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pathophysiology summer 2019 > Chapter 4: Cardiovascular Function > Flashcards

Chapter 4: Cardiovascular Function Flashcards

1
Q

Functions of the Cardiovascular System

A

vital oxygen and nutrients to cells, Removes waste products, and Transports hormones

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2
Q

Branches of the Cardiovascular System

A

Systemic, Pulmonary

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3
Q

Systemic

A

Carries blood throughout the body to meet the body’s needs and remove waste products

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4
Q

Pulmonary

A

Carries blood to and from the lungs for gas exchange

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5
Q

Pericardium

A

Surrounds the heart to provide protection and support

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6
Q

Myocardium

A

muscle portion of the organ

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7
Q

Endocardium

A

Inner structures, including the valves

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8
Q

Four Chambers

A

Two Atria, Two Ventricles

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9
Q

Atria

A

receiving chambers

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10
Q

Ventricles

A

pumping chambers

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11
Q

Blood from the systemic circulation enters from _____

A

superior vena cava and the inferior vena cava

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12
Q

Blood empties directly into the ______

A

right atrium

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13
Q

From the right atrium, blood travels through the ______ to the _____

A

tricuspid valve, right ventricle

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14
Q

right ventricle pumps blood through the _____ to the ______

A

pulmonic valve, pulmonary arteries

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15
Q

The pulmonary arteries carries blood to the _______ for gas exchange

A

lungs

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16
Q

Blood from the pulmonary circulation enters from the ______

A

pulmonary veins

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17
Q

Blood empties directly into the ______

A

left atrium

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18
Q

Blood leaves the left atrium through the ______ to the _____

A

mitral valve, left ventricle

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19
Q

The left ventricle then pumps blood through the ________ to the _____

A

aortic valve, aorta

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20
Q

Excitability

A

ability of the cells to respond to electrical impulses

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21
Q

Conductivity

A

ability cells to conduct electrical impulses

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22
Q

Automaticity

A

ability to generate an impulse to contract with no external nerve stimulus

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23
Q

Impulses originate in the____ high in the right atrium at a rate of _____

A

sinoatrial (SA) node, 60-100 bpm

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24
Q

Impulses then travels to the_____ in the right atrium adjacent to the septum

A

atrioventricular (AV) node

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25
Q

The AV node can initiate impulses if the SA node fails _____

A

40–60 bpm

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26
Q

Impulses then move rapidly through the ______, right and left ______, and _____, causing ventricular contraction

A

bundle of His, bundle branches, Purkinje network of fibers

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27
Q

Depolarization

A

Increase in electrical charge, Accomplished through cellular ion exchange, and Generates cardiac contraction

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28
Q

Repolarization

A

Cellular recovery, Ions returning to the cell membrane in preparation for depolarization

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29
Q

Sinus rhythm

A

Electrical activity when impulses originate in the SA node

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30
Q

Dysrhythmias

A

Abnormal electrical activity, Can result from issues such as myocardial infarction and electrolyte imbalances

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31
Q

Conduction Control

A

Electrolyte signals - Sodium, potassium, and calcium

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32
Q

Effects of conduction of control

A

Chronotropic, Inotropic

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33
Q

Chronotropic

A

rate of contraction

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34
Q

Inotropic

A

strength of contraction

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35
Q

Blood Pressure

A

Force that blood exerts on the walls of blood vessels

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36
Q

Systolic

A

top number; cardiac work phase

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37
Q

Diastolic

A

bottom number; cardiac rest phase

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38
Q

BP (Blood Pressure) =

A

Cardiac Output (CO) x Peripheral vascular resistance (PVR)

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39
Q

Cardiac output (CO)=

A

SV (Stroke volume) x HR (Heart rate)

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40
Q

Afterload

A

pressure needed to eject the blood (Blood viscosity, PVR)

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41
Q

Preload

A

amount of blood returning (Blood volume, Venous return)

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42
Q

Hormones

A 
Antidiuretic hormone (ADH)
Renin-angiotensin-aldosterone                                           system
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43
Q

Arteries

A

carry blood away

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44
Q

Veins

A

carry blood back

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45
Q

Capillaries

A

site of exchange

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46
Q

Three layers of blood vessels

A

Tunica intima – inner layer
Tunica media – middle muscular layer
Tunica adventitia – outer elastic layer

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47
Q

Lymphatic System

A

return excess interstitial fluid (lymph)

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48
Q

Conditions that Affect the Heart

A

Alterations resulting in Decreased Cardiac Output, Alterations resulting in Altered Tissue Perfusion, Alterations resulting in both- Hypertension, Shock

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49
Q

Cardiac Output

A 
Pericarditis
Infective endocarditis
Myocarditis
Valvular disorders
Cardiomyopathy
Electrical Alterations
Heart Failure
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50
Q

Tissue Perfusion

A 
Aneurysm
Dyslipidemia
Atherosclerosis
Peripheral vascular disease
Coronary artery disease
Thrombi and emboli
Lymphedema
Myocardial Infarction
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51
Q

Pericarditis

A

Inflammation of the pericardium

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52
Q

pericardial effusion.

