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DEA in blood typing stands for:
Dog(canine) Erythrocyte antigen
Which DEA number(s) has the highest incidence in canines?
4 and 6
Which DEA number(s) has the lowest incidence in canines?
Which DEA number(s) are the most reactive?
1 and 2
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
The cardiovascular system is why type of network?
4 components of the cardiovascular system:
- 1. arteries, arterioles, capillaries, venules, veins
- 2. circulation nutrients - blood
- 3. pump - heart
- 4. Auxiliary vessel system - lymphatics
This is the wider area of the heart that is directed cranially and dorally.
This is the pointed area of the heart that is located caudally and ventrally.
The pericardium is an invagination of what tissue?
This refers to the sac next to the heart
What is another name for the visceral pericardium?
This refers to the outer layer of the visceral pericardium.
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
Name the feline blood types
A, B and AB
A donor feline should be what blood type?
Which feline blood type is a universal recipient?
Where can blood typing cards be obtained?
DMS Laboratories = Rapid-Vet H cards
How much blood is needed to do a blood typing test?
0.4 ml in EDTA
Layers of the heart - inside to out
Trabeculae, endocardium, myocardium, epicardium(visceral pericardium), pericardial space (potential space), parietal pericaridum, fibrous pericardium
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.
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
This condition describe any inflammation and or infection of the lining of the valve and endothelium of the heart
This is a type of endocarditis seen primarily in porcine and turkeys and has characteristic diamond shaped lesions on the skin
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 Etiology
Name the atrioventricular valves:
- Tricuspid Valve (3 cusps)
- Mitral Valve (2 cusps)
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
Name the Semilunar Valves:
- Pulmonary - (3 cusps)
- Aortic - (3 cusps)
Another name for the Semilunar valves:
Structures that contain valves:
This system circulates blood through the lungs and its pressure originates from the right ventricle.
This carries blood returned from the lungs to all areas of the body.
This is the smallest terminations of the air passages.
This is a system that departs from the usual pattern of circulation
Hepatic Portal System flow:
portal vein > liver > sinusoids in liver lobule filters > hepatic vein > caudal vena cava
A macrophage in the liver:
A macrophage in loose connective tissue:
A macrophage in blood:
A macrophage in the brain:
These are the vessels that parallel the vein and carry wastes that are too large to move into the venules.
This is the name given to the fluid in the lymphatic system
Which vein does the lymphatic system ultimately empty into where it rejoins the vein-arterial circulation?
What cells do the lymph nodes produce
Lymphocytes that become T cell or plasma cells
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
Another name for the Superficial Cervical lymph node
Axillary lymph node
Another name for the Medial Femoral lymph node
Inguinal lymph node
Which fluid circulates through the spleen?
What is the function of the white pulp of the spleen?
What is the function of the red pulp of the spleen?
Lymphocyte filtration and removal
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"
This initiates the frequency of contraction in the heart
Sino-Atrial Node (SA node)
This is an arrangement of muscle fibers in the lower area of the atria that fuse to form an interconnected mass
This is an arrangement of muscle fibers in the upper area of the ventricles that fuse to form an interconnected mass
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
Canine RBC life span
Feline RBC life span
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
Unique structures of the heart
- Chordae tendineae
- Papillary muscles
- Intercalated disks
- bundle of His
- Purkinjie fibers
This is the relaxation of a heart chamber prior to and during filling of a chamber
This is the contraction of the heart in the process of emptying
This refers to the one way flow of blood from venous side to arterial side due to the operation of the four cardiac valves.
This refers to the sequence of events that occur during one complete heartbeat
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)
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.
Energy and O2 demands of the heart depend on:
tension and its relation to the force of myocaridal contractions
This is the INSTRUMENT that makes a recording of the voltage changes of the heart
This is the wave for RECORDING of the voltages changes of the heart
This represents the depolarization of the atria on an ECG
This represents the ventricular repolarization on an ECG
This represents the depolarization of the ventricles and repolarization of the atria on an ECG
This is the distance from the beginning of the P-wave to the QRS complex
This is the distance from the ending of the QRS complex to the beginning of the T-wave
Lymphatic circulation time
Systemic circulation time
Why do CO2 and O2 readily diffuse across simple squamous endothelial layer without having to use the intercellular clefts?
They are both lipophilic
This is a combination of bacteria and glycoproteins on teeth
This is the combination of bacteria with a small amount of mineralization on teeth
This is the combination of bacteria with heavy mineralization on teeth
Discovered penicillin in 1927
Dr. Alexander Fleming
This is refers how the vertical and horizontal wave distances are measure on and ECG
- vertical measurement in millivolts
- horizontal measurement in milliseconds (intervals between waves)
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
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
This is ANY abnormal heart sound
This is a sharp dip in aortic pressure that indicates the end of ventricular systole and the beginning of ventricular diastole
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
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
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)
This is the frequency of cardiac cycles and is usually measured by the number of beats per minute.
Heart Rate = Pulse
Why do small/female animals tend to have a higher heart rate than large/male animals?
Surface area and weight density
Why do younger animals tend to have a higher heart rate than older animals?
Less vagal tone inhibition development
This is the difference between systolic and diastolic pressures
Pulse Pressure (PP)= sys - dia
Mean Arterial Pressure = Dia + 1/3(PP)
Mean Blood Pressure - another name for MAP
What percentage of the blood composition is water?
