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Pathophysiology > CVD > Flashcards

CVD Flashcards

1
Q

Enclosed in the pericardial sac is the…

A

pericardium and pericardial cavity (contains fluid)

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2
Q

Layers of the heart..

A

Epicardium
Myocardium
Endocardium

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3
Q

Atrioventricular valves are made up of what 2 valves?

A

tricuspid and mitral (bicuspid)

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4
Q

Semilunar valves are made up of what two valves?

A

aortic and pulmonary

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5
Q

Does cardiac muscle regenerate?

A

no

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6
Q

Autorhythmicity

A

impulses to start contraction initiated within the cardiac muscle

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7
Q

Which wall is thicker?

A

left

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8
Q

During systole what happens?

A

blood is forced up the aorta by the ventricles contracting and pulmonary artery and blood is delivered to body tissues

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9
Q

During diastole what happens?

A

ventricles relax and atria contract so blood is forced into ventricles

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10
Q

Systemic circulation is …. has ….pressure and …..heart propels blood through the entire body.

A

larger
higher
left

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11
Q

Pulmonary system is …. has …. pressure, and ….heart propels blood through lungs.

A

smaller
lower
right

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12
Q

Left heart output=

A

right heart output

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13
Q

Coronary circulation is part of the….circulation. It originates from the beginning of the …. and accounts for …% of total blood flow.

A

systemic
aorta
5

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14
Q

Major coronary arteries? Located where? and suitable for what?

A

R. and L
heart surface
bypasses

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15
Q

Prolonged contractions of the coronary circulation can reduce blood supply to cardiac muscle cells because…

A

BV are constricted longer

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16
Q

Coronary blood flow is greater in….

A

diastole

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17
Q

Collateral circulation in the heart is….source of blood. ….. from healthy arteries extend to the area supplied by obstructed artery.

A

an alternative

capillaries

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18
Q

Anastomose

A

direct connection between small branches

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19
Q

Layers of the vessel walls

A 
tunica intima
tunica media
tunica adventitia (externa)
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20
Q

Tunica intima

A

endothelial cell lining

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21
Q

Tunica media

A

smooth muscle cells

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22
Q

Tunica adventitia

A

outer connective tissue

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23
Q

Effects of smoking on CV system:
increases ……–>increases heart workload
increases …. adhesion–> increases thrombus formation
produced CO displaces …. in Hb–> reduction in O2 supply.

A

vasoconstriction
platelet
O2

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24
Q

Example of a vasodilator? What does it do?

A

nitroglycerin
blood flow increases
reduces BP and may cause dizziness

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25
Q

Beta blockers do what? They prevent ….. in rate/force of contractions in damaged heart.
They treat… and …. and reduce ….attacks.

A 
block beta adrenergic receptors 
prevent SNS stimulation of the heart. 
increases
HBP and dysrhythmias
angina
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26
Q

Calcium channel blockers ….cardiac contractility. They also act as … and …. for smooth muscle cells.

A

decrease

vasodilators and are antihypertensive

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27
Q

Digoxin is a….. (from plants). It ….conduction of impulses and HR. Contractions are …. frequent but stronger. This drug is a treatment for … and …

A

cardiac glycoside
slows
less
heart failure and atrial dsyrhthmias

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28
Q

Two antihypertensive drugs are

A

ACE inhibitors

Angiotensin II receptor blockers

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29
Q

What treats HBP and heart failure with congestion by removing excess Na and/or water?

A

diuretics

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30
Q

Sclerosis

A

abnormal hardening of body tissue

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31
Q

Arteriosclerosis

A

general term for all types of degenerative arterial changes

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32
Q

Atherosclerosis

A

presence of atheroma (or atherosclerotic plaque)

occurs in large arteries

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33
Q

Atherosclerosis=

A

arteriosclerosis with atheromas

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34
Q

Arteriosclerosis occurs in people over ….y/o and in those with…
Usually degenerative changes in ….arteries and ….

A

50
diabetes
small
arterioles

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35
Q

Plaques in atherosclerosis can consist of ….and be related to…

A

lipids, cells, cell debris, fibrin clots

diet, exercise and stress

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36
Q

Lipids are synthesized in the….

A

liver

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37
Q

Cholesterol is the building blocks for …. components, …., vitamin…. , ….acids.

A

membrane
hormones
D
Bile

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38
Q

Triglycerides store…

A

energy

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39
Q

Lipids are transported in combo with proteins aka ….

These are… and …

A

lipoproteins
LDL
HDL

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40
Q

LDL is transported from … to cells.
They are a major factor contributing to ….formation.
They bind to a ….

A

liver
atheroma
cell surface receptor

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41
Q

HDL transports cholesterol … from peripheral cells to ….
Catabolism takes place in…

A

away
liver
liver

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42
Q

Atherosclerosis can be from …. of lipids in the wall; ….inflammation; … and…infiltration; …. formation; … of vessel wall.

A 
deposition 
vascular 
leukocyte and macrophage 
plaque 
thickening
43
Q

Atherosclerosis leads to

A

stenosis

44
Q

Early in the atherosclerotic disease process, endothelial cells that line the coronary arteries become dysfunctional in that they stop ….. and forms….

A

producing vasodilators

blood clots

45
Q

In a diagnostic test for atherosclerosis one can see levels of …. which indicates presence of inflammation.

A

C-reactive protein

46
Q

What are two other tests for atherosclerosis?

A

exercise stress test

nuclear medicine

47
Q

Nuclear medicine as a diagnostic for atherosclerosis includes…

A

determining tissue perfusion levels

presence of collateral circulation

48
Q

What are some medical interventions for atherosclerosis?

A

anti-lipidemic drugs like statins

surgical intervention like angioplasty or coronary artery bypass graft

49
Q

Angina pectoris is ….

A

partial block of blood flow to myocardium and a temporary cardiac ischemia

50
Q

MI is …

A

blood flow blocked for a long time and prolonged ischemia which leads to tissue necrosis

51
Q

When does angina pectoris occur?

A

when oxygen is impaired and the heart has to work harder than usual

52
Q

How an MI develops: thrombus or obstruction of artery–> ….
….may form from thrombus and lodge in smaller vessels blocking them.
…..may occur leading to complete occlusion.

A

partial occlusion
embolus
vasospasm

53
Q

Most MIs are transmural meaning

A

involve all three layers

54
Q

Majority of MIs involve the ….
…occurs and replaces cardiomyocytes beginning at day 7
….is formed 6-8 weeks.
….and/or …. if present may reduce infarct size.

A

LV
fibrosis
scar
collateral circulation and/or anastomoses

55
Q

Cardiomyocyte damage leads to ….

A

release of proteins

56
Q

Blood tests for MI include

A

troponins
creatine kinase
lactate dehydrogenase
aspartate aminotransferase

57
Q

Troponin testing is the most …..for MI.

Troponin should ….substantially within 4-6 hours; it peaks at 10-24 hours. Can be detected for up to …-…days.

A

specific test
increase
10-14 days

58
Q

CK increases about …hrs after MI. It peaks in ….hours and returns to normal in …-….hours.

A

6
18
24-36

59
Q

What is heart failure?

A

when the heart is unable to pump out sufficient blood to meet metabolic demands of the body.

60
Q

What are some causes of HF?

A

usually a complication of another cardiopulmonary condition or a combo of factors:
infarction, valve defect, HBP, lung disease

61
Q

In HF, often …. side fails first depending on the cause.
MI of LV —-> ….failure–> ….HF
Pulmonary disease —> ….failure —>….HF

A 
one 
LV 
left sided 
RV
right sided
62
Q

In HF, initially, ….. mechanisms maintain cardiac output causing ….

A

compensation

cardiac hypertrophy

63
Q

What two things tend to happen when heart cannot maintain pumping capability?

A

forward effect

backup congestion

64
Q

What is the forward effect?

There is ….cell function in peripheral organs. Mild acidosis develops because of …. and it is compensated by ….

A 
less blood reaches various organs
stroke volume or cardiac output decreases 
decreased 
lactic acid buildup
increase in respiration
65
Q

What is backup congestion?

A

behind the affected ventricle

output of ventricle is less than the inflow of blood so blood accumulates in circulation

66
Q

SV and CO definitions

A

SV- volume of blood pumped with each heartbeat

CO- volume of blood ejected by a ventricle in one minute.

67
Q

When left heart output is less than right what sided HF occurs?
Where does blood accumulate and lead to?

A

left
pulmonary circulation
pulmonary congestion or pulmonary edema

68
Q

When right heart output is less than left heart output what occurs?
Where does blood accumulate? and it leads to?

A

right
systemic circulation
peripheral edema

69
Q

Forward effects for HF

A 
decreased blood supply 
fatigue 
weakness 
dyspnea
exercise intolerance
cold intolerance 
dizziness
70
Q

Compensation mechanisms for HF

A

tachycardia
cutaneous and visceral vasoconstriction
daytime oliguria

71
Q

Backup effects of left-sided failure

A 
pulmonary congestion
cough
dyspnea
orthopnea
paroxysmal nocturnal dyspnea
72
Q

What consists of pulmonary congestion?

A

fluid entering alveoli

73
Q

What is dyspnea?
Orthopnea?
Paroxysmal nocturnal dyspnea?

A

shortness of breath
difficulty breathing when lying down
sudden awakening due to dyspnea while sleeping

74
Q

Back up effects of right-sided failure?

A 
increased BV in systemic circulation
edema 
distention in jugular veins
cerebral edema
hepatomegaly, splenomegaly, digestive disturbances due to edema
ascites
75
Q

Ascites

A

fluid accumulation in peritoneal cavity

76
Q

HBP caused by arteriosclerosis and stenosis may lead to …. often damaging …, …, ….

A

ischemia

kidneys, brain, eyes

77
Q

Increase in arterial vasoconstriction leads to ….

Kidney will produce …. (which normally converts angiotensinogen to angiotensin I) so further vasoconstriction occurs.

A

decreased blood flow to kidney

renin

78
Q

Primary hypertension is also called…. its …. and 95% of all cases. This is where both … and … are high. It may be due to …. stimulation. It is more likely due to excessive …. level so …. work well. It may also be behavioral from, …, …, ….

A 
essential
idiopathic
systolic and diastolic
sympathetic
angiotensin II 
ACE inhibitors 
salt, smoking, obesity
79
Q

Secondary hypertension is also called ….hypertension. It is caused by ….like …. or ….. It is most commonly linked to diabetes.

A

inessential
another medical condition
renal disease
endocrine disorder (Adrenal tumor leading to hyper aldosteronism)

80
Q

Malignant hypertension is also called. It is a subset of ….hypertension. Extremely high BP (…/…) that develops rapidly causes ….
Specifically it can cause …. and …..

A 
resistant 
primary
180/120
some type of organ damage 
encephalopathy (abnormal brain function)
profound cerebral edema
81
Q

Aortic aneurysm is … and …. of aortic wall. It develops from a defect in the ….
Most common sites are on … or ….
different types:

A 
localized dilation and weakening of aortic wall 
medial layer (tunica media)
abdominal or thoracic 
fusiform 
saccular 
dissecting
82
Q

Fusiform aneurysm

A

circumferential dilation along a section of artery

83
Q

Saccular aneurysm

A

bulging wall on one side

84
Q

Dissecting aneurysm

A

develops when there is a tear in the intima of the wall and blood continues to dissect or separate tissues.

85
Q

Causes of aortic aneurysms

A 
atherosclerosis
trauma
syphilis and other infections
congenital defects 
hypertensions
86
Q

Aortic aneurysms are frequently … until they become large or rupture.

A

asymptomatic

87
Q

Rheumatic fever usually occurs in children aged ….-…
Develops a few weeks after an untreated …. usually….
It is a ….inflammatory condition.
It affects … tissue.
May result from ……
Involves … causes …

A 
5-15
infection
A beta-hemolytic Streptococcus
acute systemic 
connective 
abnormal immune reaction 
heart
rheumatic heart disease
88
Q

Rheumatic heart disease is … of the heart. It results in three types:

A

inflammation of the heart
endocarditis
myocarditis
pericarditis

89
Q

Endocarditis is the …. problem of rheumatic heart disease. It affects the …. which disrupts blood flow and effectiveness of LV. Heart valves may scar causing …. and leads to …..

A

most common
heart valves
stenosis
rheumatic heart disease

90
Q

Myocarditis is inflammation in …. called ….bodies which interfere with conductance contributing to ….

A

localized leasions
aschoff
arrhythmias

91
Q

Pericarditis causes…. which impairs filling.

A

effusion (excessive liquid accumulation in pericardium)

92
Q

Rheumatic fever can cause inflammation in what other sites?

A

large joints in legs
skin (nonpruritic rush)
basal nuclei in brain (involuntary jerky movements of face, arms and legs)
non-tender subcutaneous nodules

93
Q

Signs and symptoms of rheumatic fever/heart disease

A 
presence of inflammation 
low-grade fever
leukocytosis
malaise
fatigue
tachycardia
94
Q

Diagnostic tests of rheumatic fever and heart disease

A

anti-streptolysin O titer

heart function tests

95
Q

Treatment of rheumatic fever and heart disease

A

prophylactic antibacterial agents
anti-inflammatory agents
drugs for arrhythmia and heart failure
surgical repair or replacement of the damaged heart valve

96
Q

Mechanism of infective endocarditis

A

microorganism attaches to endocardium–> it invades heart valves –> causes inflammation –> damages heart valves

97
Q

Two forms of endocarditis

A

acute and subacute

98
Q

Acute endocarditis

A

normal heart vales are infected by highly virulent organism (staph aureus)

99
Q

Subacute endocarditis

A

defective heart valves are infected by normal flora (strepto viridans in mouth)

100
Q

Factors that can predispose infection in endocarditis

A

presence of abnormal valves in heart
bacteremia (bacteria in blood)
reduced host defenses

101
Q

Treatments for endocarditis

A

antimicrobial drugs for several weeks via IV
blood culture to find the cause
medication to support heart function

102
Q

Pericarditis is usually ….to other conditions. Acute pericarditis lasts….
It is a …..of the pericardium. ….may develop which may compress the heart causing …. and impair expansion and filling which …. cardiac output.

A 
secondary 
a few days
simple inflammation 
effusion
cardiac tamponade 
decreases
103
Q

Chronic pericarditis may last … it results in the formation of …. between pericardial membranes which leads to….
Fibrous tissues often result from … or …to the mediastinum. It…. movement of the heart during diastole and systole which …. cardiac output. … or …. may develop from adjacent structures. Causes …, …, ….

A 
a few months
adhesions 
fibrous tissues 
TB 
radiation 
limits 
decreases 
inflammation or infection 
fatigue, weakness, abdominal discomfort
104
Q

How is pericarditis treated?

A

Primary problem must be treated
fluid may be aspirated and analyzed to determine cause
if effusion is severe, immediate aspiration is needed to prevent tamponade and shock

Pathophysiology (20 decks)

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