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5 parts to the conduction system: - ANSWERS-1. SA node (location: wall of RA)
-then spread down atrial conduction pathways
2. AV node (location: RA near septum)
-slight delay in conduction to allow for complete ventricular filling
3. Bundle of HIS
4. L and R bundle branches
5. Purkinje fibers
what are atheromas? - ANSWERS-plaques consisting of lipids, cells, fibrin, and cell
debris, often with attached thrombi, which form inside walls of large arteries
describe thrombus formation from lipids in arteries - ANSWERS-1. endothelial injury in
the artery
2. this injury causes inflammation... elevated CRP
3. WBCs accumulate in inner layer and middle layer of artery
4. smooth muscle cells multiply
5. plaque forms and inflammation persists
6. platelets adhere to rough damaged surface of arterial wall forming a thrombus and
causing partial obstruction
7. lipids continue to building up at arterial injury. platelets release prostaglandins, which
signal inflammation and vasospasm
8. more platelets come to the site, enlarging thrombus
,non-modifible risk factors of atherosclerosis - ANSWERS-age
gender
genetics
modifible risk factors of atherosclerosis - ANSWERS-obesity
sedentary lifestyle
cigarette smoking
diabetes mellitus
poorly controlled HTN
combination of oral contraceptives and smoking
why does angina pectoris occur and what is the result? - ANSWERS-occurs when one
or more coronary arteries are partially blocked
resulting in a deficit of oxygen to meet myocardial needs --> pain
different patterns of angina: - ANSWERS-classic or exertional
variant - vasospasm occurs at rest --> coronary arteries spasms for a few seconds then
let up
unstable - prolonged pain at rest ... may precede MI --> ex: pt with CP w/o exertion
precipitating factors of angina: - ANSWERS-related to activities that increase demands
of the heart: exercise, getting angry, respiratory infection w/ fever, exposure to weather
conditions, pollution, eating lg meal
general signs and symptoms of angina - ANSWERS-recurrent, intermittent brief
episodes of substernal CP usually triggered by physical or emotional stress
pain described as tightness or pressure that radiates to neck and left arm
other manifestations: pain, diaphoresis, nausea, SOB, weakness, fatigue, vomiting,
anxiety/fear, dyspnea, hypotension, tachy, V fib, shock attacks vary in severity and
duration
,treatment of angina - ANSWERS-relieved by rest or administration of coronary
vasodilators (ex: nitroglycerin --> dilutes coronary artery and improves circulation)
when does MI occur? - ANSWERS-when coronary artery is totally obstructed
____________ determines the damage of a myocardial infarction - ANSWERS-size and
location of the infarct
3 ways an infarction may develop? - ANSWERS-1. thrombus may build up to obstruct
the artery
2. vasospasm may occur in the presence of a partial occlusion by an atheroma leading
to total obstruction
3. part of thrombus may break away forming an embolus that flows through the
coronary artery until lodging in a smaller branch, blocking that vessel
what can begin to happen as a result of necrosis due to infarction? - ANSWERS-
inflammation begins to develop around the infarcted area... then it is replaced by scar
tissue
relaxation of myocardium required for filling chambers - ANSWERS-diastole
contraction of myocardium proves increase in pressure to eject blood - ANSWERS-
systole
describe the cardiac cycle: - ANSWERS-atria relaxed, filling with blood --> AV valves
open --> blood flows into ventricles --> atria contract, remaining blood forced into
ventricles --> atria relax --> ventricles contract --> AV valves close --> semilunar valves
open --> blood into aorta and pulmonary artery --> ventricles relax
Describe "lubb-dubb" sounds and murmurs - ANSWERS-'lubb; = 1st sound; closure of
AV values
, 'dubb' = 2nd sound; closure of semilunar valves
murmurs: 3rd and 4th sounds; caused by incompetent valves; "whoosh" sound due to
turbulent blood flow through damaged vessels
describe bruit - ANSWERS-similar to murmurs; a "whoosh" heard over blood vessels
what controls the rate and force of contractions? - ANSWERS-cardiac control center in
medulla oblongata
function of baroreceptors and chemoreceptors - ANSWERS-baroreceptors: detect
changes in BP; located in aorta and internal carotid arteries; stimulates SNS/PNS to
change HR or FOC chemoreceptors: detect chemical changes associated with CO2
blood ejected by a ventricle in one minute - ANSWERS-cardiac output --> directly
related to BP
cardiac output formula: - ANSWERS-CO = SV x HR
volume of blood pumped out of ventricle - contraction - ANSWERS-stroke volume
amount of blood delivered to heart by venous return (right side) - ANSWERS-preload
force required to eject blood from ventricles - ANSWERS-afterload --> determined by
peripheral resistance in arteries
Resistance left ventricle must overcome to circulate blood into aorta - ANSWERS-
peripheral resistance
exerted when blood is ejected from ventricles (high) - ANSWERS-systolic pressure