Pathophysiology Test 4 Flashcards
1
Q
systole
A
- ventricular contraction
2
Q
diastole
A
- ventricular relaxation
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
4
Q
pulse pressure formula
A
- the difference of systolic-diastolic pressure
5
Q
MAP formula
A
- equals diastolic pressure + (pulse pressure/3)
6
Q
cardiac output formula
A
- HR multiplied by stroke volume
7
Q
blood pressure formula
A
- cardiac output multiplied by the total peripheral resistance
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
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
10
Q
chemoactivators
A
- activate when there are changes in O2 and CO2 levels
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
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
13
Q
humoral mechanisms for BP
A
- Natriuretic peptides
- Renin-angiotensin-aldosterone system
- Epinephrine/norepinephrine
- Antidiuretic hormone
14
Q
primary hypertension stage
A
- 90-95%
- no cause can be identified
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
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
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
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
19
Q
hypertension treatment
A
- weight loss, reduced sodium intake, DASH diet, exercise, stop smoking, maintain calcium and potassium levels, take BP medication
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
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
22
Q
endothelium dysfucntion
A
- changes in the normal function of the endothelium in reponse to smoking, dys/hyperlipidemia, diabetes, and obesity
23
Q
tunica media
A
- where the vascular smooth muscle cells are located
24
Q
lipid examples
A
- cholesterol and triglycerides
25
Q
lipidproteins
A
- carries of lipids in the blood
26
Q
apoliproteins
A
- lipid-protein complexes that help lipids move between blood and cells
27
Q
VLDL (very low density lipoprotein)
A
- triglycerides
- play a role in antherosclerosis and cholesterol issues
28
Q
HDL (high density lipoprotein)
A
- transports cholesterol from non-hepatic tissues bacl to liver and protects against atherosclerosis
29
Q
LDL (low density lipoprotein)
A
- transports cholesterol TO non-hepatic tissues (tissues and blood vessels) and contributes to atherosclerosis
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
