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BIOS5092 > CARDIOVASCULAR 2 > Flashcards

CARDIOVASCULAR 2 Flashcards

1
Q

what is the function of the capillaries?

A

vessels where exchange between blood & tissue occurs- most numerous vessels in body- oxygen leaves the blood & carbon dioxide enters in capillaries

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2
Q

how do capillaries allow gas exchange?

A

very thinned walls, very low blood pressure, slow blood flow

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3
Q

what is the function of venules & veins?

A

return blood to heart- blood bressure in vessels is low, so they have thin walls

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4
Q

how do veins appears in radiographs?

A

during respiration, pressure in thorax changes- changes in pressure are transmitted to veins, their appearance on plain radiographs will be affected by stage of respiratory cycle

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5
Q

how do veins maintain blood flow?

A

blood pressure is insufficient to maintain blood flow- pressure changes in chest & compression of veins by contracting muscles help maintain flow

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6
Q

what is blood flow determined by?

A

by amount of blood in the vessels (cardiac output & blood volume), diameter of vessels, downstream resistance to blood flow

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7
Q

what is blood pressure?

A

amount of pressure required to keep blood flowing is determined by the resistance to blood flow in the vessels- how crowded blood is in artery

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8
Q

what is cardiac output & downstream resistance under control of?

A

of sympathetic nervous system

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9
Q

what happens when someone stands upright from a lying position?

A

gravity pulls blood towards the feet- less blood in vessels going to head as blood pressure falls + sympathetic activity increases causing cardiac output & vasoconstriction (restoring blood pressure)

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10
Q

what is long term blood pressure controlled by?

A

changing blood volume by changing amount of water in our body & therefore amount of blood in vessels

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11
Q

what happens when the body is dehydrated?

A

decreased renal perfusion causing renin release, which causes angiotensin release causing vasoconsctriction & no retention in kidney causing increased blood volume

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12
Q

what occurs following advanced hypertension?

A

heart failure

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13
Q

what is shock due to?

A

low blood pressure caused by hypocolaemia (haemorrhage), distributing (anaphylaxis, sepsis, spinal injury), cardiogenic (obstructive, tamponade, tension pneumothorax, pulmonary embolism)

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14
Q

what is activated to elevate BP?

A

Increased heart rate & peripheral vasoconstriction in arteries & veins (causing cold & pale skin)

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15
Q

what is the role of lymphatic system?

A

drains excessive interstitial fluid & protein from tissue

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16
Q

how does lymphatic drainage begin?

A

series of tiny capillaries, which form a mesh-like network throughout the tissue- fluid is lymph- pressure in lymphatic vessels is low & flow can be easily stopped

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17
Q

what is the role of lymph nodes?

A

nodes located throughout body, receiving lymph from particular regions- nodes are where metastases are removed from lymph

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18
Q

what is lymph flow under & affected by?

A

under low pressure- affected by muscle & respirtatory pumps, tone in ducts, pressure of interstitial fluid

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19
Q

what does increase of interstitial fluid cause?

A

swelling known as oedema

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20
Q

what are risk factors of atherosclerosis?

A

age, smoking, diabetes mellitus, hyperlipdaemia, hypertension

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21
Q

what are the pathogeneis of atherosclerosis?

A

fatty streaks appear in subendothelial space, formation of plaque, calcification of plaque (fibroatheomas) is common- lesions will cause clot or thrombosis

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22
Q

why do fatty streaks appear in subendothelial space?

A

LDLs penetrate endothelium, inflammation occurs, fats are oxidised & ingested by macrophages causing fatty streaks

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23
Q

what is myocardial infarcation?

A

death of myocardial cells due to blockage of artery

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24
Q

what is ischaemia?

A

restriction in blood supply to tissues, causing a shortage of oxygen that is needed for cellular metabolism (to keep tissue alive)- heart will switch to anaerobic energy production leading to pain (angia) with 75% occlusion

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25
Q

what is atherosclerosis?

