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Patho 2024 > Cardio and lymph lecture > Flashcards

Cardio and lymph lecture Flashcards

1
Q

Coronary arteries carry O 2 blood to the

A

myocardium

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2
Q

When Coronary arteries become narrow or blocked, the areas of the myocardium supplied by that artery do not receive enough Oxygen this can lead to

A

ischemia and injury
can lead to infarction
aaaand that can lead to disorders like….
Ischemic heart disease (IHD)
Coronary heart disease (CHD)
Coronary artery disease (CAD)

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3
Q

Disorders of the myocardium as a result of insufficient blood supply are collectively
known as

A

Ischemic heart disease (IHD)
Coronary heart disease (CHD)
Coronary artery disease (CAD)

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4
Q

One of the most important risk factors in both coronary heart disease and
cerebrovascular accidents

A

HYPERTENSION (HTN)

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5
Q

HYPERTENSION (HTN) can lead to

A

Cardiac hypertrophy
Heart failure
Aortic dissection
Renal failure

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6
Q

Marks Note: Systolic Pressure

A

System Engage pressure - pressure exerted when the heart contracts

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7
Q

Marks Note: diastolic pressure

A

Disengage pressure (pressure when the heart is relaxed between beats)

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8
Q

Blood pressure is the force exerted against the

A

arterial walls

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9
Q

Systolic

A

pressure exerted when the heart contracts

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10
Q

Diastolic

A

pressure when the heart is relaxed between beats

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11
Q

If kidney fails, the heart will

A

not do well :(

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12
Q

The silent Killer

A

HTN

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13
Q

HTN, Occurs when the relationship between ______ and ______ is
altered

A

blood volume, peripheral resistance

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14
Q

Primary (essential) HTN

A

cause unknown

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15
Q

Secondary HTN

A

cause known
Renal
Endocrine
ETOH abuse
Drug induced
Pregnancy induced
Acute stress

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16
Q

Primary HTN (cause unknow) accounts for what percentage of HTN?

A

90-95% maybe thats why its primary

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17
Q

Primary HTN - Modifiable vs non modifiable

A

Modifiable - can do something about it
* High sodium intake
* Obesity
* DM
* Hypercholesterolemia
Non modifiable - Can’t do anything about it
* Family history
* Age (> 55)
* Gender
* Male (<55)
* Female (>55)
* Ethnicity

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18
Q

Cardiac output is the _______ of blood

A

ejection

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19
Q

Ejection of blood can be a a product of what characteristics of heart

A

rhythm, rate, strength of heart

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20
Q

Peripheral resistance can be due to what things?

A

diameter of vessels, thickness of blood or viscosity of blood

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21
Q

BP = CO x

A

PR
Blood pressure = cardiac output x peripheral resistance

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22
Q

T/F, hyperthyroidism can cause an increase in cardiac output which would increase BP

A

T

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23
Q

an increase in Pereipheral resistance can increase

A

blood pressure

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24
Q

HTN Pathogenesis

A

-Blood flow (CO)
-Peripheral resistance (vessel diameter, blood viscosity)

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25
Q

Increased peripheral resistance as a result of the narrowing of the _______ is the
single most common characteristic

A

arterioles

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26
Q

T/F Increased peripheral resistance as a result of the narrowing of the Veins is the
single most common characteristic

A

FALSE
Increased peripheral resistance as a result of the narrowing of the ARTERIOLES is the
single most common characteristic

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27
Q

Peripheral resistance can be regulated by

A

-Autonomic regulation
Norepinephrine is released in response to stress
Epinephrine is secreted → increased cardiac contraction, increased cardiac output, vasoconstriction
-Renin-angiotensin system
Vasoconstriction causes decrease blood flow to the kidneys
Renin is secreted and angiotensin is formed
Causes vasoconstriction within the renal system – increases peripheral resistance
Angiotensin stimulates aldosterone production
Promotes sodium and water retention in the kidney causing intravascular volume

