Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiovascular System > Path 2.0 > Flashcards

Path 2.0 Flashcards

1
Q

What are the classifications of Chest Trauma?

A

50% - Chest wall injuries
26% - Pulmonary injuries
20% - Cardiovascular injuries
4% - Other (esophageal/diaphragmatic injuries)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the initial management of Chest Traumas?

A

1.Airway stabilization (c-spine control!!)
2.Breathing and ventilation
3.Circulation with hemorrhage control
4. Disability/neurologic status
Exposure

” ABCD”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are examples of Chest Wall injuries?

A

Soft tissue injury, Rib Fractures, Sternal Fractures, Sternoclavicular dislocations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the most common ribs prone to rib fracture?

A

Ribs 4-9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which ribs are markers for abdominal injury?

A

Ribs 9-12 (mobile anteriorly)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which ribs are markers for severe intrathoracic injury?

A

1-3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the characteristics of a Simple pneumothorax?

A
  • Air in the pleural space
  • Affected lung begins to collapse as pleural space expands
  • Caused by puncture wound, rib #, or lung defect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the signs and symptoms of A Single pneumothorax?

A

Dyspnea,
Pleuritic chest pain
Tachypnea
Decreased lung sounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the treatments for pneumothoraxes?

A

Observe
Needle decompression
Chest tube insertion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What happens during a Open Pneumothorax (Sucking Chest Wound) or Communication pneumothorax?

A

It is due to a Open chest wall injury
Air passes through opening into pleural space and remains outside of lung (preferential if diameter> 2/3 of trachea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which pneumothorax is characterized by gurgling sound during air movement, bubbling wound, dyspnea, tachypnea, diminished breath sounds?

A

Open pneumothorax ( sucking chest wound) OR Communicating pneumothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What happens in Tension pneumothorax?

A

Air enters pleural space and becomes trapped – leads to pressure increase.

Increased pressure further collapses lung and shifts mediastinum to unaffected side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is a Haemothorax?

A

Accumulation of blood in pleural space
* Generally due to injured lung parenchyma – usually self-limiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the management of a Haemothorax?

A

A – control airway if necessary
B - Closed-tube thoracostomy to evacuate blood – for all unstable or symptomatic patients
C – restore circulating volume
- Autotransfusion available in some centres.
L- Large volume drainage may necessitate thoracotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the indications of a Thoractomy?

A
  • Immediate drainage of more than >20ml/kg of blood (> 1500 mls in adult)
  • Persistent bleeding >7ml/kg/hour (>200 mls/hr for 2-4 hrs in adult)
  • Increasing haemothorax seen on x-ray studies.
  • Patient remains hypotensive despite volume replacement.
  • Decompensation after initial response to resuscitation.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a Tracheobrachial injury?

A

Blunt or penetrating trauma to chest or neck (30% mortality)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the Pathophysiology of Pulmonary contusion?

A
  • Hemorrhage
  • Edema
  • Progressive accumulation of interstitial fluid
  • Hypoxemia
  • Decreased pulmonary vascular flow
  • Respiratory failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the cause of Pulmonary contusion?

A

Blunt thoracic trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the most common form of Blunt cardiac trauma?

A

Myocardial contusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is Pericardial tamponade?

A

Collection of blood in indistensible pericardium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the clinical features of a pericardial Tamponade?

A
  • Beck’s Triad
    -hypotension
  • distended neck veins (>15mm H20 with hypotension is diagnostic)
  • muffled heart sounds (unlikely to be heard in trauma room)
  • Pulsus paradoxus – difficult to measure during resuscitation.
  • No response to vigorous fluid resuscitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the clinical features of a Diaphragmatic rupture?

A
  • Decreased breath sounds
  • Basilar dullness
  • Dyspnea
  • Bowel sounds in chest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is Cardiac Tamponade?

A

A condition characterized by a decrease in cardiac output due to the accumulation of fluid (blood, serous fluid, pus, etc) within the pericardial sac sufficient to restrict the filling of the ventricles .

