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Nursing > Pathophysiology Test 4 > Flashcards

Pathophysiology Test 4 Flashcards

1
Q

systole

A
  • ventricular contraction
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2
Q

diastole

A
  • ventricular relaxation
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3
Q

mean arterial pressure

A
  • measure of tissue perfusion
  • determines if all organs are getting perfused
  • should be greater than 60-65
  • MAP of 50 or 45 can lead to organ dysfunction
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4
Q

pulse pressure formula

A
  • the difference of systolic-diastolic pressure
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5
Q

MAP formula

A
  • equals diastolic pressure + (pulse pressure/3)
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6
Q

cardiac output formula

A
  • HR multiplied by stroke volume
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7
Q

blood pressure formula

A
  • cardiac output multiplied by the total peripheral resistance
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8
Q

cardiovacular center

A
  • located in the brain
  • controls the SNS (activation leads to increased HR and BP) and PNS (activation leads to a decreased HR, BP) responses
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9
Q

baroreceptors

A
  • determine changes in blood pressure
  • when there is a drop in BP, these notify the SNS to activate
  • stimulate the SNS if you move too fast from one position to another
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10
Q

chemoactivators

A
  • activate when there are changes in O2 and CO2 levels
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11
Q

natriuretic peptides

A
  • glycoproteins located in the atria, brain tissue, and blood vessels
  • released when vessels are stretched by excess volume (when in hypervolemia)
  • stimulate excretion of salt into the urine decreasing fluid and therefore BP
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12
Q

RAAS

A
  • renin activated angiotensin II and aldosterine
  • retain sodium and water but excrete potassium
  • end result is higher BP because increased volume and vasoconstriction
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13
Q

humoral mechanisms for BP

A
  • Natriuretic peptides
  • Renin-angiotensin-aldosterone system
  • Epinephrine/norepinephrine
  • Antidiuretic hormone
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14
Q

primary hypertension stage

A
  • 90-95%
  • no cause can be identified
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15
Q

secondary hypertension stage

A
  • an elevation in blood pressure due to another disease
  • 5-10%
  • causes can be renal disease, disorders of adrenal hormones, phecochromocytoma
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16
Q

hypertensive crisis stage

A
  • systolic >180 and/or
  • diastolic >120
  • can make blood vessels rupture
  • can lead to hemorrhagic stroke
  • difficult to perfuse organs which can lead to organ failure
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17
Q

orthostatis (postural) hypertension

A
  • drop in BP when moving from a seated or supine position of 20 mm Hg systolic or 10 mm Hg diastolic
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18
Q

hypertension risk factors

A
  • increase in age, more common in men and african americans, family history of hypertension, diet, or cardiac issues (dyslipidemia), tobacco/alcohol use, physical inactivity, metabolic abnormalities, sleep apnea
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19
Q

hypertension treatment

A
  • weight loss, reduced sodium intake, DASH diet, exercise, stop smoking, maintain calcium and potassium levels, take BP medication
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20
Q

long term effects of hypertension

A
  • hypertrophy of the heart
  • agina
  • myocardial infarction
  • heart failure
  • stroke or transient ischemic attack
  • chronic kidney disease
  • peripheral vascular disease
  • retinopathy
  • sexual dysfunction
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21
Q

endothelium function

A
  • selectively permeable barrier
  • modulates blood flow and vascular reactivity
  • regulates thrombosis
  • regulates cell growth
  • regulates inflammatory and immune response
  • maintains extracellular matrix
  • involved in the metabolism of lipoproteins
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22
Q

endothelium dysfucntion

A
  • changes in the normal function of the endothelium in reponse to smoking, dys/hyperlipidemia, diabetes, and obesity
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23
Q

tunica media

A
  • where the vascular smooth muscle cells are located
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24
Q

lipid examples

A
  • cholesterol and triglycerides
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25
Q

lipidproteins

A
  • carries of lipids in the blood
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26
Q

apoliproteins

A
  • lipid-protein complexes that help lipids move between blood and cells
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27
Q

