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Cardiopulmonary > Heart and Lung Function and Disease > Flashcards

Heart and Lung Function and Disease Flashcards

1
Q

Pericardium

A

-fibrous sac around heart
-Serous layers: Parietal (outer), visceral (on heart and contains fluid within space)
-Innervated by Phrenic Nerve (sensory)

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2
Q

Diastole

A

-Relaxation
-Filling

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3
Q

Systole

A

-contraction
-ejection

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4
Q

Afterload

A

pressure needed to expel blood from the heart
-synonymous with BP

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5
Q

Myocardium

A

Cardiac muscle fiber
-actin-myosin complex
-Automaticity: contract w/o external stimuli
-Rhythmicity: contract with rhythm
-Conductivity: nerve impulses from one cell to the other due to intercalated discs
-Intercalated disc junctions: Desmosomes (adhesion) and Connexins (conductivity)

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6
Q

Endocardium

A

-Smooth muscle, innermost layer

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7
Q

Pulmonary Artery

A

-only artery to carry deoxygenated blood

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8
Q

Pulmonary vein

A

-only vein to cary oxygenated blood

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9
Q

Right Coronary Artery

A

-Supplies right ventricle, AV node and SA node
-Right posterior descending
-Right marginal

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10
Q

Left Coronary Artery

A

-supplies left ventricle, L atrium, septum, SA node

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11
Q

SA Node

A

-sets heart at pace of >100 without other input
-Susceptible to disease due to pericarditis, occulsion

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12
Q

Sympathetic NS

A

-increase
-norepinephrine

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13
Q

Inotropic

A

-strength of contraction

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14
Q

Chronotropic

A

-speed of contraction

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15
Q

Parasympathetic NS

A

-decrease
-vagus nerve
-acetylcholine
-60-90 bpm

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16
Q

AV Node

A

-receive from SA
-to Bundle of His to bundle branches to perkinjie fibers
-40-60 bpm without exernal stimuli
-0.04s to contract Vs
Susceptible to disease due to RCA occlusion

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17
Q

P Wave

A

atrial depolarization

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18
Q

PR interval

A

-travel of impulse to Vs

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19
Q

QRS Complex

A

ventricular depolarization

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20
Q

T Wave

A

ventricular repolarization

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21
Q

QT Internal

A

Ventricular systole

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22
Q

Low K

A

Harder to depolarize, slower heart rate

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23
Q

High K

A

Easier to depolarize as myocardium is excitable, higher heart rate

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24
Q

Cardiac Output

A

-CO= HR x SV
-5-6L at rest, can increased 4-7x with exercise
-Effects systolic BP