These are heavier, temperature tolerant fluids with larger molecules that remain in the blood with raises blood pressure quickly
Examples of colloids:
- Whole blood
These are water-like fluids that are designed to increase the volume of fluid in the body
Examples of crystalloids:
- Lactated Ringers
- 0.9% NaCl
Diplomate, American College of Veterinary Internal Medicine
This type of blood pressure measurement requires catheterization of a peripheral artery but is more accurate
This type of blood pressure measurement is far more practical use today and has 2 primary methods.
- doppler - systolic pressure only
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
What are the 4 types of shock?
- hypovolemic shock - loss of fluid in the body
- neurogenic shock
- cardiovascular shock
- septic shock
This is a palpation technique once used in veterinary medicine to determine pregnancy
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
Bovine abdominal observations
- Left side enlargement = bloat
- Right side enlargement = pregnancy
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.
This is a device that translates one physical quantity to another
Another name for the pressure gauge
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
Advantages of Doppler monitoring
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
Canine position for non-anesthetized blood pressure monitoring
What is the ideal percentage the cuff should be relative to the circumference of the limb at the site of placement?
Why is standing not a good position for non-anesthetic blood pressure monitoring?
Muscle movement can interfere with readings
A cuff that is too wide will give what kind of reading?
A cuff that is not wide enough will give what kind of readings?
higher readings and/or will result in velcro disengaging.
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%
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
This is the most common complication of anesthesia
Chronic hypoxia -> poor vital organ perfusion -> renal damage ->cerebral hypoxia -> cardiac muscle ischemia
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
Blood pressure considered canine hypertension
Blood pressure considered feline hypertension
When are most hypertensions noted?
When the animal is under general anesthesia yet the blood pressure (systolic) remains above a given range (97-79)
Three conditions associated with hypertension
- 1. Hypertensive retinopathy
- 2. Kidney failure
- 3. Left Ventricular hypertrophy
This is the condition where retinal vessels are twisted causing retinal edema, hemorrhage and detachment ultimately resulting in blindness
This is the condition where blood vessel walls become thickened leading to reduced blood flow and serious damage to the nephrons
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
Two classifications of hypertension
- 1. Primary - usually idiopathic
- 2. Secondary to disease
4 diseases associated with secondary hypertension
- 1. Hyperadrenocorticism (Cushing's Disease)
- 2. Hyperthyroidism
- 3. Diabetes mellitus
- 4. Renal disease
How is blood pressure expressed?
Non-anesthetized systolic range
Anesthetized systolic range
Non-anesthetized diastolic range
Anesthetized diastolic range
This refers to the time required for blood to return to the right atrium after being pumped from the left ventricle (generally 60 seconds)
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.
This refers to the physical factors associated with the exchange of fluid between blood and the interstitial fluid at the level of the capillaries
This refers to the slit or space between endothelial cells of capillaries
intercellular cleft or pore
CO2 versus O2 with regards to passive diffuse across capillaries
CO2 diffuse about 20x more easily than O2
What makes up the largest volume of interchange between capillaries and interstitial fluid
Water and its dissolved substances
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
Interstitial Fluid pressure
-6 mmHg, created by the return of interstitial fluids to both the venous end of the capillary and lymphatics
Plasma colloidal pressure
Interstitial colloidal pressure
This refers to an imbalance of bulk flow where fluid accumulates in the interstitial spaces
4 types of capillary imbalances
- 1. high capillary pressure
- 2. low blood protein concentration
- 3. lymphatic blockage (elephantiasis)
- 4. increased porosity
Central Venous Pressure
What does a distended jugular vein while the animal is standing with normal head position indicate?
Caval Syndrome via heartworms
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)
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)
A weak arterial pulse can indicate:
- Dilated cardiomyopathy
A strong Arterial pulse can indicate:
A very strong Arterial pulse can indicate:
- Patent Ductus Arteriosis
This is a buzzing sensation when palpating an animals chest wall caused by loud cardiac murmurs
This portion of the stethoscope allows better auscultation of higher frequency heart sounds
Diaphragm (flat stiff part)
This portion of the stethoscope allows better auscultation of lower frequency sounds
Bell (top part of the diaphragm)
How does the force of blood change in proportion to the diameter of the left and right ventricles?
Lidocaine is indicated for what heart condition?
Atrial or Ventricular Fibrillations
This refers to the movement of cells or substances through the intercellular clefts
List the muscle types in order from greatest to least with regards to inherent rhythmic contractibility:
- cardiac muscle
- skeletal muscle
- smooth muscle
Another term for direct blood pressure determination
Another name for indirect blood pressure determination
What should be done before and after giving basal anesthesia?
Check mucous membrane color and capillary refill time
What is the order of tissues a foreign metal object travels to cause Traumatic Reticular Pericarditis?
Reticulum >> diaphragm >>pericardium >> myocardium
This is the name of the edema from submandible area to the chest often seen when cattle are moved to higher elevations
These are the nicknames associated with anasarca
- Brisket disease
- Bottle jaw
What happens if epinephrine 1:1000 is accidentally given IV?
It will stimulate the Beta receptors of the heart and cause ventricular fibrillation