unit 1 exam
In fetal circulation where does blood enter after the right atrium
the foramen ovale
where does fetal circulation occur?
How does fetal blood return to the baby
the umbilical vein
Around what day does the fetal heart development begin
Day 20 (21)
What are the 3 fetal shunts involved in fetal circulation
- ductus venosus
- foramen ovale
- ductus arteriosus
what is the first shunt in fetal circulation and what does it bypass
ductus venosus, it bypasses the liver
what is the foramen ovale
2nd shunt in fetal circulation, it is the opening between right and left atrium in septum
what is the ductus arteriosus
3rd shunt in fetal circulation, joins the pulmonary artery to the aorta
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
what are the three names of the catheter
Swan-ganz catheter, triple lumen catheter, and balloon tipped catheter flotation device
what is the purpose of using a catheter?
- Early detection, identification, and treatment of life-threatening conditions such as heart failure and cardiac tampanade
- Evaluate the patient’s immediate response to treatment such as drugs and mechanical support
- Evaluate the effectiveness of cardiovascular function such as cardiac output and index
what are the different ways of obtaining blood pressure
- invasive measurement (catheter)
- ausculatory measurement
- oscillometric measurement
what are the components of the Swan-ganz
- Proximal port – [Blue] used to measure central venous pressure/RAP and inject port for measurement of cardiac output
- Distal port – [Yellow] used to measure pulmonary artery pressure
- Balloon port – [Red] used to determine pulmonary wedge pressure;1.5 special syringe is connected
- Infusion port – [White] used for fluid infusion
definition of preload
Prior to contraction
definition of afterload
resistance the heart pumps against
how do you get cardiac output
heart rate X stroke volume
what does SVR stand for
Systemic vascular resistance (reflects left ventricular after load)
what does PVR stand for
Pulmonary Vascular Resistance (reflection of right ventricular afterload)
what is the CVP?
the central venous pressure is a direct measurement of right ventricular end diastolic pressure
What is the PCWP?
the pulmonary capillary wedge pressure is an indirect measurement of the left ventricular end diastolic pressure
what vessels carry blood to and from the heart
- pulmonary arteries- only artery to carry deoxygenated blood
- pulmonary veins-bring oxygenated blood to the left heart
- IVC-brings unoxygenated blood from the lower part of the body back to the right atrium
- SVC- brings unoxygenated blood from the head/neck vessels back to right atrium
if your pericardial fluid is leaking what will be affected?
where is the pericardial space located?
the pericardium and epicardium and it holds 10-15 ML of fluid
where is the general location of the heart?
How is the heart primarily controlled?
what are the two RECEIVING chambers?
right and left atrium
what are the two PUMPING chambers?
left and right ventricles
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
what layer of the heart is continuous with the tunica interna
where is the Eustachian valve located?
in the IVC, just above the right atrium
what valves have 3 valves
aortic valve, pulmonary valve, mitral/ tricuspid valve
what are the semilunar valves
they are the aortic valve and have three cusps-
- right coronary cusp
- left coronary cusp
- non coronary cusp
what phase is responsible for diastolic filling of ventricles
early rapid filling phase
the vagus nerve is from what nervous system?
what side of the heart has the highest pressure?
what occurs when the truncus does not divide?
Truncus arteriosus, the blood vessel does not seperate into two like it is supposed to.
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
The sinus venosus forms what?
the left and right sinus horn
what is ASD
Atrial Septal Defect, where the whole does not close and leaves a valve-like opening between the atria
what is the stroke volume equation?
End-diastolic volume (MINUS) End-systolic volume
strength of contraction
what shunt bypasses the liver?
the ductus venosus
what shunt bypasses the lungs?
what shunt is located between the left and right atrium?
the inferior vena cava drains what?
the trunk and lower extremeties
the superior vena cava drains what?
the upper extremeties
what factors assist in blood return?
calf pump muscle, cardiac suction, venous valve, and diaphram
which side of your body is systemic?
the LEFT side
what is the normal conduction sequence?
- SA Node
- AV Node
- Internodal Pathway
- Bachmann’s Bundle
- Bundle of His
- Right and Left Bundle Branches
- Purkinje Fibers
- Purkinje Network
increased afterload does what to the chambers in the heart?
what supplies the bulk of the blood to the heart?
the LEFT coronary sinus
where are the aortic valve leaflets located?
in the sinus Valsalva
what are the layers of the heart?
fibrous pericardium, serous pericardium, pericardium, epicardium, myocardium, endocardium
what are the saturation pressures of the heart?
right atrium & right ventricle- 75%, left atrium & left ventricle- 100%, coronary sinus is about 70%
what has the lowest oxygen saturation?
the coronary sinus (70%)
what moves blood through the body?
pressure gradient ( ΔP)
the three cusps found in the aortic valve are named after what?
the coronary artery
The Atrioventricular groove does what?
it separates the atrium from the ventricle
The interventricular groove does what?
it separates the right and left ventricle
the interatrial groove does what?
it separates the right and left atria
what is the CRUX?
it is the area where the 4 chambers, coronary sinus, and the posterior descending artery meet
what does the parasympathetic system do to the heart?
it lowers the heart rate
What node is stimulated during physical stress?
The AV node
where is excess pericardial fluid drained?
the lymphatic system
which chamber of the heart is thickest?
If you have a patient that has VSD which way is blood going to flow?
left to right
what are the great vessels?
- pulmonary vein
- pulmonary artery
around what day is the fetal heart complete?
day 40 (43)
Ejection fraction shows what?
the measurement of the percentage of blood leaving the heart each time it contracts
what are the names of the mitral valve leaflets
the anterior and posterior leaflets
what is normal stroke volume
what is the biggest valve in the heart?
the tricuspid valve
where is the infundibulum located
in the right ventricular outflow tract
which arteries carry blood away from the heart?
the pulmonary arteries
where is the moderator band found
in the right ventricle
where is the thick band located
the left ventricle
what is isovolumic relaxation
ventricular pressure is dropping, no volume change
what is the right ventricle shaped like?
it is cresent shaped
what is the left ventricle shaped like?
it is shaped prolated
what is the ventricular septum
it is a muscle
what is the mitral valve shaped like?
a bishops hat
which side of the heart has the lowest resistance?
the right side
what are the five structures that make up the mitral valve apparatus?
- mitral annulus
- mitral valve leaflets
- chordae tendineae
- papillary muscles
what guards the opening of the coronary sinus