Unit 4: Aortic Aneurysm Flashcards
(32 cards)
What are the different short term mechanisms to control blood pressure?
Sympathetic v parasympathetic nervous system
Baroreceptors
Osmoreceptors and RAAS
What are the mechanisms behind the control of blood flow?
Blood flow is influenced by blood pressure and systemic vascular resistance
Some circuits are parallel: resistance = 1/r for each
Some are series: resistance = sum of resistance
What is the altering response?
Activation of the sympathetic nervous system, that causes physical changes in the body
Preparing the body for a fight or flight response
B1 - increase HR
B2 - vasodilation of central blood vessels
A2 - vasoconstriction of peripheral blood vessels
How does vasovagal syncope occur?
Over activation of the sympathetic nervous system by fear or excitement
Activates the parasympathetic as a biological safety mechanism, this hijacks the brain
Leads to rapid drop in blood pressure and HR
Leads to reduced blood flow to the brain and reduced intracranial pressure
Temporary ischemic conditions cause loss of postural tone
Baroreceptors are temporaly inhibited by the parsympathetic nervous system in this scenario
What is laplace law?
How does this link to aneurysm?
Law relating the radius of blood vessels to their properties
Smaller radius = higher blood pressure for the same volume of blood, and greater wall tension
The large red the radius of the vessel the larger a wall tension in required to withstand the internal pressure
Aneurysm = more common in larger blood vessels as lower wall tension
How do beta blockers work?
Bind to beta adrenergic receptors and act as antagonists
Can be selective: bind to beta1 only to decrease HR (as adrenaline unable to increase)
Non-selective: will also bind to beta2, their leads to bronchoconstriction (as adrenaline can not dilate)
Can problematically lead to bronchospasm - hence not given to COPD patients
What is shock?
Decrease in oxygen levels in the blood stream - ischemic damage to tissue particularly the brain
Septic - low BP due to infection
Hemorrhagic - large volume blood loss
Anaphylactic - allergic reaction
What is an aortic anuerysm?
definition
Different types
Ballooning of aorta, bigger than or equal to 5cm (1.5x orignal volume)
True: layers on artery dilate
False: hole in layers, blood clot collects on outside of artery
Secular : one side only
Fusiform: symetrical ballooning
What is the cause of an aortic aneursym?
Damage to artery wall - causes the wall to stretch, becomes thinner so is more likley to burst under high blood pressure conditions
Risk factors of an AA?
Genetic - marfan syndrome (increase fibrillin)
Family history
High blood pressure - damage blood vessels
Smoking - damage blood vessels
Gender - more common in males
Age - more common as you age
Arteriosclerosis - loss of collagen and elastic in bv, calcification of arterial wall
Distance from aorta - decline in elastic tissue
diagnosis of an AA?
Found on screening programme - one off abdominal ultrasound for 65yrs old men
Identified on rupture
Identified when in hospital for something else
Conservative management of an AA?
Methods to preserve cardiovascular health
- weight loss
- exercise and diet changes
- statins to reduce blood cholesterol
- beta blockers to reduce blood pressure
- regular ultrasound/x-ray to monitor the progress of an the aneurysm
Surgical management of an AA?
Endovascular stenting - Stent placed in artery by femoral artery route - holds artery open
Open abdomainl surgery - Removal of the damage artery segment and adding in an artificial graft.
Typically only done for large aneurysms
Prognosis of an AA
Majority of patients who have a burst die (80%)
5,000 deaths a year
60% are abdominal 405 are thoracic
Consequences of an AA rupture
Rapid fall in blood pressure with large internal bleeding
Hemorrhagic shock
Unconsciousness / decline in the Glasgow coma score
Death
Coma
What are care plans?
Plan based on a discussion with the health practitioner and the patient
Determine how the illness will affect the patient and what support they would like/may need in the future.
Identiy the support the patient will be eligible for and what support they will need to pay for (particulary if the local authority is involved)
What are emergency plans?
A care plan to be activated in an emergency, such as your health worsens or rapid state of decline.
Includes advance decisions on things such as resuscitation.
health people know what to do once you are better
Help identify if you’re state of care is getting worse
For carers states that 24-hour care is needed to a person when their carer is unable to provide support
Often provided by voluntary organizations
What are disability plans?
Type of care plan, set out to detail your needs, how these needs will be met and who will be providing this care for you.
Can be given to others to help them understand more about your care, your needs, your likes and your dislikes.
What are discharge plans?
Plan made when a patient is due to leave the hospital
Information on the treatment they recieved, info on what treatment thet should continue to recieve.
Contact information
Ensure patient is given appropriate drugs/advice before they leave
May arrange for a check up appointment
What are carers hubs?
Support groups for carers, typically ran by the local authority
Offer a chance to speak to other people in similar situations
Social events
Financial advice
Emotional support
May be tailored e.g child carers or partner carers
What is early mobilisation?
Why is it important to care?
Early remobilisation is when the patient is encouraged to move and began rehabilitation quickly after surgery/treatment.
often within 24 hours
Psychologically - this can make the patient feel more confident in their recovery, prevent a fear around restarting activity
Physically - reduce risk of muscle wasting, DVT and other conditions from being sedentary for too long
What are the receptors in the parasympathetic nervous system?
M2 - decrease HR
M3 - vasodilation of bv
What is a severe learning disability?
Impairment of cognition, emotion and thoughts to decrease the quality of life
Struggle to meet development milestones withint the correct timespans
Struggle to learn and adpat new skills.
What are the signs immediatly before fainting in vaso-vagal syncope?
Blurry vision
Rapid change in temperature
Dizziness
