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Patho test #1 > Cardiovasular #1 > Flashcards

Cardiovasular #1 Flashcards

1
Q

What are the determinants of cardiac output?

A

Heart rate (HR)
Stroke Volume (SV)

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2
Q

What is systolic blood pressure?

A

Pressure of blood against the arteries when the heart is pumping (ventricles contract).

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3
Q

what is diastolic blood pressure?

A

Pressure of blood against the arteries when the heart is relaxed (ventricles filling).

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4
Q

An ideal systolic blood pressure is below _______mmHg. An ideal diastolic blood pressure is below _________ mmHg.

A

An ideal systolic blood pressure is below 120 mmHg

An ideal diastolic blood pressure is below 80 mmHg.

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5
Q

Blood pressure is determined by which two main factors?

A

-Cardiac output (CO)
-Total peripheral resistance (TPR)

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6
Q

When your your cardiac output and your total peripheral resistance are increased, due to exercise, running away from danger etc. What is the name of that part of the nervous system?

A

Sympathetic Nervous system

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7
Q

TPR is determined by which factors?

A

-Diameter of blood vessels
-Length of blood vessels
-Blood viscosity (thickness)

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8
Q

Which of the following factors has the largest impact on TPR?

-Diameter of blood vessels
-Length of blood vessels
-Blood viscosity (thickness)

A

Diameter of blood vessels

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9
Q

How can parasympathetic nervous system stimulation cause hypotension?

A

The parasympathetic nervous system, especially via the vagus nerve, slows the heart rate and causes vasodilation.

when the vagus nerve is over stimulated (eg during a straining bowel motion), it can cause;

-massive vasodilation
-reduced heart rate (leading to a sudden drop in blood pressure, hypotension)

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10
Q

what is hypotension?

A

Hypotension is decreased, or low, blood pressure.

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11
Q

what are signs of Orthostatic Hypotension?

A

-Feeling lightheaded or dizzy
-confusion
-Blurred vision or decreased vision
-syncope (fainting)

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12
Q

What are some risk factors for developing orthostatic hypotension and decribe how they would cause the blood pressure to drop?

A

-old age
-medications such as beta blockers
-hypovolemia (eg dehydration)
-sodium deficency
-pregancy
-nervous system disorders (eg dementia or parkinsons)

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13
Q

What is orthostatic hypotension

A

Orthostatic hypotension is when your blood pressure suddenly drops when you reposition your body. Eg laying down to standing up.

This happens if the body is too slow to cause vasoconstriction.

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14
Q

what is vasoconstriction?

A

Vasoconstriction occurs when the body detects a rapid drop in blood pressure. Rapidly vasoconstriction will occur to increase blood pressure, and ensure blood gets moving back to and out of the heart appropriately again.

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15
Q

What are three complications of hypertension?

A

1- Stroke
2-Heart failure
3-Kidney damage

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16
Q

Why is hypertension called the ‘silent killer’?

A

When blood pressure is consistently above 140/90mmHg. Its called the silent killer because it causes organ damage without symptoms, often until its too late.

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17
Q

How can hypertension lead to stroke?

A

High blood pressure can weaken or damage arteries in the brain leading to,

-Ischemic stroke (blocked blood flow)

-Hemorrhagic stroke (ruptured blood vessel), this reduces oxygen to brain tissue= brain damage or death

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18
Q

How does hypertension cause heart failure?

A

The heart has to work harder to pump against higher pressure.

overtime this causes

-thickened heart muscle (especially left ventricle)

-Weakened pumping ability, eventually leading to heart failure

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19
Q

How can hypertension damage the kidneys?

A

High blood pressure damages tiny blood vessels in the kidneys (nephrons), reducing their ability to;

-filter waste

-Regulate fluid/electrolytes. This can lead to chronic kidney disease or kidney failure.

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20
Q

How do beta-blockers (eg, metoprolol) reduce blood pressure?

A

They block receptors for norepinephrine and epinephrine in the heart and blood vessels. This slows the heart rate, reduces cardiac output and promotes vasodilation, lowering blood pressure

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21
Q

How do ACE inhibitors (eg, captopril) affect blood pressure?

A

They block the conversion of angiotension I to angiotensin II, a powerful vasoconstrictor.

This causes vasodilation and less aldosterone, which reduces sodium & water retention, lowering BP.

