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What is blood plasma made of?
90% water and 10% solute
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What is in electrolytes?
Potassium, calcium, sodium, magnesium, chloroid and phosphate
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Where and what are Erythrocytes? If you have high or increased erythrocytes what does that cause? What about low or decreased erythrocytes?
- RBCs
- Produced in the bone marrow
- High: polycythemia
- Low: Anemia
Erythrocyte count is higher in males then females
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What is the normal index value for Erythrocytes?
NI: 4.2-6.2 million per cubic mm
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What is hemoglobin?
Component of blood that carries oxygen to RBC's
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What is the NI for hemoglobin?
12-18g Hb/dl
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What are Leukocytes?
- WBC's
- Produced in bone marrow
- Help defend body against infectious diseases and foreign materials as part of the immune system
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What is the NI for Leukocytes or WBCs?
NI: 5000-10,000 per cubic mm
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What are Eosinophils?
Increase w/allergic reaction and parasitic infectioions i.e: asthma attacks
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What are Basophils?
They secrete heparin i.e: bacterial infection
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What are Monocytes?
They increase with invasion of foreign materials: phagocytes
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If you have too many Lymphocytes (WBCs) you can get?
Leukocytosis
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If you have the below amount or not enough WBCs you can get?
Leukopenia
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What are Lymphocytes?
- They increase w/ viral infections
- Reduced w/ immunodeficiency
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What are Neutrophils?
Increase w/ trauma and bacterial infections; reduced w/ bone marrow disease
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What is the normal value of Platelets?
Normal value: 150,000-400,00 per cubic mm
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What are platelets?
- Smallest elements of blood
- They help clot or coagulate
- AKA thrombocytes
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What is Thrombus?
Stationary clot
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What is Embolus?
A moving clot, dangerous because it can clog smaller arteries and lungs
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What are the 5 functions of blood?
- Transport gases
- Circulate defense
- Provide nutrients
- Electrolytes
- Remove waste from cells
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Where is the heart located?
- Heart is hollow, muscular, roughly fist-sized
- Lies just behind the sternum, 2/3 to the left
- Heart apex at 5th intercostal space
- Surface grooves (sulci) delineate chambers
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What is blood moving away from the heart called?
Arteries
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What is blood moving toward from the heart called?
Veins
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Layers of the heart from outer to inner?
- Pericardium
- Visceral pericardium
- Epicardium
- Myocardium
- Endocardium
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What is the pericardial sac or cavity do?
Encloses or lines the heart
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What are the 4 chambers of the heart?
- Right atrium
- Right ventricle
- Left atrium
- Left ventricle
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What are the 4 valves of the heart?
- Tricuspid valve
- Bicuspid valve
- Pulmonic valve
- Aortic valve
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What is the purpose of all the valves?
To prevent back flow
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Where do AV valves lie between?
Atria and ventricles
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What is systolic or systole?
- The first or highest beat when taking blood pressure!
- Contraction of the heart
- Valves opening, allow venticular ejection into arteries (pulmonary artery and aorta) contraction
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What are semilunar valves?
- Consist of 3 half moon shaped cusps
- Situated at ventricle exits to arterial trunks
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What is distolic or diastole?
- The lowest or last beat while taking blood pressure!
- Relaxation of the heart
- Valves close preventing back flow of blood into arteries
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What is in the Systemic Vasculature?
- 1. Arterial System: Conductive Vessels : carry oxygenated blood and controls local blood flow
- 2. Capillary System: Exchange Vessels : Transfer nutrients to waste
- 3. Venous System: Capacitance Vessels : Carries blood back to the heart
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What is an Electrocardiogram?
- ECG or EKG
- Measurement of electrical activity within the heart
- uses 12 leads to obtain 12 different views of electrical activity in the heart
- EKG's are used as screening tools to determine the PT's heart status before a mjor surgery. Are they healthy enough to survive the surgery
- EKG's DO NOT measure the pumping ability of the heart
- EKG's CAN NOT predict acute problems i.e: myocardial infarction
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What are Peripheral Receptors?
- Baroreceptors
- Chemoreceptors
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Where are the barorceptors and chemoreceptors located?
In the arch of aorta and carotid sinus
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Baroreceptors respond to and can cause?
- Pressure
- Output is directly proportional to vessel stretch negative feedback, so greater stretches cause vendilation, decreased heart rate and contractility.
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What do Chemoreceptors respond to?
- Blood chemistry
- low pH
- low O2
- high PaCO2
- increased output is vasoconstriction and increased HR
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What are P Waves?
Atrial depolarization
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What is the QRS Complex?
- Ventricular depolarization
- Normal QRS complex is not wider then 3mm (.12 seconds)
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What is a T wave?
ventricular repolarization
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What is the Sino-atrial node and what does it do?
- Controls pace of the heart, aka pacemaker
- Influenced by autonomic nervous sytem
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What is the Atrio-ventricular (AV) node?
- Back up pace maker
- Guides electrical impulse from atria into ventricles
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What is the path of the electrical system through the heart?
- Sino-atrial (SA) node
- Atrio-ventricular (AV) node
- Bundle of His
- Left bundle branch
- Right bundle branch
- Purkinje fibers
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What is depolarization?
contraction
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What is repolarization?
relaxation
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What is the path of blood?
