CVD Flashcards
1
Q
Enclosed in the pericardial sac is the…
A
pericardium and pericardial cavity (contains fluid)
2
Q
Layers of the heart..
A
Epicardium
Myocardium
Endocardium
3
Q
Atrioventricular valves are made up of what 2 valves?
A
tricuspid and mitral (bicuspid)
4
Q
Semilunar valves are made up of what two valves?
A
aortic and pulmonary
5
Q
Does cardiac muscle regenerate?
A
no
6
Q
Autorhythmicity
A
impulses to start contraction initiated within the cardiac muscle
7
Q
Which wall is thicker?
A
left
8
Q
During systole what happens?
A
blood is forced up the aorta by the ventricles contracting and pulmonary artery and blood is delivered to body tissues
9
Q
During diastole what happens?
A
ventricles relax and atria contract so blood is forced into ventricles
10
Q
Systemic circulation is …. has ….pressure and …..heart propels blood through the entire body.
A
larger
higher
left
11
Q
Pulmonary system is …. has …. pressure, and ….heart propels blood through lungs.
A
smaller
lower
right
12
Q
Left heart output=
A
right heart output
13
Q
Coronary circulation is part of the….circulation. It originates from the beginning of the …. and accounts for …% of total blood flow.
A
systemic
aorta
5
14
Q
Major coronary arteries? Located where? and suitable for what?
A
R. and L
heart surface
bypasses
15
Q
Prolonged contractions of the coronary circulation can reduce blood supply to cardiac muscle cells because…
A
BV are constricted longer
16
Q
Coronary blood flow is greater in….
A
diastole
17
Q
Collateral circulation in the heart is….source of blood. ….. from healthy arteries extend to the area supplied by obstructed artery.
A
an alternative
capillaries
18
Q
Anastomose
A
direct connection between small branches
19
Q
Layers of the vessel walls
A
tunica intima tunica media tunica adventitia (externa)
20
Q
Tunica intima
A
endothelial cell lining
21
Q
Tunica media
A
smooth muscle cells
22
Q
Tunica adventitia
A
outer connective tissue
23
Q
Effects of smoking on CV system:
increases ……–>increases heart workload
increases …. adhesion–> increases thrombus formation
produced CO displaces …. in Hb–> reduction in O2 supply.
A
vasoconstriction
platelet
O2
24
Q
Example of a vasodilator? What does it do?
A
nitroglycerin
blood flow increases
reduces BP and may cause dizziness
25
Beta blockers do what? They prevent ..... in rate/force of contractions in damaged heart.
They treat... and .... and reduce ....attacks.
```
block beta adrenergic receptors
prevent SNS stimulation of the heart.
increases
HBP and dysrhythmias
angina
```
26
Calcium channel blockers ....cardiac contractility. They also act as ... and .... for smooth muscle cells.
decrease
| vasodilators and are antihypertensive
27
Digoxin is a..... (from plants). It ....conduction of impulses and HR. Contractions are .... frequent but stronger. This drug is a treatment for ... and ...
cardiac glycoside
slows
less
heart failure and atrial dsyrhthmias
28
Two antihypertensive drugs are
ACE inhibitors
| Angiotensin II receptor blockers
29
What treats HBP and heart failure with congestion by removing excess Na and/or water?
diuretics
30
Sclerosis
abnormal hardening of body tissue
31
Arteriosclerosis
general term for all types of degenerative arterial changes
32
Atherosclerosis
presence of atheroma (or atherosclerotic plaque)
| occurs in large arteries
33
Atherosclerosis=
arteriosclerosis with atheromas
34
Arteriosclerosis occurs in people over ....y/o and in those with...
Usually degenerative changes in ....arteries and ....
50
diabetes
small
arterioles
35
Plaques in atherosclerosis can consist of ....and be related to...
lipids, cells, cell debris, fibrin clots
| diet, exercise and stress
36
Lipids are synthesized in the....
liver
37
Cholesterol is the building blocks for .... components, ...., vitamin.... , ....acids.
membrane
hormones
D
Bile
38
Triglycerides store...
energy
39
Lipids are transported in combo with proteins aka ....
| These are... and ...
lipoproteins
LDL
HDL
40
LDL is transported from ... to cells.
They are a major factor contributing to ....formation.
They bind to a ....
liver
atheroma
cell surface receptor
41
HDL transports cholesterol ... from peripheral cells to ....
Catabolism takes place in...
away
liver
liver
42
Atherosclerosis can be from .... of lipids in the wall; ....inflammation; ... and...infiltration; .... formation; ... of vessel wall.
