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cardio exam 3 Flashcards

1
Q

what are the main functions of the cardiovascular system

A

transport (nutrients, waste), communication of hormones, immunity, coagulation, mechanism of transport (bulk flow vs. diffusion)

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2
Q

Sympathetic Innervation

A

Stimulates the heart

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3
Q

Beta 1 adrenergic receptors

A

Respond to Norepi

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4
Q

Parasympathetic innervation

A

inhibits the heart

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5
Q

Muscarinic receptors

A

Respond to acetylcholine, slow the heart down at the SA node

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6
Q

Depolarization

A

Electrical activation of the heart

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7
Q

Repolarization

A

Deactivation of electrical activity in the heart

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8
Q

What pathway does the heart contraction occur

A

SA NODE»BUNDLE OF HIS»R&L BUNDLE BRANCH»PURJUNKE FIBERS

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9
Q

what does the P wave represent

A

depolarization of the atria

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10
Q

what does the QRS complex represent

A

ventricular depolarization

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11
Q

what does the T wave represent

A

ventricular repolarization

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12
Q

Bulk flow (cardiac cycle)

A

blood flow moves from high to low pressure

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13
Q

Systole

A

Isovolumetric contraction and ventricular ejection

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14
Q

Diastole

A

Isovolumetric relaxation and filling

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15
Q

Cardiac Output (CO)

A

volume pumped by each ventricle per minute

SVxHR

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16
Q

MAP

A

COxTPR

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17
Q

EDV (end diastolic volume)

A

Preload=venous return

stiffness of the ventricle

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18
Q

Starling forces

A

govern filtration of arterial side and reabsorption on venous side
hydrostatic push out, osmotic pulls in

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19
Q

ESV (end systolic volume)

A

afterload, contractility

EF

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20
Q

EF

A

SVxEDV

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21
Q

Arteries

A

low resistance vessels that serve as conduit for blood flow. High compliance, easily stretched

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22
Q

Arterioles

A

Main vessels that regulate B/P. regulates blood flow and distribution by changing the radius

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23
Q

Intrinsic Control

A

Local

active hyperemia, flow autoregulation, response to injury

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24
Q

Extrinsic control

A

Systemic

ANS, hormones

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25
Q

Epinephrine

A

catecholamine, vasoconstrictor to blood vessels, vasodilates skeletal muscle

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26
Q

Angiotensin II/ ADH

A

vasodilator

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27
Q

ANP

A

vasodilator

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28
Q

Prostacyclin

A

vasodilator

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29
Q

EDRF

A

nitric oxide. vasodilator

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30
Q

Capillaries

A

leaky think walled vessels with cross sectional area that allows for passage of blood that facilitates transport and exchange
important to fluid balance and regulation

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31
Q

Edema

A

Accumulation of excess fluid in interstitial spaces

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32
Q

Edema r/t heart failure

A

increased hydrostatic pressure d/t fluid accumulation and build up

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33
Q

Increased hydrostatic pressure

A

increased arterial/venous pressure or arterial dilation

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34
Q

Decreased osmotic pressure

A

decreased plasma proteins or increased permeability to proteins

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35
Q

Edema r/t obstruction

A

lymph failure or back up preventing recovery of tissue

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36
Q

Veins

A

low resistance blood conduits that return blood to the heart and help maintain B/P to ensure proper venous return

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37
Q

Sympathetic stimulation of veins does what?

A

contracts smooth muscle to raise venous pressure

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38
Q

What does the skeletal muscle pump do?

A

contracts muscle to constrict veins and venous venous pressure

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39
Q

what does the respiratory pump do for blood flow?

A

The thoracic cavity expands during inspiration causing a reduction in pressure, which helps generate a pressure gradient to drive blood return to the heart

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40
Q

Digitalis

A

increases the force of contraction

inhibits Na-K-ATPase to increase sodium exchange w/ calcium, causing increase calcium intracellularly

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41
Q

Nitro

A

vasodilator. increases nitric oxide, relaxes blood vessels to reduce cardiac workload and decrease oxygen demand

42
Q

Calcium channel blockers

A

Vasodilator, restricts the amount of calcium entering cardiac and smooth muscle cells by blocking voltage gated calcium channels

43
Q

Beta-adrenergic antagonists

A

reduces contractility and heart rate, decreases myocardial oxygen demand, increases ventricular filling by relaxing obstructing muscle and increases cardiac output

44
Q

ACE inhibitors

A

reduce afterload w/ vasodilation

45
Q

Diuretics

A

decrease fluid retention

46
Q

Lipoprotiens

A

represent the lipid and the associated protein capsule

47
Q

Chylomicrons

A

80-90% triglycerides, 10%proteins

48
Q

VLDL

A

55% triglycerides, 10% cholesterol, 1-% proteins

49
Q

LDL

A

“bad cholesterol”

10% triglyceride, 50% cholesterol, 25% protein

50
Q

HDL

A

“good cholesterol”

5% triglycerides, 20% cholesterol, 50% proteins

51
Q

Where are lipoproteins synthesized?

A

small intestine and liver

52
Q

Where are chylomicrons synthesized?

A

small intestine

53
Q

Where are VLDL and HDL synthesized and released?

