| Question | Answer |
| myocardium | heart muscle |
| systems that work with the cv system to provide oxygenation and tissue perfusion | respiratory and hematologic systems |
| number one cause of death in the United States | cardiovascular disease |
| the right atrium receives ____ blood from the ____ through the _____ | deoxygenated, body, superior and inferior venae cavae and from heart muscle itself |
| oxygenated blood flows into the _____ then into the ___ of the heart | pulmonary veins and into the left atrium |
| tricuspid valve separates what chambers of the heart | RA from RV |
| mitral valve separates what chambers of the heart | LA and LV |
| regurgitation in the heart | backflow of blood into the atria |
| semilunar valves | pulmonic valve and aortic valve |
| pulmonic valve separates | right ventricle from pulmonary artery |
| aortic valve separates | left bentricle from aorta |
| MAP and the heart | mean arterial pressure - must be at least 60 mm Hg to maintain adequate blood flow through coronary arteries. 60-70 mm Hg needed for perfusion of major body organs |
| cardiac muscle cells possess the characteristics of.... | automaticity, excitability, conductivity, contractility and refractoriness |
| diastole | relaxation and filling of atria and ventricles |
| systole | contraction and emptying of atria and ventricles |
| myofibril sacromere | basic contractile unit of the myocardial cell |
| preload | degree of myocardial fiber stretch at the end of diastole and just before contraction. determined by amt of blood returning to heart from venous system and pulmonary system. |
| afterload | pressure/resistance that ventricles overcome to eject blood through semilunar valves into peripheral blood vessels. resistance is directly related to arterial bp and diameter of vessels. |
| ipedance | peripheral component of afterload, pressure that heart overcomes to open aortic valve |
| amount of impedance depends on | aortic compliance and total systemic vascular resistance |
| total systemic vascular resistance | combination of blood viscosity and arteriolar constriction |
| myocardial contractility | the force of cardiac contraction independent of preload. inc by sympathetic stimulation, ca release and + inotropic drugs. dec by hypoxia and acidemia |
| vascular system purpose | route for blood to travel from heart to tissues.
carries cellular waste to excretory organs.
allows lymphatic flow to drain tissue fluid into circulation.
returns blood to heart for recirculation. |
| blood pressure definition | force of blood exerted against vessel walls. determined by quantity of blood flow or CO, as well as resistance in arterioles. |
| mechanisms that mediate and regulate BP | autonomic NS, excites or inhibits sympathetic NS activity. the kidneys, sense change in blood flow and activate renin-angiotensin-aldosterone mechanism. the endocrine system, releases hormones to stimulate sympathetic nervous system at tissue level. |
| systolic BP | amount of pressure generated by LV to distribute blood into aorta with each contraction of heart. indicates vascular tone |
| diastolic bp | amount of pressure against arterial walls during relaxation pahse of heart |
| baroreceptors | in arch of aorta and at origin of internal carotid arteries stimulated when arterial walls are stretched by inc BP. impulses inhibit vasomotor center resulting in dec BP |
| peripheral chemoreceptors | sensitive to hypoxemia. when stimulated they send impulses along vagus nerves to activate vasoconstricotr response and raise bp. |
| hypercapnia | inc in partial pressure of arterial carbon dioxide and acidosis. |
| pack-years | number of packs of cigarettes smoked per day multiplied by number of years the patient has smoked. |
| overweight determined by BMI | 25 to 30 |
| obesity defined by BMI | >30 |
| a positive family history for CAD in a first degree relative is a risk factor that ... | is more important than factors such as hypertension, obesity, diabetes or sudden cardiac death. |
| dyspnea on exertion (DOE) | trouble breathing associated with activity. usually early symptom of heart failure. |
| orthopnea | trouble breathing when lying flat. severity measured by number of pillows needed to elevate head and chest for restful sleep |
| paroxysmal nocturnal dyspnea (PND) | after lying down for several hours. patient awakens abruptly, with feeling of suffocation and panic. may last for 20 minutes. |
| palpitations | feeling of fluttering or unpleasant feeling in chest caused by an irregular heartbeat |
| best indicator of edema | sudden weight increase of 2.2 lbs. ask about tightness of socks, rings, shoes |
| syncope | brief loss of consciousness. most common cause is dec. perfusion to brain. |
| near-syncope | dizziness with inability to remain in upright position. |
| extremity pain by be caused by two conditions of the heart... | ischemia from atherosclerosis and venous insufficiency of the peripheral blood vessels. |
| intermittent claudication | cramping sensation in legs or buttocks associated with activity. related to dec. arterial tissue perfusion |
| anasarca | generalized edema |
| rubor | dusky redness suggests arterial insufficiency. |
| clubbing | nail straightens out to angle of 180 degrees and base of nail becomes spongy. |
| hypertension | systolic pressure of 140 mm Hg or higher or diastolic pressure of 90 mm Hg or higher |
| prehypertension | bp 120-139 systolic or 80-90 diastolic w/o antihypertensive drug therapy |
| postural hypotension | orthostatic - occurs when bp is not adequately maintained while moving from lying to sitting or standing. dec of more than 20 systolic or more than 10 diastolic with 10-20% inc in HR |
| paradoxical blood pressure | exaggerated dec in systolic pressure by more than 10 during inspiratory phase of respiration cycle. |
| pulse pressure | difference between systolic and diastolic values |
| ankle-brachial index (ABI) | assess vascular status of lower extremities. bp cuff applied to lower extremity above malleolus. systolic measured by doppler ultrasound at both dorsalis pedis and posterior tibal pulses. higher of two is divided by higher of two brachial pulses. |
| toe brachial pressure index (TBPI) | determine arterial perfusion in feet and toes. toe systolic pressure divided by brachial systolic pressure |
| jugular venous distention | caused by increase in jugular venous pressure. |
| hypokinetic pulse | weak pulse indicative of a narrow pulse pressure seen in hypovolemia, aoric stenosis and dec CO. |
| hyperkinetic pulse | large, bounding pulse caused by in ejection of blood. in patients with high CO and those w/ inc sympathetic system activity |
| pulsus alternans | weak pulse alternates with strong pulse despite regular heart rhythm. accurately assessed by auscultating bp |
| bruits | swishing sounds from turbulent blood flow in narrowed or atherosclerotic arteries. assessed by placing bell of stethoscope over carotid artery while patient holds breath. |
| erb's point | located in third intercostal space just left of sternum |
| paradoxical splitting | abnormal splitting of S2, has a wider split heard on expiration. |
| Ventricular gallop | S3 |
| atrial gallop | S4 |
| murmurs | reflect turbulent blood flow through normal or abnormal valves |
| pericardial friction rub | occurs with movements of the heart during the cardiac cycle. transient sign of inflammation, infection or infiltration. |
| troponin | myocardial muscle protein released into the blood with injury to myocardial muscle. troponins T and I are not found in healthy patients. |
| creatine kinase | enzyme specific to cells of the brain, myocardium and skeletal muscle |
| microalbuminuria | protein in urine that is a clear marker of widespread endothelial dysfunction in cardiovascular disease |
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