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25
Blood Pressure
BP=HR x SV x Total peripheral Resistance TPR affects diastolic BP
26
Mean Arterial Blood Pressure
-average pressure in the systemic system MAP= DBP + 1/3 (SBP-DBP) -Normal: 93 mmHg -assess peripheral functions of CV -cautions <60mmHg Determined By: -BV, CO, Peripheral resistance, distribution of blood in veins
27
Pulse Pressure
SBP-DBP, difference
28
Effect of Posture on BP
Standing: lower BP, blood pools in legs Laying: blood evenly in veins, higher BP
29
BP Normal
<120/<80
30
BP Elevated
120-129/<80
31
High BP Stage 1
130-139/80-89
32
High BP Stage 2
>140/>90
33
Hypertensive Crisis
>180/>120
34
HR
-Beats per minute Affected by: Baroreceptors, ANS, endocrine, integrity of the system, temperature, emotions
35
SV
-amount of blood pumped out each beat -Afterload-Preload, heart contractility -increases 40-60% during exercise
36
Cardiac Preload
-End diastolic volume: amount of left ventricular blood volume prior to contraction Dependent on: -venous return, BV, LA contraction, Starling law
37
Cardiac Afterload
-Amount of resistance encountered by left ventricle
38
Myocardial Contractility
-neural and hormonal influences
39
Ejection Fraction
Ejection Fraction= SV/EDV -55-70% -Low EF indicates systolic heart failure -EF can be preserved with overall decrease in BV, weak heart increases backflow that increased SV
40
Hypoxia
O2 concentration of tissues
41
Hypoxemia
O2 concentration of blood
42
ESV
End Systolic volume: volume of blood in a ventricle at the end of a contraction
43
Right Shift in O2 Concentration
-reduced affinity for for O2, higher po2 will result in lower hemoglobin concentrations -high temp, high acidity
44
Left Shift in O2 concentration
-increased affinity for O2, lower po2 will result in higher hemoglobin concentrations -low temp, basic environment
45
Fick equation
-VO2= HR x SV x (a-vO2 diff)
46
a-vO2 Diff
-difference in O2 between arteriole and venule
47
CO Distribution
Muscles: 10-15% (80-85% with exercise) Trunk: 20-30% Brain and heart: 5%
48
Oxygen Extraction
-tissues utilize the same relative amount of o2 in relation to blood o2
49
Pulmonary O2 Exchange Factors
-Area of capillary membrane -Diffusion capacity of alveoli -Pulmonary Capillary volume -Ventilation to perfusion ratio
50
Area of Capillary Membrane
invaginations increase the surface area
51
Diffusion capacity of alveoli
-changes in surface area -changes in membrane -gas uptake issues
52
Pulmonary capillary volume
-increases with exercise
53
Ventilation to Perfusion Ratio (V/Q)
-blood flow to alveoli must match ventilation or =hypoxemia -changes with posture -Norm: 0.8 Reduced: decreased ventilation to perfusion, blood shunted to other parts of the lung, vasoconstriction at arterioles to reduce BV, corrected with O2 Increased: increased ventilation to perfusion, vasodilation to increase BV, dead space
54
Arteriole Vasoconstriction
-alpha receptors Shunt blood to muscles, from skin and mesenteric
55
Arteriole Vasodilation
-induced by increased vessel stretch -induced by low O2 or high H+, CO2, metabolites Beta Receptors -increased blood flow to Skeletal muscle -increase ventilation and alveolar perfusion
56
Cardiac Muscle Dysfunction
-most common cause of Congestive Heart Failure Symptoms: -dyspnea -fluid buildup -fatigue at rest
57
Most common cause of pulmonary congestion
-heart failure -mostly right side affected
58
Causes of Cardiac Muscle Disease: Hypertension
Increased BP -increased workload w/o increased blood supply -decreased BV -hypertrophy of myocardium that cannot relax well -BV damage
59
Causes of Cardiac Muscle Disease: Coronary Artery Disease
-2nd most common cause of CMD -supply and demand issue -lipid deposits: atherosclerosis -scar formation: decreases contractility
60
Causes of Cardiac Muscle Disease: Myocardial Infarction
-irreversible myocardial necrosis -most commonly affects left ventricle PT -Increased Troponin, CK-MB that needs to come down -ST elevation on ECG "Stimmy"
61
Causes of Cardiac Muscle Disease: Cardiac Arrhythmias
-abnormal rate of contractions -can cause sudden cardiac arrest from SA node -can lead to decreased CO -Sick Sinus node syndrome -Suprasventricular tachycardia -V fib
62
Lab Values: Sodium
Increased -dehydration Decreased -overhydration
63
Lab Values: Potassium
Increased -Renal retention, decreased insulin Decreased -Excess renal secretion, aldosterone, burns
64
Lab Values: Calcium
Increased: -hyperparathyroidism, hyperthyroidism Decreased: hypoparathyroidism, renal failure
65
Causes of Cardiac Muscle Disease: Renal Insufficiency
-contributes to CMD due to increased fluid triggered by low BP or low BV -RAAS -maintains Na and K balance
66
Causes of Cardiac Muscle Disease: Cardiomyopathy
-disease of heart muscle leading to heart failure -impaired contractility -HTN, MI, metabolic disorders, heart valve issues
67
Causes of Cardiac Muscle Disease: Dilated Cardiomyopathy
Heart failure with reduced ejection fraction (<40) -systolic dysfunction: less effective pump -mitochondrial dysfunction -increased LV EDV -lead to electrical issues
68
Causes of Cardiac Muscle Disease: Hypertrophic Cardiomyopathy
-enlarged heart that cannot relax -diastolic dysfunction: less compliant -increases left EDP -Heart failure with preserved EF -rapid ventricular emptying -muscle cells disorganized -common cause for sudden cardiac arrest in young athletes
69
Causes of Cardiac Muscle Disease: Restrictive Cardiomyopathy
-cannot relax -EF preserved -diastolic dysfunction -scar tissue (sarcoidosis/radiation) OR defect in myocardial relaxation -hypertrophy
70
Heart Valve Abnormalities
-contracts more forcefully -induces myocardial hypertrophy -deceases ventricular distensibility -decreases CO and BP
71
Pericardial Effusion
-buildup of fluid compress the heart Cardiac Tamponade -pressure on heart leads to decreased heart function -worse when lying down -relieved when standing
72
Pulmonary Embolism
-lung infarction due to decreased BV -increased pulmonary hypertension -increases load to right side of heart -presence of ascities, bilateral LE edema and jugular vein distension -increases V/Q ratio
73
Pulmonary Hypertension
-risk for cardiac disease ->20mmHg -increased R ventricle work (Swangan's Catheter)
74
Heart Disease Vitals
-pO2: hypoxia (92-96%) -RR: tachypnea -HR: tachycardia -BP: orthostatic hypotension
75
Congestive Heart Failure
-decreased CO -LV failure -increased BNP (stretch protein in heart) -attempts compensatory strategies (sympathetic, RAAS, heart receptors, EPO)
76
Pulmonary System and CHF
-pulmonary edema -decreased o2 concentration
77
Skeletal Muscle Function and CHF
-decreased type 1 fibers -less contraction strength
78
Pancreas and CHF
-impairs blood flow -impairs insulin release
79
Hematologic function and BHF
-polycythemia (thick blood) -thrombocytopenia (low platelets) Anemia -can cause CHF -can harm or help -shifts curve to right; more o2 needed
80
Neurohumoral Function and CHF
-SNS overstimulation and downreg of B1 receptors B1: myocardial inotrophy and chronotrophy B2: vasodilation and bronchodilation a1: vasoconstriction a2: arterial vasodilation (constriction of coronary)
81
Renal Function and CHF
-RAAS -a receptor activity -decreased renal activity
82
MAP
-mean arterial pressure -total pressure of the system
83
Pulse Pressure
-how hard the heart is working 40-60
84
Rate Pressure Product
SBP*HR -cardiac function

Cardiopulmonary (23 decks)

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