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Path midterm 2 > alterations in blood vessels > Flashcards

alterations in blood vessels Flashcards

1
Q

what are some conditions that affect blood pressure?

A
  • orthostatic hypotension

- hypertension

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2
Q

what are some conditions that affect atrial blood flow?

A
  • atherosclerosis
  • peripheral artery disease
  • arterial ulcers
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3
Q

what are some conditions that affect venous blood flow?

A
  • varicose veins / chronic venous insufficiency
  • venous stasis ulvers
  • deep vein thrombosis
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4
Q

what is blood pressure influenced by?

A
  • cardiac output
  • blood volume
  • effective contraction
  • size of arterioles (inverse)
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5
Q

what can hypotension be due to?

A
  • hemorrhage (less blood volume)
  • poor force of contraction
  • dilated blood vessels
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6
Q

what is orthostatic hypotension?

A

The drop in blood pressure with position change (sitting to standing or vise versa) bigger and more significant drop in pressure than normal feelings of dizziness after standing up (systolic drop of at least 20 mmhg)

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7
Q

causes of orthostatic hypotension?

A

-aging- elderly need to change position slowly (degeneration of normal mechanisms to help maintain blood pressure)
- drug induced: antihypertensive medications
-Bed rest- loose plasma volume when immobilized, loos venous tone: venous contraction pushes blood back to heart
-ANS dysfunction: spinal cord injuries, Parkinson’s disease have high risk for this
Manifestations: falling, fainting, dizziness

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8
Q

what is the prevalence of hypertension?

A

1 in 5 canadians

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9
Q

what is the definition of hypertension?

A

adults- higher than 140/90 mmhg
diabetes: higher than 135/85
Two types; primary or secondary

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10
Q

what are risk factors for primary hypertension?

A
  • heredity
  • genetics
  • ethnicity
  • gender (males = more common)
  • Alcohol consumption
  • obesity
  • high salt intake (where sodium goes, water follows)
  • ties in with insulin resistance
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11
Q

what percent of ppl with hypertension have primary hypertension?

A

92- 95 %

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12
Q

what is primary hypertension?

A 
increase in peripheral resistance ( the resistance of the arteries to blood flow. As the arteries constrict, the resistance increases) 
Caused by disfuction or dysregulation of: 
R-A-A-S
SNS
Natriuetic peptides (natural diruetic) 
inflammation 
obesity 
insulin resistance
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13
Q

what is secondary hypertension caused by?

A

caused by a systemic disease process that raises peripheral vascular resistance
ex,
renal disease
adrenal cortex tumors (secrete more ATCH)
Congential heart defects
medications eg, contraceptives (slight risk)

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14
Q

are there early symptoms of hypertension?

A

no, only can be determined by checking blood pressure

- a “silent” killer

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15
Q

manifestations of hypertension?

A 
-manifestations that occur are usually as a result of impact on target organs 
Brain: 
stroke (HUGE RISK) and dementia 
Heart: 
CAD
HF
kidney failure 
retinopathy / vison loss
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16
Q

tx of hypertension?

A

lifestyle modification:

  • Excercise
  • waist circumferance
  • alcohol
  • diet
  • sodium
  • stress management
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17
Q

what is vascular disease?

A

any factor affecting pressure, resistance, flow velocity, and or turbulence inside the artery or vein

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18
Q

examples of vascular disease?

A
  • blood clots
  • blood that is compressing blood vessels (blood outside of vessels (could be a cast that is too tight)
  • aneurism
  • spasm of blood vessels in extremities from disease (ex, raynauds disease)
  • artherosclerosis
  • perihperal venous disease
  • varicose veins
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19
Q

what is atherosclerosis?

A
  • atheromatous plaque: is an abnormal accumulation of material in the inner layer of the wall of an artery; it is present in the arteries of most adults.
  • systemic arterial disease
  • leasions occurin in large to medium sized arteries
  • narrowing of artery lumen (development of plaque)
  • can develop in peripheral arteries in legs, cornoary arteries of heart, and cerebral arteries in brain
20
Q

what can cause athersclerosis?

A
  • interactions of endothelial injury of the vascular wall due to smoking, hypertension, diabetes…
  • inflammation- free radicals
  • Dyslipidemia (abnormal levels of fat in blood) -genetics and diet cause this, but mostly due to genetics
21
Q

what is dyslipidemia?

A

-imbalance of serum lipoproteins (want low levels of low density (LDL) and high levels of high density lipoprotein (HDL))

22
Q

What is low density lipoprotein- cholesterol (LDL-c)

A
  • BAD cholesterol
  • genetic and dietary factors
  • fluffy light cholesterol
  • Elevated LDL is a strong risk factor for atherosclerosis
23
Q

what is high density lipoprotein -cholesterol? (HDL-c)

A

HDL-c is protective lipoprotein
GOOD cholesterol (sucks out extra cholesterol from blood stream and carries it back to liver)
-Cleans out arteries ton liver to be metastasize
-Genetic, dietary (avocados, almonds), and exercise factors

24
Q

how are fatty streaks (atherosclerosis) formed?

