Cornish: Circulation of Specialized Vascular Beds

Question 0

Normal pressure in the capillaries

Answer 0

7-8 mmHg

Question 1

Normal pressure in pulmonary artery

Answer 1

22/8 mmHg

Question 2

Normal pressures in left atria

Answer 2

3-12 mmHg

Question 3

Normal pressures in alveoli

Answer 3

Slightly below atmospheric pressure

Question 4

Lungs as a blood reservoir

Answer 4

Normal lung volume is 450 mL.
When lungs are vasoconstricted it holds 200 mL, thus adding 250 mLs to circulation.
The lungs are 10x more compliant than systemic vasculature.

Question 5

Normal pericardial volumes and pressure.

Answer 5

15-50 mL

Normal pressures within the pericardial sac change with respiration.

Question 6

Define pulsus paradoxus and when it is seen.

Answer 6

An abnormally large decrease in systolic BP during inspiration, due to abnormal widening of the vessels. (The normal fall in pressure is 10 mmHg it is referred to as pulsus paradoxus.)
Seen in cardiac tamponade and constructive pericarditis.

Question 7

Define Kussmaul’s sign.

Answer 7

Increase in jugular venous pressure DURING INSPIRATION.

Indicates constrictive pericarditis.

Question 8

Define electrical alternans and what causes it.

Answer 8

______???

Question 9

What are the two basic physiological causes for shock?

Answer 9

Cardiogenic (Failure of the pump)

Hypovolemia (Failure of adequate venous return)

Question 10

Normal diastolic and systolic pressures.

Answer 10

Diastolic: <120 mmHg

Question 11

Prehypertensive diastolic and systolic pressures.

Answer 11

Diastolic: 80-89
Systolic: 120-139

Question 12

Stage I hypertension systolic and diastolic pressures.

Answer 12

Diastolic: 90-99 mmHg
Systolic: 140-159 mmHg

Question 13

Stage II hypertension systolic and diastolic pressures.

Answer 13

Diastolic: >100 mmHg
Systolic: >160 mmHg

Question 14

What are the two types of hypertension and know the frequency.

Answer 14

Primary: 90% is primary, no known cause (Dr. Cornish believes related to renal failure)
Secondary: 10%, most common renal parenchymal disease

Question 15

List and describe the three stages of primary hypertension.

Answer 15

Labile: Increased CO, increased BP, normal to decreased TPR. Reversible
Transitional: Increased CO, increased BP, increased TPR. If treated, may prevent progression.
Stable or established: Decreased CO, increased BP, increased TPR. Hard to reverse.

Question 16

Causes of mitral stenosis.

Answer 16

Rheumatic heart disease (an immunological disease)

Bacterial endocarditis

Question 17

Complications of mitral stenosis.

Answer 17

Reduced CO
Pulmonary edema
Right HF
Atrial fibrillation
Orthopnea (difficulty breathing, except in upright position)
Diastolic murmur (soft)
2/3 of patients have aortic involvement

Question 18

Causes of mitral regurgitation (congenitaland acquired)

Answer 18

R