unit 1 exam

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1

In fetal circulation where does blood enter after the right atrium

the foramen ovale

2

where does fetal circulation occur?

the placenta

3

How does fetal blood return to the baby

the umbilical vein

4

Around what day does the fetal heart development begin

Day 20 (21)

5

What are the 3 fetal shunts involved in fetal circulation

  1. ductus venosus
  2. foramen ovale
  3. ductus arteriosus
6

what is the first shunt in fetal circulation and what does it bypass

ductus venosus, it bypasses the liver

7

what is the foramen ovale

2nd shunt in fetal circulation, it is the opening between right and left atrium in septum

8

what is the ductus arteriosus

3rd shunt in fetal circulation, joins the pulmonary artery to the aorta

9

what is septation and when does it occur?

it is when the wall between the atria starts to form, and it begins around 27-37 days of gestation

10

what are the three names of the catheter

Swan-ganz catheter, triple lumen catheter, and balloon tipped catheter flotation device

11

what is the purpose of using a catheter?

  1. Early detection, identification, and treatment of life-threatening conditions such as heart failure and cardiac tampanade
  2. Evaluate the patient’s immediate response to treatment such as drugs and mechanical support
  3. Evaluate the effectiveness of cardiovascular function such as cardiac output and index
12

what are the different ways of obtaining blood pressure

  1. invasive measurement (catheter)
  2. ausculatory measurement
  3. oscillometric measurement
13

what are the components of the Swan-ganz

  1. Proximal port – [Blue] used to measure central venous pressure/RAP and inject port for measurement of cardiac output
  2. Distal port – [Yellow] used to measure pulmonary artery pressure
  3. Balloon port – [Red] used to determine pulmonary wedge pressure;1.5 special syringe is connected
  4. Infusion port – [White] used for fluid infusion
14

definition of preload

Prior to contraction

15

definition of afterload

resistance the heart pumps against

16

how do you get cardiac output

heart rate X stroke volume

17

what does SVR stand for

Systemic vascular resistance (reflects left ventricular after load)

18

what does PVR stand for

Pulmonary Vascular Resistance (reflection of right ventricular afterload)

19

what is the CVP?

the central venous pressure is a direct measurement of right ventricular end diastolic pressure

20

What is the PCWP?

the pulmonary capillary wedge pressure is an indirect measurement of the left ventricular end diastolic pressure

21

what vessels carry blood to and from the heart

  1. pulmonary arteries- only artery to carry deoxygenated blood
  2. pulmonary veins-bring oxygenated blood to the left heart
  3. IVC-brings unoxygenated blood from the lower part of the body back to the right atrium
  4. SVC- brings unoxygenated blood from the head/neck vessels back to right atrium
22

if your pericardial fluid is leaking what will be affected?

diastolic pressure

23

where is the pericardial space located?

the pericardium and epicardium and it holds 10-15 ML of fluid

24

where is the general location of the heart?

the mediastinum

25

How is the heart primarily controlled?

Autonomic system

26

what are the two RECEIVING chambers?

right and left atrium

27

what are the two PUMPING chambers?

left and right ventricles

28

what does the bicuspid valve do?

It regulates blood flow from the upper left chamber (left atrium) into the lower left chamber (left ventricle), the heart's main pumping chamber

29

what layer of the heart is continuous with the tunica interna

the endocardium

30

where is the Eustachian valve located?

in the IVC, just above the right atrium

31

what valves have 3 valves

aortic valve, pulmonary valve, mitral/ tricuspid valve

32

what are the semilunar valves

they are the aortic valve and have three cusps-

  1. right coronary cusp
  2. left coronary cusp
  3. non coronary cusp
33

what phase is responsible for diastolic filling of ventricles

early rapid filling phase

34

the vagus nerve is from what nervous system?

parasympathetic

35

what side of the heart has the highest pressure?

Left ventricle

36

what occurs when the truncus does not divide?

