Cardiovascular Function Assessment Chapter 26

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Questions and Answers

What is the primary pacemaker of the heart?

Sinoatrial (SA) node (correct)

Atrioventricular (AV) node

Bundle of His

Purkinje fibers

Which layer of the heart is responsible for the actual contraction?

Endocardium

Pericardium

Epicardium

Myocardium (correct)

What structure divides the bundle of His into right and left pathways?

Atrioventricular (AV) node

Purkinje fibers

Bundle branches (correct)

Sinoatrial (SA) node

Which of the following chambers receives deoxygenated blood?

Right atrium Signup and view all the answers

What is the function of the Purkinje fibers in the heart?

To stimulate ventricular contraction Signup and view all the answers

What is the primary purpose of magnetic resonance angiography (MRA)?

To examine both physiologic and anatomic properties of the heart Signup and view all the answers

What does cardiac catheterization primarily measure?

Cardiac chamber pressures and coronary artery patency Signup and view all the answers

Where is the preferred site for inserting a central venous pressure (CVP) catheter?

Subclavian vein Signup and view all the answers

What is the normal range for central venous pressure (CVP)?

2 to 6 mm Hg Signup and view all the answers

In pulmonary artery pressure monitoring, what is a key use of the procedure?

To assess left ventricular function Signup and view all the answers

Which of the following is NOT a task involved in the assessment prior to cardiac catheterization?

Preparing intravenous sedatives Signup and view all the answers

What type of catheter is typically used for intra-arterial blood pressure monitoring?

Arterial catheter Signup and view all the answers

Which of the following best describes a key component of patient education post-cardiac catheterization?

Discussing potential for dysrhythmias and circulation issues Signup and view all the answers

What is the primary purpose of signal-averaged electrocardiography?

To detect abnormalities in heart rate and rhythm Signup and view all the answers

What type of stress testing uses medication to mimic exercise effects?

Pharmacologic stress testing Signup and view all the answers

Which vasodilating agent is NOT mentioned as being used during pharmacologic stress testing?

Nitroglycerin Signup and view all the answers

What is a key feature of radionuclide imaging?

Radioisotopes are injected into the bloodstream. Signup and view all the answers

What technique is used in cardiac CT scanning to create three-dimensional images?

Complex mathematical and computer algorithms Signup and view all the answers

Which imaging technique uses tracers to determine blood flow and metabolic function in the myocardium?

Positron emission tomography Signup and view all the answers

What condition may prevent a patient from achieving their target heart rate during exercise stress testing?

Cognitive impairment Signup and view all the answers

Multidetector CT (MDCT) is characterized by what feature?

It takes multiple slices at the same time. Signup and view all the answers

What is the term for the amount of blood ejected with each heartbeat?

Stroke volume Signup and view all the answers

Which phase of cardiac action potential refers to the return of a cell to its resting state?

Repolarization Signup and view all the answers

Which term describes the resistance that the heart must overcome to eject blood?

Afterload Signup and view all the answers

What does the ejection fraction indicate?

The percentage of blood ejected with each heartbeat Signup and view all the answers

Which cardiac biomarker is most commonly used to diagnose myocardial infarction?

Troponin T and I Signup and view all the answers

What is preload primarily influenced by?

The volume of blood returning to the heart Signup and view all the answers

Which system is primarily responsible for controlling the heart rate?

Autonomic nervous system Signup and view all the answers

What is a common clinical manifestation of cardiac issues?

Chest pain Signup and view all the answers

Which factor can decrease cardiac contractility?

Hypoxemia Signup and view all the answers

What effect do baroreceptors have on heart function?

They regulate blood pressure and heart rate. Signup and view all the answers

Study Notes

Overview of Heart Anatomy and Physiology

Composed of three layers: endocardium, myocardium, epicardium.
Contains four chambers: two atria and two ventricles.
Heart valves ensure unidirectional blood flow.

Cardiac Conduction System

Generates and transmits electrical impulses prompting myocardial contraction.
Sinoatrial (SA) node: primary pacemaker.
Atrioventricular (AV) node: secondary pacemaker.
Impulses travel through bundle of His, dividing into right and left bundle branches.
Purkinje fibers rapidly conduct impulses, triggering ventricular contraction.

Cardiac Action Potential

Depolarization: Activation from sodium influx; potassium exits.
Repolarization: Return to resting state with potassium re-entry; sodium exits.
Effective refractory period: Cells can't depolarize.
Relative refractory period: Stronger stimulus needed for depolarization.

Cardiac Output Components

Stroke Volume: Blood ejected per heartbeat.
Cardiac Output (CO): Blood volume pumped by ventricles in liters per minute (CO = SV x HR).
Preload: Stretch of cardiac muscle fibers at diastole's end.
Contractility: Cardiac muscle's ability to shorten after electrical stimulation.
Afterload: Resistance against which ventricle must eject blood.
Ejection Fraction: Percentage of end-diastolic volume ejected per heartbeat.

Factors Influencing Cardiac Function

Heart rate controlled by the autonomic nervous system and baroreceptors.
Stroke volume affected by preload, afterload, and contractility, influenced by various factors including medications and physiological conditions.

Patient Assessment

Collect health history including demographics, family history, and cultural factors.
Identify risk factors: modifiable and nonmodifiable.
Common symptoms: chest pain, dyspnea, peripheral edema, weight gain, fatigue, dizziness, and syncope.

Laboratory Tests

Cardiac biomarkers: CK, CK-MB, myoglobin, troponins, lipid profile, B-type natriuretic peptide, C-reactive protein, homocysteine.

Electrocardiography Techniques

12 Lead ECG for initial assessment; continuous monitoring in high-risk patients.
Cardiac stress tests include exercise and pharmacologic types for those unable to exercise.

Diagnostic Testing Methods

Radionuclide imaging for myocardial perfusion and function.
Computed tomography (CT) provides detailed heart images using x-rays.
Positron Emission Tomography (PET) assesses blood flow and metabolic function.
Magnetic Resonance Angiography (MRA) examines heart properties non-invasively.

Cardiac Catheterization

Invasive procedure to measure chamber pressures, assess coronary artery status.
Requires careful monitoring and pre/post-procedure assessments for potential risks.

Hemodynamic Monitoring

Central Venous Pressure (CVP): Indicates pressure in vena cava/right atrium; normal range is 2 to 6 mm Hg.
Pulmonary artery pressure monitoring used to assess left ventricular function and treatment effectiveness.
Intra-arterial blood pressure monitoring for continuous sampling and measurements.

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Description

This quiz covers Chapter 26, focusing on the assessment of cardiovascular function. It explores the anatomy and physiology of the heart, including its structure, chambers, valves, and the cardiac conduction system. Test your knowledge on the essential concepts related to cardiovascular health.