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Chapter 8 Pathology > The Circulatory System > Flashcards

The Circulatory System Flashcards

1
Q

What is cardiovascular disease?

A

A broad, umbrella term that encompasses a collection of diseases and conditions

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2
Q

What are the two main components of cardiovascular disease?

A

Diseases of the heart and diseases of the blood vessels

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3
Q

What are some examples of cardiovascular disease?

A

Aneurysms, heart attacks, varicose veins

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4
Q

What is atherosclerosis?

A

The gradual buildup of fatty deposits (mainly cholesterol)

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5
Q

What causes plaque?

A

Lipids that are deposited in the arteries

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6
Q

What does atherosclerosis progressively narrow?

A

The artery, decreasing the blood flow

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7
Q

When does atherosclerosis begin?

A

At an early age

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8
Q

What is arteriosclerosis?

A

The hardening of the wall of the arteries due to the plaque formation and calcification

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9
Q

What is stenosis?

A

The narrowing of arteries

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10
Q

What is the major cause of a thrombus?

A

A change in the wall of blood vessels such as the irregularity caused by arteriosclerosis

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11
Q

What is a thrombus?

A

A blood clot that has attached itself to the inner wall of an artery or vein

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12
Q

What occurs if one of the coronary arteries becomes completely blocked, and that part of the heart muscle dies?

A

Myocardial infarction

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13
Q

What is the major site of involvement with myocardial infarctions?

A

The left ventricle

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14
Q

What is myocarditis?

A

Inflammation of the myocardium

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15
Q

What is pericarditis?

A

Inflammation of the pericardium

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16
Q

What is cardiac dilation?

A

When the muscle fibers stretch, causing the heart to enlarge

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17
Q

What is cardiomegaly?

A

When the heart remains enlarged because of a disease process

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18
Q

What is dyspnea?

A

Shortness of breath

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19
Q

What is dextrocardia?

A

Occurs when the hearts displaced to the right side of the body (known as dextroposition)

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20
Q

What is cardiac heterotaxia?

A

If the heart is reversed so that it is a mirror image of a normal heart

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21
Q

What is situs inversus?

A

When all the organs of the body are reversed from normal and on the opposite side of the body

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22
Q

What is valvular disease?

A

When the valves of the heart are affected by some pathologic condition such as thickening or shrinking due to infection

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23
Q

What is an incompetent valve?

A

Valves that will not operate normally. The valve is normally formed but will not completely close the orifice, which allows retrograde blood flow

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24
Q

What is an insufficient valve?

A

One that will not operate properly because it is deformed

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25
Q

What is coarctation of the aorta?

A

The severe narrowing of the aorta that causes the left ventricle of the heart to suffer an increase in workload in order to push blood through the a narrow passageway

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26
Q

If the narrowing of the aorta is severe enough or complete with coarctation, what happens?

A

Anastomotic vessels develop in an attempt to compensate for the inadequate blood supply to the lower portion of the body

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27
Q

What does coarctation of the aorta result in?

A

Hypertension in the upper extremities and hypotension in the lower extremities

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28
Q

What are the two varieties of coarctation of the aorta?

A

Localized and tubular

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29
Q

What is the most common coarctation of the aorta?

A

Localized (formerly known as adult)

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30
Q

Who does localized coarctation of the aorta occur more often in?

A

Males

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31
Q

In an adult with coarctation of the aorta, what is apparent?

A

severe hypertension proximal to the coarctation and results dilation of the aortic arch

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32
Q

What is an important radiographic sign of coarctation of the aorta?

A

Rib-notching

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33
Q

What does rib-notching show with coarctation of the aorta?

A

Sharply defined bony erosions along the lower margins of the ribs caused by the development of anastomotic vessels that enlarge under their increased volume and cause pressure erosions on the ribs

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34
Q

What is tubular coarctation?

A

Hypoplasia of a long segment of aortic arch after the origin of the innominate artery

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35
Q

What are common with tubular coarctation but not localized?

A

Cardia anomalies

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36
Q

What are congenital heart abnormalities that result of?

