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What is blood plasma made of?
90% water and 10% solute
What is in electrolytes?
Potassium, calcium, sodium, magnesium, chloroid and phosphate
Where and what are Erythrocytes? If you have high or increased erythrocytes what does that cause? What about low or decreased erythrocytes?
- Produced in the bone marrow
- High: polycythemia
- Low: Anemia
Erythrocyte count is higher in males then females
What is the normal index value for Erythrocytes?
NI: 4.2-6.2 million per cubic mm
What is hemoglobin?
Component of blood that carries oxygen to RBC's
What is the NI for hemoglobin?
What are Leukocytes?
- Produced in bone marrow
- Help defend body against infectious diseases and foreign materials as part of the immune system
What is the NI for Leukocytes or WBCs?
NI: 5000-10,000 per cubic mm
What are Eosinophils?
Increase w/allergic reaction and parasitic infectioions i.e: asthma attacks
What are Basophils?
They secrete heparin i.e: bacterial infection
What are Monocytes?
They increase with invasion of foreign materials: phagocytes
If you have too many Lymphocytes (WBCs) you can get?
If you have the below amount or not enough WBCs you can get?
What are Lymphocytes?
- They increase w/ viral infections
- Reduced w/ immunodeficiency
What are Neutrophils?
Increase w/ trauma and bacterial infections; reduced w/ bone marrow disease
What is the normal value of Platelets?
Normal value: 150,000-400,00 per cubic mm
What are platelets?
- Smallest elements of blood
- They help clot or coagulate
- AKA thrombocytes
What is Thrombus?
What is Embolus?
A moving clot, dangerous because it can clog smaller arteries and lungs
What are the 5 functions of blood?
- Transport gases
- Circulate defense
- Provide nutrients
- Remove waste from cells
Where is the heart located?
- Heart is hollow, muscular, roughly fist-sized
- Lies just behind the sternum, 2/3 to the left
- Heart apex at 5th intercostal space
- Surface grooves (sulci) delineate chambers
What is blood moving away from the heart called?
What is blood moving toward from the heart called?
Layers of the heart from outer to inner?
- Visceral pericardium
What is the pericardial sac or cavity do?
Encloses or lines the heart
What are the 4 chambers of the heart?
- Right atrium
- Right ventricle
- Left atrium
- Left ventricle
What are the 4 valves of the heart?
- Tricuspid valve
- Bicuspid valve
- Pulmonic valve
- Aortic valve
What is the purpose of all the valves?
To prevent back flow
Where do AV valves lie between?
Atria and ventricles
What is systolic or systole?
- The first or highest beat when taking blood pressure!
- Contraction of the heart
- Valves opening, allow venticular ejection into arteries (pulmonary artery and aorta) contraction
What are semilunar valves?
- Consist of 3 half moon shaped cusps
- Situated at ventricle exits to arterial trunks
What is distolic or diastole?
- The lowest or last beat while taking blood pressure!
- Relaxation of the heart
- Valves close preventing back flow of blood into arteries
What is in the Systemic Vasculature?
- 1. Arterial System: Conductive Vessels : carry oxygenated blood and controls local blood flow
- 2. Capillary System: Exchange Vessels : Transfer nutrients to waste
- 3. Venous System: Capacitance Vessels : Carries blood back to the heart
What is an Electrocardiogram?
- ECG or EKG
- Measurement of electrical activity within the heart
- uses 12 leads to obtain 12 different views of electrical activity in the heart
- EKG's are used as screening tools to determine the PT's heart status before a mjor surgery. Are they healthy enough to survive the surgery
- EKG's DO NOT measure the pumping ability of the heart
- EKG's CAN NOT predict acute problems i.e: myocardial infarction
What are Peripheral Receptors?
Where are the barorceptors and chemoreceptors located?
In the arch of aorta and carotid sinus
Baroreceptors respond to and can cause?
- Output is directly proportional to vessel stretch negative feedback, so greater stretches cause vendilation, decreased heart rate and contractility.
What do Chemoreceptors respond to?
- Blood chemistry
- low pH
- low O2
- high PaCO2
- increased output is vasoconstriction and increased HR
What are P Waves?
What is the QRS Complex?
- Ventricular depolarization
- Normal QRS complex is not wider then 3mm (.12 seconds)
What is a T wave?
What is the Sino-atrial node and what does it do?
- Controls pace of the heart, aka pacemaker
- Influenced by autonomic nervous sytem
What is the Atrio-ventricular (AV) node?
- Back up pace maker
- Guides electrical impulse from atria into ventricles
What is the path of the electrical system through the heart?
- Sino-atrial (SA) node
- Atrio-ventricular (AV) node
- Bundle of His
- Left bundle branch
- Right bundle branch
- Purkinje fibers
What is depolarization?
What is repolarization?
What is the path of blood?
- Superior/Inferior vena cava
- Rigth atirum
- Tricuspid valve
- Right ventricle
- Pulmonary valve
- Pulmonary artery
- Pulmonary vein
- Pulmonic valve
- Left atrium
- Bicuspid or Mitral valve
- Left ventricle
- Aortic valve
What is Starlings Law?
