Cardiovascular system part 2 (Peripheral vascular disorders) Flashcards by Mohab sha

Which term refers to the pressure changes occurring during breathing that enhance venous return? Where during inhalation, pressure decreases in the thoracic cavity and increases in the abdominal cavity creating an upward “sucking” effect that pulls blood toward the heart into the right atrial, and then the right ventricle

Respiratory pump

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Which term refers to when right atrial pressure falls during cardiac diastole, where the elastic potential energy stored in the myocardium during each vigorous contraction is released during diastole, thus creating a negative pressure which sucks blood into the ventricles?

Cardiac suction effect

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Veins have something called a ___ ___, which prevents bidirectional the movement of blood. We have constant movement of blood toward cardiac system, even against gravity.

Venous valve

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Which term refers to distended, torturous, palpable, and superficial veins where it occurs due to stasis of blood within the venous system?

This can be due to trauma to the saphenous (a large, subcutaneous, superficial vein of the leg) results in damage to one or more valves or when blood is not being moved back to heart due to gravity pulling it back down

What are some risk factors for said condition?

Varicose veins
- Older age, female gender, (huge part) family history, other factors that damage the intima, obesity , pregnancy (During we have pressure of growing uterus, not allowing venous return to be done properly, they have some degree of vercose), DVT, & previous leg injury (trauma to vessels & damage the valves)

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Which term refers to when your leg veins don’t allow blood to flow back up to your heart due to valve dysfunction? (similar to varicose vein)

This can be caused by valvular incompetence, damages to venous due to trauma or previous DVT, obesity, high pressure in venous over a long period(due to sitting or standing for long periods, pregnancy), or family history

What are some risk factors for said condition?

Chronic venous insufficiency

Sitting or standing for long periods of time, lack of exercise, smoking, & history of DVT

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Edema to lower extremities – can extend to knees, hyperpigmentation of skin (Brown-colored skin, often near the ankles), Tight feeling in your calves or itchy, pain when walking that stops when you rest, varicose veins, painful leg cramps or muscle spasms, Venous stasis ulcers which might be hard to treat
(Cellular demand because removal of metabolic waste is not
fully met=> increased infection risk are all manifestations of..?

Chronic venous insufficiency

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Why do thromboemboluses occur more frequently in veins than arteries?

Occurs more frequently in veins than arteries due to lower pressure.

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(Thrombus Formation in Veins)
Accumulation of clotting factors and platelets particularly close to valves leads to…?

Age, obesity, pregnancy, smoking, thick blood (increased in RBCS or WBCS polycytopenia), & trauma are all risk factors of..?

& what are the manifestations of said state?

thrombus formation in a vein, where inflammation around thrombus causes attracting more platelets
Deep Vein Thrombosis
Unilateral leg pain starting in calf & cramping, red or discolored skin on the leg, & feeling of warmth on the leg

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(Thrombus Formation in Veins)

Immobility, age, heart failure leads to..?

Trauma, intravenous medications causes…?

Inherited disorders, pregnancy, oral contraceptives, hormone replacement therapy… lead to…?

Venous stasis
Venous endothelial damage
Hypercoagulable states

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In venous insufficiency, elevating your legs, wearing support/compressive stockings, & increasing physical exercise will all do what?

Reduce pain & reduces heaviness.
Simulates muscle action to push the blood, it’s a preventive action
Improves circulation

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Which term refers to the abnormal thickening and hardening of the vessel walls?

Arteriosclerosis

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Which term refers to the thickening & hardening caused by accumulation of lipid-laden macrophages in the arterial wall? & is also the leading cause of cerebral vascular diseases and coronary artery disease & cerebrovascular disease

What are the causes of said condition?

Atherosclerosis

Consumption of high fat & cholesterol containing LDL foods,
Hypertension, smoking and obesity (inhibits the oxidation of LDL)
-Diabetes, hyperlipidemia
-Insulin resistance, infection & periodontal disease

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Partial vessel occlusion which can result in transient ischemic events during exercising or stress, tissue infarction, & obstruction of peripheral arteries causing significant pain & disability are all manifestations of..?