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the Primary pathological effect in Tension pneumothorax?

A

Decreased cardiac output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the causes of a Cardiac Tamponade?

A
  • Penetrating Injury (icepick, knife, bullet etc.)
  • Blunt Injury with cardiac contusion
  • Collagen Vascular Disease (eg. SLE)
  • Renal or Hepatic Disease
  • Malignancy (pericardial metastases)
  • Congestive Cardiac Failure
  • Infection (eg. Staph., TB, Viral pericarditis)
  • Post Operative (diagnostic tap, heart surgery)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the clinical findings?

A
  • Evidence of penetrating injury
  • Evidence / history of predisposing condition
  • Dyspnoea
  • Low-blood pressure, SHOCK
  • Distended neck veins
  • Quiet heart sounds
  • Low-voltage electrocardiogram
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the treatments for a Cardiac Tamponade?

A
  1. Needle Aspiration of Fluid
  2. Tube Drainage
    3.Open repair
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the causes of Tension Pneumothorax?

A
  • Penetrating Injury with lung damage
  • Rupture of pulmonary bulla
    • Spontaneous Pneumothorax: Younger patient
    • Emphyesema: Older patient, smoker
  • Barotrauma
    • Scuba Divers, Miners, Firemen, Construction Worker
      Iatrogenic: Patients on Ventilators
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the clinical signs of a Tension Pneumothorax?

A
  • Dyspnoea
  • Distended Neck Veins
  • Shock
  • Cyanosis
  • Mediastinal shift away from affected side.
  • Subcutaneous emphysema (air bubbles in tissues).
  • Absent or quiet breath sounds
  • Hyper-resonant percussion note (drum-like)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

True or False? One should perform a Chest X-Ray to determine the diagnosis of a Tension Pneumothorax.

A

FALSE!! ONE SHOULD NOT NEED A CXR TO CONFIRM THE DIAGNOSIS OF TENSION PNEUMOTHORAX.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is shock?

A

Acute widespread reduction in effective tissue perfusion leading to an imbalance in oxygen and nutrients supply and demand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the classifications of Shock?

A

Cold or “Low cardiac output shock”

Warm or “Distributive shock”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the types of Cold or “Low cardiac output shock”?

A
  • Cardiogenic
  • Obstructive
  • Hypovolemic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the causes of Cardiogenic shock?

A
  • acute myocardial infarction
    • Myocardial contusion
      -Severe valvular dysfunction
    • Congestive Heart failure
  • Vascular disease
35
Q

What are the causes of Obstructive shock?

A
  • Cardiac tamponade
    -Tension pneumothorax
  • Pulmonary embolism
36
Q

What are the causes of Hypovolemic shock?

A
  • Haemorrhagic –blood loss
  • Non- Haemorrhagic-
    Skin- Burns
    GI Tract- diarrhoa, vomiting
    Kidneys-Diabetes Mellitus, Diabetes Insipidus or Nephrogenic DI, salt losing nephropathy
37
Q

What is the endotoxin involved with Septic shock?

A

Lipid A (endotoxin) and Polysaccharide

38
Q

What is the most common cause of Septic shock ?

A

Sepsis duuhhh

39
Q

What is Sepsis?

A

Sepsis is defined as a ”life-threatening organ dysfunction due to dysregulated host immune response to infection”.

40
Q

What is an anaphylactic shock?

A

Extreme reaction to allergen, release of mast cell which degranulate to release Histamine and Bradykinin which causes vasodilation, bronchoconstriction and oedema.

41
Q

What are the causes of Neurogenic shock ?

A

Injury to the CNS resulting in loss of sympathetic tone, loss of reflexes below the level of injury and Parasympathetic unopposed leading to Bradycardia and vasodilation causing DECREASED CARDIAC OUTPUT .

42
Q

True or False? In regards to the pathophysiology of shock, Neutrophil apoptosis may be INHIBITED, enhancing the release of inflammatory mediators.

