Ch. 8 Cardiovascular System Flashcards
1
Q
Heart rate is controlled by what?
A
Autonomic Nervous System
2
Q
What are the 4 layers of the Heart?
A
- Endocardium- inner layer
- Myocardium- muscular layer
- Epicardium- outer layer
- Pericardium- fibrous sac
3
Q
What are the 3 layers of the arteries?
A
- Adventitia- endothelium inner layer
- Media- smooth muscle middle layer
- Intima/Lumen- connective tissue external layer
4
Q
What takes place within the capillary network?
A
Exchange of nutrients and CO2 to O2
5
Q
This is the gold standard in diagnosis and treatment of stenosis in both legs and the heart. It is the most commonly performed procedure for cardiovascular disease.
A
Angiography
6
Q
The contraction of the myocardium is what?
A
Systole
7
Q
The subsequent relaxation of the heart is termed this.
A
Diastole
8
Q
This is the pacemaker of the heart.
A
SA Node (sinoatrial)
9
Q
These carry blood away from the heart.
A
Arteries
10
Q
These are blood vessels that carry blood to the heart.
A
Veins
11
Q
These are microscopic vessels that connect the arteries and veins.
A
Capillaries
12
Q
This is a temporary vessel that is used during in utero life.
A
Ductus Arteriosus
13
Q
This is when the ductus arteriosus does not close at birth.
A
Patent ductus arteriosus
14
Q
This is the narrowing or constriction of the aorta commonly occurring just beyond the branching of the blood vessels to the head and arms compromising the blood flow to the abdomen and lower extremities.
A
Coarction of the Aorta
15
Q
What is a classic sign of coarctation of the aorta?
A
Normal blood pressure in the arms but very low blood pressure in the legs.
16
Q
This is the most frequent cause of hypertension in children.
A
Coarctation of the aorta.
17
Q
This is the most common congenital cardiac lesions permitting mixing of the blood in the systemic and pulmonary circulations.
A
Left-to-Right Shunts/ Septal Defects
18
Q
What controls the magnitude of the left to right shunts?
A
- Defect Size
- Pressure differences
19
Q
What is the most common type of Left to Right shunts/ Septal Defects?
A
Atrial Septal Defect
20
Q
What is a radiographic indication of coarctation of the heart?
A
Rib Notching
21
Q
Rib Notching in coarctation of the heart refers to what radiographically?
A
Well defined bony erosions along the lower rib margin as a result of the enlargement of anastomotic vessels.
22
Q
The blood is generally shunted in which direction causing enlargement of the right side of the heart and increased pulmonary vascularity as the lungs are overloaded with blood.
A
Shunted from the left to the right chamber because of increased pressure on the left side of the heart.
23
Q
This is a type of septal defect in which the foramen oval does not close at birth and an opening remains between the right and left atria.
A
Atrial Septal Defects.
24
Q
Atrial septal defects occur twice as frequently in boys or girls?
A
Girls
25
How are Atrial Septal Defects detected?
Clinically by an audible heart murmur at the upper left sternal border around the age of 1 year.
26
What will Atrial Septal defects look like radiographically?
Enlargement of the right atrium and ventricle resulting in cardiomegaly.
27
This involves defects between the two ventricles of the heart and are more serious because of the pressure difference is greater between the ventricles than between the atria.
Ventricular Septal Defects
28
This is a congenital anomaly in which the aorta arises from the right ventricle instead of the left and the pulmonary trunk arises from the left ventricle instead of the right ventricle.
Transposition of the Great Vessels
29
Transposition of the Great Vessels does not allow what to communicate?
The pulmonary and systemic subsystems.
30
What is the flow of blood through the heart in patients with Transposition of the Great Vessels?
Deoxygenated blood returns to the
- rt atrium into the
- rt ventricle pumped through
- aorta back into the
- systemic subsystem without becoming oxygenated
31
What does Transposition of the Great Vessels appear like Radiographically?
On a CXR is will demonstrate as a narrow mediastinum because the vessels are superimposed and the main pulmonary trunk is not in the usual location
As well as Pulmonary congestion.
32
This is the most common cause of cyanotic congenital heart disease and is a combination of 4 defect.
Tetralogy of Fallot
33
What are the 4 abnormalities associated with Tetralogy of Fallot?
1. High Ventricular Septal Defect
2. Pulmonary Stenosis- obstruction of rt ventricle
3. Overriding of the arotic orifice above the ventricular defect
4. Right Ventricular Hypertrophy- increase in volume
34
This is abnormalities of the hearts valve often causing cardiac symptoms such as dyspnea, fatigue, syncope or chest pains with signs like murmurs.
Valvular Diseases
35
Lesions of the valves in valvular disease can cause what to occur with a patients pulse.
An abnormal pulse will be detected clinically via palpitation.
