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NS374—Pathophysiology > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

relaxation & filling

A

diastole

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2
Q

contraction & ejection of blood

A

systole

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3
Q

sounds made by turbulent BF

A

murmur

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4
Q

palpable murmur

A

thrill

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5
Q

rhythmical throbbing of arteries as BF through

against bony prominence

A

pulse

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6
Q

difference in rate between apical & radial/peripheral pulses

A

pulse deficit

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7
Q

sound made by closure of atrioventricular valves (mitral, tricuspid)

A

S1

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8
Q

S1 occurs when?

A

end of diastole

beginning of systole

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9
Q

sound made by closure of semilunar valves (aortic, pulmonic)

A

S2

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10
Q

S2 occurs when?

A

end of systole

beginning of diastole

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11
Q

explain cardiac cycle including events, valve closure, sounds

A

SYSTOLE

  • atria relax
  • AV valves close (S1) — SL valves open
  • ventricles contract
  • blood moves out into pulmonic & aortic arteries

DIASTOLE

  • ventricles relax
  • SL valves close (S2) — AV valves open
  • atria contract
  • blood moves into ventricles
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12
Q

inflammation/pain from inside joint

A

arthralgia

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13
Q

particle moving through vessels

A

embolus

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14
Q

blood clot in vessel

A

thrombus

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15
Q

moving blood clot

A

thromboembolus

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16
Q

cardiac output =

A

stroke volume x HR

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17
Q

pathway of electrical conduction through heart (5)

A

Sinoatrial node (SA) → atrioventricular node (AV) → bundle of HIS → L & R bundle branch → Purkinje fibers

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18
Q

A normal event becomes audible

A

abnormal heart sounds

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19
Q

3 potential causes of a murmur

A
  • Increased volume - ex pregnancy
  • Abnormal valve
  • Abnormal flow b/t structures
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20
Q

why can pregnancy cause a murmur?

A

blood volume ↑ 45% during pregnancy

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21
Q

“kentucky”

A

S3

Ventricular gallop

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22
Q

when does S3 occur

A

early diastole (after S2)

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23
Q

etiology of S3

A

impact of incoming blood against a distended ventricle wall

(extra compliant ventricular wall)

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24
Q

How to hear S3

A

apex

bell

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25
Q

S3 can be normal in…

it is always pathological in…

A

children; pregnant women; athletes

>35yo

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26
Q

“tennessee”

A

S4

atrial gallop

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27
Q

when does S3 occur

A

late diastole

before S1

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28
Q

etiology of S4

A

atria contract to force blood into stiff ventricle

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29
Q

how to hear S4

A

apex

bell

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30
Q

S4 is associated with…

A

left ventricular hypertrophy

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31
Q

when does split S2 occur?

A

during inspiration

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32
Q

split S2 normal in…

A

most young people

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33
Q

how to hear split S2

A

over SL valves (2nd ICS, sternal borders)

diaphragm

pt semirecumbent, quiet inspiration

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34
Q

when is split S2 pathological?

A

when it is heard as pt holds their breath

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35
Q

etiology of split S2 (5)

A

pulmonary HTN

ASD

conduction disorder

right side HF

vascular disorder

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36
Q

Valve leaflets become stiffer, narrowing valve opening

valves neither open nor close well

smaller amt of blood can pass through

A

valvular stenosis

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37
Q

etiology of valvular stenosis (4)

A

congenital

infection

overuse

Ca+ accumulation

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38
Q

congenital condition causing aortic valvular stenosis

A

bileaflet aortic valves

(normally there are 3 leaflets)

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39
Q

r/f for valvular stenosis

A

older age

renal disease

CV disease

hx infections

IV drug use (infection)

CHD

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40
Q

s/s of valvular stenosis (7)

A

fatigue

wt loss

lack of wt gain (children)

palpitations

chest pain

dizziness

murmur

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41
Q

a child is not gaining weight and has palpitations…

A

valvular stenosis

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42
Q

complications of valvular stenosis (7)

A

HF

CVA

emboli

dysrhythmia

bleeding

infection

death

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43
Q

BF back through closed/closing valves

A

regurgitation

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44
Q

etiology of regurgitation

A

congenital

infection

overuse

trauma

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45
Q

r/f for regurgitation

A

older age

infection

congenital

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46
Q

s/s of regurgitation (6)

