Circulatory 2 Flashcards
Mastery
Atherosclerosis
Atheromas
what is it? harden? restrict? forms with? Risk factor for…
Atherosclerosis - blocking of path
Atheromas
Fatty plaques within vessel walls
Can harden into plaques, Restrict blood flow
* Clot formation
Form with obesity, inactivity, smoking, alcohol, genetics, diabetes
Risk factors for cardiac ischemia, infarct and stroke
Arteriosclerosis
What is it? tends to happen with…? forms? flow? BP? risk for? Treat with
Arteriosclerosis
Hardening of the arteries
Thickening of wall
* Fibrous plaques
Tends to happen with aging
Stiffer blood vessels
Faster flow
Higher blood pressures
Risk for cardiac events
Treat with exercise, diet changes, blood
pressure medication, anti-coagulants (also done for atherosclerosis)
Peripheral Vascular Disease
what is it? what causes it? can result in? lead to? Risk factors?
Decreased flow to the peripheral vessels. Specific muscles or organs, feet hands
Plaques, clots, vascular spasm
Can cause pain, fatigue, poor circulation
Can lead to heart attack, stroke, or
tissue necrosis (amputation)
Risk factors – obesity, diabetes,
smoking, high cholesterol etc.
Deep Vein Thrombosis/ Thrombophlebitis
Thrombus / Thrombi
what is it? result?
when can it form? eg…? treatment?
AFTER
Aneurysms
3 types? risks?
Thrombus / Thrombi
Blood clots and Pain, redness, swelling
Can form if blood is not
moving
Eg. Restrictive clothing
Immobility (eg. Long plane flights)
Need anti-coagulants
AFTER
FSD
Fusiform - Saccular - Dissection
Can rupture In Brain * strokes
Aortic Dissection
what is it? blood flow? risk?
TYPES A.B.C
Aortic Dissection Surgery
first type? when?
Second type? when?
Aortic Dissection
Where the inner wall of the aorta gets a split
Allows blood into site
Outer wall pulls away and “balloons” due to high pressure. causes a tear.
The force of blood within the “balloon”
causes the aortic dissection to spread
Risk of rupture
Dissection Surgery
Stents – smaller segments. Replace aortic wall
Grafts - Aortic arch replacement
Embolism:
what is it? what causes it?
▪ Pulmonary embolism —
▪ Cerebral embolism—
▪ Cardiac embolism—
▪ Sudden blockage of a blood vessel
▪ Blood clot
▪ Fat deposits, tissue fragments, cancer cells, clumps of
bacteria, bubbles of air
▪ Locations
▪ Pulmonary embolism—chest pain, shortness of
breath
▪ Cerebral embolism—may cause a stroke
▪ Cardiac embolism—may cause a heart attack
Strokes
blood supply? types and why?
TIA’s -
Symptoms (depends on area of brain affected):
80% of all strokes….
Controllable Risk factors:
Non-controllable
Assessment
Treat:
Strokes
↓ blood supply to brain
Ischemic (87%) * Due to thrombus or embolus or
plaque blockage
Haemorrhagic (13%) * Bleeding (weak wall rupture)
TIA’s - transient ischemic attacks
Mini-strokes (transient)
Symptoms (depends on area of brain affected):
Drooping face * drooling - Confusion - Dizziness - Sudden loss of consciousness. - Poor coordination / paralysis - Arm weakness - Sudden headache - Difficulty with speech - Loss of vision
80% of all strokes are preventable
Controllable Risk factors:
Smoking / Alcohol
High-fat diet / Obesity
Lack of exercise
High blood pressure
Diabetes
Non-controllable
Age, gender, ethnicity
genetics
Assessment
EEG, CT scan, MRI, Angiogram, Doppler flow
Treat:
* Anticoagulants
* Hypertensive meds
* Carotid endarterectomy
* Change diet
* Exercise regime
Blood Pressure Primary Determinants
Mean arterial pressure =
Blood Pressure Control
*Short-term control
*Long-term control
Cardiac output
Total peripheral resistance
Mean arterial pressure = cardiac output x total
peripheral resistance
Short-term control
- Within seconds
- Baroreceptors
- Cardiovascular system
Long-term control
- Minutes to hours
- Kidneys
Short-term Control -
Baroreceptors
control? receptors?
