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52 Cards in this Set
- Front
- Back
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Left-Sided Heart Failure
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A. The left heart can fail, producing symptoms due to a backup of blood into the pulmonic circulation (pulmonary edema).
B. The failing left heart is unable to pump adequate blood tot the systemic circulation, producing S&S related to poor tissue oxygenation. |
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Right-Sided Heart Failure
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Blood backs up behind the filed right ventricle, causing jugular vein distention (JVD), hepatomegaly, splenomegaly, digestive problems, and ankle edema.
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Heart: Autonomic Control
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A. The autonomic nervous system (AMS) allows the heart to respond to changing body needs.
B. Stimulation of the sympathetic nerves increases heart rate (SA node), conduction velocity (AV node), and contractile force (myocardium). |
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Cardiac Cycle
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A. The cardiac cycle is a sequence of events that occurs during one heart beat.
B. The events of the cardiac cycle include atrial and ventricular systole (contraction) and diastole (relaxation). |
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Cardiac Output (CO)
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A. CO is the amount of blood pumped by the ventricle 1 minute.
B. CO is determined by heart rate and stroke volume. C. There are many factors that change HR and or SV. |
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How Stroke Volume (SV) Can Be Changed
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A. SV can be changed by Starling's law of the heart (stretch).
B. SV can be changed by an inotropic effect (nonstretch). |
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Amount of blood in the ventricle at the end of its resting phase.
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preload
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Percentage of the end-diastolic volume (EDV) pumped by the ventricle.
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ejection fraction
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Arteriolar constriction and hypertension cause the ______ to increase.
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afterload
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Forms the basis of Starling's law of the heart.
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preload
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The effect of a drug that changes heart rate.
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chronotropic effect
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Digoxin slows the speed of the cardiac impulse through the conduction system thereby causing a heart block.
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dromotropic effect
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Same as end-diastolic volume (EDV).
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preload
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May decline from 67% to 30% in the failing heart.
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ejection fraction
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Which statement is true of ventricular diastole?
a. Blood is ejected from the ventricles b. The semilunar valves are open c. The atrioventricular valves are closed d. Blood fills the ventricles |
Blood fills the ventricles
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Which of the following is least apt to increase cardiac output?
a. increased heart rate b. increased stroke volume c. increased venous return (Starling's law of the heart) d. Vagal discharge |
vagal discharge
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Which of the following statements is correct about cardiac output?
a. Cardiac output is determined by the heart rate and pulse b. Stimulation of the sympathetic nerves decreases cardiac output c. Vagal discharge increases cardiac output d. Cardiac output is determined by heart rate and stroke volume |
cardiac output is determined by heart rate and stroke volume
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Increased return of blood to the heart stretches the heart muscle thereby
a. stimulating the vagus nerve b. increasing stroke volume c. closing the atrioventricular valves d. increasing coronary blood flow |
increasing stroke volume
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Ventricular systole refers to
a. ventricular depolarization b. the opening of the valves of the ventricles c. ventricular filling d. contraction of the ventricular myocardium |
contraction of the ventricular myocardium
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Which of the following is least characteristic of sympathetic nerve stimulation?
a. (-) Inotropic effect b. Increased heart rate c. Increased stroke volume d. Increased cardiac output |
(-) Inotropic effect
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Which of the following is least related to the vagus nerve?
a. Parasympathetic b. Slows heart rate c. (+) Inotropic effect d. Autonomic nerve |
(+) Inotropic effect
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Which of the following is least characteristic of sympathetic nerve stimulation?
a. (-) Inotropic effect b. Increased heart rate c. Increased stroke volume d. Increased cardiac output |
(-) Inotropic effect
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Which of the following is least related to bradycardia?
a. <60 beats/min b. Vagal discharge c. (-) Chronotropic effect d. Beta1-adrenergic receptor activation |
Beta1-adrenergic receptor activation
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cardiac output
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5000 ml/min
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stroke volume
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70 ml/beat
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stroke volume times heart rate
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cardiac output
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Phase of the cardiac cycle that refers to myocardial contraction
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systole
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Phase of the cardiac cycle when the ventricles fill with blood
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diastole
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Phase of the cardiac cycle that refers to myocardial relaxation
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diastole
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Change in myocardial constriction that is due to stretching of the heart muscle
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Starling's law of the heart
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Change in myocardial contraction that is not due to stretching of the heart muscle
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inotropic effect
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Amount of blood pumped by the ventricle in one beat
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stroke volume (70 ml/beat)
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Amount of blood pumped by the ventricle in one minute
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cardiac output (5000 ml/min)
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cardiac output
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5000 ml/min
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stroke volume
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70 ml/beat
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stroke volume times heart rate
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cardiac output
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Phase of the cardiac cycle that refers to myocardial contraction
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systole
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Phase of the cardiac cycle when the ventricles fill with blood
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diastole
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Phase of the cardiac cycle that refers to myocardial relaxation
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diastole
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Change in myocardial constriction that is due to stretching of the heart muscle
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Starling's law of the heart
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Change in myocardial contraction that is not due to stretching of the heart muscle
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inotropic effect
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Amount of blood pumped by the ventricle in one beat
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stroke volume (70 ml/beat)
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Amount of blood pumped by the ventricle in one minute
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cardiac output (5000 ml/min)
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Left-Heart Failure
Backward Failure NO MUD |
N: nitroglycerin (decrease the work of the heart)
O: oxygen (relieve anxiety, oxygenate the myocardium) (+) inotropic agent (such as digoxin or dopamine) M: morphine (relieve anxiety, decrease the work of the heart) U: upright position (ease breathing) D: diuretic (excrete excess fluid, relieve edema) |
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What are the goals of treatment of heart failure?
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1. Strengthening of myocardial contractile force
2. Removal of excess water (edema) 3. Decreasing the work of the heart 4. Protection of the heart from excess sympathetic nerve activity |
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Inotropic Effect
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Change in myocardial contraction that is not due to stretch.
(+) inotropic effect=increase in contractile force (-) inotropic effect=decrease in contractile force |
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Chronotropic Effect
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Change in heart rate.
(+) chronotropic effect=anything that increases heart rate (-) chronotropic effect=anything that decreases heart rate |
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Sympathetic nerve stimulation causes what type of effect?
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(+) chronotropic effect
(+) dromotropic effect |
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Parasympathetic nerve (ie vagal) stimulation causes what type of effect?
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(-) chronotropic effect
(-) dromotropic effect |
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Dromotropic Effect
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Change in the speed at which the cardiac impulse travels from the SA node through the AV node and the His-Purkinje system.
(+) dromotropic effect=increases the speed of cardiac impulse (-) dromotropic effect-decreases the speed of cardiac impulse |
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Ejection fraction
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The percentage of the EDV that is pumped is called the ejection fraction.
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End-diastolic volume (EDV)
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refers to the amount of blood in the ventricle at the end of its resting phase (diastole).
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