A

buildup of cholesterole & fat creating plaque causing narrowing of blood vessels- if plaques are disrupted, clotting will occur, which will block the vessel- can cause ectopic pacemakers (cause premature heart beat)- anaerobic metabolism producing lactic acid which causes pain- causes strokes

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26
Q

what is a stroke?

A

buildup of plaque in the brain arteries- clot will develop, preventing blood flow= ISCHAEMIC STROKE- when blood

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27
Q

what is the diagnosis of myocardial infarction (heart attack)?

A

symptoms of ischaemia, ECG anormalities, loss of viable mycardium or regional wall abnormality

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28
Q

how can we investigate ischaemic disease?

A

via stress scintigraphy, stress enchocardiography, coronary arteriography, stress testing

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29
Q

what is stress scintigraphy?

A

radioactive isotopes are taken up by active heart muscle. Areas with less blood flow take up less isotope.

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30
Q

what is stress enchocardiography?

A

gives images of abnormal wall motion

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31
Q

what is coronary arteriography?

A

contrast media are injected to allow direct visualisation of the coronary arteries

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32
Q

what is stress testing?

A

pharmacological agents induce stress (adenosine & dobutamine), used with radionuclide imaging & echocardiography to show myocardial blood flow- mimics exercise

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33
Q

what is the role of adenosine?

A

dilates coronary vessels and increases flow rate in normal vessels & less of a response in stenotic vessels

34
Q

what is the role of dobutamine?

A

a synthetic catecholaime which increases heart rate, blood pressure & myocardial contractility- acts like adrenaline

35
Q

what does adrenaline do the body?

A

heart rate increases, stimulates sympathetic nervous system-

36
Q

what is an aneurysm of blood vessels?

A

localised area of widening of vessel wall- due to atherosclerosis which destroys elastic tissue- aorta commonly affected- haemorhagic stoke

37
Q

what is aneurysm associated with?

A

increased risk of vessel rupture which causes usually fatal haemorrhage

38
Q

how do we investigate aneurysms?

A

plain radiographs, ultrasound, CT

39
Q

how do aneurysms show in plain radiographs?

A

may appear as large soft tissue mass with calcification

40
Q

how do aneurysms show in ultrasound?

A

shows enlargement of vessel

41
Q

how do aneurysms show in CT?

A

shows location & extend, and some evidence of rupture

42
Q

what is claudication?

A

peripheral arterial disease causes severe muscle pain on exercise

43
Q

how is claudication diagnosed?

A

nonimaging & doppler ultrasongraphy & angiography

44
Q

what is heart failure?

A

inability of heart to pump enough blood to meet requirement of the tissues

45
Q

what is heart failure due to?

A

systolic dysfunction (not pumping), diastolic dysfunction (unable to relax and fill)

46
Q

what are the main imaging features of heart failure?

A

changes in stroke volume & ejection fraction + structural changes in chambers (wider than 50% of transverse width of thorax)

47
Q

what is oedema in the heart?

A

failing heart does not empty effectively, harder to fill chamber with blood & venous pressure goes up - as more pressure develops in ventricles

48
Q

what happens when venous pressure goes up?

A

causes back pressure throughout the vascular system- high pressure in capillaries forces out into the tissue

49
Q

what happens to the lung during oedema?

A

veins supplying the left side of heart are draining he lungs- congestion will develop in lungs

50
Q

what happens to extremities during oedema?

A

veins supplying the right side of heart are draining the extremities- congestion will develop in abdomen, ankles

51
Q

how do plain radiographs show oedema?

A

show enlargemnt of chambers & congestion in chest

52
Q

how do echocardiogram show oedema?

A

shows chamber enlargement, ventricular function & valve function- used to measure ejection fraction

53
Q

how does doppler ultrasound show oedema?

