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Human Pathophysiology > Chapter 9 > Flashcards

Chapter 9 Flashcards

1
Q

how do myocardial cells function

A

one large cell

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2
Q

how many chambers are in the heart

A

4

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3
Q

what are the heart chambers

A

right/left atria and ventricles

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4
Q

role of atria

A

receiving chambers

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5
Q

role of ventricles

A

pumping chambers

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6
Q

how many systems are in the heart

A

2

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7
Q

pulmonary system

A

right side
deoxygenated blood to lungs

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8
Q

systemic system

A

left side
oxygenated blood to rest of body

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9
Q

electrocardiogram

A

electrical activity

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10
Q

true or false: the heart generates it’s own electricity

A

true

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11
Q

p wave

A

atrial depolarization

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12
Q

qrs complex

A

ventricle depolarization (contraction)

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13
Q

t wave

A

ventricle repolarization

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14
Q

what do all heart disorders affect

A

cardiac output and/or effort

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15
Q

examples of heart disorders/affects

A

pump failure
obstructed flow
regurgitant flow
shunted flow
abnormal conduction

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16
Q

congenital heart disease

A

cyanotic or acyanotic
atrial/ventricular septal defects
tetralogy of fallot

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17
Q

cyanotic CHD

A

right to left
less common
poorly oxygenated blood flows to oxygenated
BLUE

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18
Q

acyanotic CHD

A

left to right
more common
adds to right side workload, more blood

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19
Q

types of atrial/ventricular septal defects

A

shunt

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20
Q

manifestations of ASD/VSD

A

murmur
easily fatigued
RIGHT sided heart failure

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21
Q

tetralogy of fallot defects

A

VSD
pulmonary stenosis
right ventricle hypertrophy
misplaced aorta

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22
Q

manifestations of tetralogy of fallot

A

cyanosis
digital clubbing
slow growth
heart failure
variable life expectancy

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23
Q

treatment for tetralogy of fallot

A

surgery shortly after birth

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24
Q

ductus arteriosus

A

allows blood to bypass lungs using pulmonary artery to descending aorta
normally closes at birth

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25
Q

patent ductus arteriosus

A

shunt stays open after birth
cyanosis
blood shunted from aorta to pulmonary artery

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26
Q

is heart failure a disease

A

no, syndrome

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27
Q

what is the meaning of heart failure

A

describes several types of cardiac dysfunction that results in inadequate perfusion of tissues with blood-borne nutrients

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28
Q

is heart failure age associated

A

yes

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29
Q

is heart failure prevalence increasing or decreasing? why?

A

increasing, people are living longer

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30
Q

what are 2 ways the heart compensates to inadequate perfusion

A

increase SNS and cardiac muscle hypertrophy

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31
Q

systolic heart failure

A

impaired contraction caused by incomplete emptying

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32
Q

what happens to EF in systolic heart failure

A

decreases
less than 40%

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33
Q

normal ejection fraction

A

55%

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34
Q

what causes systolic heart failure

A

coronary artery disease
ischemia
cardiomyopathy
previous heart attack

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35
Q

diastolic heart failure

A

impaired filling
relaxation phase

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36
Q

what happens to EF in diastolic heart failure

A

remains same

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37
Q

what causes diastolic heart failure

A

ventricular stiffness caused by hypertension
results in smaller chamber size

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38
Q

compensated heart failure

A

failing ventricles dilate, increases chamber size to maintain cardiac output
don’t know you’re in heart failure

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39
Q

uncompensated heart failure

A

increased stretching results in weaker contractions

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40
Q

uncompensated forward failure

A

low cardiac output

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41
Q

uncompensated backward failure

A

upstream venous conjestion

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42
Q

is left or right sided heart failure more common

A

left

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43
Q

what causes left sided failure

A

cardiac muscle damage (MI)
valve defects
hypertension
cardiomyopathy

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44
Q

what causes right sided failure

A

LUNGS
pulmonary hypertension
pulmonary valve defect

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45
Q

forward heart failure

A

inadequate cardiac output
decreased perfusion (kidneys)
organs downstream don’t get as much oxygen

