Anatomy and Function of the Heart
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Questions and Answers

What is the primary function of ions during the stimulation of myocytes?

  • They cause the cells to expand in size.
  • They regulate the movement and speed of specific ions. (correct)
  • They directly alter genetic material.
  • They create heat within the cells.

    • Which type of refractory period is characterized by the cell being completely unresponsive to any electrical stimulus?

  • Effective (or absolute) refractory period (correct)
  • Relative refractory period
  • Phase 0
  • Repolarization phase

    • Which ion is considered the primary extracellular ion that influences myocyte stimulation?

  • Potassium
  • Magnesium
  • Sodium (correct)
  • Chloride

    • During which phases of the action potential does the effective refractory period occur?

    <p>Phase 0 to the middle of Phase 3</p> Signup and view all the answers

    What characterizes the relative refractory period in terms of cellular response?

    <p>Cells can respond to stronger stimuli.</p> Signup and view all the answers

    What causes the intracellular space to become positively charged during depolarization?

    <p>Exchange of sodium and potassium ions</p> Signup and view all the answers

    What is the primary intracellular ion involved in the stimulation of myocytes?

    <p>Potassium</p> Signup and view all the answers

    What occurs at the end of Phase 3 in connection to the refractory period?

    <p>The relative refractory period begins.</p> Signup and view all the answers

    What is the primary purpose of stress testing in cardiovascular diagnostics?

    <p>To measure cardiac response under physical stress</p> Signup and view all the answers

    Which of the following describes a possible function of the myocardium?

    <p>Initiating electrical impulses for contraction</p> Signup and view all the answers

    What is a key indicator of left-sided heart failure?

    <p>Pulmonary congestion</p> Signup and view all the answers

    What method is commonly used to visualize anatomical structures of the heart?

    <p>Chest x-rays</p> Signup and view all the answers

    Which aspect does NOT influence cardiac output in the heart's functionality?

    <p>Valve closure efficiency</p> Signup and view all the answers

    Which test would be least likely to provide information about electrical activity in the heart?

    <p>Echocardiogram</p> Signup and view all the answers

    Which factor can significantly affect cardiac output?

    <p>Amount of circulating blood volume</p> Signup and view all the answers

    What type of imaging is specifically utilized to assess coronary arteries?

    <p>Coronary angiography</p> Signup and view all the answers

    What is the primary function of the Sinoatrial (SA) node?

    <p>To initiate electrical impulses in the heart</p> Signup and view all the answers

    Which artery supplies the right side of the heart?

    <p>Right coronary artery</p> Signup and view all the answers

    What is the inherent firing rate of a normal resting adult heart?

    <p>60 to 100 impulses per minute</p> Signup and view all the answers

    What is the role of the Atrioventricular (AV) node?

    <p>To delay electrical impulses from the atria to the ventricles</p> Signup and view all the answers

    Which of the following can best describe repolarization in cardiac action potential?

    <p>Exchange of ions returning to a resting state</p> Signup and view all the answers

    What is conducted along the myocardial cells of the atria?

    <p>Electrical impulses via internodal pathways</p> Signup and view all the answers

    Where does the posterior descending artery supply blood?

    <p>The posterior wall of the heart</p> Signup and view all the answers

    What is the significance of the delay at the Atrioventricular (AV) node?

    <p>It provides time for the atria to contract and ventricles to fill</p> Signup and view all the answers

    What is a primary characteristic of right-sided heart failure?

    <p>Swelling of the lower extremities</p> Signup and view all the answers

    Which condition is NOT a risk factor for diastolic heart failure?

    <p>Congestive heart failure</p> Signup and view all the answers

    What mechanism leads to systolic heart failure?

    <p>The heart loses the ability to contract</p> Signup and view all the answers

    What can indicate a lack of blood flow caused by diastolic dysfunction?

    <p>Fatigue and weakness</p> Signup and view all the answers

    Which of the following is a behavior that can increase the risk of developing heart failure?

    <p>Living a sedentary lifestyle</p> Signup and view all the answers

    Which heart failure condition is characterized by a stiff heart muscle?

    <p>Diastolic heart failure</p> Signup and view all the answers

    Which of the following diseases can lead to diastolic dysfunction?

    <p>Heart disease</p> Signup and view all the answers

    What is the most common relationship of heart failure to other health conditions?

