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Pathophysiology > 15 Alterations in Blood Flow > Flashcards

15 Alterations in Blood Flow Flashcards

1
Q

5 types of obstruction that cause altered flow

A 
1 arteriosclerosis/atherosclerosis
2 inflammation
3 vasospasm
4 thrombi/emboli
5 acute occlusion
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2
Q

2 types of mechanical alterations that cause altered flow

A

1 arteriovenous fistulas (arteriovenous malformation)

2 aneurysm

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3
Q

effects of reduction in flow

A 
*impairs ability to transport gases + nutrients to body tissues
1 hypoxia
2 ischemia
3 venous engorgement
4 venous obstruction
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4
Q

Obstructions in BLOOD VESSELS

effects

A
  • reduced flow beyond the obstruction

- increased pressure before the obstruction

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5
Q

Obstructions in BLOOD VESSELS

arterial vs venous system manifestation

A

A: distal ischemia

V: edema

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6
Q

Thrombus

A

stationary blood clot formed w/in a vessel or chamber of heart

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7
Q

Thrombosis

treatment

A

1 anticoagulant therapy
2 thrombolytic drugs
3 surgery to remove thrombus

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8
Q

anticoagulant therapy

A
  • used to prevent clot enlargement

- blood thinner

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9
Q

Embolus aka Thromboembolus

A
  • traveling clot

- -material that forms a clot w/in the bloodstream

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10
Q

embolus leaving L ventricle

A

ISCHEMIC STROKE

  • differ depending on brain area affected
  • loss of cogntv functn, motor changes, diff levels of sensory loss
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11
Q

embolus leaving R ventricle

A

PULMONARY EMBOLUS

  • vague, nonspecific
  • most common: sudden onset of shortness of breath, inc resp rate, chest pain, sudden death
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12
Q

Other causes of Emboli

A 
1 fat
2 malignant neoplasm/tumor
3 collection of bacteria/infectious exudate
4 air
5 amniotic fluid
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13
Q

Embolus

treatment

A

1 Embolectomy

2 filter in inferior vena cava

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14
Q

Artetiosclerosis/Atherosclerosis

A

hardening + narrowing in medium + large sized arteries

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15
Q

lipoprotein

A

soluble protein that combines/transports fat in plasma

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16
Q

PDGF

A

platelet-derived growth factor

  • released by aggregation of platelets
  • stimulated the growth of smooth muscles
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17
Q

Foam Cells

A

lipid-filled macrophages

  • macrophage engulf lipids turning into FOAM CELLS
  • -release inflammatory mediators (attract more leukocytes) + growth factors (stim smooth muscle proliferation)
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18
Q

Arteriosclerosis/Atherosclerosis

Process

A

1 initiated by ENDOTHELIAL SURFACE DAMAGE to arterial intima
-initiates inflammatory respns + inc vessel wall permeability
2 LOW-DENSITY LIPOPROTEINS breach intimal layer
–leukocytes + endothelial cells oxidize lipids
3 oxidized lipids are damaging to endothelial + smooth muscle cells
–stim recruit of macrophage
4 platelet aggregate + release PDGF
–stim growth of smooth muscles
5 TUNICA MEDIA SMOOTH MUSCLE CELLS move to intima where they proliferate + HARDEN
6 MACROPHAGE engulf lipids; FOAM CELLS release inflammatory mediators + GF
–attract more leukocytes + stim smooth muscle growth
7 excess lipid + debris accumulate w/in vessel wall + coalesce into lipid core (NARROWING)

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19
Q

what causes the “hardening” + “narrowing” in Arteriosclerosis/Atherosclerosis

A

HARD: when tunica media smooth muscles move inwards to intima where they proliferate and harden

NARROW: excess lipid + debris accumulate w/in vessel wall + coalesce into lipid core

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20
Q

Arteriosclerosis/Atherosclerosis can lead to…

A 
1 hypertension
2 cardiac CAD + renal disease
3 peripheral arterial disease
4 stroke
5 myocardial infarction
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21
Q

Atherosclerosis Plaque

A
  • causes narrowing
  • slowly enlarge> orifice or artery decreases +perfusion diminished
  • primarily composed of smooth muscle cells, epithelium, blood clot, lipoprotein, + inflammatory debris
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22
Q

perfusion

A

passage of blood/fluid through vessels

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23
Q

NONmodifiable risk factors of Arteriosclerosis/Atherosclerosis

A
  • age
  • gender
  • ethnicity
  • fam history of CAD
24
Q

Modifiable risk factors of Arteriosclerosis/Atherosclerosis

A

1 Phys activity
2 Stress + Mental Health
3 Tobacco
4 Hypertension
5 Cholesterol, Lipoprotein, Triglycerides
6 Glucose Intolerance/Metabolic Syndrome, + Diabetes
7 Obesity

