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Vessels Flashcards

1
Q

Modifiable risk factors for atherosclerosis

A

Smoking
HTN
Lipid metabolism - VLDL, LDL, chylomicrons
Diabetes
Lack of exercise
Type of personality/ability to manage stress?

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2
Q

Non-modifiable risk factors for atherosclerosis

A

Age
Gender
Genetics

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3
Q

How many of those with HTN have primary HTN? What is the cause of primary HTN?

A

90-95% of people with HTN - don’t know the cause

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4
Q

What percentage of people with HTN have secondary HTN? Cause known?

A

5-10% - yes, cause is known. Ex is renal artery narrowed

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5
Q

What is the pathogenesis for primary HTN? How is pathogenesis for primary different from secondary?

A

Pathogenesis same for both

involves narrowing of arteries - arteriolorsclerosis - leading to enlargement of L ventricle of heart, increasing possibility of MI and CVA

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6
Q

Most likely areas for atherosclerosis? What makes them so? Complications?

A

Abdominal aorta and iliac
Thoracic aorta, popliteal and femoral arteries
Proximal coronary arteries (curvature of vessels)
Internal carotid arteries
Vertebral, basilar, middle cerebral (have 90* angles)

———

Narrowed lumen (ischemia -> infarction) 75% to see signs and symptoms - do stress tests to determine
Weakened arterial walls
Thombosis

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7
Q

Is atherosclerosis reversible?

A

Yes

Take away stressors, exercise more, put dietary plan in place, use lipid meds

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8
Q

Signs and symptoms of MI (13)

A

Severe substernal chest pain or squeezing pressure
Pain radiating down arms
Feeling of indigestion
Angina lasting for 30 mins or more
Angina unrelieved by rest
Nausea
Pallor
Pain of infarct unrelieved by positional change
Diaphoresis
SOB
Weakness and feeling of faintness
ST segment elevation
T Wave inversion

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9
Q

Parts of movement system and methods of measurement?

A

Lungs - RR
Heart - HR/BP?
Muscles - aerobic or anaerobic metabolism

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10
Q

Blood pathway

A

RA
RV
Pulmonary artery
Pulmonary capillaries
Pulmonary vein
LA, LV
aorta
Arteries
Arterioles
Capillaries
Venules
Veins

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11
Q

Signs and symptoms of CV disease

A

Dependent edema - hallmark of R ventricular failure, usually bilateral and peripheral, may be accompanied by jugular vein distension, cyanosis, and abdominal distension from ascites

Claudication - PVD and CAD - walk patient in small bouts to build tolerance, keep going till 8/10 pain before resting and going again

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12
Q

Layers of the heart from outside —> in (FPPVEME)

A

Fibrous pericardium
Parietal layer of serous pericardium
Pericardial space (fluid)
Visceral layer of serous pericardium
Epicardium
Myocardium
Endocardium

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13
Q

Coronary arteries start and end where?

A

Superficial to deep structures of heart, blockage results in ischemia occurring from inside —> out

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14
Q

How does HTN effect heart?

A

Increases size of myocardium (LV?)

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15
Q

SA node and function?

A

Sinoatrial node - pacemaker of heart - sends electrical impulse through atria

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16
Q

AV node and function?

A

Atrioventricular node - sends pulse through ventricles, can takeover for SA node in the case of failure - speeds up HR if so

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17
Q

Strong HR is reflected how in EKG?

A

Larger P, larger QRS

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18
Q

What does the P wave represent?

A

Atrium where atrial depolarization occurs

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19
Q

QRS wave?

A

Ventricle depolarization, atrial repolarization

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20
Q

T wave?

A

Ventricle repolarization

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21
Q

PR interval?

A

Atria - time it takes for signal to travel from SA to AV

22
Q

ST segment?

A

Ventricles
Elevated = MI
Depressed =. Angina

23
Q

Atrial fibrillation would be seen where in EKG?

A

P wave or PR interval

24
Q

Ischemia vs infarction?

A

Ischemia = blood flow to tissue has decreased and correspondingly, O2 supply is decreased (hypoxia)

