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Pathophysiology > Ch-24 Part 1 Alteration in Cardiovascular Function > Flashcards

Ch-24 Part 1 Alteration in Cardiovascular Function Flashcards

1
Q

What is varicose veins?

A

vein where blood has pooled, producing distended and palpable vessels.

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2
Q

What is the cause of varicose veins?

A

trauma that damages valves or gradual distension caused by action of gravity.

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3
Q

In varicose vein, valve damage is due to increase ____ (1) and ____ (2) of blood under pressure of gravity.

A

pressure (1) & volume (2)

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4
Q

What veins of legs is involve in varicose veins?

A

saphenous veins

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5
Q

What causes that remodel of vessel wall? What does it lead to when vessel wall is changed?

A

enzymes; veins swell with increased pressure thus the pressure pushes plasma through vessel wall.

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6
Q

What are the risk factors of varicose veins?

A
  • standing for long time
  • age
  • obesity
  • genetics
  • pregnancy
  • previous leg injury
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7
Q

Varicose veins tx?

A
  • elevated legs
  • compression stockings
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8
Q

What is the invasive tx for varicose veins?

A

surgical ligation (tying up blood vessels)

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9
Q

Which disease of veins is associated with inadequate venous return over extended period?

A

chronic venous insufficiency

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10
Q

What are the symptoms of chronic venous insufficiency? (4 pts)

A

edema of lower extremeties; hyperpigmentation of ankle and feet skin; circulation sluggish, reduced O2 to cells

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11
Q

What are the risk for chronic venous insufficiency?

A

infection

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12
Q

What happens if there is a reduced O2 to cells?

A

necrosis

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13
Q

T or F: Reduced circulation makes surgery a risk for chronic venous insufficiency?

A

TRUE

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14
Q

Which disease of veins is associated with infection due to poor circulation in veins, thus it impairs delivery of O2?

A

venous static ulcers

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15
Q

What is the difference between thrombus and thromboembolism?

A

thrombus – blood clot that remains attached to vessel wall

Thromboembolism – a detached thrombus

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16
Q

T or F: Arterial thrombi is more common than Venous thrombi as flow and pressure are lower in artery.

A

FALSE; Venous thrombi is more common as flow and pressure are lower in VEINS

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17
Q

What are the 3 Virchow Triad that promote Deep Venous Thrombosis (DVT)

A
  1. Venous stasis
  2. Venous endothelial damage
  3. Hypercoagulable states
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18
Q

What is the increased tendency of blood to thrombose?

A

Hypercoagulable states

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19
Q

What is the cause of hypercoagulable states?

A

pregnancy, oral contraceptives & heredity

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20
Q

What are some examples of venous stasis? (3 pts)

A

immobility, age and heart failure

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21
Q

What is Superior Vena Cava Syndrome?

A

progressive OCCLUSION of SVC leads to venous distension to upper extremities and head

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22
Q

What causes of SVC syndrome?

A

Bronchogenic cancer

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23
Q

What % of cases does bronchogenic cancer cause SVC syndrome?

A

75%

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24
Q

When people have bronchogenic cancer, their lung ___ (1) abuts _____ (2) = bronchi cancer puts pressure on SRV.

Results:
_____ (3) and venous distension in upper extremities and ______ (4)

