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23 General Pathology > 10/16 - Pathology of the Heart > Flashcards

10/16 - Pathology of the Heart Flashcards

1
Q

normal heart weights what percent of body weight? g in females and males

A

0.4% 0.5%

250-320 g in females
300-360 g in males

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2
Q

what is increased heart weight or ventricular thickness

A

hypertrophy

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3
Q

what is enlarged heart chambers

A

dilation

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4
Q

what is increased heart weight or thickness or enlarged heart chambers

A

cardiomegaly

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5
Q

what is main function of heart

A

pumping of blood

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6
Q

how does pumping function of heart occur

A
  1. coordinated contraction (during systole)
  2. coordinated relaxation (during diastole) of cardiac myocytes of myocardium
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7
Q

how is contraction achieved

A

shortening of serial contractile elements (sarcomeres) within parallel myofibrils

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8
Q

what is the other function of heart instead of being primarily pump

A

endocrine function

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9
Q

what are released from heart in response to increased stretch? what does this result in?

A

release protein hormones
1. promotes vasodilation
2. stimulate renal salt and water elimination

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10
Q

what are the heart valves

A

4: tricuspid, pulmonary, mitral, and aortic

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11
Q

what maintain unidirectional flow in heart

A

heart valves

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12
Q

valve function depends on what

A
  1. mobility
  2. pliability
  3. structural integrity

of AV vavlves of cusps of semilunar valives

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13
Q

cardiac valves are lined by what

A

endothelium

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14
Q

what is part of the conductin system

A
  1. SA node pacemaker
  2. AV node
  3. AV bundle (bundle of His)
  4. right and left bundle branch divisions
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15
Q

what is at the junction of R atrial appendage and SVC

A

SA node

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16
Q

what is located at right atrium along interatrial septum

A

AV node

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17
Q

what connects the right atrium to the ventricular septum

A

AV bundle (bundle of His)

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18
Q

what stimulates respective ventricles via further arborization into Purkinje network

A

right and left bundle branch divisions

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19
Q

Cardiac myocytes rely almost exclusively on ___ for their energy needs

A

oxidative phosphorylation

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20
Q

how does blood supply maintain energy

A
  1. high density of mitchondria
  2. constant supply of oxygenated blood
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21
Q

is the myocardium extremely vulnerable to ischemia

A

yes

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22
Q

nutrients and oxygen are delivered t the heart via what

A

coronary arteries with ostia immediately distal to aortic valve

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23
Q

does the myocardium of mammals have very LOW or HIGH replicative potential after fetal and neonatal live

A

LOW

24
Q

myocardium of mammals average ___% cardiomyocytes turnover per year in adult humans

A

less than 1%

so has very low capacity of regeneration

25
Q

more forms of heart disease become more prevalent when

A

with each advancing decade

26
Q

the size of ___ is reduced in later life in heart

A

left ventricular capacity (particularly in base to apex dimension)

27
Q

reduced size of left ventricle is exacerbated by what

A

HT as basal ventricular septum protrudes into left ventricular outflow tract (so called sigmoid septum)

28
Q

compared to younger myocardium, an elderly heart as waht

A
  1. Fewer myocytes
  2. Deposition of extracellular amyloid that stiffens the heart
29
Q

what is a condition in which a heart cannot pump blood to adequately meet the metabolic demands of the peripheral tissues, or can do so only at elevated filling pressures

A

heart failure (CHF)

30
Q

what is the common end stage of many forms of chronic heart diseases

A

CHF

31
Q

are adaptive mechanisms capable of maintaining adequate cardiac capacity?

A

yes it can potentially maintain, but can ultimately be OVERWHELMED

32
Q

what is increased filling volume that dilates the heart and increases contractivity and stroke volume

A

Frank-Starling mechanisms

33
Q

what is the released of norepinephrine, activation of renin-angiotensin-aldoesterone? basically the kidneys are attemptin to help heart function

A

activation of neurohumoral system

34
Q

how can the heart be overwhelmed

A
  1. Frank-Starling mech
  2. acivation of neurohumoral system
  3. myocardial adaptations
35
Q

heart failure can result from what

A
  1. systolic dysufnction
  2. diastolic dysfunction
36
Q

what is the deterioration of myocardial contractile dysfunction? examples?

A

systolic dysfunction
e.g., HT, valvular disease

37
Q

what is the inability of heart chambers to expand? examples?

A

diastolic dysfunction
e.g., myocardial fibrosis, amyloid deposition, constrictive pericarditis

38
Q

left sided heart failure = ___ failure

A

LUNG failure

39
Q

what is left sided heart failure most often caused by

A
  1. Ishemic heart disease (IHD) (coronary a)
  2. Hypertension (other artieries have HT)
  3. Aortic and mitral valvular disease (heart)
  4. primary myocardial disease (heart)
40
Q

clinical and morphologic effects of left sided CHF are consequence of what

A
  1. Passive congestion (blood-backing up) in the pulmonary circulation
  2. Stasis of blood in the left-sided chamber
  3. Inadequate perfusion of down stream tissue leading to organ dysfunction
41
Q

what is the most commonly affeted organ in LHF

A

heavy wet lungs (pulmonary congestion)

42
Q

what does pulmonary congestion lead to

A
  1. dyspnea
  2. orthopenea
  3. paoxysmal noctural dyspnea
43
Q

clinical signs of LS-CHF

A
  1. dyspenea
  2. orthopnea
  3. pulmonary edema
  4. pleural effuction
  5. fatigue, tachycardia
44
Q

what is breathlesness

A

dyspnea

45
Q

what is dyspnea while lying down

A

orthopnea

46
Q

what is buildup of fluid in lungs

A

pulmonary edema

47
Q

what is buildup of fluid in tissues lining the lungs

A

pleural effusion

48
Q

what most commonly causes RIGHT sided heart fialure

A

left sided heart failure

49
Q

T/F: Any increase in pressure on the left side of the heart inevitably burdens the right side of the heart

A

TRUE

50
Q

in right sided heart failure, are clinical features the same as left sided CHF?

A

YES

51
Q

are isolated right sided CHF frequent? who does this occur in?

A

INFREQUENT!

Occurs in patients with one of
variety of disorders affecting the lungs;
hence often called cor pulmonale

52
Q

what are clinical signs of RS-CHF

A
  1. Systemic venous congestion
  2. Soft tissue edema
  3. Distended neck veins
  4. Enlarged liver
  5. Increased deep vein thromboses/pulmonary emboli
53
Q

what is the ISOLATED right side of the heat to fail due to lung pathology

A

Cord Pulmonale

54
Q

causes of cor pulmonale? most common cause?

A
  1. Pulmonary hypertension (most common cause)
  2. Scleroderma (damages lungs)
  3. COPD
  4. Cystic fibrosis
  5. Severe bronchiectasis
  6. Obstructive sleep apnea
  7. Idiopathic
55
Q

CHF tx

A
  1. focus on correcting underlying cause (valvular defect or inadequate cardiac perfusion)
  2. salt restriction
  3. pharmacological agents
56
Q

pharmacological agents for CHF tx

A
  1. diuretics (reduce volume overload)
  2. positive inotropes (increase cardiac contractibility)
  3. ACE-inhibitors
57
Q

even if you treat CHF does it remains a serious cause of morbidity and mortality

A

yes

23 General Pathology (24 decks)

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