week 8 part 1 Flashcards
Venous Disorders
irregular dilated tortuous area to superficial or deep veins
most common on legs
venous disorder treatment and risk factors
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
thrombophlebitis
development in vein where inflammation is oresent
phlebothrombosis
thrombus forms spontaneously without prior inflammation ; attached loosely
factors for thrombus development
- status of blood or sluggish blood flow
-endothelial injury
increased blood coagulation
Venous Thrombosis – Signs/Symptoms
- aching, burning, or tenderness in the affected area
- warmth, redness
-edema as blood pools distal to obstruction
Venous Thrombosis –Treatment
prevention
- compression stocking
- exercise to improve muscle tone, reduce stasis
pharmaceutical
surgical intervention
hypertension
- Sustained daytime BP > 135 mmHg systolic and/or > 85 mmHg diastolic
- Sometimes isolated as systolic or diastolic
hypertension risk factors
-Age
- Family History
- Type 2 Diabetes Mellitus
- High salt intake, salt sensitivity
- Excess alcohol, smoking, stress, physical inactivity
-
Effects of Uncontrolled Hypertension
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)
afterload
resistance left ventricle must overcome to circulate blood
increases in hypertension and vasoconstriction
preload
volume of blood in the ventricle at the end of diastole
increased in hypervolemia regurgitation of cardiac valve
Mean Arterial Pressure =
Cardiac Output x Peripheral Resistance
possible cause of hypertension
Elevation in blood volume (due to kidney defect in Na+ handling)
* Increased systemic vascular resistance (Peripheral Resistance)
hypertension treatment
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
Acute Hypotension (Shock)
Inadequate tissue perfusion Tissue Hypoxia, Cellular Damage
Acute Hypotension (Shock) signs and symptoms
- Tachycardia
- Decreased urine output
- Altered mental status
Main classifications of shock:
- Hypovolemic
- Cardiogenic
- Anaphylactic
- Septic
- Neurogenic
Hypovolemic
- Hemorrhagic & non-hemorrhagic (diarrhea, vomiting)
- Decreased blood volume Decreased venous return Decreased CO
Cardiogenic
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
‘Warm’ Shock: Distributive
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
Neurogenic Shock
- loss of sympathetic tome
autonomic balance tips toward parasympathetic nervous system - vasodilation
Neurogenic Shock cause
- 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
Orthostatic Hypotension
- 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
Causes of orthostatic hypotension
- Impaired baroreceptor reflex function, hypovolemia
- Most commonly due to medication (anti-hypertensives, diuretics, vasodilators, others)
- Increased risk in older adults
signs and symptoms of orthostatic hypotension
- Pallor, vertigo, blurred vision, nausea, tachycardia
treatment of orthostatic hypotension
- Water intake, salt intake, compression stockings, sleep in a slightly inclined position
- Leg resistance exercise
