week 8 part 1

Question 1

Venous Disorders

Answer 1

irregular dilated tortuous area to superficial or deep veins
most common on legs

Question 2

venous disorder treatment and risk factors

Answer 2

risk factors; increased body mass index, pregnancy, weight lifting, family history
treatment
- keep leg elevated, support stockings
- surgically
-intermittent voluntary contractions when sitting for longer periods

Question 3

thrombophlebitis

Answer 3

development in vein where inflammation is oresent

Question 4

phlebothrombosis

Answer 4

thrombus forms spontaneously without prior inflammation ; attached loosely

Question 5

factors for thrombus development

Answer 5

• status of blood or sluggish blood flow
  -endothelial injury
  increased blood coagulation

Question 6

Venous Thrombosis – Signs/Symptoms

Answer 6

• aching, burning, or tenderness in the affected area
• warmth, redness
  -edema as blood pools distal to obstruction

Question 7

Venous Thrombosis –Treatment

Answer 7

prevention
- compression stocking
- exercise to improve muscle tone, reduce stasis
pharmaceutical
surgical intervention

Question 8

hypertension

Answer 8

• Sustained daytime BP > 135 mmHg systolic and/or > 85 mmHg diastolic
• Sometimes isolated as systolic or diastolic

Question 9

hypertension risk factors

Answer 9

-Age
- Family History
- Type 2 Diabetes Mellitus
- High salt intake, salt sensitivity
- Excess alcohol, smoking, stress, physical inactivity
-

Question 10

Effects of Uncontrolled Hypertension

Answer 10

Endothelial cell injury
 Atherosclerosis
Cardiac consequences:
* Coronary Artery Disease, Angina, MI
* Left Ventricular Hypertrophy (due to higher
afterload)
* Heart Failure
Organ damage (kidneys, brain, eyes)

Question 11

afterload

Answer 11

resistance left ventricle must overcome to circulate blood
increases in hypertension and vasoconstriction

Question 12

preload

Answer 12

volume of blood in the ventricle at the end of diastole
increased in hypervolemia regurgitation of cardiac valve

Question 13

Mean Arterial Pressure =

Answer 13

Cardiac Output x Peripheral Resistance

Question 14

possible cause of hypertension

Answer 14

Elevation in blood volume (due to kidney defect in Na+ handling)
* Increased systemic vascular resistance (Peripheral Resistance)

Question 15

hypertension treatment

Answer 15

Pharmaceuticals –Vasodilators, Diuretics, Cardioinhibitory Drugs
Diet
-”DASH” diet (Dietary Approaches to Stop Hypertension)
- Reduce Na+ intake
- Reduce caffeine intake (positive inotrope)
- Achieve and maintain healthy dietary balance
Lifestyle
- Increase PA levels
- Achieve and maintain a healthy body weight
- Smoking cessation
- Decrease alcohol intake
- Decrease stress

Question 16

Acute Hypotension (Shock)

Answer 16

Inadequate tissue perfusion Tissue Hypoxia, Cellular Damage

Question 17

Acute Hypotension (Shock) signs and symptoms

Answer 17

• Tachycardia
• Decreased urine output
• Altered mental status

Question 18

Main classifications of shock:

Answer 18

• Hypovolemic
• Cardiogenic
• Anaphylactic
• Septic
• Neurogenic

Question 19

Hypovolemic

Answer 19

• Hemorrhagic & non-hemorrhagic (diarrhea, vomiting)
• Decreased blood volume  Decreased venous return  Decreased CO

Question 20

Cardiogenic

Answer 20

Problem with heart function  Decreased ability for heart to pump  CO
* E.g. heart failure, arrhythmia, MI, Valvular Dysfunction
* Compensation: Baroreceptor reflex  vasoconstriction  increased Systemic
vascular resistance
* Blood flow is redirected to vital organs

Question 21

‘Warm’ Shock: Distributive

Answer 21

Decreased systemic vascular resistance due to peripheral vasodilation
Compensation: increased heart rate
* Anaphylactic Shock: the most extreme reaction to an allergen
* Mast cells release histamine & bradykinin  ++vasodilation, edema, bronchoconstriction
* Treatment: IM Epinephrine  increased CO, smooth muscle relaxation (airways), vasoconstriction
* Septic Shock e.g. due to an infection in the bloodstream
* Macrophage activation  Cytokine release ++ vasodilation
* Treatment: IV fluids & antibiotics

Question 22

Neurogenic Shock

Answer 22

• loss of sympathetic tome
  autonomic balance tips toward parasympathetic nervous system - vasodilation

Question 23

Neurogenic Shock cause

Answer 23

• Spinal Cord Injury
• Traumatic Brain Injury
• Vasovagal reflex
• Overreaction of the vagus nerve (parasympathetic)
• An abnormal response to pain, fear, emotion,
  sight of blood, etc

Question 24

Orthostatic Hypotension

Answer 24

• Sudden, sustained drop in blood pressure caused by standing up from a sitting/lying position* SBP decreased by at least 20mmHg or DBP decreased by at least 10mmHg for the first 3 minutes in upright position

Question 25

Causes of orthostatic hypotension

Answer 25

• Impaired baroreceptor reflex function, hypovolemia
• Most commonly due to medication (anti-hypertensives, diuretics, vasodilators, others)
• Increased risk in older adults

Question 26

signs and symptoms of orthostatic hypotension

Answer 26

• Pallor, vertigo, blurred vision, nausea, tachycardia

Question 27

treatment of orthostatic hypotension

Answer 27

• Water intake, salt intake, compression stockings, sleep in a slightly inclined position
• Leg resistance exercise