Cardiovascular System

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Cardiovascular System
2014-02-08 19:15:19
VTHT Anesthesia Surgery

Section 1
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  1. DEA in blood typing stands for:
    Dog(canine) Erythrocyte antigen
  2. Old name for DEA 1
  3. Old name for DEA 2
  4. Old name for DEA 3
  5. Old name for DEA 4
  6. Old name for DEA 5
  7. Old name for DEA 6
  8. Old name for DEA 7
  9. Old name for DEA 8
  10. Which DEA number(s) has the highest incidence in canines?
    4 and 6
  11. Which DEA number(s) has the lowest incidence in canines?
  12. Which DEA number(s) are the most reactive?
    1 and 2
  13. Why should random transfusions be avoided as much as possible?
    • 1. Risk of sensitization which results in severe transfusion reactions
    • 2. transfused blood cells have a shortened life span
  14. The cardiovascular system is why type of network?
    joined vessels
  15. 4 components of the cardiovascular system:
    • 1. arteries, arterioles, capillaries, venules, veins
    • 2. circulation nutrients - blood
    • 3. pump - heart
    • 4. Auxiliary vessel system - lymphatics
  16. This is the wider area of the heart that is directed cranially and dorally.
  17. This is the pointed area of the heart that is located caudally and ventrally.
  18. The pericardium is an invagination of what tissue?
    Parietal Pleura
  19. This refers to the sac next to the heart
    visceral pericardium
  20. What is another name for the visceral pericardium?
  21. This refers to the outer layer of the visceral pericardium.
    parietal pericardium
  22. What is the purpose of the potential space?
    The potential space also called the pericardial sac contains fluid that lessens friction providing lubrication and cooling
  23. Name the feline blood types
    A, B and AB
  24. A donor feline should be what blood type?
  25. Which feline blood type is a universal recipient?
  26. Where can blood typing cards be obtained?
    DMS Laboratories = Rapid-Vet H cards
  27. How much blood is needed to do a blood typing test?
    0.4 ml in EDTA
  28. Layers of the heart - inside to out
    Trabeculae, endocardium, myocardium, epicardium(visceral pericardium), pericardial space (potential space), parietal pericaridum, fibrous pericardium
  29. A condition of the pericardium where a build up of fluid in the potential space does not allow the heart to expand normally between contractions.
    Cardiac Tamponade
  30. A condition of ruminants where metal objects that have been swallowed penetrate through the reticulum into the thoracic cavity, through the diaphragm and into the pericardium causing damage and infection.
    Traumatic Reticular Pericarditis
  31. This condition describe any inflammation and or infection of the lining of the valve and endothelium of the heart
  32. This is a type of endocarditis seen primarily in porcine and turkeys and has characteristic diamond shaped lesions on the skin
  33. Erysipelas etiology
    Erysipelothrix rhusioperthiae
  34. This refers to an infectious disease associated with streptococci in the body that results in inflammation in the heart valves and was a common killer of children
    Rheumatic Fever
  35. Rheumatic Fever Etiology
    Streptococcus spp
  36. Name the atrioventricular valves:
    • Tricuspid Valve (3 cusps)
    • Mitral Valve (2 cusps)
  37. Valves and their location during auscultation
    • Start about 1/3 of the way up.
    • Left side:
    • Pulmonic - 3rd/4th intercostal space
    • Aortic - 4th/5th intercostal space
    • Mitral - 5th/6th intercostal space

    • Right side:
    • Tricuspid - 4th/5th intercostal space
  38. Name the Semilunar Valves:
    • Pulmonary - (3 cusps)
    • Aortic - (3 cusps)
