2E

Question 1

What two major variables affect the blood flow thru arteries?

Answer 1

pressure and resistance. Q(flow)=^P/R

Question 2

What is the major influence on resistance?

Answer 2

Radius of the artery

Question 3

What does vasodilation do to resistance and flow?

Answer 3

Decreases resistance and increases flow

Question 4

What does vasoconstriction do to resistance and flow?

Answer 4

Increases resistance and decreases flow

Question 5

Where is the entire blood supply to the myocardium derived from?

Answer 5

R & L coronary arteries

Question 6

How much of the resting cardiac output does the heart receive?

Answer 6

5%

Question 7

What two branches come off of the RCA?

Answer 7

Right Marginal and Posterior Descending

Question 8

What two branches come off of the LCA?

Answer 8

Circumflex and Left Anterior Descending

Question 9

Which is longer the RCA or the LCA?

Answer 9

RCA

Question 10

How many main coronary branches are there?

Answer 10

6 big coronary branches

Question 11

What is the main force that drives blood thru the coronary vessels?

Answer 11

Aortic pressure

Question 12

What does the dichrotic notch help to facilitate?

Answer 12

Coronary blood flow (CBF)

Question 13

Changes in what cause major changes in CBF?

Answer 13

Coronary resistance

Question 14

What are the two types of normal factors that influence coronary resistance?

Answer 14

Neural and metabolic (adenosine, O2, CO2, K+, H+)

Question 15

What is ischemia?

Answer 15

poor blood flow

Question 16

Ischemic Heart Disease (IHD) is due to in imbalance in what?

Answer 16

Imbalance between supply and demand of oxygen, ie demand > suppy

Question 17

What are the three main factors in the physiology of decreased blood supply?

Answer 17

Hemodynamic - increased resistance in coronary arteries or hypotension
Cardiac - valve disease or increased heart rate
Hematologic - anemias and poisons

Question 18

What are the three major factors of the physiology of increased demand?

Answer 18

Myocardial hypertrophy
Overcoming excessive preload
Overcoming excessive afterload

Question 19

What is the cause of IHD in most cases?

Answer 19

Atherosclerotic narrowing of the coronary arteries

Question 20

The frequency of IHD is increased in patients who manifest which syndrome?

Answer 20

Metabolic syndrome

Question 21

What is Angina Pectoris?

Answer 21

episodic chest pain caused by inadequate oxygenation of the myocardium

Question 22

What is classic angina?

Answer 22

atheresclerotic disease that produces fixed obstruction of the coronary arteries - when metabolic needs of myocardium exceed the ability of the occluded coronary arteries to deliver adequate blood flow

Question 23

What is variant angina caused by?

Answer 23

spasms of the coronary arteries - in most cases it is present along with coronary artery stenosis

Question 24

What is the major difference of classic and variant angina?

Answer 24

Classic angina occurs with exertion or stress. Variant angina occurs during rest, with minimal exercise or nocturnally

Question 25

What is unstable angina?

Answer 25

a clinical syndrome of myocardial ischemia that falls between stable angina and MI.

Question 26

What is the difference b/w classic angina and unstable angina?

Answer 26

Classic angina is caused by a fixed obstruction and unstable angina is caused by atherosclerotic plaque disruption

Question 27

Why is unstable angina also referred to as pre-infarction angina?

Answer 27

As the plaques are disrupted they cause a tiny hemorrhage that begins to form a clot and can completely occlude the blood vessel and cause an MI

Question 28

What are the two distinct patterns of myocardial ischemic necrosis?

Answer 28

Transmural and subendocardial infarction

Question 29

What is transmural infarction?

Answer 29

It traverses the entire ventricular wall from the endocardium to the epicardium

Question 30

What is subendocardial infarction?

Answer 30

Limited to the interior one-third of the wall of the ventricle

Question 31

What is the most common cause of death in the first several hours following infarction?

Answer 31

Arrhythmia

Question 32

What can myocardial failure lead to?

Answer 32

congestive heart failure and/or shock

Question 33

What is myocardial rupture?

Answer 33

a catastrophic complication of MI that usually occurs within the first 4-7 days and may result in death from cardiac temponade

Question 34

What is cardiac tamponade?

Answer 34

compression of the heart by hemorrhage into the pericardial space

Question 35

What is mural thrombosis?

Answer 35

A thrombus (clot) formation on the endocardium overlying the infarct

Question 36

What is PTCA (percutaneous transluminal coronary angioplasty)?

Answer 36

A revascularization technique that sends a deflated balloon on a catheter to the blockage site and then inflates the balloon to crush the blockage

Question 37

What is CABG (coronary artery bypass grafting)?

Answer 37

A bypass graft from the aortic arch to one of the coronary arteries beyond the blockage

Question 38

What is the etiology of heart failure?

Answer 38

Anything that "taxes" the heart to the point where cardiac output (CO) is consistently decreased.

Question 39

What is pressure overload caused by?

Answer 39

Pulmonary hypertension (RV) and systemic hypertension (LV)

Question 40

What is volume overload caused by?

Answer 40

Valvular insuffiency

Question 41

What can cause decreased cardiac contractility?

Answer 41

Cardiomyopathies and myocarditis

Question 42

What can cause diminished filling?

Answer 42

pericarditis and cardiac tamponade

Question 43

What is the result of LV heart failure?

Answer 43

Dyspnea (labored breathing) and orthopnea (shortness of breath) as a result of pulmonary congestion/edema. can lead to cyanosis

Question 44

What is the result of RV heart failure?

Answer 44

Systemic edema and systemic venous distention that could lead to hepatomegaly, splenomegaly, ascites, peripheral edema, and jugular vein distention