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Patho Test 2 > Patho Test 2 lect. 1 > Flashcards

Patho Test 2 lect. 1 Flashcards

1
Q

Hemodynamics is concerned with the _______ generated by the ______ and the resulting _______ of blood through the cardiovascular system

A

Hemodynamics is concerned with the forces generated by the heart and the resulting motion of blood through the cardiovascular system

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2
Q

What are 4 disorders that arise from a disruption of normal blood flow?

A

circulatory, cerebral, renal , and maternal

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3
Q

What is Om’s Law?

A

Q = P/R

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4
Q

What does P, in OM’s law mean?

A

pressure difference from a to b

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5
Q

What does R, in OM’s law mean?

A

resistance

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6
Q

True or False, Q in Om’s law = blood flow

A

TRUE

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7
Q

True or False, blood moves from areas of low P to high?

A

FALSE, blood moves from high P to low P

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8
Q

What is resistance determined by?

A

vessel length, radius, viscosity

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9
Q

If vessel LENGTH increases or decreases, what will happen to RESISTANCE?

A

L ^ = ^ R, v L = vR

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10
Q

IF RADIUS increases or decreases, what will happen to RESISTANCE?

A

r^ = vR, v r= ^R

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11
Q

If VISCOSITY increases or decreases, what will happen to RESISTANCE?

A

V^ = ^R, vV = R v

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12
Q

TRUE or FALSE, 99% of blood is made up of WBCs

A

FALSE, RBC

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13
Q

RBCs and plasma= _____

A

RBCs and plasma = Hct

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14
Q

IF you increase RBCs, what will happen to viscosity?

A

Increase

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15
Q

IF you decrease RBCs, what will happen to viscosity?

A

Decrease

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16
Q

What does TPR mean?

A

total resistance throughout vascular system

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17
Q

What does SVR mean?

A

resistance peripheral to heart and lungs

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18
Q

What does increased SVR lead to and why?

A

HTN, increases work of heart to eject blood, CO

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19
Q

What does decreased SVR lead to and why?

A

Shock, spread over larger areas (SLOWS)

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20
Q

Measure of distance traveled in a given amount of time

A

Velocity

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21
Q

What is laminar flow? And give examples.

A

layer levels of blood movement through smooth vessels (Core center, sides, wall flow)

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22
Q

Give 2 examples of Turbulent flow, a flow created by cross flow to laminar

A

Bruit, thrills

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23
Q

Place in order the most dynes/cm? Aorta, capillary, vena cava

A

Aorta (170,000 dynes/cm), vena cava 21,000 dynes/cm, capillary (6 dynes/cm)

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24
Q

What is a dyne?

A

Unit of force. The force required to cause a mass of one gram to accelerate at a rate of one cenitmeter per second squared.

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25
Q

Wall tension allows an aorta of 1cm to sustain an internal pressure of 100 mmHg, using which structures?

A

elastin, collagen, and smooth muscle

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26
Q

Wall tension allows a capillary w/ a radius of .000001cm to sustain an internal pressure of 100 mmHg with only _________

A

a single endothelial cell layer

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27
Q

What things have an effect on pressure?

A

size, internal pressure

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28
Q

What is hydrostatic pressure?

A

pressure created by fluid, movement of blood from aorta to capillary

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29
Q

What is colloids and what is colloid pressure?

A

Colloids are big, heavy weighted plasma proteins. If you put something heavy in the liquid you will sink/get sucked in

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30
Q

_________ has some exerting positive pressure on the blood vessel

A

Interstital fluid

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31
Q

True or False, without proteins you can maintain pressure.

A

FALSE, w/out protein you can not maintain pressure, and will have swelling

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32
Q

What is autoregulation?

A

The intrinsic ability of an organ to maintain constant blood flow despite changes in perfusion pressure. Ex: if I get up fast, there is a gravity pull, which will pull blood from the brain to compensate

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33
Q

Define resitance

A

arterioles resistance to ventricular contraction and ejection of blood

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34
Q

______ = cardiac output (L/min) 5-6

A

FLOW

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35
Q

What is the formula for MAP?

A

MAP = CO X SVR

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36
Q

What is the formula for CO?

A

CO = SV + HR

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37
Q

What is the short-cut formula for estimating MAP?

A

ADD diastolic and systolic BP and divide by 2

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38
Q

What does SVR stand for?

A

Systemic vascular resistance

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39
Q

What is SVR dependent on?