```
deposition
vascular
leukocyte and macrophage
plaque
thickening
```
43
Atherosclerosis leads to
stenosis
44
Early in the atherosclerotic disease process, endothelial cells that line the coronary arteries become dysfunctional in that they stop ..... and forms....
producing vasodilators
| blood clots
45
In a diagnostic test for atherosclerosis one can see levels of .... which indicates presence of inflammation.
C-reactive protein
46
What are two other tests for atherosclerosis?
exercise stress test
| nuclear medicine
47
Nuclear medicine as a diagnostic for atherosclerosis includes...
determining tissue perfusion levels
| presence of collateral circulation
48
What are some medical interventions for atherosclerosis?
anti-lipidemic drugs like statins
| surgical intervention like angioplasty or coronary artery bypass graft
49
Angina pectoris is ....
partial block of blood flow to myocardium and a temporary cardiac ischemia
50
MI is ...
blood flow blocked for a long time and prolonged ischemia which leads to tissue necrosis
51
When does angina pectoris occur?
when oxygen is impaired and the heart has to work harder than usual
52
How an MI develops: thrombus or obstruction of artery--> ....
....may form from thrombus and lodge in smaller vessels blocking them.
.....may occur leading to complete occlusion.
partial occlusion
embolus
vasospasm
53
Most MIs are transmural meaning
involve all three layers
54
Majority of MIs involve the ....
...occurs and replaces cardiomyocytes beginning at day 7
....is formed 6-8 weeks.
....and/or .... if present may reduce infarct size.
LV
fibrosis
scar
collateral circulation and/or anastomoses
55
Cardiomyocyte damage leads to ....
release of proteins
56
Blood tests for MI include
troponins
creatine kinase
lactate dehydrogenase
aspartate aminotransferase
57
Troponin testing is the most .....for MI.
| Troponin should ....substantially within 4-6 hours; it peaks at 10-24 hours. Can be detected for up to ...-...days.
specific test
increase
10-14 days
58
CK increases about ...hrs after MI. It peaks in ....hours and returns to normal in ...-....hours.
6
18
24-36
59
What is heart failure?
when the heart is unable to pump out sufficient blood to meet metabolic demands of the body.
60
What are some causes of HF?
usually a complication of another cardiopulmonary condition or a combo of factors:
infarction, valve defect, HBP, lung disease
61
In HF, often .... side fails first depending on the cause.
MI of LV ----> ....failure--> ....HF
Pulmonary disease ---> ....failure --->....HF
```
one
LV
left sided
RV
right sided
```
62
In HF, initially, ..... mechanisms maintain cardiac output causing ....
compensation
| cardiac hypertrophy
63
What two things tend to happen when heart cannot maintain pumping capability?
forward effect
| backup congestion
64
What is the forward effect?
| There is ....cell function in peripheral organs. Mild acidosis develops because of .... and it is compensated by ....
```
less blood reaches various organs
stroke volume or cardiac output decreases
decreased
lactic acid buildup
increase in respiration
```
65
What is backup congestion?
behind the affected ventricle
| output of ventricle is less than the inflow of blood so blood accumulates in circulation
66
SV and CO definitions
SV- volume of blood pumped with each heartbeat
| CO- volume of blood ejected by a ventricle in one minute.
67
When left heart output is less than right what sided HF occurs?
Where does blood accumulate and lead to?
left
pulmonary circulation
pulmonary congestion or pulmonary edema
68
When right heart output is less than left heart output what occurs?
Where does blood accumulate? and it leads to?
right
systemic circulation
peripheral edema
69
Forward effects for HF
```
decreased blood supply
fatigue
weakness
dyspnea
exercise intolerance
cold intolerance
dizziness
```
70
Compensation mechanisms for HF
tachycardia
cutaneous and visceral vasoconstriction
daytime oliguria
71
Backup effects of left-sided failure
```
pulmonary congestion
cough
dyspnea
orthopnea
paroxysmal nocturnal dyspnea
```
72
What consists of pulmonary congestion?
fluid entering alveoli
73
What is dyspnea?
Orthopnea?
Paroxysmal nocturnal dyspnea?
shortness of breath
difficulty breathing when lying down
sudden awakening due to dyspnea while sleeping
74
Back up effects of right-sided failure?
```
increased BV in systemic circulation
edema
distention in jugular veins
cerebral edema
hepatomegaly, splenomegaly, digestive disturbances due to edema
ascites
```
75
Ascites
fluid accumulation in peritoneal cavity
76
HBP caused by arteriosclerosis and stenosis may lead to .... often damaging ..., ..., ....
ischemia
| kidneys, brain, eyes
77
Increase in arterial vasoconstriction leads to ....
| Kidney will produce .... (which normally converts angiotensinogen to angiotensin I) so further vasoconstriction occurs.
decreased blood flow to kidney
| renin
78
Primary hypertension is also called.... its .... and 95% of all cases. This is where both ... and ... are high. It may be due to .... stimulation. It is more likely due to excessive .... level so .... work well. It may also be behavioral from, ..., ..., ....