It usually starts with lipids first, and the WBCs start swallowing the lipids, and these macrophages trying to swallow the lipids create foam cells. These foam cells get ruptured and release some growth factors and cytokines. These cytokines aggregate inflammation process making the situation even worse. Inflammation is one huge factor & level of lipids. LDL is the lipid in question. This accumulation of debris, will decrease the size of vessel lumen, creating venous insufficiency, hypertension, etc.. Sometimes some of these plugs an be ruptured, and increase risk for creation of clots over the plug, then we might have total obstruction. This can happen in our heart or bran vessels, creating stroke or infraction in the heart.

Also, if there is a systemic presentation in one area, what does that mean?

Atherosclerosis

It may indicate risk for complications elsewhere

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Which term refers to the system that controls blood pressure & is a long-term regulatory factor of blood pressure?

Renin-angiotensin-aldosterone system (RAAS)

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Which term refers to a high blood pressure of a systolic blood pressure > 140 mm Hg - OR
Diastolic blood pressure > 90 mm Hg? & 90% of Canadians will develop this condition in a normal lifespan

It also puts people at risk for developing cardiac events, kidney disease, and stroke

Hypertension

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This type of high blood pressure accounts for 92-95% of the populous, & is due to a primary disease with no known cause?

This type of high blood pressure accounts for 5-8% of the populous, & is caused by underlying disease such as possibly renal diseases?

Which term refers to when blood pressure readings at a health care provider’s office are higher than they are in other settings, such as at home?

& which term refers to a blood pressure reading of less than 90/60?

Primary hypertension
Secondary hypertension
White coat hypertension
Hypotension

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Which type of hypertension is also called idiopathic hypertension since there aren’t any known defined reason for it, where It can be genetic & passed to offspring?

Primary hypertension

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High sodium intake, natriuretic peptide abnormalities, inflammation within vessels, obesity, & Insulin resistance (Type 2 diabetes) are all risk factors for..?

Primary hypertension

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Which term refers to substances made in your heart, which are involved inthe long-term regulation of sodium and water balance, blood volume & arterial pressure? Where high levels indicate insufficient pumping by the heart

& name the 2 major pathways of this peptides actions

Natriuretic peptides (NPs)

1) Vasodilator effects, & 2) Renal effects that leads to natriuresis (sodium excretion in the urine through the action of the kidney) & diuresis (increased urination).

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(Hypertension)
Increase in sodium which leads to increase plasma volume, which increases stroke volume causing…?

Vasoconstriction peripheral vascular arterioles – increases calcium mediated contraction in smooth muscle… causing…?

What is primary hypertension mainly related to?

Increases in systolic blood pressure (SBP)
Increases in diastolic blood pressure (DBP)
Increases in peripheral resistance

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(Causes of primary hypertension)
Beta 1 (increases SA node, AV node, & ventricular muscular firing) = increased heart rate and contraction force =increased BP

Alpha 1 = peripheral vasoconstriction = = increased BP

Increased ADH (antidiuretic hormone) = kidneys release less water = Increased BP.

These are all components of which system? what binds to these receptors? & how does this system contribute to primary hypertension?

Increase in SNS, leads to the development & sustaining of hypertension:
Epinephrine/Norepinephrine

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(Causes of primary hypertension)
RAAS: Renin => Angiotensin I= > ACE in lungs => Angiotensin I to ANGIOTENSION II… Which causes___ leading to___ & also causes secretion of ___ from the adrenal cortex which retains sodium & the reabsorption of water, which increases ___

Vasoconstriction; increased bp
Aldosterone; increased bp

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(Causes of primary hypertension) What is the peptide called that issecreted primarily by the atrial myocardium in response to dilation & functions to reduce arterial pressure by decreasing blood volume and systemic vascular resistance?

What is it called when this peptide is decreased or isnt functioning well & how does that affect bp?

Natriuretic peptides
Natriuretic peptides dysfunction (NPD), promoting arterial hypertension

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(Causes of primary hypertension) What is the term called that causes the hardening and narrowing of the arteries, & thus increasing the cardiac force?

& how does that affect bp?

Atherosclerosis
Increases bp

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(Causes of primary hypertension) Which disease state increases atherosclerosis & increases sodium with decreases in potassium, magnesium, and calcium? & how does that affect bp?