Infarction = blood supply completely cut off resulting in necrosis

25
Signs and symptoms of angina
Pressure behind breast bone Pain may radiate to neck, jaw, back, shoulder, arms Toothache Burning indigestion Dyspnea Nausea Belching ST segment depression
26
Treatment for angina (5)
Diet Exercise (routine decreases CAD by 25%) Meds Angioplasty CABG
27
What is angina?
Chest pain often spreading to shoulders, arms, neck due to inadequate blood supply to the heart
28
Different types of angina?
Stable angina -most common. When the heart is working very hard Unstable angina - most dangerous. Doesn’t follow a pattern and can happen w/o physical exertion Variant angina - rare. Happens when you’re resting
29
What is CK MB?
Serum enzyme that is released into the blood and can tell docs that the person has ad an MI within past 24 hrs
30
CK MM?
Released from skeletal muscle and is an indicator of rhabdomyolysis
31
L v R sided heart failure
Left - caused by MI, fluid backs up into lungs, can be identified w/ S3 heart sounds (heart murmur, swish, etc.) Right - caused by L sided heart failure, dependent edema 5-10lbs of extra fluid into legs) JVD
32
Signs and symptoms of valvular disease
Easy fatigue Dyspnea Palpitations Chest pain Pitting edema Orthopnea (breathlessness) Dizziness and fainting
33
Function of lymphatic system
Returns excess interstitial fluid back to the cardiovascular system Filters and destroys foreign material, initiate immune response Absorbs lipids from GI tract
34
Structures of lymphatic system
Lymphatic vessels Lymphoid tissue Lymphatic nodules Tonsils Lymph nodes Spleen Thymus gland Red bone marrow
35
Types of collagen
Type 1 - skin bone tendon ligament builds tensile force when stretched Type 2- cartilage surface resists shear forces, deep resists compression Type 3- pliable tissues like skin, blood vessels, uterus, Gi tract Type 4- all epithelial cells except liver tensile strength to underlying structure - basement membrane Type 7- anchoring filaments of lymph vessels
36
Roles of osmotic pressure and hydrostatic pressure in lymphatic system
Proteins pushed from arterial circulation to interstitial fluid increase OSMOTIC pressure in interstitial fluid - slows return of fluids to blood and lymph capillaries Increased fluid in interstitial spaces increases HYDROSTATIC pressure - pushes fluid into lymphatic vessels
37
Lymphokinetic motion and pressure gradient
HIGH pressure — blood capillaries, interstitial fluid, lymph capillaries, lymph veins, lymph ducts, large circulatory veins (LOW pressure)
38
Population and Hodgkin’s lymphoma vs Non-Hodgkins
HL - ages 15-40 and over 55 NHL - older than 60 Both types affect males slightly more than females People w HIV are 10-20x more likely to develop NHL NHL more common than HL
39
Multiple myeloma
Unknown cause Increased production of plasma cells in bone marrow (mature B lymphocytes) Abnormal antibodies Multiple tumors -loss of bone in vertebrae, ribs, pelvis, skull -severe bone pain -spontaneous fractures -hypercalcemia from bone breakdown -tumors spread through body - lymph nodes, multiple organs
40
Lymphadema - how does it occur?
Inability of extra cellular fluid to be Re absorbed by impaired lymphatic system -blockage due to congenital malformation - damage to lymph vessels to nodes, secondary Lymphatic accumulation leads to peripheral edema Abnormal lymph system
41
Functions of integumentary system (4)
Temperature regulation Protection Elasticity UV light protection
42
Layers of skin
Epidermis -basal layer: stratum germinativum (constantly dividing) -spinous layer: stratum spinous -granular layer: stratum granulosum -stratum Corneum: dust in the wind - dead keratinocytes Dermis - blood vessels, nerve fibers, connective tissue, fibroblasts - hair follicle -sebaceous glands - sebum, oil lubricates skin -apocrine gland - axillary, genital, anal - eccrine glands - thermoregulation by perspiration
43
Cells in epidermis
Keratinocytes - epithelial cells found in all layers of the epidermis, produce keratin Melanocytes - forms melanin and found in the basal layer. Protects against sunburn, determines skin color Langerhans cells - tissue macrophages that aid in immune response
44
Hypodexmis
Subcutaneous tissue - fat filled area that acts as insulator. Elderly lose this layer of fat. Function = energy storage and balance, trauma absorption
45
Arterial wounds - location and S&S
Ulcerations usually distal to medial malleolus, dorsum of foot or toes Dependent rubor Pallor on elevation Pain at night in LEs Ulcers have irregular edges, poor granular tissue with little bleeding Trophic changes - altered nail/hair growth and skin changes
46
Venous wound location and S&S
Located proximal to medial malleolus or lower leg Edema Hyperpigmented skin 2+ pulses Oozing wounds Edges of wounds are irregular in shape, shallow, and have a granulating base with rounded edges
47
Cellulitis v Eczema
Eczema = superficial inflammatory reaction caused by irritant exposure etc. Can be acute, subacute, or chronic Cellulitis - acute inflammation accompanied by infection. Lymph vessels may be affected/infected - antibiotics = primary treatment
48
Shingles what is it? Pathogenesis?
Damage of skin caused by same virus that causes varicella/chicken pox - occurs 50-70 yrs most commonly, can be recurring, Reactiviation of varicella virus lying dormant in spinal cord - aging, immunosuppression, varicella at young age
49
Pressure ulcers presentation? Location?
Occur over boney prominences Pressure, ischemia, necrosis
50
Causative factors of pressure ulcer
Pressure, decreased circulation Friction Shearing forceS Maceration Decreased skin resilience Malnutrition

Pathophys (8 decks)

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