A

fatigue; dyspnea; chest pain

edema

emboli

CVA

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47
Q

enlargement of walls of LV

A

left ventricular hypertrophy

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48
Q

LVH etiology

A

uncontrolled HTN

valvular disease

congenital

LV has to work harder

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49
Q

s/s of LVH

A

dyspnea; chest pain

S4

palpitations

dizziness

activity intolerance

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50
Q

LVH can lead to…

A

HF

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51
Q

Inability to pump enough blood to body

↓ cardiac output

A

heart failure

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52
Q

systolic HF vs diastolic HF

A

pump failing

filling problem - not enough blood

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53
Q

why does infarction increase the heart’s workload?

A

the rest of the heart has to “carry” the dead piece

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54
Q

why does HTN lead to hypertrophy of heart?

why does this lead to HF?

A

must work harder to overcome pressure in peripheral system

less space in the LV, lower stroke volume

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55
Q

HF r/f (5)

A

HTN

CAD

valvular dysfunction

MI

medications

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56
Q

A-stage HF

A

at risk — pt with HTN, CAD, DM, family hx

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57
Q

B-stage HF

ejection fraction

A

asymptomatic HF — pt with previous MI, LV systolic dysfunction, asymptomatic valvular disease

ejection fraction <55%

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58
Q

C-stage HF

A

symptomatic HF — pt with known structural heart defect, SOB, fatigue, activity intolerance, orthopnea, LVH, enlargement

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59
Q

D-stage HF

A

refractory end-stage HF — pt with marked sx at rest despite maximal medical therapy - hospitalized & cannot be discharged w/o specialized interventions

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60
Q

New York Heart Association stages of HF

A
  • Class I — no physical activity limitation
  • Class II — slight limitation of physical activity; comfortable at rest
  • Class III — marked limitation of physical activity; normal activity causes sx; comfortable at rest
  • Class IV — severe limitation & discomfort with physical activity; sx even at rest
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61
Q

most common form of HF

A

left side

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62
Q

left sided HF vs right sided HF

where does blood back up into?

A

left - pulmonary circulation

right - body circulation

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63
Q

left side HF etiology (4)

A

HTN

CM

CAD

MI

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64
Q

complications of left side HF (2)

A

right side HF

pulmonary edema

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65
Q

“cor pulmonale”

A

right side HF

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66
Q

right side HF etiology (2)

etiology of isolated right side HF

A

left side HF

CAD

isolated: pulmonary disease

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67
Q

complication of right side HF

A

ascites/3rd spacing

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68
Q

t/f most patients have sx of either left side or right side HF

A

false

most pts have sx of both

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69
Q

Impulses that coordinate heart do not work properly

A

dysrhythmias/arrhythmias

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70
Q

etiology of dysrhthmias (5)

A

disruption of normal conduction system

misfiring of action potential

damage to nodes

excitation of myocardial cells

genetic

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71
Q

r/f for dysrhythmias (7)

A

HTN; DM; obesity

CAD

high fat diet/high cholesterol

stimulant drug use

excessive alcohol

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72
Q

s/s of dysrhythmias (5)

A

palpitations

dizziness

weakness

loss of consciousness

pulse deficit

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73
Q

complications of dysrhythmias (2)

A

thrombi formation

CVA

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74
Q

atrium acts weird

A

atrial fibrillation

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75
Q

complications of a-fib

A

CVA - blood sloshing around in atria causes thrombus formation

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76
Q

Cessation of electrical activity of heart

A

cardiac arrest

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77
Q

s/s of cardiac arrest (3)

A

asystole

pulselessness

sudden loss of consciousness

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78
Q

tx for cardiac arrest

A

CPR

AED

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79
Q

Arteries supplying heart harden & narrow due to plaque buildup

A

coronary artery disease (CAD)

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80
Q

most common form of heart disease

A

CAD

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81
Q

etiology of CAD

A

atherosclerosis

blood components stick to plaque

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82
Q

why does smoking ↑ risk for all kinds of CV problems?

