Module 3

Question 1

Blood flow to the heart (right side) anatomy

Answer 1

1. superior and inferior vena cava streams blood into the right atrium–> through the tricuspid valve—> letting blood into the right ventricles–> the blood shoots up into the pulmonary valve and then to the pulmonary artery–> which sends deoxygenated blood to the LUNGS. “Tri it before you bi it”

Question 2

Blood flow to the heart (left side) anatomy

Answer 2

2. enters back through the pulmonary veins oxygenated–> left atrium—> shot through the bicuspid (mitral or atrioventricular valve) valve—> then into left ventricle–> goes into the aortic valve—> and then shoots up into aorta and into the BODY “A comes before V so Atriam is on top and ventricles are on the bottom”

Question 3

A&P for the vascular system

Question 4

Cardiac Conduction System

Question 5

Perfusion

Answer 5

the passage of blood, blood substitutes, or other fluids through a vessel into the organs and tissues

Question 6

Cardiac output

Answer 6

amount of blood being pumped by each ventricle in L/min

Question 7

Stroke volume

Answer 7

amount of blood ejected with each heartbeat (the average is 70mL)

Question 8

Ejection fraction

Answer 8

the fraction of blood present in the ventricles that is ejected with each heartbeat (normal EF of Left ventricle is 50-70%)

Question 9

Stroke volume factors

Answer 9

stroke volume x heart rate
1. Preload- the pressure at the end of diastole and the resultant stretching of the muscle fibers (how much blood comes through the atria)
2. Afterload- total resistance to ejection of blood from the ventricle
3. Contractility- the force that causes the myocardium to contract under any given condition(

Question 10

Heart auscultation

Answer 10

rewatch lecture for slide 14

Question 11

Diagnostic Evaluation

Answer 11

rewatch lecture for slide 15

Question 12

Diagnostic testing for the heart

Answer 12

ECG, stress test, echocardiography, doppler, central venous, pulmonary artery, and intra-arterial blood pressure monitoring

Question 13

Hypertension

Answer 13

BP of <120/80 is considered normal
BP of 120-139/80-89 is considered prehypertension
BP of 140/90 or higher is considered hypertension
(Peripheral vascular resistance related to the diameter of the blood vessel and the viscosity of the blood) (Blood pressure is the product of the cardiac output multiplied by cardiac resistance)

Question 14

Risk factors for HTN

Answer 14

sleep apnea, renal changes, oral contraceptive use, possibly insulin resistant, diet high in Na and K

Question 15

Clinical Manifestations of HTN

Answer 15

CAD, left ventricular hypertrophy, changes in the kidneys, retinal changes, cerebrovascular involvement

Question 16

Dietary modifications

Answer 16

slide 24

Question 17

Coronary Atherosclerosis

Answer 17

plaque build up in the vessels, a thrombus are possible to form and therefore cut off the blood flow and cause an MI

Question 18

Modifiable risk factors for atherosclerosis

Answer 18

diabetes HTN, smoking, high cholesterol,

Question 19

Manifestations of atherosclerosis

Answer 19

1. ischemia- inadequate blood flow that deprives the cardiac muscle of O2
2. angina pectoris- chest pain brought by myocardial ischemia
3. myocardial ischemia- acute onset of chest pain, SOB, diaphoresis, N/V, extreme fatigue

Question 20

Management of CAD and angina

Answer 20

Nitrates (nitroglycerin)
HMG-CoA reductase inhibitors (statins)
Antiplatelet medications & anticoagulants (aspirin and heparin or warfarin)
Bile acid-sequestrants (cholestyramine)
Oxygen administration
Ca+ channel blockers (diltiazem)
Beta-blockers (metoprolol)

Question 21

CABG

Answer 21

rewatch lecture for slide 39

Question 22

Diagnosis of MI

Answer 22

based on ECG changes and analysis of cardiac biomarkers
1. unstable angina
2. ST-segment elevation MI
3. Non-ST-segment elevation MI

Question 23

Medications for MI

Answer 23

nitroglycerin, morphine, beta-blockers, ACE inhibitors, statins, thrombolytics, analgesics, therapy and rehabilitation, clopidogril-reduces ability of platelets to stick together, therefore preventing clots from forming

Question 24

Heart failure

Answer 24

the inability of the heart to pump sufficient blood to meet the needs of the tissues for O2 and nutrients (systole- the contraction of the heart, diastole- filling of the heart)

Question 25

Classes of heart failure

Answer 25

Class 1: exhibits no symptoms with activity Class 2: symptoms with ordinary exertion Class 3: symptoms with minimal exertion Class 4: symptoms at rest

Question 26

Types of heart failure

Answer 26

systolic- weakened heart muscle, the inability of the heart to contract, EF is low diastolic- stiff and non-compliant heart muscle, the inability of the left ventricle to relax or fill, and stroke volume decreased

Question 27

Right-sided heart failure

Answer 27

(rest of the body) increased backup of blood to the body and decreased blood to the lungs. Manifestations: JVD, polyuria, pitting edema, weight gain, SOB, ascites, nausea/anorexia Treatment: is (positive inotropic) such as digoxin which helps the muscle to squeeze (check apical pulse)

Question 28

EDEMA (with right-sided heart failure)

Answer 28

enlarged liver distended neck veins enlarged spleen most edema in LE ascites and anorexia

Question 29

Left-sided heart failure

Answer 29

decreased perfusion, weak thready pulse, increased cap refill, decreased EF, crackles, Manifestations: S3 gallop, oliguria, fatigue, increased Na and water retention which results in increased preload, orthopnea, SOB, decreased O2 sat Treatment: diuretics (lasix, aldosterone)

Question 30

DYSPNEA (with left-sided heart failure)

Answer 30

dyspnea cyanosis S3 gallop low O2 sat pulmonary congestion, pink frothy sputum nasal flaring elevation in respiratory rate anxiety or activity intolerance

Question 31

Risk factors of heart failure

Answer 31

age, male gender, HTN, left ventricular hypertrophy, MI, valvular heart disease, obesity, cardiomyopathy

Question 32

Normal sinus rhythm (NSR)

Answer 32

originates in the SA node, HR 60-100, normal p wave, PRI, and QRS, and rhythm is normal

Question 33

Sinus bradycardia

Answer 33

HR is less than 60, everything else stays the same

Question 34

Sinus tachycardia

Answer 34

HR is more than 100 to 150 bpm, sometimes p wave is peaked and tall, and can sometimes be partially hidden

Question 35

Atrial fibrillation

Answer 35

no discernable p waves, when controlled the rate is <100 when uncontrolled the rate is >100, rhythm is irregular

Question 36

Vascular disease

Answer 36

stenosis- narrowing of the valve causing a forced flow of blood regurgitation- it causes backflow of the blood and is also an insufficiency

Question 37

Peripheral arterial disease (PAD)

Answer 37

a common manifestation is an atherosclerosis, symptoms are seen in the end organs they will complain of intermittent claudication (walking and say pain in their legs and then when sitting it goes away) no hair on their legs, and rubor color (purple)

Question 38

The Ps of PAD

Answer 38

pain, pallor, pulselessness, poikilothermia (cool temperature), paresthesia (numbness and tingling), paralysis

Question 39

Raynauds disease

Answer 39

vasospasms of the fingers, change in color of the fingertips, coldness, tingling, or numbness (could be from long-term use of beta blockers)