MID 2: CARDIO Flashcards
1
Q
Varicose veins
A
- a vein in which blood has pooled, producing distended, tortuous and palpable vessels
- blood moves towards the heart in one-way valves in the veins. When the valves become weakened or damaged, blood can collect in the veins. This causes the veins to become enlarged
2
Q
Varicose veins: Caused by
A
- trauma to the saphenous veins (a large, subcutaneous, superficial vein on the leg) results in damage to one or more valves
- blood is not being moved back to heart- gravity is pulling it back down
3
Q
Varicose veins: Risk factors
A
- age
- female gender
- family history
- obesity
- pregnancy
- DVT (deep vein thrombosis)
- previous leg injury
4
Q
Chronic venous insufficiency
A
inadequate venous return over a long period
5
Q
Chronic venous insufficiency: Caused by
A
- valvular incompetence
- damages to venous due to trauma or previous DVT
- obesity
- high pressure in venous over a long period (due to sitting or standing for long periods, pregnancy)
- family history
6
Q
Chronic venous insufficiency: Risk factors
A
- sitting or standing for long periods
- lack of exercise
- smoking
- history of DVT
7
Q
Chronic venous insufficiency: Manifestations
A
- edema to lower extremities- can extend to knees
- hyperpigmentation of skin of feet and ankles (brown-coloured skin, often near the ankles)
- tight feelings in your calves or itchy
- pain when walking that stops when you rest
- varicose veins
- painful leg cramps or muscle spasms
- venous stasis ulcers which might be hard to treat
8
Q
Thromboembolus (DVT)
A
- thrombus: blood clot that remains attached to a vessel wall
- thromboembolus: detached thrombus
9
Q
Thromboembolus (DVT): Caused by
A
- venous stasis (veins can not send the blood from your legs back to your heart)
- venous endothelial damage
- hypercoagulable states
- orthopedic surgery/trauma
- spinal cord injury
10
Q
Thromboembolus (DVT): Manifestations
A
- leg pain- starts in calf, cramping
- red or discoloured skin on the leg
- feeling of warmth on leg
11
Q
Atherosclerosis
A
- arteriosclerosis: abnormal thickening and hardening of the vessel walls
- form of arteriosclerosis- thickening and hardening caused by accumulation of lipid-laden macrophages in the arterial wall
- leading cause of cerebrovascular diseases and coronary artery disease
12
Q
Atherosclerosis: Risk factors
A
- consumption of high fat food and cholesterol causing increase in LDL (low density lipoprotein, “bad cholesterol”)
- hypertension
- smoking
- obesity (inhibits the oxidation of LDL)
- diabetes
- hyperlipidemia
- insulin resistance
- infection
- periodontal disease
13
Q
Atherosclerosis: Manifestations
A
- Partial vessel occlusion can result in transient ischemic events- when exercising or stress
- As lesion becomes complicated- creation of a thrombosis may result in total obstruction of an artery → ischemia → significant pain and tissue infarction if tissues reperfusion is not done immediately
14
Q
Hypertension
A
- Consistent elevation of systemic arterial BP
- Prevalence higher in those of African descent and in those with diabetes
- Silent killer
- Primary- no known cause (idiopathic); 92-95% of population
- Secondary- caused by a systemic disease process that raises peripheral vascular resistance or cardiac output e.g. renal vascular or parenchymal disease, adrenal tumors; 5-8% of population
15
Q
Hypertension: Risk factors (for primary hypertension)
A
- High sodium intake
- Natriuretic peptide abnormalities: substances made in the heart, high level of it seen in heart failure, involved in the long-term regulation of sodium and water balance, blood volume and arterial pressure, 2 major pathways of natriuretic peptide actions: (1) vasodilator effects, (2) renal effects that leads to natriuresis (sodium excretion) and diuresis
- Inflammation
- Obesity
- Insulin resistance
16
Q
Hypertension: White coat syndrome
A
- Anxiety when in hospital
- Temporary hypertension