A

Inborn defects caused by failure of the heart or major blood vessels near the heart to develop normally during the growth period before birth

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37
Q

What are the most common types of congenital abnormalities?

A

Those in which holes in the heart wall occur known as shunts

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38
Q

What are shunts?

A

Holes in the heart wall and allow pulmonary and systemic blood to mix which causes the lungs to become overloaded with blood

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39
Q

What are the three major types of shunts?

A

ASD, VSD, and PAD

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40
Q

What are septal defects?

A

Small openings in the septum of the heart

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41
Q

What are atrial septal defects?

A

Openings in the septum between the two atria

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42
Q

What are the most common congenital defects of the heart?

A

ASD

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43
Q

What type of shunt is a ASD?

A

A left-to-right shunt because the pressure is higher in the left atrium than it is in the right atrium

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44
Q

What is an ASD considered a left-to-right shunt?

A

A large amount of oxygen-rich blood leaks from the left side back to the right side and back to the lungs

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45
Q

What is increased because of an ASD?

A

Pulmonary blood flow

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46
Q

In addition to overloading the pulmonary bed with a ASD, what happens?

A

The right ventricle experiences an overload which produces a radiographic appearance of enlargement of the right ventricle and right atrium

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47
Q

What is a VSD?

A

If the defect occurs between the two ventricles

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48
Q

What is a VSD more serious than a ASD?

A

Because there is a greater pressure difference between the two ventricles than between the two atria

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49
Q

Where may a VSD occur?

A

In the membranous or muscular portion of the ventricular septum

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50
Q

What occurs during systole with a VSD?

A

Because of higher pressure in the left ventricle, a shunting of blood from the left to the right occurs because of the higher pressure in the ventricle during that phase

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51
Q

If pulmonary vascular resistance produces pulmonary hypertension with a VSD, what happens?

A

the shunt of blood is then reversed from the right to the left ventricles, resulting in cyanosis

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52
Q

What is the radiographic appearance of a VSD?

A

Enlargement of the left side of the heart

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53
Q

What is a PAD?

A

When the arterial duct in a newborn fails to close after birth

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54
Q

What is the arterial duct?

A

A vessel that extends from the bifurcation of the pulmonary artery to join the aorta just distal to the left subclavian artery

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55
Q

What does the arterial duct do?

A

It serves to shunt blood from the pulmonary artery into the systemic circulation during intrauterine life

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56
Q

If a PAD does not close, what happens?

A

Oxygenated blood is continuously shunted from the aorta to the pulmonary artery and back to the lungs instead of going through the aorta to the body. The heart will be overworked

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57
Q

What happens to a persons breathing with PAD?

A

It becomes dyspneic on light exertion

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58
Q

What does the radiographic image show with PAD?

A

Enlargement of the left atrium and left ventricle and increased vascular congestion

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59
Q

What occurs when four conditions exist simultaneously?

A

Tetralogy of Fallot

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60
Q

What has to occur with Tetralogy of Fallot?

A
  1. Pulmonary stenosis
  2. Right ventricle hypertrophy (thickening)
  3. A VSD
  4. Displacement of the aorta to the right (or overriding of the aorta above the VSD)
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61
Q

What do the four conditions associated with tetralogy of Fallot cause?

A

The blood to be unoxygenated, as it does not flow through the pulmonary system

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62
Q

What is pulmonary stenosis?

A

A narrowing of the pulmonic valve and the muscular region below the valve

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63
Q

What does pulmonary stenosis cause?

A

A decrease in the amount of blood that is trying to flow from the right ventricle into the pulmonary circulation. Thus, there is a decreased blood flow from the lungs. This is turn causes an election of pressure in the right ventricle and hypertrophy of that chamber as it overworks to pump blood through the narrow pulmonary valve

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64
Q

What does a VSD allow with tetralogy of fallot?

A

It allows unoxygenated blood in the right ventricle to mix with oxygenated blood in the left ventricle (know as a right-to-left shunt). This allows blood to travel up through the displaced aorta, which opens directly into both the right and left ventricles

65
Q

What does the aorta carry with a VSD with tetralogy of fallot?