28
Q

Renin-angiotensin system

A

Vasoconstriction causes decrease blood flow to the kidneys
Renin is secreted and angiotensin is formed
Causes vasoconstriction within the renal system – increases peripheral resistance
Angiotensin stimulates aldosterone production
Promotes sodium and water retention in the kidney causing intravascular volume

29
Q

arteriosclerosis

A

Arteriole becomes less distensible
Greater resistance to blood flow
Accelerates degenerative changes in the walls of arteries

30
Q

T/F, Prolonged hypertension leads to elastic tissue within the arterioles being replaced
with fibrous collagen tissue

A

True

31
Q

T/F, Prolonged hypertension leads to elastic tissue within the arterioles being replaced
with awesome 100% repaired collagen tissue

A

F, Fibrous
T/F, Prolonged hypertension leads to elastic tissue within the arterioles being replaced
with FIBROUS collagen tissue

32
Q

Narrowing or complete obstruction of the lumina

A

Progressively – atherosclerosis
Completely – thrombus

33
Q

Weakening of the walls can lead to

A

Dilation
Rupture

34
Q

in ARTERY: Lesions at the Tunica, can block the lumen, weakens the lumen, loss of elasticity

A

basically i believe, a blockage will weaken walls and lose elasticity

35
Q

T/F, Arteriosclerosis is a broad term, atherosclerosis is a more specific term and will be used interchangeably

A

T

36
Q

Arteriosclerosis / atherosclerosis basically means decreased _____ to parts of body

A

blood flow

37
Q

ATHEROSCLEROSIS

A

Generic term for thickening and loss of elasticity of arterial walls
Atherosclerosis is a specific type of arteriosclerosis, but the terms are sometimes used interchangeably
Atherosclerosis refers to the buildup of fats, cholesterol and other substances in and on the artery walls
which restricts blood flow

38
Q

T/F Atherosclerosis is a specific type of arteriosclerosis, but the terms are sometimes used interchangeably

A

T

39
Q

Atherosclerosis

A

Atherosclerosis refers to the buildup of fats, cholesterol and other substances in and on the artery walls
which restricts blood flow

40
Q

ATHEROSCLEROSIS Characterized by intimal lesions that protrude into and obstruct the vascular lumina

A

Weakens the underlying media
Atherosclerosis = build up of stuff > lesion >protrude into lumina (space of the vessels)

41
Q

ATHEROSCLEROSIS Primarily affects the elastic arteries, and large/medium muscular arteries and can lead to

A

Myocardial infarction
Cerebral infarction
Aortic aneurysms
Peripheral vascular disease (gangrene of the LEs)

42
Q

ATHEROSCLEROSIS happens by a

A

Intimal thickening and lipid
accumulation giving rise to an
atheroma
Atherosclerotic plaque

43
Q

ATHEROSCLEROTIC PLAQUE

A

Three principal components:
-Smooth muscle cells, macrophages, and leukocytes
-ECM with collagen, elastic fibers
-Intra and extracellular lipids

Foam cells – large lipid laden cells derived from monocytes
Evidence of neovascularization
The plaques continue to change and progressively enlarge through cell death,
synthesis, and remodeling

44
Q

ATHEROSCLEROTIC PLAQUE
3 principal components

A

-Smooth muscle cells, macrophages, and leukocytes
-ECM with collagen, elastic fibers
-Intra and extracellular lipids

45
Q

ATHEROSCLEROSIS Pathogenesis

A

Chronic inflammatory response of the arterial wall initiated by injury to the endothelium
Harmful substances in the blood or the result of high blood pressure

46
Q

ATHEROSCLEROSIS Epidemiology

A

Genetic predisposition
Hyperlipidemia (> 200mg/dL)
LDL (BAD) (≥ 130 mg/dL)
HDL (GOOD) (≤ 39 mg/dL)
Triglycerides (> 150 mg/dL)
HTN
Cigarette smoking
Diabetes

47
Q

ISCHEMIC HEART DISEASE

A

Group of closely related syndromes caused by an imbalance between myocardial
oxygen demand and blood supply
Most common cause is a narrowing of the lumina of the coronary arteries
Most often termed coronary artery disease (CAD)
One of four syndromes may develop:
Angina pectoris
Acute myocardial infarction
Sudden cardiac death
Chronic ischemic heart disease with congestive heart failure

