcium
64
limb leads: precordial leads: augmented leads:
I, II, III V1-V6 aVR, aVL, aVF
65
an imaginary line joining the positive and negative poles of a lead
lead axis
66
left leg electrode is ___ charged right arm electrode is ____ charged left arm electrode is ___ charged
always positive always negative positive to RA, negative to LL
67
one small ECG paper box is __ seconds one large box is ___ seconds
0.04 0.2
68
what does the P wave represent and what are its parameters
atrial depolarization less than 0.11 seconds
69
what is the PRI interval and what are its parameters
beginning of P wave to beginning of QRS, AV node delaying transmission 0.12-0.2 seconds
70
what does the QRS represent and what are its parameters
ventricular depolarization less than 0.11 secs
71
parameters for Q wave
first negative deflection in QRS less than 0.04 seconds, less than 1/3 of QRS complex's height
72
what is the R wave
first upward deflection of QRS complex
73
what is the S wave
any downward deflection after R wave
74
hat is a second upward deflection in QRS complex called
R-prime wave
75
R wave is depolarization of __ ventricle S wave is depolarization of __ ventricle
right left
76
what is the J point
QRS complex ends and ST segment begins end of depolarization and beginning of repolarization
77
what is the ST segment
begins at J point and ends at T wave period between ventricular depolarization of repolarization
78
elevated ST segment indicates ___, depressed ST segment indicates ___
myocardial injury myocardial ischemia
79
what does the T wave represent
ventricular repolarization
80
peaked T waves are indicative of
hyperkalemia
81
a tall U wave can be indicative of what
hypokalemia
82
QT interval parameters
beginning of QRS to end of T wave 0.4-0.44secs
83
what is the R-R interval
period between QRS complexes, interval between two ventricular depolarizations
84
5 step method for ECG interpretation
1. identify waves 2. measure PRI 3. measure QRS duration 4. determine rhythm regularity 5. measure heart rate
85
two classes of dysrhythmias
disturbances of automaticity or disturbances of conduction
86
an impulse or rhythm originating from a site other than SA node
ectopic
87
how to calculate the upper limit of sinus tachycardia
220bpm - patient's age
88
what is sick sinus syndrome
variety of rhythms from poorly functioning SA node alternating patterns of extreme brady and tachycardia
89
most common type of SVT
AV nodal reentrant tachycardia
90
what is "occurring in spasms"
paroxysmal
91
what are cannon A waves and what physical sign can be found
dissociation between atria and ventricles depression of jugular veins forming an "a" during wave
92
early depolarization of ventricular tissue through an accessory pathway between atria and ventricles
preexcitation
93
most common preexcitation disorder
Wolff-Parkinson-White syndrome
94
what disorder causes preexcitation of ventricular tissue and is characterized by short PRI and normal QRS
Lown-Ganong-Levine syndrome
95
what disorder causes preexcitation and is characterized by short PRI and widened QRS delta wave
WPW
96
what rhythm increases risk for emboli and strokes
afib
97
rhythm in which atria quiver instead of contract
afib
98
rhythm in which atrial impulse fire too rapid for ventricles
aflutter
99
rhythm in which P wave shape varies
wandering atrial pacemaker
100
rhythm in which multiple ectopic sites within atria depolarize at rapid rates
multifocal atrial tachycardia
101

PARAMEDIC SCHOOL (74 decks)

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