A

shows direction & acceleration of blood flow through the chambers- used to assess valcular regurgitation & stenosis

54
Q

how does radionucleotide ventriculography show oedmea?

A

shows right & left ventricular ejection fraction

55
Q

what is cardiomyopathies?

A

as a group, these conditions cause heart failure- the inability of heart to performs its normal function- affects the myocardium (effects the size of heart)- dilates

56
Q

why may the heart be enlarged?

A

because of dilation & hypertrophy

57
Q

what is dilation of the heart?

A

stretching of heart due to weakened muscles & excessive blood in heart- easy to see on plain radiographs

58
Q

what may dilation be due to?

A

idiopathic, coronary artery disease (muscle is weak), valcular or hypertensive disease (heart is overloaded), infections, endocrime diseases, haematological disease (sickle cell anaemia), alcholism- wall of ventricle is thin & will affect function of valves

59
Q

what does dilation cause?

A

fall in stroke volume (ejection function) causing systolic failure- valves fail to form an effective seal

60
Q

what is hypertrophy?

A

increase in size & number of muscle cells in heart- occurs due to heart trying to pump against increased resistance- hard to see on plain radiographs- increased ventricle wall thickness

61
Q

what is hypertrophy due to?

A

hypertension, outflow obstruction, endocrine disease

62
Q

what occurs in hypertrophy?

A

size of chambers of ventricle & amount of blood it can hold is decreased which causes diatolic failure & ventricle walls are thick

63
Q

what does hypertrophy develop in to?

A

outflow obstruction, diastolic failure, myocardial ischaemia

64
Q

what are 2 main types of problems with valvular heart disease?

A

narrowing (stenosis) + incompetence (regurgitation)

65
Q

what is stenosis?

A

anatomical obstruction of valves- increased resistance to outflow of blood because outlet has been narrowed

66
Q

what happens to the myocardium during stenosis?

A

hypertrophies in response to increased work it is required to do- systolic dysfunction develops because myocardium is unable to maintain the high work load required to maintain function

67
Q

what is imcompetence (regurgitation)?

A

caused by disease to the valve or its supporting structures due to infection (valves wont be able to close in normal position)

68
Q

what occurs during incompetence (regurgitation)?

A

causes a large increase in end diastolic volume as blood flows backwards through incompetent valve- blood sits in heart (overstretches)- heart murmur

69
Q

how do plain radiographs show valvular abnormalities?

A

hypertrophy of chambers which occur in response to pressure overload

70
Q

how do echocardiographs show vulvular abnormalities?

A

used to examine valve motion, and chamber enlargement which occurs with volume overload

71
Q

how do doppler ultrasounds show vulvular abnormalities?

A

used to meaure the pressure gradient across valve

72
Q

what is atrial septal defect?

A

hole in wall seperating the 2 atria- congenital

73
Q

what occurs due to atrial septal defect?

A

because of pressure gradient, blood passes through hole in atrial wall from left side to right side- increases amount of blood being ooumped from right ventricle & may lead to damage in lungs

74
Q

what is ventricular septal defect?

A

systolic pressure in left ventricle much higher than in the right- blood flows from left ventricle to right- increase in pulmonary blood flow

75
Q

what is pericardial effusion?

A

abnormal accumulation of fluid in pericardial sac due to irritation or injury to pericardium- can cause tamponade- any extra fluid will compress and collape the chambers

76
Q

what is pericardial effusion caused by?

A

tumours, renal disease, heart attack, iatrogenic, infection, radiation

77
Q

when does tamponade occur?

A

when effusion compresses the chamber of heart- chambers collape during diastole increasing the systemic venous pressure

78
Q

what happens as a result of decreased filling of ventricles in tamponade?

A

systemic arterial pressure is low

79
Q

what is tamponade due to?

A

metastatic tumours

80
Q

how does a pericardial effusion appear on radiograph?

A

looks like a ball- not regular heart shape

BIOS5092 (17 decks)

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