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Cardiopulmonary > Quiz 2 > Flashcards

Quiz 2 Flashcards

1
Q

What are the 4 major cardiovascular diseases?

A

-Ishemic Heart Disease (MI), Hypertension, HF, and CVD (stroke)

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2
Q

What is the leading cause of death in the US?

A

-Heart disease

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3
Q

What is the outer layer of coronary arteries called?

A

-Adventitia

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4
Q

What is the adventitia formed by?

A

-collagen fibers

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5
Q

What is the basic support structure of the coronary arteries?

A

-The adventitia

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6
Q

What is the term for the blood supply to arterial walls?

A

-Vaso Vasorum

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7
Q

What is the name of the middle layer of coronary arteries?

A

-Media

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8
Q

What is the media composed of?

A

-Several layers of smooth muscle and an elastic membrane

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9
Q

What is the media of coronary arteries responsible for?

A

-Making adjustments to lumen diameter

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10
Q

What is the inner most layer of coronary arteries called?

A

-The intima

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11
Q

What is the intima composed of?

A

-Endothelial layer, basement membrane, smooth muscle cells, elastic and collagen fibers

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12
Q

Lipoprotiens and fibrinogen is most likely to accumulate in what layer of coronary arteries?

A

-The Intima

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13
Q

What two layers are on each side of the media?

A

-Internal and External elastic lamina

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14
Q

What are the 3 basic rules of fluid dynamics for myocardial perfusion?

A
  • Fluid flow from an area of high pressure to low pressure
  • Fluids follow the path of lest resistance
  • if there is a blockage, the surrounding vessel will dilate to allow flow around the blockage
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15
Q

What are the 4 major determinants of myocardial blood flow?

A
  • Diastolic BP
  • Vasomotor tone
  • Resistance to flow
  • Left Ventricular end-diastolic pressure
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16
Q

What is the primary driving force for moving blood into myocardial tissue?

A

-Diastolic BP

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17
Q

What determines the volume of blood passed along to myocardial tissue?

A

-Vasomotor tone

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18
Q

A decrease in vasomotor tone will do what to the amount of blood passed along to myocardial tissue?

A

-It will increase it

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19
Q

What normally causes increased resistance to flow in myocardial tissue?

A

-Atherosclerosis

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20
Q

What is an atherosclerosis made up of?

A

-lipids and thrombus

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21
Q

Exposure of what leads to platelet aggregation and the formation of a thrombus?

A

-Endothelial layer

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22
Q

What is a hallmark sign of of advanced atherosclerosis?

A

-Hyperplasia of intimal smooth muscle

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23
Q

What gender is more likely to had CAD?

A

-Males, until 55 y/o then it is equal

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24
Q

What is the best predictor of a persons risk of CAD?

A

-Ratio of total cholesterol to HDL

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25
Q

What is considered low for HDLs?

A

-50 mg

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26
Q

What is considered high for triglycerides?

A

-150

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27
Q

BP greater than what presents you with a risk for CAD?

A

-140/90

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28
Q

BMI greater than what increases risk for CAD?

A

-30

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29
Q

What mainly causes sudden cardiac death?

A

-ventricular tachycardia or fibrillation

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30
Q

Why does ventricular fibrillation cause sudden cardiac death?

A

-The fluttering will not allow blood to be ejected from the ventricles

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31
Q

For those already diagnosed with CHF, an ejection fraction less than what increases a persons risk for sudden cardiac death?

A

-35%

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32
Q

What are the classical signs of stable angina?

A

-Tightness or pressure anywhere above the waist

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33
Q

Where can pain from angina radiate?

A

-Neck, arms and between the shoulder blades

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34
Q

When do symptoms develop and diminish with stable angina?

A

-develop with exertional activity and deminish with rest

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35
Q

What do women tend to complain of with unstable angina?

A

-indigestion, and pain between shoulder blades

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36
Q

What may diabetics present with with with stable angina?

A

-SOB

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37
Q

What mainly causes prinzmetal angina?

A

-Vasospasm

38
Q

What will patients with prinzmetal angina present with on an EKG?

A

-Elevated ST segment

39
Q

When will patients with Prinzmetal angina have symptoms?

A

-In the morning

40
Q

How will pain with pericarditis present?

A

-pain at rest, worsening with activity and does not get better with nitroglycerin

41
Q

How can you tell if chest pain in the chest wall is MSK related?

A

-there will be pain with palpation

42
Q

When is pain worse with pulmonary pain?

A

-Worse with breathing

43
Q

What is the only way to tell if an MI occured?

A

-ECG

44
Q

What 4 factors contribute to unstable angina?

A
  • circadian variation in catecholamine levels
  • increased plasma viscosity
  • increased platelet aggregation
  • pathological changes in atherosclerosis
45
Q

What causes a STEMI acute coronary syndrome?

