Module 4 (part of test 2) Flashcards
Hypertension is when the blood in _____ is ______ than the space available?
vessels
greater
The source of the pressure in Hypertension is?
pumping of the heart
Arteries _____ to the heart have the highest pressure?
closest (aorta)
Where is the most common place to get an aneurysm?
descending aorta
_______ pressure is the pressure created when the ventricles CONTRACT?
Systolic (high number)
Diastolic Pressure is when the ventricles _______
relax
The resting resistance is modified by the _______ of the arteries?
elasticity
Normal BP?
120/80
Hypertension BP?
160/100
Pre-Hypertensive BP?
121/89
What are the 3 factors that create pressure?
Cardiac Output
Peripheral Resistance
Blood Volume
What is the basic underlying defect in hypertension?
failure in regulating vascular resistance
If you increase viscosity or volume of blood you _______resistance?
increase
_______million is the US have hypertension?
65
Young- men are at _______ risk
Old- men are at ________risk
higher
less
Hypertension is seen with ________Hypertrophy?
L ventricular
If hypertension is untreated it will decrease your life span by?
10-20 yrs.
Sustained hypertension eventually results in ______ and _______
arterial damage
multiple complications
_______ hypertension is found in 90% of hypertensive pts. and has no identifiable cause?
Essential-Primary-Idiopathic
Secondary Hypertension is due to?
underlying condition
Secondary Hypertension is most commonly due to _______disorders?
renal
Hypertensive Oral Manifestations are due to?
Medications used to treat hypertension
What are 3 common oral manifestations due to medications used to treat hypertension?
Xerostomia
Ulcerations
Lichenoid Reaction
We should avoid using LA with _____ in it for pts. that are hypertensive?
epi
An inability of the ventricles to pump enough blood to meet the metabolic demands is termed?
Congestive Heart Failure
Congestive Heart Failure most often begins with _______?
L ventricular failure
Left Ventricular Failure is initiated by?
increased workload
Myocardium Disease
Left Ventricular Failure leads to ______ Of the ventricle and _______ in the lungs?
hypertrophy
fluid accumulation
Congestive Heart Failure is also referred to as?
L Ventricular Failure
What is the most common cause of right-sided heart failure?
L ventricle failure
If the R-side of the heart fails first it is associated with what two problems?
congenital heart defects
emphysema
R-sided heart failure causes blood to back up into the ________ which causes ______?
peripheral veins peripheral edema (swollen ankles/feet)
50-60% of pts. with severe symptoms of CHF die within?
1 yr
50% of pts. with less severe symptoms of CHF die within?
3-5 yrs
NYHA stands for?
New York Heart Association
NYHA Class _____ of CHF has MARKED limitation of activity which causes symptoms?
3
NYHA class _______ of CHF has no limitations of physical activity?
1
NYHA class ________ of CHF has slight limitations of activity and slight symptoms?
2
What are the slight symptoms present in a class 2 CHF?
fatigue
palpitations
dyspnea
Class 4 CHF has symptoms present at _____ and worsen on ______ physical exertion?
rest
any
We CANT use vasoconstrictors (epi) on class ______ or ____
3
4
What is the term used to describe alternating episodes of hyperventilation and apnea during sleep?
Cheyne-Stokes Respiration
A pt. with Heart Failure will have Inspiratory _____ and _____, ______ breathing?
rales (crackles)
shallow
rapid
Ascites is defined as?
accumulation of fluid in the peritoneal cavity
The peritoneal cavity is?
membrane separating the organs in the abdomen.
What is the most common cause of Ascites?
liver disease
What is pitting edema?
pressure indent that persists when pressure is removed.
Oral Manifestations of CHF are _____ related?
drug
Untreated or Uncontrolled CHF:
Should we do elective tx?
NO
CHF pts. who are under control should be in a ________ chair position and watch for signs of _______ __________?
semi-supine
orthostatic hypotension
What is the hierarchy of Oxygen Depravation?
Coronary Artery Disease leads to
Ischemia which leads to
Infarction
Any reduction in blood supply to the heart will result in a?
ischemia
What is the most common cause of Coronary Artery Diseas?
Atherosclerosis
What coronary artery is called the “widow maker”
L coronary artery
Ischemia means?
insufficient blood supply
In Ischemia the cells are ______ but can’t _____
alive
function
What is the leading cause of death in ages 65 and older in the U.S.
Coronary Artery Disease
_ in ___ teenagers already have pathologic initial thickening of coronary arteries?
