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Cardiopulm Test 1 > Lecture 1 > Flashcards

Lecture 1 Flashcards

1
Q

Where is the right portion of the heart located in relation to the ribs?

A

3rd costal cartilage to 6th intercostal space

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2
Q

Where is the left portion of the heart located in relation to the ribs?

A

From the 2nd to the 5th intercostal cartilage

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3
Q

The viseral pericardium is also known as the….

A

Epicardium

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4
Q

4 Layers of the heart

A

Parietal Pericardium
Visceral Pericardium (epicardium)
Myocardium
Endocardium

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5
Q

What are the 2 parts of an intercalated disc and their functions?

A

Desmosomes- attach cells together

Connexins- spread electrical impulse

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6
Q

The right coronary artery supplies the AV node in __% of people

A

55%

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7
Q

The left coronary artery supplies the AV node in __% of people

A

45%

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8
Q

What coronary artery supplies the SA node?

A

right coronary artery

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9
Q

The SA node automatically paces the heart to beat ___bpm

A

100

The parasympathetic NS (via the vagus nerve) slows it down to 60-90

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10
Q

The SA node must set a pace of depolarization that is _____ than any other cell

A

Faster

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11
Q

The AV node can spontaneous discharge at a rate of…

A

40-60bpm

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12
Q

Why is the SA node suspectible to disease?

A

Proximity to epicardium (Pericarditis)

Coronary artery occulsion

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13
Q

What does the PR interval represent on an EKG

A

The conduction time between the atria and the ventricals

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14
Q

What does the QT interval represent

A

The time between the onset of ventricular depolarization and the end of ventricular repolarization

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15
Q

What does the red portion of the chart represent?

Rapid influx of ___ ions during depolarization

A

Calcium (Ca2+)

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16
Q

The green part of the chart represents what ion?

A

K+ Ions

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17
Q

Normal stroke volume is ____L and may increase ____ times during exercise

A

5-6L of blood

x4-7

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18
Q

How do you calculate mean arterial pressure?

A

Diastolic + 1/3(Systolic - Diastolic)

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19
Q

Normal MAP is about 93. At what MAP should we be cautious with getting a patient out of bed?

A

60 or below

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20
Q

What are the three factors that effect blood pressure?

A

Heart rate

Stroke volume

Periphreal Resistance

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21
Q

Resistance of a system to blood flow is determined by the diameter of _____

A

Arterioles

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22
Q

Where are baroreceptors located?

A

Carotid Sinus and Aortic arch

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23
Q

What is the primary determinant for increased cardiac output and blood pressure during exercise

A

Heart rate

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24
Q

Cardiac preload AKA End Diastolic volume is….

A

amount of left ventricular blood volume prior to contraction

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25
Q

What is cardiac afterload?

A

Amount of resistance (pressure) encountered by the left ventricle (aortic pressure)

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26
Q

Increased afterload leads to ______ stroke volume and ______End systolic volume (ESV)

A

Decreased SV

Increased End Systolic Volume (ESV)

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27
Q

What is ejection fraction and how do you calculate it?

A

Amount of ventricular blood volume pumped per heart beat

Stroke volume/ end diastolic volume

28
Q

What is the normal ejection fraction at the left ventrical?

A

55-70%

29
Q

The S1 Sound _____ the carotid pulse, whereas the S2 sound _____ the carotid pulse

A

S1 precedes whereas S2 follows

30
Q

most of the blood in the body (64%) is found in the….

A

Veins

31
Q

What is the percentage breakdown of blood composition? Plasma? WBC? RBC?

A

55% plasma

> 1% WBC/Platelet

45% RBC

32
Q

True or false: Thrombocytes are a bloodcell

A

False

33
Q

hematopoiesis is what and where does it happen

A

production of RBC

Bone Marrow

34
Q

Low levels of hematocrit lead to…

A

Anemia, vitamin deficienies, nutrition deficienies

35
Q

High levels of hematocrit lead to…

A

dehydration, polycythemia vera, lung/heart disease

36
Q

What does the hematocrit mean

A

the concentration of RBC in blood

37
Q

What is hemogloblin

A

Specialized protein in RBCs that binds to O2 for delivery to all bodily tissues
One HgB molecules can bind up to four O2 molecules

38
Q

Each gram of HgB can combine with _____ ml of O2

A

1.34 ml

39
Q

__% of oyxgen in blood is bound to Hgb

A

97%

whereas 2% is dissolved plasma

40
Q

Amount of O2 that is bound to HgB is called __________

A

O2 saturation (SaO2):
Normal is 95-97%

41
Q

What is PaO2?

