FISDAP Cardiology Test Questions & Answers Accurate 100%

When would do not start CPR - Answer 1. Rigor mortis 2. decapitation of the head 3. DNR How to treat hypotension - Answer Lay them down supine and elevate the legs, call for ALS, rapid transport Signs and symptoms of a cardiac dysrhythmia - Answer Dyspnea, SVT (heart rate above 150), irregular heartbeat and atrial fibrillation, too slow 15-20 minutes no pulse/CPR - Answer start CPR and call medical directors to see when to terminate How can EMS reduce cardiovascular deaths? - Answer Encouraging healthy lifestyle, Early access to medical care More CPR training of laypeople Increased use of evolving technology in dispatch and response Public access to defibrillation devices Recognizing the need for advanced life support (ALS) The use of cardiac specialty centers when they are available What do the atria do? - Answer the atria receive incoming blood What do the ventricles do? - Answer the ventricles pump outgoing blood Define the tricuspid valve - Answer one-way valve that keeps blood from flowing backward into the right atrium Define aorta - Answer the body's main artery, it receives blood ejected from the left ventricle What does the right side of the heart receive? - Answer the right side of the heart receives oxygen-poor blood from veins. Blood from the vena cava enters the right atrium which fills the right ventricle trough the tricuspid valve. What happens after the right ventricle contracts? - Answer After contraction of the right ventricle, blood flows into the pulmonary artery and the pulmonary circulation in the lungs, where the blood is oxygenated. How does blood return from the lungs? - Answer The blood then returns to the heart through the pulmonary veins. The left side of the heart receives oxygen-rich (oxygenated) blood from the lungs through the pulmonary veins. Blood enters the left atrium and then passes into the left ventricle. The left ventricle is more muscular than the right ventricle because it must pump blood into the aorta to supply all the other arteries of the body. What does the heart's electrical system control? - Answer The heart's electrical system controls heart rate and coordinates the atria and ventricles Steps of electrical impulses in the heart - Answer Normal electrical impulses begin in the sinus node, which is in the upper part of the right atrium and is also known as the sinoatrial (SA) node. The impulses travel across both atria, stimulating them to contract. Between the atria and the ventricles, the impulses cross a bridge of special electrical tissue called the atrioventricular (AV) node. Here, the signal is slowed for about one- to two-tenths of a second to allow blood time to pass from the atria to the ventricles. The impulses then exit the atrioventricular node and spread throughout both ventricles via the bundle of His, the right and left bundle branches, and the Purkinje fibers, causing the ventricular muscle cells to contract What happens if there is no impulse from the sinoatrial node - Answer As long as impulses come from the sinoatrial node, the other myocardial cells will contract when the impulse reaches them. If no impulse arrives, however, the other myocardial cells are capable of creating their own impulses and stimulating a contraction of the heart, although at a generally slower rate. Automaticity - Answer allows spontaneous contraction without stimulus from a nerve source If impulses come from the SA node, - Answer the other myocardial cells with contract If no impulse arrives, - Answer the other cells are capable of creating their own impulses and stimulating a contraction What control involuntary activities - Answer autonomic nervous system control in voluntary activities that stimulates the sinoatrial node What does the autonomic nervous system control - Answer a system in the brain that controls the functions of the body that do not require conscious thought, such as the heartbeat, respirations, dilation and constriction of blood vessels, and digestion of food. What are the two parts of the autonomic nervous system? - Answer sympathetic and parasympathetic Sympathetic - Answer (fight or flight) nervous system and parasympathetic(breathing rate, pulse, etc) nervous system. makes adjustments to the body to compensate for increased physical activity. The sympathetic nervous system speeds up the heart rate, increases respiratory rate and depth, dilates blood vessels in the muscles, and constricts blood vessels in the digestive system. Parasympathetic nervous system? - Answer The parasympathetic nervous system directly opposes the sympathetic nervous system. The parasympathetic nervous system slows the heart and respiratory rates, constricts blood vessels in the muscles, and dilates blood vessels in the digestive system. Parasympathetic versus sympathetic - Answer Normally, these two systems balance each other, but in times of stress, the sympathetic nervous system gains primary control, whereas in times of relaxation, the parasympathetic system takes control. What does the myocardium need to pump blood? - Answer the myocardium must have a continuous supply of oxygen and nutrients to pump blood What is the myocardium? - Answer the heart muscle When does the myocardium demand more oxygen? - Answer when there is physical exertion or stress, the myocardium requires more oxygen. The heart must increase cardiac output to meet the increased metabolic requirements of the body. When the myocardium is demanding more oxygen - Answer dilation of the coronary arteries happens How is cardiac output increased? - Answer Cardiac output is increased by increasing the heart rate or stroke volume. Define stroke volume - Answer stroke volume is the volume of blood ejected with each ventricular contraction. How much blood is pumped when the left ventricle contracts The increased oxygen demand of the myocardium itself is supplied by - Answer dilation or widening, of the coronary arteries, which increases blood flow Coronary arteries are - Answer blood vessels that supply blood to the heart muscle Where do coronary arteries start? - Answer the coronary arteries start at the first part of the aorta, just above the aortic valve. The aortic valve is in the midline of the heart. Straight middle. What are the two parts of the coronary arteries? - Answer the right and left coronary artery The right coronary artery - Answer supplies blood to the right atrium and the bottom part of the left ventricle The left coronary artery - Answer The left coronary artery supplies blood to the left atrium and left ventricle and divides into two major branches, just a short distance from the aorta. Aorta arteries - Answer Two major arteries branching from the upper aorta supply blood to the head and arms. The right and left carotid arteries supply the head and brain with blood. The right and left subclavian arteries (under the clavicles) supply blood to the upper extremities. As the subclavian artery enters each arm, it becomes the brachial artery, the major vessel that supplies blood to each arm. Just below the elbow, the brachial artery divides into two major branches: the radial and ulnar arteries, supplying blood to the lower arms and hands. At the level of the umbilicus, the descending aorta divides into two main branches called the right and left iliac arteries, which supply blood to the groin, pelvis, and legs. As the iliac arteries enter the legs through the groin, they become the right and left femoral arteries. At the level of the knee, the femoral artery divides into the anterior (front) and posterior (back) tibial arteries and the peroneal artery, supplying blood to the lower legs and feet. Level of vessels - Answer aorta, arteries, smaller and smaller vessels called arterioles, and eventually enter the capillaries What are capillaries - Answer Capillaries are tiny blood vessels about one cell thick that connect arterioles to venules. Capillaries, which are found in all parts of the body, allow the exchange of nutrients and waste at the cellular level. As the blood passes through the capillaries, it gives up oxygen to the tissues and picks up carbon dioxide and other waste products to be removed from the body Venules - Answer Venules are the smallest branches of veins. After traveling through the capillaries, oxygen-poor blood enters the system of veins, starting with the venules, on its way back to the heart. The veins become larger and larger and eventually form the two large venae cavae: the superior vena cava and the inferior vena cava. Arteries supply oxygen to different parts of the body - Answer Right and left carotid Right and left subclavian Brachial Radial and ulnar Right and left iliac Right and left femoral Anterior and posterior tibial and peroneal Subclavian artery - Answer becomes brachial artery as it supplies blood to each arm What supplies blood to the lower arms and hands? - Answer the radial and ulnar arteries Iliac arteries - Answer enter legs through the groin and become the right and left femoral arteries which divide into the anterior and posterior tibial arteries and peroneal artery at the knees which supply blood to lower legs and feet The superior (upper) vena cava - Answer carries blood from the head and arms back to the right atrium. The inferior (lower) vena cava - Answer carries blood from the abdomen, kidneys, and legs back to the right atrium. The superior and inferior venae cavae - Answer join at the right atrium of the heart, where blood is eventually returned into the pulmonary circulation for oxygenation. Used blood comes through the venae cava. . Right and left carotid arteries - Answer supply the head and brain with blood What different parts of the body do arteries supply oxygen to via blood? - Answer Right and left carotid Right