Week 10 - Study Guide

Question 1

P-wave

Answer 1

1. atrial depolarization initiated by the SA node

(the spreading of the electrical signal (depolarization) through the atria)

Question 2

Pause after P wave and before QRS complex

Answer 2

2. Atrial depolarization complete, the impulse is delayed at the AV node

Question 3

QRS complex

Answer 3

3. Ventricular depolarization begins at the apex, causing the QRS complex.
   Atrial Repolarization occurs.

When the QRS wave initiates - that is the signal (depolarization phase) spreading down the bundle of His, and up the Purkinje fibers.

It covers up the repolarization phase of the atria.

Question 4

Ventricular depolarization is complete after_____

Answer 4

the QRS complex - before the T wave

4. once the ventricle is get the electrical signal (depolarization) is able to go through contraction

Question 5

T- wave

Answer 5

5. Ventricular repolarization of the ventricle begins at the apex, causing the T wave.

Repolarization phase will occur in the ventricles

Question 6

Line after T wave

Answer 6

6. Ventricular repolarization is complete

Question 7

Common symptoms of heart attack (myocardial infarction)

Answer 7

1. Crushing pain in chest (50%) or squeezing sensation
2. Nagging discomfort, achy pain under shoulder blade, along clavicle, or jaw
3. Cold sweats
4. Shortness of breath at rest
5. Nausea
6. Episodes of dizziness and lightheadedness

Question 8

Heart block is a

Answer 8

disorder of the hearts electrical system

Question 9

1st-degree heart block

Answer 9

1. asymptomatic - found on EKG as delayed transmission

person not aware

Question 10

2nd-degree heart block

Answer 10

1. arrhythmias
2. skipped beats
3. periodic absence of QRS wave
4. AV node does not always respond

P-wave –> no QRS complex –> no T-wave

T-wave only occurs at the repolarization of the ventricles

So - you get a P-wave and then a flat line until the next P-wave occurs

Not life-threatening but the person would be aware of it

Question 11

3rd-degree heart block

Answer 11

1. Life-threatening
2. Requires a PACEMAKER
3. can lead to heart failure

The signals being sent by the pacemaker are not being responded to appropriately. SO - replacement of the pacemaker is essential to keep the signaling in the heart going so the heart will continue to function as an appropriate pump

Question 12

4 types of Circulatory shock

Answer 12

1. Cardiogenic
2. Hypovolemic
3. Vasodilatory (Vasogenic)
4. Neurogenic

Question 13

Hypovolemic Shock

Answer 13

1. Blood volume loss (hemorrhage or bleeding ulcer)
2. Fluid loss - fluid out of circulation means you do not have enough blood volume

Low arterial pressure (circulatory shock
Low cardiac output
Low blood volume due to loss of blood and/or loss of body fluids

Question 14

Cardiogenic shock

Answer 14

1. Cardiac output is insufficient (myocardial infarction)

A heart problem that is now creating insufficient cardiac output

In the beginning where the formation occurred - at the level of the heart itself

Question 15

Vasogenic Shock

Answer 15

1. Vasodilation - cannot get blood back to the heart
2. vascular tone is lost
3. blood vessels relax

usually due to septic shock & spinal cord injury

Blood volume is normal but the blood is not being delivered appropriately.

Due to the loss of vascular tone we do not have enough blood to send equally to all places of the body at the same time.

So- we have to reduce the amount of blood flow to some regions to get blood to others

Can result in Anaphylactic shock and Septic shock

Question 16

Anaphylactic shock

Answer 16

Histamines released in severe allergic reactions

Immune-related where the body overreacts to a stimulus

Question 17

Septic Shock

Answer 17

Vasodilator substances released from bacteria

A bacterial overload in the bloodstream - and all the toxins cause a problem.
Infection causing vasodilation

Question 18

Neurogenic shock

Answer 18

a SNS issue - loss of control over the cardiovascular system.

Without sympathetic innervation, the parasympathetic innervation of the heart (Vagus Nerve) is left without antagonism.
This results in bradycardia and diminished contractility.

you have trouble keeping your heart rate, blood pressure, and temperature stable because of damage to your nervous system after a spinal cord injury.

