Hemoglobin / O2
A hemoglobin has _____ subunits. They consist of two ____ and two ______ subunits in an adult male.
Four. Alpha and Beta
Name the three layers of the heart
Endocardium, myocardium, endocardium
Cardiac cells depolarize adjacent cardiac cells via
Gap junctions / intercalated discs
Can dead heart tissue depolarize?
What is the cardiac output equation?
CO = HR x SV
True or False. Carbon Monoxide has a higher affinity for hemoglobin than oxygen AND carbon dioxide
True of False, the pulmonary artery consists of oxygenated blood that carries blood away from the heart to the lungs.
False
True or False, The action potential being sent to the AV node is much more slower than the SA node.
True
Where are the three leads on our body and what charges are they?
Lead 1: (RA- and LA+)
Lead 2: (RA- and LL+)
Lead 3: (LL+ and LA-)
If you were to add EPI to the heart, what kind of shift would we see in the frank starling curve?
(bonus 200 points) A change in radius size would impact the flow of blood by how much?
Up shift, heart works harder.
To the power of 4 (r^4)
Where does myoglobin reside in the body and what shape curve does it display?
Muscles. Hyperbolic
10%
During the resting membrane potential state, what ion is heavily concentrated in the intracellular space.
Potassium
What is happening in each of the waves of an ECG?
(p,q,r,s,t)
P - Atrial depolarization
QRS - Ventricle depolarization
T - repolarization
Your pt pushes out 100mL of blood per heart beat and had an end dystolic volume of 150mL. Calculate the ESV from this. Is this normal?
ESV = EDV - SV
150 - 100 = 50mL
Within normal ranges
List (at least) three identifiers for there to be a right shift on the oxygen disassociation curve.
High levels of CO2, temp, BPG, and a lower pH
List the flow of blood from the vena cava to the aorta (body)
Right atrium, tricuspid, right ventricle, pulmonary valve, pulmonary arteries, (lungs), pulmonary veins, left atrium, bicuspid valve, left ventricle, aortic valve, aorta
List the entire conduction pathway of the heart
SA node, AV node, bundle of His, bundle branches, purkinje fibers
A patient has an average R-R wave every 0.25 seconds. What would this patients heart rate (bpm) be?
What might they be doing during this time frame?
240bpm. Working out etc.
If EDV increases, what would happen to contractility, stroke volume, and cardiac output?
Everything increases. The heart needs to work harder and use more energy.
A 74-year-old male presents to the emergency room with confusion, fever, and shortness of breath. His wife reports he has had a productive cough for three days. Chest X-ray shows right lower lobe consolidation consistent with pneumonia. Blood cultures later grow Streptococcus pneumoniae.
What type of oxygen dissociation shift might you observe in the patient and why?
Right shift
A pt presents to the ER after collapsing from chest pain while shoveling his side walk. The friend who found him claims the pt had crushing chest pain, shortness of breath, and nausea. After labs and imaging, they conclude that the left ventricle has stopped working due to an infarction of the tissue.
What coronary artery could have bursted to cause this scenario?
Left coronary artery (widow maker)
A 68-year-old male with a history of hypertension and coronary artery disease is brought to the ER after collapsing at work. He says he regained awareness but appears confused and extremely fatigued. He has a HR of 32 and his EKG shows no consistent relationship between P waves and the QRS complex. What type of heart failure is this and what part of the conduction system failed? (why?)
3rd degree heart block and failure of the AV node
Electrical signals from the atria completely fail to get to the ventricles. This makes the atria and the ventricle beat independently of one another.
A 64-year-old female presents to the ER complaining of worsening leg swelling that is cool to the touch and abdominal bloating over the past 2 weeks. She also reports increased fatigue and shortness of breath, especially when walking short distances. She sleeps on two pillows but denies sharp chest pain. She has a history of chronic obstructive pulmonary disease.
If you were to do an MEA on this patient, what kind of shift would you observe and why?
Right sided shift. The right side of the heart is failing so it begins to work harder and grow more muscle.
A 70 year old female is brought in to the ER for severe chest pain, shortness of breath, and dizziness. They have a history of hypertension and smoking. The doctor diagnoses the patient with an infarction of the left anterior descending artery.
What kind of shift might we see in the frank starling curve? Why?
Downward shift. No contraction due to dead muscle tissue, impaired contraction, stroke volume then goes down.