A

increases blood viscosity

plaque deposits in vessels

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83
Q

r/f for CAD (8)

A

older age; family hx; smoking; DM; HLD; HTN; obesity

male

84
Q

population most affected by CAD

A

older males

85
Q

s/s of CAD (4)

A

dyspnea

angina (especially with activity)

numbness in jaw/arm

other referred pain

86
Q

complication of CAD

A

progression to MI

87
Q

populations an S3 may be normal in

A

pregnant women

athletes

children

88
Q

population a split S2 may be normal in

A

younger people

89
Q

populations most affected by valvular stenosis

A

older

IV drug users

90
Q

cardiac-related chest pain

A

angina

91
Q

etiology of angina

A

ischemia to heart muscle

(not yet infarction)

92
Q

3 types of angina

A
  • Stable - predictable - with activity
  • Unstable - unpredictable
  • Variant - even less predictable
93
Q

r/f for angina (9)

A

older age; family hx; DM; HTN; HLD; obesity; smoking

lack of cardio exercise

stress

94
Q

locations for referred angina

A

jaw

arm

abdomen

95
Q

complication of angina

A

MI

96
Q

interventions & tx for if a patient is having/thinks they are having a heart attack (5)

A

try to calm their anxiety & slow their breathing

O2

chewable sublingual aspirin 325 mg

morphine for anxiety

PO nitroglycerine (massive vasodilator)

97
Q

EKG indication of MI

labs indication of MI

A

ST elevation

T & I troponins elevated

98
Q

muscle cells die due to hypoxia

A

myocardial infarction

99
Q

etiology of MI

A

coronary artery blockage

100
Q

if someone has MI, they probably have….

(same disease process)

A

peripheral artery disease

101
Q

r/f for MI (8)

A

older age; family hx; HTN; HLD; obesity; smoking; DM

male

102
Q

populations most affected by MI

A

older males

103
Q

s/s of MI (7)

A

angina

jaw pain, arm pain

diaphoresis

dyspnea

pallor

anxiety

n/v

104
Q

3 infectious/inflammatory disease process related to cardio

A

rheumatic heart disease

infective endocarditis

pericarditis

105
Q

Valves permanently damaged by rheumatic fever

A

rheumatic heart disease

106
Q

what cardio condition can strep throat lead to if untreated?

A

rheumatic heart disease

107
Q

etiology of rheumatic heart disease

A

untreated strep throat

108
Q

r/f for rheumatic heart disease (4)

A

incomplete antibiotic (stopping prematurely)

poverty

overcrowding

↓ access to medical care

109
Q

s/s of rheumatic heart disease

A

fever; dyspnea

arthralgia

rash

nodules

uncontrolled arm/leg movement

weakness

110
Q

SX

fever

dyspnea

arthralgia

rash

nodules

uncontrolled arm/leg movement

A

rheumatic heart disease

111
Q

complications of rheumatic heart disease (3)

A

HF

bacterial endocarditis

damaged valves

112
Q

Infection in heart lining, valve, or vessel of heart

A

infective endocarditis

113
Q

populations most affected by infective endocarditis

A

immunocompromised

IV drug users

artificial valves

114
Q

r/f for infective endocarditis (5)

A

IV drug use

artificial valves

damaged valve

congenital defect

hx endocarditis

115
Q

s/s of infective endocarditis (10)

A

fever; dyspnea

new murmur

myalgia

angina

night sweats

wt loss

hematuria

Osler’s nodes (raised red lesions on hands or feet)

petechial rash

116
Q

Osler’s nodes indicate…

A

infective endocarditis

117
Q

when a person has a new murmur, always do a(n) _________ assessment

A

integumentary

118
Q

how to dx infective endocarditis

A

echocardiogram

ultrasound

119
Q

tx for infective endocarditis

A

long term antibiotics

sometimes surgery

120
Q

complications of infective endocarditis (6)

A

endocardial vegetations in right valves leading to emboli

abscess

HF

valvular dysfunction

seizure

aneurysm w/i heart

121
Q

Inflammation of pericardium

third-spacing of fluid into pericardium

A

pericarditis

122
Q

etiologies of pericarditis

A

idiopathic

viral

chronic

123
Q

r/f for pericarditis (4)

A

infection

recent MI

trauma

autoimmune disorders

124
Q

EKG indicator of pericarditis

A

ST elevation through all 12 leads

125
Q

s/s of pericarditis (7)

A

fever; cough

chest pain on inspiration

orthopnea

palpitations

edema

flu-like sx

126
Q

complications of pericarditis (2)

A

constrictive pericarditis

cardiac tamponade

127
Q

permanent thickening, scarring, contraction of pericardium

A

constrictive pericarditis

128
Q

pressure on heart when blood/fluid accumulates in pericardium, impairing ability to pump

A

cardiac tamponade

129
Q

Beck’s triad

indicates…?