25
Q

physical activity as treatment/prevention for Arteriosclerosis/Atherosclerosis

A

INC: HDL lvl, collateral circ, vessel size

DEC: tot cholesterol lvl, glucose intolerance, body weight, + BP

26
Q

stress + mental health for Arteriosclerosis/Atherosclerosis

A

stress + depression increase risk

27
Q

tobacco on Arteriosclerosis/Atherosclerosis

A

-injures epithelium
INC: LDL, cholesterol, triglycerides, platelet aggregation, BP + heart rate, risk of coronary heart disease [CHD]

DEC: HDL

28
Q

hypertension on Arteriosclerosis/Atherosclerosis

A

hypertension increases risk

29
Q

Cholesterol on Arteriosclerosis/Atherosclerosis

A

excess cholesterol acts as irritant causing PLAQUE formation

30
Q

Lipoproteins on Arteriosclerosis/Atherosclerosis

A

high levels of LDL promotes atherosclerosis

high levels of HDL inhibits

31
Q

Glucose Intolerance/Metabolic Syndrome, + Diabetes on Arteriosclerosis/Atherosclerosis

A

increases risk of Arteriosclerosis/Atherosclerosis

32
Q

Obesity on Arteriosclerosis/Atherosclerosis

A

ACCELERATES atherosclerotic process

33
Q

Raynaud Syndrome

A

extreme vasoconstriction producing cessation of flow to fingers + toes
-color changes like cyanosis or red due to hyperemia, pain, numbness, cold trigger attacks

34
Q

cyanosis

A

white/blue discoloration of skin fr poor circulation or lack of oxygen

35
Q

hyperemia

A

excess of blood in vessels supplying an organ or part of body
-red

36
Q

Aneurysm

A

localized arterial dilation, bulge outward

  • frequently found in cerebral circulation + thoracic + abdominal aorta
  • classified as true or false aneurysms
37
Q

true aneurysms

A

SACCULAR: one-sided balloon

FUSIFORM: both sides balloon out

BERRY: balloon has stem/neck

38
Q

Aneurysm

clinical manifestations

A

AORTIC: sudden severe tearing pain, radiates into back/abdomen, shock

CEREBRAL: increasing intracranial pressure, hemorrhaging stroke

39
Q

Aneurysm

tests

A

AORTIC: CT, MRI, cerebral angiography

CEREBRAL: CT, TEE

40
Q

Acute Arterial Occlusion

A

absence of arterial circulation-emergency

-may result fr thrombi/emboli or mechanical compressin

41
Q

Acute Arterial Occlusion

classic signs + symptoms

A 
1 pallor
2 paresthesia
3 paralysis
4 pain
5 polar
6 pulseless
42
Q

Acute Arterial Occlusion

treatment

A 
medical + surgical
1 loosen tight dressing
2 cut cast
3 anticoagulant therapy
4 thrombolytic therapy
5 bypass surgery
6 embolectomy
7 amputation
43
Q

4 alterations to ARTERIAL flow

A 
1 Arteriosclerosis/Atherosclerosis (obstruction)
2 Raynaud Syndrome
3 Aneurysm (mechanical alteration)
4 Acute Arterial Occlusion (obstruction)
44
Q

3 Alterations in VENOUS Flow

A

1 Varicose Veins
2 Chronic Venous Insufficiency
3 Deep Vein Thrombosis

45
Q

alterations to venous flow are usually accompanied by…

A

edema
venous stasis ulcers
pain

46
Q

life-threatening type of alteration to venous blood flow

A

Deep vein thrombosis

47
Q

valvular incompetence

cause + manifestations

A
  • overstretching valves owing to excessive venous pressures resulting in backflow of blood
  • obesity, pregnancy, RT heart failure, prolonged standing

-results in Venous insufficiency + varicose veins

48
Q

valvular incompetence

treatment

A
  • smoking cessation
  • reg walk/exercise
  • drugs that interfere w platelet aggregation
49
Q

Varicose Veins

A

impaired venous returns results in superficial darkened, raised, tortuous veins

50
Q

most common vein affected by varicose

A

Greater Saphenous Vein

51
Q

Varicose Veins

treatment

A
  • increase venous flow + reduce venous pressure
  • sclerotherapy + surgical interventions for severe cases
  • elevate legs, avoid standing, elastic stockings
  • vein stripping + vein ligation
52
Q

Chronic Venous Insufficiency

A
  • results when valvular incompetence involves DEEP veins

- venous stasis ulcers are typically present, skin turns brown

53
Q

Chronic Venous Insufficiency

evaluation + treatment

A
  • ultrasound is best method for evaluation

treatment: compression therapy + infection control

54
Q

Deep Vein Thrombosis

A
  • due to thrombus in a deep vein in lower extremity

- may be asymptomatic

55
Q

Deep Vein Thrombosis

risk factor + treatment

A
  • previous DVT is a risk factor for further hypercoagulation

- treated aggressively w Anticoagulation therapy

56
Q

thrombus vs emboli

A

thrombus is a blood clot

emboli is a traveling clot

Pathophysiology (32 decks)

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