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human disease > exam 4 > Flashcards

exam 4 Flashcards

1
Q

hemostasis

A

process of stop bleeding

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2
Q

thrombus

A

clot

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3
Q

5 major factors affecting hemostasis

A

integrity of small blood vessels

adequate numbers of normal platelets

normal amounts of clotting factors (liver)

normal amounts of clotting inhibitors

adequate amounts of calcium

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4
Q

first defense after injury

A

small vessels

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5
Q

platelets and injury

A

accumulate and adhere to site

plug hole in vessel
release chemicals for vasoconstriction and aggregation
release substance that initiate blood clotting

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6
Q

platelets characteristics

A

survive for 10 days
contractile proteins
become activated
prevent bleeding from capillaries

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7
Q

blood coagulation process

A

1) release prothrombin by injured vessel
2) convert prothrombin into thrombin
3) soluble fibrinogen converted into insoluble fibrin strands by thrombin

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8
Q

blood clot

A

result of clotting process

meshwork of fibrin threads and blood cells

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9
Q

disturbances of blood coagualtion

A

adnormalities of small blood vessels
abnormality of platelet numbers
deficiency of 1+ clotting factors
liberation of thromboplastic material

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10
Q

abnormalities of small vessels

A

abnormal bleeding from failure of small vessels to contract after injury

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11
Q

abnormality of platelet numbers

A 
abnormal platelet formation
low platelets
injury or disease t bone marrow
cancer of bone marrow
destruction of platelets via antibodies
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12
Q

petechiae

A

small red or blue spots
pinpoint hemorrhages in skin
indicated defective or inadequate platelets
dont blanch

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13
Q

hemorrhagic disease

A

presence of petechiae and fever with infection

poor prognosis

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14
Q

hemophilia

A

x linked hereditary disease

episodes of hemorrhage in joints and organs

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15
Q

von willebrand disease

A

vWF adheres to damaged vessel wall, framework frames

helps maintain normal levels of other clotting factors

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16
Q

causes of abnormal blood clotting

A

anticoagulant drugs
inadequate synthesis of vitamen K
inadequate absorption of vitamen K
severe liver disease

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17
Q

causes of thrombocytopenia

A

injury or disease to bone marrow
leukemic or cancer cells enter bone marrow
antiplatelet antibody destroys platelets in circulation

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18
Q

liberation of thromboplastic material into circulation

A

thromboplastic chemicals released into circulation, intravascular coagulation
shock and tissue necrosis
bacterial infections

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19
Q

disseminated intravscular coagulation

A

abnormal state of bleeding and clotting
severe trauma or hemorrhage= shock, bacterial infection

many small clots in capillaries
body releases chemicals to dissolve clots
net effect: hemorrhage
high mortality

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20
Q

lab tests for hemostasis

A

platelet count
bleeding time- funktion of capillaries
clotting times

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21
Q

clotting time tests

A

PTT vs PT

thrombin time

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22
Q

partial thromboplastin time (PTT)

A

measure the time of the first phase of coagulation

lipid and calcium added to blood

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23
Q

prothrombin time (PT)

A 
measure of time combines second and third phases of coagulation
measure coumodin (anticoagulant)
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24
Q

thrombin time

A

bypass first two phases of blood coagulation

measure level of fibrinogen

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25
Q

pathogenesis of intravascular clotting

A

slowing or stasis of blood flow
blood vessel wall damage
increased clotting of blood

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26
Q

embolus

A

circulating clot carried into lungs or body

plugs vessels

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27
Q

infarct

A

tissue necrosis from interruption of blood flow

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28
Q

fat embolusim

A

following severe bone fracture that disrupts fatty bone marrow and adipose tissue

emulsified fat globules sucked into vein and carried into lungs, obstruct lung capillary

may block vessels in brain or organ

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29
Q

air emboluism

A

air sucked into circulation from lung injury or open chest wound

air may enter right chambers and prevents filing of heart of blood, unable to pump

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30
Q

foreign particle embolusim

A

forign matter
injected substances users
injected IV
severe respiratory distress

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31
Q

venous thrombosis

A

clot in leg from prolong bed rest
varicose veins
leg swelling
possible pulmonary embolism

