Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pathophysiology Exam 2 > Disorders of Blood Flow and Blood Pressure > Flashcards

Disorders of Blood Flow and Blood Pressure Flashcards

1
Q

What are the Characteristics for Normal Blood Flow?

A

Hemodynamics and the biology of the cells that form the blood vessels need to be considered when thinking about blood flow.

Blood vessels that are open and unobstructed.

Blood pressure that is forceful enough to circulate blood to all tissues.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is hemodynamics?

A

Mechanics of blood movement.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is Laminar blood flow?

A

Blood flow is fastest in the middle of the stream.

Blood flow is slowest at the outer edge.

Slower blood flow promotes clotting.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the most important thing in determining blood flow?

A

Vessel radius

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are abnormalities of blood flow caused by?

A

Abnormal changes in blood vessels – atherosclerosis, vasculitis

Abnormal vessel dilation – aneurysms, varicose veins

Acute vessel obstruction – vasospasm, thrombus, extravascular force

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are endothelial cells?

A

Continuous innermost lining of blood vessels and with a semipermeable membrane.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

The production or release of vasoactive substances are in response to…

A

Cytokines, bacteria, virus, parasites

Changes in blood flow and/or pressure

Level of lipids circulating in blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What plays a major role in inflammation and immune reactions?

A

Vessel relaxation – nitric oxide - Hypotension (vasodilation)

Vessel contraction – endothelins - Hypertension (vasoconstriction)

Normally, these substances together balance for normal blood pressure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Vascular Smooth Muscle Cells?

A

Major cell layer of tunica media (middle layer of vessels)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the function of Vascular Smooth Muscle Cells?

A

Constriction and dilation function.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is Vascular Smooth Muscle Cells controlled by?

A

Controlled by sympathetic nerves that release norepinephrine

  • Norepinephrine constricts blood vessels (raised BP)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How can Vascular Smooth Muscle Cells become harmful when being constricted?

A

Constriction decreases vessel/radius and increases circulating volume to a point BUT there can become a tipping point at which vasoconstriction will cause decreased blood supply to tissue.

Too much constriction = Harmful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is arterial blood flow disorder?

A

Blood flow is pumped from the heart’s left ventricle and through the aorta into the circulation

EX: Atherosclerosis is a common cause of abnormal blood flow and can include hyperlipidemia (elevated cholesterol), blood flow obstruction, and loss of circulating volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is venous blood flow disorder?

A

Blood flow is generated from the venules and returns into the heart’s right atrium

EX: Impaired outflow of blood from tissues or organs causes an organ to become enlarged

EX: Back up of venous blood in organs/tissues causes impaired removal of wastes from cellular metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Atherosclerosis?

A

A slow developing process involving inflammation within the endothelium

  • Homocysteine and C reactive protein are elevated with inflammation and contribute to atherosclerosis risk.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the mechanisms of Atherosclerosis?

A

Vessel narrowing leading to ischemia

Sudden vessel obstruction due to plaque rupture or embolization

Aneurysm due to vessel weakening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is Atherosclerosis made up of?

A

Fatty streak

Fibrous plaque

Complicated lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the etiology/risk factors for Atherosclerosis?

A

Hypercholesterolemia

Cigarette smoking

BP > 139/89

Increasing age

Family history of premature coronary artery disease:
- Male younger than 55
- Female younger than 45

Male sex

Postmenopausal female (due to decrease in estrogen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What results from an arterial circulation disorder?

A

Ischemia and Infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is ischemia?

A

Decreased blood supply

Inadequate oxygen, nutrients to support cellular metabolism

Impaired removal of end products of metabolism such as lactic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is infarction?

A

Necrosis of tissue due to inadequate arterial supply and/or venous drainage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is Acute Arterial Occlusion?

A

Acute arterial occlusion can be due to atherosclerosis buildup, a sudden clot, and/or spasms within an artery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are some clinical manifestations of Acute Arterial Occlusion?

