Cardiopulm day I

• Arterial Blood Gas (ABG)

  • evaluate acid-base status (pH), ventilation (PaCO2), and oxygenation of arterial blood (PaO2)
  • PaO2 and SaO2 provide info about how well the lungs are functioning to oxygenate the blood
  • PaCO2 provides info on how well the lungs are able to remove CO2
  • Changes in PaO2 directly affect the balance of pH since imbalances can lead to convulsions or comas
  • Blood pH imbalance can cause convulsions or comba
  • Bicarbonate (HCO3-) is an important component of the chemical buffering system that keeps the blood from becoming too acidic or basic
• Normal Values

  • pH: 7.4 (7.35-7.45)
  • PaCO2: 40 mm Hg (35-45)
  • PaO2: 97 mm Hg (80-100)
  • HCO3-: 24 mEq/L (22-26)
  • SaO2: 95-98%
  • Hemoglobin for women: 12.0-15.8 gm/dL
  • Hemoglobin for men: 13.3-16.2 gm/dL
• Respiratory Alkalosis


  CO2 is low, high pH (alkalemia), inspiration is lower, expiration is higher, tachypnea, tachycardia, hyperventilation, and dizziness
• Respiratory Acidosis


  CO2 is high, low pH (acidemia), hyperventilating prevents adequate removal of CO2 from the body causing hypercapnia, cannot catch their breath, headaches, drowsiness, expiring more than inspiring, pursed lip breathing, cyanosis
• Metabolic Alkalosis

  • increase in bicarbonate accumulation or an abnormal loss of acids
  • pH rises above 7.45
  • occurs when there is continuous vomiting, hypokalemia, or nasogastric suctioning
  • Sx: nausea, diarrhea, prolonged vomiting, confusion, muscle cramping, paresthesias, hypoventilation, if left untreated lead to coma, seizures, and respiratory paralysis
• Metabolic Acidosis

  • accumulation of acids due to an acid gain or bicarbonate loss
  • pH drops below 7.35
  • occurs with conditions such as renal failure, lactic acidosis, starvation, severe diarrhea, or poisoning
  • Sx: hyperventilation, vomiting, diarrhea, headache, weakness, hyperkalemia, and cardiac arrhythmias, if left untreated can induce coma
• Apex 


  lowest part of the heart, anterior and left of the 5th intercostal space and left midclavicular line
• Base


  Upper border of the heart involving the left atrium, part of the right atrium, and the proximal portions of the great vessels, lies below the second rib at the level of the second intercostal space
• Endocardium


  endothelial tissue that lines the interior of the heart chambers and valves
• Epicardium


  serous layer of the pericardium; contains epicardial coronary arteries and veins, autonomic nerves, and lymphatics
• Myocardium


  thick contractile middle layer of muscle cells that forms the bulk of the heart wall
• Pericardium


  double-walled connective tissue sac that surrounds the outside of the heart and great vessels
• Aorta

  • body's largest artery
  • central conduit of blood from the heart to the body
  • begins at the upper part of the left ventricle, arches backward and to the left, descends within the thorax, and passes into abdominal cavity
• Superior vena cava


  vein that returns venous blood from the head, neck, and arms to the right atrium
• Inferior vena cava


  vein that returns venous blood from the lower body and viscera to the right atrium
• Pulmonary veins


  veins that carry oxygenated blood from the right and left lungs to the left atrium
• Pulmonary Arteries


  arteries that carry deoxygenated blood from the right ventricle to the left and right lungs
• SA Node


  normal pacemaker of the heart
• Chambers of the Heart - Blood Flow

  • Superior and inferior vena cava into the right atrium
  • Right atrium (RA) through the tricuspid valve to the right ventricle
  • RA through the pulmonic valve to the pulmonary artery and the lungs
  • Lungs to the left atrium (LA) and passes through the mitral valve into the left ventricle 
  • Blood within the left ventricle through the aortic valve through the aorta and out the body