A

-an occlusion of a major coronary artery

46
Q

What will present on a ECG with a STEMI?

A

-Q wave

47
Q

STEMI causes a transmural infarct, what does this mean?

A

-It affects the thickness of the myocardium

48
Q

What causes a Non-STEMI Syndrome?

A

-occlusion of a non-major coronary artery or partial occlusion of coronary artery

49
Q

What can a Non-STEMI syndrome?

A

-nontrasmural and subendocardial region infarct

50
Q

With an MI, where does necrosis begin?

A
  • In a small zone of the myocardium beneath the endocardial surface
51
Q

To aviod necrosis of myocardial tissue, how soon does reprofusion need to occur?

A

-20 minutes

52
Q

A right coronary artery infarct will cause what complications?

A

-Risk of AV block and Arrhythmia; 50% have right ventricular infarct

53
Q

A left main artery or left anterior descending artery infarct will cause what type of complications?

A

-pump dysfunction or failure

54
Q

An infarct of the circumflex artery will cause what type of complication?

A

-no specific complication

55
Q

what is dyssynchrony?

A

-uncoordinated contraction with adjacent segments

56
Q

What is hypokensis?

A

-Reduced strength of contraction

57
Q

A what akinesis?

A

-Reduced strength of contraction

58
Q

What is dyskinesis?

A

-Abnormal movement during the contraction

59
Q

Individuals with what percent of left ventricular involvement infarct may experience what?

A

-Sudden death

60
Q

15% Left ventricle involvement infact can cause what?

A

-Decrease stroke volume, and elevated LV end diastolic volume

61
Q

Lower stroke volume and increase left ventricle end diastolic volume can cause what?

A

-lower aortic pressure and causes decreased perfusion to muscle

62
Q

What does ventricular remodeling the depend on?

A

-The type of MI, the size of the infarct, ventricular load, and satency of the artery that was infarcted

63
Q

BPs greater than what is considered stage I hypertension?

A

-140/90

64
Q

BPs greater than what are considered stage II hypertension?

A

-159/99

65
Q

What are the major determinants of hypertension?

A

-Cardiac output and total peripheral resistance

66
Q

What complications can hypertension cause for the left ventricle?

A

-Can cause hypertrophy leading to impaired relaxation and diastolic dysfunction

67
Q

How can uncontrolled hyertension affect the brain?

A

-Can cause stoke or aneurysm

68
Q

How can uncontrolled hypertension affect the eye?

A

-Can affect the retina, and cause a mircoaneurysm

69
Q

What can uncontrolled hypertension cause in the heart?

A

-congestive heart failure, angina or MI

70
Q

How can uncontrolled hypertension affect the kidneys?

A

-can cause chronic renal failure and nephrosclerosis

71
Q

What type of heart failure is described as ventricular hypertrophy that decreased stroke volume, and ejection fraction that leave more blood in the ventricle after systole?

A

-Heart failure with reduced ejection fraction

72
Q

Diastolic dysfunction that impairs ventricula relaxation and impairs ventricular filling but does not affect ejection fraction is known as what?

A

-Heart failure with preserved ejection fraction

73
Q

What are the goal of intervention of hypertension?

A

-normalize BP and reverse left ventricular hypertorophy

74
Q

What does prehypertension treatment consist of?

A

-making life style modifications

75
Q

In what stage of hypertension of medications introduced?

A

-type I

76
Q

By how much can hypertension reduce exercise capacity?

A

-15 to 30%

77
Q

Why does hypertension effect exercise capacity?

A

-It reduced stroke volume and heart rate which lowers cardiac output

78
Q

How does exercise effect both systolic and diastolic blood pressures?

A

-it lowers them

79
Q

What does not increase during exercise because of beta blockers?

A

-HR

80
Q

At what BP should you refer a patient to a physician?

A

-greater than 200/100

81
Q

BP of what mean you should discontinue exercise testing?

A

-greater than 250/115

82
Q

A BP above what requires medical clearance for medical training?

A

-180/110 or above

83
Q

What physical presentations can poor circulations cause?

A

-dry skin, hair loss, thick toe nails, and muscle atrophy

84
Q

What causes pain that is associated with PAD?

A

-Lactic acid build up

85
Q

What is the best functional exercise for those with PAD?

A

-Walking

86
Q

How should you dose exercise for those with PAD?

A

-In short intervals with rest periods in between

87
Q

What type of exercises can be performed at higher intensities and longer duration for those with PAD?

A

-NWB activities

88
Q

Prior to exericsing a patient with arterial insufficiency, what should be performed?

A

-a sensory exam

89
Q

What should a person with arterial insufficiency not do?

A

-Prop up their legs

90
Q

What does slow blood flow encourage?

A

-Clotting, especially at bifircations

Cardiopulmonary (7 decks)

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