Intro to Perfusion

Question 0

Cardiac Cycle

-Systole

Answer 0

1. Ventricular contraction and atrial filling (Systole)

Question 1

Cardiac Cycle

-Diastole

Answer 1

1. Atrial Contraction causes ventricular filling (Diastole)

2. Relaxation of ventricle (Diastole)

Question 2

Stroke Volume

Answer 2

1. Amount of blood ejected per beat

Question 3

Cardiac Output

Answer 3

1. Amount of blood ejected per minute

Question 4

Ejection Fraction

Answer 4

1. Percentage of blood ejected in systole

Question 5

Cardiac Index

Answer 5

1. CO / Bod Surface Area
2. More specific indicator of circulation ** Best indication of perfusion **
3. Takes height & Weight into consideration

Question 6

Cardiac Output

-Influenced by

Answer 6

1. Activity level & metabolic rate
2. Physiologic & Psychologic stress
3. Age
4. Body size

Question 7

Cardiac Output

-Involves interaction of

Answer 7

1. HR
2. Preload & After-load
3. Contractility

Question 8

Cardiac Reserve

Answer 8

1. Ability to respond to body’s changing needs

Question 9

Base of the Heart

-Location?

Answer 9

1. The base of the heart it the top

- 2nd intercostal space

Question 10

Apex of the Heart

-Location

Answer 10

1. Bottom - 5th intercostal space, midclavicular line

Question 11

Coronary Circulation

-Aorta: Filling of Coronary Arteries?

Answer 11

1. Coronary arteries fill during DIASTOLE

Question 12

Coronary Circulation

-Right Coronary Artery

Answer 12

1. Feeds inferior and posterior portions of heart (R side of heart)

Question 13

Coronary Circulation

-Left Main Coronary Artery

Answer 13

1. Left anterior descending
   - Feeds anterior and septal portion (Left ventricle)
2. Left Circumflex
   - Feeds lateral and posterior

Question 14

Preload

Answer 14

1. Volume of blood in the ventricles at the end of diastole

2. Influenced by venous return and compliance of ventricles

Question 15

Preload

-Starling’s Law

Answer 15

1. The greater the volume, the greater the force, the greater the fibers contract to accomplish emptying

Question 16

Drugs that Increase Preload

Answer 16

1. Vasopressors

2. Fluid

Question 17

Drugs that decrease Preload

Answer 17

1. Vasodilators

2. Diuretics

Question 18

After-load

Answer 18

1. The amount of force needed to eject blood from the ventricles (open the semilunar valves)

Question 19

After-load

-Right Ventricle

Answer 19

1. Must overcome Pulmonary Vascular resistance

Question 20

After-Load

-Left Ventricle

Answer 20

1. Must overcome Systemic Vascular Resistance

Question 21

Cardiac Output

-Visual Clues of Low Output?

Answer 21

1. Decreased:
   - BP
   - LOC
   - UOP
   - Bowel sounds

Question 22

Cardiac Output

-Visual Clues of High output?

Answer 22

1. Septic - fever
   - High HR
   - High or low BP

Question 23

Heart Sounds

-S1

Answer 23

1. Lub
2. Onset of ventricular contraction (SYSTOLE)
3. CLosure of AV valves

Question 24

Heart Sounds | -S2

Answer 24

1. Dub 2. Onset of ventricular relaxation (DIASTOLE) 3. Closure of semilunar valves

Question 25

Apical Impulse

Answer 25

1. Visible pulsation at the point of maximal impulse (PMI) | 2. Seen in half of adults

Question 26

Point of Maximal Impulse (PMI) | -Where is it Palpated?

Answer 26

1. Normally palpated at the: - 5th intercostal space - midclavicular line

Question 27

PMI | -Displaced Laterally?

Answer 27

1. If the PMI is displaced laterally it indicates an ENLARGED HEART

Question 28

Extra Heart Sounds | -S3 (Ventricular Gallop)

Answer 28

1. Immediately after S2 2. Myocardial failure - CHF, Mitral Regurgitation, Tricuspid Regurgitation

Question 29

Extra Heart Sounds | -S4 (Atrial Gallop)

Answer 29

1. Immediately before S1 2. Resistance to ventricular filling - HTN, CAD, Aortic stenosis

Question 30

Extra Heart Sounds | -Summation Gallop

Answer 30

1. Combination S3 & S4 | - Severe CHF

Question 31

Diagnostics | -Serum Cholesterol/Triglycerides/Lipids

Answer 31

1. Normal Total Cholesterol <110 4. If Pt has high cholesterol: - Assess current diet - Reduce animal products

Question 32

Extra Heart Sounds | -Pericardial Friction Rub

Answer 32

1. Pericarditis

Question 33

Calculating Mean Arterial Pressure (MAP) **TEST**

Answer 33

1. SBP + 2(DBP) / 3 = MAP