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46
Q

backward heart failure

A

increased pressure due to blood backing up
pulmonary edema
hepatomegaly

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47
Q

symptoms of left sided failure

A

dyspnea
increased heart rate
pulmonary edema
LVent dilation
FATAL due to hypoxia, acidosis, arrhythmias

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48
Q

symptoms of right sided failure

A

dilated neck veins
swelling
ascites
edema in liver and spleen
NO DYSPNEA

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49
Q

how do you diagnose heart failure

A

ECHO

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50
Q

ways to treat heart failure

A

diet, drugs

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51
Q

dietary treatment for heart failure

A

weight loss
low salt diet
stop smoking

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52
Q

drug treatment for heart failure

A

diuretics
ACE inhibitors
aldosterone receptor blockers
digoxin

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53
Q

prognosis for heart failure

A

poor unless underlying cause is treatable

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54
Q

what is the role of coronary arteries relative to the heart

A

supply blood to heart through right and left arteries

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55
Q

coronary artery atherosclerosis

A

atherosclerosis blocks coronary arteries leading to ischemia

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56
Q

what is ischemia

A

low oxygen due to low flow

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57
Q

what can ischemia cause

A

angina
myocardial infarction
arrhythmias
conduction deficits
heart failure
sudden death

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58
Q

acute ischemia

A

may result in angina pectoris
comes on quickly
unremitting

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59
Q

angina pectoris

A

chest pain due to ischemia

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60
Q

types of angina pectoris

A

stable and unstable angina
silent myocardial ischemia

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61
Q

stable angina

A

most common and predictable
pain when heart’s oxygen demand increases

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62
Q

unstable angina

A

no pattern, comes quickly
caused by aggregation of platelets on plaque
MEDICAL EMERGENCY

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63
Q

silent myocardial ischemia

A

myocardial ischemia without pain

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64
Q

myocardial infarction

A

necrosis of heart muscle due to ischemia

65
Q

what causes MI

A

sudden disruption of plaque, leads to thrombus
thrombus occludes vessel

66
Q

what is the rank of MI in deaths in US

A

leading cause of death
1.5million cases/yr
⅓ die

67
Q

percent of MI that occurs without warning

A

20%

68
Q

percent of MI patients arriving alive

A

80-90%

69
Q

cause of death in MI patients in die before hospital

A

cardiac arrhythmia

70
Q

are there complications of MI?

A

yes, most develop clinical complications

71
Q

what areas are affected by MI

A

left ventricle
anterior

72
Q

what type of necrosis is MI

A

coagulative

73
Q

symptoms of acute MI

A

angina…severe, crushing, constrictive, or heartburn
SNS responses…GI distress, nausea, vomiting
tachycardia, vasoconstriction
anxiety, restlessness, feeling of impending doom
hypotension…shock, weakness in extremities

74
Q

men vs. women MI symptoms

A

men have more hallmark symptoms

75
Q

women MI symptoms

A

unusual fatigue
sleep disturbances
indigestion
anxiety

76
Q

do all MI patients have symptoms

A

no

77
Q

diagnosis of MI

A

ECG abnormalities
elevation of blood enzymes

78
Q

ECG abnormalities of MI

A

ischemia in ventricles
T wave of ST segment

79
Q

elevated blood enzymes of MI

A

due to tissue necrosis
creatine kinase
cardiac CK
cardiac troponin

80
Q

what are the enzyme levels in more severe heart attacks?