- Superior/Inferior vena cava
- Rigth atirum
- Tricuspid valve
- Right ventricle
- Pulmonary valve
- Pulmonary artery
- Lungs
- Pulmonary vein
- Pulmonic valve
- Left atrium
- Bicuspid or Mitral valve
- Left ventricle
- Aortic valve
- Aorta
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What is Starlings Law?
- Greater the stretch of the heart muscle, the stronger the contraction
- Greater the volume of blood entering heart during diastole, greater the volume being ejected during systolic contraction
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What is a normal sinus rhythm?
- Upright P wave that is identical throughout the strip
- 60-100bpm
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What is different about Sinus bradycardia?
Sinus bradycardia meets are the criteria for a normal sinus rhythm except for the HR, which is less then 60bpm
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What treatment is given when someone has sinus bradycardia?
Atropine - speeds up HR
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What are some properties about Sinus tachycardia?
- It is present when the heart rate is at 100-150bpm at rest
- All normal conduction pathways in the heart are followed
- Symptoms: pain, anxiety, fever, hypovolemia and hypoxemia
- Bronchodilaters can cause tachycardia
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What are some properties about Sinus arrhythmia?
- This is a benign arrythmia that meets all the criteria for a normal sinus rhythm except that the rhythm is irregular
- It usually does not produce symptoms in the PT and requires no treatment
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What is Premature ventricular contractions? PVC
- Occurs when the ectopic beats originate in one of the ventricles due to enhanced automaticity
- PVC's are comonly the result of hypoxia, electrolyte imbalances and acid-based disorders
- PVC's occur in botht he normal heart and the diseased heart, and are usually due to anxiety or excessive use of caffine, alcohol, or tobacco.
- QRS complex is wide and has no preceding P wave
- Frequent PVCs call for the treatment of the underlying cause (lidocaine offers temporary solution in some cases)
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What treatment is given when someone has a reading of PVC on their EKG?
Lidocaine
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What is Ventricular tachycardia?
- Represent a run of three or more PVCs
- Easy to recognize as a series of wide QRS complexes w/ no proceeding P wave
- VT represents a serious arrhythmia that often progresses to a V Fib if untreated
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HR of Ventricular tachycardia?
Ventricular rate is 100-125bpm
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Treatment for Ventricular tachycardia?
cardioversion
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What is Ventricular Fibrilation? V Fib
- Represents the most life threatning arrythmia
- Defined as erratic or quivering of ventricular muscle mass
- Causes cardiac output to drop to zero
- The ECG show grossly irregular fluctuations w/ a zig-zag pattern
- Treatment: cardioversion, CPR, O2, antiarrhytmic medication
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What is Asystole?
- Asystole is cardiac stand still and is invariably fatal unless an acceptable rhythm is restored
- Asystole is recognizable on the ECG monitor as a straight or almost straight line
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What is the normal cardiac output? (amount of blood being pumped out of the heart)
5L a min or 5,000mL
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What is the correct way to take a pulse reading?
with fingers NOT thumb
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What are the 5 sites you can take a pulse reading?
- Radial - wrist/thumb
- Carotid - neck
- Femoral - groin
- Brachial - inside of elbow
- Dorsalis Pedis - top of foot
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What is normal systolic blood pressure range?
100-140 mHg (millimeters of mercury)
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What is normal diastolic blood pressure range?
60-90 mHg (millimeters of mercury)
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What is a Sphygmomanometer?
Glass tube with mercury used tomeasure blood pressure sounds reflected through a stethoscope
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What is Hypertension?
High blood pressure
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What is Myocardial infarction? MI
- Heart attack
- tissue become ishemic and necrotic
- muscle is weakened
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What is Cor Pulmonale?
- Right side heart failure
- neck vein (venious distension) will protrude
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What is Congenital abnormalities?
- May cause right to left shunt
- Blood may be unable to oxygenate
- Babies are born with it
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What is an aneurysm?
- Ballooning out of vessels
- Weakening vessels
- Can cause hemmorage, rupture or death
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What is Arteriosclerosis?
Hardening of arteries by calcium - HBP
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What is atherosclerosis?
Fat deposits causing narrow arteries
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What is Ischemia?
Decrease of blood flow to area for a variety of reasons: blood clots, low blood pressure, etc
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What is a hemorrhage?
- loss of blood (trauma)
- uncontrolled bleeding
- usually a rupture or torn vessel
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What is shock?
- loss of circulating fluid
- deragnement of circulatory control
- symptoms: pale, clamminess of skin, hypotension, bradypnea, restlessness, anxiety and sometimes unconsciousness
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What are the 3 states of cardiac inflammation?
- Endocarditis: inflammed endocardium
- Myocarditis: inflammed mycardium
- Pericarditis: inflammed pericardium
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What is angina pectoris?
- Pain located over the heart, left shoulder or jaw
- Due to decreased blood supply (ischemia) to the heart by the coronary arteries
- Leads to heart attack
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What is congestive heart failure?
- left side heart failure
- impaired cardiac pumping
- caused by: MI, ischemic heart disease, cardiomyopathy (heart muscle diseases)
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What are the 4 key properties to conduct electrical impulses through the heart?
- Excitablity- ability to respond to stimuli
- Automaticity- intiation of spontaneous electrical impulse
- Conductivity- spreads impulses quickly
- Contractility- contraction in response to electrical impulse
- *unique feature - cannot go tetany
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