NUR 460 - Structure of the Heart
NUR 460 - Structure of the Heart 460
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This 4 page Class Notes was uploaded by ndp33 on Wednesday July 13, 2016. The Class Notes belongs to 460 at Niagara University taught by in Summer 2016. Since its upload, it has received 8 views. For similar materials see Nursing Concepts IV: Health of Maturing Adults / Chronic Disease in Nursing and Health Sciences at Niagara University.
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Date Created: 07/13/16
Cardiac Quiz There are three major arteries that arise off the aortic arch. Name them. Brachiocephalic artery, left common carotid artery, left subclavian artery What are the arteries that arise off the brachiocephalic artery? Right subclavian artery, right common carotid artery (The brachiocephalic artery branches off of the arch of aorta). Name the valves that are in the heart: Aortic, pulmonic, tricuspid, pulmonic What two valves are the semilunar valves? Aortic and pulmonic Name the vessels that drain blood into the left atrium INCLUDE the major vein that drains blood from the coronary arteries Left coronary artery and circumflex branch of left coronary artery; left anterior descending artery; anterior interventricular branch of left coronary artery; left marginal artery; lateral (diagonal) branch of anterior VI branch Great cardiac vein drains blood from coronary arteries into coronary sinus. What are the chordae tendinae? The chordae tendinae are strong, dense, cords of connective tissue that are attached to the cusps of the mitral and tricuspid valves on the ventricular side of the heart. The chordae tendinae are also attached to the papillary muscles in the ventricles in order to help prevent the mitral and tricuspid valve cusps from prolapsing back into the atrium during systole. What are the papillary muscles: The papillary muscles, located in the ventricles, attach to the cusps of the mitral and tricuspid valves via the chordae tendinae, and they help prevent the valve cusps from prolapsing back into the atrium during systole. As a nurse, you have a patient with an MI. What would happen if the patient ruptured either the papillary muscles or the chordae tendinae? (I did not give you the answer to this, I want you to think and reason through the answer) The ruptured papillary muscles (or chordae tendinae) could result in valve regurgitation (backward flow of flow) into the previous chamber of the located valve. This would result in an increased workload on the heart, and possible heart failure can develop overtime. In what phase of the cardiac cycle do the ventricles relax? Diastole. (Blood is passively flowing from the left atrium and the right atrium into the right ventricle and left ventricle.) (And during systole, the right and left ventricles contract and eject blood into the aorta and pulmonary arteries, respectively. The AV valves are closed, and no blood is entering the ventricles.) Define “atrial kick”: The force from atrial contraction immediately before ventricular systole that increases the amount of blood reaching the ventricles and ventricular ejection of blood. With high heart rates, which atrial contraction can account for up to 40% of ventricular filling. (Normally, atrial contraction accounts for about 10% of ventricular contraction when a person is at rest as a majority of ventricular filling occurs before atrial contraction.) Where is the SA node located? Upper posterior portion of right atrial wall, near opening of superior vena cava Where is the AV node located? Floor of right atrium, just above the tricuspid valve (It takes over as secondary pacemaker when node fails.) What occurs in the heart during the “p” wave? Electrical depolarization of the atria and contraction of the atrial musculature. As the atria contract, the pressure within their chambers increases, forcing more blood across the atrioventricular valves, leading to a rapid flow of blood into the ventricles. (During atrial depolarization, the atria contract in response to an electrolyte exchange (in NaK pump) and stimulus in cardiac cells.) What does the QRS signify? It signifies depolarization of the right and left ventricles and contraction of the ventricular musculature. (Impulses are conducted from the bundle of His by the AV junction to the Purkinje network of fibers in the ventricles.) At what phase of the cardiac cycle do the coronary arteries fill? During diastole. (The aortic valve is closed and the coronary ostium is open, enabling the coronary arteries to fill.) Knowing this, why would tachycardia be detrimental to cardiac muscle. (once again, I did not give you the answer specifically, i want you to use your critical thinking skills) With increased cardiac workload, it results in increased oxygen requirements for the cardiac muscle cells cells. However, damage occurs because with the increase in heart rate and contractions, there is less time required for filling. Less blood is ejected from the heart during systole. Cardiac output would decrease. What would an S3 indicate? S3 would indicate ventricular dilatation, it is heard during ventricular filling. It is a pathological sound in adults, but may be heard as normal in children (as tensing of the chordae tendinae). What would an S4 indicate? A sound that could be heard during atrial contraction, as caused by vibration of the ventricular wall when the ventricle is “stiff.” At what stage of the cardiac cycle does Aortic Stenosis occur? Systole. (Blood flow is blocked or obstructed across the aortic valve; the left ventricle can’t eject blood to the aorta during systole as well, resulting in a decreased cardiac output.) At what stage of the cardiac cycle does Mitral Regurgitation occur? Systole. (Blood flow backs, or regurgitates, into left atrium as left ventricle contracts, because of the mitral valve’s insufficiency to close properly.) At what stage of the cardiac cycle does Aortic Regurgitation occur? Diastole. (Blood regurgitates into left ventricle when the left ventricle is also being filled from the left atrium. This filling causes the leftend diastolic volume to further increase, due to an inability of aortic valve to close properly (e.g. scarring, calcification).)
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