A

TRUE!!

43
Q

True or False? In regards to the pathophysiology of shock, Cellular apoptosis may be AUGMENTED, increasing programmed cell death and thus worsening organ function.

A

TRUE!!

44
Q

Circulating beta-adrenergic amines (epinephrine, norepinephrine) also increase cardiac contractility and trigger release of ?

A
  1. Corticosteroids from the adrenal gland - this enhances the effects of catecholamines.
  2. Renin from the kidneys - stimulates volume retention and vasoconstriction.
  3. Glucose from the liver - Increased glucose increases pyruvate uptake in the mitochondria which increases lactate production when there is insufficient oxygen.
45
Q

What is one of the most defining features of Septic shock?

A

Organ failure

46
Q

Fill in the blanks.” The combination of direct and reperfusion injury may cause ________.”

A

Multiple organ dysfunction syndrome (MODS)

47
Q

What is the most frequent target organ in Multiple organ dysfunction syndrome (MODS)?

A

The lungs

48
Q

What is the cardiovascular response to Cardiogenic shock?

A
  • Decrease Blood pressure
  • Decrease cardiac Output
  • Decrease Venous oxygen saturation ( SVO2)
  • INCREASE Pulmonary capillary wedge pressure (PCWP)
  • INCREASE Peripheral vascular resistance(SVR)
49
Q

What is the cardiovascular response to Hypovolemic Shock?

A
  • Decrease Blood Pressure
  • Decrease cardiac Output due to decrease in intravascular volume & decrease venous return.
  • Decrease Venous oxygen saturation ( SVO2)
    *Decrease Pulmonary capillary wedge pressure (PCWP)
  • INCREASE Peripheral vascular resistance(SVR)
50
Q

What is the cardiovascular response to Obstructive Shock?

A
  • Decrease Blood pressure
  • Decrease cardiac Output
  • Decrease Venous oxygen saturation ( SVO2)
  • INCREASE Pulmonary capillary wedge pressure (PCWP)
  • INCREASE Peripheral vascular resistance(SVR)
51
Q

What is the cardiovascular response to “warm shock”?

A

*Increased HR
* Increased Stroke Volume
* Increased Venous oxygen saturation (SVO2)]
* Increase Vasodilation
* Increase Cardiac Output
*DECREASED Peripheral resistance (SVR)
* DECREASED Blood Pressure
* DECREASED Pulmonary capillary wedge pressure (PCWP)

52
Q

True or False ? In Neurogenic shock (warm shock) the Heart rate and Cardiac output is DECREASED.

A

TRUE!!

53
Q

What are the basics of an ECG?

A

Rate
Rhythm
Axis
Intervals
Voltage
ST segments/T waves

54
Q

What are the diagnostic tools used to diagnose a Cardiac arrhythmia ?

A
  • Electrocardiogram (ECG)
  • 24 Hour Holter monitoring
  • Exercise testing
  • Loop recorder
55
Q

What are the symptoms of Cardiac arrhythmias?

A

Palpitations
Precipitants, onset, duration, termination
Weakness
Chest pain
Shortness of breath
Confusion
Lightheadedness
Sudden loss of consciousness (syncope) Transient ischaemic attack (TIA) Cerebrovascular accident (stroke) Sudden cardiac death

56
Q

What are the signs of Cardiac arrhythmias?

A

Abnormal pulse
- Weak, absent, irregular, slow, fast
Hypotension
Altered mental status
Syncope
Congestive heart failure
Embolic event (TIA, CVA, peripheral embolus.

57
Q

What are the symptoms of Angina Pectoris?

A
  • Dyspnea or shortness of breath
  • Epigastric discomfort with or without nausea and vomiting
  • Diaphoresis or sweating
  • Syncope or near-syncope without other cause
  • Impairment of cognitive function without other cause
58
Q

What is Stable Angina?