  39. Another name for the Semilunar valves:
    Arterial Valves
  40. Structures that contain valves:
    • Heart
    • Veins
    • Lymphatics
  41. This system circulates blood through the lungs and its pressure originates from the right ventricle.
    Pulmonary System
  42. This carries blood returned from the lungs to all areas of the body.
    Sytemic Circulation
  43. This is the smallest terminations of the air passages.
    pulmonary alveoli
  44. This is a system that departs from the usual pattern of circulation
    portal system
  45. Hepatic Portal System flow:
    portal vein > liver > sinusoids in liver lobule filters > hepatic vein > caudal vena cava
  46. A macrophage in the liver:
    kupffer cell
  47. A macrophage in loose connective tissue:
  48. A macrophage in blood:
  49. A macrophage in the brain:
    microglial cell
  50. These are the vessels that parallel the vein and carry wastes that are too large to move into the venules.
    Lymphatic system
  51. This is the name given to the fluid in the lymphatic system
  52. Which vein does the lymphatic system ultimately empty into where it rejoins the vein-arterial circulation?
    Azygos Vein
  53. What cells do the lymph nodes produce
    Lymphocytes that become T cell or plasma cells
  54. 5 lymph nodes locations we palpate
    • Parotid - just under the ear
    • Mandibular - under the ramus of the mandible
    • Superficial Cervical - apex of the scapula
    • Medial Femoral
    • Popliteal - behind stifle
  55. Another name for the Superficial Cervical lymph node
    Axillary lymph node
  56. Another name for the Medial Femoral lymph node
    Inguinal lymph node
  57. Which fluid circulates through the spleen?
  58. What is the function of the white pulp of the spleen?
    Lymphocyte production
  59. What is the function of the red pulp of the spleen?
    Lymphocyte filtration and removal
  60. What is the 3rd function of the spleen?
    Collects and lyses old red blood cells. 

    note: these cells can be dumped back into circulation via splenic contraction during a time of "fight or flight"
  61. This initiates the frequency of contraction in the heart
    Sino-Atrial Node (SA node)
  62. This is an arrangement of muscle fibers in the lower area of the atria that fuse to form an interconnected mass
    Atrial syncytium
  63. This is an arrangement of muscle fibers in the upper area of the ventricles that fuse to form an interconnected mass
    Ventricular syncytium
  64. What is the function of the syncytia?
    Both syncytia are separated by a fibrous ring that acts as an insulator so that impulses are not conducted from the atria to the ventricles.  Instead they ensure that the impulse moves through the AV node
  65. Canine RBC life span
    110 days
  66. Feline RBC life span
    120 days
  67. Conduction of the heart
    • SA node initiates impulse
    • Impulse travels through internodal pathways in the atria
    • Atria contract
    • Impulse pauses at the AV node
    • Then travels down the bundle of His located in the interventricular septum to the apex
    • Impulse continues up the walls of the ventricles through the purkinjie fibers
    • Ventricles contract
  68. Unique structures of the heart
    • Chordae tendineae
    • Papillary muscles
    • Intercalated disks
    • bundle of His
    • Purkinjie fibers
  69. This is the relaxation of a heart chamber prior to and during filling of a chamber
    Diastole (=repolarization=filling)
  70. This is the contraction of the heart in the process of emptying
    Systole (=depolarization=contraction)
  71. This refers to the one way flow of blood from venous side to arterial side due to the operation of the four cardiac valves.
  72. This refers to the sequence of events that occur during one complete heartbeat
    Cardiac cycle
  73. Cardiac Cycle Sequence
    • Atria fill from incoming blood through pulmonary vein and vena cavas
    • AV valves (Tricuspid and Mitral) open d/t to atrial pressure > ventricular pressure - atria contract
    • About 70% of the blood flows into the filling ventricles while about 30% backs up into the pulmonary vein and venae cavae
    • Ventricles contract closing the AV valves (Lub) which allows the atria to relax/fill
    • The semilunar valves (pulmonic and aortic) open from increase pressure in the ventricles
    • Blood is ejected into the pulmonary artery and aorta
    • As the ventricles relax the pa and aorta contract and the pressure and blood backup  close the semilunar valves (dup)
  74. This is where the pressure equals the tension developed by the ventricle wall contraction divided by the sum of the 2 radii curvatures in cm.
