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Physiology > Cardiac Lecture #3 > Flashcards

Cardiac Lecture #3 Flashcards

(73 cards)

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1
Q

major side effect from all valvular abnormalities on the left side

A

pulmonary edema

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2
Q

normal pressure of the left atrium

A

5

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3
Q

normal left ventricular diastolic pressure

A

5

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4
Q

what happens during mitral stenosis

A
  • narrowing of the mitral valve

- cannot get blood from atria to ventricle

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5
Q

in mitral stenosis, the aortic pressure is increased or decreased

A

decreased

-no blood to pump out

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6
Q

in mitral stenosis, the left atrial pressure is increased or decreased

A

increased

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7
Q

in mitral stenosis, is pre-load increased or decreased

A

decreased pre-load

-less stretch in left ventricle

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8
Q

in mitral stenosis, is cardiac output/ stroke volume increased or decreased

A

decreased

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9
Q

valve disease where blood backs left atrium from the left ventricle

A

mitral valve regurgitation

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10
Q

what happens during mitral valve regurgitation

A
  • valve is prolapsed
  • blood goes back into left atrium
  • left atrium expands
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11
Q

in mitral valve regurgitation, is left ventricular systolic pressure increased or decreased

A

decreased

-blood has 2 places to go

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12
Q

in mitral valve regurgitation, is there an increase/decrease in preload/ afterload

A

increase in pre-load

-more blood backs up into left atrium, more blood for diastolic filling

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13
Q

in mitral valve regurgitation, is the diastolic pressure increased or decreased

A

increased

-more blood in diastole increases pressure

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14
Q

in mitral valve regurgitation, will aortic pressure increase or decrease

A

decrease

  • less blood being pumped out through aorta
  • decreased CO
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15
Q

what happens during aortic stenosis

A

narrowing of the aorta

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16
Q

in aortic stenosis there is an increase/ decrease in afterload/ preload

A

increase in afterload

-increased pressure the left ventricle has to pump against

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17
Q

in aortic stenosis, cardiac output is increased/ decreases

A

decreased

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18
Q

severe side effect of aortic stenosis

A

hypertrophy

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19
Q

in aortic stenosis is BP increased or decreased

A

decreased

-low CO and stroke volume because blood cannot get through

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20
Q

in aortic stenosis is the left ventricular pressure increased or decreased

A

increased due to increased afterload

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21
Q

in aortic stenosis is left ventricular diastolic pressure increased or decreased

A

increased because more blood left in ventricle during diastole

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22
Q

what happens in aortic regurgitation

A

blood flows back from the aorta into the left ventricle

-chamber dilation

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23
Q

in aortic regurgitation, is there an increase/ decrease in afterload/preload

A

increase in pre-load

-increased stretching of the left ventricle due to increase in back flow of blood

