Heart Anatomy & Physiology

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Questions and Answers

Which layer of the heart is directly responsible for its pumping action?

  • Epicardium
  • Endocardium
  • Pericardium
  • Myocardium (correct)

What is the primary function of the valves in the cardiovascular system?

  • To ensure unidirectional blood flow (correct)
  • To filter waste products from the blood
  • To oxygenate the blood
  • To regulate blood pressure

During which phase of the cardiac cycle does the heart relax and fill with blood?

  • Systole
  • Diastole (correct)
  • Ventricular contraction
  • Atrial kick

If the SA node fails, which of the following structures will act as a secondary pacemaker?

<p>AV Node (D)</p> Signup and view all the answers

What is the normal range for the heart's primary pacemaker?

<p>60-100 bpm (C)</p> Signup and view all the answers

Which of the following factors directly influences stroke volume?

<p>Preload (A)</p> Signup and view all the answers

Which heart sound is associated with the closure of the atrioventricular (AV) valves?

<p>S1 (B)</p> Signup and view all the answers

An S3 or S4 heart sound is considered:

<p>Abnormal (D)</p> Signup and view all the answers

An elevated level of which cardiac marker indicates muscle damage?

<p>Troponin I (C)</p> Signup and view all the answers

What does an elevated BNP level typically suggest?

<p>Heart Failure (B)</p> Signup and view all the answers

Atherosclerosis is the primary pathological process underlying which of the following cardiovascular diseases?

<p>Coronary Artery Disease (C)</p> Signup and view all the answers

Which of the following is considered a modifiable risk factor for coronary artery disease (CAD)?

<p>Smoking (D)</p> Signup and view all the answers

Peripheral edema, jugular venous distension (JVD), and ascites are most indicative of:

<p>Right-sided Heart Failure (A)</p> Signup and view all the answers

Which of the following drug classes decreases afterload in patients with heart failure?

<p>ACE inhibitors (B)</p> Signup and view all the answers

Pulmonary symptoms such as crackles and dyspnea are characteristic of:

<p>Left-sided Heart Failure (B)</p> Signup and view all the answers

Which of the risk factors are modifiable in hypertension?

<p>Smoking, alcohol, obesity, inactivity (B)</p> Signup and view all the answers

A patient with hypertension is prescribed a diuretic. Which of the following parameters should the nurse monitor regularly?

<p>Potassium levels and weight (C)</p> Signup and view all the answers

What should nurses monitor in geriatric patients?

<p>Increased risk for HF, HTN, CAD (D)</p> Signup and view all the answers

What is a common nursing diagnosis related to excess fluid volume?

<p>Excess fluid volume (B)</p> Signup and view all the answers

What reading indicates hypertension, according to the text?

<blockquote> <p>140/90 mmHg (B)</p> </blockquote> Signup and view all the answers

Which valve separates the left atrium and the left ventricle?

<p>Mitral (D)</p> Signup and view all the answers

If one were experiencing angina, dyspnea, nausea, and indigestion, this might indicate they are experiencing symptoms of what condition?

<p>Coronary Artery Disease (C)</p> Signup and view all the answers

What is the normal cardiac output range?

<p>4-6 L/min (C)</p> Signup and view all the answers

Which of the following lab values, if elevated, would be most indicative of a myocardial infarction?

<p>Troponin T (C)</p> Signup and view all the answers

What is the normal range of HDL for men to indicate good cardiovascular health?

<blockquote> <p>40 mg/dL (B)</p> </blockquote> Signup and view all the answers

In the context of cardiac output (CO), what do HR and SV stand for respectively?

<p>Heart Rate and Stroke Volume (A)</p> Signup and view all the answers

Which of the following is a secondary risk factor for hypertension?

<p>Identifiable cause (~5%) (A)</p> Signup and view all the answers

What is the definition of hypertension, according to the text provided?

<blockquote> <p>140/90 mmHg on multiple readings (A)</p> </blockquote> Signup and view all the answers

Which medication increases contractility for heart failure, but requires monitoring for toxicity.

<p>Digoxin (D)</p> Signup and view all the answers

Which medication requires the nurse to watch potassium levels, BP and a cough

<p>ACE Inhibitors (D)</p> Signup and view all the answers

If systolic heart failure is occurring, what is happening?

<p>Poor Contraction (D)</p> Signup and view all the answers

If someone has a BMI of >40" waist (men), >35" (women) then they are at ______.

<p>High Risk (D)</p> Signup and view all the answers

What could elevated BUN/Creatinine indicate?

<p>Poor Renal Perfusion (D)</p> Signup and view all the answers

Which of the following is a symptom of heart failure?

<p>Edema (C)</p> Signup and view all the answers

Which value regarding triglycerides is normal?

<p>less than 150 mg/dL (D)</p> Signup and view all the answers

Which of the following is a non-modifiable risk for Coronary Artery Disease?

<p>Gender (A)</p> Signup and view all the answers

What is the name of the inner lining of the heart?

<p>Endocardium (D)</p> Signup and view all the answers

Which medication decreases heart rate and contractility?

<p>Beta-Blockers (C)</p> Signup and view all the answers

Which common nursing diagnoses is often associated with decreased cardiac output?