VLDL (very low density lipoprotein)

A
  • triglycerides
  • play a role in antherosclerosis and cholesterol issues
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28
Q

HDL (high density lipoprotein)

A
  • transports cholesterol from non-hepatic tissues bacl to liver and protects against atherosclerosis
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29
Q

LDL (low density lipoprotein)

A
  • transports cholesterol TO non-hepatic tissues (tissues and blood vessels) and contributes to atherosclerosis
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30
Q

Five types of lipids

A
  • chylomicrons, VLDL, IDL, HDL, LDL
31
Q

labs for hypercholesteremia

A
  • want to keep LDL below 100
  • total cholesterol less than 200
  • HDL greater than 60
32
Q

atherosclerosis

A
  • an accumulation of fibrofatty material in the intimal wall of large and medium arteries
  • a progressive disease influenced by diet, lifestyle, and genes
  • can lead to decreased perfusion, issues with coronary artery disease (arteries), peripheral arterial disease (extremities), and strokes (carotid arteries and brain)
33
Q

atherosclerosis risk factors

A
  • age, smoking, obesity, high cholesterol levels, hypertension, diabetes (double risk)
34
Q

atherosclerosis clinical manifestations

A
  • usually none until the condition is severe because the body compensates well
  • arterial blockage and decreased perfusion occurs
  • tissue hypoxia, cyanosis, altered mental status, stroke symptoms
35
Q

atherosclerosis complications

A
  • rupture of plaques which can form a thrombus, leading to an MI or ischemia leading to injury and death of cells, or aneurysm
  • severe weakening and dilation of blood vessel wall making it prone to rupturing
36
Q

atherosclerosis process

A
  • endothelial injury
  • inflammatory cells migrate and enguld lipids
  • form foam cells which are macrophages which eat lipids
  • foam cells accumulate and develop a necrotic core
  • fibrous plaque covers the area and grows which stretched the blood vessels and make it calcifed and hardened
  • this results in an increased risk of rupture, bleeding, and thrombus formation
37
Q

3 types of athersclerosis lesions

A
  • fatty streaks (we all have)
  • fibrous plaques
  • complicated lesions (signifigantly calcified plaques/broken off obstructions)
38
Q

risk factors for epithelial dysfunction

A
  • smoking, hyperlipidemia, diabetes, lifestyle
39
Q

peripheral artery disease

A
  • occurs in larger arteries aside from the brain and heart due to athersclerosis or inflammatory process
40
Q

peripheral artery disease symptoms

A
  • gradual onset, intermittent claudication (calf pain), decrease in leg muscle size, numbness, dependent rubor, cool extremities, absent/weak pulse, gangrene because of decreased perfusion
41
Q

peripheral arterial disease diagnosis

A
  • diagnosed through physical exam and ultrasound of blood vessels
  • could also use MRI
  • angiography (dye injected into bloodstream to see blood flow)
  • blood pressure measurements
42
Q

peripheral arterial disease treatment

A
  • decreasing risk
  • managing symptoms
  • can do vascular surgeries if necessary
43
Q

Burger’s Disease (Thromboangiitis Obliterans)

A
  • inflammatory disorder which leads to thrombosis in arteries and veins (typically in legs and feet)
  • unknown cause
  • more common in younger patients, under 30, smoking, genetics
44
Q

Burger’s Disease (Thromboangiitis Obliterans) smyptoms

A
  • pain in the arch of the foot, intermittent claudication, decreased pulses in foot, thin and shiny skin, thin/absent hair and nails, tissue ulceration which leads to gangrene
45
Q

Burger’s Disease (Thromboangiitis Obliterans) diagnostic

A
  • diagnosed through arteriography, ankle-arm ration, ultrasound, MRI, CT
46
Q