    <p>It is often related to another disease or illness</p> Signup and view all the answers

    What intervention is most effective in educating patients about their medications?

    <p>Educate regarding medication use</p> Signup and view all the answers

    Which of the following contributes to an increase in preload?

    <p>Fluid volume increase</p> Signup and view all the answers

    What is the primary goal of following a low-sodium diet in patients with cardiac issues?

    <p>To decrease water retention</p> Signup and view all the answers

    What is Starling's Law primarily concerned with?

    <p>Connection between preload and cardiac output</p> Signup and view all the answers

    What could indicate successful management of cardiac issues related to fluid volume?

    <p>Decrease in body weight</p> Signup and view all the answers

    Which of the following factors can decrease preload?

    <p>Fluid volume losses</p> Signup and view all the answers

    Which intervention is appropriate for enhancing patient rest in cardiac care?

    <p>Promoting periods of rest</p> Signup and view all the answers

    What should be monitored every 4 hours to assess fluid status in cardiac patients?

    <p>Intake and output</p> Signup and view all the answers

    Study Notes

    Anatomy of the Heart

    • The heart is composed of three layers:
      • Epicardium
      • Myocardium
      • Endocardium
    • The heart has four chambers:
      • Right Atrium
      • Right Ventricle
      • Left Atrium
      • Left Ventricle
    • The heart contains four valves:
      • Tricuspid valve
      • Pulmonary valve
      • Mitral valve
      • Aortic valve
    • The heart is supplied by the coronary arteries:
      • The left side of the heart is supplied by the left coronary artery:
        • Left anterior descending artery
        • Circumflex artery
      • The right side of the heart is supplied by the right coronary artery:
        • Posterior descending artery
    • The coronary veins lie superficial to the coronary arteries.

    Function of the Heart

    • The heart has two functions:
      • Cardiac electrophysiology:
        • Sinoatrial (SA) node:
          • Primary pacemaker of the heart
          • Located at the junction of the superior vena cava and the right atrium
          • Normal firing rate of 60 to 100 impulses per minute
        • Atrioventricular (AV) node:
          • Secondary pacemaker of the heart
          • Coordinates the incoming electrical impulses from the atria and relays them to the ventricles.
      • Cardiac action potential:
        • Depolarization: the exchange of ions creates a positively charged intracellular space and a negatively charged extracellular space.
        • Repolarization: the cells revert to their resting state after depolarization.

    Cardiac Hemodynamics

    • The heart has two cycles:
      • Cardiac cycle: involves atrial contraction, ventricular contraction, and relaxation.
      • Cardiac output: the amount of blood pumped by the heart each minute.
    • Factors affecting cardiac output:
      • Heart Rate
      • Contractility (the ability to contract by the myocytes of the ventricles)
      • Preload (the volume of blood/amount of fibre stretch in the ventricles at the end of diastole)
      • Afterload (the resistance the ventricle must overcome to pump blood out)
      • Conductivity (the ability to transmit an electrical impulse from one cell to another)

    Congestive Heart Failure

    • Congestive heart failure is a syndrome, not a specific disease.
    • It occurs when the heart is unable to pump an adequate amount of blood to meet the body's metabolic needs.
    • Left-sided heart failure results in pulmonary congestion, and right-sided heart failure results in peripheral edema.
    • Risk factors for Congestive Heart Failure:
      • Long-standing hypertension
      • Coronary artery disease
      • Hyperthyroidism
      • Hypothyroidism
      • Emphysema
      • Anemia
    • Behavioural risk factors for Congestive Heart Failure:
      • Smoking
      • High fat/cholesterol diet intake
      • Sedentary lifestyle
      • Obesity

    Types of Congestive Heart Failure

    • Diastolic Heart Failure:
      • Occurs when the heart muscle stiffens.
      • It reduces the ability of the heart to fill with blood.
      • Leads to a lack of blood flow throughout the body.
    • Systolic Heart Failure:
      • Occurs when the myocardium loses the ability to contract.
      • This weakens the heart and reduces its ability to pump oxygenated blood.

