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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
Q

What is the effect of edema and venous distension in upper extremities and face? (4 pts)

A

tightness of shirts collars, necklaces, headache, & visual disturbances.

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26
Q

What are the diagnosis for SVC?

A

chest x-ray , CT & MRI

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27
Q

What are the tx for thrombus formation in veins?

A
  • most dissolve without tx.
  • meds like anticoagulants(e.g., aspirin, warfarin)
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28
Q

What is the diagnosis for thrombus formation in veins?

A

doppler ulatrasonography

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29
Q

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?

A

doppler ultrasonography; thrombus formation in veins

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30
Q

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

A
  1. platelets
  2. inflammation
  3. edema
31
Q

Which diseases of the arteries is associated with consistent elevation of systemic arterial blood pressure?

A

Hypertension

32
Q

Who are at risk for hypertension?

A

increases with age; higher in diabetics

33
Q

What are the most effective at maintenance for proper BP?

A

exercise and proper nutrition

34
Q

What is the difference between primary and secondary hypertension?

A

Primary - essential or idiopathic; 95% of cases

Secondary - caused by separate underlying disorder (e.g., renal disease); 5%

35
Q

What is malignant hypertension?

A

rapidly progressive hypertension

36
Q

T or F: Malignant hypertension leads to system and organ complications.

A

TRUE

37
Q

T or F: Malignant hypertension is not considered as a medical emergency.

A

FALSE; IT IS CONSIDERED AS A MEDICAL EMERGENCY

38
Q

What makes a person have a malignant hypertension? (hint: systolic and diastolic values)

A

Systolic: > 180mmHg
Diastolic: > 120mmHg

39
Q

What are some factors with primary hypertension?

A
  • idiopathic
  • genetic factors (associated with epigenetic changes) and envrionmental factors
40
Q

T or F: Genetic factors of primary hypertension is associated with epigenetics.

A

TRUE

41
Q

What does hypertension results from?

A

increase peripheral resistance (arterial vasoconstriction) & increase blood volume

OR BOTH

42
Q

What are the 2 primary factors of primary hypertension?

A

SNS & RAAS

43
Q

Primary hypertension: Increased in SNS = increased HR, cardiac contractility and systemic _____ (1) = rise in ____ (2).

A
  1. vasoconstriction
  2. blood pressure
44
Q

What is RAAS?

A

Renin – angiotensin – angiotensin II – aldosterone pathway

45
Q

RAAS increase in _____ (1) and angiotensin II

A

aldosterone

46
Q

Aldosterone increased ____ (1) reabsorption from kidney = increased blood volume = increased BP

Angiotensin II = increased _____ (2) = increases vasoconstriction = increased BP

A
  1. Na
  2. vasopressin
47
Q

What is sclerosis?

A

ab hardening of body tissue

48
Q

What is the difference between atherosclerosis and arteriosclerosis?

A

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
Q

T or F: Atherosclerosis is a dominant pattern of arterioscleroisis.

A

TRUE

50
Q

Athero is from a Greek word athera meaning “_____”

A

porridge

51
Q

What is the tx for hypertension?

A

lifestyle modifications: diet and exercise, stopping smoking and losing weight

Advance: diuretics, Angiotensin II blockers

52
Q

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?

A

orthostatic hypotension

53
Q

What are the signs/symptoms of orthostatic hypotension? (3pts)

A

dizziness, loss of vision, reduced brain blood flow

54
Q

What is the tx for orthostatic hypotension?

A

no curative tx.
suggested: increased fluid and Na intake, wear thigh-high stockings

55
Q

What is embolism?

A

vessel obstruction by an embolus.

56
Q

What does embolism consists of?

A

dislodged thrombus, aggregration of fat/cancer cells or foreign substance

57
Q

Embolism causes _____ (1) (restricts blood supply)/ continual obstruction = ______ (2) which results in necrosis.

A
  1. ischemia
  2. infarction
58
Q

Which disease of arteries is associated with localized dilation (outpouching) of vessel wall?

A

aneurysm

59
Q

T or F: Aneurysm involves all three layers of arterial wall, thus weakening of vessel wall.

A

TRUE

60
Q

Where do aneurysm most commonly occur?

A

aorta

61
Q

Why is aorta the most common area where aneurysm develops?

A

result of constant high-pressure stress

62
Q

What are the risk factors of aneurysm? (3pts)

A

smoking, genetics and diet

63
Q

What are the 3 CV vessel layers?

A

tunica adventitia, tunica media and tunica intima

64
Q

Which disease of the arteries is associated with inflammation of peripheral arteries?

A

Thromboangiitis obliterans or (Buerger’s disease)

65
Q

T or F: Thromboangiitis obliterans is strongly associated with alcoholism.

A

FALSE; Strongly associated with SMOKING

66
Q

T or F: Thromboangiitis obliterans is an autoimmune disease

A

TRUE

67
Q

What are the symptoms of thromboangiitis obliterans? (2 pts)

A

pain and tenderness in affected area (usually extremities)

68
Q

What are the signs of thromboangiitis obliterans? (3 pts)

A

reddish skin , thickened and malformed nails

69
Q

Advanced thromboangiitis obliterans cause what?

A

causes gangrene amputation

70
Q

What are the tx thromboangiitis obliterans?

A

stop smoking/ if not = amputation likely required

71
Q

Atherosclerosis is the leading cause of ___ ___ disease

A

coronary artery disease

72
Q

What are the causes of atherosclerosis? (6pts)

A
  1. smoking
  2. hypertension
  3. diabetes
  4. increased low-density lipoproteins
  5. decreased levels of high-density lipoproteins
  6. autoimmune action
73
Q

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

A
  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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