Hemodynamic Lecture Flashcards
arteries
muscular
most common heart failure
biventricular
most common plasma protein in fetus
alpha-fetal protein
in adults - albumin
albumin
holds water in vasculature
hydrostatic pressure
if higher - pushes blood out
cor pulmonale
right heart failure
most common cause of CHF
artherosclerotic disease of coronary arteries
hyopalbuminemia
lose water
most common liver disease
alcohol use
-liver gets scarred down
steatotic change
fatty change
burns
increased capillary permeability
-loss of fluid
angioedema
facial edema
- *should always be of concern
- may lead to airway obstruction
adult respiratory distress syndrome
damage to pulmonary interstitial capillaries
interstitial pneumonia
primary atypical
-interstitial capillary is where gas exchange occurs
normally only a few cells thick
-some organisms invade this area
lymphatic obstruction
most common
-upper extremity in women with axillary lymph node removal after breast removal with cancer
malignant ascites
nothing to do with cancer
nor does malignant HTN
hypertension
affects at level of arterioles
acute pulmonary edema
left ventricular dysfunction
-can be caused from myocardial infarction
pressure transferred backwards and results in edema
most MI patients
don’t die with initial infarction
-rather die with CHF or later infarctions
common cause of nutmeg liver
CHF
-chronic passive congestion
subungal hematoma
under the nail
petchiae
platelet associated hemorrhage
-
purpura
larger than petchiae
ecchymosis
red cell breakdown
-metabolism of Hg to biliverdin
abrasion
scrape
contusion
bruise
subdural hematoma
venous
epidural hematoma
arterial
visceral hemorrhage
with intrinsic defects in coag process
venous bleeding
often stops on its own
-low pressure bleed
arterial bleeding
medical emergencies
-can get hypovolemic shock
atherosclerosis
most common cause of death
-chronic inflammatory disease of endothelium**
where is atherosclerosis
aortic arch and bifurcation
- high pressure with lots of turbulence
- some degree of endothelial damage
over time endothelium
calcification
-only in older individuals
primary hemostasis
platelet with vWF
secondary hemostasis
fibrin polymerization with platelet
clots and cholesterol
in clots - trap neutrophils, RBCs, and cholesterol
cholesterol may cause secondary increase in the plaque size
continuous capillary
cytoplasm is continuous and has no openings
metabolism can diffuse across endothelium
fenestrated capillary
have windows
-complete basal lamina
in glomeruli**
discontinuous capillary
spaces between cells themselves
-incomplete basal lamina
vWF deficiency
provoked in aspirin use
not widespread
-nosebleeds (epistaxis)
bernard soulier
know this
glanzmann thrombasthenia
know this
quantitative platelet defect
total number decreased
-150,000 - below this get bleeding
most common - HIV
-get thrombocytopenia
qualitative platelet defect
normal platelet count
-but they are negatively morphed
hemophilia
bleed to death
look at table 4-2 **
robbins page 122
primary common risk
secondary high risk
adenocarcinoma
mucin production
-can lead to secondary hypercoagulability
endocarditis vegatations may result
arterial thrombi
large vessel
venous thrombi
stasis in larger veins
small arteries
can get total occlusion with thrombus
-can recanalize
coronary artery thrombosis
can get removal (rare)
or narrows lumen
or full occlusion
streptokinase
IV fibrinolytic agent
common Tx for coronary artery thrombosis
bypass**
also angioplasty with stent and streptokinase
left ventricle wall
normal no more than 1.5cm
common cause of right ventricular infarct
left ventricular infarct
mural
means wall
transmural - spans entire vessel wall in heart
vegetations
in valves of heart
endocarditis
vegetations
subacute endocarditis
from normal skin flora infection
strep viridans
strep viridans
often cause endocarditis
libman sacks endocarditis
lupus
superior and inferior surface of cardiac valves
DIC
often with septic shock
not primary disease
-simultaneous bleeding and clotting
most common embolus
due to atherosclerosis
-from mural thrombi
at carotid bifurcation - can go to brain
DVT
to lungs
red infarct
secondary reperfusion
-goes right to interstitium
white infarct
ischemic
-thrombi
liquefactive necrosis
lungs and brain
brain does not scar
coagulative necrosis
leads to scarring
septic infarction
emobli with organism
shock
failure to perfuse
nonprogressive shock
tachycardia
- low BP
- vital organs still perfused
shunting - to heart, lung, brain
away from kidney**
ischemic encephalopathy
irreversible shock
