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Board Review CRNA (Sweat Book) > Cardiac Quiz > Flashcards

Flashcards in Cardiac Quiz Deck (118)
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1

What two factors determine mean arterial blood pressure?

1) CO (HR x SV)
2) SVR

2

What two factors determine cardiac output?

1) SV
2) HR
CO= SV x HR

3

The interplay of what 3 factors determine stroke volume?

1) preload
2) afterload
3) contractility

4

What two factors determine preload?

1) intravascular volume
2) venous tone
* when veins constrict, blood is diverted to the heart

5

What is the major determinant of intravascular volume?

the amount of sodium in the body

6

What hormone is most important for controlling intravascular volume?

aldosterone--> controls the Na+

7

What is the best equation for MAP if you know CO and SVR?

MAP = (CO x SVR)/80 + CVP
*this equation can be manipulated to find other values

8

Preload is the ________ present in the wall of the left ventricle at the end of diastole (immediately prior to contraction).

tension--> "tightness"--> force
*preload is d\t volume, but is not volume--> it is the tension in the wall

9

Preload is determined by the _______ of blood in the LV chamber at the end-diastole.

VOLUME--> but it is the tension not volume

10

Afterload is the _______ in the wall of the heart at the time the ______ valve opens.

tension--> force at the time the aortic valve opens
* "After"load--> after systole starts

11

Afterload is determined by ___________.

SVR...... SVR= PRESSURE
* the > the SVR, the > the afterload
* afterload is d\t the SVR (pressure) on the other side of the valve but is actually the tension on the wall after systole begins

12

The _______ the SVR, the _______ the afterload.

>SVR=>afterload

13

When afterload increases, SV _______.

decreases

14

When preload increases, SV ________.

increases

15

The > the ventricular filling (volume), the ________ the preload (tension). What explains this?

greater--> this is d\t Frank Starlings Law of the Heart

16

Where _____ goes, H2O follows.

sodium

17

When you hear preload think _______, afterload think _______, contractility think ________.

preload=volume
afterload=pressure
contractility=chemicals (inotropes, CCB's, etc)

18

SV= _______ - _______.

EDV-ESV

19

EF= _____________

EF= (EDV-ESV)/EDV x 100

20

Contractility doesn't influence _______, it influences ______.

filling--> it influences emptying

21

Where does angiotensinogen come from?

the liver

22

Where does renin come from?

the kidney (JGA); its dumped into the blood and affects angiotensinogen--> Ang1

23

Where is angiotensin converted enzyme (ACE) primarily found and what does it do?

LUNGS--> converts angiotensin I to II

24

Anytime you see "-ogen" as in angiotensinogen, think ______.

substrate

25

How can you easily remember the layers and products of the adrenal cortex?

AG (aldosterone--> zona glomerulosa)
CF (cortisol--> zona fasiculata) (glucocorticoids such as cortisol)
TR (testosterone--> zona reticularis)
*remember--> salt, sugar, sex (aldosterone, cortisol, testosterone)

26

Given you have filled the heart (preload) and that the aortic valve opens (afterload), can you squeeze better? This is contractility. It is determined by the CHEMICAL environment of the cardiac cell. What are some examples of chemicals that alter contractile function?

ions (calcium and magnesium), oxygen, acids, drugs, hormones
*when contractility increases, the ventricle empties MORE completely and SV increases

27

What is the difference between concentric and eccentric hypertrophy in relation to the size of the left ventricular chamber?

concentric= no change in the size of the LV chamber
eccentric= increased size of the LV chamber

28

What law has to do with ventricular hypertrophy in response to pressure or volume overload?

law of Laplace

29

What happens during concentric hypertrophy?

LV wall thickens and chamber size remains same--> results from chronically elevated afterload (coarctation of aorta, chronic aortic stenosis, chronic untreated arterial HTN)
*IHSS is different than concentric hypertrophy b\c size of LV chamber would decrease

30

What happens during eccentric hypertrophy?

LV wall dilates, thus permitting the chamber to enlarge--> results from chronic requirement to pump large volumes of blood (mitral insufficiency, chronic aortic insufficiency, morbid obesity d\t increased volume)