Diabetes - Increases bp

(Causes of primary hypertension) What is it called when the vessels constrict instead of dilating?

Endothelial (lining of arteries) dysfunction, increasing bp

(Pathological Effects of Sustained, Complicated Primary Hypertension) Left ventricular hypertrophy, angina, heart failure, MI as heart is having to work too hard... are all potential pathological effects caused...? To the ...?

- Increased workload combined with diminished blood flow through coronary arteries of the myocardium

Renal complications, arterial sclerosis (thickening over time due to increased pressure) & damage to endothelium, cerebrovascular complications such as transient ischemia, stroke, cerebral thrombosis, aneurysm, hemorrhage, & dementia – too much volume is pumped through vessels Are all pathological effects of ____

Complicated Primary Hypertension

(Pathological effects of sustained, complicated primary hypertension) Which term refers to retinal vascular damage caused by hypertension where fundus examination shows: vascular changes, hemorrhages, cotton-wool spots, yellow hard exudates, and optic disk edema?

Hypertensive retinopathy

(Pathological effects of sustained, complicated primary hypertension) Which term refers to the medical emergency of a bp > 180/120 where there is a rapid progression of hypertension causing an increase in arterial pressure, & vascular fluid is pushed into interstitial space leading to cerebral edema or encephalopathy – other systems involved – medical emergency?

Hypertensive crisis

Which type of hypertension is caused by a systemic disease process that raises peripheral vascular resistance or cardiac output? Such as Renal vascular or parenchymal disease, (renal failure) OR.. Adrenal tumours: adrenocortical tumors or adrenomedullary tumors; OR... Medications: NSAIDS, acetaminophen What does it frequently involve though?

Secondary hypertension - Kidneys, where if you fix the disease the hypertension will be solved

Why is hypertension labeled as a silent killer? & what do manifestations include once damage is done?

Since it is frequently asymptomatic until affected organ disease (no manifestations early on) - Heart disease , myocardial infarction, cerebrovascular accident (CVA or stroke), kidney failure, vision loss headaches, epitaxies (nose bleeds), confusion, & dyspnea

Which term refers to low blood pressure occuring when there is one or a combination of the following factors: decrease in blood volume, vasodilation, &/or decrease in cardiac contractility ?

Severe hypotension

Symptoms of hypotension include..?

fatigue, lightheadedness, dizziness, nausea, clammy skin, depression, loss of consciousness, blurry vision, & irritation

Pregnancy, large amounts of blood loss, heart attack or faulty valves causing impaired circulation, weakness & a state of shock, anaphylactic, infections of the bloodstream, & endocrine disorders such as diabetes,adrenal insufficiency, and thyroid disease. Are all potential causes for...?

Acute Hypotension

Which term refers to a sudden decrease in bp from moving from sitting to standing, or from lying down to standing, gravity acts on the vascular system which reduces the volume of blood returning to the heart and blood pools in the leg? Where the lower venous return reduces the volume of blood that is available to pump out of the heart, which causes a drop in Cardiac output and a momentary drop in BP. This drop can be particularly marked when moving from lying down to standing and can increase the risk of falls.

Orthostatic hypotension

Which term refers to a localized dilation or outpouching of a vessel wall or cardiac chamber?

Aneurysm

Which term refers to an aneurysm involving all three layers of the arterial wall and are best described as a weakening of the vessel wall? Where the artery or vessel weakens and bulges, sometimes forming a blood-filled sac

True aneurysm

Which term refers to when a blood vessel wall is injured and the leaking blood collects in the surrounding tissue leading to an extravascular hematoma?

False aneurysm, a pseudoaneurysm, or pseudoaneurysm of the vessels

Which term refers to an aneurysm that splits the vessel wall along the length of the vessel?

Dissecting aneurysm

Which types of aneurysms are the most common?

Abdominal aortic aneurysms (AAA) & thoracic aortic Aneurysm

Smoking, bad diet, atherosclerosis, & hypertension are all risk factors for..?

Aneurysms

Manifestations of aneurysms depend on..? Where they can be..?

- Location - Can be asymptomatic until they rupture, causing severe pain & hypotension

Dysphagia, dyspnea – bulge affects surrounding tissue are all manifestations of which type of aneurysm?