A

The 7 P’s:

-Pistol shot
-Pallor
-Paresthesia
-Paralysis
-Pulselessness
-Polar
-Pain –Permanent tissue loss may already be possible.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is an aneurysm?

A

Abnormal dilation of blood vessel.

More common in arteries than veins.

Aorta is the most common site.

Cause linked to gene mutation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are some clinical manifestations in an aortic aneurysm?

A

May be asymptomatic

Rupture may be 1st sign

Edema – jugular veins, face, neck

Localized pain due to pressure on associated tissues/structures:

-Acute myocardial infarction
-Bowel infarction
-Acute renal failure
-Acute paralysis from impaired blood flow to spinal cord

26
Q

How can venous disorders be described?

A

Blood drainage from tissues returns to the heart through veins.

Low pressure system using skeletal muscle pump to help move blood back into heart.

Backup of blood in veins promotes clotting.

27
Q

What are the alterations in venous blood flow?

A

Valve incompetence

Varicosities

Chronic venous insufficiency

Deep vein thrombosis

28
Q

What are some etiologies of DVT?

A

Venous stasis:
- Immobility
- Unconscious client

Pregnancy

Obesity

Smoking

Oral contraceptives

Hypercoagulability

Cancer

Prolonged air travel

Inherited clotting disorder

Trauma to a vein (s)

29
Q

What are the clinical manifestations of DVT?

A

Skin reddened.

Skin warm, hot.

Localized edema.

Pain in the calf and/or nearby area.

Pedal pulse is present and palpable because clot is in a vein, not in an artery that generates a pulse.

30
Q

What are some complications with DVT?

A

Pulmonary embolism

  • Sudden dyspnea
  • Chest pain
  • Low arterial oxygen by blood gas
  • Low O2 saturation by blood gas or pulse oximetry
  • High mortality
31
Q

What is blood pressure?

A

Blood pressure is the pressure of blood pushing against the walls of your arteries. Arteries carry blood from your heart to other parts of your body.

32
Q

What determines blood pressure?

A

The volume of blood in the vessels

Elasticity of blood vessels

Cardiac output

Cardiac contractility

Systemic vascular resistance
Vessel radius – dilation versus constriction or obstruction

33
Q

How can we control BP with humoral control?

A

Renin-angiotensin-aldosterone system

Antidiuretic hormone (ADH) also called (vasopressin)

Epinephrine

34
Q

How can we control BP with neural control?

A

Intrinsic reflexes
- Baroreceptors, chemoreceptors

Extrinsic reflexes
- Sensory receptors
(Pain, cold, Mood, emotions)

35
Q

How is renal control of BP explained?

A

Decrease in arterial pressure by increased heart rate and/or increased vasoconstriction leads to decrease in blood flow into kidneys.

Change in neural-humoral control of BP can alter the diuresis-natriuresis balance to increase arterial pressure.

36
Q

What is the break down of Renin-angiotensin-aldosterone system (RAAS)?

A

Renin – enzyme from kidneys

Angiotensinogen – circulating plasma protein

Angiotensin I
- Angiotensin-converting enzyme works in lung endothelium

Angiotensin II –potent vasoconstrictor
- Promotes sodium reabsorption by kidneys
- Stimulates release of aldosterone by adrenals

Antidiuretic Hormone
- Stimulates water reabsorption by kidneys
- Constricts arterial vessels, especially splanchnic (gastrointestinal) circulation

37
Q

How does blood vessel diameter alter systemic vascular resistance?

A

Increases upon constriction.

Decreases upon dilation.

38
Q

What is cardiac output?

A

Amount of blood ejected from heart each minute measured in liters/minute.

Cardiac Output = Heart Rate x Stroke Volume

Average Stroke Volume in adult = 80 milliliters

39
Q

What is Primary hypertension?

A

Essential, Idiopathic

40
Q

What is Secondary hypertension?

