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Cardiopulmonary > Central Vascular Pathophysiology > Flashcards

Central Vascular Pathophysiology Flashcards

1
Q

How does kidney dysfunction cause systemic hypertension?

A

Causes hypertension by increasing fluid retention and overactivating the RAAS, leading to vasoconstriction and higher blood pressure.

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2
Q

Why do elevated catecholamines and thyroid hormone cause systemic hypertension?

A

increase heart rate and vasoconstriction, while excess thyroid hormone raises cardiac output and enhances sensitivity to catecholamines

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3
Q

Why is there a relationship between sleep apnea and systemic HTN?

A

Sleep apnea causes intermittent hypoxia, which activates the sympathetic nervous system and increases blood pressure, contributing to systemic hypertension.

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4
Q

What hormones can increase BP?

A

Angiotensin II
Aldosterone
Catecholamines (e.g., epinephrine, norepinephrine)
Vasopressin (ADH)
Thyroid hormone

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5
Q

Critical hypertension is when sBP is above what value?

A

above 180 mmHg

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6
Q

Critical hypertension is when dBP is above what value?

A

140 or above

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7
Q

Does systemic hypertension compromise preload or afterload

A

Afterload

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8
Q

Does systemic hypertension compromise the right or left side of the heart?

A

Left side

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9
Q

What is normal pulmonary blood pressure (sBP/dBP)?

A

20/10 mmHg

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10
Q

What are the exercise stopping points for sBP and dBP?

A

250 sys, 115 dias.
if sBP goes down or if dBP goes down more than 10 mmHg

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11
Q

Pulmonary hypertension is defined as a sBP is above what value?

A

25 at rest and 30 and above during activity

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12
Q

Pulmonary hypertension is defined as a dBP is above what value?

A

20 at rest

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13
Q

How is pulmonary BP measured?

A

pulmonary artery catheter

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14
Q

Why does systemic hypertension sometimes cause chest pain?

A

increased myocardial oxygen demand, which may exceed supply, leading to ischemia.

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15
Q

How does pulmonary hypertension cause low O2 sats?

A

Higher pressure decreases transit time. Less gas exchange.

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16
Q

Why is the reduction in O2 sats greater with exercise?

A

increased physical activity demands more oxygen. Higher demand.

17
Q

What is the mechanism that causes peripheral edema with pulmonary hypertension?

A

pulmonary hypertension puts increased strain on the right ventricle. This can lead to right heart failure. Blood backs up in the venous system, leading to fluid retention and edema

18
Q

What type of exercise(s) prevents/ lowers BP?

A

Aerobic

19
Q

What diet modifications help lower BP?

A

Sodium reduction, increase potassium reduce alcohol, reduce caffeine

20
Q

How does smoking increase BP?

A

by causing vasoconstriction, stimulating the release of catecholamines, and promoting inflammation, which leads to arterial stiffness and increased heart rate.

21
Q

What is an aneurysm? Where can they occur in the body?

A

bulging of a blood vessel wall due to weakness in the vessel. Can occur in pretty much any artery.

22
Q

What are the 2 main pathologies associated with aortic aneurysm?

A

Thrombus
Rupture

23
Q

What is an aortic dissection?

A

a serious condition where there is a tear in the inner layer of the aortic wall, allowing blood to flow between the layers of the artery.

24
Q

What is the main pathology that occurs with an aortic dissection?

A

tear of the tunica intima (inner layer) of the aorta, leading to the creation of a false lumen where blood flows between the layers of the aortic wall.

25
Q

How does an aortic dissection compromise heart fluid dynamics?

A

Stroke volume decreases due to afterload. End systolic increases. Blood doesn’t get out as well.

26
Q

What can cause thrombi formation in the heart?

A

A-fib, MI, heart valve disease

27
Q

Where do thrombi travel to the lungs?

A

Through the right side of the heart

28
Q

Which veins are most at risk for generating thrombi that become PEs?

A

Deep veins of the LE

29
Q

Pathophysiology for V-Q mismatching

A

Obstruction of pulm. Arteries impedes BF. Areas of lung distal to embolism are ventilated but not perfused.

30
Q

Pathophysiology for Lung tissue hypoxia

A

Reduced BF leads to less oxygenated blood.

31
Q

Pathophysiology for Pulmonary artery hypertension

A

Obstruction increases resistance to BF

32
Q

Pathophysiology for blood stasis

A

Slow blood is able to clot

33
Q

Pathophysiology for hypercoagulability

A

Blood able to clot easily can form a thrombus easier

34
Q

Pathophysiology for vessel injury

A

Damage to vessel walls expose pro-coagulant factors.

35
Q

If you suspected a patient had a PE, what course of act would be appropriate?

A

Call 911 immediately. Go to ER

Cardiopulmonary (7 decks)

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