The right and left ________________ arteries, used as grafts during coronary bypass surgery, branch off the subclavian arteries and course behind and parallel to the edges of the sternum.
Internal mammary arteries (thoracic)
External respiration occurs in the capillary beds and the alveoli, where ______________ is exchanged for _________. Freshly oxygenated blood from the lungs flows through the ____________ into the ___________.
Carbon dioxide, oxygen, pulmonary veins, left atrium
The conduction system process of excitation and contraction originates in the _____________ node, located in the area where the __________ meets the right atrium. The impulse spreads to the atria through intermodal pathways and travels to the ____________ ( which contains the ___ node) located medial to the entrance of the coronary sinus in the right atrium, close to the tricuspid valve. From the AV junction, the impulses spreads to the bundle of HIS, which extends down the right side of the inter ventricular septum. The bundle of HIS divides into the right and left bundle branches, which terminate in a network of fibers called the Purkinje system. Purkinje fibers are spread throughout the inner surface of both ventricles and the papillary muscles, which when stimulated procedure contracture of the heart muscle.
(sA) sinoatrial, superior vena cava (SVC), AV junction,
The blood is oxygenated in the lungs and returns to the left atrium through the pulmonary veins. From the left atrium, it flows through the ___________ into the left _________ where it is ejected through the aortic valve into the aorta and the systemic circulation.
Mitral valve, ventricle
______________ imaging is employed to illustrate wall motion and blood flow through the heart and to quantify cardiac function. These noninvasive techniques are generally well tolerated by patients, especially when patients may be too unstable to withstand a cardiac catheterization. These techniques may also be used as a complement to catheterization. ____________________ provides definitive information about the extent and location of ischemic heart disease and is an adjunct to echocardiography for diagnosing valvular heart disease.
Radionuclide, cardiac catheterization
List seven. Invasive diagnostic tests commonly performed for cardiovascular disorders:
The ______ retractor is used to elevate the sternal border for exposure of the ___________ artery.
IMA ( internal mammary artery) , retrosternal
Destruction of diseased conductive tissue
Three methods to perform ablutions
Cryosurgery Radio frequency Ultrasonic
A _____________ may be used for acute forms of heart block and dysrhythmias that occasionally occur during and after cardiac surgery. The transvenous or the epicardical approach may be used to place the electrodes. Cardiac resynchronization therapy (CRT), dual-site pacing, employs leads placed on the atrium and the right ventricle.
Two methods for putting in pacemaker
Percutaneous and cutdown
List valve prosthetic materials and techniques
Allograft = homografts Mechanical Biological Autograft= same person Xenografts= another species
Describe laser safety
Safety goggles Damp towel on top of drape Non reflecting instruments bowl of fluid
Describe the steps LVA
List the presenting symptoms that indicate surgical intervention is required
Necessary when presenting symptoms indicate a compromised circulation or danger or rupture. Failure of medical treatment
Describe the use of the heart lung machine
The temporary substitution of a pump oxygenator for the heart and lungs allows the surgeon to stop the heart to perform cardiac procedures under direct vision in a relatively dry, motionless field.
Biological assistance in the form of an ________________________ ( cardiomyoplasty) may be useful in some patients who may not be candidates for transplantation, but the procedure is used infrequently. The left ______________ muscle is dissected from the back and repositioned around the heart! where it is sewn around the ventricle. This ( skeletal) muscle is then transformed into a continuously beating muscle by a cardiomyostimulator that paces the muscles with increasing frequency, allowing the muscle to become fatigue-resistant. The muscle wrap squeezes the heart in synchronization with natural electrical impulses moving through the heart muscle.
Autogenous muscle wrap
Describe the steps to reduce risks when using a bioprosthetic valve replacement. Name the gold standard rule when dealing with bio prosthetics.
Gold standard: manufacture instructions
Name the closed cavity that contains the heart
The _______________ initiates the cardiac cycle and is sometimes called the heart's pacemaker.