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32
Q

clincal manifestations of pulmonary embolism

A

size and location in artery

cynosis or shortness of breath= deoxygenation of blood

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33
Q

large pulmonary emboli

A

right side becomes distended with blood
left ventricle unable to pump enough blood to brain and organs
systemic BP falls and go into shock

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34
Q

small pulmonary emboli

A

may pass through arteries or lodge in small arteries
lung segments undergo necrosis
dyspnea, chest pain, cough, bloody spit

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35
Q

gold standard for detecting pulmonary embolus

A

pulmonary angiogram

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36
Q

treatment for embolus

A

anticoagulants
thrombolytic drugs
angioplasty
remove clot

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37
Q

arterial thrombosis

A

may cause injury to vessel wall= ulcers

blocks blood flow

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38
Q

coronary artery

A

heart attack

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39
Q

major leg artery

A

gangrene

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40
Q

cerebral artery

A

stroke

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41
Q

thrombosis by increased clotting

A

rise in coagulation factors following surgrey or injury
estrogen or contraception pills=synthetic clotting factors
gene mutations

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42
Q

edema

A

swelling
accumulation of fluid outside vascular system
ankles
extracellular circulation between capillary and ISF

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43
Q

pitting edema

A

pit or indent formed when tissue is pressed

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44
Q

ascites

A

fluid accumulates in abdominal cavity

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45
Q

pathogenesis of edema

A

increased capillary permeability-inflammation
low plasma protein
lymphatic obstruction

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46
Q

factors regulating fluid flwo between capillaries and tissues

A

capillary BP force fluid out of capillaries
capillary permeability-fluid flow threw wall
osmotic pressure
lymphatic channels

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47
Q

osmotic pressure

A

due to proteins in blood

pulls fluid into capillaries

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48
Q

shock

A

inadequate tissue perfusion (delivery of oxygenated blod) due to low BP

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49
Q

hypovolemic

A

low blood volume

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50
Q

cadriogenic

A

failure of the heart as a pump

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51
Q

septic shock

A

excessive vasodilation secondary to release of toxins and inflammatory chemicals

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52
Q

anaphylactic shock

A

excessive vasodilation from release of inflammatory chemicals

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53
Q

prognosis of shock

A

early recognition and rapid treatment
drugs to vasoconstrict (restore BP)
IV fluids to restore blood volume
treat underlying cause