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22
Q

How do ARBs (eg candesartan) reduce blood pressure? (RAAS blockers)

A

They block angiotensin II receptors on blood vessels, preventing vasoconstriction. This results in relaxed vessels and reduced blood pressure.

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23
Q

How do aldosterone blockers (e.g., Spironolactone) lower BP?

A

They block aldosterone receptors in the kidneys, preventing sodium and water reabsorption.
This reduces blood volume, lowering blood pressure, but can cause high potassium levels.

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24
Q

How do loop diuretics (e.g., Frusemide) manage hypertension?

A

They block sodium reabsorption in the Loop of Henle, leading to water loss (diuresis).
This reduces blood volume and blood pressure. Watch for low potassium & dehydration.

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25
How do calcium channel blockers (e.g., Amlodipine) affect BP?
They block calcium from entering smooth muscle cells in blood vessels. No calcium = less contraction, leading to vessel relaxation and lower blood pressure.
26
What is the RAAS system?
Its the bodys hormaonal system that helps regulate blood pressure and fluid balance
27
What is arteriosclerosis?
Arteriosclerosis is when the walls of the arteries become thick and hard, making it harder for blood to flow. This can happen with age, high blood pressure, or damage to the arteries. It reduces blood flow and can lead to heart and circulation problems.
28
What is the pathophysiology of atherosclerosis?
1- Artery lining gets damaged (e.g. from smoking, high BP). 2-LDL cholesterol enters the damaged area. 3- Body reacts with inflammation. 4- White blood cells turn into foam cells, forming a fatty streak. 5- A plaque forms (fat + immune cells + calcium). 6- The plaque narrows the artery and can rupture, leading to blood clots.
29
What are the risk factors for developing atherosclerosis?
High LDL (bad cholesterol) Smoking High blood pressure (hypertension) Diabetes Obesity Physical inactivity Older age Family history Unhealthy diet
30
What are the complications of atherosclerosis?
-Heart attack (MI) – if plaque blocks a coronary artery -Stroke – if plaque affects brain arteries -Peripheral artery disease – poor circulation in legs -Aneurysm – weak artery wall bulges -Gangrene – tissue death from poor blood flow
31
what does LDL stand for?
Low density lipoprotein
32
What does HDL stand for
High density lipoprotein
33
What is LDLs job?
LDL is "lousy" cholestrerol. -It carries cholesterol to your arteries -Needed to carry cholesterol to cells (important for hormones, vitamin D, etc.) -It can stick to artery walls and cause blockages -It increases risk of heart attack and stroke -It contributes to plaque build up, (atherosclerosis)
34
are high levels LDLs good or bad
High levels of LDLs are bad for the heart
35
What is HDLs job?
-HDL is healthy cholesterol -Carries cholesterol away from the arteries, cleaning up extra from you blood -Returns it to the liver for excertion -Helps protect against heart disease
36
are high levels HDLs good or bad
High levels of HDLs are good for the heart
37
What is the desirable level of cholesterol in the blood?
Lower than 5.0mmol/L is desirable
38
what is the ideal level of LDL cholesterol?
Less than 2.6mmol/L is desirable
39
What a elevated level of LDL cholesterol
More than 3.4mmol/L is too elevated
40
What is the ideal level of HDL cholesterol for men?
More than 1.0 mmol/L is ideal for men
41
What is the ideal level of HDL cholesterol for women?
More than 1.3mmol/L is ideal for women
42
At what stage is HDL levels too low?
Less than 1.0mmol
43
What is Peripheral Artery Disease (PAD)?
PAD is a type of peripheral vascular disease caused by atherosclerosis in arteries of the limbs (especially legs). It reduces blood flow, often linked with diabetes & coronary artery disease.
44
Pathophysiology of Peripheral Artery Disease (PAD)?
-Fatty plaques (atherosclerosis) build up in limb arteries -Arteries narrow meaning less oxygen-rich blood gets through -Muscles and tissues don't get enough blood during activity -Can be gradual or sudden (acute) blockage -Same risk factors as atherosclerosis (e.g. smoking, high cholesterol)
45
Signs and symptoms of Peripheral Artery Disease (PAD)?
-Intermittent claudication: cramping or pain during walking/exercise - Cold, pale, or blue skin on legs/feet -Weak or absent foot/leg pulses -Leg ulcers that don’t heal - Severe pain with sudden blockages -Gangrene (tissue death) if severe or untreated
46
what are statins used for?
Statins (e.g. Simvastatin) are used to treat high cholesterol (hypercholesterolemia). They help lower LDL ("bad") cholesterol and reduce the risk of heart disease and stroke.
47
How do statins work?