Sinoatrial (SA node) ( the start)
Uncoordinated muscular activity in the heart muscle, which results in a "quivering" rather than pumping action
How does fibrillation have a negative impact on the patient
Doesn't allow for full systemic circulation
Two types of cardiac transplantation can be performed. What are they, and how are they different.
Heterotrophic ( piggyback)
Describe V fib
Chaotic, disorganized stimulation of one or both ventricles that does not pump the blood
That phase of the cardiac cycle when the ventricles contract is
Name the procedure whose goal is to increase blood flow to the heart in patients in whom bypass surgery or medical management is not feasible.
Transmyocardial revascularization ( TMR)
List the diagnostic procedure that demonstrates the movement of blood through the valves and can be used to used to measure the ejection fraction ( the amount of blood pumped from the ventricles) and end systolic and end diastolic volumes.
Name the instrument used to enter the coronary artery
# 11 blade / Potts coronary scissors
How are patients susceptible to ventricular fibrillation or ventricular tachycardia, surgically treated?
Implantable cardioverter defibrillator (ICD)
The ICD may be implanted through a thoracotomy or median sternotomy incision, although most are inserted transvenous lay. Describe the steps
Sensing leads are commonly placed in the right ventricle through a transvenous approach. Ventricular defibrillation leads are inserted into the heart transvenously and the generator is placed in the superficial tissue of the chest or abdominal wall. A sub canoes thoracic patch occasionally is used to optimize defibrillation.
______________ is reduced blood supply to tissue. _____________ may be a result of obstruction within the blood vessels or external pressure! which acts as a tourniquet. This causes ________________.
Slow heart rate/ below 40 to 60 per minute conduction discuss disease can arise from ischemic heart disease.
A malfunctioning pacemaker generator is replaced to produce continuos pacing, which is called a _______________.
Replacement of a pacemaker battery
A ____________________ incision is made to expose the heart and great vessels.
Cardioplegia is intentional stopping of the heart during cardiac surgery. This is achieved with a ________________, which often contains a mixture of potassium chloride, _________, dextrose, _____________, ____________, torment hamming, and ____________.
The left ventricle receives oxygenated blood from the ____________. From the left ventricle, the blood is pumped into the ___________ and the systemic circulation. The valves of the heart maintain one-way flow through the cardiac chambers.
A transverse incision is made in the inferior aortic wall during _________________ surgery.
Aortic value replacement
The mitral valve is situated between the _____________ and the ____________.
Left atrium Left ventricle
The surgeon then occluded the ascending aorta and inserts the ________________ for infusion of ____________ and venting of air.
Indwelling catheter Cardioplegic solution
Heart transplant may be performed in suitable patients with
End stage cardiac disease
Aneurysms can be classified as saccule or fusiform. A saccule aneurysm is a _______________________. A fusiform aneurysm _________________.
Ballooning out of localized area in the artery.
Involves the entire circumference of the artery.
Tachycardia is __________________ usually more than _______ beats per minute.
Fast heart rate 120
List the three layers of the wall of the heart
Epicardium Myocardium Endocardium
Median sternotomy incision
A partial of full midline incision is made through the sternum.
Large chambers that collect and expel blood received from the atrium toward the peripheral beds.
What does a pacemaker treat?
Correct cardiac arrhythmia caused by a disease of the conduction system.
Fogarty clamps is a vascular forcep used to
Clamping off vessels
Uncoordinated muscular activity in the heart muscle, which results in a " quivering" rather than a pumping action.
Abnormal heart rhythm that occurs in the atria of the heart. Associated with tachycardia
A slow heart rate, usually a heart rate under 60 beats per minute in a adult.
Rapid heart beat, that starts in the bottom chambers of the heart, called the ventricles.
Cardiac catheterization is an interventional radiology procedure and involves insertion of a cardiac catheter into the heart chambers and large vessels via a peripheral artery or vein.
Catheter that is injected to monitor the ejection fraction and end-systolic and end-diastolic volumes.
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