    LaPlaces Law

  75. Energy and O2 demands of the heart depend on:
    tension and its relation to the force of myocaridal contractions
  76. This is the INSTRUMENT that makes a recording of the voltage changes of the heart
  77. This is the wave for RECORDING of the voltages changes of the heart
    Electrocardiogram (ECG)
  78. This represents the depolarization of the atria on an ECG
  79. This represents the ventricular repolarization on an ECG
  80. This represents the depolarization of the ventricles and repolarization of the atria on an ECG
    QRS complex
  81. This is the distance from the beginning of the P-wave to the QRS complex
    P-R interval
  82. This is the distance from the ending of the QRS complex to the beginning of the T-wave
    S-T segment
  83. Lymphatic circulation time
    24 hrs
  84. Systemic circulation time
    60 minutes
  85. Why do CO2 and O2 readily diffuse across simple squamous endothelial layer without having to use the intercellular clefts?
    They are both lipophilic
  86. This is a combination of bacteria and glycoproteins on teeth
  87. This is the combination of bacteria with a small amount of mineralization on teeth
  88. This is the combination of bacteria with heavy mineralization on teeth
  89. Discovered penicillin in 1927
    Dr. Alexander Fleming
  90. This is refers how the vertical and horizontal wave distances are measure on and ECG
    isoelectric line

    • vertical measurement in millivolts
    • horizontal measurement in milliseconds (intervals between waves)
  91. This is considered the 1st heart sound and represents the closure of the atrioventricular valves and the contraction of the ventricles
    Lub - lower pitch, louder and longer duration
  92. This is considered the 2nd heart sound and represents the closure of the semilunar valves and arterial contraction of the aorta and the pulmonary artery
    Dup - higher pitch, softer and shorter duration
  93. This is ANY abnormal heart sound
  94. This is a sharp dip in aortic pressure that indicates the end of ventricular systole and the beginning of ventricular diastole
  95. This represents the volume of blood flow from either ventricle of an animal during a given period and is considered the product of stroke volume x the pulse
    Cardiac Output - usually 60 seconds
  96. This refers to the sum of the volume of blood pumped from both ventricles over a period of time
    Total Cardiac Output - usually 60 seconds
  97. This is the point at which the heart beats too fast which reduces the stroke volume which reduces the cardiac output
    Starling's Law (named for Frank Starling)
  98. This is the frequency of cardiac cycles and is usually measured by the number of beats per minute.
    Heart Rate = Pulse
  99. Why do small/female animals tend to have a higher heart rate than large/male animals?
    Surface area and weight density
  100. Why do younger animals tend to have a higher heart rate than older animals?
    Less vagal tone inhibition development
  101. This is the difference between systolic and diastolic pressures
    Pulse Pressure (PP)= sys - dia
  102. MAP
    Mean Arterial Pressure = Dia + 1/3(PP)
  103. MBP
    Mean Blood Pressure - another name for MAP
  104. What percentage of the blood composition is water?
  105. These are heavier, temperature tolerant fluids with larger molecules that remain in the blood with raises blood pressure quickly
  106. Examples of colloids:
    • Hetastarch
    • Dextran
    • Whole blood
  107. These are water-like fluids that are designed to increase the volume of fluid in the body
  108. Examples of crystalloids:
    • Lactated Ringers
    • D5W
    • Normosol
    • 0.9% NaCl
  109. DACVIM
    Diplomate, American College of Veterinary Internal Medicine
  110. This type of blood pressure measurement requires catheterization of a peripheral artery but is more accurate
  111. This type of blood pressure measurement is far more practical use today and has 2 primary methods.

