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BSNC 1000 > Module 4 > Flashcards

Module 4 Flashcards

1
Q

3 Factors Affecting Stroke Volume

A

Contractility
Pre load
After load

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2
Q

Types of shock

A 
Anaphylactic
Pulmonary
Cardiogenic
Hypovolemic
Septic
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3
Q

Scope of Perfusion

A

Optimal –> Suboptimal –> No Perfusion

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4
Q

Types of Hypertension

A

Primary

Secondary

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5
Q

Primary Hypertension

A

Hypertension that occurs without an identified disease

Obscure causes

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6
Q

Secondary Hypertension

A

Hypertension that occurs as a result of an identified disease

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7
Q

Short Term Regulators of Blood flow

A

Neural
Cardiovascular Center –> receives input from baroreceptors + chemoreceptors

Hormonal
RAAS System –> angiotensin II, aldosterone
Vasopressin (ADH)
Epinephrine/Norepinephrine

Local
Blood vessel autoregulation

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8
Q

Longterm Regulators of Bloodflow

A

Kidneys

resp for filtering blood, reabsorption, excretion

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9
Q

Target-Organ Damage from Hypertension

A

Heart
Brain
Eyes
Kidneys

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10
Q

Cholectamine

A

Chemical messenger released into blood in responset to stress

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11
Q

Examples of Cholectamine

A

Epinephrine

Norepinephrine

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12
Q

Contractility

A

force of myocardial contraction

determined by preload

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13
Q

Afterload

A

Resistance that must be overcome to eject blood from the left ventricle
impacted by blood viscosity, vasoconstriction

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14
Q

Mean Arterial Pressure

A

Average pressure of the arterial system through one cardiac cycle
Used as an indicator of perfusion

calculated by: cardiac output x total peripheral resistance

~60-100 mm Hg

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15
Q

Systolic vs. Diastolic Blood Pressure

A

Systolic BP = blood pressure in arteries during ventricular contraction

Diastolic BP = blood pressure in arteries during ventricular relaxation

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16
Q

Pulse Pressure

A

Measures pulsing nature of blood flow
Calculated by: systolic BP - diastolic BP

~40 mm HG

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17
Q

Peripheral Vascular Resistance

A

Resistance to blood flow in the systemic arteries

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18
Q

Heart Conduction System

A

SA Node –> AV Node –> AV Bundle –> Purkinje Fibers

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19
Q

Autoregulation

A

ability of organs to maintain optimal perfusion despite changes in blood pressure

local effect

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20
Q

High Blood Pressure

A 
systole = >140
diastole = >90
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21
Q

Diuresis

A

excretion of water/extracellular fluid by kidneys

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22
Q

Natriuresis

A

excretion of sodium by kidneys

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23
Q

Consequences of High SBP

A

leads to left ventricular hypertrophy

heart failure

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24
Q

Hypertensive Crisis

A 
systole = >180
diastole = >110

includes hypertensive urgency and hypertensive emergency

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25
Q

Secondary Hypertension Risk Factors

A

Kidney disease
Adrenal Cortical disease
Pheochromocytoma
Coarctation of aorta

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26
Q

Consequences of High DBP

A

decreased coronary perfusion

increases total peripheral resistance

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27
Q

Secondary Hypertension Risk Factors

A

Kidney disease
Adrenal Cortical disease
Pheochromocytoma
Coarctation of aorta

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28
Q

Kidney Disorders

A

Acute glomerulonephritis
Acute renal failure
Acute urinary obstruction
Atherosclerosis of renal blood vessels

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29
Q

Total Peripheral Resistance

A

Total resistance to blood flow in systemic circulatory system

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30
Q

Angiotensin II Effects

A

vasoconstrictor
promote reabsorption of sodium in proximal convoluted tubule
stimulate adrenal cortex to produce aldosterone

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31
Q

Aldosterone Effects

A

promote reabsorption of sodium in DCT

promote excretion of potassium in DCT

32
Q

Hypertension & Blood Vessesls

A 
Atherosclerosis
Hypertrophy
Inward Remodeling
Vascular Stiffness 
Rearctation
33
Q

Pheochromocytoma

A

catecholamine-secreting tumors of adrenal chromaffin cells

continually release norepinephrine/epinephrine

34
Q

Coarctation of Aorta

A

congenital issue

narrowing of the aorta lumen

35
Q

Chromaffin cells

A

Secreting cells of the adrenal medulla

36
Q

Effects of norepinephrine/epinephrine

A

Norepinephrine - vasoconstriction, increase heart rate (increase in cardiac output), increase myocardial contraction
Epinephrine - inhibit insulin release, promotes glycolysis, decrease sweating, vasoconstriction blood vessels

37
Q

Perfusion

A

flow of blood from arteries –> capillaries –> tissue

can be calculated as blood flow/mass or (ml/min)/kg of unit mass

optimal perfusion = when tissue receives sufficient blood flow to meet metabolic need (this varies)

38
Q

Signs/symptoms of peripheral perfusion

A 
capillary refill <2-3 seconds
temperature of extremities 
skin tone
pulse rates 
urine production
bowel movements
39
Q

Baseline history

A

trying to obtain a general assessment of a patient’s health and relevant lifestyle factors

medication
recreational/illicit drug use
chronic conditions
smoking
diet
exercise
40
Q

Problem-based history

A

reported symptoms that could indicate impaired perfusion

dyspnea - shortness of breath 
syncope - fainting 
edema
dizziness 
pain
41
Q

Factors affecting blood pressure readings

A 
caffeine
bowel movement
faulty equipment
poor assessment technique
pain 
medication (prescription  or over-the-counter)
42
Q

