Alterations Of Cardiovascular Function 2

Question 1

Systole is?

Answer 1

Ventricle contracts and pumps blood into arteries

Question 2

Diastole is?

Answer 2

Ventricles relax and fill

Question 3

Stroke volume

Answer 3

Blood ejected from ventricle with each contraction

Question 4

Ejection fraction

Answer 4

Stroke volume/diastolic volume

Question 5

Cardiac output

Answer 5

Stroke volume X heart rate

Question 6

RV

Answer 6

Residual volume

Question 7

Preload and what factor affects it

Answer 7

End diastolic pressure.

Changes in volume affect preload

Question 8

After load is and what affects it?

Answer 8

Resistance in the arteries

Pressures in aorta or pulmonary arteries

Question 9

Heart valve disorders

Answer 9

Valve regurgitation

Valve stenosis

Question 10

Valve regurgitation is when? And common causes are?

Answer 10

Valve leaflets do not close completely

Congenital heart defects
Rheumatic fever
Bacterial endocarditis

Question 11

Valve stenosis is what and common causes?

Answer 11

Narrowing. Calcified leaflets dont close completely

Congenital heart defects
Atherosclerosis
Rhuematic fever

Question 12

Aortic valve regurgitation

Answer 12

diastole

Question 13

Mitral valve regurgitation

Answer 13

systole

Question 14

Aortic valve stenosis

Answer 14

systole

Question 15

Mitral valve stenosis

Answer 15

diastole

Question 16

What is heart failure

Answer 16

The inability of heart to maintain adequate circulatory volume and pressure measured by reduced CO and EF

Question 17

Types of heart failure

Answer 17

Systolic dysfunction (inability of contraction resulting in decreased EF and increased LV end diastolic volume)

Diastolic dysfunction (leads to decreased cardiac output)

Left ventricular failure

Right ventricular failure

Acute heart failure

Chronic heart failure

Question 18

Left ventricular failure patho

Answer 18

LV is unable to generate SV and CO
Increased residual volumes in LV
Causes an increased in LV preload and dilation
Pressure backs up to LA and PV
Increase in pressure in pulmonary caps lead to pulmonary edema

Question 19

Why is fluid overload a concern with individuals with LVF?

Answer 19

Causes and increase in BV which causes dilation

More fluid means cap pressure goes up contributing to the edema

Question 20

Decrease in cardiac output leads to a decrease in arterial BP which activates:

Answer 20

Sympathetic (alpha and beta)

Renal compensation (renin angiotensin aldosterone system)

Question 21

Angiotensin 2 does what?

Answer 21

Vasoconstriction of systemic arteries

Question 22

Aldosterone does what?

Answer 22

Increase sodium and water reabsorption by kidneys

Question 23

Increased B type natriuretic peptide BNP secretion is stimulated by? And does what? and is what?

Answer 23

Stimulated by ventricular contraction

Increased LV residual volume/preload
Renal retention of fluid

*elevate BNP is a lab indicator of heart failure

Question 24

Detrimental affects of long term exposure to compensatory hormones

Answer 24

Exposure to catecholamines, angiotensin 2, leads to long term cardiac injury

Question 25

Clinical consequences of LVF related to sympathetic nervous system

Answer 25

tachycardia, cool extremities

Question 26

Clinical consequences of LVF related to renal compensation

Answer 26

Decreased urine output | Are retaining fluid

Question 27

Clinical consequences of LVF related to hypotension

Answer 27

Low BP | Signs of organ hypoxia and failure (brain, renal, intestines)

Question 28

Clinical consequences of LVF related to pulmonary edema

Answer 28

``` Hypoxemia Tachypnea (rapid breathing) Dyspnea Auscultation of respiratory crackles Cough ```

Question 29

Patho of LVF, systolic dysfunction

Answer 29

Myocardial ischemia from atherosclerosis in coronary arteries

Question 30

Patho of LVF, diastolic dysfunction

Answer 30

Systemic Hypertension- Increase in arterial BP leads to increase in LV afterload which leads to myocardial hypertrophy which leads to an increase in wall thickness which leads to a decrease in ventricle compliance which leads to an increase in filling volumes which leads to diastolic dysfunction Myocardial infarction Constructive pericarditis- inflammation of pericardial sac Hypertrophic obstructive cardiomyopathy- gene mutations causing abnormal thickening of ventricular wall and septum (usually need heart transplant)

Question 31

Patho of LVF, limited ventricular filling

Answer 31

Mitral stenosis Reduces BF from LA to LV during diastole Atrium starts to dilate

Question 32

Patho of LVF, volume overload and causes of

Answer 32

Causes: renal failure, IV fluid admin, failure to take diuretics Increased BP leads to increased preload which leads to ventricular dilation which leads to “failure”