A

elasticity and diameter of vessels

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40
Q

What is CO and how what is that dependent on?

A

Volume and rate, preload and afterload

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41
Q

What is MPAP

A

Mean pulmonary arterial pressure

42
Q

What kinds of things contribute to the cardiac/blood flow dynamic?

A

strucutre of the vessels, vascular factors ( how fast the blood is moving), neurohumoral factors (renin/angiotensin or nateuretic hormones)

43
Q

What does nateuretic hormones do?

A

blocks sodium

44
Q

What does aldosterone do?

A

Helps take up sodium

45
Q

If you body needs to absorb fluid, which one (aldosterone or naterurtic )will be utilized?

A

Aldosteron

46
Q

If you are fluid overloaded, the body will block what?

A

Nateuretic

47
Q

Someone with HTN, will that increase or decrease flow?

A

Decrease flow? b/c you have more resistance

48
Q

As resistance goes higher, will go up or down?

A

Down

49
Q

True or False, Kidneys are totally dependent on blood flow?

A

TRUE

50
Q

What is the fxn of kidneys?

A

To filter blood of wastes, electrolytes, ect.

51
Q

IF cardic output decrease, what will happen to kidneys?

A

Kidney fxn will decrease

52
Q

True or False, If you are in shock/bleeding, you want to add Na & water and tighten vessels

A

TRUE

53
Q

True or False, if you had an infarction, it is a good idea to add Na and H20

A

False, adding more fluid, will cause the heart to work harder and fail more

54
Q

What can cause alterations in blood flow?

A

Obstruction, hypertension, stress, inflammation

55
Q

What are examples of obstruction and occlusion?

A

thrombi, emboli, vasospasm, inflammation, arterio/athersclerosis, valvular disease, infarction

56
Q

True or False, Vasospasm means shut down

A

TRUE

57
Q

What can an emboli be made of?

A

blood, amniotic fluid, air, fat

58
Q

What is the difference between MI and CVA?

A

CVA- brain attack, no blood flow to the tissue of the brain, MI- no blood flow to the tissue of the heart

59
Q

True or False, as you get older, you your arteries are less elastic and flexible?

A

TRUE

60
Q

What happens to the coronary arteries as you get older?

A

Decreased blood flow

61
Q

What happens to the Vavles as you get older?

A

become rigidity and thickened

62
Q

True of False, as you get older, you have decreased compliance, but increased contractility and c.o.

A

False, aging = decreased compliance, contractility, and c.o.

63
Q

What is preload?

A

Is how much the ventricular wall stretch. It is the amound of blood in the ventricle before it contacts/ejects. It’s the gas in the tank

64
Q

Increased preload is seen in:

A

increased circulating vol. (too much vol.), mitral insufficiency, aortic insufficiency, heart failure, and vasoconstrictor use (e.g. dopamine)

65
Q

Decreased preload is is seen in :

A

shock ( where the vol. drops), decreased circulating vol. ( bleeding, 3rd spacing), mitral stenosis, vasodilator use (NTG), asynchrony of atria and ventricles

66
Q

What is 3rd spacing?

A

interstitial space- someone has cardiac surgery, from the surgery you get inflammation, which pulls in a lot of cells and fluids in. The surgery causes damage to blood vessels and arterials, which leaks protein, blood, & water into peritneal cavity. Days later, when the lymph & blood vessels have closed, the fluid will go back in. BIG PICTURE: you have a leak, the more fluid will fill your body… looks like shock, but just have shifted where the fluid is. Decrease Bp, CO, & urine output

67
Q

What is NTG?

A

Nitroglycerine, a vasodilator, give it b/c coronary artery is so constricted causes lack of blood flow to tissues

68
Q

Do pulmonary arteries take oxygenated or deoxygenated blood?

A

Deoxygenated

69
Q

What does P , A, L, R mean ?

A

P = pulmonary, A = arteriole, L = left, R = Right

70
Q

What does Afterload mean?

A

Resistance the blood in the ventricle must overcome ot force the valves open and eject contents to circulation

71
Q

People on Beta blockers have a higher or lower HR and BP?

A

Lower

72
Q

What is a Hemodynamic Monitoring?

A

It is a mechanical setup by inserting a cardiac cath in to the person, connected to a mointor to give you hemodynamic perameters

73
Q

What kind of people will get put on hemodynamic monitoring?

A

trauma , MI, cardiac surgery pt.

74
Q

Why do you need a pressure pushing down on the cath?

