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Pathophys > Vessels > Flashcards

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
Q

Signs and symptoms of angina

A

Pressure behind breast bone
Pain may radiate to neck, jaw, back, shoulder, arms
Toothache
Burning indigestion
Dyspnea
Nausea
Belching
ST segment depression

26
Q

Treatment for angina (5)

A

Diet
Exercise (routine decreases CAD by 25%)
Meds
Angioplasty
CABG

27
Q

What is angina?

A

Chest pain often spreading to shoulders, arms, neck due to inadequate blood supply to the heart

28
Q

Different types of angina?

A

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
Q

What is CK MB?

A

Serum enzyme that is released into the blood and can tell docs that the person has ad an MI within past 24 hrs

30
Q

CK MM?

A

Released from skeletal muscle and is an indicator of rhabdomyolysis

31
Q

L v R sided heart failure

A

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
Q

Signs and symptoms of valvular disease

A

Easy fatigue
Dyspnea
Palpitations
Chest pain
Pitting edema
Orthopnea (breathlessness)
Dizziness and fainting

33
Q

Function of lymphatic system

A

Returns excess interstitial fluid back to the cardiovascular system
Filters and destroys foreign material, initiate immune response
Absorbs lipids from GI tract

34
Q

Structures of lymphatic system

A

Lymphatic vessels
Lymphoid tissue
Lymphatic nodules
Tonsils
Lymph nodes
Spleen
Thymus gland
Red bone marrow

35
Q

Types of collagen

A

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
Q

Roles of osmotic pressure and hydrostatic pressure in lymphatic system

A

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
Q

Lymphokinetic motion and pressure gradient

A

HIGH pressure — blood capillaries, interstitial fluid, lymph capillaries, lymph veins, lymph ducts, large circulatory veins (LOW pressure)

38
Q

Population and Hodgkin’s lymphoma vs Non-Hodgkins

A

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
Q

Multiple myeloma

A

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
Q

Lymphadema - how does it occur?

A

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
Q

Functions of integumentary system (4)

A

Temperature regulation
Protection
Elasticity
UV light protection

42
Q

Layers of skin

A

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
Q

Cells in epidermis

A

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
Q

Hypodexmis

A

Subcutaneous tissue - fat filled area that acts as insulator. Elderly lose this layer of fat.

Function = energy storage and balance, trauma absorption

45
Q

Arterial wounds - location and S&S

A

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
Q

Venous wound location and S&S

A

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
Q

Cellulitis v Eczema

A

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
Q

Shingles what is it? Pathogenesis?

A

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
Q

Pressure ulcers presentation? Location?

A

Occur over boney prominences

Pressure, ischemia, necrosis

50
Q

Causative factors of pressure ulcer

A

Pressure, decreased circulation
Friction
Shearing forceS
Maceration
Decreased skin resilience
Malnutrition

Pathophys (8 decks)

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