Fatal issue because blood flow is too low

Question 19

In all circulatory shock cases - you suffer from —

Answer 19

a reduction in cardiac output

Question 20

Compare and Contrast
Blood Flow vs Perfusion

Answer 20

-blood flow: RATE of blood flowing through a tissue in a given time (ml/min)
Blood flows through vessels to get to tissues. When blood is in a tissue it is perfused.

-perfusion: RATE of blood flow PER GIVEN MASS OF TISSUE (ml/min/g)
*more imp. than blood flow
- spreads out in tissue
When the blood gets to a tissue so it can do its job of oxygenating

Question 21

How does Epinephrine affect the Circulatory system?

Answer 21

1. In the heart it increases the rate and force of contraction
2. thus increasing the output of blood
3. and raising the blood pressure

dilates bronchioles
raises blood pressure

Question 22

How does ADH affect the Circulatory system?

Answer 22

1. Helps control blood pressure by acting on the kidneys and the blood vessels
2. retains water - raises BP

Question 23

How does Aldosterone affect the Circulatory system?

Answer 23

1. Holds Na+
2. Gets rid of K+
3. increase BP

Retention of sodium causes water to be retained, aldosterone increases blood volume which causes blood pressure to rise

Question 24

Circulatory Shock is ___.

Answer 24

1. An inadequate blood flow throughout the body, to the extent that the body tissues are damaged.
2. Shock results in inadequate output.
3. Decline in tissue perfusion resulting in hypoxia - low oxygen at the tissues.

meaning - insufficient oxygen for supporting metabolism

Question 25

Circulatory Shock: Functionality causes ____

Answer 25

1. Stressed cells & blood vessel endothelial cells release chemical mediators saying - I do not have enough oxygen!

Question 26

What are the chemical mediators that are released by cells and actions due to circulatory shock?

Answer 26

1. Chemical mediators cause vasodilation in heart and lungs. Trying to keep the core organs alive. 2. Epinephrine - will increase cardiac output by increasing heart rate and peripheral resistance 3. Hormones for water retention - Aldosterone & ADH trying to hold on to body water -

Question 27

Symptoms of circulatory shock

Answer 27

1. Pale, clammy, or cyanotic skin 2. drop in body temperature 3. rapid and feeble pulse 4. shallow rapid breathing

Question 28

Congestive Heart Failure (CHF)

Answer 28

1. Decline in the efficiency of the heart to pump 2. Cardiac output is not sufficient to meet the needs of the body (tissues) in terms of metabolism

Question 29

Common causes of Congestive Heart failure

Answer 29

1. Coronary Atherosclerosis 2. Persistent high blood pressure 3. Multiple myocardial infarcts 4. Dilated cardiomyopathy (DCM)

Question 30

Right-sided Congestive Heart Failure

Answer 30

1. Fluid accumulates in systemic circuit (backs up) 2. Ascites - protein-fluid in abdomen Cirrhosis is most common cause - Fluid will build up from the right ventricle - to the right atria (increase in size of right atria) - build up in the body's extremities -typically the abdomen or extremities like ankles

Question 31

Left-sided Congestive Heart Failure

Answer 31

1. Fluid accumulates in the lungs (leading to PCWP = high Left atria pressure) (PCWP = pulmonary capillary wedge pressure) **long way of saying - build-up of fluid in the lung and associated with high pressure in left atria** 2. Does not lie down while sleeping - cannot breathe - Left ventricle backs up to - left atrium - backs up to lungs

Question 32

Congestive Heart Failure Symptoms

Answer 32

1. Cough (edema in lungs) 2. Swelling (location will vary) 3. Shortness of breath (build-up of fluid in lungs) 4. Weight gain 5. Irregular, rapid pulse 6. Fatigue, weakness, fainting (heart not able to meet needs of metabolism) 7. Nausea, vomiting 8. Decreased urine output (all fluid is building up in the body tissue) 9. Difficulty sleeping (build up fluid in lungs)

Question 33

Cor Pulmonale

Answer 33

Right-sided heart failure due to high pulmonary pressure

Question 34

Cor Pulmonale most commonly caused by

Answer 34

Pulmonary hypertension which causes right ventricle to enlarge which causes it to fail

Question 35

Cor Pulmonale - other causes

Answer 35

1. pulmonary hypertension 2. High blood pressure in lungs due to chronic lung disease (COPD, CF, obstructive sleep apnea)

Question 36

Cor =

Answer 36

heart

Question 37

Pulmonale =

Answer 37

lungs