Hemodynamics Flashcards

1
Q

Cardiogenic shock results from _____ and/or to generate an adequate blood pressure to perfuse distal tissues.

A

failure of the heart to pump an adequate amount of blood

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2
Q

Infarcts are areas of tissue death (necrosis) caused by _____.

A

ischemia

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2
Q

A red infarct includes a _____, a _____, and ____ tissue that permits movement of blood from adjacent areas into the necrotic area.

A

venous occlusion; a dual blood supply; loose

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3
Q

Heart failure, fluid overload, venous obstruction or compression, or arteriolar dilation can all cause ____.

A

increased hydrostatic pressure

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4
Q

______ in the arterial system most commonly occurs due to endothelial injury and turbulent blood flow, often associated with atherosclerosis.

A

Thrombosis

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5
Q

Thrombosis in the arterial system most commonly occurs due to ______ and _____, often associated with atherosclerosis.

A

endothelial injury; turbulent blood flow

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5
Q

What can cause abnormal blood flow?

A

stasis (a-fib, bed rest), turbulence (atherosclerosis)

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6
Q

Hydrostatic pressure “pushes” fluid from the capillary into the interstitial space on the _____.

A

arterial end

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6
Q

What is an active increase in blood flow due to arteriolar dilation called?

A

hyperemia

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6
Q

What is a thromboemboli?

A

an emboli that was a thrombus or part of one

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6
Q

____ often presents clinically with anemia, respiratory insufficiency, convulsions, acute renal failure, and shock.

A

DIC

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7
Q

______ most commonly occur in the coronary, cerebral, and femoral arteries.

A

Arterial thrombi

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8
Q

Patients with hypovolemic and cardiogenic shock typically present with ____, _____, and _____.

A

coolness and pallor of their skin, tachycardia, and decreased urine output

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9
Q

Where do transudates typically occur?

A

in intact vessel walls under increased pressure

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9
Q

As the thrombus propagates, additional layers of platelets, red cells and fibrin added to the thrombus become less stable and are prone to fragmentation, forming _______.

A

thromboemboli

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10
Q

Hypovolemic shock occurs when _____, and the cardiac output decreases because there is low blood return to the heart.

A

there is not enough blood volume to widely perfuse all tissues

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10
Q

_____ occurs when there is not enough blood volume to widely perfuse all tissues, and the cardiac output decreases because there is low blood return to the heart.

A

Hypovolemic shock

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11
Q

What happens when a clot lodges in the brain?

A

stroke

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11
Q

Shock occurs when the circulating blood volume or blood pressure is ____.

A

not adequate to perfuse body tissues

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12
Q

____ occurs when the circulating blood volume or blood pressure is not adequate to perfuse body tissues.

A

Shock

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14
Q

Name 2 ways fluid inappropriately accumulates in the tissues.

A

1) damage to capillary walls 2) inadequate lymphatic drainage

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14
Q

_____ typically initially presents with warm, flushed skin and fever.

A

Septic shock

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15
Q

What is DIC?

A

hemorrhage and thrombosis occurring simultaneously and systemically

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15
Q

The _____ can be caused by any underlying condition that results in release of procoagulants.

A

systemic activation of thrombin

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16
Q

Fluid movement into the body cavity is called ____.

A

effusion

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18
Q

Damage to capillary walls or inadequate lymphatic drainage can cause _____.

A

fluid to inappropriately accumulate

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19
Q

Emboli in the _____ most commonly lodge in the lungs.

A

venous/right sided system

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19
Q

_____ results from failure of the heart to pump an adequate amount of blood and/or to generate an adequate blood pressure to perfuse distal tissues.

A

Cardiogenic shock

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19
Q

_____ is a subtype of shock due to systemic inflammation (SIRS), occurring when microbial infections cause high levels of inflammatory mediators in the blood leading to widespread arterial vasodilation, vascular leakage, and venous blood pooling.

A

Septic shock

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21
Q

What can cause fluid overload?

A

infusions or renal failure

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23
Q

What is hyperemia?

A

an active increase in blood flow due to arteriolar dilation

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23
Q

What happens when a clot lodges in the kidney?

A

acute kidney injury

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24
Q

Emboli in the venous/right sided system most commonly lodge in the ____.

A

lungs

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26
Q

Fluid is “pulled” back into the capillary on the venous end to balance ______.

A

the protein concentration

27
Q

Amniotic fluid emboli are highly correlated to ____.

A

DIC

28
Q

Septic shock is a subtype of shock due to _____, occurring when microbial infections cause high levels of inflammatory mediators in the blood leading to widespread arterial vasodilation, vascular leakage, and venous blood pooling.

A

systemic inflammation (SIRS)

29
Q

What happens when a clot lodges in the lungs?

A

respiratory insufficiency, chest pain

30
Q

_____ are due to an arterial blockage of a single blood supply in a dense tissue that limits accumulation of blood in the necrotic areas.

A

White infarcts

32
Q

What 2 things cause increased osmotic pressure?

A

1) protein loss 2) low protein production

33
Q

Bleeding typically dominates in _____ of DIC, and thrombosis dominates with _____ DIC.