A

1) endothelium is injured, LDL enters injured endothelium
2) LDL oxidizes free radicals
3) Macrophages engulf oxidized LDL
4) They now turn into foam cells
5) build up of foam cells -> lipid pool, forms fatty streaks

25
Q

what are the 3 stages of atherosclerosis?

A

1) fatty streak
2) fiberous plaque
3) complicated lesion

26
Q

what are some modifiable risk factors for atherosclerosis?

A
  • smoking
  • hypertension
  • dyslipidemia
  • diabetes (contributes to epitherial injury / insulin resistance)
  • obesity
27
Q

what are some non modifiable risk factors of atherosclerosis?

A
  • age (older adults)
  • genetics
  • gender - estrogen is a protective factor until menopause, woman loss the advantage
  • ethnicity- african american
28
Q

what does atherosclerosis contribute/ a risk factor for?

A
  • peripheral artery disease
  • angina / MI
  • stroke
29
Q

what are some manifestations of atherosclerosis?

A
  • weak pulse, possibly absent
  • cyanotic, pallow, cool feet, numbness, pain in legs when walking
  • intermittent claudication (pain in legs with exercise)
30
Q

what are some complications of peripheral artery disease?

A

-arterial ulcer: round in shape, tends to have clean edges, deepish, accompanied by cool feet (as circulation to the extremities gets worse, amputations may have to occur

31
Q

what would happen if u elevated the legs of a person who has peripheral artery disease?

A

-makes it worse (now blood flow will have to go uphill, these ppl have better blood flow standing up)

32
Q

what are some disease of the veins?

A
  • varicoe veins -> venois insufficieny -> venous stasis ulcers
    deep vein thrombosis (DVT)
33
Q

what is varicose veins?

A

a vein in which blood has pooled

  • distending, tortuous, and palpable veins
  • CAN lead to chronic venous insufficiency
34
Q

what is varicose vein caused by?

A

-caused by age, genetics, trauma, or prolonged retorgraed pressure (standing for long perids of time, causes pressure in veins, which contributes to distension in veins) pregnancy imparis blood flow in legs

35
Q

Tx for varicose veins?

A
  • elevating legs, avoid standing
  • compression stockings
  • sclerotherapy (injestion that blocks off vein / laser)
  • surgery- called stripping of vein, they take out the vein
36
Q

what is chronic venous insufficiency?

A
  • inadequate venous return over a long period due to varicose veins or valvular incompetence
  • can lead to venous stasis ulcers
37
Q

what are venous stasis ulcers?

A

-irregular edges, shallow, irregular shape, surrounded by blackish blueish coloration

38
Q

would elevating the legs help someone with venous insufficiency?

A

yes, helps get blood out of legs and back to heart

-wearing compression stockings will aslo help along with increasing exercise

39
Q

what is deep vein thrombosis? (DVT)

A
  • also known as venous thromboembolism
  • is a clot, in deep vein of the legs
  • primarly in lower extremities
40
Q

Fro DVT, what is virchows triad of risk factors?

A
  • stasis of blood flow- mobiliy complications
  • vessel wall injury ( orthopedic surgery to knees or hip, gential surgery interfers with big vein. these ppl are at higher risk)
  • hypercoagulability- disoders or meds that make us prone to clots, dehydration (thicker blood = increased coagulation)
41
Q

what is untreated DVT associated with?

A

associated with a high risk of embolization

  • an embolus is a piece of blood clot that breaks off an causes a blockage of blood low
  • it can go to the heart, or lungs (gets catch in pulmonary arteries= blockage of flow to lungs. dead space (effects oxygenation) = pulmonary embolus. can die from this
42
Q

what does a pulmonary embolus commonarly occur secondary to?

A

a clot in the deep veins of the legs (DVT)

  • Can also be due to the tissue fragments, fat, or air
  • this can affects oxygenation because of deadspace- effects O2 exchange
43
Q

what prevention of DVT / pulmonary embolus is available?

A
  • ambulation
  • anti-embolic stockings
  • pneumatic stockings
  • prophylactic anticoagulation
  • keep pt up and moving
44
Q

what can interruption of blood flow in arteies and or veins lead to?

A
  • hypoxia, decreased nutrients, and decreased removal of wastes
45
Q

what can lead to interruption of blood flow?

A

-obstruction, structural changes in vessel walls, trauma and disruption of intrinsic regulation mechanisms

Path midterm 2 (13 decks)

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