A

stronger/larger enzyme levels

81
Q

does angina have elevated enzymes

A

no

82
Q

what is the most common cause of CAD

A

thrombus blocking blood flow

83
Q

goals of CAD treatment

A

reverse thrombosis
control pain
limit infarct size
reduce cardiac workload w/beta blockers
treat complications

84
Q

lifestyle treatments for CAD

A

lose weight
low salt
stop smoking
increased physical activity

85
Q

drug treatments for CAD

A

nitroglycerin (vasodilator)
antiplatelet/anticoagulant (warfarin, aspirin)
beta blockers (inhibits SNS)
antiarrhythmias (maintains stability)

86
Q

surgery treatments for CAD

A

destroy clot via (angioplasty)
cardiac bypass (INVASIVE, rerouting blood flow)
stent (brace lumen so vessel remains open)

87
Q

long term complications of MI

A

heart failure
cardiogenic shock
pericarditis
thromboemboli
cardiomyopathy
heart rupture
ventricular aneurysms

88
Q

late complications of MI

A

heart failure

89
Q

early complications of MI

A

arrhythmias

90
Q

hypertensive heart disease

A

due to hypertension ONLY
LEFT SIDE

91
Q

manifestations of HTN heart disease

A

LVent hypertrophy
enlarge heart…chamber size decreases resulting in diastolic failure…heart may be so thick and result in angina
left heart failure
pulmonary edema

92
Q

treatment for HTN heart disease

A

reduce blood pressure

93
Q

is HTN heart disease reversible

A

yes

94
Q

what is the role of valves

A

control direction of flow
must fully open/close

95
Q

types of valves in heart

A

AV values
semilunar valves

96
Q

stenosis

A

failure to open completely

97
Q

regurgitation

A

failure to close tightly
blood regurgitates to previous chamber

98
Q

valvular stenosis

A

aortic/mitral stenosis

99
Q

valvular insufficiency

A

aortic regurgitation (LVent)
mitral regurgitation (LAtria)
tricuspid regurgitation (RVent)

100
Q

degeneration

A

most common cause of valve disease

101
Q

types of degeneration

A

aortic stenosis
calcification of mitral valve
mitral prolapse (regurgitation)

102
Q

why is left valvular degeneration more common

A

age, greater workload, higher pressure

103
Q

what causes valve disease

A

rheumatic fever

104
Q

valvular dysfunction

A

irregular blood flow
stenosis
regurgitation

105
Q

manifestations of valvular dysfunction

A

ASYMPTOMATIC
murmur
easily fatigued
shortness of breath

106
Q

aortic stenosis

A

most common valve defect w/age

107
Q

what causes aortic stenosis

A

age-associated wear and tear
calcification

108
Q

manifestations of aortic stenosis

A

increase LVent pressure during ejection…increased resistance to flow/reduced stroke volume
LVent hypertrophy…impaired filling
back up blood into LAtria….increases LAtrial pressure

109
Q

what is aortic stenosis a risk factor for

A

heart failure
arrhythmia
atrial fibrillation

110
Q

is aortic stenosis a systolic or diastolic murmur

A

systolic

111
Q

causes of mitral stenosis

A

rheumatic fever

112
Q

manifestations of mitral stenosis

A

difficulty emptying blood into LVent during diastolic…reduces EDV and Q
blood backs up into LAtria…hypertrophy, pulmonary congestion and hypertension

113
Q

is mitral stenosis a systolic or diastolic murmur

A

diastolic

114
Q

regurgitation of mitral valve

A

backflow of blood into LAtria

115
Q

manifestations of regurgitation of mitral valve

A

LAtria pressure increases, hypertrophy
atrial fibrillation
increase LVent EDV…increase preload and Q
net amount of blood ejected is reduced because it’s going back to where it came from

116
Q

what can regurgitation of mitral valve lead to

A

right side heart failure

117
Q

is regurgitation of mitral valve a systolic or diastolic murmur

A

systolic

118
Q

regurgitation of aortic valve

A

backflow of blood into LVent

119
Q

manifestations of regurgitation of aortic valve

A

volume overload…LV pressure increases
increase LV EDV
hypertrophy of LVent…heart failure