Pressure receptors
Send input? Monitor?
Baroreceptors
- Fast control
- cardiovascular
Pressure receptors
- Send input to cardiovascular
centre
Output to heart and blood vessels
Low blood pressure
Decrease firing of baroreceptors
input to CV centre
Decrease parasympathetic, increase sympathetic
Increase HR
increase CO
increase BP
by increasing sympathetic tone
increase vasoconstriction
TPR goes up
increase BP
by increasing sympathetic tone
increase contractility
ejecting more, SV goes up
increase CO and increase BP
by increasing sympathetic tone
increase venoconstriction
more venous return
increase SV increase CO, increase BP
Response to decrease in blood
pressure :
Due to hemorrhage
Long-Term Mechanisms: Renal Regulation
Indirect Method
control BP by altering? organ? mechanism?
Controls….
Direct Renal Mechanism
Alters blood volume….
Increased BP or blood volume
*
*
Decreased BP or blood volume causes the
kidneys ….
Long-Term Mechanisms: Renal Regulation
Control BP by altering blood volume
Kidneys
Direct renal mechanism
Indirect renal (renin-angiotensin) mechanism
Controls blood volume and arterioles
Direct Renal Mechanism
Alters blood volume independently of
hormones
Increased BP or blood volume
* Increased filtration
* causes the kidneys to eliminate more urine, thus
reducing BP
Decreased BP or blood volume causes the
kidneys to conserve water, and BP rises
Renin-Angiotensin System
Arterial blood pressure release of renin
Renin→ triggers production of….
*
….→ aldosterone and ADH secretion
* results in
Renin-Angiotensin System
decrease Arterial blood pressure
→ release of renin
Renin→ triggers production of angiotensin II
* potent vasoconstrictor
Angiotensin II → aldosterone and ADH secretion
* Conservation of Fluid
Decrease BP
less filtration and urine to conserve fluid
increase renin(increase thirst)
increase ANG I
increase ANG II
increase vasoconstriction, TPR up, BP up
increase aldosterone
increase ADH
conserves fluid
Hypotension
Blood pressure…
Hypertension
Blood pressure…
Two broad classes
*
*
Hypotension
Blood pressure below 100/60 mm Hg
Hypertension
Blood pressure above 140/90 mm Hg
Primary hypertension
* Excessive salt intake or hormones
* Abnormalities in arterioles
* Poor kidney function (RAAS)
* Age / genetics
* Stress
* Smoking
* Diet / obesity
Secondary hypertension
*Accounts for about 10% of hypertension cases
*Occurs secondary to another known primary problem
Examples of secondary hypertension
* Renal hypertension
* Endocrine hypertension
* Neurogenic hypertension
Complication of hypertension
Treatments
Hypotension
blood pressure?
Occurs when
results? Alcohol?
Orthostatic (postural) hypotension
Circulatory shock
occurs when?
Four main types
*
*
*
*
Complication of hypertension
- Congestive heart failure
- Stroke / Heart attack
- Spontaneous hemorrhage
- Renal failure
- Retinal damage
Treatments
- ACE inhibitors, beta blockers, Ca blockers
Diet, exercise
Hypotension
- Low blood pressure
Occurs when
- There is too little blood to fill the vessels
- Heart is too weak to drive the blood
Dizziness, fainting, blurry eyes, confusion,
palpitations
Alcohol may make it worse (RAAS)
Orthostatic (postural) hypotension
Transient hypotensive condition resulting from
insufficient compensatory responses to gravitational
shifts in blood when person moves from horizontal to
vertical position
Circulatory shock
Occurs when blood pressure falls so low that adequate blood flow to the tissues can no longer be maintained
HCVN
Four main types
* Hypovolemic (“low volume”) shock
* Cardiogenic (“heart produced”) shock
* Vasogenic (“vessel produced”) shock
* Neurogenic (“nerve produced”) shock
