Vet Sci 4 Cardio

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lynnsy
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133448
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Vet Sci 4 Cardio
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2012-04-27 06:59:10
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Vet Sci 4
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  1. Heart location
    Between 3rd and 6th intercostal space
  2. why is the hearts location important
    • palpate apical beat
    • asculation
    • IC injection
  3. Why Must BP be maintained
    • O2+Nurtition
    • Removal of waste product
    • transport of hormones
  4. What is the blood flow through the heart
    • Anterior Vena Cava
    • Right Atrium
    • Tricuspid valve
    • Right Ventricle
    • pulmonary valve
    • pulmonary Artery
    • LUNGS
    • Pulmonary Vein
    • Left Atrium
    • Bicuspid valve
    • left ventricle
    • Aortic Valve
    • Aorta
  5. Cardiac Conduction Sustem
    • 1. SA node
    • 2. AV node
    • 3. Bundle of HIS
    • 4. Perkinje Fibers
  6. Function of the SA node
    sets rythmic activity of the heart by stimulationg contraction
  7. AV Node function
    transfers impulse from SA to the ventricals aloowing slight delay for complete filling of the ventricals
  8. Bundle of HIS function
    transfers impulse from AV node to bundle branches
  9. Purkinji Fibers function
    send impulase from branches to the myocardium
  10. What is a ECG?
    Recording of electrical activity in the heart
  11. Patient Postintioning for ECG?
    Right Lateral
  12. Placement of Leads
    • Right Axillary - White
    • Right inguinal - Green
    • Left Axillary - Black
    • Left inguinal - Red
    • Chest - Brown
  13. PQRST Waves meanings
    • P - Atrial Contraction
    • QRS - Ventricular Contraction
    • T - Ventricular Repolarization
  14. What is an Arrhythmia?
    • Disruption in normal activity in the heart
    • abnormal in rate, rythem, or impulse origin
  15. Steps in recognizing arrythmia
    • 1. Evaluate R-R intervals
    • 2. Determine if the impulses are sinus or not.
    • a.Evaluate P waves
    • b. Determine the relationship between P waves and QRS complexes
    • c. Evaluate T waves
    • 3. Look for anything unusual
  16. Intrinsic Pacemaker rates
    • SA Node 70-120 impulses per minute
    • AV node 40-60
    • Bundle of HIS 40-60
    • bundle branches 20-40
    • purkinji fibers 20-40
  17. causes of Artifact
    • Electrical interference
    • Pt movement
    • wandering baseline
    • dried electrodes
  18. Sinus Bradycardia
    • Regular sinus rythem with slower rate
    • Dogs <70bpm
    • Cats <120Bpm
  19. 4 Ways to get heart rate
    • Auscultate
    • Pulse
    • Palpate apex
    • ECG
  20. Murmur
    Turbulent blood flow that creates extra heart sound
  21. Systolic Murmurs
    heard between S1 and S2 lubb (swoosh) dubb
  22. Diastolic Murmurs
    occurs after S2 dubb dubb (swoosh)
  23. 3 Most frequent causes of murmurs
    • 1.Valvular insufficiency - Leaky Valves ( Tricuspid & Bicuspid / Aortic & Pulmonic)
    • 2. Valvular Stenosis - Partially blocked valve (Aortic & Pulmonary, Right causes Ascites / Left causes pulmonary edema )
    • 3. PDA - opening between aorta and pulmonary artery (Pulmonary edema)
  24. Murmur grading
    • I - quite & Local
    • II-quite
    • III-murmur can be heard immediatly
    • IV-constant and loud, thrill can be felt
    • V-constant with prominant thrill
    • VI can hear w/o a stethoscope
  25. Stroke Volume
    colume of blood ejected from the heard during each beat
  26. Cardiac output
    Volume of blood ejected by the heart per minute

  27. Preload
    amount of pressure stretching the right ventricle after passive filling
  28. Afterload
    pressure the chamber generates to eject blood from the heart
  29. 3 ways heart compensates for decrease in cardiac output
    • 1. Increase HR
    • 2. myocardium Hypertrophy - muscle mass inc
    • 3. Dilation of chambers - inc chamber size
  30. Ascites
    excess fluid in the space between the tissues lining the abdomen and abdominal organs (the peritoneal cavity).
  31. Cachexia
    Physical wasting with loss of weight and muscle mass
  32. Orthopnea
    The inability to breathe easily unless one is sitting up straight or standing erect
  33. Heart Dz
    abnormality in the heart; condition can lead to heart failure

    C/S : tachycardic, lethergy, cardiac cough, tachypnea
  34. Heart Failure
    unable to maintain Cardiac output