A

acute onset; chronic

34
Q

DIC often presents clinically with ____, ____, ____, _____, and _____.

A

anemia; respiratory insufficiency; convulsions; acute renal failure; shock

35
Q

When would low protein production occur?

A

in liver disease or malnutrition

36
Q

A _____ can form after an arterial occlusion if blood flow is subsequently reestablished and damaged vessels allow movement of blood into the necrotic area

A

red infarct

38
Q

What is congestion?

A

a pathologic accumulation of blood due impaired outflow of venous blood

39
Q

_____ “pushes” fluid from the capillary into the interstitial space on the arterial end.

A

Hydrostatic pressure

39
Q

White infarcts are due to an _____ blockage of a ____ in a ____ tissue that limits accumulation of blood in the necrotic areas.

A

arterial; single blood supply; dense

40
Q

______ typically dominates in acute onset of DIC, and ____ dominates with chronic DIC.

A

Bleeding; thrombosis

42
Q

Protein loss or low protein production can cause ____.

A

increased osmotic pressure

42
Q

What is the purpose of hyperemia?

A

to bring oxygenated blood into the tissues b/c of inflammation or exercise demand

43
Q

Fluid movement into the adjacent tissues is called ____.

A

edema

44
Q

Infarcts can be classified as red (____) or white (____).

A

hemorrhagic; anemic

46
Q

What is edema?

A

fluid movement into the adjacent fluid

48
Q

Emboli in the arterial/left sided system can affect any organ, but most commonly travel to the ____.

A

legs or brain

50
Q

What can cause protein loss occur?

A

the kidneys or GI tract

51
Q

Where is thrombosis more likely to occur and why?

A

in the venous system b/c of slower blood flow

51
Q

Infarcts can be classified as ____ (hemorrhagic) or ____(anemic).

A

red; white

52
Q

A ____ includes venous occlusion, a dual blood supply, and loose tissue that permits movement of blood from adjacent areas into the necrotic area.

A

red infarct

53
Q

_____ are areas of tissue death (necrosis) caused by ischemia.

A

Infarcts

54
Q

Arterial thrombi most commonly occur in the _____, _____, and _____ arteries.

A

coronary; cerebral; femoral

55
Q

As the thrombus propagates, additional layers of _____, _____, and _____ added to the thrombus become less stable and are prone to fragmentation, forming thromboemboli.

A

platelets; RBCs; fibrin

56
Q

Septic shock typically initially presents with _____.

A

warm, flushed skin and fever

58
Q

What is an embolus?

A

A free floating, intravascular mass of a solid, liquid or gas

59
Q

Patients with ______ typically present with coolness and pallor of their skin, tachycardia, and decreased urine output.

A

hypovolemic and cardiogenic shock

61
Q

What does hyperemic tissue look like and why?

A

red (erythemic) b/c of increased oxygenated blood

63
Q

What can cause endothelial injury?

A

hypercholesterolemia, inflammation

64
Q

What happens when a clot lodges in the joints?

A

the Bends

65
Q

Emboli in the _____ can affect any organ, but most commonly travel to the legs or brain.

A

arterial/left sided system

67
Q

Name things that can be emboli.

A

fat, atherosclerotic debris, gas bubbles, bone marrow, tumor fragments, amniotic fluid, or foreign material

68
Q

What happens when a clot lodges in the GI tract?

A

pain and bleeding

70
Q

What happens when a clot lodges in the legs?

A

swelling, necrosis

71
Q

Name 4 causes of increased hydrostatic pressure.

A

1) heart failure 2) fluid overload 3) venous obstruction or compression 4) arteriolar dilation

72
Q

What is a pathologic accumulation of blood due impaired outflow of venous blood called?

A

congestion

73
Q

Where do exudates typically occur?

A

damaged vessels due to inflammation and WBCs

74
Q

What is the Virchow triad?

A

3 basic factors that promote thrombosis: endothelial injury, abnormal blood flow, and hypercoagulability

75
Q

What happens when a clot lodges in the heart?

A

myocardial ischemia

76
Q

Thrombosis in the ______ most commonly occurs due to endothelial injury and turbulent blood flow, often associated with atherosclerosis.

A

arterial system

77
Q

Fluid is “pulled” back into the capillary on the _____ to balance the protein concentration.

A

venous end

78
Q

Septic shock is a subtype of shock due to systemic inflammation (SIRS), occurring when microbial infections cause high levels of inflammatory mediators in the blood leading to ____, ____, and ____.

A

widespread arterial vasodilation, vascular leakage, and venous blood pooling

79
Q

What can cause hypercoagulation?

A

inherited disorders (factor V Leiden), acquired disorders (disseminated cancer)

80
Q

How does congested tissue look and why?

A

red-blue b/c of accumulated deoxygenated blood

81
Q

Name 3 causes of lymphatic obstruction.

A

1) inflammation, infection 2) neoplasms 3) post surgery or irradiation

82
Q

What is effusion?

A

fluid movement into the body cavity

83
Q

The systemic activation of thrombin can be caused by any underlying condition that results in _____.

A

release of procoagulants

84
Q

Inflammation, infection, neoplasms, post surgery, or irradiation can all cause ____.

A

lymphatic obstruction