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Physiology > Exam 2 – Cardio Ch 23 > Flashcards

Exam 2 – Cardio Ch 23 Flashcards

(79 cards)

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1
Q

What is the placenta responsible for?

A

Nutrient and oxygen delivery to the fetal blood

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2
Q

When does the heart start beating?

A

At 18 days

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3
Q

In the fetus, what side of the heart has a higher pressure?

A

The right side, or the two sides could be somewhat equal

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4
Q

What does blood to the fetus come through?

A

Umbilical vessels

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5
Q

What are the different fetal accommodations?

A

Umbilical vessels, urachus
PDA, foramen ovale
Fetal hemoglobin

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6
Q

What is the placenta the site of?

A

Oxygenation

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7
Q

What is the ductus venosus?

A

Bypassing the liver (nonfunctional)–from umbilical vein to inferior vena cava directly

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8
Q

What is the foramen ovale?

A

Shunt from right to left atrium
Oval hole
Highest O2 content to left ventricle to supply carotid and brain

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9
Q

What is the ductus arteriosus?

A

Shunt from pulmonary artery to aorta, also right to left shunt

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10
Q

Look at the organization of the fetal circulation

A

Look at the organization of the fetal circulation

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11
Q

Where do umbilical arteries come off?

A

Close to where the renal arteries come off

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12
Q

What do umbilical arteries do?

A

Pick up nutrients and oxygen then goes to the umbilical vein

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13
Q

What does the umbilical vein carry?

A

Oxygenated blood

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14
Q

Where does the highest oxygenated blood go through?

A

Right atrium

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15
Q

What does 30% of the blood go out of?

A

Pulmonary artery

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16
Q

What does most of the blood bypass?

A

The lungs

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17
Q

What is a very common infection in calves?

A

Umbilicus infections

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18
Q

Where do the 2 umbilical arteries go?

A

Go through the bladder and join the umbilical vein

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19
Q

What happens to blood due to the fact that capillaries have a higher pressure?

A

Blood is forced into the aorta

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20
Q

Which has a higher affinity for oxygen, fetal Hgb or mother Hgb?

A

Fetal Hgb

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21
Q

What does loss of blood flow from the placenta cause?

A

2X increase in vascular resistance
Decreased venous return to right atrium
Increased aortic pressure

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22
Q

When does the ductus venosus close?

A

3-7 days after birth

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23
Q

What does the closing of the ductus venosus cause?

A

Loss of umbilical venous return and low blood flow

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24
Q

What causes pulmonary vascular resistance to decrease?

