Upgrade to remove ads
NYCPM; Physiology exam 2 cases
Terms in this set (18)
Starting from the right atrium to the aorta, what is the path of blood through the heart?
Include the valves involved
4.pulmonary semilunar valve
5.pulomonary trunk-> pulmonary arteries
6.pulomonary veins->left atrium
9.Aortic semilunar valve-> Aorta
If the volume that flows into each heart chamber is unequal a _______ ________ develops.
If the left ventricle pumps less blood than the right ventricle what will eventually happen? why?
The left ventricle will gradually stretch to accommodate a larger preload volume.
Increasing the preload volume increases the pumping capabillity (stroke volume) of the left ventricle.
This can fix the fluid imbalance
What does end-sytolic volume of the left ventricle mean?
What does end-diasystolic mean?
Stroke volume? explain a way to calculate this.
end systolic is the volume of blood in the left ventricle after it contracts
end-diasystolic is the volume before it pumps (max volume of blood the ventricle holds)
Stroke volume is the amount of blood pumped out of the ventricle in one contraction/pump-> equivalent to the the end-diasystolic volume minus the end-systolic volume.
What are some useful things and echocardiogram can tell you about a heart? (4)
1. chamber size
2. chamber shape
Why is it important to know the relative chamber size, shape, wall thickness and valvular function of the right and left ventricles?
What can you calculate?
Knowing these dimensions allows you to calculate the ejection volumes of the ventricles
What is an ejection fraction?
What kinds of numbers would you see in a healthy person?
Ejection fraction is the ratio between the stroke volume and the end-diasystolic volume. (the percentage of the max volume that is pumped out each time)
Normal according to Carrol is 60-70%, Eggena prefers around 75%
In case 8 the patient's left ventricle ejection fraction is 40%, is that low?
What does this mean for the patient?
40% would be low.
A low ejection fraction indicates tha there is a systolic dysfunction
What does Congestive heart failure actually mean?
What is a common cause of this? Why?
Medically congestive heart failure is a broad term meaning that there is a weakness in the heart that is causing fluid to build up in the lungs and other tissues.
This does not mean that a person is on the precipice of having a heart attack. In fact it is often an effect due to the damage that occurs after a myocardial infarction. (some heart muscle died-> heart can't pump as well)
What is noturnal dyspnea?
If your patient had this what would you suggest for them to do, to make sleeping easier?
awakening at night due to shortness of breath.
Suggest using pillows or something similar to keep the head and chest upright or inclined when resting instead of lying horizontally.
In case 8, the patient has congestive heart faiure.
Why would the patient complain of having fatigue and noturnal dyspnea as symptoms?
The heart failure causes a build up of fluid in the lungs.
This plumonary edema makes oxygen exchange harder causing chronic fatigue due to lowering oxygen levels (hemoglobin saturation) circulating throughout the blood.
At night this is worse because while standing the fluid is mostly in the bottom of the lungs due to gravity. When lying down horizontally, the fluid spreads throughout the lungs impairing the entire organ's oxygen exchange capability. The hypoxemia (lack of O2) wakes the patient up
In a physical exam what might hint to a doctor that there is a pulmonary edema? (4)
1. Rapid and shallow respiration
2. Crackles or ral sounds in the lungs during ascultation
3. dullnees to percussion near the base of the lung
4. Third heart sound (s3)
Impaired left ventricle function causes the arterial blood pressure to ___________.
Meanwhile the pressure in the left atrium _________.
As well as increasing the pressure in the ________ circulation.
In case 8; congestive heart failure after left ventricle myocardial infarction
What causes the third heart sound?
The impaired Left ventricle function causes elevated left atrial pressure.
This atrial pressure elevation causes the third heart sound because the blood flow during atrial filling has become turbulent.
In case 8 the arterial blood pressure is low because of left ventricle dysfunction.
What are the body wide consequences of this low arterial pressure?
More fluid id retained by the kidneys
Increased storage of blood in the venous vascular system-> increases preload into right atrium-> increased pressure in pulomonary capillaries-> pulomonary edema
In a case of decreased gas exchange due to pulmonary edema why might you see a deficit in oxygen exchange before you see a deficit in CO2 exchange?
Pulmonary edema increases the distance gas molecules must travel to be exchanged.
CO2 is more soluble than O2 so this increased distance will affect O2 exchange more than CO2 exchange.
How does a beta-adrenergic blocker help someone with congestive heart failure?
beta blockers block the affect of epinephrine on the heart.
This causes the heart to beat more slowly with less force. This give the left ventricle more time to fill to match the right ventricular volume.
Why might you add the use of a diuretic and/or cardiac glycoside if the heart failure persists?
Diuretics will decrease total body blood volume (decreases preload in right atrium and ventricle-> decrease pulmonary capillary pressure)
The cardiac glycosides as poisins that inhibit NaATPase in the heart causes increased intracellular Ca. Contractions become stronger and longer. Helps increases Left vetricular output
THIS SET IS OFTEN IN FOLDERS WITH...
Problem Based Physiology:Carroll Section :Nerves a…
NYCPM Physiology exam 1pt I
NYCPM Physio Exam 1 Muscle
NYCPM Physio Exam 1 Heart as a Pump
YOU MIGHT ALSO LIKE...
Chapter 18 Mastering A&P
Chapter 12: Heart
OTHER SETS BY THIS CREATOR
NYCPM; MBG exam 1 Gout lecture essentials
NYCPM; MBG exam 1 FH4 and Clinical supplement
NYCPM; MBG chapter 17
NYCPM: Immunology hour 1
OTHER QUIZLET SETS
LCM and GCF
THEO EXAM GOD HELP US
Life Skills Final Exam
Theology Ch. 1 *New Book*