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IB physiology > Clinical Cardiovascular physiology > Flashcards

Clinical Cardiovascular physiology Flashcards

1
Q

4 clinical conditions that can result from ABP control being disrupted

A

Hypertension, Cardiac failure, Cardiac arrhythmia and circulatory shock

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2
Q

what is hypertension?

A

ABP > 140/90 mmHg in humans.

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3
Q

why is hypertension bad?

A

overwork of the heart, damage to blood vessels.
[leading to cardiac failure, cardiac arrhythmia and ischaemic damage (restriction of blood supply and therefore oxygen) to organs e.g. stroke]

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4
Q

what physiological features does hypertension result from?

A

raised TPR and/or raised MSFP (failure of homeostasis).[treatment focuses on restoring to normal values]

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5
Q

what is the cause of 90% of hypertension and what is it associated with?

A

‘essential hypertension’, no clearly defined cause.

Linked to genetic factors and age.

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6
Q

what is the ~10% of hypertension with clear cause defined as?

A

secondary hypertension.

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7
Q

what is the most common cause of secondary hypertension?

A

kidney disease. (kidneys important for hormonal control of circulatory volume through controlling angiotensin II levels.)

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8
Q

what can also cause secondary hypertension (but not main cause)

A

excess adrenaline from pheochromocytoma tumour (activating sympathetic receptors)

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9
Q

what can be used to reduce MSFP to treat secondary hypertension?

A

reducing circulatory volume (with diuretics) and hormone antagonists blocking renal signalling

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10
Q

example of hormone antagonists that block renal signalling

A

ACE Inhibitors

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11
Q

what can be used to reduce TPR as treatment for secondary hypertension?

A

drugs causing arteriolar vasodilatation e.g. Ca2+ channel blockers such as nifedipine

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12
Q

what lifestyle changes can also help treat hypertension ?

A

exercise; lowers mean resting blood pressure. (even through raises ABP during the exercise)

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13
Q

why is it important to treat secondary hypertension ?

A

reduces risk of; stroke, heart disease, heart failure, dementia and death

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14
Q

why is it important to make sure patients with hypertension understand why they are being treated?

A

can be asymptomatic, drugs can cause side effects that make them feel less well. (even tho preventing fatal harm) [also hypotension is symptomatic]

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15
Q

what is it pessary to ensure when doing a trial for new hypertension treatment?

A

study design does not influence stress levels of participants as this can affect ABP

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16
Q

what is atherosclerosis ?

A

build up of inflammatory lipid deposits beneath endothelium of blood vessels. Progress to form fibrous and calcific layers

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17
Q

why does atherosclerosis cause problems?

A
  • Narrows blood vessels and resistrics flow
  • endothelial damage which promotes clotting (thrombosis, local and distant)
  • weakening blood vessel walls, leading to aneurysm.
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18
Q

how is hypertension linked to atherosclerosis ?

A

hypertension accelerates the development of atherosclerosis by damage to endothelium (other risk factors; obesity, diabetes and smoking)

19
Q

circulatory effects of hypertension

A

increase risk of atherosclerosis and abnormal blood vessels might rupture under pressure.

20
Q

what are coronary arteries?

A

arteries that supply the HEART with blood

21
Q

cardiac effects of hypertension

A

atherosclerosis affects coronary arteries, which can result in cardiac ischaemia (patient feels pain)

22
Q

what des ischaemia literally mean?

A

stopping blood. (leads to inadequate oxygen supply)

23
Q

why is cardiac ischaemia a particular problem in hypertension?

A

heart has to pump blood into arteries, raised arterial pressure increases work demand for heart

24
Q

what is hypertrophy?

A

enlargement of cells and increase in mass

25
Q

difference between eccentric hypertrophy and concentric hypertrophy in the heart (eccentric and concentric)

A

eccentric; due to exercise, ventricular volume INCREASES along with the muscle mass.
concentric; muscle expands inwards, DECREASES ventricular volume.

26
Q

3 major problems due to concentric hypertrophy

A
  • increased myocardial oxygen demand
  • Diastolic dysfunction, cardiac filling and stroke volume is impaired
  • increased risk of cardiac arrhythmias
27
Q

what can concentric hypertrophy lead to?

A

ventricular dilatation - heart can’t empty fully (systolic dysfunction)

28
Q

diastolic vs systolic dysfunction

A

diastolic - less compliant to filling

systolic - less contractile

29
Q

what does diastolic and systolic dysfunction produce?

A

cardiac failure

30
Q

what is cardiac failure?

A

cardiac output that is inadequate for the body’s needs.

CO insufficient to maintain body target arterial blood pressure

31
Q

how do normal responses to low ABP fair if it is due to heart failure?

A

Make it worse, responses make heart work harder and can lead to oedema

32
Q

what do Pharmacological treatments aim to do for low ABP cause by HEART FAILURE

A

block natural responses low ABP.

33
Q

what is a myocardial infarction?

A

heart attack, occurs when blood flow decreases or stops to a part of the heart, causing damage to the heart muscle.

34
Q

what does cardiac arrhythmia represent?

A

disorder in cardiac rhythm and/or failed co ordination of individual myocytes within each chamber.

35
Q

what can be the cause of cardiac arrhythmia?

A

hypertension, lead to heart failure and produce disordered conduction pathways. (also infarction and ischema)

36
Q

what is the most common cardiac arrhythmia?

A

atrial fibrillation

37
Q

how does atrial fibrillation arise?

A

irregular heart beat, pacemaker function is lost

38
Q

how does atrial fibrillation affect cardiac output?

A

reduces it by impairing ventricular filling

39
Q

what is the most common terminal event in heart failure and following myocardial infarction?

A

VENTRICULAR arrthymias.

40
Q

what is (circulatory)shock ?

A

if cardiac output is insufficent to supply metabolic substrates for aerobic respiration to all tissues, life-threatening medical emergency

41
Q

different types of (circulatory) shock

A
  • hypovolaemic shock (loss of circulating volume)
  • cardiogenic shock (cardiac pathology)
  • distributive shock (fall in vascular tone and leaking of plasma, similar to hypovolaemic)
42
Q

what can distributive shock be caused by?

A

septicaemia or anaphylaxis due to failure of sympathetic intervention.

43
Q

typical signs of shock

A

hypotension, tachycardia, reduced organ perfusion such as low urine output and loss of consciousness

IB physiology (4 decks)

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