A

both unoxygenated and oxygenated blood and because of this, the amount of oxygen the aorta carries to the body tissues is decreased

66
Q

What gives rise to extreme cyanosis and is a common cause of “blue baby”

A

A VSD associated with tetralogy of Fallot

67
Q

What happens when the right ventricle enlarges with Tetralogy of Fallot?

A

It causes the apex of the heart to become displaced upward and laterally which is the classic radiographic appearance known as “Coeur en Sabot”

68
Q

What are the clinical manifestations associate with Coeur en Sabot?

A

clubbing of fingers and toes, systolic murmurs and retardation of growth

69
Q

Where is a shunt inserted for Tetralogy of Fallot?

A

Between the aorta and pulmonary artery

70
Q

What is an aneurysm?

A

A major process that will affect the adult aorta. It is a dilation of an artery (usually the aorta)

71
Q

What is an aneurysm usually caused by?

A

Atherosclerosis in almost 80% of cases

72
Q

What are some common diseases that can cause aneurysms?

A

Syphilis, Marfan syndrome, and high blood pressure

73
Q

What is a true aneurysm?

A

A permanent dilation of all layers of a weakened but intact vessel wall

74
Q

What are the three different types of aneurysm?

A

Saccular, Fusiform, and dissecting

75
Q

What is a saccular aneurysm?

A

A localized outpouching of one side of the vessel wall, usually located in the cerebral arteries but it may be in the distal abdominal aorta

76
Q

What is a fusiform aneurysm?

A

A uniform dilation of the entire portion of the artery. They are usually found in the distal abdominal aorta

77
Q

What is a dissecting aneurysm?

A

It occurs when a hemorrhage occurs between the layers of the wall of the artery

78
Q

What other type of aneurysm can a dissecting aneurysm look like?

A

A fusiform type as the dissection causes progressive widening of the aortic shadow

79
Q

When an aneurysm is found in the abdominal aorta, what is it termed?

A

The triple A for abdominal aortic aneurysm

80
Q

What is an additional type of aneurysm?

A

A false aneurysm

81
Q

What is a false aneurysm?

A

A pulsating hematoma and must be distinguished as such

82
Q

What are the dangers of an aneurysm?

A

Its tendency to increase in size and rupture, leading to massive hemorrhage that may be fatal if it involves a critical organ such as the brain

83
Q

What is the modality of choice to diagnose aneurysms?

A

Angiography

84
Q

What is generally recommended as treatment for aneurysms?

A

Surgery unless the diameter of the aorta is small (less than 4.5)

85
Q

What is the major cause of vascular disease?

A

Atherosclerosis

86
Q

What is atherosclerosis characterized by?

A

Irregularly distributed fat deposits in medium and large sized arteries

87
Q

When does atherosclerosis begin?

A

When the lining of the artery becomes damaged through some process such as smoking

88
Q

What accumulates as the site of damage with atherosclerosis?

A

Plaque, which is low-density lipoproteins

89
Q

What does plaque formation and stenosis often involve?

A

The coronary arteries causing arteriosclerotic heart disease

90
Q

What is arteriosclerotic heart disease also known as?

A

Cardiovascular disease

91
Q

What disease remains the leading cause of deaths in the United States

A

Arteriosclerotic heart disease

92
Q

What procedure remains among the most frequently performed surgical procedures associated with arteriosclerotic heart disease?

A

Coronary artery bypass grafting because of hypertension

93
Q

What accelerates the development of atherosclerotic plaque?

A

Hypertension, so it is often found un conjunction with arteriosclerotic heart disease

94
Q

What happens if enough plaque finally accumulates with arteriosclerotic heart disease?

A

The myocardium is damaged and continual plaque buildup results in a myocardial infarction

95
Q

What can be seen on radiographic images with arteriosclerotic heart disease?

A

Mild cardiomegaly as well as calcification in the coronary arteries

96
Q

What results when the heart cannot supply enough blood at a sufficient rate to meet the metabolic requirement of tissues?

A

CHF

97
Q

What can CHF be caused by?