Statins block an enzyme in the liver that helps make LDL cholesterol. Less LDL = less plaque buildup in arteries = less cardiovascular risk.
48
what are some Important side effects of statins
- Leg cramps or muscle pain (can be severe) - Liver effects – check liver function with labs - Can interact with grapefruit juice (raises statin levels)
49
what are some Nursing cares to consider when giving statins?
- Monitor cholesterol levels (labs) -Assess for leg/muscle pain or weakness - Give at night (when liver makes more cholesterol) -Educate client to avoid grapefruit juice
50
How can constipation in the elderly lead to syncope (fainting)? A- Increased abdominal pain sensitivity with aging B- Drinking too much fluid to relieve constipation C- Straining on the toilet can stimulate the parasympathetic nervous system D- Post-defecation muscle stimulation reduces blood flow to the head
C- Straining on the toilet can stimulate the parasympathetic nervous system Activating the PSNS can lead to vasodilation which will allow blood to pool in the lower limbs, reducing return to the heart and blood pumped to the brain
51
A client has a blood pressure reading of 145/92. The client is asymptomatic. The GP writes for the client to come back in 2 weeks to check the blood pressure again, but during that 2 weeks, the client likely is started on: A- a calcium channel blocker and a loop diuretic B- a low sodium diet and increased exercise C- a calcium channel blocker and exercise D- a low sodium diet and a loop diuretic
B- a low sodium diet and increased exercise At this stage, hypertension is not diagnosed- the GP would like an additional measure to confirm. However, with a Bp measure this high, it would be worth trying something to reduce BP if indeed hypertension is an issue. Reducing sodium in the diet and increasing exercise are ways to help the body mauntaun a more homesostatic blood presure, and if subsequent blood pressure measure are nit high, these changes wont have liked caused any problem (and the client can return to their normal diet if no other problems are detecred).
52
How does hypertension lead to atherosclerosis?
Hypertension causes micro-insults into the epithelial lining of the blood vessels. The bodys response to damage is to start inflammation. Atherosclerosis is a form of inflammatory response.
53
what are 6 risk facors of developing orthostatic hypotension
Older rage, Medications, Hypovolemia, mineral deficiencies, Pregnancy, Nervous system disorders
54
Why is old age a risk factor for hypotension
Vascular changes with age can affect how easily vessels are able to respond to blood flow changes; decreased thirst reflex can also have an influence on blood volume and therefor blood pressure, which may not be adequate when body position changes.
55
Why is medication a risk factor for hypotension?
Blood pressure medications, especially beta blockers which stop the sympathetic nervous system from reacting quickly to increase blood pressure when a person stands.
56
Why is Hypovemia a risk factor for hypotension?
This can be caused by dehydration (eg from heat exposure)
57
Why is pregnancy a risk factor for hypotension?
Pregancy hormones relax smooth muscle, enhancing vasodilation which may contribute to increased pooling of blood in veins in the lower limbs.
58
Why are nervous system disorders a risk factor for hypotension?
Diseases like parkinsons or dementia can affect
59
Why are you at higher risk for hypotension after just eating?
Blood has gone to the stomach and the parasympathetic nervous system is activated
60
What is a foam cell? A- A macrophage that has engulfed oxidized LDL cholesterols within the tunica intima B- A cell that transports cholesterol through the blood C- The soft cells surrounding a hardened atherosclerotic plaque D- A collection of smooth muscle cells surrounded by elastic fibres within the tunica intima
A- A macrophage that has engulfed oxidized LDL cholesterols within the tunica intima
61
describe arteriosclerosis
Hardending, stiffening and thickening of arterial walls
62
intermittent claudication is the most common (and typically first) sign of peripheral artery disease. describe intermittent claudication.
Cramping or pain felt in the lower limb when moving or exercising (the pain/cramping typically subsides with rest)
63
Briefly outline the formation of an atherosclerotic plaque once foam cells have formed.
Foam cells accumulate forming a fatty streak, smooth muscle cells invade the tunica intimacy and produce collagen fibers, forming a fibrous cap around the fatty streak. Calcium deposits form within the plaque as it continues to grow.
64
What will happen after an atherosclerotic plaque ruptures?
A thrombus forms over the site of rupture (due to the exposure of underlying tissues)

Patho test #1 (13 decks)

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