OLT test study Flashcards
structures of the circulatory system
The heart (pump)
- Right side to pulmonary circulation
- Left side to systemic circulation
Peripheral vascular system (tubing)
- Arteries carry oxygenated blood (except for pulmonary arteries)
- Veins carry de-0xygenated blood (except for Pulmonary and umbilical veins)
Hematological system (blood and components)
- Closely inter-linked with the lymphatic system
function of circulatory system
Deliver oxygen, nutrients and other requirements to the cells
Remove and transport waste, such as carbon dioxide to be excreted
Your heart pumps ~ 80 bpm/minute x 80 yrs = 3,363,840,000 times in a lifespan!!!
blood pathway
Blood from right atrium enters right ventricle and pulmonary arteries carry deoxygenated blood from right ventricle to lungs for oxygenation. Two pulmonary veins come from each lung and pass O2-rich blood to left atrium. Blood enters left ventricle from the left atrium.
arterial blood supply originates?
aorta
coronary arteries originate
originate at the start of the aorta to feed the myocardium and they form venules that become veins that empty into the right atrium itself via the coronary sinus
main influence of coronary circulation
the pressure in the Aorta of itself (basically from left ventricle pressure).
- Several disorders of the heart affect heart contraction, therefore strength of the blood being pumped out therefore affecting the strength of the blood being pumped out and therefore the flow of blood of the into heart itself and into the system
blockage or spasm of partcular coronary aretery can leadto…
ischemia of that part of the myocardium fed by that blood vessel.
- The type of myocardial infarction depends on what coronary artery/ branch of an artery is blocked or spasming…
examples of coronary arteries
right coronary artery marginal artery posterior interventricular artery anterior decending artery circumflex artery left coronary arteru aorta
examples of coronary veins
superior vena cava anterior cardiac veins small cardiac vein middle cardiac vein coronary sinus great cardiac vein
what is the pericardial sac
- surrounds the heart. protects cushions and anchors it in place with his various blood vessels and surrounding structures
structures of the heart wall
three layers of the pericardium down through the three linings of the heart wall itself.
Pericardium Parietal and visceral Pericardial cavity and fluid Myocardium Endocardium
functions of the pericardium (outermost layer)
protection, its receptors that respond to changes in blood pressure and pulse at the relative thickness of the myocardium which is much thicker
t or f
continuous supply of blood is essential to body function
t
what facillitates one way blood flow
Correct functioning heart valves facilliitate the one way blood flow, opening and closing of valves functioning correctly
valves during diastole
Diastole (ventricles filling)- the 2 AV valves are open, SL valves closed
what happens to valves once ventricles are full?
When ventricles are full AV valves close, SL valves open
what are the valves
Atrioventricular valves - Tricuspid valve - Mitral valve Semilunar valves - Pulmonary semilunar valve - Aortic semilunar valve
what is cardiac action potential
transmission of electrical impulses that form the conduction system that coordinated the rhythmical nature of the heart
where is AP initiated in heart
AP is initiated in Nodes (Specialized cells that generate and transmit without any nervous system initiation)
what is invlolved in the hearts conduction system
Sinoatrial node (SA)- pacemaker of the heart - Intranodal pathways Atrioventricular node (AV) Bundle of His (AV bundle) Right and left bundle branches Purkinje fibres
what is preload
Preload (the initial stretching of the cardiac muscle cells prior to contraction)
- Left ventricular end-diastolic volume
- Frank-Starling law of the heart
What is afterload
Afterload ( the force or pressure against which the heart has to contract to eject the blood).
- Resistance that must be overcome for blood to be ejected
what is contractility
Contractility (Sstrength and vigour of the heart’s contraction during systole)
What is stroke volume
Stroke volume ( The amount of blood pumped by the left ventricle of the heart in one contraction.)
what is ejection fraction
Ejection fraction ( is a measurement, expressed as a percentage, of how much blood the left ventricle pumps out with each contraction)
how many sections of the respiratory system
Divided into upper and lower but does function as a whole
upper respiratory system is composed of ?
- The nose (filters the air, mucus trapping dust and bacteria which is then destroyed by enzymes, air is also warmed by excellent blood supply)
- Sinuses ( several, hollows in the skull that make it lighter)
- Pharynx ( tube in 3 parts that extends from the back of the nose to the larynx that is the path of food and air)
- Larynx ( 5 sm, shorter, contains vocal cords and voice box, at entrance there is the epiglottis which only allows air to enter)
mucus combined with cilli in upper resp work to?
The mucus combined with cilia work to move the foreign debris by either cough/ spitting out (expectorating) or swallowing
why do we need defence mechanism in upper respiratory system
because we have a dirty environment in our upper respiratory.
Mouth< is bacteria contaminated
Lower airway< is sterile When functioning well the airway becomes cleaner the further you go down.
structires of uppr airway (conducting zone)
• Conducting airways
Upper airways • Nasopharynx • Oropharynx • Larynx • Connects upper and lower airways
Lower airways • Trachea • Left and right bronchus • Secondary bronchi • Tertiary bronchi • Bronchioles • Terminal bronchioles • Respiratory bronchioles
3 stages of respiration
Respiration has three stages:
- Ventilation
- Diffusion
- Perfusion
main function of upper respiratory
conducts air especially oxygen.
why is there often inflammation in upper airways
Upper airway is designed to remove foreign debris including microorganism meaning the upper respiratory system is constantly exposed to potential infections and inflammatory conditions.
