Card Set Information
medic11 cardiology cards
What are the 2 parts of the pericardium & their locations?
Visceral (epicardium) – inner
Parietal – outer, fibrous layer
The 2 main heart sounds are what?
S1 – “lubb” caused by the closing of the AV valves
S2 – “dupp” Caused by the closing of the SL valves
The R coronary artery branches into what 2 parts?
Posterior Descending Artery
The left coronary artery branches into what 2 parts?
Left anterior descending
Left circumflex Artery
Give 5 facts about the L anterior descending.
Originates on left side of aorta
“widow maker” associated w/sudden death
Part of R ventricle
Intraventricular septal artery (septum)
Give 2 facts about the L circumflex artery
Lateral wall of L ventricle
Posterior wall of L ventricle
Define cardiac cycle
Period of time fr end of 1 contraction to the end of the next
Period of time when myocardium is relaxed & cardiac filling & coronary perfusioni occur
Period of cardiac cycle when myocardium is contracting
What is “atrial kick?”
When the atria contract filling ventricles to capacity. This kick accounts for 30% of output
Define stroke volume & what is it equal too?
Amt of blood ejected fr 1 ventricle w/each heart beat usually 60-100ml
SV = HR x Cardiac output
Pressure in filled ventricle @ end of diastole
Define Frank Starling Law & what drug effects it.
Greater the vol of blood in heart during diastole causing myocardial muscle stretch, the more forceful the contraction
Dopamine works directly on this principle
What is afterload?
Resistance against which ventricle must contract to eject blood
If we increase peripheral vascular resistance we will ____ stroke vol.
Decreasing peripheral vascular resistance will ____ stroke vol?
Define venous return.
Amt of blood flowing into R atrium each min fr systemic circulation
What is cardiac output?
Amt of blood pumped each minute by the heart
How many ml in an avg stroke vol?
Define systemic vascular resistance.
Resistance to the flow of blood determined by vessel diameter & tone
The sympathetic nervous sys influences both the atria & ventricles. T or F
The parasympathetic nervous sys primarily influences what part of the heart?
Where are alpha receptors in the heart?
Located in peripheral blood vessels & responsible for vasoconstriction
Where are Beta 1 receptors located?
Primarily in the heart to increase HR & contractility
Where are Beta 2 receptors located?
Lungs & peripheral blood vessels to cause bronchodilation & peripheral vasodilation
What is cardiac excitability?
The ability of cardiac muscle cells to respond to an external stimulus (chemical, electrical, mechanical
What is cardiac conductivity?
The ability of cardiac cells to receive an elec stimulus & conduct that impulse to an adjacent cell
What is cardiac autiomaticity?
Ability of cardiac pacemaker cells lto spontaneously initiate an elec impulse
What is cardiac contractility?
Ability of cardiac cells to shorten causing muscle contraction in response to electrical stimulus
Normal ejection fraction is greater than ____ %.
The avg cardiac stroke vol is ____?
The resistance against which the ventricle must pump blood is called what?
Peripheral vascular resistance
The formula for cardiac output is _______?
Stroke vol (ml) x HR
The formula for BP is _____?
Cardiac output x systemic vascular resistance
What type of receptors cause bronchodilation & peripheral vasodilation?
Na's major role in the cardiac cell is ____?
Resting membrane potential is measures @ around ____ mV.
The Na/K exchange pump exchanges ____ Na for every ____ K taken into the cell
3 Na out
2 K in
What are ions?
Atom or grp of atoms w/ an elec charge
What is diffusion?
Movement of ions fr high concentration to area of low concenttration
What is a gradient?
A force which drives diffusion
When Na rushes into a cell rapidly & the inside of the cell is more pos tan the outside this is called ____?
How many P waves must be noted in order for a rhythm to be considered to have a wandering pacemaker?
When a wandering atrial pacemaker rhythm >100 bpm is considered to be what?
Multifocal Atrial Tach
The term that applies to any tachycardic rhythm originating above the ventricle is called ____?
What are the 6 "H"s for reversible causes?
What are the 6 T reversible causes?
Name the bipolar leads.
I, II, III
What is the proper placement of the V5 lead?
5th intercostal anterior axillary
What happens -- physically -- when depolarization occurs?
Ability of cardiac pacemaker cells to spontaneously initiate an electrical impulse is called?
A "P" wave represents what actions of the heart?
Atrial depolarization and contraction
The QRS represents what 2 actions of the heart?
Ventricular depolarization and contraction
The "T" wave represents what action of the heart?
What are the 2 valves that lie between the atria?
Tricuspid and Mitral
What level of the heart do the terminal ends of the purkinje Fibers lay?
Spread out beneath the endocardium
Ventricular conduction is composed of purkinje fibers that use fast moving ____ ions for conduction.
What are the 2 phases of ventricular repolarization & how are they represented on EKG?
Plateau Phase & Rapid Phase
ST segment & T wave
Ventricualr systole begins @ the _____ & persists until the end of the ____ wave.
Pt's w/long QT syndrome are in danger of developing _____?
Rapid ventricular Rhythms
The release of free Ca++ ions into the interior of the myocytes produce myocardial ____?
Following depolarization, repolarization is due to the controlled outflow of ____ fr the myocytes.
What neurotransmitter activates the heart's B1 adrenergic receptors?
Junctional foci have an inherent rate of ____ to ____.
40 to 60
Ventricular foci have an inherent rate of ____ to ____.
Lead V6 is placed where?
5th intercostal mid axillary
If an impulse is moving toward a lead it will have a ____ deflection.
Phase II of the cardiac action potential is?
Phase I of a cardiac action potential is?
The left anterior descending artery supplies which wall of the heart?
What is the paper speed on the EKG?
The left circumflex artery supplies which 2 walls of the heart?
Lateral Wall & Septum
What is the period of time fr the end of 1 contraction to the end of the next is called?
The PR interval measures what?
Time for impulse to travel fr atria to ventricles
Atrial kick accounts for what % of cardiac output?
Lead V3 is placed where?
Halfway between leads V2 & V4
V4R lead placement is where?
V4 lead lead moved to right side, 5th intercostal, mid clavicular
What is the compensatory pause?
Absence of an appropriate beat after a PVC as the ventricles repolarize
A rhythm of 1 NS beat followed by an ectopic one
Which is worse for an ectopic beat to fall on? The absolute refractory period or the relative refractory period?
Relative refractory period
What lead looks at the high lateral wall?
What lead looks at the base of the heart & can help diagnose a TCA OD?
What is the criteria for a posterior hemiblock?
Left axis deviation
Sm "Q" in lead 3
Big "R" in lead 1
A left bundle branch has a ____ deflection b/f the J point.
An extreme right axis and upright V1 equals ____.
An RSR pattern b/f the J point is what?
Two hemiblocks are also called what?
Which left hemibock has the highest mortality rate?
What rate determines rapid ventricular response in A Fib? A Flutter?
Afib = >100 bpm
A flutter = 200-250
What is the deviation allowed in the R-R for a rhythm to still be regular?
What is a wandering atrial pacemaker w/a rate over 100 called?
Multi focal A Tach
What is the preferred drug w/dosage for Torsades?
Mag Sulfate @ 1-2 g IV drip over 10 minutes
Your pt is in an idioventricular rhythm, pale, diaphoretic, & unconscious. Do what?
What are five drugs for treating V Fib?
How does pericarditis present on an ECG?
The ST segment is usually flat or concave
Entire T may be elevated off baseline
What is the effect of digitalis on an ECG?
Depressed ST segment looking like a scoop
How does hyperkalemia present on and ECG?
W/ tall peaked T waves