A

indicates cardiac tamponade

low arterial BP

distended neck veins

distant muffled heart sounds

130
Q

cellular & tissue hypoxia due to ↓ O2 delivery, ↑ O2 consumption, inadequate O2 utilization, or combo

A

shock

131
Q

3 etiologies of shock (with regards to O2)

A

↓ O2 delivery

↑ O2 consumption

inadequate O2 utilization

132
Q

6 types of shock

A

distributive/vasogenic

cardiogenic

hypovolemic

obstructive

septic

anaphylactic

133
Q

vasodilation secondary to loss of sympathetic/vasomotor tone resulting in shock

caused by pain and fear, spinal cord injury, hypoglycemia

A

distributive/vasogenic shock

134
Q

decreased pumping capability resulting in shock

caused by MI of LV, arrhythmia, PE, cardiac tamponade

A

cardiogenic shock

135
Q

loss of blood/plasma resulting in shock

caused by hemorrhage, burns, dehydration, peritonitis, pancreatitis

A

hypovolemic shock

136
Q

3 stages of shock

A
  • Pre-shock - compensation for ↓ tissue perfusion
  • Shock - compensation overwhelmed
  • End-stage shock - irreversible multiorgan failure
137
Q

s/s of pre-shock (3)

A

tachycardia

modest BP change

mild to moderate hyperlactatemia

138
Q

s/s of shock (middle stage between pre- and end-stage)

A

tachycardia

dyspnea

restlessness

diaphoresis

metabolic acidosis

hypotension

oliguria

cool/clammy skin

139
Q

how does shock affect pH balance?

A

metabolic acidosis

140
Q

s/s of end stage shock (7)

A

anuria/acute renal failure

acidemia

severe hypotension

hyperlactatemia worsens

restlessness

coma

death

141
Q

Swollen, twisted, visible veins

A

varicose veins

142
Q

etiology of varicose veins (2)

A

↑ BP in vein

weakened/damaged valves in veins

143
Q

r/f for varicose veins (6)

A

obesity; family hx; older age

female

pregnancy

standing or sitting for long periods

144
Q

populations most affected by varicose veins & chronic venous insufficiency

A

older women

pregnant women

145
Q

s/s of varicose veins (4)

A

large, raised, swollen, blue/purple vein

achy heavy feeling

itching

palpable twisted, swollen vein

146
Q

Blood in legs not able to return to heart effectively

A

chronic venous insufficiency

147
Q

etiology of chronic venous insufficiency

A

damaged venous valves

148
Q

r/f of chronic venous insufficiency

A

older age; family hx; obesity

female

pregnancy

standing or sitting for long periods

tallness

hx DVT

149
Q

intervention for chronic venous insufficiency

A

ambulate pt

150
Q

s/s of chronic venous insufficiency (4)

A

bilateral edema in legs, feet

itchy

intermittent claudication

skin changes (shinyness, loss of hair, darkening color)

151
Q

chronic venous insufficiency uni/bilateral?

A

bilateral

152
Q

why can chronic venous insufficiency lead to ulceration?

A

inability to carry waste products away

153
Q

inflammation of vein wall

A

thrombophlebitis

154
Q

DVT uni/bilateral?

A

unilateral

155
Q

Blood clot in deep vein - usually in legs

A

deep vein thrombosis

156
Q

r/f for DVT (10)

A

obesity; smoking

injury to vein

surgery

immobility/decreased mvmt/prolonged disuse

pregnancy & postpartum period

oral contraceptives

clotting disorder

cancer

HF

157
Q

populations most affected by DVT

A

postsurgical pts

truckers/others who sit constantly

pregnant women/postpartum

158
Q

s/s of DVT (4)