A
  1. bronchi
  2. SVC
  3. edema
  4. face
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25
What is the effect of edema and venous distension in upper extremities and face? (4 pts)
tightness of shirts collars, necklaces, headache, & visual disturbances.
26
What are the diagnosis for SVC?
chest x-ray , CT & MRI
27
What are the tx for thrombus formation in veins?
- most dissolve without tx. - meds like anticoagulants(e.g., aspirin, warfarin)
28
What is the diagnosis for thrombus formation in veins?
doppler ulatrasonography
29
What tx is associated with non-invasive test that can be used to estimate blood flow through blood vessels by bouncing high fq. sound waves? Which disease of veins is this tx associated?
doppler ultrasonography; thrombus formation in veins
30
Thrombus formation in veins pathophysio: Accumulation of clotting factors and ____ (1) near a venous valve = venous obstruction _____ (2) promotes further platelet aggregation = pain and redness Thrombus obstruction creates extremity ___ (3) = ulceration of limb
1. platelets 2. inflammation 3. edema
31
Which diseases of the arteries is associated with consistent elevation of systemic arterial blood pressure?
Hypertension
32
Who are at risk for hypertension?
increases with age; higher in diabetics
33
What are the most effective at maintenance for proper BP?
exercise and proper nutrition
34
What is the difference between primary and secondary hypertension?
Primary - essential or idiopathic; 95% of cases Secondary - caused by separate underlying disorder (e.g., renal disease); 5%
35
What is malignant hypertension?
rapidly progressive hypertension
36
T or F: Malignant hypertension leads to system and organ complications.
TRUE
37
T or F: Malignant hypertension is not considered as a medical emergency.
FALSE; IT IS CONSIDERED AS A MEDICAL EMERGENCY
38
What makes a person have a malignant hypertension? (hint: systolic and diastolic values)
Systolic: > 180mmHg Diastolic: > 120mmHg
39
What are some factors with primary hypertension?
- idiopathic - genetic factors (associated with epigenetic changes) and envrionmental factors
40
T or F: Genetic factors of primary hypertension is associated with epigenetics.
TRUE
41
What does hypertension results from?
increase peripheral resistance (arterial vasoconstriction) & increase blood volume OR BOTH
42
What are the 2 primary factors of primary hypertension?
SNS & RAAS
43
Primary hypertension: Increased in SNS = increased HR, cardiac contractility and systemic _____ (1) = rise in ____ (2).
1. vasoconstriction 2. blood pressure
44
What is RAAS?
Renin -- angiotensin -- angiotensin II -- aldosterone pathway
45
RAAS increase in _____ (1) and angiotensin II
aldosterone
46
Aldosterone increased ____ (1) reabsorption from kidney = increased blood volume = increased BP Angiotensin II = increased _____ (2) = increases vasoconstriction = increased BP
1. Na 2. vasopressin
47
What is sclerosis?
ab hardening of body tissue
48
What is the difference between atherosclerosis and arteriosclerosis?
Atherosclerosis - formation of fatty plague with a core rich in lipids Arteriosclerosis - generic term for vascular disease which causes thickening and inelasticity of arteries
49
T or F: Atherosclerosis is a dominant pattern of arterioscleroisis.
TRUE
50
Athero is from a Greek word athera meaning "_____"
porridge
51
What is the tx for hypertension?
lifestyle modifications: diet and exercise, stopping smoking and losing weight Advance: diuretics, Angiotensin II blockers
52
What disease of arteries is associated with decreased in systolic BP of 20 mmHg or a decrease in diastolic BP of 10 mmHg within 3 min of standing?
orthostatic hypotension
53
What are the signs/symptoms of orthostatic hypotension? (3pts)
dizziness, loss of vision, reduced brain blood flow
54
What is the tx for orthostatic hypotension?
no curative tx. suggested: increased fluid and Na intake, wear thigh-high stockings
55
What is embolism?
vessel obstruction by an embolus.
56
What does embolism consists of?
dislodged thrombus, aggregration of fat/cancer cells or foreign substance
57
Embolism causes _____ (1) (restricts blood supply)/ continual obstruction = ______ (2) which results in necrosis.
1. ischemia 2. infarction
58
Which disease of arteries is associated with localized dilation (outpouching) of vessel wall?
aneurysm
59
T or F: Aneurysm involves all three layers of arterial wall, thus weakening of vessel wall.
TRUE
60
Where do aneurysm most commonly occur?
aorta
61
Why is aorta the most common area where aneurysm develops?
result of constant high-pressure stress
62
What are the risk factors of aneurysm? (3pts)
smoking, genetics and diet
63
What are the 3 CV vessel layers?
tunica adventitia, tunica media and tunica intima
64
Which disease of the arteries is associated with inflammation of peripheral arteries?
Thromboangiitis obliterans or (Buerger's disease)
65
T or F: Thromboangiitis obliterans is strongly associated with alcoholism.
FALSE; Strongly associated with SMOKING
66
T or F: Thromboangiitis obliterans is an autoimmune disease
TRUE
67
What are the symptoms of thromboangiitis obliterans? (2 pts)
pain and tenderness in affected area (usually extremities)
68
What are the signs of thromboangiitis obliterans? (3 pts)
reddish skin , thickened and malformed nails
69
Advanced thromboangiitis obliterans cause what?
causes gangrene amputation
70
What are the tx thromboangiitis obliterans?
stop smoking/ if not = amputation likely required
71
Atherosclerosis is the leading cause of ___ ___ disease
coronary artery disease
72
What are the causes of atherosclerosis? (6pts)
1. smoking 2. hypertension 3. diabetes 4. increased low-density lipoproteins 5. decreased levels of high-density lipoproteins 6. autoimmune action
73
Atherosclerosis Pathophysiology: Begins with injury to epithelial cells lining artery wall. Injured cells become _____ (1) Inflamed cells express adhesion molecules that bind _____ (2) Bound macrophages release ____ (3) and enzymes that further damage vessel wall Inflammation causes ___ ___ (4) to oxidize ___(5) that has accumulated in vessel _____ (6) Macrophages engulf oxidized LDL Macrophage now called '____' (7) Foam cells accumulate and form ____ ____ (8) Fatty streak results in recruitment of ____ cells (9) = autoimmunity = more damage to vessel wall. Macrophage release growth factors = production of _____ (10) Collagen accumulates over fatty streak forming a ____ ___ (11) Fibrous plaque protrudes into lumen = obstructs/occludes blood flow Fibrous plaques may rupture -- called ___ (12) plaques Complicated plagues produce rapid ____ (13) formation Result in occlusion/ thrombus formation = _____ (14)/infarction
1. inflammed 2. macrophages 3. cytokines 4. free radicals 5. LDL 6. intima 7. foam cell 8. fatty streak 9. T cells 10. collagen 11. fibrous plague 12. complicated plagues 13. thrombus 14. ischemia

Pathophysiology (20 decks)

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