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CV Module > Path- Hem DyN I > Flashcards

Path- Hem DyN I Flashcards

1
Q

What creates the first heart sound (S1)?

A

The mitral valve closing (beginning of sytole)

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2
Q

What creates (S2) the second heart sound?

A

The aortic valve slamming shut

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3
Q

What is the Valve between the R Atrium and the R ventricle?

A

Trucuspid Valve

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4
Q

What is the valve between the R ventricle and Pulmonary Artery (lungs)

A

Pulmonary valve

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5
Q

What is the approximate pressure in the pulmonary Artery?

A

25 mmHg about the same as R ventricle

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6
Q

What is preload?

A

The ventricular wall tension at the end of diastole just before contraction (sytole)

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7
Q

How is preload measured?

A

By end diastolic pressure, normally determined by end diastolic blood volume

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8
Q

What is the Frank-Starling mechanism?

A

The physiologic relationship between end-diastolic volume and force of contraction

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9
Q

What is Afterload?

A

The resistance the ventricle must overcome to pump out its contents.

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10
Q

What are some common causes of decreasesed ventricular compliance?

A
  1. Fibrosis

2. Amyloidosis

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11
Q

What is restrictive cardio myopathy?

A

When ventricular compliance decreses below the ability of the atrium to fill it normally.

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12
Q

What is dyastolic dysfunction?

A

Impaired cardiac filling

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13
Q

What is sytolic dysfunction?

A

Impaired cardiac pumping

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14
Q

What are the usually causes of systolic dysfunction?

A

Impaired contractility or greatly increased afterload.

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15
Q

What does sytolic function normally affect?

A
  1. Decreases amount of blood ejected from the ventricle
  2. Decreases the stroke volume
  3. decreases the ejection fraction
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16
Q

Does diastolic dysfunction typically affect EJECTION FRACTION?

A

NO

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17
Q

What are the five major categories of the factors determining the hearts function as a pump?

A
  1. Preload
  2. Afterload
  3. contractility
  4. Compliance
  5. Heart Rhythm
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18
Q

What is heart failure?

A

The inability of the heart to pump sufficient blood to meet the needs of the body.

19
Q

What is the most common cause of Chronic heart failure?

A

Old myocardial infarctions (ischemic cardiomyopathy)

20
Q

How does uncontrolled severe hypertension cause heart failure?

A

By causing severe afterload exceeding the ability of the heart to compensate.

21
Q

What does aortic stenosis cause?

A

Increases afterload (increased pressure required to force open stenotic valve) resulting in heart failure

22
Q

Which pathologies generally lower the ejection fraction?

A
  1. Aortic Stenosis
  2. Severe Hypertension
  3. Coronary artery disease
23
Q

Which pathologies generally preserve ejection fraction?

A
  1. Left ventricular hypertrophy
  2. Restrictive cardiomyopathy
  3. Pericardial disease
24
Q

What is the most common symptom of heart failure?

A

Dyspnea

25
Q

What is the pathophysiology of dyspnea?

A

LA (pulmonary venous) pressure builds up above 20mmHg causing a transudate of fluid to pass from the congested pulmonary veins to the interstitium creating interstitial edema around bronchioles and alveoli and compressing them increasing the resistance to airflow

26
Q

What are the two most specific symptoms of Heart failure?

A

Paroxysmal nocturnal dyspnea and orthopnea

27
Q

What are the two most common symptoms of HF?

A

Fatigue and dyspnea

28
Q

What is the cause of pulmonary crackles?

A

Associated with pulmonary alveolar edema, over 25mmHg in the pulmonary veins causes passage of transudate into the the airspaces

29
Q

What are crackles?

A

These are INSPIRATORY sounds attributed to the popping open of small airways occluded by edema between inspiration.

30
Q

Where are crackles first heard?

A

At the base of the lungs where vascular hydrostatic pressure is highest but are heard higher and higher as the conditions worsen

31
Q

What is wheezing due to HF?

A

Cardiac Asthma (caused by edema around large areways)

32
Q

What is the cause of the pathological S3 sound in Adults?

A

A third heart sound early in diastole dull and low pitched attributed to rapid filling

33
Q

What is the function of BNP?

A

It is counterregulatory it causes excretion of sodium and water but also causes vasodilation inhibition of renin secretion and antagonism of Angiotensin II

34
Q

What can be discerned from the level of BNP?

A

The level of BNP correlates with the severity of heart failure, elevated BNP helps differentiate from lung disease to HF

35
Q

How does the left ventricle respond to the increased afterload caused by hypertension?

A

Concentric hypertrophy

36
Q

What is the most common cause of HF with preserved ejection fraction?

A

Hypertension

37
Q

What is the Gallop associated with Hypertension?

A

S4 gallop

38
Q

What is decompensative hypertension associated with?

A

Impaired left ventricular filling, distolic dysfunction

39
Q

What generates the S4 sound?

A

The S4 sound is generated by the vigorous left atrial contraction required to inject blood into a stiffened left ventricle .

40
Q

What is a summation gallop?

A

Patients with both an S3 and S4 have tachycardia that so shortens diastole that causes the S3 and S4 sounds to overlap

41
Q

What tool is useful in distinguishing heart failure due to diastolic dysfunction versus systolic heart failure?

A

Echocardiography

42
Q

What treatments beneficial for systolic heart failure are not beneficial for diastolic heart failure?

A
  1. Beta Blockers
  2. ACE inh
  3. ARBs
  4. Inotropic agents
43
Q

What is the most common cause of hypovolemic shock?

A
  1. Hemmorhage
  2. Diarrhea
  3. Vomiting
44
Q

What are the four profiles of acute heart failure?

A
  1. Profile A Warm and Dry
  2. Profile B Warm and Wet
  3. Profile C Cold and Wet
  4. Profile L Cold and Dry

CV Module (24 decks)

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