You will see this In: children< as they develop their immune system
Older adults< as their immune system begins to weakened.
URTI< Upper respiratory tract infection
descrive viral URTIs
• Most common
• Highly contagious
Droplet, direct contact
Contact forms immunity but many types…
• Commonly are rhinoviruses and RSVs (Respiratory syncytial virus)
• But there are many other viruses
Adeno/parainfluenza/respiratory syncytial +++
• Symptoms form from inflammatory response
Swollen mucous membranes
Nasal congestion and secretions
Headache, fever, general malaise (which is A general sense of being unwell often accompanied by fatigue, diffuse pain or lack of interest in activities.)
describe the influenza
• Highly contagious, many subtypes, type A most common
• Respiratory and systemic symptoms (With severity of symptoms usually worse than common cold >muscle weakness, general malaise and more severe fever)
• There is a greater chance of a flu proceeding to form pneumonia, sinusitis and middle ear infection.
• Older adults are at risk of bacterial infections due to debilitated condition. This can occur due to their condition.
• Most people treat themselves often over the counter treatments> cold and flu decongestants tablets, analgesic and histamine.
• It is a virus not a bacterial infection, so antibiotics are unnecessary. Sometimes they are prescribed to those at risk e.g. To patients who are very old to prevent bacterial infection coming in on top of the virus.
>Plenty of rest and fluid needs to encourage.
describe flu vaccine
• Encourage vaccinations
Influenza has three types of flu viruses: Type A, B and C
Type A and B have up to 20% of population sniffling, aching, coughing and running high fevers.
Type C causes flu, however, the symptoms are much less severe
descibe sinitis
- Bacterial or viral (or fungal), acute or chronic
- Develops when sinuses blocked, swell, inflame and pressure
- Greater risk in older adult or immuno-compromised
- Treatment varies
- Restore drainage
- Treat infection
- Relieve symptoms
- Irrigation/surgery
development of sinitis
( Bacterial or viral infections can travel up to the nose causing swelling, congestion and blocking of the opening leading to great pressure, swelling and inflammation > Increase headaches and feeling of general malaise
Nasal polyps or other types of nasal obstruction can increase the risk of developing sinusitis. As this can affect the pre draining component of the siunus
descrbe Pharyngitis (viral)/tonsillitis (usually bacterial but can be viral)
Pharyngitis is often viral but can be bacterial. Often the virus is rhinovirus though in teenage group It can be from the Epstein Bar virus (called kissing disease. Its nickname is ‘mono’).
Pharyngitis and tonsillitis may occur in combination because tonsil as a lymph node seats in the recess in the pharynx.
• Droplet spread
• Pharyngitis
• Symptoms vary, minor or major
• Complications
• Tonsillitis
• Inflamed/painful/fever/lymphadenopathy/general malaise
• Abscess/quinsy
Quinsy can be quite dangerous because it’s a type of abscess that forms in between tonsil and the pharynx > It can increase in size and can block part of the airway.
• If strep. glomerulonephritis (cause of major kidney disease)/rheumatic fever
Pharyngitis symptoms may vary it can go from minor to major e.g. from simple throat to difficulty swallowing.
Tonsillitis symptoms may vary from minor to major. Tonsil are inflamed and painful> increasing fever, increase size of a lymph node (lymphadenopathy) and general malaise abscess or quinsy.
- Correct diagnosis (Whether its viral and bacterial. Then adjust the treatment accordingly)
- Treatment
- Antipyretics/analgesia/symptomatic/antibiotics
- Tonsillectomy - If the patient suffers from regular dosage of tonsillitis
Antipyretics< to get the temperature down
Analgesic< to relieve pain
Symptomatic treatment< if it is bacterial you give antibiotics
If the patient suffers from regular dosage of tonsillitis.
describe epiglottitis
Epiglottis< Its viral. Its uncommon but when it does occur it is an emergency > Obstruction in the airway, laryngospasm (temporarily difficult to speak or breathe
• Uncommon but an emergency
• Obstruction, laryngospasm
• Antibiotics, steroids, close monitoring
• Laryngitis
• Usually viral
swollen, oedematous vocal cords (Result in hoarse voice or loss of voice all together.)
• Conjunction with other respiratory conditions
• Rest, fluids
describe laryngitis
- Usually viral
- swollen, oedematous vocal cords
- Conjunction with other respiratory conditions
- Rest, fluids maybe with with analgesic
describe pertussis
Pertussis is a whooping cough
• Highly contagious bacterial infection
• Droplet spread
• Life threatening in infants, less so as older
• Complications
• Hypoxic brain injury, pneumonia
• The bacteria/toxins
• Cause inflammation, inhibits immune responses, affect cilia…
…Foreign material/ microorganism that are usually remove by natural processes stay in the lungs, in the airway and develop other infection such as pneumonia.