and left subclavian Brachial Radial and ulnar Right and left iliac Right and left femoral Anterior and posterior tibial and peroneal What connects arterioles and venules - Answer capillaries What are arterioles and capillaries? - Answer They are smaller vessels What is the name of the smallest branches of veins - Answer venules Vena cavae - Answer return deoxygenated blood to the heart What are the two types of vena cava - Answer inferior and superior What does blood consist of? - Answer Red blood cells: carry oxygen White blood cells: fight infection Platelets: which help the blood to clot Plasma: which is what the fluid cells float in What is blood pressure - Answer the force of circulating blood against the artery walls What is systolic blood pressure - Answer The max pressure generated by the left ventricle contracting during the time period called systole What is diastolic blood pressure - Answer The pressure against artery walls while the left ventricle is at rest: period called diastole What does one cardiac cycle consist of? - Answer The cardiac cycle consists of one systolic and one diastolic time period What is the pulse - Answer a pulse is felt when blood passes through an artery during systole Define systole - Answer the phase of the heartbeat when the heart muscle contracts and pumps blood from the chambers into the arteries. Where is peripheral pulses felt? - Answer in the extremities or radial and the posterior tibial, are called peripheral pulses, Where is the central pulse felt - Answer near the body's trunk. femoral and carotid pulses are known as central pulses. What controls cardiac contractions? - Answer The rate of cardiac contractions can be increased or decreased by the autonomic nervous system. The heart also has the ability to increase or decrease the volume of blood it pumps with each contraction based on the autonomic nervous system response Define cardiac output - Answer is the volume of blood that passes through the heart in one minute What is the formula for the cardiac output - Answer heart rate multiplied by volume ejected with each contraction (stroke volume) Heart rate - Answer Heart rate is the number of times the heart contracts in 1 minute. Perfusion is - Answer the constant flow of oxygenated blood to tissues What are the requirements for good perfusion? - Answer 1. Heart must pump at the appropriate rate 2. Adequate volume of fluid or blood 3. The blood must be carried in a properly sized container: vessels must not be too constricted or dilated What happens if perfusion fails - Answer cells die and later patient death occurs Where does chest pain usually stem from? - Answer chest pain usually stems from ischemia Define ischemia - Answer decreased blood flow to one or more portions of the heart. Decreased blood flow. Because of a partial or complete blockage of blood flow through the coronary arteries, heart tissue fails to get enough oxygen and nutrients. The tissue soon begins to starve and, if blood flow is not restored, eventually dies. Ischemic heart disease, then, is a disease involving a decrease in blood flow to one or more portions of the heart muscle. What happens if blood blow is not restored - Answer tissue dies Define atherosclerosis - Answer the buildup of calcium and cholesterol(fatty material) form a plaque inside the walls of blood vessels, obstructing flow and interfering with their ability to dilate or contract What can atherosclerosis cause - Answer can cause complete occlusion of the arteries also as age increases so do fatty material inside the artery Define lumen - Answer the inside diameter of the artery Atherosclerosis and age - Answer As a person ages, more of this fatty material is deposited; the lumen, or the inside diameter of the artery, narrows. As the cholesterol deposits grow, calcium deposits can form as well. The inner wall of the artery, which is normally smooth and elastic, becomes rough and brittle with these atherosclerotic plaques. Damage to the coronary arteries may become so extensive that they cannot accommodate increased blood flow during times of maximum need. How is thromboembolism caused - Answer For reasons that are still not completely understood, a brittle plaque will sometimes develop a crack, exposing the inside of the atherosclerotic wall. Acting like a torn blood vessel, the ragged edge of the crack activates the blood-clotting system, just as when an injury has caused bleeding. In this situation, however, the resulting blood clot will partially or completely block the lumen of the artery. If it does not occlude the artery at that location, the blood clot may break loose and begin floating in the blood, becoming what is known as a thromboembolism. What is thromboembolism - Answer blood clot floating through blood vessels. Blood clots happen when the body tries to fix a vessel but the clot that the body forms after trauma may float around