Thoracic aneurysm

Ischemia to lower limbs occurs if this type of aneurysm affects circulation..?

Femoral aneurysm

Which often occur in the circle of Willis, are associated with signs and symptoms of increased intracranial pressure. Signs and symptoms of stroke occur when this type of aneurysms leak This is...?

Cerebral aneurysm

___ ____ presents with hypotension and severe back pain – large amount of bleeding internally, moves into lower extremities due to gravity

Ruptured aneurysm

Which term refers to the obstruction of a vessel by an embolus—a bolus of matter circulating in the bloodstream? The embolus may consist of a dislodged thrombus; an air bubble; an aggregate of amniotic fluid; an aggregate of fat, bacteria, or cancer cells; or a foreign substance. An embolus travels in the bloodstream until it reaches a vessel through which it cannot pass.

Embolism

(Dislodged thrombus) Pulmonary emboli originate on the ___? Usually due to ___ Arterial emboli originate in ___ ___? Due to __?

- On the venous side, usually due to a DVT - Left ventricle, after a MI, valvular disease, endocarditis, & dysrhythmias

Which term refers to a bolus of air that displaces blood in vasculature; source usually room air entering circulation through intravenous (IV) lines; trauma to chest also may allow air from lungs to enter vascular space?

Air embolism

Which term refers to extensive intra-abdominal pressure attending labour and delivery can force amniotic fluid into bloodstream of mother; introduces antigens, cells, and protein aggregates that trigger inflammation, coagulation, and immune responses?

Amniotic fluid embolism

Which term refers to globules of fat floating in bloodstream associated with trauma to long bones; lungs in particular are affected?

Fat embolism

Which term refers to an aggregate of bacteria in the bloodstream; source is subacute bacterial endocarditis or abscess?

Bacterial embolism

Which term refers to small particles or fibres introduced during trauma or through an IV or intra-arterial line; coagulation cascade is initiated and thromboemboli form around particles?

Foreign matter embolism

What does an embolism cause in tissue distal to obstruction?

- Ischemia or infarction, & can be life threatening depending on the location. It also produced organ dysfunction & pain

What will occlusion in the coronary artery cause..? What will occlusion in the cerebral artery cause..? What will occlusion in the pulmonary artery cause..?

- MI - Stroke - Emboly

Which term refers to atherosclerotic disease of arteries in limbs, with intermittent claudication, which is muscle pain that happens when you're active and stops when you rest?

Peripheral artery disease

When peripheral artery disease is gradual, what occurs?

- There is pain with ambulation, such as walking more than 50 steps, or climbing the stairs, and it stops if ambulation stops

When peripheral artery disease is acute, what occurs?

- Thrombus development over atherosclerotic lesion

Which term refers to an inflammatory disease of the peripheral arteries, that is strongly associated with smoking, where this disease condition is characterized by the formation of thrombi filled with inflammatory and immune cells, also, over time, these thrombi become organized and fibrotic and result in permanent occlusion and obliteration of portions of small- and medium-sized arteries in the feet and sometimes in the hands? Symptoms of said disease condition are...? Which are caused by manifestations are caused by sluggish blood flow and include rubor (redness of the skin), which is caused by dilated capillaries under the skin, and cyanosis, which is caused by tissue ischemia. Due to dilated capillaries under skin, the skin becomes..? This disease has also been associated with..?

- Thromboangiitis Obliterans (Buerger's Disease) - Pain & tenderness. - Skin is thin and shiny & nails are thick and deformed - Cerebrovascular disease (stroke), & rheumatic symptoms (joint pain)

Which term refers to a disease that is characterized by attacks of vasospasm in the small arteries and arterioles of the fingers and, less commonly, the toes? The primary type of this disease is...? The secondary type of this disease is...?

Raynaud Phenomenon - Primary Raynaud phenomenon: Is a common primary vasospastic disorder of unknown origin - Secondary Raynaud phenomenon: Is associated with systemic diseases, such as lupus

Which disease is associated with clinical manifestations such as changes in skin colour and sensation caused by ischemia, & vasospasm occurs with varying frequency and severity and causes pallor, numbness, and the sensation of coldness in the digits?

Raynaud Phenomenon