Pertussis starts off with classic flu> Rhinovirus symptoms (nasal dryness, irritation, sore throat/ throat irritation, nasal discharge, nasal congestion and sneezing, headache, facial and ear pressure, loss of sense of smell and taste)
And builds up to a week later with coughing> gradually increases intensity to> Paroxysmal coughing.
• Classic ‘flu symptoms paroxysmal coughing
• Treatment – antibiotics (usually erythromycin), hospitalisation
Best protection is vaccination. * highly recommended for pregnant women because it protects the newborn.
describe epitaxis/ nasal trauma
Epistaxis/ nasal trauma often caused by trauma/ punched on the nose/ nose picking/ cocaine abuse.
• Major arterial supply ( Nose has major arterial supply. When it bleeds it bleeds heavily. )
• Trauma, cocaine abuse
• Underlying health disorder
• Treatment
• Pinch nose, head forward, ice (Head forward so blood doesn’t run into the stomach because it can cause nausea and vomiting. It also cannot be measured)
• Topic vasoconstrictors
• Cauterisation (chemical, diathermy)
• Nasal packing (anterior and posterior)
Nasal packing is basically a nasal tampon. Children have anterior bleed and posterior bleed is more likely for adults. Or you can have both.
lower respiratory syetem comprised of
- The bronchi
- The lungs
- The alveoli
- The pleura
- The ribs
- Intercostal muscles.
what is the respiratory zone
Respiratory zone< where gas exchange diffusion, perfusion occurs.
Most bronchioles and large airways are part of the conducting zone of the lung, which delivers gas to sites of gas exchange.
what is ventilation and perfusion
Ventilation< refers to the flow of air and out of the alveoli.
Perfusion< refers to flow of blood to alveolar capillaries.
what is the carina
The trachea at the carina is where it divides into two main bronchi> left and right lung at the level of the sternum.
Carina contains various sensitive nerve ending, this helps with expulsion of dust and foreign particles.
^This part of the airway is known to go for Bronchospasm if over stimulated. This occur from a result of several disease processes including asthma/ number of different medication/ anaphylactic.
Endotracheal tube< can result in life threatening hypoxia.
Bronchi branches> have thinner walls
Bronchioles (looks like a tree)> Very thin membrane around them to allow gas exchange diffusion to occur
Trachea > Thick walls
what are the gas exchange airways
• Respiratory bronchioles (With a membrane consisting one cell around them) Bronchioles> terminates in the alveolar ducts that contains the alveoli • Alveolar ducts • Alveoli • Epithelial cells (pneumocytes) • Squamous type I alveolar cells • Covers 95% of alveolus surface area • Rapid gas exchange • Great type II alveolar cells • Surfactant production • Covers 5% of alveolus surface
what is paranchyma
Parenchyma means functional part> parenchyma of liver/lungs/kidney and all functional part of those organs
what is involved in the pulmonary ciruculation
- Right side of heart
- Pulmonary artery
- Pulmonary capillaries
- Pulmonary vein.
- Alveolar-capillary membrane
wall of smallest alveoli are how thick
one cell thick
Describe third process of respiration
The third process of respiration- perfusion. Provides the blood to off low CO2 and pick up O2 oxygen. Provide nutrients to the pulmonary tissues and provide filter system as blood enters from right ventricle.
what does the pulmonary artery do
Pulmonary artery< Deoxygenated blood from heart to lungs (the only artery that carries deoxygenated blood in the body)
is the pulmonay system low pressure
Pulmonary system is low pressure system meaning the right ventricle in normal circumstance doesn’t have to pump as hard as left ventricle, which pumps oxygenated blood out against resistance into the system of the body.
what happens at the alveolar capillary membrane
Alveolar capillary membrane is where blood and air goes through across very thin membrane.
what is cerebral blood flow
The brain receives a constant supply of blood, which is essential for normal brain functioning.
what is cerebral blood volume
amount of blood in the cranial vault (approx 10% of total intracranial volume- CSF and brain tissue make up remainder)
t or f brain hs high metabolic activity
Brain has high metabolic activity however is not able to perform anaerobic metabolism and requires continual supply of o2 and glucose
Brain not able to store ATP and glycogen which are essential for metabolism ( therefore if there is even a short interruption to blood supply it can have devastating effects
Brain is able to maintain cerebral blood flow despite changes in peripheral blood flow (exact mechanism is unknown but because of this it is able to ensure the brain received the oxygen and glucose it requires for maintaining normal brain activity.
describe cerebral circulation
- brain receives approx. 15-20% of cardiac output
- Cerebral circulation is designed to ensure if a vessel is blood there is an alternate vessel
- (collateral circulation)
Circle of Willis – series of interconmected vessels that ensure blood supply to the brain. Fed by 2 internal carotid arteries and 2 vertebral arteries. if blood flow ceases for even a few minutes an individual will become unconscious.
what is the monroe kellie doctrine
The pressure–volume relationship between ICP, volume of CSF, blood, and brain tissue, and cerebral perfusion pressure (CPP) is known as the Monro–Kellie doctrine or hypothesis
