Perfusion

Question 0

Perfusion

Answer 0

Flow of blood through arteries and capillaries, delivering nutrients and oxygen to cells and removing cellular waste products

Question 1

Cardiovascular System Function

Answer 1

• Supply oxygenation to the body

- Perfusion affects all body functions and systems

Question 2

Central Perfusion

Answer 2

• Force of blood movement generated by cardiac output
• Requires adequate cardiac function, blood pressure, and blood volume
• Requires adequate cardiac output

Question 3

Tissue Perfusion (Local)

Answer 3

• Volume of blood that flows to target tissue

- Requires patent vessels, adequate hydrostatic pressure, and capillary permeability

Question 4

Impaired Tissue Perfusion

Answer 4

Loss of vessel patency or permeability, or inadequate central perfusion

Question 5

Localized Effect

Answer 5

Results in impaired blood flow to the affected body tissue

Leads to ischemia and, ultimately, cell death if uncorrected

Question 6

Impaired Tissue Perfusion Symptoms

Answer 6

• Hypotension
• Restlessness
• Confusion
• Cool Extremeties
• Pallor or cyanosis
• Diminished or absent peripheral pulses
• Slow capillary refill
• Edema
• Oliguria

Question 7

Impaired Central Perfusion

Answer 7

Occurs when cardiac output is inadequate.

Associated with loss of vessel patency of permeability.

Question 8

Systemic Effect

Answer 8

Reduced cardiac output results in a reduction of oxygenated blood reaching the body tissues

If severe, associated with shock
If untreated, leads to ischemia, cell injury, and cell death

Question 9

Pericardium

Answer 9

Thin sac composed of fibroserous material that surrounds the heart

• outer layer
• inner layer
• fluid between layers

Question 10

Layers of the heart muscle

Answer 10

• Epicardium
• Myocardium
• Endocardium

Question 11

Valves

Answer 11

Permit the flow of blood between chambers and into blood vessels
Each valve has 3 leaflets (cusps) except the mitral which has 2

Question 12

Atrioventricular (AV) valve

Answer 12

• Tricuspid
• Mitral
• Made of endocardium and connective tissue
• Between atria and ventricles

Question 13

Semilunar (shaped like half moons) valves

Answer 13

• Pulmonary
• Aortic
• Made of endocardium and connective tissue which are reinforced by fibers that prevent them from turning inside out

Question 14

Vasoconstriction

Answer 14

Causes cell death

Ex) hypothermia

Question 15

Heart Tissue Pattern

Answer 15

Pericardium >serous pericardium (parietal) >space >serous pericardium (visceral) >myocardium >endocardium

Question 16

3 places blood goes:

Answer 16

1. Carotid to brain
2. Axillary arteries to arms
3. Torso to toes

Question 17

Ischemia

Answer 17

Lack of oxygen to tissues

Question 18

Compliance

Answer 18

Elasticity of lungs

Question 19

Contractility

Answer 19

Heart muscle fibers elasticity

Question 20

Chordae Tendinae

Answer 20

Tricuspid valve and mitral valve made up of connective tissue

Question 21

Conduction system of the heart

Answer 21

Sinoatrial node (SA) > Intra atrial pathways> AV node> Bundle of His> Right/Left bundle branches> Purkinje fibers

Question 22

Contraction

Answer 22

Systole reaction

“Lub” AV valves closing

Question 23

Relaxation

Answer 23

Diastole

“Dub” SemiLunar valves closing

Question 24

Pulmonary Circulation

Answer 24

Circulates blood to lungs | -Low pressure system

Question 25

Systemic circulation

Answer 25

Blood circulates to body | -high pressure system

Question 26

Coronary Circulation

Answer 26

Blood flows to the heart

Question 27

Heart Rate

Answer 27

Affected by the autonomic heart system

Question 28

Sympathetic Nervous System

Answer 28

Increases heart rate

Question 29

Parasympathetic Nervous System

Answer 29

Slows heart rate

Question 30

Elevated heart rate

Answer 30

Increases Cardiac Output | Rapid HR decreases filling time which decreases output

Question 31

Decreased Heart Rate

Answer 31

Decreased Cardiac Output

Question 32

Stroke Volume

Answer 32

The amount of blood pumped by the left ventricle of the heart in one contraction (End Diastolic Volume) - (End Systolic Volume) = SV

Question 33

Diastole Phase

Answer 33

Ventricles fill by gravity and then by atrial systole. This blood is considered end diastolic volume.

Question 34

Systole Phase

Answer 34

Blood is pumped from the ventricle. Some blood is left over called end systolic volume

Question 35

Ejection Fraction

Answer 35

Stroke Volume / end systolic volume Represents % of blood ejected from the heart during contraction Normal is 50-70% Damaged hearts have reduced EF and decreased perfusion to body systems

Question 36

Cardiac Output

Answer 36

SV x HR Amount of blood pumped into pulmonary and systemic circulation in 1min. Avg. adult CO is 4-8L/min Poor tissue perfusion=tissue ischemia=tissue necrosis or infarction (death) CO decreases with poor heart

Question 37

Factors determining CO

Answer 37

HR Preload Afterload Contractility

Question 38

Contractility

Answer 38

Ability of heart muscle fibers to shorten | Poor contractility decreases forward flow of blood=decrease CO, increase ventricular pressures

Question 39

Preload

Answer 39

Stretch of cardiac muscle fibers | - initial stretching of the cardiac myocytes prior to contraction

Question 40

Starling's Law

Answer 40

- The greater the volume, the greater the stretch, the greater the force of contraction to empty - Too much volume causes overstretch, ineffective contraction, causes HF, renal disease - Too little volume, too little stretch, decreases CO (fluid volume deficit)

Question 41

After load

Answer 41

- Force of ventricles must overcome to eject blood | - end load against which the heart contracts to eject blood

Question 42

Pulmonary Vascular Resistance

Answer 42

Low pressure (right heart)

Question 43

Systemic Vascular Resistance

Answer 43

High pressure (left heart)

Question 44

CV changes with aging

Answer 44

- Myocardial hypertrophy - Stiffened heart valves (fibrosis & calcification) - Stenosis or incompetence of valves

Question 45

Perfusion affects:

Answer 45

``` Renal system Vascular system Look at cholesterol Serum lipids (circulated blood bound to proteins) Triglycerides Phospholipids Troponin I (0.5-2.3mg/ml) ```

Question 46

MI Indicators

Answer 46

Troponin greater than 2.3ng/ml Echoes needed for heart issues ST segment on tele