54
Q

What is the main carrier of cholesterol?

55
Q

Which type of cholesterol participates in reverse transport of cholesterol?

A

HDL. it brings it from tissues to the liver

56
Q

Aneurysm

A

Change in dilation of blood vessel wall that can lead to rupture and bleeding

57
Q

True aneurysm

A

Bounded by complete vessel wall, all the blood remains inside that compartment

58
Q

False aneurysm

A

localized, dissection/tear of blood vessel wall that causes an intravascular hematoma

59
Q

Berry aneurysm

A

small spherical dilation of vessel at bifurcation point (splits in 2)

60
Q

Fusiform aneurysm

A

involves entire circumference of the vessel, gradual and progressive dilation

61
Q

dissecting aneurysm

A

false; results in tear in tunica intima, blood enters vessel wall forming a blood pocket

62
Q

PAD

A

presence of systemic atherosclerosis that’s distal to the aortic arch causing gradual vessel occlusion

63
Q

what are the symptoms of PAD

A

pain at rest, damage and ulceration to blood vessels, can lead to gangrene

64
Q

Thromboangiitis obliterans/ Beurgers disease

A

vasculitis that affects medium sized arteries . Typically in men 25-40 who smoke

65
Q

what are the symptoms of Beurgers disease?

A

pain, impaired circulation, sensitivity to cold, gangrene

66
Q

Raynauds

A

intensive vasospasm of arterioles and arteries

67
Q

what is MAP governed by

A

regulated variable governed by feedback inhibition

68
Q

where are baroreceptors located

A

carotid sinus, aortic arch

69
Q

Where are afferent pathways located

A

carotid sinus nerve, aortic depressor nerve

feed into integrating system of brainstem

70
Q

Where are efferent pathways located

A

vagus nerve, sympathetic nerves

71
Q

Short term regulation is related to:

A

baroreceptor reflux, feedback inhibition

72
Q

Long term regulation is related to:

A

blood volume

73
Q

Hypertension

A

elevation of B/P or MAP

74
Q

Primary HTN

A

chronic without evidence of disease

75
Q

Secondary HTN

A

d/t disease that increases CO or TPR

adrenal tumor that releases catecholamines or increased stress/aldosteron

76
Q

How do beta-adrenergic blockers help with HTN?

A

promote vasodilation

77
Q

How do calcium channel blockers help with HTN?

A

promote vasodilation

78
Q

How do ACE inhibitors help with HTN?

A

block vasoconstricting angiotensin II

79
Q

Acute Pericarditis

A

inflammatory response results in exudate accumulation around the heart

80
Q

Restrictive/ Constrictive pericarditis

A

formation of scar tissue between pericardial layers

81
Q

Pericardial effusion

A

fluid accumulation in pericardial sac

82
Q

Cardiac tamponade

A

accumulation of exudates under pressure in the percardial sac causing compression of the heart

83
Q

Ischemia

A

lack of blood flow that indicates lack of oxygen availability

84
Q

Injury

A

ischemia that can compromise/lead to cell injury or death

85
Q

Infarct

A

death of myocardial cells

86
Q

CAD

A

narrowing of coronary arteries d/t atherosclerosis process causing decreased heart blood flow

87
Q

what can CAD lead to?

A

loss of nutrients and oxygen that can lead to hypoxia and anaerobic respiration

88
Q

what can anaerobic respiration in cardiac cells cause?

A

lactic acid build up that causes chest pain and impairment of LVF

89
Q

ACS is caused by what?

A

initiated by rupture of plaques in unstable lipid-rich environment. platelets stick to site causing fibrin clots to form and thrombin is activated

90
Q

Dilated cardiomyopathy

A

dilation of the heart chambers that impairs the function of the heart as a pump

91
Q

What does dilated cardiomyopathy cause?

A

impairment of the ventricles ability to pump during systole causes hypertrophy and eventually heart failure

92
Q

Hypertrophic cardiomyopathy

A

hypertrophy of muscle mass that can lead to obstruction of blood filling
often young athletes

93
Q

what are the consequences of hypertrophic cardiomyopathy?

A

irregular heart beats, increased metabolic demand, possible obstruction, death

94
Q

Restrictive cardiomyopathy

A

involves extremely rigid ventricular walls that restrict blood filling but spare contractility properties of the muscle

95
Q

What are the consequences of restrictive cardiomyopathy

A

reduced preload and EDV, back up of blood flow leads to CHF

96
Q

What are the causes of restrictive cardiomyopathy?

A

primary- endocarditis

secondary- amyloidosis, sarcoidosis

97
Q

Endocarditis

A

infection of the endocardium, heart valves, cardiac prosthesis

98
Q

Who is at risk for endocarditis?

A

IV drug users, those with prosthetic valves, history of rhematic heart disease

99
Q

what is the pathophysiology of endocarditis?

A

Bacteremia causes fibrin and platelets to aggregate on valve tissue leading to ulceration of valves

100
Q

cardiac stenosis

A

narrowing of valve opening, leading to greater resistance of blood flow

101
Q

cardiac insufficiency

A

failure of valve to close completely resulting in regurgitation

advanced patho (4 decks)

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