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Cardiopulmonary Physiology > Atherosclerosis > Flashcards

Atherosclerosis Flashcards

1
Q

What is atherosclerosis?

A

Build up and deposition of fatty plaques in the vessel’s inner walls.

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2
Q

Name 3 variations of Atherosclerotic disease that affect differing areas of the body?

A

Coronary Disease, Cerebrovascular Disease, Peripheral Arterial Disease

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3
Q

What is the number one cause of death worldwide?

A

Heart disease

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4
Q

Name some cardiovascular risk factors

A 
Cigarette Smoking
Abnormal Lipid Levels
Hypertension
Diabetes
Obesity
Stress
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5
Q

Name some cardioprotective factors

A

Fruit/Veggies
Exercise
Moderate Alchohol (Red Wine)

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6
Q

Physical measures of cardiovascular risk factors include 5 measures..

A

BMI, waist circum, BP, HR, Blood Test (Lipid Levels)

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7
Q

What contributes MOST to acute myocardial infarction?

A

Abnormal Lipid levels and smoking

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8
Q

What is the major difference between NSTEMI and STEMI

A

STEMI has full occlusion of an artery, while NSTEMI is a partial occlusion of an artery

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9
Q

Is artherosclerosis an acute or progressive disease?

What are the consequences of having it?

A

Progressive

Narrow diameter of vessel
Blockage
Stiffness (not as reactive)

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10
Q

Name 3 layers of the arterial walls ( Outside to inside order)

A

Tunica adventitia (collagen) –> Tunica Media (Smooth Muscle) –> Tunica Intima (Endothelium lining lumen)

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11
Q

Initial process of artherosclerosis has excess levels of what penetrate blood vessels, becoming trapped?

A

LDL

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12
Q

As LDL is trapped, what happens to it?

A

It oxidizes, releasing anions

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13
Q

Macrophages consume oxidized LDL, creating what kind of cell?

A

Foam Cell. Indicator of high cholesterol levels

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14
Q

Macrophages were previously what type of cell before chemical and adhesion factors attracted them?

A

Monocytes

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15
Q

Foam cells hold primarily what?

A

Free cholesterol

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16
Q

What does the smooth muscle do to foam cells and lipids?

A

Engulfs it, creating a fibrofatty atheroma in the vessel

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17
Q

What is the difference between a stable plaque and an unstable plaque?

A

Stable plaque has a thick cap and smaller fatty core. Is the primary cause of hardened and narrowed arteries.

Unstable plaque has thin cap with LARGE fat core, more likely to rupture –> heart attack or stroke possibility

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18
Q

When does myocardial perfusion occur?

A

During muscle relaxation (diastole)

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19
Q

What is ischemia?

A

Imbalance of supply and demand of O2

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20
Q

What results from increased myocardial demand?

A

Increase HR, Increased Contractile state, Increased systolic tension (HTN, Cold)

21
Q

What are some gender specific symptoms of chest pain in males?

A

Crushing Pain, Elephant on Chest feeling, Nausea, Left arm pain, Jaw pain

22
Q

What are some gender specific symptoms of chest pains in women?

A

Nausea/Vomiting, Fatigue, Anxiety, mid back tightness and discomfort

23
Q

Stable angina is what?

A

Chest pain associated with increase in physical activity, relieved by rest.

Substernal chest pain radiating to elbow.

Crushing pain, or pressure feeling.
PREDICTABLE!

24
Q

Define Rate Pressure Product

A

Myocardial oxygen consumption (O2 demand of heart)

25
Q

What is the formula for Rate Pressure Product (RPP)?

A

HR x SBP

EX: 70 x 100 = 7000 RPP

26
Q

Unstable Angina occurs when?

A

Randomly, without pattern.

@ rest
@ lower level of exercise than usual
@ varying patterns of activity

Blood pressure decreases with same amount of activity

27
Q

What can happen to tissues if the supply of O2 does not meet the O2 demands?

A

Death of myocardial tissue

28
Q

What is myocardial infarction and what does it result in?

A

Heart attack from prolonged period of ischemia, death of myocardial tissues

29
Q

What are 2 common EKG changes during an MI?

A

ST elevation, and Q wave abnormality

30
Q

When does an ST elevation occur?

A

During full occlusion of an artery in an instance of an acute MI. AN INJURY (EX: HEART ATTACK)

31
Q

When does ST depression occur?

A

Due to ischemia

32
Q

Q wave abnormality results from what?

A

Absence of electrical forces, an indicator of an MI or history of

33
Q

Exercise testing for diagnosing CAD evaluates what?

A

HR/BP
EKG
Limiting symptoms and signs
Gas exchange or ventilatory response (VO2Max)

34
Q

What is an indicator of myocardial ischemia?

A

ST depression

35
Q

What is an indicator of an MI?

A

ST elevation with Q wave abnormality

36
Q

What drop in blood pressure is indicative of exertional hypotension?

A

SBP drop of 10 mmhg

37
Q

What happens in PCI (percutaneous coronary intervention)?

A

aka angioplasty, where a stent is placed in the affected artery and a balloon is then expanded. The plaque is then compressed and widened.

38
Q

Another common procedure other than PCI for occluded arteries is what?

A

A CABG (coronary artery bypass graft) uses the saphenous vein.

39
Q

An oral medication often used for angina , or CAD is what?

A

Nitroglycerin

40
Q

Name 2 red flags as a PT for CAD/ischemia?

A

Angina, Nitroglycerin usage

41
Q

Does chest pain need to be evaluated before physical therapy starts?

A

Duh.

42
Q

What is peripheral artery disease?

A

Decreased blood flow to legs

43
Q

What is a common symptom of PAD?

A

claudication pain (cramping angina in legs)

44
Q

PAD does not increase risk of MI and stroke (TRUE OR FALSE)

A

False

45
Q

PAD is increased by smoking and diabetes? ( Yes or no)

A

Yes. These are MAIN RISK FACTORS

46
Q

What is the Ankle Brachial Index?

A

Checks risk for PAD, using brachial artery and the highest BP of either dorsalis pedis or posterior tibial artery

A low ABI indicates narrowing of the arteries in the legs.

ABI > 0.90 is normal

Formula is ankle systolic/arm systolic

47
Q

Main 2 risk factors for PAD?

A

Smoking and diabetes

48
Q

What are signs of intermittent claudication?

A

Achy, cramping legs
Pain during exercise
Decreases pain in rest
Onset of pain is PREDICTABLE

49
Q

Patient needs to be in what position to compare blood pressure in legs/arms?

A

Supine

Cardiopulmonary Physiology (7 decks)

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