36
This is the most common cause of chronic valve disease of the heart and is an autoimmune disease that results from a reaction of the patients antibodies against anitgens from a previous streptococcal infection.
Rheumatic Fever
37
Rheumatic Fever most frequently affects these valves and is more common in women than men.
Bicuspid (mitral) Valve and the aortic valves
38
Rheumatic Fever causes this to occur to the connective tissue of the body.
- Inflammatory changes thus affecting the valves within the heart.
- Stenosis- Valve openings too narrow
- Insufficient- Valves do not close completely
39
This is caused by scarring of the valve cusps that eventually adhere to one another. It takes years to become apparent because it takes years for the scarring to affect valve function.
Valvular Stenosis
40
This type of valve stenosis inhibits blood flow from the left atrium into the left ventricle during diastole. It is almost always a complication of Rheumatic Disease.
Mitral (bicuspid) Valve Stenosis
41
Mitral valve stenosis allows what to occur when the valves do not close properly.
Allows blood to reflux during systole.
42
Mitral Stenosis is usually a complication often following what?
- Endocarditis
| - Mitral Valve Prolapse
43
Mitral Stenosis increases pressure in this chamber causing its enlargement.
Left Atrium
44
Mitral Insufficiency is most often caused by what?
Rheumatic Heart Disease
45
What are 2 other causes of Mitral Insufficiency?
- Rupture of the chordae tendineae-heart strings
| - Dysfunction of the papillary muscles- heart ventricle muscle
46
This is regurgitation of blood into the left atrium during ventricular systole causing overfilling and dilation of the left atrium.
Mitral Insufficiency
47
Mitral Insufficiency can lead to a decrease in these 2 things.
1. Ventricular Stroke Volume
| 2. Cardiac Output
48
Cardiac output is the product of?
Stroke volume x heart rate
49
Ventricular Stroke Volume is what?
The volume of blood pumped from one ventricle of the heart with each beat
50
This refers to the inability of the heart to propel blood at a rate and volume sufficient to provide an adequate supply to the tissues.
Congestive Heart Failure (CHF)
51
What are 3 causes of CHF?
1. Intrinsic (natural) Cardiac Abnormality
2. Hypertension
3. Any obstructive process that abnormally increases the peripheral resistance to blood flow.
52
This is when the left ventricle of the heart cannot pump an amount of blood equal to the venous return in the right ventricle and the pulmonary circulatory subsystem becomes overloaded.
Left-sided Congestive Heart Failure
53
THis occurs when the right ventricle cannot pump as much blood as it receives from the right atrium causing the venous blood flow to slow down producing engorgement of the superior and inferior vena cava and edema of the lower extremities.
Right-Sided Congestive Heart Failure
54
Individuals with Left-Sided Congestive Heart Failure are found to have an increased heart rate due to what?
Because the heart tries to overcompensate for the deficiency.
55
What are the most common causes of Left-Sided Congestive Heart Failure?
Hypertension
56
What is a common complaint of individuals with Right-Sided Congestive Heart Failure?
Swelling of the ankles.
57
What does Right-Sided CHF appear like radiographically?
Right ventricle and right atrium appear enlarged.
58
What are common causes of Right-Sided CHF?
- Pulmonary Valve Stenosis
- Emphysema
- Pulmonary Hypertension
59
This is a degenerative condition that affects the major arteries of the body and is the most prevalent disease in humans occuring in epidemic proportions in the U.S.
Atherosclerosis
60
Atherosclerosis is often termed this?
Hardening of the arteries.
61
Atherosclerosis can occur in any artery but mostly affects which ones?
- Aorta
- Coronary Arteries
- Cerebral Arteries
62
These are formations of fibrofatty plaques composed of intracellular and extracellular lipids, muscle, and connective tissue that begin as fatty streaks and progress into fibrous plaques that collect within the vessels reducing its ability to expand during systole.
Atheromas
63
Atheroma Formations are the most common cause of what 2 things?
- CAD- Coronary Artery Disease
| - CVA- Cerberovascular Accident
64
This is the narrowing of the lumen of one or more coronary arteries.
Coronary Artery Disease (CAD)
65
What are the results of Coronary Artery Disease?
- Oxygen Deprivation of the myocardium
| - Ischemic heart disease
66
What complications are associated with Coronary Artery Disease?
Angina Pectoris
67
What are the 3 classes of Lipoproteins?
1. Low Density Lipoproteins (LDLs)
2. High Density Lipoproteins (HDLs)
3. Very Low Density Lipoproteins (VLDLs)
68
These are 25% proteins, 20% triglycerides, 55% cholesterol and may deposit cholesterol in and around smooth muscle fibers in arteries.