Burger’s Disease (Thromboangiitis Obliterans) treatment

A
  • stop smoking, surgery, and medication
47
Q

Reynaud Phenomenon

A
  • vasoscpastic
  • blood vessels get small and bloodflow is obstructed
  • generally occurs in hands and fingers
  • unknown cause, but common in younger women and those who live in colder climates
  • mediated by stress which stimulates SNS (vasoconstriction)
48
Q

Reynaud Phenomenon symptoms

A
  • pallor, cyanosis, hyperemia (increase in blood flow), redness, cold, numbness, or parethesia
49
Q

Reynaud Phenomenon diagnosis

A
  • cold water immersion
50
Q

Reynaud Phenomenon treatment

A
  • eliminating cause and medications that decrease vasospasms
  • can sometimes involve surgery
51
Q

Aneurysm

A
  • an area of vessel dilation caused by weakness in the arterial wall
  • when occuring in an artery, more severe
  • happens often in aorta
  • types: berry, fusiform, dissecting
52
Q

berry aneurysm

A
  • a small dilation in a bifurcation
  • localized little pouch
53
Q

fusiform aneurysm

A
  • entire circumference of vessel dilates, gradual, progressive dilation
  • can expand longitudinally or horizontally
54
Q

dissected aneurysm

A
  • life threatening
  • a rupture or tear in the blood vessel wall
55
Q

aneurysm symptoms

A
  • can vary be location
  • blood vessels increase in size, see changes in BP and HR
56
Q

aneurysm diagnosis

A
  • MRI, CT scans, ultrasounds to see blood vessels
57
Q

aneurysm treatment

A
  • reduce risk of rupture by decreasing BP
  • surgery
58
Q

AAA (abdominal aortic aneurysm)

A
  • can be fixed by EVAR (endovascular aortic repair)
59
Q

venous disorders

A
  • venous pressure system is a lower pressure system - valves help maintain direction of blood back to the heart
  • movement of muscular system helps with venous return
  • disorders are anything that messes up this system
59
Q

varicose veins

A
  • dilated, tortuous veins in the lower extremities
  • primarily superficial, secondary if deep veins
  • Dilation of veins and malfunction of valves due to hypertension in venous system
59
Q

varicose veins risk factors

A
  • prolonged standing, female, increasing age, obesity, increased abdominal pressure, pregnancy
60
Q

varicose veins symptoms

A
  • edema, swelling, aching of legs, warm skin, twisted veins on the legs
61
Q

varicose veins complications

A
  • venous insifficiency
  • initially do not cause many problems
  • severe edema, discoloration, chornic venous stasis ulcers
62
Q

varicose veins diagnosis

A
  • physical examn, doppler for blood flow, angiography
63
Q

varicose veins treatment

A
  • compression socks, sclerotherapy, SCDs, surgical treatment
  • improve flow and prevent injury
64
Q

superficial veins

A
  • collected blood from skin, subQ tissues
65
Q

deep veins

A
  • have more support
  • surrounded by bones, muscle, and connective tissue
66
Q

venous thrombosis (thrombophlebitis)

A
  • blood clot causes inflammatory response and a decrease in blood flow
  • virchow’s triad: risk factors for blood vlot (venous stasis, increased blood coagulability, vascular wall injury)
67
Q

venous thrombosis (thrombophlebitis) risk factors

A
  • immobility
68
Q

venous thrombosis (thrombophlebitis) symptoms

A
  • pain distal to blood clot, swelling, tenderness of muscles
69
Q

venous thrombosis (thrombophlebitis) diagnosis

A
  • ultrasounds, venography, d-dimer which is elevated in the presence of a clot
70
Q

venous thrombosis (thrombophlebitis) treatment

A
  • prevention (TED hose, SCDs, heparin)
  • repositioning
  • anticoagulants
  • gradual ambulation
71
Q

venous thrombosis (thrombophlebitis) complication

A
  • pulmonary embolism
72
Q
A

Nursing (4 decks)

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