    C/S : pulmonary edema, pall MM, low BP, long CRT, orthopnea, cachexia

    Due to ascites
  35. Diagnostic Tests (7)
    • 1. Ausculation - evaluates source of murmur
    • 2. Echocardiogram - measure chambers & sounds
    • 3. Doppler - let us hear artery, systolic BP 85-130mm hg
    • 4. Oscillometric - diastolic BP
    • 5.Blood Gas - O2 - % of oxigen saturated hemoglobin
    • 6.Radiographs - size position
    • 7.ECG - arrythmias
  36. Systolic Blood presure measurement
    80-130 mmhg
  37. Congenital Heart Diseases (4)
    • 1.PDA
    • 2.Atrial Septal Defect (ASD) - hole allowing blood go from left to right / right to left
    • 3. Ventricular Septal Defect (VSD)
    • 4. Aortic or Pulmonic Stenosis (Pulmonary edema / Ascites)
  38. Aquired Heart diseases (6)
    • 1. AV insufficiency - caused by periodontal dz
    • 2. Heartworm - right side of heart, right ventricle pulmonary valve (ascites)
    • 3.Vegetative Endocarditis - bacteria settles on AV nodes
    • 4. Hypertrophic cardiomyopathy - big muscle small chambers (maincoons)
    • 5. Dilated cardiomyopathy - small muscle, large chambers Commonly related to feline taurine def.
    • 6. Pericarditis/Cardiac Tamponade - caused by bac,virus,renal failure(muffled heart sounds)
  39. Breeds predisposed to Dialated cardiomyopathy
    • Great dane
    • wolf hound
    • cockers
    • goldens
    • gemans
    • doberman pinchers
    • boxers
  40. CPCR
    Cardiopulmonary cerebrovascular Resuscitation
  41. CPA
    Cardiopulmonary Arrest- sudden cessation of spontaneous and effective ventilation and systemic perfusion
  42. Potential Causes of CPA
    • *hypoxia
    • *metabolidc disorders (addisons)
    • *trauma
    • *Anesthetic or other drugs
    • *enviornmental influences
  43. 5 Signs of CPA
    • 1. no palpable pulse
    • 2.no auscultable heart beat
    • 3. no ventilatory attempts
    • 4. Discolored MM
    • 5.dilated Pupils
  44. How long does it take for cerebral injury from CPA to occur and why?
    • 3-4 mins of arrest
    • Changes in O2 Delivery to the brain
    • Generation of toxins doue to Hypoxia
  45. factors that affect CPA survival rate
    • pre-arrest condition
    • time elapsed since arrest
    • cause of arrest
    • inefective external cardial massage
    • client wishes
  46. 3 phases of CPCR
    • Basic life support-temporary
    • Advanced life support-drugs and Dfib
    • Prolonged life support- Past CPCR if Pt survives
  47. Five tasks involved in CPCR
    • 1 airway management
    • 2 cardiovascular managemnt
    • 3 venous access
    • 4 Monitoring
    • 5 Drug administration
  48. Defibrillator
    portable med. device that can be used to shack a heart back into rhythm; delivers a jolt of electricity that can shock the heart back into its proper rhythm
  49. ABCD's of CPR
    • Airway
    • Breathing
    • Circulation
    • Drugs/Defib
  50. Inotropes and Chronotropes
    • I = Force of contraction - antiarrhythmias
    • C = Heart Rate - Vasodilators
  51. 4 layers of heart
    epicardium, myocardium, endocardium, pericardium
  52. Quinidine
    (Cardioquin, Quindex) - Atrial Fibulation, increases Conduction
  53. Procainaminde
    (Pronestryl, Procamide SR) - VPC's V Tach
  54. Lidocaine
    (Lidocaine, Xylocaine) - VPCs and V Tach

    toxic in cats
  55. Propranolol
    (Inderal, Intensol) - Cat's VPC, Hypertrophic cardiomyopathy
  56. Bretylium
    • (Bretylol) Chem defib, V tach, V fib
    • decreases HR
  57. Amiodarone
    (Cordarone) -tx vpc and vtach chemical defib.
  58. Enalapril
    (Enacarol) -congestive heart failure, hypertension
  59. Hydralazme
    (Apresoline) dec BR
  60. Nitroglycerin
    (Nitro-bid, Nitrol) - dec BP rapidly
  61. Pimobendan
    (Vetmedin) - tx CHF caused by DCM
  62. Furosemide
    (Lasix) - TX of pulmonary Edema
  63. Hydrocodone
    (Hycodan) - tx Cardiac Cough
  64. Theophylline
    (Thedair, Uniphyl) - Bronchodilalator, tx asthma used in conjuction w/ other in CHF and pulmonary Edema
  65. Cardiac Glycosides
    tx heart failure, Increase CO by increasing the force of conractions (+I)
  66. Digoxin
    • (Cardoxin, Lanoxin)
    • Digitalis drug-tx of CHF and Afib (+I) (-C)
  67. Catacholamines
    • mimic CNS (+I) (+C)
    • Increase BP by vasoconstriction
  68. Epinephrine
    Catacholamine tx: CPA
  69. Dopamine
    • (Dopram HCL, Inotropine)
    • Catacholamine tx for actue heart failure, shock, oligura due to renal failure (Natural)
  70. Dobutamine
    • (Dobutrex)
    • catecholamine
    • synthetic tx for shock, increase BP (+I)
  71. Isoproterenol
    • (Isuprel)
    • works as antiarrythmic, bronchoconstrictione
  72. Atropine
    Bradycardia
  73. HR on ECGs
    • 50mm = x20
    • 25mm = x10

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