A

pain

erythema

warmth

unilateral edema in leg

159
Q

effect of DVT on pulses

A

none

160
Q

complications of DVT

A

PE

postphlebitic syndrome

161
Q

how to dx a DVT

A

ultrasound

162
Q

tx for DVT

A

meds to prevent other DVTs and enlargment of current clot

do not dissolve current clot

163
Q

Elevated force of blood against walls of vessels

A

hypertension

164
Q

normal BP

A

<120/80

165
Q

HTN range

A

130/>80

166
Q

stage 2 HTN range

A

>140/90

167
Q

most common form of HTN

A

essential HTN

168
Q

__% of blood goes to kidneys

A

45

169
Q

decreased blood flow to kidney causes continuous stimulation of RAAS system

causes HTN

A

renal artery stenosis

170
Q

how does an adrenal tumor cause HTN?

A

stimulates sympathetic NS

171
Q

r/f for HTN (11)

A

older age; obesity; smoking; family hx; DM

too much alcohol

sedentary

OSA

stress

excessive Na

deficient K

172
Q

electrolyte r/f for HTN

A

high Na+

low K+

173
Q

“silent killer”

A

HTN

174
Q

s/s of HTN

A

usually none

dyspnea

h/a

175
Q

complications of HTN (6)

A

MI

HF

CVA

kidney damage

aneurysm

dementia

176
Q

screenings for HTN

A

recommended for everybody

adults should have BP taken at least 1x/year

177
Q

Narrowed arteries (due to plaque) - ↓ BF to limbs

A

peripheral artery disease

178
Q

etiology of PAD

A

atherosclerosis

179
Q

r/f for PAD (7)

A

older age; smoking; DM; HTN; HLD; obesity; family hx

180
Q

s/s of PAD (9)

A

intermittent claudication

coldness

numbness

paleness

sores on toes

no hair

thin shiny skin

weak/absent pulse

ED

181
Q

leg pain aggravated by activity & relieved by rest, associated with vascular diseases

A

intermittent claudication

182
Q

Vessels become thick, stiff, hardened

restrict BF to organs, tissues

A

atherosclerosis

183
Q

etiology of atherosclerosis

A

excessive lipids in bloodstream (especially LDL)

inner layer of vessel becomes injured

plaque (fatty cholesterol substance) builds up at injury site & hardens

narrows vessel

impedes vessel’s ability to stretch

184
Q

r/f for atherosclerosis (6)

A

HTN; HLD; DM; smoking; family hx

fatty diet

185
Q

tx for atherosclerosis

A

statins

186
Q

Part of vessel wall becomes weak and balloons out

A

aneurysm

187
Q

r/f for aneurysm (6)

A

older age; family hx; HTN; smoking

men

trauma

188
Q

populations most affected by aneurysms

A

older men

189
Q

dissection

A

small hole in AAA → rupture

empties blood volume quickly into peritoneum

low survival rate

190
Q

Anything lodged in vessels

causes ischemia & death of tissue

A

embolism

191
Q

LEFT OR RIGHT SIDE HF

air hunger

A

left

192
Q

LEFT OR RIGHT SIDE HF

pulmonary congestion

A

left

193
Q

LEFT OR RIGHT SIDE HF

paroxysmal nocturnal dyspnea

A

left

194
Q

LEFT OR RIGHT SIDE HF

orthopnea

A

left

195
Q

LEFT OR RIGHT SIDE HF

tachycardia

A

left

196
Q

LEFT OR RIGHT SIDE HF

exertional dyspnea

A

left

197
Q

LEFT OR RIGHT SIDE HF

cyanosis

A

left

198
Q

LEFT OR RIGHT SIDE HF

rales

A

left

199
Q

LEFT OR RIGHT SIDE HF

raised peripheral venous pressure

A

right

200
Q

LEFT OR RIGHT SIDE HF

hepatosplenomegaly

A

right

201
Q

LEFT OR RIGHT SIDE HF

DJV

A

right

202
Q

LEFT OR RIGHT SIDE HF

anorexia

A

right

203
Q

LEFT OR RIGHT SIDE HF

dependent edema

A

right

204
Q

LEFT OR RIGHT SIDE HF

weight gain

A

right

204
Q

LEFT OR RIGHT SIDE HF

weight gain

A

right

205
Q

ejection fraction

systolic vs diastolic HF

A

systolic - low EF

diastolic - normal EF

NS374—Pathophysiology (18 decks)

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