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54
Q

funktion of the heart

A

muscular pump

propels blood to tissues

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55
Q

heart disease

A

diturbance of the funktion

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56
Q

pericardium

A

double layer sac surrounding heart

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57
Q

fibrous pericardium

A

outer connective tissue

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58
Q

serous pericardium

A

parietal and visceral layers

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59
Q

epicardium

A

same layer as visceral pericardium

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60
Q

myocardium

A

thick layer of cardiac muscle

contracts to form beats

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61
Q

endocardium

A

innermost layer lining chambers and valves

smooth surface for blood flow

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62
Q

superior vena cava

A

recieves blood from regions above heart

drains into right atria

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63
Q

inferior vena cava

A

recieves blood from regions below the heart

drains into right atria

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64
Q

coronary sinus

A

collects blood that drains from myocardium

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65
Q

pulmonary veins

A

enter left atria

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66
Q

tricuspid valave

A

right side

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67
Q

biscupid/mitral valve

A

left side

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68
Q

pulmonary valve side

A

right

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69
Q

aortic valve side

A

left

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70
Q

pulmonary circulation

A

pums blood to the lungs
pick up o2
drops off co2

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71
Q

systemic circulation

A

pumps o2 rich blood to body tissues
drop off o2
picks up co2

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72
Q

coronary circulation

A

delievers o2 rich blood to myocardium and takes away co2

during diastole

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73
Q

coronary sinus

A

cardiac veins that empty into right atrium

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74
Q

right coronary artery

A

supply right side and SA node

75
Q

left coronary artery

A

supply left side

76
Q

what happens to injured heart tissue

A

does not regenerate

forms scar tissue that cannot conduct impulses

77
Q

conduction system

A

muscle cells that initiate own electrical impulses

SA node in right atria

78
Q

cardiac cycle

A

all events with blood flow through the heart during one beat

79
Q

systole

A

contraction

80
Q

diastole

A

relaxation

81
Q

cardiac output

A

amount of blood pumper per minute

82
Q

blood pressure

A

blood flow in the arteries

83
Q

highest pressure

A

contraction

systolic pressure

84
Q

lowest pressure

A

relax

diastolic pressure

85
Q

electrocardiogram

A

meausres electrical activity of heart

86
Q

depolarization

A

contraction

87
Q

repolarization

A

relaxation

88
Q

p wave

A

atrial depolarization

atrial systole

89
Q

qrs complex

A

ventricular depolarization

ventricular systole

90
Q

t wave

A

ventricular repolarization

ventricular diastole

91
Q

atrial fibrilitation

A

atria quiver instead of contracting normally
ventricles beat faster than normal
concern of blood clot

92
Q

ventricular fibriliation

A

ventricles quiver-incompatible with life

only treatment-defibriliation

93
Q

heart block

A

delay or intermissions of impulse transmission from atria to ventricles

94
Q

fetal blood flow diferences

A

blood in pulmonary trunk shunted away from fetal lungs

95
Q

ductus arteriosus

A

opening between aorta and pulmonary trunk

after birththe ductus should close

96
Q

foramen ovale

A

opening in atrial septum covered by flap of tissue
one way valve to bypass lungs
after birth the opening should close

97
Q

abnormal heart development

A

effect of structural abnormality depends on type and effect on circulation
blood may be shunted between chambers-depends on size of opening

98
Q

L to R shunt

A 
systemic to pulmonary
most common
mixes oxygenated with deoxygenated blood
o2 still reaches tissues
bad affect- increase pulmonary pressure-damage to lungs
99
Q

R to L shunts

A 
pulmonary to systemic
mixes deoxygenated with oxygenated blood in right chaners
decreases 02 to the tissues
activities restricted
cynosis
100
Q

4 groups of congenital heart disease

A

failure of normal fetal bypass channels to close
atiral and ventricular septal defects
abnormalities that obstruct blood flow
abnormal formations of aorta or pulmonary artery or connection

101
Q

failure of fetal bypass channels to close

A

patent ductus arteriosus-surgery

patent foramen ovale-asymptomatic/surgrey

102
Q

atrial and ventricular septal defects

A

small defects- close randomly but surgery

large defects- surgrey bc of L to R shunt

103
Q

obstruction of blood flow

A

narrow valve opening-depends on size

dilate valve opening

104
Q

pulmonary stenosis

A

obstruct blood flow from right ventricle

105
Q

aortic stenosis

A

obstructs blood flow from left ventricle

106
Q

coarctation of the aorta

A

localized narrowing of aorta (close to heart)
pressure and volume of blood decrease
high BP in brachial, low BP in legs
reconstruct aorta

107
Q

tetralogy of fallot

A 
pulmonary stenosis
large ventricular septal defect
enlarged aorta that overrides septal defect
right ventricle hypertrophy
cynosis
clubbing fingers and toes
increase blood viscosity
treatment- opening narrowed trunk and close septal defect
108
Q

valvular heart disease

A

rheumatic fever and heart disease
non rheumatic aortic stenosis
mitral valve prolapse
infective endocarditis

109
Q

rheumatic fever

A

complication of strep
fever and inflammation-heart and joints
acute arthritis=scarring
can repair valves

110
Q

rheumatic heart disease

A 
complication of rheumatic fever caused by scarring ofheart valves (mitral and aortic)
backflow of blood
narrowed valve
heart failure
artificial valve
111
Q

non rheumatic aortic stenosis

A

aortic valve has 2 cusps instead of 3
asymptomatic for years but may calcify=rigid
valve replacement
risk factoes: high cholesterol, diabetes, high BP

112
Q

mitral valve prolapse

A

valve cusps are enlarged
prolapse into left atrium during ventricular systole
backflow of blood or murmur

113
Q

infective endocarditis

A

bacterial infection of heart valve (mitral or aortic)
subacute- organisms of low virulence that infect abnormal or damaged heart valves
acute-highly virulent organisms that previousl normal heart valves

114
Q

subacute infection endocardities

A

small deposits of platelets and fibrin accumulat on damged valve-bacteria=inflammation
normally body defenses destroy bacteria
prophylactic antibiotics for dental work
artificial valve

115
Q

acute infective endocarditis

A

highly pathogenic organism spread in blood from infection elsewhere and infect valve
staph infection
vegetations form on valve

116
Q

coronary heart disease

A

arteriosclerosis of coronary arteries
arteries narrow and accumulate fatty material
damage to lining of vessels
calcification on walls
end result- yellow, mushy debris that narrows lumen
ulcers

117
Q

atheroma

A 
collection of fatty material and debris
new plaques are unstable plaques
degenerative changes are irreversible
permantly narrows
risk factors: elevated blood lipids, high BP, smoking, diabetes
118
Q

coronary heart disease symptoms

A

excessive demands on the heart if active
ischemia
bouts of chest pain

119
Q

myocardial ischemia

A

reduced blood supply to heart caused by narrowing or obstruction of coronary arteries

120
Q

angina pectoris

A

bouts of chest pain caused by ischemia

occurs on exertion and subsides when rest

121
Q

unstable angina

A

pain occurs more often and longer

122
Q

diagnosing coronary heart disease

A

coronary angiogram is gold stnadard
catheter in femoral artery to abdominal aorta
dye injected to show location and degree

123
Q

treatment of coronary heart disase

A 
drugs to reduce myocardial o2 consumption and improve circulation
stop smoking
control BP
low fat/cholesterol diet
lose weight
exercise
124
Q

percutaneous coronary inerventio (PCI)

A

angioplasty
similar to angiogram but affected artery are dilated with balloon and stent is placed
within 90 minutes of arriving at hospital

125
Q

coronary artery bypass graft (CABG)

A

patients with severe sclerosis of all major coronary arteries
vein from leg used for bypass

126
Q

severe myocardial ischemia complications

A

severe and prolonged ishcemia cause heart attack

cardiac arrest or necrosis of heart muscle

127
Q

4 triggers of heart attack with CAD

A

sudden blockage of coronary artery
hemorrage into a plaque
arterial spasm
sudden greatly increase myocardial 02 demand

128
Q

ischemia

A

damage due to lack of blood flow

129
Q

myocardial infacrtion

A 
necrosis of heart muscle from severe ischemia
blood is insufficient to sustain muscle 
severe chest pain and collapse
thickness of heart wall
L ventricle and septum
130
Q

complications of heart attack

A

arrhythmias
heart failure
intra cardiac thrombi
cardiac rupture

131
Q

cardiac rupture

A

perforation thru necrotic tissue-blood leaks into pericardial sac and compresses the heart

132
Q

survival of heart attack patients depends on

A 
size of onfarct
patients age
complications
preseence of other disease
go to the hospital immediately
133
Q

most helpful diagnostic tools for heart attacks

A

EKG

blood level of enzymes

134
Q

EKG

A

reveals abnormalities when blood flow to heart muscle is inadequate
muscle becomes infarcted

135
Q

labs fro heart attack

A

troponin

creatine kinase

136
Q

troponin

A

not detectable in healthy people

peak in 24 hours

137
Q

creatine kinase

A

only present when severe damage

138
Q

thromoblytic therapy

A

dissolving the clot restores blood flow and salvages muscle
done before to much damage occurs
via IV

139
Q

future thrombus

A

those who had MI have higher risks of clots

sudden death from arrhythmias

140
Q

aspirin

A

interfers with platelet funktion
prevents them from clumping and clotting
increase chance of hemorrhage

141
Q

blood lipids

A

elevated blood lipids important for pathogenesis of atherosclerosis
triglycerides and cholesterol
sugar elevated triglycerides

142
Q

cholesterol adn CAD

A

high cholesterol diets leads to evelvate blood levels and premature athersclerosis

143
Q

LDL

A

bad cholesterol

transports cholesterol from blood into cells

144
Q

HDL

A

good cholesterol
removes cholesterol from cells and takes it to liver for excretion
protects against CAD

145
Q

hypertension

A 
high BP
excessive vasoconstriction of arterioles
heart pumps more forcefully=damage
heart will fail bc increased workload
narrow renal arteries
wear out vessels
arterioles thicken
146
Q

treatments for high BP

A

drugs to dilate peripheral arteries

147
Q

heart failure

A

heart unable to pump adequate amounts of blood to tissues
back up of blood in veins or lungs
edema

148
Q

treatments for heart failure

A

diurectics
meds for forced contractions
meds that lower BP

149
Q

aneurysms

A

dilation or arterial wall outpouching of portion of wall

result of arteriosclerosis

150
Q

arteriosclerotic aneurysms

A

atheromatous deposits damage aortic wall, reduce elastictiy and weak
wall balloons outward
inside will calcify and clot
fatal if rupture

151
Q

dissecting aortic aneurysms

A

one or more layers of aortic wall separate and form tears
blood forced between layers
severe chest and back pain
fatal unless caught early

152
Q

disease of veins

A 
venous thrombosis
leg veins
inflammation
excessive dilation
varicose veins
153
Q

thrombosis in veins

A

post-op patients in bed
may form pulmonary embolism
early walking

154
Q

varicose veins

A

ssuperficil veins become dilated and valves faulty

blood pools in veins

155
Q

complications of varicose veins

A

stasis of blood in veins=poor oxygen
skin becomes thin, prone to infection
may rupture

156
Q

treatment of varicose veins

A

stockings and elevation of legs to promote venous return

sugrey

157
Q

trachea

A

rigid tube with C-shaped cartilage rings

158
Q

carina

A

split of the trachea

159
Q

alveoli

A

tiny air filled sacs for gas exchange
produce surfactant
covered in pulmonary capilarries

160
Q

ventilation

A

movement of air into and out of lungs

breathing

161
Q

respiration

A

gas exchange between blood and tissure or blood and lungs

162
Q

gas exchange via

A

diffusion

high to low pressure

163
Q

requirements for efficient gas exchange

A

large capillary surface area
unimpeded diffusion across membrane
normal pulmonary blood flow
normal pulmonary alveoli

164
Q

pulmonary funktion tests

A

measure volume of air that can be moved into adn out of lungs under normal conditions

165
Q

vital capacity

A

max volume of air expelled after max inspiration

166
Q

pleura

A

thin membrance covering lungs and surface fo chest wal

167
Q

pleural cavity

A

potential space between ungs and chest wall

168
Q

intrapleural pressure

A

pressure of pleural cavity
has to be less than the pressure in lungs for alveoli to expand
increase pressure=lung collapse

169
Q

pnemothorax

A

escape of air into pleural spce due to lung injury or disease
stab or gun shot=air enters chest

170
Q

tension pneumothorax

A

positive pressure in pleural cavity
air enter sna dcannot escape
chest tube entered to release air

171
Q

atelectasis

A

collapse of lung

obstructive atelectsis caused by bronchial obstruction from mucus

172
Q

pneumonia

A

inflammation of the lung

exudate in lung, fills alveoli

173
Q

classification of pneumonia

A

etiology
anatomic distribution of inflammation
predisposing factors

174
Q

tuberculosis

A 
contagious bacterial infection
breath in toxic bacteria
lesion in lungs=body produce antibodies and form tubercle (dead bacteria and lung tissue)
necrosis occurs, tubercle coughed up
antibiotics
175
Q

drug resistant tuberculosis

A

resistance strains of organisms emerge

176
Q

bronchities

A

inflammation of bronchial mucosa

177
Q

chronic obstructive pulmonary disease

A

combo of emphysema and chronic bronchitis

178
Q

pulmonary emphysema

A

destruction of alveolar structure of lungs with cycstic spaces
dysonea

179
Q

chronic bronchitits

A

chronic inflammation of terminal bronchioles

180
Q

anatomic derangement in COPD

A 
inflammation and narrowing of terminal bronchioles
swelling of bronchial mucosa
dilation of pulmonary air spaces
diffusion of gases
loss of lung elasticity
181
Q

pathogenesis of COPD

A

inflammatory swelling of mucosa
leukocytes accumulate in bronchioles and alveoli
coughing
retention of secretions

182
Q

bronchial asthma

A

spasmodic contraction of smooth muscle on walls of bronchi
dyspnea and wheezing
treat with drugs to dilate bronchioles

183
Q

neonatal respiratory distress syndrome

A

respiratory distress after birth
inadequate surfactant in lungs=alveoli collaspe
preemies

184
Q

pulmonary fibrosis

A

thickening of alveolar septa from irritant gases and particles
lungs rigid restricting breathing
decreased diffusion

human disease (5 decks)

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