<p>Activity intolerance (D)</p> Signup and view all the answers

Which medication is a diuretic (HCTZ, furosemide, spironolactone)?

<p>diuretics (A)</p> Signup and view all the answers

Flashcards

Pericardium

The protective sac surrounding the heart, located in the chest.

Endocardium

The innermost layer of the heart.

Myocardium

Muscular layer of the heart responsible for pumping blood.

Epicardium

The outer layer of the heart.

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Diastole

Phase of the cardiac cycle where the heart relaxes and fills with blood.

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Systole

Phase of the cardiac cycle where the heart contracts and ejects blood.

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Atrioventricular (AV) Valves

Valves that ensure unidirectional blood flow between the atria and ventricles. Includes the tricuspid (R) and mitral (L) valves.

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Semilunar Valves

Valves that ensure unidirectional blood flow from the ventricles to the pulmonary artery and aorta, including the pulmonic (R) and aortic (L) valves.

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SA Node

The heart's primary pacemaker, generating 60-100 bpm.

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AV Node

Secondary pacemaker, generating 40-60 bpm.

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Ventricular Cells

Backup pacemaker for the heart, generating 30-40 bpm.

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Cardiac Output (CO)

Volume of blood pumped by the heart per minute (4-6 L/min).

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Stroke Volume (SV)

Volume of blood ejected from the left ventricle per beat (60-130 mL/beat).

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Preload

Volume of blood in ventricles at end of diastole (venous return).

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Afterload

Resistance against which the heart must pump blood.

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Contractility

The force of ventricular contraction.

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Normal BP

Normal blood pressure range.

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Normal Pulse

Normal heart rate range.

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S1 Heart Sound

Normal heart sound produced by closure of AV valves.

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S2 Heart Sound

Normal heart sound produced by closure of semilunar valves.

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Elevated Troponin

Elevated troponin levels indicate myocardial damage.

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BNP

BNP levels are elevated in elderly patients with heart failure.

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LDL goal

LDL should be less than 100 mg/dL

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HDL goal

HDL should be greater than 40 mg/dL for men and 50 mg/dL for women.

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Triglycerides Goal

Triglycerides should be less than 150 mg/dL.

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Atherosclerosis

Narrowing of the arteries due to plaque buildup.

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Modifiable Risks for CAD

Smoking, hypertension, hyperlipidemia, obesity, and diabetes mellitus.

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Heart Failure (HF)

Ventricles fail to pump effectively.

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Systolic

Poor contraction during systole.

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Diastolic

Stiff ventricle with poor filling during diastole.

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Left-sided HF Symptoms

Pulmonary symptoms (crackles, dyspnea, fatigue).

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Right-sided HF Symptoms

Peripheral symptoms (JVD, edema, ascites).

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ACE Inhibitors

Decrease afterload, watch K+, BP, and for cough.

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Beta-Blockers

Decrease heart rate and contractility, start low, monitor fluid.

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Diuretics

Decrease fluid, watch K+, and weight.

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Digoxin

Increase contractility, monitor for toxicity (vision, bradycardia).

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Hypertension (HTN)

Greater than 140/90 mmHg on multiple readings.

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Study Notes

  • Heart anatomy has 4 chambers: 2 atria and 2 ventricles.
  • The heart is surrounded by the pericardium, a protective sac.

Layers of the Heart

  • The endocardium is the inner lining of the heart.
  • The myocardium is the muscular layer responsible for pumping.
  • The epicardium is the outer layer of the heart.

Cardiac Cycle

  • Diastole refers to the relaxation and filling phase of the heart.
  • Systole refers to the contraction and ejection phase of the heart.

Heart Valves

  • Valves ensure unidirectional blood flow.
  • AV valves include the tricuspid (right) and mitral (left) valves.
  • Semilunar valves include the pulmonic (right) and aortic (left) valves.

Cardiac Electrophysiology

  • The SA node is the primary pacemaker and generates 60–100 bpm.
  • The AV node is the secondary pacemaker and generates 40–60 bpm.
  • Ventricular cells act as a backup pacemaker and generate 30–40 bpm.

Cardiac Output (CO)

  • CO equals heart rate (HR) times stroke volume (SV) with a normal range of 4–6 L/min.

Stroke Volume (SV)

  • Stroke volume, normally 60-130 mL/beat, is influenced by preload, afterload, and contractility
  • Preload refers to venous return.
  • Afterload refers to resistance to ejection.
  • Contractility refers to myocardial strength.

Cardiac Assessment

  • Normal BP should be less than 120/80 mmHg
  • Normal resting pulse is 60–100 bpm

Heart Sounds

  • Normal heart sounds include S1 (AV valves) and S2 (semilunar valves).
  • Abnormal heart sounds include S3/S4 gallops, murmurs, and rubs.

BMI

  • BMI risk is indicated by a waist measurement greater than 40 inches for men and greater than 35 inches for women.

Cardiac Symptoms

  • Reported symptoms include chest pain, shortness of breath (SOB), edema, palpitations, and fatigue.

Troponin Levels

  • A Troponin T level of <0.01 ng/mL is normal
  • Elevated troponin indicates MI

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