    Starling’s Law

    • Describes the relationship between preload and cardiac output.
    • The strength of contraction is proportional to the initial resting fiber length (preload).
    • Preload increases with:
      • Fluid volume increases
      • Vasoconstriction
    • Preload decreases with:
      • Fluid volume losses
      • Vasodilation

    Diagnostic Procedures

    • Diagnostic tests:
    • Stress Testing
      • Measures the heart's electrical activity, ability to pump blood, and blood flow during physical activity.
      • Helps determine coronary artery disease.
    • Blood tests:
      • Evaluate specific markers of heart disease (e.g., Troponin I, Troponin T etc).
    • Pulmonary function testing:
      • Measures lung capacity and function.
      • May be used to identify secondary conditions related to heart failure.
    • Cardiac CT scans:
      • Provide detailed images of the heart and coronary arteries.
      • Help diagnose coronary artery disease, heart valve problems, and tumors.
    • Myocardial biopsy:
      • Involves extracting a small sample of heart muscle.
      • Helps diagnose heart muscle inflammation and damage.
    • Chest x-rays:
      • Provide a view of the heart and lungs.
      • Can reveal signs of heart failure, such as fluid buildup in the lungs.
    • Coronary angiography:
      • Involves injecting a contrast dye into the coronary arteries.
      • Helps visualize the coronary arteries and detect blockages.
    • Cardiac catheterization:
      • Involves inserting a thin, flexible tube into a blood vessel in the arm or leg and threading it to the heart.
      • Helps assess heart function, measure pressure, and collect samples of blood.
    • Echocardiogram (Echo):
      • Uses sound waves to create images of the heart.
      • Helps assess heart function, valve function, and detect structural abnormalities.
    • Electrocardiogram (EKG):
      • Records the heart's electrical activity.
      • Helps detect heart rhythm abnormalities and identify signs of heart attack, heart enlargement, and coronary artery disease.
    • Electrophysiology study:
      • Involves inserting electrodes into the heart to map the electrical pathway.
      • Helps diagnose and treat abnormal heart rhythms.
    • Radionuclide imaging:
      • Involves injecting a small amount of radioactive tracer into the bloodstream.
      • Helps measure the amount of blood flow to the heart and identify areas of damage.
    • Treadmill exercise test:
      • A patient is asked to walk on a treadmill and be monitored for how their heart functions during stress from the exercise.

    Nursing Management for Congestive Heart Failure

    • Nursing management for congestive heart failure focuses on:
      • Providing Oxygenation:
        • Administering supplemental oxygen
        • Positioning the patient for optimal ventilation
        • Monitoring respiratory status
      • Decreasing Anxiety:
        • Providing emotional support
        • Explaining procedures and medications
        • Creating a calm environment
      • Facilitating Fluid Balance:
        • Monitoring intake and output
        • Administering diuretics as prescribed
        • Restricting fluids as needed
      • Promoting Nutrition:
        • Providing a low-sodium diet
        • Encouraging small, frequent meals
        • Monitoring weight
      • Nursing Diagnosis for Left-Sided Heart Failure:
        • Impaired gas exchange
        • Activity intolerance
        • Anxiety
      • Nursing Diagnosis for Right-Sided Heart Failure:
        • Fluid volume excess
        • Disturbed body image
        • Impaired skin integrity

    Medical management for congestive heart failure:

    • Pharmacological Interventions:
      • Diuretics - reduce fluid volume
      • ACE inhibitors (Angiotensin-Converting Enzyme Inhibitors) - prevent vasoconstriction
      • Beta-blockers - also help with blood pressure
      • Digitalis: - increases contractility and improves cardiac output
      • Vasodilators - reduce peripheral vascular resistance
      • Nitrates - help with blood pressure
    • Non-pharmacological interventions for Congestive Heart Failure:
      • Lifestyle modifications - including a low-sodium diet, quitting smoking, weight loss, and regular exercise
      • Cardiac rehabilitation programs - provide education, support, and exercise to improve heart health
      • Surgical interventions - such as coronary artery bypass grafting or valve replacement, may be necessary for some patients

    Nursing Diagnosis for Congestive Heart Failure

    • Knowledge deficient r/t lack of understanding or misconceptions related to cardiac disease.
    • Interventions:
      • Promote rest.
      • Promote healthy nutrition.
      • Educate regarding medication regimen.

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    Description

    Explore the intricate structures and functions of the heart in this quiz. Learn about the heart's layers, chambers, valves, and its vital role in cardiac electrophysiology. Test your understanding of how these components work together to maintain circulatory health.

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