A

So you don?t filll up the whole line with blood, if you don?t have pressure pushing down on it.

75
Q

What percent is CO increased in pregnant women and why?

A

30-60% b/c heart is pumping for 2 bodies

76
Q

Does SV stay up throughout the entire pregnancy?

A

No. It is initially up in the 1st tri, then down in 2nd and 3rd

77
Q

If RBC mass is increased, why does it lead to dilution?

A

b/c extra with extra flow, you have extra water. So, you have more blood vol. not more concentration

78
Q

Why is it good that vascular resistance goes down during pregnancy?

A

Because you have all these increases in blood vol. you want it to easily flow throughout the body.

79
Q

What is PIH?

A

Pregnancy Induced Hypertension

80
Q

TRUE or FALSE, Gestational HTN occurs outside of pregnancy?

A

FALSE, Only HTN occures during pregnancy

81
Q

What is chronic hypertension?

A

Already have HTN prior to pregnancy

82
Q

What does it mean that PIH is considered a progressive manifestation of a single process with one etiology?

A

There is a flow that starts with elevated Bp > preeclampsia> elcamspia

83
Q

What does M and M stand for?

A

Morbidity and Mortality

84
Q

True or False, everyone is at risk for preeclampsia/eclampsia

A

TRUE

85
Q

Maternal immunologic intolerance, abnormal placental implantation, genetic, nutritional, environmental factors, cardiovascular and inflmmatory changes are all causes of what?

A

Preeclampsia/eclampsia

86
Q

What are some pregnancy-associated risk factors?

A

chromosomal abnormalites, hydatidiform mole, hydrops fetalis, multifetal pregnancy, oocyte donation, structural congenital anomlalies, and urinary tract infections

87
Q

First -time father and having fathered a preeclamptic pregnancy in another woman are risk factors for what?

A

Preeclampsia/eclampsia

88
Q

What are maternal specific risk factors for preeclampsia/eclampsia?

A

Older than 35, younger than 20, black, fam hx of preeclampsia, nulliparity, hx of preeclampsia, med conditions ( gestational diabetes, obestiy, chronic HTN, stress)

89
Q

Gina comes into the community clinic with a BP of 140/90 for the first time, no proteinuria. Post-partum, her BP returns to normal. What is this a diagnosis of?

A

Gestational HTN

90
Q

What are the 2 classifications of Chronic HTN

A

BP 140/90 or greater before pregnancy or dx before 20 weeks GA OR HTN first dx after 20 weeks GA and persistent after 12 weeks postpartum

91
Q

Whats the difference between gestational HTN and preeclampsia?

A

Presence of leaking of protein in kidney, from 20 weeks to 1-3 days postpartum

92
Q

Becky comes into the clinic with BP less than 160/100, MILD edema, proteinurua trace/1+, and minimal liver enzymes. What is her dx?

A

MILD Preeclampsia

93
Q

Tiffany comes into Memorial hospital, with a BP over 160/110, has marked edema, proteinuria 2+, headache, visual distrubances, abdominal pain, only 399 Ml of urine in the past 24 hrs,and liver enzymes. What is her dx?

A

Severe Preeclampsia

94
Q

What is the difference between Eclampsia and preeclampsia?

A

Neuro effects (CNS effects, seizures, coma)

95
Q

What is the pathophysiology cause of eclampsia?

A

Placental Ischemia, which causes damage> inflammation > forms endothelin and thromboxane> more sensitive to Angiotensin, which increases Na and H20 = edema, effects the blood vessels, which causes the BP to go up

96
Q

What are the clinical manifestations of Pre/elampsia?

A

BP greater than or equal to 140/90, edema, proteinuria greater than equal to 300mg/24 hr, SBP up 30, 15 mmhg Dbp, headaches, visual changes, abdominal pain, seizures, coma

97
Q

What is HELLP syndrome?

A

a group of symptoms in pregnant women, H Hemolytic anemia, EL elevated liver enzymes, and LP Low platelet count

98
Q

What are treatments for Pre/Eclampsia?

A

Rest, delivery, decrease Na intake, increase IV water, Left sidelaying, Hydralazine ( vasodilator), Lasix, Labetalol (vasodilator), Nifedipine

99
Q

What is the action of Mag sulfate?

A

anticonvulsant, increases conc. & osmotic pressure, Helps with movement

100
Q

Why do you need to watch for muscle weakness in Mag Sulfate?

A

It can lead to paralysis

Patho Test 2 (2 decks)

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