A

Inflammatory process, fluid shifts from the capillaries to the space between the sac and the heart

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53
Q

cardiac tamponade

A

the fluid accumulates in the pericardial cavity to the point that it compresses the heart.

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54
Q

decreased cardiac output

A

when the compression prevents the heart from stretching and filling during diastole

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55
Q

Loss of elasticity

A

the pericardium becomes thick and fibrous from the chronic inflammation and adheres to the heart.

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56
Q

Pericarditis Manifestations

A

Pericardial friction rub (grating sound heard when breath is held), Sharp, sudden, severe chest pain that increases with deep inspiration and decreases when sitting up and leaning forward, Dyspnea, Tachycardia, Edema, Flulike symptoms

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57
Q

Infective Endocarditis

A

An infection of the endocardium (inner layers of the heart) or heart valves.

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58
Q

Infective Endocarditis caused by _____ and _______

A

Streptococcus, Staphylococcus

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59
Q

Pathogenesis

A

Endothelial damage ->Attracts platelets->Thrombus

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60
Q

Risk factors of Infective Endocarditis

A

intravenous drug use, valvular disorders, prosthetic heart valves, rheumatic heart disease, coarctation of the aorta, congenital heart defects, and Marfan syndrome

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61
Q

Manifestations of Infective Endocarditis

A

flulike symptoms, embolization, heart murmur, conjunctival petechiae, splinter hemorrhages under the nails, hematuria, and Osler’s nodes

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62
Q

Myocarditis

A

Inflammation of the myocardium

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63
Q

Complications of Myocarditis

A

heart failure, cardiomyopathy, dysrhythmias, and thrombus formation

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64
Q

Manifestations of Myocarditis

A

May be asymptomatic, flulike symptoms, dyspnea, dysrhythmias, palpitations, tachycardia, heart murmurs, chest discomfort, and cardiac enlargement

65
Q

Valvular Disorders

A

Disrupt blood flow through the heart

66
Q

Stenosis

A

narrowing

67
Q

Regurgitation

A

insufficient closure

68
Q

Causes of Valvular Disorders

A

congenital defects, infective endocarditis, rheumatic fever, myocardial infarction, cardiomyopathy, and heart failure

69
Q

Manifestations of Valvular Disorders

A

Vary depending on valve involved, Reflect alteration in blood flow through the heart

70
Q

Cardiomyopathy

A

Conditions that weaken and enlarge the myocardium

71
Q

Cardiomyopathy Classified into three groups

A

Dilated cardiomyopathy

Hypertrophic, cardiomyopathy, Restrictive cardiomyopathy

72
Q

Dilated Cardiomyopathy

A

Most common type – affects systolic function

73
Q

Causes of Dilated Cardiomyopathy

A

Mostly idiopathic. Other causes: chemotherapy, alcoholism, cocaine abuse, pregnancy, infections, thyrotoxicosis, diabetes mellitus, neuromuscular diseases, hypertension, coronary artery disease, and hypersensitivity to medications

74
Q

Cardiomegaly /

ventricular dilation

A

->Damage to myocardium

muscle fibers-> Cardiac output and blood stagnation

75
Q

Manifestations of Dilated Cardiomyopathy

A

Appear as compensatory mechanisms fail, dyspnea, activity intolerance

76
Q

Hypertrophic Cardiomyopathy

A

Affects systolic and diastolic function.

77
Q

Causes of Hypertrophic Cardiomyopathy

A

sudden cardiac death in young people, especially young athletes

78
Q

Stiff ventricle wall

A

->Ventricular

filling -> Cardiac output -> Atrial and pulmonary pressures

79
Q

Manifestations of Hypertrophic Cardiomyopathy

A

dyspnea on exertion, fatigue, syncope, orthopnea, angina, activity intolerance, dysrhythmias, left ventricular failure, and myocardial infarction

80
Q

Restrictive Cardiomyopathy

A

Least common of the cardiomyopathies. Characterized by rigidity of the ventricles, leading to diastolic dysfunction.