    • doppler - systolic pressure only
    • oscillometric
  112. Doppler Blood Pressure monitor
    • 1. Shave an area under carpus or tarsus
    • 2. Place appropriate cuff above shaved area
    • 3. Attach sphygmomanometer
    • 4. Place small amount of ultrasound gel on convex side of probe
    • 5. Place probe on shaved area - gel side down
    • 6. Find artery = swooshing sound
    • 7. Tape probe into place
    • 8. Squeeze sphygmomanometer until artery sound disappears
    • 9. Slowly release pressure until the first sound returns
    • 10. The point at which the sound returns is the systolic pressure
    • 11. Repeat 5 times to get an average number
  113. What are the 4 types of shock?
    • hypovolemic shock - loss of fluid in the body
    • neurogenic shock
    • cardiovascular shock
    • septic shock
  114. This is a palpation technique once used in veterinary medicine to determine pregnancy
  115. Components of the Cardiac Exam
    • 1. Observation of Respiratory pattern
    • 2. Mucous Membrane/Capillary Refill Time
    • 3. Jugular Vein - indicate central venous pressure. An increase = Caval Syndrome
    • 4. Arterial Pulse - femoral artery most common
    • 5. Precordium - chest palpation
    • 6. Evaluation for fluid accumulation
    • 7. Auscultation
  116. Bovine abdominal observations
    • Left side enlargement = bloat
    • Right side enlargement = pregnancy
  117. How does a doppler detect sound?
    The probe is a transducer that emits high-frequency sound waves. A pulse from an artery changes the frequency.  That change is sent to the instrument box that contains another transducer that changes that sound and amplifies it so it can be heard.
  118. This is a device that translates one physical quantity to another
  119. Another name for the pressure gauge
  120. What is the purpose of the blood pressure cuff?
    It occludes the artery and stops the flow of blood momentarily.  As the pressure is release the blood pressure can be measured
  121. Advantages of Doppler monitoring
    • 1. Affordable
    • 2. Quick
  122. Disadvantages of Doppler monitoring
    • All are due to the inability to measure diastolic pressure.
    • 1. Pulse pressure cannot be determined without diastole
    • 2. MAP cannot be determined
    • 3. Without diastolic pressure, true hypo/hypertension cannot be determined
  123. Canine position for non-anesthetized blood pressure monitoring
    lateral recumbency
  124. What is the ideal percentage the cuff should be relative to the circumference of the limb at the site of placement?
  125. Why is standing not a good position for non-anesthetic blood pressure monitoring?
    Muscle movement can interfere with readings
  126. A cuff that is too wide will give what kind of reading?
    lower readings
  127. A cuff that is not wide enough will give what kind of readings?
    higher readings and/or will result in velcro disengaging.
  128. 3 factors that can affect blood pressure in non-anesthetized monitoring
    • anxiety resulting in struggling
    • natural movement of limbs
    • pressure of the cuff width if less than 40%
  129. Techniques to minimize "white coat" effect
    • 1. allow animal to acclimate to the room
    • 2. room should be kept quite and away from the waiting room
    • 3. have the owner in the room
    • 4. use minimal restraint
  130. This is the most common complication of anesthesia
  131. Hypotension effects:
    Chronic hypoxia -> poor vital organ perfusion -> renal damage ->cerebral hypoxia -> cardiac muscle ischemia
  132. 4 manifestations of hypotension
    • 1. cool extremities
    • 2. prolonged capillary refill time
    • 3. diminished consciousness = cerebral hypoxia = ataxia and syncope
    • 4. little to no urine output - w/o pressure the nephrons cannot produce urine
  133. Blood pressure considered canine hypertension
  134. Blood pressure considered feline hypertension
  135. When are most hypertensions noted?
    When the animal is under general anesthesia yet the blood pressure (systolic) remains above a given range (97-79)
  136. Three conditions associated with hypertension
    • 1. Hypertensive retinopathy
    • 2. Kidney failure
    • 3. Left Ventricular hypertrophy
  137. This is the condition where retinal vessels are twisted causing retinal edema, hemorrhage and detachment ultimately resulting in blindness
    Hypertensive retinopathy
  138. This is the condition where blood vessel walls become thickened leading to reduced blood flow and serious damage to the nephrons
    Kidney Failure
  139. This is the condition where there is enlargement of the left ventricle which leads to a reduce blood flow due to arterial constriction
    Left Ventricular Hypertropy
  140. Two classifications of hypertension
    • 1. Primary - usually idiopathic
    • 2. Secondary to disease
  141. 4 diseases associated with secondary hypertension
    • 1. Hyperadrenocorticism (Cushing's Disease)
    • 2. Hyperthyroidism
    • 3. Diabetes mellitus
    • 4. Renal disease
  142. How is blood pressure expressed?
    Systolic/Diastolic mmHg
  143. Non-anesthetized systolic range
  144. Anesthetized systolic range
  145. Non-anesthetized diastolic range
  146. Anesthetized diastolic range
  147. Non-anesthetized mean
  148. Anesthetized mean
  149. This refers to the time required for blood to return to the right atrium after being pumped from the left ventricle (generally 60 seconds)
    Circulatory time
  150. This is the time required for a substance injected in the blood to be mixed thoroughly which is usually longer than circulatory time due to being injected into a vein.
