Cardiovascular I

Question 1

Define varicose veins

Answer 1

Veins in which blood has pooled, producing distended, tortuous and palatable vessels.

Question 2

Describe how varicose veins develop, 4 risk factors for developing this condition, and how this condition can be treated.

Answer 2

If a valve in a vein is damaged, a section of the vein is put under pressure of a larger volume of blood under the influence of gravity. Vein swells, edema occurs in surrounding tissue. Can damage remaining valves in vein, making them unable to maintain normal venous levels.
Risk factors include age, standing for long periods, obesity, pregnancy.
It can be treated using compression stockings, physical exercise and surgery.

Question 3

Describe a possible complication of varicose veins (CVI)

Answer 3

A complication of varicose veins is inadequate venous return over a long period of time. Tissue hypoxia, venous hypertension causing inflammation in vessels and tissue.

Question 4

Define DVT and describe 3 risk factors

Answer 4

Deep venous thrombus is a blood clot deep in the vein. Occurs in the lower extremities.
Risk factors include: venous stasis, venous endothelial damage, hypercoagulatible states.

Question 5

Describe the development of DVT, and one means to lower risk of occurrence.

Answer 5

Clotting factors and platelets cumulate (near a valve) and form a thrombus.
Inflammation around the thrombus promotes platelet aggregation and thrombus grows.
Because it is deep in the leg, it is usually asymptomatic.
Prophylaxis with anticoagulants.

Question 6

Describe superior vena cava syndrome.

Answer 6

Progressive occlusion of superior vena cava, leading to venous distention in upper extremities and head.

Question 7

Explain why the superior vena cava is prone to occlusion and give two causes.

Answer 7

SVC is relatively low pressure vessel, so tissue expansion can easily compress it. (Cancers, TB)

Question 8

Define hypertension and possible results.

Answer 8

A consistent elevation of systemic arterial blood pressure.
Myocardial infarction, kidney disease, and stroke.

Question 9

What is ISH and what is it associated with?

Answer 9

Isolated systolic hypertension, associated with cardiovascular and cerebrovascular events.

Question 10

What is the difference between primary and secondary hypertension?

Answer 10

Primary hypertension is due to environmental/genetics while secondary is from an underlying disease (renal disease)

Question 11

List 4 factors that can lead to hypertension

Answer 11

Family history, obesity, smoking, age

Question 12

The increase in blood pressure is due to what 2 changes in the circulatory system?

Answer 12

Increase in circulating blood volume or increase in peripheral resistance.

Question 13

What 5 factors can interact to produce these changes?

Answer 13

Sympathetic nervous system increases heart rate and vasoconstriction
Over activity of RAAS increases blood volume and pressure.
Chronic inflammation
Low potassium, calcium, magnesium
Obesity and insulin resistance.

Question 14

Why is hypertension called the “silent disease”?

Answer 14

No signs symptoms other than elevated blood pressure.

Question 15

What are 3 examples of damage that can be caused by sustained hypertension?

Answer 15

Heart diseases, renal issues, impaired vision, CNS dysfunction

Question 16

Describe treatment for hypertension.

Answer 16

No smoking, weight loss, exercise

Question 17

Define orthostatic hypotension and why it is of concern.

Answer 17

Decreased diastolic or systolic blood pressure.

Low blood pressure that is of concern because the normal mechanisms aren’t working. Cause of falls in older people.

Question 18

Describe an aneurism, possible causes and effects.

Answer 18

Local outpouching of a vessel or heart chamber wall, most commonly caused by atherosclerosis or hypertension.
Risk of rupture causing severe hemorrhage or death.

Question 19

Identify 3 causes of thrombi and why they are of concern.

Answer 19

Can be caused by surgery, infection, low BP and inflammation.
Can occlude artery or become an embolus.

Question 20

Define embolism.

Answer 20

Obstruction of vessel by an embolus. Will eventually lodge in a vessel.

Question 21

What is the difference in origin between pulmonary and arterial emboli?

Answer 21

Pulmonary arise from venous side or the right side of the heart.
Arterial arise from left side of the heart and occur after heart trauma.

Question 22

What is the difference between atherosclerosis and arteriosclerosis?

Answer 22

It is a type of arteriosclerosis (hardening of the arteries)

Question 23

Describe the steps involved in the development of atherosclerosis.

Answer 23

Injury to endothelial wall that line an artery wall causes damage, inflammatory response occurs, macrophages arrive. Macrophages secrete cytokines and enzymes that further damage the wall. Secretions include toxic oxygen which oxidize LDL that have accumulated. Macrophages ingest oxidized lipids, because foam cells. Accumulation of foam cells forms a lesion called a fatty streak. Macrophages release growth factor that stimulates smooth muscle cell proliferation. This happens over the fatty streak. These cells secrete collagen over the fatty streak causing a fibrous plaque. May obstruct blood flow. Some plaques are unstable and rupture and expose underlying tissue. Results in platelet adhesion and thrombus formation. Thrombus may occlude a vessel and cause ischemia.

Question 24

Describe 3 possible clinical manifestations of atherosclerosis

Answer 24

May have angina with exercise or stress
Obstruction of vessels supplying the brain is cause for stroke
Coronary artery disease is a major cause of myocardial infarction

Question 25

Describe the management of atherosclerosis where the obstruction has not become acute.

Answer 25

Preventing plaque formation, exercising, no smoking, control of hypertension, reducing LDL.