PERFUSION

Question 1

PERFUSION WITH RESPECT TO HEART FAILURE PATIENT

Answer 1

Generated by cardiac output. Coordinated efforts of electrical and mechanical factors that move the blood through the heart and into the arteries and capillaries delivering nutrients and oxygen to cells and removing cellular waste products

Question 2

CARDIAC OUTPUT

Answer 2

The amount of blood pumped by the heart each minute

Question 3

CENTRAL PERFUSION

Answer 3

Force of blood movement generated by cardiac output
Requires adequate cardiac function, blood pressure, and blood volume
Cardiac output = stroke volume x heart rate

Question 4

AFTERLOAD

Answer 4

What is left in ventricles after pumping out the blood

Question 5

PRE LOAD

Answer 5

Blood coming into the ventricles

Question 6

RIGHT SIDE

Answer 6

= venous side

In CHF the right side backs up into the vena cava

Question 7

LEFT SIDE

Answer 7

= arteriole side

In CHF left side backs up into the lungs

Question 8

ETIOLOGY OF HEART FAILURE

Answer 8

Systemic hypertension is the cause in most cases
About one third of patients experiencing MI also develop heart failure
Structural heart changes causes pressure or volume overload

Question 9

COMPENSATORY MECHANISMS

Answer 9

Sympathetic nervous system stimulation (increase HR, vasoconstriction, increased BP, epi and norepinephrine)
Renin angiotensin system activation
Chemical responses ( BNP starts dieresis when retaining fluid)
Myocardial hypertrophy ( increase in heart size)

Question 10

RENIN-ANGIOTENSIN SYSTEM

Answer 10

Renin is secreted from the kidney when in heart failure. Renin activates angiotensin and gets converted by the liver into angiotensin 1 and then to angiotensin 2 in the lungs. Angiotensin 2 increases the blood pressure and causes vasoconstriction

Question 11

LEFT SIDED HEART FAILURE

Answer 11

SYSTOLIC - pumping problem, amount of blood ejected from left ventricle is decreased
Ejection fraction , 40%

DIASTOLIC- not enough relaxation from the right atria. The ventricle is not compliant and is not pumping well

Question 12

CARDIAC OUTPUT

Answer 12

Stroke volume x heart rate

Question 13

STROKE VOLUME

Answer 13

Volume of blood pumped from the ventricle per beat

Question 14

CARDIAC RESERVE

Answer 14

The difference between the rate at which the heart pumps blood and its maximum capacity for pumping blood at any given time

Question 15

HEART RATE

Answer 15

Number of times a heart beats per minute

Question 16

PRELOAD

Answer 16

Blood coming into the ventricles

Question 17

AFTERLOAD

Answer 17

What is left in the ventricles after pumping out the blood

Question 18

EJECTION FRACTION

Answer 18

Amount of blood ejected with each contraction. Normal is > 60
< 40 is a problem

Question 19

PERFUSION

Answer 19

Flow of blood though arteries and capillaries delivering nutrients and oxygen to the cells

Question 20

ARTERIOSCLEROSIS

Answer 20

Thickening or hardening of arterial wall, often associated with aging

Question 21

ATHEROSCLEROSIS

Answer 21

Formation of plaque in the arterial walls

Question 22

CONSEQUENCES OF IMPAIRED TISSUE PERFUSION

Answer 22

Loss of vessel potency and inadequate central perfusion

Ischemia and cell death

Question 23

ISCHEMIA

Answer 23

Lack of blood flow and tissue or cell death

Question 24

INFARCTION

Answer 24

No blood supply to muscle

Question 25

ANOXIA

Answer 25

No oxygen supply

Question 26

COMMON CLINICAL FINDINGS OF IMPAIRED PERFUSION

Answer 26

Pain
Non healing wound
Claudication
Rubor