A

Occurs as effect of another underlying condition

Can be temporary if primary problem resolves

41
Q

What is Hypotension?

A

Orthostatic

Shock

42
Q

People with diabetes or chronic kidney disease should keep their blood pressure below what number?

A

130/80

43
Q

What is the cause of primary hypertension?

A

Constitutional
- Increasing age
- Family history
- Insulin resistance – Type 2 diabetes mellitus

Lifestyle
- Excess calories, sodium, alcohol intake
- Inadequate potassium intake

44
Q

What are the leading theories for primary HTN?

A

Heredity

Increased water & sodium retention

Insulin resistance/Hyperinsulinemia

Altered renin-angiotensin-aldosterone activity

Endothelial cell dysfunction

45
Q

What are the components of sodium and water retention?

A

Excessive sodium intake

Possible activation of vasopressors

Hypertension can decrease with sodium restriction

46
Q

What is Insulin Resistance / Hyperinsulinemia?

A

Abnormal metabolism of insulin, glucose, and lipoproteins with primary hypertension

Increased insulin level stimulates sympathetic nervous system and decreases vasodilation directed by nitric oxide

47
Q

What is Endothelial Cell Dysfunction?

A

Endothelium produces many vasoactive substances

Not all substances and their functions identified

Possible role in hypertension development

48
Q

What is the Altered Renin-Angiotensin Aldosterone System?

A

Hypertension normally inhibits kidney renin production.

Some people with hypertension have low renin.

Renin-angiotension mechanisms are altered.

Angiotension II is a highly potent vasoconstrictor.

49
Q

What are symptoms of primary hypertension?

A

Symptoms are usually absent until target organ damage has occurred, therefore there are no symptoms of primary hypertension.

50
Q

How does hypertension cause cardiac issues?

A

Heart workload is increased and leads to left ventricular hypertrophy.

Heart must pump harder against increased resistance in blood vessels and or heart valves.

Myocardial oxygen demand is increased.

51
Q

What is secondary hypertension not a cause of?

A

Secondary hypertension is NOT a condition that occurs because primary hypertension was not “fixed”.

It is NOT a complication of primary hypertension.

52
Q

What is secondary hypertension the cause of?

A

It IS related to an underlying disease, process, or medication:
- Renal disease – leading cause
- Pheochromacytoma
- Cushing’s syndrome
- Coarctation of aorta
- Brain tumors, brain injury
- Pregnancy
- Medications - Oral contraceptives are major risk > age 35

If the cause is removed/resolved, the secondary hypertension may be resolved.

52
Q

How is pediatric primary hypertension explained?

A

Sedentary lifestyle

Excess calories

Excess salt

Obesity

53
Q

How is pediatric secondary hypertension explained?

A

Remains most likely type of hypertension in pediatrics although primary hypertension increasing rapidly

About 80% related to kidney dysfunction

Coarctation of aorta

Endocrine disorders

Transplant medications

Drug abuse

54
Q

What is Isolated Systolic Hypertension (ISH)?

A

SBP > 140 mm Hg

Diastolic < 90 mm Hg or within normal range

55
Q

What are the etiologies of Isolated Systolic Hypertension (ISH)?

A

An expected anatomic age-related blood pressure elevation

Calcification of the great vessels and/or cardiac valves

Decreased vessel elasticity

56
Q

What are the complications of Isolated Systolic Hypertension (ISH)?

A

Myocardial infarction

Cerebrovascular accident

Congestive heart failure

Caution – rapid lowering of BP can cause or worsen above conditions

57
Q

What is Orthostatic Hypotension?

A

BP drops with posture elevation

58
Q

What are the etiologies of Orthostatic Hypotension?

A

Medications side effects

Pregnancy

Starvation

Dehydration

Recent or prolonged immobility

59
Q

What are the acute manifestations with Orthostatic Hypotension?

A

Dizziness

Syncope

Blurred vision

Sudden blindness

Pathophysiology Exam 2 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions