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Block 10 > Hemodynamic Disorders 1 > Flashcards

Hemodynamic Disorders 1 Flashcards

1
Q

Normal LV end diastolic pressure

A

10 mmHg

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2
Q

Normal LV systolic pressure

A

130 mmHg

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3
Q

Normal RA pressure

A

3 mmHg

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4
Q

Normal RV systolic pressure

A

25 mmHg

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5
Q

Normal LA pressure

A

8 mmHg

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6
Q

Preload is represented by

A

EDV and ED pressure

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7
Q

Frank-Starling mechanism

A

?

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8
Q

Afterload is sometimes referred to as

A

systolic ventricular wall tension or stress

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9
Q

Laplace relationship

A

Systolic ventricular wall stress = (systolic ventricular wall pressure x ventricular chamber radius)/(2 x ventricular wall thickness)

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10
Q

determinants of the force of ventricular contraction in systole

A

preload
afterload
contractility

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11
Q

inotropic state of the heart

A

contractility

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12
Q

Contractility is determined by

A 
sympathetic/parasympathetic nerve input
hormonal influences (epi, norepi, etc)
drugs (dobutamine, milrinone, etc)
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13
Q

compliance of the ventricle

A

stiffness of the ventricular wall

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14
Q

restrictive cardiomyopathy

A

ventricular compliance decreases below the ability of the atrium to fill it normally

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15
Q

diastolic dysfunction

A

impaired cardiac filling

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16
Q

systolic dysfunction

A

impaired cardiac pumping

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17
Q

impaired contractility or greatly increased afterload cause

A

systolic dysfunction

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18
Q

Systolic dysfunction decreases the

A

stroke volume

ejection fraction

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19
Q

The more stiff a ventricle is, the harder it is to _____.

A

fill

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20
Q

Diastolic dysfunction does not typically reduce

A

ejection fraction

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21
Q

THE 5 MAJOR CATEGORIES OF THE FACTORS DETERMINING THE HEART’S FUNCTION AS A PUMP (CO)

A
  1. PRELOAD
  2. AFTERLOAD
  3. CONTRACTILITY
  4. COMPLIANCE
  5. HEART RHYTHM
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22
Q

The inability of the heart to pump sufficient blood to meet the needs of the body.

A

Cardiac Failure

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23
Q

The most common cardiac hemodynamic disorder.

A

Cardiac Failure

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24
Q

Heart failure epidemiology

A

Old age

AA

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25
Population attributable risk of heart failure due to_____(62%), _____(17%), _____(10%), _____(8%), _____(3%), and _____(2%).
``` CAD smoking hypertension overweight diabetes mellitus valvular heart disease ```
26
The most common structural correlate with heart failure.
myocardial infarction
27
Chronic heart failure is most frequently caused by
old myocardial infarctions (often multiple)
28
ischemic cardiomyopathy
aka Chronic Ischemic Heart Disease; progressive heart failure secondary to ischemic myocardial damage
29
Heart failure that typically lowers the ejection fraction.
Heart failure due to aortic stenosis, severe hypertension or CAD.
30
Heart failure that typically preserves the ejection fraction.
Heart failure due to left ventricular hypertrophy, restrictive cardiomyopathy or pericardial disease. Transient myocardial ischemia can do this too.
31
Non-congestive heart failure
There aren't any! All heart failure is congestive.
32
_____ heart failure is associated with cardiomegaly.
Most
33
Cardiomegaly due to heart failure is caused by _____ more often than thickening of the walls.
dilation of the chambers
34
The most common symptom of heart failure.
Dyspnea
35
Pulmonary edema occurs when pulmonary venous pressure exceeds ___ mmHg.
20
36
The condition in which one pillow is sufficient to prevent paroxysmal nocturnal dyspnea.
One-pillow orthopnea
37
Two most common symptoms of heart failure.
Dyspnea | Fatigue
38
Two most specific symptoms of heart failure.
Paroxysmal nocturnal dyspnea | orthopnea
39
Signs of heart failure
``` tachycardia tachypnea hypotension pulmonary crackles pulmonary wheezing diaphoresis gallops ```
40
Tachycardia is a compensatory response to
reduced ejection fraction
41
When pulmonary venous pressure exceeds ____ mmHg, transudate passes not only into the interstitium but also into airspaces.
25
42
Crackles are (CHOOSE: inspiratory OR expiratory) sounds attributed to _____.
inspiratory; popping open of small airways occluded by edema
43
Crackles are first heard _____
at lung bases
44
cardiac asthma
wheezing caused by edema around large airways from hear failure
45
Diaphoresis can be a sign of heart failure due to _____ stimulation
sympathetic nerve
46
Chest xray findings of _____, _____, and _____ can help heart failure diagnosis.
cardiomegaly pulmonary vascular congestion interstitial or alveolar edema
47
Level of ____ correlates with the severity of heart failure.
BNP
48
BNP causes
excretion of Na and water vasodilation inhibition of renin secretion antagonism of the effects of angiotensin II on aldosterone and ADH levels
49
The most common cause of heart failure with preserved ejection fraction.
Hypertension
50
Gallop associated with hypertensive heart disease
S4 gallop
51
People who can have a physiologic S4
young people
52
Myocardial fibrosis, decreased compliance and restrictive cardiomyopathy commonly accompany
decompensated hypertensive heart disease
53
summation gallop
S3 plus S4 in tachycardic pt
54
The prognosis of _____ heart failure is poor.
diastolic
55
The 4 profiles of acute heart failure.
A: warm and dry B: warm and wet C: cold and wet L: cold and dry
56
The warm and dry profile of acute heart failure is most associated with _____ or _____.
transient myocardial ischemia | heart failure from lung disease
57
Compensatory responses elicited by hypovolemia leading to shock.
rapid breathing baroreceptors -> increased symp and decreased parasymp ADH released by posterior pituitary
58
5 consequences of sympathetic nervous activity
``` increased HR augmented myocardial contractility peripheral vasoconstriction release of renin from kidney (inc AII -> vasoconstriction) epinephrine released by adrenal medulla ```
59
Effect of epinephrine
peripheral and then splanchnic vasoconstriction
60
Effects of ADH
water retention | vasoconstriction
61
Mechanism of increased capillary oncotic pressure in hypovolemia.
Glycogenolysis in the liver induced by epi and norepi
62
Normal central venous pressure
3 mmHg

Block 10 (16 decks)

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