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PCT FINAL


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cardiogenic shock
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the state in which the heart has been damaged where it cannot supply enough blood to the organs, tissues and cells of the body

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Cardiogenic shock
The state in which the heart has been damaged where it cannot supply enough blood to the organs, tissues and cells of the body
Myocardial infarction
Death and necrosis of heart muscle due to inadequate oxygen supply
Angina
The Hearst demand for oxygen exceeds the bloods oxygen supply
Pulmonary edema
Abnormal buildup of fluid in the lungs. This buildup of fluid leads to shortness of breath
Left sided heart failure
Increased hydrostatic pressure in pulmonary vessels, caused by MI, hypertension and other forms of heart disease
Right sided heart failure
Increased pressure into the systematic vessels, the most common cause f this is L sided HF
Pulmonary embolism
Blockage of an artery by a blood clot or other particle
Pulses paradoxus
Exaggeration of the normal variation in the pulse which becomes weaker (decrease of greater than 10mmHg in systolic blood pressure) with inspiration and stronger on expiration.
Pedal edema
JVD due to the backup in R ventricle/atrium
Abdominal aortic aneurysm
Often the result of atherosclerosis
Cardiac electrical pathway
Electrical stimulus travels down through the conduction pathways and causes the heart's ventricles to contract and pump out blood. The bundle of His divides into right and left pathways, called bundle branches, to stimulate the right and left ventricles
Hypertensive emergencies
Diastolic BP >130mmHg, usually occurs with hypertensive encephalopathy
Deep vein thrombosis
Blood clot in the vein, this typically occurs in the larger veins of the thigh and calf
Varicose veins
Dilated superficial veins, common with pregnancy and obesity
Pulsus alternans
Pulse alternates between weak and strong
Heart
Located in the center of the chest in the mediastinum
R coronary artery
Suppose 15% of the blood supply to the heart muscle
L coronary artery
Supplies 85% of blood to the heart muscle
Atherosclerosis
Fatty tissue (plaque) being deposited on the inner lining of the wall of the coronary arteries
Arteriosclerosis
Build up of calcium on the arterial walls
Cardiac cycle
The interval from the end of one cardiac contraction to the end
Preload
The initial stretching of the cardiac myocytes (muscle cells) prior to contraction. It is related to ventricular filling
Afterload
The force or load against which the heart has to contract to eject the blood.
Chronotrophy
Heart rate
Inotropy
Contractile strength
Dromotrophy
Rate of nerve impulse conduction
Electrolytes
Na+ depolarization K+ repolarization Ca++ depolarization, muscle & vessel contraction
Calcium channel blockers
Amlodipine, diltiazem, nifedipine, verapamil
Absolute refractory period
Cardiac muscle cell is completely insensitive to further stimulation
Relative refractory period
The interval of time during which a second action potential can be initiated, but initiation will require a greater stimulus than before.
Excitability
Responds to electrical stimulus
Conductivity
Propagate impulse to other cells
Automatcity
Depolarize on its own, on a regular basis
Contractibility
Ability to contract
Residual volume
On contraction a certain volume is left behind in the L ventricle that is not apart of the stroke volume
Ejection fraction
Amount ejected on contraction versus total L ventricular volume
End systolic volume
Volume pushed into the aortic arch at the end of systolic contraction (volume actually pushed through)
Pulse deficit
Difference between pulse and the peripheral pulse
Pluses paradoxus
Decrease of greater than 10mmHg in systolic blood pressure with inspiration and stronger on expiration.
Pluses aternans
Beat to beat variation in the pressure in terms of amplitude, power behind each pulse changes
Starlings law
Contractibility of cardiac muscle and the amount of stretch placed in that muscle
Auscultation
Listening to sounds of the body
Transmural infarction
Entire thickness of myocardium destroyed, Q wave changes
Subendocardial infarction
Involves only the subendocardial layer, no Q wave change
Cardiac risk factors
Smoking, alcohol, inactivity, nutrition, obesity, HTN, dietary fat, BGL, cocaine use, type A personality, stress, prolonged use of oral contraceptives
Cardiac tamponade
Fluid buildup in the pericardium of the heart
Paroxysmal nocturnal dyspnea
Laboured breathing or shortness of breath while laying down like at night time
Atelectasis
Complete or partial collapse of the lung, or lobe
Preload
The initial stretching of the cardiac myocytes (muscle cells) prior to contraction. It is related to ventricular filling
Sounds of partial airway obstruction
Coughing, stridor, gagging/choking difficulty speaking
Pulse oximetry
Rapid and accurate measure of oxygen saturation
Causes of airway obstruction
Tongue is the most common cause. can also be foreign bodies, trauma, laryngeal spasm and edema and aspiration
Emphysema
The destruction of alveolar surfaces, there is a decreased area for gas exchange resulting in hypoxia
Chronic bronchitis
Increased number of goblet cells in the respiratory tree
Dyspnea
Shortness of breath
Simple pneumothorax
Air leaks into the pleural space "paper bag syndrome"
Open pneumothorax
Air accumulates between the chest wall and the lung as the result of an open chest wound or other physical defect
Tension pneumothorax
Air is trapped in the pleural cavity under positive pressure
Hypoxic drive
The body uses oxygen chemoreceptors instead of carbon dioxide receptors to regulate the respiratory cycle.
Risks of mouth to mouth oxygen therapy
Potential exposure to communicable diseases
Hypoxemia
Low levels of oxygen in the blood
Flail chest
3 ribs fractured in 2 or more places
Barotrauma
Injuries caused by increased air or water pressure, such as during airplane flights or scuba diving
Atelectasis
A condition in which an area of lung tissue is collapsed