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Pathophysiology Test 3 > Perfusion II > Flashcards

Perfusion II Flashcards

0
Q

Hepatic Vein

A
  1. Carries blood through the liver to the Vena Cava
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1
Q

Pulmonary Veins

A
  1. Oxygenated blood flows from the lungs into the left atrium through the pulmonary veins
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2
Q

Veins

A

Carry blood to the heart

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3
Q

Arteries

A

Carry blood away from the heart

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4
Q

Nitro-glycerin

-Contraindications

A
  1. Nitro-glycerin is contradicted in patients with aortic stenosis
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5
Q

Heart Rate Initiation

A
  1. SA node runs at 60-100 BPM’s
  2. AV Node runs at 40-60 BPM’s
  3. Purkinjee fiber’s run at 20-40 BPM’s
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6
Q

Causes of Varicose Veins

A
  1. Gravity
  2. Long Periods of Standing
  3. Trauma to the saphinous veins
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7
Q

Aortic Stenosis

-Contraindicated Medication

A
  1. Nitro-glycerin is contraindicated in patients with aortic stenosis.
  2. Vasodilation causes decreased pressure and possible inability to perfuse through stenosed valve
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8
Q

Preload

A
  1. The ability of the heart to receive the load
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9
Q

After-load

A
  1. Ability of the heart to take off the load
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10
Q

Cardiac Output =

A
  1. Stroke Volume X Heart Rate = CO
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11
Q

Stroke Volume

-Things that affect Preload

A
  1. Venous return

2. End systolic volume

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12
Q

Stroke Volume

-Thinks that affect After-load

A
  1. Aortic Pressure

2. Aortic Valvular function

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13
Q

Stroke VOlume

-Things that Affect Contractility

A
  1. End Diastolic Volume
  2. Sympathetic stimulation
  3. Myocardial Oxygen supply
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14
Q

Stroke Volume

-Med’s that affect Contractility

A
  1. Digoxin
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15
Q

Things that affect Heart Rate

A
  1. CNS
  2. ANS
  3. Neural Reflexes
  4. Atrial receptors
  5. Hormones
16
Q

Where is Vascular Plaque Located?

A
  1. Plaque is normally located in the tunica intima, not on the surface of the lumen
17
Q

Complicated Lesion

A
  1. Rupture of the endothelial lining exposing the plaque and causing activation of platelets
  2. Usually cause MI’s
18
Q

Factors Affecting Blood Flow

A
  1. Poiseuille Law (Viscosity of Fluid)
    - Stroke is a risk from Dehydration TEST
  2. Pressure
  3. Resistance
  4. Neural control of total peripheral resistance
    - RAAS
19
Q

Underlying Problem Of Shock

A
  1. Inadequate Tissue perfusion

2. Leads to microcirculatory failure and organ failure

20
Q

Order of Organ Failure

A
  1. 1st organ to go is the Kidney’s

2. Liver is the last organ to go

21
Q

Types of Shock

A
  1. Hypovolemic - Volume
  2. Cardiogenic - Pump
  3. Distributing - Plumbing
22
Q

Hypovolemic Shock

-External Causes

A
  1. GI loses
  2. Loss of limb
  3. Vessel disruption
  4. Diabetes Insipidus & DKA
  5. Burns - loss of albumin
  6. Trauma
23
Q

Hypovolemic Shock

-Internal Causes

A
  1. Dissecting Aorta
  2. Retroperitoneal bleed (Pt’s returning from Cath Lab)
  3. Hemothorax
  4. Splenic Rupture
  5. Third Spacing
24
Q

What to Look for in Pt’s returning from Cath Lab?

A
  1. Retroperitoneal bleed

- Occult bleeding in the retroperitoneal cavity

25
Q

Cardiogenic Shock

A
  1. More than 40% of muscle mass has to be lost for cardiogenic shock to occur (in 80% of pt’s)
    - It matters where the muscle mass is lost
  2. Left Ventricular muscle loss is the most serious
26
Q

Cardiogenic Shock

-Things that Cause it

A
  1. Papillary muscle rupture
  2. Cardiac Tamponade
  3. Tachyarrhythmias
  4. Bradyarrhythmias
  5. Drugs
27
Q

Distributive Shock

A
  1. Anaphylactic
  2. Neurogenic
  3. Septic
28
Q

Distributive Shock

-Anaphylactic

A
  1. Systemic Allergic Reaction
    - Drugs
    - Food
    - Insect bites or stings
    - Chemicals
29
Q

Distributive Shock

-Neurogenic

A
  1. Damage to the SNS
    -Spinal Cord injury above T7
  2. Because there is no SNS response, there is
    NO COMPENSATION
30
Q

Septic Shock

A
  1. Release of Inflammatory mediators that result in massive vasodilation
    - Gram Negative Bacteria
    - E. coli
31
Q

Superior Vena Cava Syndrome

-

A
  1. Progressive occlusion of the SVC that leads to venous distention in the upper extremities and head
32
Q

Superior Vena Cava Syndrome

-What Causes it?

A
  1. Bronchogenic cancer

2. TB

33
Q

Superior Vena Cava Syndrome

-Clinical Manifestations

A
  1. Edema and venous distention in the upper extremities and face, including ocular beds
  2. Pt complains of feeling:
    - fullness in the head
    - tightness in shirt collars, necklace, or ring
  3. Face and arms may become purple w/ slow cap refill
34
Q

Superior Vena Cava Syndrome

-Diagnosis

A
  1. Chest X-Ray
  2. Doppler Studies
  3. CT or MRI
35
Q

Superior Vena Cava Syndrome

-Treatment

A
  1. Radiation therapy , surgery, chemotherapy for malignant disorders
  2. Bypass surgery using grafts, thrombolysis, ballon angioplasty or stents for NON-MALIGNANT
36
Q

Complicated Hypertension

-Examples

A
  1. Left Ventricular hypertrophy
  2. Angina pectoris
  3. HF, CAD, MI
  4. Sudden death

Pathophysiology Test 3 (8 decks)

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