and block the lumen/vessel. The tissue downs stream of a blood clot will have hypoxia. If blood flow is resumed in a short time, the hypoxic tissues will recover. However, if too much time goes by before blood flow is resumed, the hypoxic tissues will die If clot lodges in the coronary artery, - Answer acute myocardial infarction (AMI) results Define acute myocardial infarction (AMI) - Answer If a blockage occurs in a coronary artery, the condition is known as an acute myocardial infarction (AMI). a classic heart attack Infarction means - Answer Infarction means the death of tissue Death of a heart muscle can cause - Answer cardiac arrest Coronary artery disease is the - Answer leading cause of death in US Define the controllable AMI risk factors - Answer The major controllable factors are cigarette smoking, high blood pressure, elevated cholesterol level, elevated blood glucose level (diabetes), lack of exercise, obesity. Define uncontrollable AMI risk factors - Answer that cannot be controlled are older age, family history of atherosclerotic coronary artery disease, race, ethnicity, male(sex) Acute coronary syndrome (ACS) is a group of systems caused by: - Answer myocardial ischemia. Can lead to CHF Define myocardial ischemia - Answer Myocardial ischemia occurs when blood flow to your heart is reduced, preventing the heart muscle from receiving enough oxygen. The reduced blood flow is usually the result of a partial or complete blockage of your heart's arteries (coronary arteries). Chest pain does not always mean - Answer AMI Define angina pectoris - Answer When, for a brief time, heart tissues are not getting enough oxygen, the pain is called angina pectoris, or angina. Angina pectoris occurs when - Answer the heart's need for oxygen exceeds the supply. When the increased oxygen demand goes away (eg, the person stops exercising), the pain typically goes away. Or can happen from a spasm of an artery. A large meal or sudden fear may also trigger an attack. When the increased oxygen demand goes away (eg, the person stops exercising), the pain typically goes away. Angina pectoris is most often a symptom of - Answer atherosclerotic(calcium and cholesterol) coronary(in the coronary artery) artery disease The effects of angina pectoris are - Answer crushing or squeezing pain('someone is standing on my chest). The pain is usually in the mid-portion of the chest under the sternum although it can radiate to the jaw, arms, left arm, midportion of the back or the epigastrium, or the upper middle region of the abdomen. does not lead to death or permanent heart damage should be taken as a serious warning sign. The pain usually lasts from 3 to 8 minutes, rarely longer than 15 minutes. It may be associated with shortness of breath, nausea, or sweating. It usually disappears promptly with rest, supplemental oxygen, or nitroglycerin (NTG), all of which decrease the need or increase the supply of oxygen to the heart What can be disrupted by angina pectoris? - Answer Even with angina, because the oxygen supply to the heart is diminished, the electrical system can be compromised, and the person is at risk for significant cardiac rhythm problems. When there is unstable angina - Answer it is in response to fewer stimuli than normal. Unstable angina is characterized by pain or discomfort in the chest of coronary origin that occurs in response to progressively less exercise or fewer stimuli than ordinarily required to produce angina. Can lead to AMI. When there is stable angina - Answer it is relieved by rest or nitroglycerin. Stable angina is characterized by pain in the chest of coronary origin that is relieved by the things that normally relieve it in a given patient, such as resting or taking nitroglycerin. When are EMTs usually called in angina patients - Answer EMS usually becomes involved when stable angina becomes unstable, such as when a patient whose pain is normally relieved by sitting down and taking one nitroglycerin tablet has taken three tablets with no relief. Treat angina patients like_____ patients - Answer AMI Patients What is AMI? - Answer acute myocardial infarction What does AMI pain signal? - Answer AMI pain signals the actual death of cells in the heart muscle. If cells of the heart die, they cannot be revived which means they become scar tissue and become a burden to the beating heart What prevents the death of cells due to clots - Answer "clot-busting" thrombolytic drugs or angioplasty within the first few hours prevent damage When does heart muscle begin to die? - Answer About 30 minutes after blood flow is cut off, some heart muscle cells begin to die. After about 2 hours, as many as half of the cells in the area can be dead; in most cases, after 4 to 6 hours, more than 90% will be dead. What helps stop AMI? - Answer thrombolytic medication or angioplasty Define thrombolytic medication - Answer clot-busting medication