```
essential
idiopathic
systolic and diastolic
sympathetic
angiotensin II
ACE inhibitors
salt, smoking, obesity
```
79
Secondary hypertension is also called ....hypertension. It is caused by ....like .... or ..... It is most commonly linked to diabetes.
inessential
another medical condition
renal disease
endocrine disorder (Adrenal tumor leading to hyper aldosteronism)
80
Malignant hypertension is also called. It is a subset of ....hypertension. Extremely high BP (.../...) that develops rapidly causes ....
Specifically it can cause .... and .....
```
resistant
primary
180/120
some type of organ damage
encephalopathy (abnormal brain function)
profound cerebral edema
```
81
Aortic aneurysm is ... and .... of aortic wall. It develops from a defect in the ....
Most common sites are on ... or ....
different types:
```
localized dilation and weakening of aortic wall
medial layer (tunica media)
abdominal or thoracic
fusiform
saccular
dissecting
```
82
Fusiform aneurysm
circumferential dilation along a section of artery
83
Saccular aneurysm
bulging wall on one side
84
Dissecting aneurysm
develops when there is a tear in the intima of the wall and blood continues to dissect or separate tissues.
85
Causes of aortic aneurysms
```
atherosclerosis
trauma
syphilis and other infections
congenital defects
hypertensions
```
86
Aortic aneurysms are frequently ... until they become large or rupture.
asymptomatic
87
Rheumatic fever usually occurs in children aged ....-...
Develops a few weeks after an untreated .... usually....
It is a ....inflammatory condition.
It affects ... tissue.
May result from ......
Involves ... causes ...
```
5-15
infection
A beta-hemolytic Streptococcus
acute systemic
connective
abnormal immune reaction
heart
rheumatic heart disease
```
88
Rheumatic heart disease is ... of the heart. It results in three types:
inflammation of the heart
endocarditis
myocarditis
pericarditis
89
Endocarditis is the .... problem of rheumatic heart disease. It affects the .... which disrupts blood flow and effectiveness of LV. Heart valves may scar causing .... and leads to .....
most common
heart valves
stenosis
rheumatic heart disease
90
Myocarditis is inflammation in .... called ....bodies which interfere with conductance contributing to ....
localized leasions
aschoff
arrhythmias
91
Pericarditis causes.... which impairs filling.
effusion (excessive liquid accumulation in pericardium)
92
Rheumatic fever can cause inflammation in what other sites?
large joints in legs
skin (nonpruritic rush)
basal nuclei in brain (involuntary jerky movements of face, arms and legs)
non-tender subcutaneous nodules
93
Signs and symptoms of rheumatic fever/heart disease
```
presence of inflammation
low-grade fever
leukocytosis
malaise
fatigue
tachycardia
```
94
Diagnostic tests of rheumatic fever and heart disease
anti-streptolysin O titer
| heart function tests
95
Treatment of rheumatic fever and heart disease
prophylactic antibacterial agents
anti-inflammatory agents
drugs for arrhythmia and heart failure
surgical repair or replacement of the damaged heart valve
96
Mechanism of infective endocarditis
microorganism attaches to endocardium--> it invades heart valves --> causes inflammation --> damages heart valves
97
Two forms of endocarditis
acute and subacute
98
Acute endocarditis
normal heart vales are infected by highly virulent organism (staph aureus)
99
Subacute endocarditis
defective heart valves are infected by normal flora (strepto viridans in mouth)
100
Factors that can predispose infection in endocarditis
presence of abnormal valves in heart
bacteremia (bacteria in blood)
reduced host defenses
101
Treatments for endocarditis
antimicrobial drugs for several weeks via IV
blood culture to find the cause
medication to support heart function
102
Pericarditis is usually ....to other conditions. Acute pericarditis lasts....
It is a .....of the pericardium. ....may develop which may compress the heart causing .... and impair expansion and filling which .... cardiac output.
```
secondary
a few days
simple inflammation
effusion
cardiac tamponade
decreases
```
103
Chronic pericarditis may last ... it results in the formation of .... between pericardial membranes which leads to....
Fibrous tissues often result from ... or ...to the mediastinum. It.... movement of the heart during diastole and systole which .... cardiac output. ... or .... may develop from adjacent structures. Causes ..., ..., ....
```
a few months
adhesions
fibrous tissues
TB
radiation
limits
decreases
inflammation or infection
fatigue, weakness, abdominal discomfort
```
104
How is pericarditis treated?
Primary problem must be treated
fluid may be aspirated and analyzed to determine cause
if effusion is severe, immediate aspiration is needed to prevent tamponade and shock