    Mixing time
  151. This refers to the physical factors associated with the exchange of fluid between blood and the interstitial fluid at the level of the capillaries
    Capillary dynamics
  152. This refers to the slit or space between endothelial cells of capillaries
    intercellular cleft or pore
  153. CO2 versus O2 with regards to passive diffuse across capillaries
    CO2 diffuse about 20x more easily than O2
  154. What makes up the largest volume of interchange between capillaries and interstitial fluid
    Water and its dissolved substances
  155. This is the balanced movement to the interstitial space from plasma by the amount returning to the capillaries from the interstitial space and the amount returning through the lymphatics
    Volume of Bulk Flow
  156. Capillary pressure
    17 mmHg
  157. Arteriole pressure
    25 mmHg
  158. Venule pressure
    10 mmHg
  159. Interstitial Fluid pressure
    -6 mmHg, created by the return of interstitial fluids to both the venous end of the capillary and lymphatics
  160. Plasma colloidal pressure
    28 mmHg
  161. Interstitial colloidal pressure
    5 mmHg
  162. This refers to an imbalance of bulk flow where fluid accumulates in the interstitial spaces
  163. 4 types of capillary imbalances
    • 1. high capillary pressure
    • 2. low blood protein concentration
    • 3. lymphatic blockage (elephantiasis)
    • 4. increased porosity
  164. Central Venous Pressure
    8-12 mmHg
  165. What does a distended jugular vein while the animal is standing with normal head position indicate?
    Caval Syndrome via heartworms
  166. This is when the difference between the systolic and diastolic pressures (pulse pressure) is wide and the pulse feels abnormally strong
    Hyperkinetic (e.g 97/58 mmHg)
  167. This is when the difference between the systolic and the diastolic pressure (pulse pressure) is small and the pulse feels week
    Hypokinetic (e.g. 70/55 mmHg)
  168. A weak arterial pulse can indicate:
    • Dilated cardiomyopathy
    • Shock
    • Dehydration
  169. A strong Arterial pulse can indicate:
    • Pyrexia
    • Hyperthyroidism
    • Excitement
  170. A very strong Arterial pulse can indicate:
    • Patent Ductus Arteriosis
    • Pyrexia/Sepsis
  171. This is a buzzing sensation when palpating an animals chest wall caused by loud cardiac murmurs
    Precordial thrill
  172. This portion of the stethoscope allows better auscultation of higher frequency heart sounds
    Diaphragm (flat stiff part)
  173. This portion of the stethoscope allows better auscultation of lower frequency sounds
    Bell (top part of the diaphragm)
  174. How does the force of blood change in proportion to the diameter of the left and right ventricles?
    It increases
  175. Lidocaine is indicated for what heart condition?
    Atrial or Ventricular Fibrillations
  176. This refers to the movement of cells or substances through the intercellular clefts
  177. List the muscle types in order from greatest to least with regards to inherent rhythmic contractibility:
    • cardiac muscle
    • skeletal muscle
    • smooth muscle
  178. Another term for direct blood pressure determination
  179. Another name for indirect blood pressure determination
  180. What should be done before and after giving basal anesthesia?
    Check mucous membrane color and capillary refill time
  181. What is the order of tissues a foreign metal object travels to cause Traumatic Reticular Pericarditis?
    Reticulum >> diaphragm >>pericardium >> myocardium
  182. This is the name of the edema from submandible area to the chest often seen when cattle are moved to higher elevations
  183. These are the nicknames associated with anasarca
    • Brisket disease
    • Bottle jaw
  184. What happens if epinephrine 1:1000 is accidentally given IV?
    It will stimulate the Beta receptors of the heart and cause ventricular fibrillation