A

Lung expansion

Lung vasculature vasodilates

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25
After birth, which side of the heart is the high pressure system? Low pressure system?
Left side | Right side
26
What changes at birth?
Loss of placenta First breath decreases vascular resistance in lung Closure of foramen ovale Closure of ductus arteriosus
27
What is the closure of the ductus arteriosus related to?
Oxygen content
28
How long does it take for the ductus arteriosus to fully close?
1-8 days
29
Which has lower O2, fetus or adults?
Fetus
30
What is the most common feature for horses to have?
A ductus arteriosus that does not fully close, cuasing there to be a sound similar to a murmur
31
Describe the 1st heart sound
Lub AV valves close Luder than the second sound Low pitch
32
Describe the second heart sound
Dup | Aortic and pulmonary valves close
33
Describe the 3rd heart sound
Very low pitch | Caused by inrushing of blood into ventricles
34
Describe the 4th heart sound
Atrial contraction late in diastole | Hard to hear with stethoscope except in hypertensive patients with a thick left ventricle
35
What are cardiac sounds?
Vibrations
36
What causes more vibrations (cardiac sounds)?
Turbulent flow
37
What happens if there is a larger vessel and larger turbulence?
The sound is louder
38
What happens if the opening is smaller?
The turbulence is greater
39
What are acquired heart defects?
Stenosis | Insufficiency
40
What are congenital heart defects?
Atrial septal defect Ventricular septal defect Tetralogy of fallot
41
Which side will you always be able to hear the heart better?
Left
42
What do we listen to on the left side of the heart?
Pulmonic, aortic, and mitral valves
43
What do we listen to the right side of the heart?
Tricuspid valves
44
What is the grading of heart murmurs based on?
``` Timing Loudness Point of maximal intensity Cardiac thrill Acquired vs congenital ```
45
What are the different timings of murmurs?
Systolic/pansystolic or holosystolic Diastolic/pandiastolic of holodiastolic Continuous (systole and diastole) Crescendo-decrescendo
46
How is the loudness of murmurs evaluated?
Grade I-VI/VI
47
What is the modulation for systolic murmurs?
Crescendo-decrescendo
48
What are the association with a systolic murmur?
``` Congenital pulmonic stenosis Congenital aortic stenosis Innocent murmurs Mitral regurgitation Tricuspid regurgitation Ventricular septal defect ```
49
What is the modulation of diastolic murmurs?
Decrescendo
50
What are the associations with diastolic murmurs?
Aortic regurgitation Aortic valve bacterial endocarditis Secondary to chronic aortic stenosis Secondary to a high ventricular septal defect
51
What is the modulation of continuous murmurs?
Machinery
52
What are the associations with diastolic murmurs?
Patent ductus arteriosis | Tetraology of fallot
53
What is stenosis?
Narrowing/scarring–systolic
54
What is insufficiency?
Not sealing, leaky–diastolic | Regurgitation
55
What are the valves most commonly affected by a murmur?
``` Mitral valves (most common in dogs) Tricuspid valves (most common in cattle, horses, and pigs) Aortic valve (second most common in dogs) ```
56
What are results of heart valve damage?
Stenosis | Destruction of valve –regurgitation or insufficiency
57
Describe mitral stenosis
Murmur heard in last 3rd of diastole Thrill over apex of heart Low rumbling murmur
58
What are the hemodynamics of mitral stenosis?
Cardiac output and mean arterial pressure do not decrease nearly as much as in aortic stenosis Atrial volume leads to atrial fibrillation Right ventricle pressure could lead to right ventricle failure Left atrial pressure could cause pulmonary edema Left ventricle is normal
59
What is mitral regurgitation?
Idiopathic myxomatous degeneration Blowing murmur head throughout systole–high pitch Best heard over left thorax
60
When does regurgitation occur?
During systole
61
What are the hemodynamics of mitral regurgitation?
Left atrial pressure can lead to pulmonary edema Cardiac output falls more if right heart fails Left atrial volume can lead to atrial fibrillation
62
Describe aortic stenosis (narrowed)
Diamond shaped– or crescendo and decrescendo Pressure in ventricle causes ventricular hypertrophy Very loud (can be felt if severe) Fairly common
63
What are the hemodynamics of aortic stenosis?
Left ventricle hypertrophy | Chronic increase in blood volume
64
When does leaking/regurgitation occur?
Diastole
65
Describe aortic regurgitation
Blowing murmur–high pitch Listen over left ventricle for best sound Short murmur means blood flows back rapidly and is more severe
66
What are the hemodynamics of aortic regurgitation?
Aortic diastolic pressure decreases rapidly Filling of ventricle can compress inner parts of heart and coronary artery Left ventricular hypertrophy
67
How can a diagnosis of murmurs be done?
Stethoscope or phonocardiogram Echocardiogram X-ray Catheterization
68
What are congenital murmurs?
Failure of heart formation during gestation
69
Look at patent ductus arteriosus
Look at patent ductus arteriosus
70
What can patent ductus arteriosus be treated with?
Prostaglandin blocker, indomethacin
71
What happens to blood with patent ductus arteriosus?
It recirculates through the lungs
72
What happens to blood volume with a decreased net cardiac output in patent ductus arteriosus?
It is increased to bring CO back to normal
73
What happens to cardiac reserve with patent ductus arteriosus?
Decreased
74
What can patent ductus arteriosus develop?
Pulmonary edema
75
What are the hemodynamics of patent ductus arteriosus?
Left ventricular hypertrophy | Right ventricular hypertrophy
76
What happens with interventricular septal defect?
Pan systolic murmur unless hole closes during contraction | The larger the hole the quieter the murmur
77
Describe interventricular septal defect
Foramen ovale may not fuse closed May not have normal fibrotic closure of foramen ovale, but left atrial pressure causes it to functionally close If right atrial pressure becomes greater than left atrial pressure, flowery be reversed
78
What is tetraology of fallot?
4 abnormalities that results in insufficiently oxygenated blood pumped to the body
79
What are the 4 abnormalities of tetraology of fallot
Ventrical septal defect (opening between the left and right ventricles) Displacement of aorta over ventricular septal defect Narrowing of pulmonary valve Thickening of wall of right ventricle

Physiology (70 decks)

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