81
Q

Causes of Restrictive Cardiomyopathy

A

amyloidosis, hemochromatosis, radiation exposure to the chest, connective tissue diseases, myocardial infarction, sarcoidosis, and cardiac neoplasms

82
Q

Manifestations of Restrictive Cardiomyopathy

A

Many cases are asymptomatic. include: fatigue, dyspnea, orthopnea, abnormal lung sounds, angina, hepatomegaly, jugular vein distension, ascites, murmurs, peripheral cyanosis, and pallor

83
Q

Electrical Alterations

A

Normal electric conduction - sinus rhythm

84
Q

Electrical Alterations Classified by origin

A

Supraventricular rhythms

Ventricular rhythms

85
Q

Manifestations of Electrical Alterations

A

palpitations, abnormal heart rate

86
Q

Congestive Heart Failure

A

Inadequate pumping, Compensatory mechanisms activated

87
Q

Types of Heart Failure

A

Systolic dysfunction, Diastolic dysfunction, Mixed dysfunction

88
Q

Systolic dysfunction

A

Decreased contractility

89
Q

Diastolic dysfunction

A

Decreased filling

90
Q

Mixed dysfunction

A

Decreased contractility, Decreased filling

91
Q

Left-sided failure

A

Blood backs up to the pulmonary circulation,

92
Q

Right-sided failure

A

Blood backs up to the systemic circulation

93
Q

Manifestations of Left-sided failure

A

pulmonary congestion, dyspnea, and activity intolerance

94
Q

Manifestations of Right-sided failure

A

edema and weight gain

95
Q

Heart Failure

A

May be acute or chronic, Appear as compensatory mechanisms fail

96
Q

Aneurysms

A

Weakening of the wall of an artery, Can rupture – exsanguination

97
Q

True aneurysms

A

affect all three vessel layers – (intima, media, adventitia)

98
Q

Saccular aneurysm

A

bulge on the side

99
Q

Fusiform aneurysm

A

occurs the entire circumference

100
Q

False aneurysm

A

does not affect all three layers of the vessel

101
Q

Dissecting aneurysms

A

occurs in the inner layers

102
Q

Dyslipidemia or Hyperlipidemia

A

High levels of lipids in the blood, Increases risk for many chronic diseases, Lipids come for dietary sources and liver production

103
Q

Dyslipidemia or Hyperlipidemia classified

A

based on density

104
Q

classifications of Dyslipidemia or Hyperlipidemia

A

Very-low density lipoproteins
Low density lipoproteins
High density lipoproteins

105
Q

Manifestations of Dyslipidemia or Hyperlipidemia

A

asymptomatic until it develops into other diseases

106
Q

Low density lipoproteins

A

AKA “bad” cholesterol

107
Q

High density lipoproteins

A

AKA “good” cholesterol

108
Q

Atherosclerosis

A

thickening and hardening of the arterial wall, Inflammatory process is triggered by a vessel wall injury, Leads to vessel obstruction, platelet aggregation, and vasoconstriction

109
Q

Peripheral Vascular Disease

A

Narrowing of the peripheral vessels

110
Q

Causes of Peripheral Vascular Disease

A

atherosclerosis, thrombus, inflammation, and vasospasms

111
Q

Thromboangiitis obliterans

A

an inflammatory condition of the arteries

112
Q

Raynaud’s disease

A

vasospasms of arteries, usually in the hands, because of sympathetic stimulation

113
Q

Coronary Artery Disease

A

Atherosclerotic changes of the coronary arteries

114
Q

Angina

A

intermittent chest pain resulting from myocardium ischemia

115
Q

Infarction

A

permanent necrotic damage to the myocardium

116
Q

Complications of Coronary Artery Disease

A

myocardial infarction, heart failure, dysrhythmias, and sudden death

117
Q

Manifestations of Coronary Artery Disease

A

angina, indigestion-like sensation, nausea, vomiting, clammy extremities, diaphoresis, and fatigue

118
Q

stable

A

goes away with demand reduction

119
Q

unstable

A

increased intensity or frequency, does not go away with demand reduction, or occurs at rest

120
Q

Thrombus

A

Stationary blood clot

121
Q

Emboli

A

traveling body

122
Q

Prevention of Thrombus

A

increasing mobility

123
Q

Varicose Veins

A

Engorged veins resulting from valve incompetency

124
Q

Risk factors of Varicose Veins

A

genetic predisposition, pregnancy, obesity, prolonged sitting or standing, alcohol abuse and liver disorders (esophageal varices), and constipation (hemorrhoids)