1 in 6
____are more likely to have an ischemic heart?
men 5:1
Myocardial Ischemia is manifested clinically as __ pain called?
brief
angina pectoris
Myocardial ischemias being with accumulation of?
lipid laden cells in blood vessels
What are the 3 types of lesions associated with Myocardial Ischemia?
fatty streaks
fibrous plaque
complicated plaque
Everyone has _______ _______ or early benign deposits in their vessels?
fatty streaks
A complicated plaque consists of what 4 things?
fibrin
fibrous tissue
calcium
lipid deposits
The most important symptom of myocardial infarction is?
pain
If a pt. is having radiating pain in lower jaw this is a huge sign of?
Myocardial Infarction
____Angina is predictably reproduced and relieved by cessation of activity or with nitro?
stable
unstable angina has pain that is _____ in frequency and precipitated by ______ effort and occurs while _______ as well?
increasing
less
rest
Any variation in the normal rhythm of the heart beat is termed a?
arrhythmias
An arrhythmia may be a disturbance of what 3 things?
rate
rhythm
conduction
The _____ node is the “pacemaker” of the heart?
SA
What is the pattern of Sequential Depolarization?
SA node AV node Bundle of HIS R and L bundle branches Purkinje Fibers
What node is considered the “vice president”
AV node
What is an abnormal conduction pathway between the atria and ventricles which stimulates the ventricles to contract PREMATURELY?
Wolff- Parkinson- White
AV tachycardias
A heart rate of less than _____/min is called a bradycardia?
60
_______ is heart rate (at rest) greater than 100/min?
tachycardia
Ventricular tachycardia almost always occurs with diseased hearts because?
heart works too hard to get more oxygen to the body
A Fibrillation is a “_______”
quiver
Ventricular Fibrilations are _____ but _____ contractions?
rapid
ineffective
_________ disease is the most common form of heart disease predisposing ventricular fibrillation?
ischemic heart disease
What is the term for NO CONTRACTION of the ventricles?
ventricular asystole
No pulse = ________
ventricular asystole
What do you do to treat ventricular asystole?
defibrillator
What are signs of a slow heart rate?
fatigue
dizziness
palpitation
What are signs of a SUSTAINED high heart rate?
syncope
angina
congestive heart failure
What is the tx used most often to fix arrhythmias?
medication
COPD stands for
Chronic Obstructive Pulmonary Disease
COPD is a general term characterized by _____ airflow ______ from the lungs?
chronic
limitation
What are the 2 common diseases classified as COPD?
Chronic Bronchitis
Emphysema
In Emphysema you can’t get air _____?
out of lungs
What is the most important factor in the etiology of COPD?
Smoking
Chronic bronchitis has excessive ______ production due to increased size of ____ glands and _____ cells?
mucous
mucous
goblet
Chronic Bronchitis pts. have a chronic ____ with _____ production?
cough
sputum
Chronic Bronchitis is caused by a _____ of small airways, mucous _____ or a loss of _____?
narrowed/collapsed
plugs
surfactant
Emphysema is seen with a loss of _____ ______ and an enlargement of air spaces _____ to the ______ ______?
elastic recoil
distal
terminal bronchioles
Emphysema complications:
pulmonary ______
___- sided heart failure
low ______
hypertension
R
oxygen (hypoxemia)
Can you use Nitrous oxide in a pt. with COPD?
NO
What is a CHRONIC inflammatory respiratory disease termed?
Asthma
Asthma is associated with increased airway __________
hyperresponsiveness
Asthma is provoked by?
allergens (antigen)
Asthma is an ____ respiratory infection?
upper
Asthma is the result of bronchial smooth muscle _____ and mucous _____
spasm
hypersecretion
What is the most common cause of Asthma?
Extrinsic ( allergens-pollen etc.)
Mild asthma occurs?
less than 2 x wk
Moderate asthma occurs?
more than 2 x wk
____Asthma limits normal activity and occurs when you sleep as well?
severe
What can we use on Asthma pts. to decrease stress of dental appts.?
Nitrous
Do we use LA with or without epi on asthma pts.?
without
What is the etiology of TB
Mycobacterium Tuberculosis
How is TB transmitted?
airborne droplets of mucus or saliva
Replication of the TB virus occurs where?
in the Macrophage
You could have TB and have a NEGATIVE skin test for up to how long?
6-8 wks after exposure to virus
TB signs and symptoms are _____ and similar to a cold/flu?
nonspecific