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  1. Outer layer of heart
  2. Middle layer of heart
  3. inner layer of heart
    • endocardium
    • forms the 4 chamber separating valves
  4. right AV valve
  5. left AV valve
    mitral bicuspid
  6. aortic valve seperates
    • L ventricle and aorta
    • semilunar
  7. pulmonary valve seperates
    right ventricle and pulmonary artery
  8. ECG 'P'
    atrial depolarization and contraction
  9. ECG 'Q,R,S'
    Ventricular depolarization and contraction
  10. ECG 'T'
    • Ventricular re-polarization and relaxation
    • recovery phase
  11. SA node
    • pacemaker of heart
    • WNL 60-70 BPM
  12. AV node
    backs up SA node
  13. Arrhytmias on ECG show as variations and may indicate acute problems such as
    • infarction
    • systemic electrolyte imbalances
  14. SA nodal problems or total heart block may require this device
  15. this can be implanted for conversion of ventricular fibrillation
  16. What are barorecptors and where
    • Medulla
    • Detect BP changes
  17. Beta blockers
    • block SNS stimulation
    • block (stop) any increase in rate/force of contraction
  18. HR increases with
    • Increase temp
    • Increase environmental temp/high humidity
    • Exercise
    • Smoking
    • Stress
    • SNS stimulation
    • dehydration
    • caffinee
  19. Cardiac Cycle
    Atria relax-> Pressure in atria open AV valves-> blood enters ventricles-> conduction stimulates atrial muscle to expel any remaining blood to ventricles-> atria relaxes-> ventricles begin to contract-> av valve closes-> semilunar valves open-> blood enters pulmonary artery and aorta-> atria begin to fill as ventricles relax
  20. Whats occurring during heart sounds
    Closure of valves
  21. What causes murmur
    • defective valves that leak or don't open fully
    • turbulence in flow makes sound
  22. cardiac output
    volume of blood from ventricle in one min. CO=HRxSV
  23. Exercise __ return of blood to heart
  24. EX __ SV
  25. CO=HRxSV definition
    • cardiac output= (heart rate) x (stroke volume)
    • HR= number of ventricle contractions each minute
    • SV= amount of blood ejected from each ventricle with each contraction
  26. Factors affecting CO
    • HR- SNS, epinephrine
    • SV- Venous return (preload), blood volume, SNS, peripheral resistance (after load)
  27. BP norms
  28. What is pulse pressure
  29. BP variables
    • CO and peripheral resistance¬†
    • Venous return (preload)
    • HR
    • force of contraction of ventricles
    • peripheral return/resistance (afterload)
    • elasticity of arteries
  30. Peripheral resistance factors
    • constric/dilation of arterioles
    • -increase sns= vasoconstriction
    • -decrease sns= vasodilation
    • blood vessel obstruction
  31. What happens when BP changes sensed by baroreceptors
    • info sent to medulla
    • blood flow adjusted to maintain normal BP ie rising from supine
    • SNS, epinephrine- Increase HR and force of contraction
  32. Auscultation diagnostic test
    valve abnormalities
  33. exercise stress test
    • bike, step,¬†treadmill
    • assess CV function and arrhythmias
    • used in fitness clubs/cardiac rehab program
  34. blood flow tests
    • coronary
    • peripheral
  35. arterial blood gas test
    • check on O2 level
    • acid base balance
  36. CAD includes
    • Angina pectoris
    • MI
    • May lead to HF, arrhytmia, or suddent death
    • Not enough O2 for needs of heart
  37. CAD arteriosclerosis
    • changes of small arteries/arterioles (loss of elasticity and walls thick and hard)
    • lumen narrows
    • leads to ischemia/necrosis of kidneys, brain, and/or heart
  38. CAD atherosclerosis
    • plaques- lipids, cells, fibrin, and debris
    • associated with thrombi
    • primarily in large arteries
    • often starts from an injury to artery when very young
  39. CAD etio
    • unchangeable factors
    • age >40
    • Premenopause protected by higher HDL levels
    • Genetics/lifestyle
    • changeable factors
    • obesity/high fat diet
    • cig smoking
    • sedentary lifestyle
    • DM (diabetes mellitus)
    • HTN
    • Oral contraceptives
  40. CAD tx
    • decrease cholestrol levels esp LDL
    • decrease sodium
    • control HTN, diabetes
    • stop smoking
    • anti-coagulant therapy: coumadin or ASA
    • Surgery for atheroma
    • -flatten thru cath using balloon
    • -LASER
    • -CABG reroute blood flow around using veins
  41. Angina Pectoris Patho
    O2 deficit due to obstruction or spasm in artery or patient working/exercising harder than usual
  42. Angina pectoris etiology
    insufficient blood supply due to athero, arterio, or artery spasm
  43. angina pectoris tx
    • rest
    • nitroglycerin
    • O2
    • with known angina hx 2nd dose of nitroglycerin if still in pain after 5 min; if after 10 min assume heart attack
  44. MI patho
    • coronary artery totally obstructed
    • ischemia/cell death
    • usually from atherosclerosis
    • quick attention decreases area of necrosis
  45. MI SNS
    • pain in chest, left arm, and neck
    • pain described as steady, severe, crushing with no relief
    • sometimes misinterpreted as gastric pain
    • pallor/sweating
    • hypotension, pulse weak/rapid
    • low grade fever
  46. MI tx
    • Rest
    • O2 therapy
    • analgesics
    • anticoagulants
    • cardiac rehab programs
    • -individualized exercise plan, schedule for return to normal function
  47. MI prognosis
    30-40% mortality in 1st year
  48. Cardiac arrest
    • cessation of all heart activity
    • ECG flat line
    • all cardiac function ceased
    • no impulse conduction
    • heart and brain deprived of O2
  49. CHF patho
    • heart unable to pump enough blood
    • may be problem in heart ie valve or from HTN or a lung disease
    • body may attempt to compensate resulting in less blood to organs
  50. CHF when heart can no longer maintain itself these occur
    • CO/SV decrease
    • "backup" congestion in circulation occurs
    • blood inflow>output
  51. CHF etio
    • infarcts that effect pumping capacity of heart
    • valve defects
    • congenital heart defects
    • CAD leading cause
  52. CHF SNS
    • fatigue, weakness, dyspnea
    • SOB, exercise intolerance
    • cold intolerance
  53. L CHF
    • HTN or infarction of left ventricle
    • orthopnea/dyspnea
    • left ventricle circulation backup into pulmonary artery (drowning lungs)
    • cough
    • paroxysmal nocturnal dyspnea
  54. R CHF
    • cannot keep up with output
    • blood backs up into LEs
    • dependent edema
    • hepatomegaly/spleenomegaly
    • ascitis (fluid accumulates in abdominal cavity)
    • Pressure on vena cava
    • -distended neck veins, HA, facial flushing and visual distrubances
  55. rheumatic heart disease patho
    • acute inflam 5-15 y/o
    • new streptococcus strains occur
    • occurs after a few weeks of an untreated infection
    • antibodies form usually but then react abnormally
    • may affect larg ejoint in the child especially legs, may migrate
    • also may effect skin, other joints with subcutaneous nodules
    • may affect brain resulting in jerky movement of face, arms/legs
  56. rheumatic heart disease SNS
    • systemic inflam: low grade fever and malaise
    • anorexia
    • fatigue
    • tachycardia, heart murmurs, acute HF, arrthymias
  57. rheumatic heart disease TX
    • penicillin
    • anti-inflam (ASA/cortico steroids)
Card Set:
2013-11-02 02:42:47
PTA 21 Cardio

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