Physiological Changing of Aging

A

reduced arterial compliance (arteries stiffen and elastin is replaced with collagen)
reduced arterial patency (atherosclerosis, occlusions)
reduced baroreceptor sensitivity (reduced neural response)
reduced cardiac output
reduced renal blood flow (higher blood volume)
increased peripheral resistance
venous valves less effective –> peripheral edema

43
Q

Measuring blood pressure

A 
person has rested five minutes
thirty minutes after exercise or caffeine 
sitting position, both feet on the floor
arm at chest or heart level
take two readings
44
Q

Factors affecting central perfusion

A 
reduction in cardiac output
structural defects (heart valves, myocardial tissue)
viscosity of blood (increases afterload)
poor tissue perfusion to myocardium 
conduction issues
45
Q

Factors affecting tissue perfusion

A

arterial compliance
occlusion, obstruction in arteries
poor central perfusion
blood viscosity

46
Q

Modifiable Risk Factors

A

Diet (alcohol, sodium, fat intake)
Sedentary lifestyle
Obesity
Smoking

47
Q

Non-modifiable Risk Factors

A

Race
Age
Sex
Genetics (Family History)

48
Q

What are Risk Factors?

A

habits or characteristics that make an individual more at risk for certain conditions/disease

49
Q

Effects of Hypertension on blood vessels

A 
Atherosclerosis
Hypertrophy
Vascular Stiffness
Inward Remodeling
Rarefaction
50
Q

Target Organ Damage

A 
Brain - Stroke, TIA
Eyes - Retinopathy
Kidneys - Kidney Disease
Arteries - Atherosclerosis 
Heart - left ventricular hypertrophy, heart failure, aortic aneurysm, myocardial infarction, coronary artery disease
51
Q

Angina

A

severe chest pain accompanying an ischemic attack

52
Q

Hypoxia

A

reduced oxygen levels in blood –> weakens cells

53
Q

Arrhythmia

A

irregular heartbeat due to an issue in the electrical conduction system

54
Q

Pathophysiology Interrelated Concepts

A

etiology - cause of disease
pathogenesis - onset/development of disease
clinical manifestation - signs/symptoms of disease

55
Q

Hypoxia

A

decreased amount of O2 in tissue cells

56
Q

Hypoxemia

A

decreased amount of O2 in arterial blood

57
Q

Variations in Perfusion Impairment

A

duration (acute v. chronic)
type (central v. tissue)
degree (ischemia v. infarction)

58
Q

Determinants of Perfusion

A

Blood pressure
Cardiac output
Peripheral vascular resistance

59
Q

Shock

A

Critical condition that occurs when there is inadequate blood volume to supply the bodily tissues/organs

central perfusion can no longer support tissue perfusion. various causes.

60
Q

Areas of the cardiovascular center

A

Cardioinhibitor –> parasympathetic, decrease heart rate, vagus nerve
Cardioaccelerator –> sympathetic, increase heart rate, cardiac accerelator nerve
Vasomotor –> sympathetic, vasoconstriction,

61
Q

Diagnostic Studies

A

Blood tests
ECG
Radiographic Studies
Cardiac Stress Tests

62
Q

Preload

A

volume of blood in the ventricles at the end of diastole

affected by venous return of blood to heart

63
Q

Blood Vessel patency

A

openness/unobstructedness of artery

diameter of lumen

64
Q

What triggers renin release?

A 
reduced sodium levels in blood
reduced blood volume
reduced perfusion to kidneys
sympathetic nervous system stimulation 
angiotensin II
65
Q

Factors contributing to resistance

A 
blood viscosity
length of blood vessel
radius of blood vessel
arterial compliance
arterial patency
66
Q

Types of arteries

A

large arteries –> more elastin > smooth muscle (higher compliance ex: aorta)
small + medium arteries –> more smooth muscle > elastin (autoregulation of bloodflow)

67
Q

Hypertensive urgency

A

Blood pressure >180/110 but no signs of end-organ damage.

Treated with medication.

68
Q

Hypertensive emergency

A

Blood pressure >180/110 with end-organ damage.

Will require emergency medical interventions.

69
Q

Arterial compliance

A

ability of arteries to respond to changes in pressure

increased pressure –> arteries distend
decreased pressure –> arteries retract

70
Q

Physiological variations in blood pressure

A

age –> increased blood pressure
stress –> temporary increase in blood pressure
circadian rhythm –> time of day affects blood pressure

71
Q

Baroreceptor response to blood pressure

A

baroreceptor = located in the arch of the aorta + carotid bodies

mechanoreceptors that respond to stretch

increased blood pressure = increased stretch = increased firing to the CV center –> parasympathetic activation –> vasodilation

decreased blood pressure = decreased stretch = decreased firing to the CV center –> sympathetic stimulation –> vasoconstriction

72
Q

Circulatory System Components

A

heart = pump
arterial system = transport blood away from heart. pressure reservoir. elastic vessels.
venous system = transport blood towards heart. blood reservoir. compliant vessels. have valves.
capillary beds = site of gas exchange.

73
Q

Determinants of Perfusion

A

blood pressure
cardiac output
peripheral vascular resistance

74
Q

Prehypertension

A

<120-139/80-89

75
Q

Stage 1 Hypertension

A

<140-159/90-99

76
Q

Stage 2 Hypertension

A

> 160/100

77
Q

Treatment goals for hypertension

A

reduce modifiable risk factors

goal BP for non-diabetic patients: <140/90
goal BP for diabetic patients: <130/80

BSNC 1000 (10 decks)

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