120
Q

is regurgitation of aortic valve a systolic or diastolic murmur

A

diastolic

121
Q

acute rheumatic fever

A

autoimmune disorder
streptococcal infection

122
Q

cardiomyopathy

A

pathology of heart muscle

123
Q

what causes cardiomyopathy

A

inflammation
acquired (diet…alcohol, radiation)
genetic

124
Q

symptoms of cardiomyopathy

A

asymptomatic

125
Q

types of cardiomyopathy

A

dilated, hypertrophic, restrictive

126
Q

dilated cardiomyopathy

A

ventricles weaken because of too much stretching, enlarge
MOST COMMON
reduced systolic function….no strong contraction

127
Q

cause of dilated cardiomyopathy

A

idiopathic

128
Q

what does dilated cardiomyopathy lead to

A

heart failure, valve disease, irregular heart rate

129
Q

hypertrophic cardiomyopathy

A

ventricles and septum enlarge and thicken
affects mitral valve (diastolic) function if chamber gets too thick
cellular changes in myocardium

130
Q

who is the most at risk for hypertrophic cardiomyopathy deaths

A

young athletes

131
Q

what causes hypertrophic cardiomyopathy

A

genetic (mutation in myosin)
acquired (hypertension)
idiopathic

132
Q

how to screen for hypertrophic cardiomyopathy

A

familial history
ECHO
blood genetic tests

133
Q

restrictive cardiomyopathy

A

heart is rigid and restricted from increased stretching
ventricles don’t thicken
DIASTOLIC

134
Q

what does restrictive cardiomyopathy lead to

A

heart failure
valve problems

135
Q

causes of restrictive cardiomyopathy

A

idiopathic
amyloidosis
chemotherapy

136
Q

symptoms of cardiomyopathy

A

NONSPECIFIC
asymptomatic
murmur
dyspnea
angina
syncope
arrhythmia

137
Q

complications of cardiomyopathy

A

heart failure
blood clots
valve defects
cardiac arrest
sudden death

138
Q

pericardial disease

A

inflammation of pericardium

139
Q

what causes pericardial disease

A

MI due to inflammation factors

140
Q

is pericardial disease primary or secondary

A

secondary to other conditions like virus, bacteria, infection

141
Q

complications of pericardial disease

A

leads to chronic scarring and restrictive pericarditis

142
Q

restrictive pericarditis

A

interference with heart ability to pump

143
Q

primary tumors of the heart

A

rare
myxoma
90% benign
90% occur in left atria

144
Q

what is most common with tumors of the heart

A

metastasis

145
Q

normal sinus rhythm

A

cardiac conduction system important for coordination of pumping

146
Q

arrhythmias

A

disturbance of heart rhythm (irregular heartbeat)

147
Q

classification of arrhythmias

A

abnormal impulse formation
abnormal conduction
tachycardia
bradycardia

148
Q

automaticity arrhythmia

A

SA node is natural pacemaker
enhanced or suppressed automaticity

149
Q

factors enhancing automaticity

A

increase SNS, CO2, H+, stretch
decrease PNS, O2
hypokalemia

150
Q

atria arrhythmia

A

atrial fibrillation (disorganized)
atrial flutter (beats faster than ventricle)
stroke

151
Q

ventricular arrhythmias

A

premature ventricular contractions (PVC)
ventricular tachycardia
ventricular fibrillation (no ejection of blood)

152
Q

re-entry

A

mechanism for arrhythmia
2 distinct pathways come together to form loop

153
Q

examples of re-entry

A

afib
atrial flutter
ventricular tachycardia

154
Q

complications of ventricular arrhythmias

A

sudden cardiac death

155
Q

complications of atrial arrhythmias

A

atrial thrombi
increase risk for stroke

156
Q

treatment for arrhythmias

A

anti-arrhythmic drugs
defibrillation
ablation
pacemaker

157
Q

sudden cardiac death

A

natural death from cardiac causes within one hour of acute symptoms

158
Q

what causes sudden cardiac death

A

arrhythmia
MI
aortic aneurysm
electrocution
drugs like cocaine

Human Pathophysiology (8 decks)

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