Truncus arteriosus, the blood vessel does not seperate into two like it is supposed to.

37

what system is stimulated during a hostile situation? what are the factors or the system that is stimulated?

the sympathetic system, increased heart rate/ conduction

38

The sinus venosus forms what?

the left and right sinus horn

39

what is ASD

Atrial Septal Defect, where the whole does not close and leaves a valve-like opening between the atria

40

what is the stroke volume equation?

End-diastolic volume (MINUS) End-systolic volume

41

define contractility

strength of contraction

42

what shunt bypasses the liver?

the ductus venosus

43

what shunt bypasses the lungs?

ductus arteriousus

44

what shunt is located between the left and right atrium?

foraman ovale

45

the inferior vena cava drains what?

the trunk and lower extremeties

46

the superior vena cava drains what?

the upper extremeties

47

what factors assist in blood return?

calf pump muscle, cardiac suction, venous valve, and diaphram

48

which side of your body is systemic?

the LEFT side

49

what is the normal conduction sequence?

  1. SA Node
  2. AV Node
  3. Internodal Pathway
  4. Bachmann’s Bundle
  5. Bundle of His
  6. Right and Left Bundle Branches
  7. Purkinje Fibers
  8. Purkinje Network
50

increased afterload does what to the chambers in the heart?

creates hypertrophy

51

what supplies the bulk of the blood to the heart?

the LEFT coronary sinus

52

where are the aortic valve leaflets located?

in the sinus Valsalva

53

what are the layers of the heart?

fibrous pericardium, serous pericardium, pericardium, epicardium, myocardium, endocardium

54

what are the saturation pressures of the heart?

right atrium & right ventricle- 75%, left atrium & left ventricle- 100%, coronary sinus is about 70%

55

what has the lowest oxygen saturation?

the coronary sinus (70%)

56

what moves blood through the body?

pressure gradient ( ΔP)

57

the three cusps found in the aortic valve are named after what?

the coronary artery

58

The Atrioventricular groove does what?

it separates the atrium from the ventricle

59

The interventricular groove does what?

it separates the right and left ventricle

60

the interatrial groove does what?

it separates the right and left atria

61

what is the CRUX?

it is the area where the 4 chambers, coronary sinus, and the posterior descending artery meet

62

what does the parasympathetic system do to the heart?

it lowers the heart rate

63

What node is stimulated during physical stress?

The AV node

64

where is excess pericardial fluid drained?

the lymphatic system

65

which chamber of the heart is thickest?

the left

66

If you have a patient that has VSD which way is blood going to flow?

left to right

67

what are the great vessels?

  1. pulmonary vein
  2. pulmonary artery
  3. IVC
  4. SVC
  5. aorta
68

around what day is the fetal heart complete?

day 40 (43)

69

Ejection fraction shows what?

the measurement of the percentage of blood leaving the heart each time it contracts

70

what are the names of the mitral valve leaflets

the anterior and posterior leaflets

71

what is normal stroke volume

60-100 mL/heartnbeat

72

what is the biggest valve in the heart?

the tricuspid valve

73

where is the infundibulum located

in the right ventricular outflow tract

74

which arteries carry blood away from the heart?

the pulmonary arteries

75

where is the moderator band found

in the right ventricle

76

where is the thick band located

the left ventricle

77

what is isovolumic relaxation

ventricular pressure is dropping, no volume change

78

what is the right ventricle shaped like?

it is cresent shaped

79

what is the left ventricle shaped like?

it is shaped prolated

80

what is the ventricular septum

it is a muscle

81

what is the mitral valve shaped like?

a bishops hat

82

which side of the heart has the lowest resistance?

the right side

83

what are the five structures that make up the mitral valve apparatus?

  1. mitral annulus
  2. mitral valve leaflets
  3. chordae tendineae
  4. papillary muscles
84

what guards the opening of the coronary sinus

Thebesius vavle