48
Q

Angina pectoris has intermittent

A

chest pain

49
Q

Atherosclerosis is a narrowing of the

A

lumina

50
Q

ischemic heart disease may lead to one of four syndromes

A

Angina pectoris
Acute myocardial infarction
Sudden cardiac death
Chronic ischemic heart disease with congestive heart failure

51
Q

MYOCARDIAL INFARCTION (MI)

A

Development of myocardial necrosis caused by local ischemia
Pathogenesis
Coronary artery thrombus
Atherosclerotic plaque serves as the source for the generation of the thrombus
Location of the MI is determined by the site of vascular occlusion

52
Q

Dead heart tissue = decrease in blood flow and a decrease in

A

oxygen for heart muscle

53
Q

MI Morphology

A

LAD (40-50%)
R coronary artery (30-40%)
Left circumflex (15-20%)

54
Q

MI of the LAD - left anterior descending artery

A

the WIDOW MAKER, this area pushes blood out to the entire body

55
Q

The widow maker, where would this clot occur

A

this clot would be at the LAD
Way for me to remember:
the LAD died, and the widow was LEFT by herself and she was DOWN

56
Q

MI PAIN PATTERNS

A

chest, neck, L shoulder, medial arm, right below chest, upper back
Women can have very minor feelings that would actually be an MI
Women can have unexplained anxiety - and like a feeling of DOOM coming

57
Q

CONGESTIVE HEART FAILURE (CHF)

A

Multisystem derangement that occurs when the heart is no longer able to eject the
blood delivered to it by the venous system
Inadequate cardiac output accompanied by congestion of the venous circulation
Failing ventricle unable to eject normal volume of venous blood delivered to it
Increased blood in the ventricle at the end of diastole
Increased end diastolic pressure
Elevated venous pressure

58
Q

CHF 4 types

A

Systolic – contractile failure of the myocardium
Diastolic – increased pressures are required to maintain adequate cardiac output despite normal
contractile function
Heart failure with preserved ejection fraction
Left side – left ventricle can no longer maintain normal cardiac output
Right side – right ventricular dysfunction due to left sided failure or pulmonary disease (cor pulmonale)

59
Q

EJECTION FRACTION

A

Amount, percentage, of blood that is pumped (or ejected) out of the ventricles with
each contraction

60
Q

if pt doesnt die from heat attack will probably in up with CHF, ejection of blood decreased, decrease in overall

A

cardiac output

61
Q

CHF means a back up of the

A

venous system

62
Q

EJECTION FRACTION percentages

A

Ejection Fraction (EF) 55% to 70%
Pumping Ability of the Heart: Normal
Ejection Fraction (EF) 40% to 54%
Pumping Ability of the Heart: Slightly below normal
Ejection Fraction (EF) 35% to 39%
Pumping Ability of the Heart: Moderately below normal
Ejection Fraction (EF) Less than 35%
Pumping Ability of the Heart: Severely below normal

63
Q

CHF is a positive feed back loop

A

LV Dysfunction causes, Decreased cardiac output > Decreased Blood Pressure and
Decreased Renal perfusion > Stimulates the release of renin, Which allows conversion of Angiotensin to Angiotensin II. Angiotensin II stimulates Aldosterone secretion which causes retention of Na + and water, increasing filling pressure&raquo_space; repeats

64
Q

CHF is a positive feed back look and will continue because there heart is pumping out a decreased amount of cardiac output

A

This continues to make the system feel like something is wrong that it can just adjust buuuut the shit aint working right at the heart

65
Q

CHF symptoms

A

Anxiety, confusion, nausea and vomiting, tachycardia, hypotension, decreased urine output, lower leg edema

hypoxia, jugular venous distention, infarct, hepatosplenomegaly, weak pulse, cool moist skin, pale grey or cyanotic skin, dyspnea orthopenea crackles wheeze cough, ascites

Patho 2024 (1 decks)

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