- Greater the stretch of the heart muscle, the stronger the contraction
- Greater the volume of blood entering heart during diastole, greater the volume being ejected during systolic contraction
What is a normal sinus rhythm?
- Upright P wave that is identical throughout the strip
What is different about Sinus bradycardia?
Sinus bradycardia meets are the criteria for a normal sinus rhythm except for the HR, which is less then 60bpm
What treatment is given when someone has sinus bradycardia?
Atropine - speeds up HR
What are some properties about Sinus tachycardia?
- It is present when the heart rate is at 100-150bpm at rest
- All normal conduction pathways in the heart are followed
- Symptoms: pain, anxiety, fever, hypovolemia and hypoxemia
- Bronchodilaters can cause tachycardia
What are some properties about Sinus arrhythmia?
- This is a benign arrythmia that meets all the criteria for a normal sinus rhythm except that the rhythm is irregular
- It usually does not produce symptoms in the PT and requires no treatment
What is Premature ventricular contractions? PVC
- Occurs when the ectopic beats originate in one of the ventricles due to enhanced automaticity
- PVC's are comonly the result of hypoxia, electrolyte imbalances and acid-based disorders
- PVC's occur in botht he normal heart and the diseased heart, and are usually due to anxiety or excessive use of caffine, alcohol, or tobacco.
- QRS complex is wide and has no preceding P wave
- Frequent PVCs call for the treatment of the underlying cause (lidocaine offers temporary solution in some cases)
What treatment is given when someone has a reading of PVC on their EKG?
What is Ventricular tachycardia?
- Represent a run of three or more PVCs
- Easy to recognize as a series of wide QRS complexes w/ no proceeding P wave
- VT represents a serious arrhythmia that often progresses to a V Fib if untreated
HR of Ventricular tachycardia?
Ventricular rate is 100-125bpm
Treatment for Ventricular tachycardia?
What is Ventricular Fibrilation? V Fib
- Represents the most life threatning arrythmia
- Defined as erratic or quivering of ventricular muscle mass
- Causes cardiac output to drop to zero
- The ECG show grossly irregular fluctuations w/ a zig-zag pattern
- Treatment: cardioversion, CPR, O2, antiarrhytmic medication
What is Asystole?
- Asystole is cardiac stand still and is invariably fatal unless an acceptable rhythm is restored
- Asystole is recognizable on the ECG monitor as a straight or almost straight line
What is the normal cardiac output? (amount of blood being pumped out of the heart)
5L a min or 5,000mL
What is the correct way to take a pulse reading?
with fingers NOT thumb
What are the 5 sites you can take a pulse reading?
- Radial - wrist/thumb
- Carotid - neck
- Femoral - groin
- Brachial - inside of elbow
- Dorsalis Pedis - top of foot
What is normal systolic blood pressure range?
100-140 mHg (millimeters of mercury)
What is normal diastolic blood pressure range?
60-90 mHg (millimeters of mercury)
What is a Sphygmomanometer?
Glass tube with mercury used tomeasure blood pressure sounds reflected through a stethoscope
What is Hypertension?
High blood pressure
What is Myocardial infarction? MI
- Heart attack
- tissue become ishemic and necrotic
- muscle is weakened
What is Cor Pulmonale?
- Right side heart failure
- neck vein (venious distension) will protrude
What is Congenital abnormalities?
- May cause right to left shunt
- Blood may be unable to oxygenate
- Babies are born with it
What is an aneurysm?
- Ballooning out of vessels
- Weakening vessels
- Can cause hemmorage, rupture or death
What is Arteriosclerosis?
Hardening of arteries by calcium - HBP
What is atherosclerosis?
Fat deposits causing narrow arteries
What is Ischemia?
Decrease of blood flow to area for a variety of reasons: blood clots, low blood pressure, etc
What is a hemorrhage?
- loss of blood (trauma)
- uncontrolled bleeding
- usually a rupture or torn vessel
What is shock?
- loss of circulating fluid
- deragnement of circulatory control
- symptoms: pale, clamminess of skin, hypotension, bradypnea, restlessness, anxiety and sometimes unconsciousness
What are the 3 states of cardiac inflammation?
- Endocarditis: inflammed endocardium
- Myocarditis: inflammed mycardium
- Pericarditis: inflammed pericardium
What is angina pectoris?
- Pain located over the heart, left shoulder or jaw
- Due to decreased blood supply (ischemia) to the heart by the coronary arteries
- Leads to heart attack
What is congestive heart failure?
- left side heart failure
- impaired cardiac pumping
- caused by: MI, ischemic heart disease, cardiomyopathy (heart muscle diseases)
What are the 4 key properties to conduct electrical impulses through the heart?
- Excitablity- ability to respond to stimuli
- Automaticity- intiation of spontaneous electrical impulse
- Conductivity- spreads impulses quickly
- Contractility- contraction in response to electrical impulse
- *unique feature - cannot go tetany