Care of the Patient with a Cardiovascular or Peripheral Vascular Disease Exam Study Guide 2024

Electrical conduction system of the heart – ▪ Sinoatrial node of the heart "pacemaker" ▪ Atrioventricular (AV) node ▪ Bundle of His (R & L bundle branches) ▪ Perkinje fibers what are the 4 chambers of the heart? - right atrium, right ventricle, left atrium, left ventricle Pericardium - outermost layer of the heart Blood Flow through the heart – ▪ Vena Cava ▪ Right atrium ▪ Tricuspid valve ▪ Right Ventricle ▪ Pulmonic semilunar valve ▪ Pulmonic artery ▪ Lungs ▪ Pulmonary vein ▪ Left atrium ▪ Bicuspid (mitral) valve (left AV valve) ▪ Left ventricle ▪ Aortic semilunar valve ▪ Aorta Myocardium - Thick middle muscle layer of the heart (muscle) endocardium - Inner layer of the heart Which chamber of the heart receives DEoxygenated blood the body? - Right Atrium What is the contraction phase of the cardiac cycle? - Systole "Pacemaker" of the heart - sinoatrial node Care of the Patient with a Cardiovascular or Peripheral Vascular Disease Exam Study Guide 2024 The S2 (dub) sound is the second heart sound and indicates closure of the - semilunar Valves Which chamber of the heart receives DEoxygenated blood from the Right Atrium? - Right Ventricle the S1 ("Lub") sound is created when the valves close: - Atrioventricular (AV) List the valves of the heart - tricuspid, bicuspid, aortic semi-lunar, and pulmonary semi-lunar valve Modifiable Risk Factors for cardiovascular Disease – Smoking Hyperlipidemia Hypertension Diabetes mellitus (Type 2) Obesity Sedentary lifestyle Stress Psychosocial Total cholesterol levels - Greater than 200 mg/dL What is used to determine severity of heart failure? - B-type natriuretic peptide (BNP) (Greater than 100 pg/mL indicates HF) An abnormal accumulation of fluid in the thoracic cavity between the visceral and parietal pleurae: - Pleural effusion Triglyceride Levels - Less than 160 mg/dL Males 40-160 mg/dL Females 35-135 mg/dL What is the relaxation phase of the cardiac cycle? - diastole Hypertension: - "the silent killer" ▪ Patients with elevate blood pressure often do not display s/sx until damage has occurred LDL cholesterol levels - Less than 130 mg/dL Cardiac Specific Troponin: - Troponin I (most frequently used lab test to diagnose MI) HDL Cholesterol Level - greater than 50 EKG has 3 distinct waves: - ▪ P wave (depolarization of the atria) ▪ QRS complex (depolarization of the ventricles) ▪ T wave (repolarization of the ventricles) ▪ Depolarization = contraction ▪ Repolarization = relaxation If patient is unable to participate in exercise, (stress test) medications can be given to produce stress - Dipyridamole or adenosine systemic circulation: - Arteries - arterioles - capillaries - venules - veins - vena cava - right atrium when the PT is wearing a Holter Monitor, educate the PT to - Keep a diary of daily activities while wearing the monitor. Myoglobin - released into circulation within a few hours after an MI ▪ Also present in skeletal muscle injury Non-Modifiable Risk Factors for Cardiovascular Dissease - Family History Age Gender Cultural and ethnic considerations When dealing with risk factors for Cardiovascular Disease ALWAYS start with the - Modifiable Risks (Lifestyle modification) systemic circulation - The arteries, arterioles, capillaries, venules, veins, vena cava, right atrium what should you asses prior to your patient receiving contrast dye - allergies what is cardiac catheterization used to visualize - the heart chambers, valves, great vessels, coronary arteries and can show other heart abnormalities such as valvular defects, and congenital abnormalities you should get consent prior to a cardiac cath true/false - true The P wave represents atrial depolarization - true QRS complex represents - depolarization of the ventricles T wave represents - ventricular repolarization Ventricle ejection fraction - normal- 55 to 70 percent moderate HF- 40-55 percent moderate to severe HF- less than 40 percent thallium stress test - performed to evaluate how well blood flows through the coronary arteries of the heart muscle during exercise Echocardiagram (ECHO) - high frequency ultrasound of the heart that outlines the size, shape and position of cardiac structures Positron Emission Tomography (PET) - an imaging technique used to study dementia, stroke, epilepsy, tumors and cardiac disease and can also distinguish between viable/nonviable cardiac tissue which can help determine candidates for CABG electrolytes - na CK, CK-MB - Not as sensitive or specific to cardiac cell injury. Ck identifies inflammation of muscles, and the CK-MB isoenzyme is specifc for cardiac muscle troponin I - blood test that measures protein released into the blood by damaged heart muscle Homocysteine - an amino acid normally found in the blood and used by the body to build and maintain tissues and digest proteins