A

Damage from a heart attack, cardiovascular disease, hypertension, or infection to the heart muscle and damage to the valves

98
Q

What categories can CHF be divided into?

A

Right heart failure and left heart failure

99
Q

What happens when one side of the heart fails while the other side continues its normal output with right or left CHF?

A

There is increased pressure in the pulmonary or systemic veins, or both, resulting in “backing up” of blood

100
Q

What is CHF usually accompanied by?

A

Pleural effusion

101
Q

What is the classical radiographic sign of CHF?

A

Diffuse cardiomegaly

102
Q

What happens when there is left heart failure?

A

the left ventricle does not pump a volume of blood equal to that of the venous return in the right ventricle

103
Q

What happens when fluid builds up with left sided heart failure?

A

A point is reached at which it has nowhere to go but the alveoli and bronchial tree of lungs which produces rales and pulmonary edema

104
Q

What is left sided heart failure usually caused by?

A

hypertension, but can result from coronary heart disease or valvular disease

105
Q

What do the radiographic images show with left sided heart failure?

A

A congested hilar region of the lungs with increased vascular markings

106
Q

What might left heart failure lead to?

A

Right heart failure because increased pressure is transmitted through the pulmonary circulation to the right heart

107
Q

What does right sided heart failure cause?

A

dilation of the right ventricle and right atrium

108
Q

What can the transmission of increased pressure cause with right sided heart failure?

A

Dilation of the superior vena cava, widening of the right superior mediastinum, and edema of the lower extremities

109
Q

What can right sided heart failure be caused by?

A

Pulmonary valvular stenosis, emphysema, or pulmonary hypertension resulting from pulmonary emboli

110
Q

What is the typical appearance of the pulmonary vessels in an upright chest radiograph with CHF?

A

The pulmonary vessels in the lower lung zones are larger than those in the apices

111
Q

What is the typical appearance of the pulmonary vessels in an upright chest radiograph with severe pulmonary venous hypertension associated with CHF?

A

there is a redistribution of flow so that vessels in the upper zones are larger than those in the lower lung zones

112
Q

What does a chest radiographic image of a person with CHF show?

A

a pulmonary vascular shift, an increase in heart size, and more importantly cephalization which is the hallmark on the image

113
Q

What is the most common cause of CHF in older adults?

A

hypertensive heart disease

114
Q

What does high blood pressure, over a long period of time cause?

A

Narrowing of the systemic blood vessels. Because of this resistance, the left ventricle must work harder, causing dilation and enlargement of the ventricle

115
Q

What often occurs with the heart with hypertensive heart disease?

A

there is often downward displacement of the apex of the heart

116
Q

What does failure of the left ventricle lead to with hypertensive heart disease?

A

Increased pulmonary venous pressure and congestive failure

117
Q

What are the radiographic signs and symptoms for hypertensive heart disease?

A

Same as for CHF

118
Q

What is hypertrophy?

A

Enlargement of the atria or ventricles

119
Q

How is right atria enlargement recognized?

A

By enlargement of the cardiac shadow to the right of the thoracic spine in the frontal view

120
Q

What can right atrial enlargement be caused by?

A

subacute bacterial endocarditis or ASD

121
Q

How is right ventricular enlargement recognized?

A

By encroachment of the cardiac shadow into the retrosternal space on the lateral projection

122
Q

What happens with right ventricular enlargement?

A

The right ventricle works harder and enlarges in the presence of defects of the pulmonary vascular bed, as with pulmonary hypertension. The alterations in the pulmonary circulation lead to pulmonary arterial hypertension

123
Q

What is right ventricular enlargement usually associated with?

A

Right atrial enlargement

124
Q

How is enlargement of the left atrium seen radiographically?

A

As a rounded opacity in the retrocardiac region projecting to the left and right of the spine on the posteroanterior projection of the chest

125
Q

What enlarges with rheumatic heart disease?

A

The left atrium with mitral stenosis or mitral insufficiency

126
Q

How is enlargement of the left ventricle seen?

A

By the cardiac shadow to the left of the spine, often with a round lateral contour projecting below the diaphragm

127
Q

What happens with enlargement of the left ventricle?

