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Pathophysiology and Pharmacology 2 > Week 1 > Flashcards

Week 1 Flashcards

1
Q

Name the four layers of the heart from outer to inner

A

Pericardium (external)
Epicardium
Myocardium (thickest)
Endocardium (innermost)

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2
Q

What is the pathway of blood flow through the heart?

A 
Superior/inferior vena cava
Right atrium 
(through the tricuspid valve) Right ventricle
Pulmonary artery
Lungs
Pulmonary Vein
Left Atrium 
(through the mitral valve) Left ventricle
Aorta
Body
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3
Q

What layer is the Pericardium?

A

Outermost (external) layer of the heart

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4
Q

What layer is the Endocardium?

A

Innermost (internal) layer of the heart

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5
Q

Which layer of the heart is the thickest?

A

Myocardium

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6
Q

Describe the conduction pathway of the heart

A

Sinoatrial Node (SA) [Atrial Contraction]
Atrioventricular Node (AV) [Ventricular Contraction]
AV Bundle
Right and Left Bundle Branches
Purkinje Fibres

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7
Q

What are some causes of the disorders of the heart?

A 
Congenital 
Degenerative - e.g. artery becomes less elastic
Structural (walls/valves)
Trauma
Abnormal Electrical Conduction
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8
Q

Describe Endocarditis

A
  • Inflammation of the inside lining of the heart chambers/valves
  • Bacterial and fungal infection is the most common source of endocarditis and can cause vegetation to heart valves
  • Can be caused by tooth abscesses, infected piercings, IDC’s = sepsis
  • Risk factors: injection drug use, permanent CVA lines, prior valve surgery, recent dental surgery
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9
Q

Describe Pericarditis

A
  • Inflammation of the sac-like covering around the heart
  • Caused by bacterial, fungal or viral infections - may also be a result of injury or trauma to the chest, oesphagus or heart
  • Pain caused by pericardium rubbing up against the parietal layer - an effusion may occur
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10
Q

Is inflammation good?

A

Inflammation is good on a localised level but is more dangerous when diffused

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11
Q

Briefly describe Coronary Heart Disease

A

Damage or disease in the heart’s major blood vessels

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12
Q

What are some non-modifiable risk factors of coronary heart disease?

A
  • Age (males >45) (females >55)
  • Family history
  • Gender (male)
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13
Q

What are some modifiable risk factors of coronary heart disease?

A
  • Hypertension
  • Smoking
  • Physical Inactivity
  • Obesity
  • Poorly managed diabetes
  • Stress behaviour pattern
  • Salt intake
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14
Q

Briefly describe Arteriosclerosis.

A

Abnormal thickening and hardening of blood vessels

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15
Q

What is a form of Arteriosclerosis? Describe it

A

Atherosclerosis

Formation of fibro fatty lesions (plaque) in the intimae of medium and large arteries which narrows the blood passage

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16
Q

What is the name for turbulent blood flow around plaque calling thrombi formation?

A

Stenosis

17
Q

Describe hypertension

A
  • Consistent elevation of systemic arterial blood pressure

- Increase individual’s risk of coronary heart disease, heart failure and/or stroke

18
Q

What are the 3 stages of Hypertension?

A

Grade 1 - Systolic 140-159, Diastolic 90-99
Grade 2 - Systolic 159-179, Diastolic 99-109
Grade 3 - Systolic 180+, Diastolic 110+

19
Q

Describe postural hypotension

A
  • Decreased BP when standing - lack of normal BP compensation in response to sudden gravitational changes on the circulation
  • Caused by blood pooling in the lower extremities upon a change in body position
20
Q

Describe Angina Pectoris

A

A clinical syndrome of myocardial ischaemia (poor blood flow to cardiac muscle cells) ranging between stable angina and myocardial infarction

21
Q

Describe the difference between stable and unstable angina

A

Stable angina is myocardial ischaemia that occurs on exertion (exercise or a build up of stress)
Unstable angina is myocardial ischaemia that occurs even at rest/minimal exertion

22
Q

Describe Myocardial Infarction

A
  • One or several arteries becomes blocked by either a clot or plaque
  • Myocardium that is supplied by the blocked artery is starved of blood
  • Myocardium is damaged or dies
  • Dying cells release chemical markers
23
Q

What chemical markers are released during a myocardial infarction?

A

Troponin T
Myoglobin Levels
Creatine Kinase
Natriuretic Peptides

24
Q

Describe the difference between STEMIs and Non-STEMIs

A

STEMI

  • Worse type - long interruption to the blood supply to the myocardium
  • Total blockage of coronary artery
  • ST segment on ECG will show elevation

Non-Stemi

  • Less serious
  • Only a smaller part of the heart may be damaged - still a serious medical emergency
  • No changes to ECG
  • Serum cardiac markers
25
Q

What are the signs and symptoms of a MI?

A
  • Chest pain (>20 min) - severe, crushing [like heart burn]
  • Referred pain in left arm/jaw
  • Breathless
  • Cyanosis
  • Tachycardia
  • Hypotensive
  • Anxiety/restlessness
  • Pallor/cold/clammy
  • Nausea/vomiting/weakness
26
Q

What is the treatment used for myocardial infarction?

A 
MONA (ONAM)
Morphine 
Oxygen
Nitrates
Aspirin
27
Q

Explain Morphine (in terms of an MI)

A

Blocks pain receptors in the brain - drops blood pressure and respiratory rate

28
Q

Explain Oxygen (in terms of an MI)

A
  • Increased flow, non-rebreather - lie flat to increase oxygen supply to the brain
  • Only administer oxygen therapy if SpO2 <94% and titrate down
29
Q

Explain Nitrates (in terms of an MI)

A
  • Glyceryl trinitrate (GTN) dilate blood vessels (vasodilation)
  • Preparations - oral tablets, buccal spray/tablet, IV, transdermal patch
  • Causes flushing, headaches, hypotension, palpitations
30
Q

Explain Aspirin (in terms of an MI)

A
  • Anti-platelet - prevents further clotting at the blockage site
31
Q

What are the nursing interventions for an AMI?

A
  • O2 therapy
  • Analgesia
  • ECG monitoring
  • IV access
  • Assistance with ADLs
  • Blood tests
  • Rest
  • Reassurance
32
Q

Describe Arrhythmias

A
  • Meaning ‘without cardiac rhythm’
  • Can change in severity from occasionally ‘missed’ or rapid beats to serious disturbances that impair pumping ability of the heart and may result in heart failure or death
33
Q

How do inotropic drugs affect the heart?

A

Work on the contractibility of the heart muscle

34
Q

How do conotropic drugs affect the heart?

A

Works on the heart rate

Pathophysiology and Pharmacology 2 (12 decks)

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