A

Chest pain associated with exertion, emotional distress
Relieved by rest
Defined amount of exertion noted by the patient.

59
Q

What is Unstable Angina?

A

New onset angina
Worsening angina
Angina at rest
Angina post MI
Angina post PCI
Angina post CABG

60
Q

What is Prinzmetal’s Variant Angina?

A

Angina secondary to coronary artery spasm causing obstructive symptoms.

61
Q

Non-ST Elevated Myocardial Infarction (NSTEMI ) is characterized by?

A
  • Patient who presents with similar characteristics of unstable angina but found to have-
    Elevated cardiac enzymes.

Usually due to incomplete/non-obstructive thrombus in the coronary vessel.

62
Q

What are the primary causes of Cardiomyopathy?

A

Genetic Disease
- Inherited
- De novo mutation

63
Q

What are the Secondary causes of Cardiomyopathy?

A
  • Inflammation (myocarditis)
  • Drugs
  • Systemic disorder
  • Infiltrative
  • Metabolic/ Storage
  • Pregnancy
  • Neuromuscular disease
64
Q

What are the clinical manifest stations of Cardiomyopathy?

A
  • Mechanical dysfunction
  • Diastolic/ systolic dysfunction
  • Heart Failure
  • Mural thrombosis 🡪
  • Thromboembolism
  • Electrical dysfunction
  • Arrhythmias
  • Mural thrombosis
  • Sudden Death
65
Q

What are the Morphofunctional types of Cardiomyopathies?

A

Hypertrophic (HCM)
Arrythmogenic (AC)
Restrictive (RCM)
Dilated (DCM)

HARD

66
Q

What is the most common type of Cardiomyopathies?

A

Dilated (DCM)

67
Q

What is the normal age at presentation of Dilated (DCM)?

A

20-50

68
Q

What is the most common valvular heat disease?

A

Aortic stenosis

69
Q

What is themes common valvular disease in pregnancy?

A

Mitral stenosis

70
Q

What are the causes of Valvular diseases?

A

Congenital Heart disease
Rheumatic Heart disease
Infections-bacterial endocarditis
Heart attack
Weakening of supporting structures of the heart.

71
Q

What is Value regurgitation?

A

The valve doesn’t close all the way so blood leaks backwards due to scarring and retraction of valve leaflets OR weakening of supporting structures.

72
Q

What is valvular stenosis?

A

This occurs when the valve leaflets become fused or thickened doesn’t open all the way so not enough blood cases through .

73
Q

What is the most common Stenosis?

A

Aortic stenosis

74
Q

What is the most common regurgitation?

A

Mitral regurgitation

75
Q

Which valvular stenosis is associated with a “fish mouth “ appearance ?

A

Mitral stenosis

76
Q

What are the clinical manifestations of Mitral stenosis?

A

Pulmonary congestion
Hemptysis
Fatigue ( low CO)
Oedema ( Right heart failure)
Palpitations
Thromboembolic complications

77
Q

What is the treatment for Mitral Stenosis?

A

Anticoagulant
Digoxin, Beta-blockers, rate-limiting calcium antagonists
Diuretic

78
Q

What are the causes of Mitral regurgitation?

A

Tear, shortening or elongation of:
Valve leaflets
Chordae tendinae
Annulus
Papillary muscles

79
Q

What are the clinical features of Mitral regurgitation?

A

Dyspnea
Syncope
Atrial fibrillation
Weakness
Palpitations
Cough
Paroxysmal nocturnal dyspnea
Lower extremity oedema
Atrial fibrillation

80
Q

What are the causes of Aortic stenosis?

A

Congenital leaflet malformations
Rheumatic endocarditis

81
Q

What are the Clinical features of Aortic stenosis?

A

S- Syncope
A - Angina
D - Dyspnea

82
Q

Which valvular diseases is associated with a lough, rough , “crescendo–decrescendo” murmur?

A

Aortic stenosis

83
Q
A

Cardiovascular System (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions