Hemodynamics

Question 1

Cardiogenic shock results from _____ and/or to generate an adequate blood pressure to perfuse distal tissues.

Answer 1

failure of the heart to pump an adequate amount of blood

Question 2

Infarcts are areas of tissue death (necrosis) caused by _____.

Answer 2

ischemia

Question 2

A red infarct includes a _____, a _____, and ____ tissue that permits movement of blood from adjacent areas into the necrotic area.

Answer 2

venous occlusion; a dual blood supply; loose

Question 3

Heart failure, fluid overload, venous obstruction or compression, or arteriolar dilation can all cause ____.

Answer 3

increased hydrostatic pressure

Question 4

______ in the arterial system most commonly occurs due to endothelial injury and turbulent blood flow, often associated with atherosclerosis.

Answer 4

Thrombosis

Question 5

Thrombosis in the arterial system most commonly occurs due to ______ and _____, often associated with atherosclerosis.

Answer 5

endothelial injury; turbulent blood flow

Question 5

What can cause abnormal blood flow?

Answer 5

stasis (a-fib, bed rest), turbulence (atherosclerosis)

Question 6

Hydrostatic pressure “pushes” fluid from the capillary into the interstitial space on the _____.

Answer 6

arterial end

Question 6

What is an active increase in blood flow due to arteriolar dilation called?

Answer 6

hyperemia

Question 6

What is a thromboemboli?

Answer 6

an emboli that was a thrombus or part of one

Question 6

____ often presents clinically with anemia, respiratory insufficiency, convulsions, acute renal failure, and shock.

Answer 6

DIC

Question 7

______ most commonly occur in the coronary, cerebral, and femoral arteries.

Answer 7

Arterial thrombi

Question 8

Patients with hypovolemic and cardiogenic shock typically present with ____, _____, and _____.

Answer 8

coolness and pallor of their skin, tachycardia, and decreased urine output

Question 9

Where do transudates typically occur?

Answer 9

in intact vessel walls under increased pressure

Question 9

As the thrombus propagates, additional layers of platelets, red cells and fibrin added to the thrombus become less stable and are prone to fragmentation, forming _______.

Answer 9

thromboemboli

Question 10

Hypovolemic shock occurs when _____, and the cardiac output decreases because there is low blood return to the heart.

Answer 10

there is not enough blood volume to widely perfuse all tissues

Question 10

_____ occurs when there is not enough blood volume to widely perfuse all tissues, and the cardiac output decreases because there is low blood return to the heart.

Answer 10

Hypovolemic shock

Question 11

What happens when a clot lodges in the brain?

Answer 11

stroke

Question 11

Shock occurs when the circulating blood volume or blood pressure is ____.

Answer 11

not adequate to perfuse body tissues

Question 12

____ occurs when the circulating blood volume or blood pressure is not adequate to perfuse body tissues.

Answer 12

Shock

Question 14

Name 2 ways fluid inappropriately accumulates in the tissues.

Answer 14

1) damage to capillary walls 2) inadequate lymphatic drainage

Question 14

_____ typically initially presents with warm, flushed skin and fever.

Answer 14

Septic shock

Question 15

What is DIC?

Answer 15

hemorrhage and thrombosis occurring simultaneously and systemically

Question 15

The _____ can be caused by any underlying condition that results in release of procoagulants.

Answer 15

systemic activation of thrombin

Question 16

Fluid movement into the body cavity is called \_\_\_\_.

Answer 16

effusion

Question 18

Damage to capillary walls or inadequate lymphatic drainage can cause \_\_\_\_\_.

Answer 18

fluid to inappropriately accumulate

Question 19

Emboli in the _____ most commonly lodge in the lungs.

Answer 19

venous/right sided system

Question 19

\_\_\_\_\_ results from failure of the heart to pump an adequate amount of blood and/or to generate an adequate blood pressure to perfuse distal tissues.

Answer 19

Cardiogenic shock

Question 19

\_\_\_\_\_ is a subtype of shock due to systemic inflammation (SIRS), occurring when microbial infections cause high levels of inflammatory mediators in the blood leading to widespread arterial vasodilation, vascular leakage, and venous blood pooling.

Answer 19

Septic shock

Question 21

What can cause fluid overload?

Answer 21

infusions or renal failure

Question 23

What is hyperemia?

Answer 23

an active increase in blood flow due to arteriolar dilation

Question 23

What happens when a clot lodges in the kidney?

Answer 23

acute kidney injury

Question 24

Emboli in the venous/right sided system most commonly lodge in the \_\_\_\_.

Answer 24

lungs

Question 26

Fluid is “pulled” back into the capillary on the venous end to balance \_\_\_\_\_\_.

Answer 26

the protein concentration

Question 27

Amniotic fluid emboli are highly correlated to \_\_\_\_.

Answer 27

DIC

Question 28

Septic shock is a subtype of shock due to \_\_\_\_\_, occurring when microbial infections cause high levels of inflammatory mediators in the blood leading to widespread arterial vasodilation, vascular leakage, and venous blood pooling.

Answer 28

systemic inflammation (SIRS)

Question 29

What happens when a clot lodges in the lungs?

Answer 29

respiratory insufficiency, chest pain

Question 30

\_\_\_\_\_ are due to an arterial blockage of a single blood supply in a dense tissue that limits accumulation of blood in the necrotic areas.

Answer 30

White infarcts

Question 32

What 2 things cause increased osmotic pressure?

Answer 32

1) protein loss 2) low protein production

Question 33

Bleeding typically dominates in _____ of DIC, and thrombosis dominates with _____ DIC.

Answer 33

acute onset; chronic

Question 34

DIC often presents clinically with \_\_\_\_, \_\_\_\_, \_\_\_\_, \_\_\_\_\_, and \_\_\_\_\_.

Answer 34

anemia; respiratory insufficiency; convulsions; acute renal failure; shock

Question 35

When would low protein production occur?

Answer 35

in liver disease or malnutrition

Question 36

A _____ can form after an arterial occlusion if blood flow is subsequently reestablished and damaged vessels allow movement of blood into the necrotic area

Answer 36

red infarct

Question 38

What is congestion?

Answer 38

a pathologic accumulation of blood due impaired outflow of venous blood

Question 39

\_\_\_\_\_ “pushes” fluid from the capillary into the interstitial space on the arterial end.

Answer 39

Hydrostatic pressure

Question 39

White infarcts are due to an _____ blockage of a ____ in a ____ tissue that limits accumulation of blood in the necrotic areas.

Answer 39

arterial; single blood supply; dense

Question 40

\_\_\_\_\_\_ typically dominates in acute onset of DIC, and ____ dominates with chronic DIC.

Answer 40

Bleeding; thrombosis

Question 42

Protein loss or low protein production can cause \_\_\_\_.

Answer 42

increased osmotic pressure

Question 42

What is the purpose of hyperemia?

Answer 42

to bring oxygenated blood into the tissues b/c of inflammation or exercise demand

Question 43

Fluid movement into the adjacent tissues is called \_\_\_\_.

Answer 43

edema

Question 44

Infarcts can be classified as red (\_\_\_\_) or white (\_\_\_\_).

Answer 44

hemorrhagic; anemic

Question 46

What is edema?

Answer 46

fluid movement into the adjacent fluid

Question 48

Emboli in the arterial/left sided system can affect any organ, but most commonly travel to the \_\_\_\_.

Answer 48

legs or brain

Question 50

What can cause protein loss occur?

Answer 50

the kidneys or GI tract

Question 51

Where is thrombosis more likely to occur and why?

Answer 51

in the venous system b/c of slower blood flow

Question 51

Infarcts can be classified as ____ (hemorrhagic) or \_\_\_\_(anemic).

Answer 51

red; white

Question 52

A ____ includes venous occlusion, a dual blood supply, and loose tissue that permits movement of blood from adjacent areas into the necrotic area.

Answer 52

red infarct

Question 53

\_\_\_\_\_ are areas of tissue death (necrosis) caused by ischemia.

Answer 53

Infarcts

Question 54

Arterial thrombi most commonly occur in the \_\_\_\_\_, \_\_\_\_\_, and _____ arteries.

Answer 54

coronary; cerebral; femoral

Question 55

As the thrombus propagates, additional layers of \_\_\_\_\_, \_\_\_\_\_, and _____ added to the thrombus become less stable and are prone to fragmentation, forming thromboemboli.

Answer 55

platelets; RBCs; fibrin

Question 56

Septic shock typically initially presents with \_\_\_\_\_.

Answer 56

warm, flushed skin and fever

Question 58

What is an embolus?

Answer 58

A free floating, intravascular mass of a solid, liquid or gas

Question 59

Patients with ______ typically present with coolness and pallor of their skin, tachycardia, and decreased urine output.

Answer 59

hypovolemic and cardiogenic shock

Question 61

What does hyperemic tissue look like and why?

Answer 61

red (erythemic) b/c of increased oxygenated blood

Question 63

What can cause endothelial injury?

Answer 63

hypercholesterolemia, inflammation

Question 64

What happens when a clot lodges in the joints?

Answer 64

the Bends

Question 65

Emboli in the _____ can affect any organ, but most commonly travel to the legs or brain.

Answer 65

arterial/left sided system

Question 67

Name things that can be emboli.

Answer 67

fat, atherosclerotic debris, gas bubbles, bone marrow, tumor fragments, amniotic fluid, or foreign material

Question 68

What happens when a clot lodges in the GI tract?

Answer 68

pain and bleeding

Question 70

What happens when a clot lodges in the legs?

Answer 70

swelling, necrosis

Question 71

Name 4 causes of increased hydrostatic pressure.

Answer 71

1) heart failure 2) fluid overload 3) venous obstruction or compression 4) arteriolar dilation

Question 72

What is a pathologic accumulation of blood due impaired outflow of venous blood called?

Answer 72

congestion

Question 73

Where do exudates typically occur?

Answer 73

damaged vessels due to inflammation and WBCs

Question 74

What is the Virchow triad?

Answer 74

3 basic factors that promote thrombosis: endothelial injury, abnormal blood flow, and hypercoagulability

Question 75

What happens when a clot lodges in the heart?

Answer 75

myocardial ischemia

Question 76

Thrombosis in the ______ most commonly occurs due to endothelial injury and turbulent blood flow, often associated with atherosclerosis.

Answer 76

arterial system

Question 77

Fluid is “pulled” back into the capillary on the _____ to balance the protein concentration.

Answer 77

venous end

Question 78

Septic shock is a subtype of shock due to systemic inflammation (SIRS), occurring when microbial infections cause high levels of inflammatory mediators in the blood leading to \_\_\_\_, \_\_\_\_, and \_\_\_\_.

Answer 78

widespread arterial vasodilation, vascular leakage, and venous blood pooling

Question 79

What can cause hypercoagulation?

Answer 79

inherited disorders (factor V Leiden), acquired disorders (disseminated cancer)

Question 80

How does congested tissue look and why?

Answer 80

red-blue b/c of accumulated deoxygenated blood

Question 81

Name 3 causes of lymphatic obstruction.

Answer 81

1) inflammation, infection 2) neoplasms 3) post surgery or irradiation

Question 82

What is effusion?

Answer 82

fluid movement into the body cavity

Question 83

The systemic activation of thrombin can be caused by any underlying condition that results in \_\_\_\_\_.

Answer 83

release of procoagulants

Question 84

Inflammation, infection, neoplasms, post surgery, or irradiation can all cause \_\_\_\_.

Answer 84

lymphatic obstruction