- Have patient take BP at home or an automated BP without a physician present
17
Q
Hypotension
A
- Can happen when there is one or a combination of the following factors: decrease in blood volume, vasodilation
- Decrease in cardiac contractility
18
Q
Hypotension: Caused by
A
- Pregnancy, due to an increase in demand for blood from both mother and the growing fetus
- Large amounts of blood loss through injury
- Impaired circulation caused by heart attacks or faulty heart valves
- Weakness and a state of shock that sometimes accompanies dehydration
- Anaphylactic- a severe form of allergic reaction
- Infections of the bloodstream
- Endocrine disorders such as diabetes, adrenal insufficiency and thyroid disease
19
Q
Hypotension: Manifestations
A
- Fatigue
- Lightheadedness
- Dizziness
- Nausea
- Clammy skin
- Depression
- Loss of consciousness
- Blurry vision
20
Q
Orthostatic hypotension
A
- On moving from sitting to standing, or from lying down to standing, gravity acts on the vascular system which reduces the volume of blood returning to the heart and blood pools in the leg. The lower venous return reduces the volume of blood that is available to pump out of the heart, which causes a drop in cardiac output and a momentary drop in BP
- Normal compensation for position changes: decrease in intrathoracic pressure causes stimulation of baroreceptor- increase heart rate through increase the sympathetic outflow and decrease the parasympathetic outflow, closure of valves in venous system causes maintaining more blood in right heart, contraction of leg muscles causes more blood return to heart
- Reflex mechanisms are inadequate
21
Q
Aneurysm
A
- Dilation or outpouching of a vessel wall
- True aneurysm- all 3 layers of the arterial wall
- False aneurysm- occurs when a blood vessel wall is injured and the leaking blood collects in the surrounding tissue leading to an extravascular hematoma
- Dissecting aneurysm- splits the vessel wall along the length of the vessel
- Most common types of aneurysm: abdominal aortic aneurysm (AAA) and thoracic aortic aneurysm (TAA)
22
Q
Aneurysm: Risk factors
A
- Genetic and environmental
- Smoking and diet- aortic aneurysms
- Atherosclerosis plaque erodes the vessel wall
- Hypertension contributes to increases stress of vessel wall
23
Q
Aneurysm: Manifestations
A
- Depends on location
- Can be asymptomatic until they rupture- then severe pain and hypotension
- Thoracic- dysphagia, dyspnea- bulge affects surrounding tissue
- Femoral aneurysm- if it affects circulation- ischemia to lower limbs
- Cerebral- increased ICP- signs of stroke
24
Q
Embolism: Caused by
A
- Dislodged thrombus
- Bolus of air- IV lines, chest trauma
- Amniotic fluid forced in to bloodstream by intra-abdominal pressure during delivery
- Trauma of the long bones
- Subacute bacterial endocarditis or abscess
- Foreign body introduced through IV or arterial lines
25
Q
Embolism: Manifestations
A
- Ischemia or infection in tissue distal to obstruction→ organ dysfunction and pain
- Life threatening depending on location: In coronary artery → causes MI, Cerebral artery → causes stroke, Pulmonary artery → causes pulmonary emboli
26
Q
Peripheral vascular disease
A
- Atherosclerotic disease of arteries in limbs
- Gradual- pain with ambulation
27
Q
Intermittent claudication
A
Muscle pain- Normally pain free but with increase activity the vessels cannot handle the increased blood flow required by the body
28
Q
Buerger’s disease
A
- Formation of thrombus in peripheral arteries
- Associated with smoking, stroke and joint pain
- Permanent occlusion causes collateral vessels to develop but are inadequate- not quick enough, lower blood volume
29
Q
Buerger’s disease: Diagnosis
A
- <45 years of age
- Smoker
- Evidence of peripheral ischemia
30
Q
Reynaud phenomenon disease
A
- Attacks of vasospasm in the small arteries and arterioles of fingers (less common toes)
- Primary- vasospastic disorder with unknown origin
- Secondary- associated with systemic diseases e.g. lupus