Low Density Lipoproteins
69
These are 50% proteins, 37% triglycerides, 13% cholesterol and they remove excess cholesterol from body cells and transport it to the liver for elimination. It decreases the risk of heart disease.
High Density Lipoproteins.
70
These are 10% proteins, 65% triglycerides, 25% cholesterol and transport triglycerides synthesized by the liver cells to adipose cells for storage. A high fat diet promotes its production and some can convert to LDL.
Very Low Density Lipoproteins
71
This is a degenerative disease commonly caused by an acute thrombus of the coronary arteries and primarily affect the left ventricle of the heart.
Myocardial Infarction (MI)
72
Why is early intervention of Myocardial Infarction important?
To significantly increase survival since 85% of first attack victims who obtain medical attention within 30 minutes of the attack survive.
73
What are the treatments of Myocardial Infarction?
- Thrombolytic Therapy- drugs
| - PCTA- Balloon Angiography
74
THis is the localized dilatation of an artery that most commonly involves the aorta especially its abdominal portion.
Aneurysm
75
What are the 2 types of Aneurysms?
1. Saccular Aneurysm
| 2. Fusiform Aneurysm
76
This type of aneurysm involves only one side of the arterial wall.
Saccular Aneurysm
77
This type of aneurysm is a bulging of the entire circumference of the vessel wall.
Fusiform Aneurysm
78
What does a saccular aneurysm look like?
A "Berry" Aneurysm protruding from one side of the arterial wall.
79
A fusiform aneurysm is typically found where?
Distal abdominal aorta
80
Where is a saccular aneurysm typically found?
In a cerebral artery
81
These are the most common type of aneurysm 90% of which occur in the abdominal aorta below the level of the renal arteries.
Abdominal Aortic Aneurysm
82
This abdominal projection may demonstrate enlargement of the abdominal aorta with calcification of the vessel wall.
Cross table lateral abdomen- decubitis
83
How big must an abdominal aortic aneurysms and thoracic aneurysms be in order to perform surgical repair?
Greater than 6cm in diameter
84
This type of aneurysm most commonly results from congenital anomalies or blunt chest trauma.
Thoracic Aneurysm
85
Thoracic Aneurysms can be detected on which type of X-ray?
Conventional Chest X-rays
86
Aneurysms occuring the the extremities often occur where?
Popliteal Artery often bilateral
87
Aneurysms in the extremities typically occur in conjunction with what?
Abdominal Aortic Aneurysms
88
This is a potentially life threatening condition in which disruption of the intima permits blood to enter the wall of the aorta and separate its layers. it creates a true false lumen in the aorta.
Aortic Dissection
89
A false lumen may form this as a result of the high pressure in the systemic vascular system.
Aneurysm
90
Aortic Dissection is most common in patients with what?
Aterial Hypertension
91
What are some other causes of Aortic Dissection?
- Trauma
| - Congenital defects such as Marfans Syndrome (genetic disorder of the connective tissue)
92
This is a potentially fatal compilation of closed chest trauma such as rapid deceleration, blast, and compression.
Traumatic Aortic Rupture
93
An aortic tear of traumatic aortic rupture usually occurs where?
Distal to the left subclavian artery at the site of the ductus arteriosus.
94
This is an intravascular clot caused by stasis, endothelium injury or inflammation, blood changes to the clotting mechanisms, increase in RBCs
Thrombus
95
This is part or all of a thrombus that becomes detached from the vessel wall and enters the bloodstream and lodges in other vessels.
Embolism
96
An Embolism can cause what after it lodges in other vessels?
- Ischemia/ Occlusion
97
What are 3 other types of embolisms?
- Fat- due to trauma
- Septic- from infection
- Air- air bubbles introduced via trauma, surgery or injection
98
What is the treatment for thrombus and embolisms?
Venous Filters- Greenfield Filters inserted into the inferior vena cavan to catch blood clots
99
This primarily involves the lower extremities and is a major source of potentially fatal pulmonary embolisms.
Deep Vein Thrombosis (DVT)
100
What are the factors that may cause a DVT?
- Trauma
- Bacterial Infection
- Prolonged bed rest
- Oral Contraceptives
101
DVT may be the earliest symptom of malignancies of what?
- Pancreas
- Lungs
- Gastrointestinal System
102
What is the treatment of DVT?
Venuos Filters- Greenfield filter inserted into the inferior vena cava to catch blood clots
103
This is a dilation, elongation and tortuous vessel most commonly involving the superficial veins of the leg under the skin.
Varicose Veins
104
This is inflammation of the vein often associated with venous thrombosis.
Phlebitis
105
This is a term used to specify the combination of phlebitis and venous thrombosis.
Thrombophlebitis
106
This occurs when a blood clot forms or becomes lodged in a pulmonary artery.
Pulmonary Emboli
107
Rheumatic Heart Disease can lead to what?
Carditis