A

The left ventricle works harder and longer with each beat when it meets increased resistance to the emptying of blood into the systemic circulation as occurs with aortic stenosis, volume overload, and systemic hypertension

128
Q

What happens to the left ventricle with enlargement?

A

The ventricle hypertrophies because of the extra exercise and sometimes it becomes displaced laterally

129
Q

What is pericardial effusion?

A

Fluid in the pericardial sac

130
Q

What are the cause of pericardial effusion?

A

TB and viral infections

131
Q

When should pericardial effusion be suspected?

A

When there is a rapid increase in heart size on the chest images without other signs of heart failure

132
Q

What is an excellent method of demonstrating pericardial effusion?

A

echocardiography

133
Q

What amount of fluid can be detected by a echocardiography?

A

As little as 50 mL, whereas at least 200 mL on a radiographic image

134
Q

What is the cause of rheumatic fever?

A

The cause is unknown, but the attacks are preceded by Strep

135
Q

What do episodes of rheumatic fever cause?

A

Inflammation of the heart valves rather than the myocardium and leads to scarring deformities of the valves known as rheumatic heart disease

136
Q

What is the most common valve deformity associated with rheumatic heart disease?

A

stenosis of the mitral valve

137
Q

What is valvular disease?

A

At variable times following acute illness, chronic damage to heart valves may become evident

138
Q

What happens with valvular disease?

A

The functional valve damage is produced by stenosis of the valve opening or valvular insufficiency or both

139
Q

What valves are most commonly affected with valvular disease?

A

Fibrosis of the mitral valve which usually leads to left heart failure and stenosis and insufficiency of the aortic valve

140
Q

What does the left heart failure result from with valvular disease?

A

The left heart failure results either from backup of blood into the lungs caused by stenosis or from regurgitation of blood back through the insufficient valve

141
Q

What does stenosis and insufficiency of the aortic valve cause with valvular disease?

A

left ventricular hypertrophy and eventually heart failure. The valves may also become infected, producing infective endocarditis

142
Q

What is seen on a radiographic image with rheumatoid heart disease?

A

Calcification of the mitral valve and Kerley B lines

143
Q

What is subacute bacterial endocarditis caused by?

A

Organisms that live on the heart valves and produce an inflammatory reaction

144
Q

What is the most common cause of subacute bacterial endocarditis?

A

Bacteria

145
Q

What is the most common predisposing factor to the development of subacute bacterial endocarditis?

A

Rhuematic vulvitis

146
Q

What is the most striking feature of subacute bacterial endocarditis?

A

The formation of large number of emboli because of the breaking off of fragments of the vegetations

147
Q

What is angiography?

A

A general term used to describe the radiographic procedure of the vessels of the body

148
Q

What is arteriography?

A

The study of the arterial system

149
Q

What is venography?

A

The study of the venous system

150
Q

What is aortography?

A

The study of the thoracic or abdominal aorta

151
Q

What is angiocardiography (cardiography)?

A

the examination of the chambers of the heart

152
Q

What are the steps taken from angiocradiography?

A

A catheter is fed into the femoral or brachial artery of the patient

153
Q

What is an arteriogram?

A

The injection of contrast material into one or more arteries to make them visible on the radiographic image

154
Q

What is percutaneous transluminal angioplasty?

A

With the use of a balloon catheter, it is a procedure for the alleviation of symptoms in patients with arteriosclerosis

155
Q

What happens with percutaneous transluminal angioplasty?

A

A catheter is threaded into the artery to the site of the plaque. At this point a balloon is inflated “cracking” the plaque off the arterial wall

156
Q

What is an endovascular stent repair?

A

It is not a diagnostic procedure but it is performed with the aid of fluoroscopy

157
Q

What happens with endovascular stent repair?

A

A stent is threaded over a catheter and placed in the aorta where the aneurysm is found. The graft (stent( is expanded and fastened in place to form a stable channel for blood flow

158
Q

What does echocardiography visualize?

A

The chambers of the heart and the valves; determines septal defects and pericardial effusion

Chapter 8 Pathology (1 decks)

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