125
Q

Manifestations of Varicose Veins

A 
Irregular, purplish, bulging veins
Pedal edema
Fatigue
Aching in the legs
Shiny, pigmented, hairless skin on the legs and feet
Skin ulcer formation
126
Q

Lymphedema

A

Swelling due to a lymph obstruction

127
Q

Primary lymphedema

A

Rare, usually congenital

128
Q

Secondary lymphedema

A

Causes: surgery, radiation, cancer, infection, and injury

129
Q

Myocardial Infarction

A

Death of the myocardium, Coronary artery blood flow is blocked due to atherosclerosis, thrombus, or vasospasms, Risk factors are the same as those for atherosclerosis

130
Q

Manifestations of Myocardial Infarction

A

Some are asymptomatic – “Silent” MI, Includes: angina, fatigue, nausea, vomiting, shortness of breath, diaphoresis, indigestion, elevation in cardiac markers, electrocardiogram changes

131
Q

Complications of Myocardial Infarction

A

heart failure, dysrhythmias, cardiac shock, thrombosis, and death

132
Q

Treatment for Myocardial Infarction

A

Immediately: Morphine, Oxygen, Nitrate, Aspirin; may also administer thrombolytics

133
Q

Hypertension

A

Prolonged elevation in blood pressure, In hypertension, the heart is working harder than normal to pump the blood to all the parts of the body.

134
Q

Risk factors of Hypertension

A

advancing age, ethnicity, family history, being overweight or obese, physical inactive, tobacco use, high-sodium diet, low-potassium diet, high vitamin D intake, excessive alcohol intake, stress, and other chronic conditions

135
Q

Types of Hypertension

A

Primary, Secondary, Malignant HT

136
Q

Primary hypertension

A

Most common form, Develops gradually over time

137
Q

Secondary hypertension

A

Tends to be more sudden and severe

Causes: renal disease, adrenal gland tumors, certain congenital heart defects, certain medications, and illegal drugs

138
Q

Malignant hypertension

A

Intensified form

Does not respond well to treatment

139
Q

Manifestations of hypertension

A

“Silent killer”

Include: fatigue, headache, malaise, and dizziness

140
Q

Complications of hypertension

A

atherosclerosis, aneurysms, heart failure, stroke, hypertensive crisis, renal damage, vision loss, metabolic syndrome, memory problems

141
Q

Pregnancy-induced hypertension

A

Hypertension first seen in pregnancy

142
Q

Indicators of Pregnancy-induced hypertension

A

high blood pressure, proteinuria, and edema

143
Q

Risk factors of Pregnancy-induced hypertension

A

history of pregnancy-induced hypertension, renal disease, diabetes mellitus, multiple fetuses, and maternal age less than 20 years or greater than 40 years

144
Q

Complications of Pregnancy-induced hypertension

A

seizures, miscarriages, poor fetal development, and placental abruption

145
Q

Treatment of Pregnancy-induced hypertension

A

bed rest and magnesium sulfate

146
Q

Shock

A

Decreased blood volume or circulatory stagnation resulting in inadequate tissue and organ perfusion

147
Q

Stages of shock

A

Compensatory, Progressive, Irreversible

148
Q

Compensatory

A

Sympathetic nervous system and renin-angiotensin-aldosterone system are activated

149
Q

Progressive

A

Compensatory mechanisms fail

Tissues become hypoxic, cells switch to anaerobic metabolism, lactic acid builds up, and metabolic acidosis develops

150
Q

Irreversible

A

Organ damage occurs

151
Q

Distributive shock

A

results from excessive vasodilation and the impaired distribution of blood flow.

152
Q

Neurogenic shock

A

Loss of vascular sympathetic tone and autonomic function lead to massive vasodilatation

153
Q

Septic shock

A

Bacterial endotoxins activate an immune reaction

154
Q

Anaphylactic shock

A

Excessive allergic reaction

155
Q

Cardiogenic shock

A

Left ventricle cannot maintain adequate cardiac output

156
Q

Hypovolemic shock

A

Venous return reduces because of external blood volume losses

157
Q

Complications of shock

A

acute respiratory distress syndrome, renal failure, disseminated intravascular coagulation, cerebral hypoxia, and death

158
Q

Manifestations of shock

A

Varies depending on type, Include: thirst, tachycardia, restlessness, irritability, tachypnea progressing to Cheyne-Stokes respiration, cool and pale skin, hypotension, cyanosis, and decreasing urinary output

pathophysiology summer 2019 (8 decks)

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