A

Partial pressure of oxygen in blood

42
Q

If PaO2 is over or equal to 50mmHg, what happens to SaO2 (amount of oxygen bound to hemagloblin)

A

SaO2 does not need to decrease to release the oxygen into the blood to increase the pressure (NO CHANGE IN SaO2)

43
Q

If PaO2 drops below 50mmHg what happens to SaO2?

A

SaO2 decreases because oxygen is released back into the blood from the hemaglobulin

44
Q

What is Capillary hydrostatic pressure?

A

Pressure originates from the blood pressure in the arterial system

Moves blood from capillary to interstitium

45
Q

What is Capillary oncotic pressure?

A

osmotic pressure induced by the albumin in a blood vessel’s plasma that causes a pull on fluid back into the capillary.

Albumin causes fluid to re-enter the capillary from the interstitial fluid

46
Q

What does Interstitial hydrostatic pressure do?

A

Moves fluid from interstitium into the capillaries

47
Q

what is Interstitial oncotic pressure:

A

Draws fluid out of the microcirculation (capillaries) into the interstitium

48
Q

What is the fick equation?

A

Determines VO2

VO2 = cardiac output x (arterial oxygen content - venous oxygen content)

49
Q

What is the net fluid exchange from a capillary?

A

2mmHg outward from capillary

50
Q

Muscles normally receive ____% of cardiac output

but under intense exercise they can receive ____ % of cardiac output

A

10-15%

80-85%

Exercising muscle will require increased blood flow while tissue beds of other organs (GI, Splenic, Kidneys) are reduced

Increased blood flow directed to the skin to promote cooling

51
Q

Mesenteric, splenic and portal tissues receive _______% of cardiac output
Brain and myocardium receive ~ __% of cardiac output

A

20-30%

5%

52
Q

What is the oxygen extraction ratio at rest?

A

23%

53
Q

4 effects of VO2 falling below critical levels

A

Anaerobic metabolism will ensue

Serum lactate levels will increase

Multi-organ system failure may be present

Sedation may be necessary to reduce tissue metabolism

54
Q

What happens to VO2 levels in the blood if DO2 decreases (DO2= global oxygen delivery)

A

The tissues will utilize the same relative amount of O2 that is present in the blood

Tissue metabolism will decrease to survive on a lesser absolute amount of O2

Therefore VO2 does not decrease

55
Q

Diffusion of O2 and CO2 across the alveoli to the pulmonary arterial circulation dependent on four factors:

A

Area of capillary membrane

Diffusion capacity of alveolar capillary membrane:

Pulmonary capillary volume:

Ventilation to perfusion ratio (V/Q) - Blood flow to avleoli must match the amount of oxygen

56
Q

What happens if the V/Q Ratio is too low? (not enough blood flowing to alveoli)

A

vasodilation occurs at the arterioles to allow for increased blood flow

*If ventilation volume is too small for relative blood flow:
vasoconstriction occurs at the arterioles to reduce blood flow through the capillaries

57
Q

What is the normal V/Q ratio?

A

0.8

58
Q

Decreased O2 or increased ___ , ____ , _____ can lead to vasodilation

A

H+ ion

CO2

Metabolites

59
Q

Vasoconstriction and vasodilation controlled by extrinsic controls such as…

A

Endocrine system

Autonomic nervous system

60
Q

What controls the endocrine system?

A

Hypothalamus

61
Q

Which nervous system decreases heart rate,

which nervous system increases it?

Sympathetic or parasympathetic

A

Sympathetic- Increases HR

Parasympathetic- decreases (via the vagus nerve)

62
Q

Systolic heart failure results in a low ejection fraction whereas diastolic heart failure results in…

A

No change to ejection fraction

63
Q

What does the S1 sound represent?

A

Closure of the mitral and tricuspid valves

64
Q

What does the S2 sound represent

A

Closure of the Aortic and pulmonary valves

65
Q

What part of the stethoscope do you use to hear heart sounds?

A

Diaphram (not the drum)

66
Q

Blood makes up what percent of bodyweight on average?

A

7-8%

Cardiopulm Test 1 (11 decks)

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