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24
Q

in aortic regurgitation, is SV increased or decreased

A

increased

-more preload = bigger ST= bigger contraction

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25
in aortic regurgitation, will systolic pressure in the aorta and ventricle be increased or decreased
increased | -pre-load increases pulse pressure
26
in aortic regurgitation will aortic diastolic pressure be increased or decreased
decreased
27
in aortic regurgitation, is ventricular diastolic pressure increased or decreased
increased
28
when is mitral valve regurgitation heard
ventricular systole
29
when is mitral valve stenosis heard
ventricular diastole- end
30
when is aortic stenosis heard
ventricular systole
31
when is aortic regurgitation heard
ventricular diastole
32
heart condition that results in a dilated ventricle and weak thin walls
dilated cardiomyopathy
33
3 problems with dilated cardiomyopathy
1. weakened enlarged portion of the heart 2. Low ejection fraction 3. increased systolic and diastolic volumes - increase in ANP and BNP
34
heart condition that results in increase in size of heart muscle
pathological cardiac hypertrophy
35
another name for pathological cardiac hypertrophy
heart failure with preserved ejection fraction (diastolic HF) -stroke volume is low but chamber volume is also low
36
what is the cause of pathological cardiac hypertrophy
increased afterload; aortic stenosis
37
5 problems with pathological cardiac hypertrophy
1. small chamber size due to inward growth of muscle 2. concentric hypertrophy 3. release of ANP and BNP released due to increased stretch of ventricle and want to decrease BP 4. decreased SV 5. arrythmias from slow relaxation
38
after an MI, what content does the damaged cardiac myocyte release into the blood FIRST
myoglobin
39
after an MI, what content does the damaged cardiac myocyte leak into the blood LAST
LDH
40
conduction where blood gets trapped between the endothelium and the blood vessel
coronary artery dissection
41
3. problems with coronary artery dissection
1. blood trapping 2. hematoma can get so big that it occludes blood flow 3. clotting
42
systolic heart failure is also known as
Heart failure with reduced ejection fraction | -SV is low but chamber volume is high
43
2 changes in cardiac myocytes in heart failure
1. release of ANP and BNP due to chamber stretching | 2. lower contractility (cardiac myocytes become weaker)
44
what is the primary cause arrythmias in heart failure
change in shape of the ventricle
45
2 things the body does to compensate for MILD heart failure
because CO decreases 1. increase sympathetics to increase HR by baroreceptor 2. increase RAAS system to increase blood pressure
46
what is the optimal blood pressure in those with hypertension
130/80
47
why is blood pressure high in someone with HF?
1. hypertension caused the problem in the first place 2. decreased CO 3. activates the sympathetic NS and RAAS system to increase HR and BP
48
what is the main goal of treatment for heart failure
decrease sympathetics decrease the RAAS system decrease afterload and decrease BP
49
medications used in patients with HFpEF
1. control systolic and diastolic BP 2. diuretics 3. beta blockers 4. ACE inhibitors 5. ARBS 6. aldosterone receptor antagonist
50
treatments for HFrEF
same as HFpEJ 2. ARNI 3. use diuretics as needed with congestive heart failure
51
what is the last effort in HF to prevent shock
inotropic agents
52
mechanism of digitalis/ digoxin
inotropic agent inhibits Na+/K+ pump, Increases Ca++ concentration -slows conduction in the AVnode -too high can lead to arrhythmias
53
mechanism of dobutamine
- mainly used for LEFT side heart failure - can induce vasodilation - incraese heart rate and arrythmias
54
mechanism of milrinone
-mainly used for RIGHT side heart failure -phosphodiesterase inhibitor- Increases cAMP -vasodilation- increases K+ in smooth muscle increases HR and arrythmias
55
mechanism of levosimendan
- increases suceptibility of Ca++ to Troponin C - opens K+ channels- vasodilation - does NOT increase HR
56
what are 2 types of hypovolemic shock?
1. hemorrage | 2. vomiting/ diahrrea
57
what is a type of cariogenic shock
decrease in cardiac pumping ability
58
what 2 types of vasogenic shock
1. septic shock from toxins | 2. anaphylactic shock- massive immune response
59
what is a type of sympathetic shock
decreased sympathetic motor activity
60
3 reasons for cardiogenic shock
1. MI 2. arryhthmias 3. cardiomyopathy
61
side effects of cardiogenic shock
1. reduced CO 2. weak heart 3. pulmonary edema
62
3 reasons for hypovolemic shock
1. low blood volume 2. decreased venous return 3. decreased cardiac output
63
what are some compensatory mechanisms of hypovolemic shock
1. increase in sympathetic nervous system 2. baroreceptor reflex 3. vasoconstriction 4. induce RAAS system
64
causes of septic shock
1. rupture of GI system 2. UTI 3. skin or staph infections 4. pulmonary infections
65
3 big problems with septic shock
1. system wide blood clots-release of clotting factors 2. massive systemic vasodilation-release of nitric oxide by monocytes 3. increase capillary permeability leading to edema
66
treatment for septic shock
Angiotension II to treat hypotension | antibiotics
67
problems of anaphylactic shock
1. MABP decreases 2. antigen-antibody reaction 3. release of histamines by mast cells 4. vasodilation 5. increased capillary permeability= edema
68
treatment for anaphylactic shock
norepinephrine will induce vasoconstriction and bronchodilation
69
problems with neurogenic shock
1. loss of vasomotor tone; vasodilation 2. lose pressure; reduced venous return to the heart 3. sympathetics are blocked; reduced NE
70
causes of neurogenic shock
1. deep general anesthesia depresses the vasomotor center 2. spinal anesthesia- block sympathetic outflow 3. spinal cord damage 4. brain damage from concussion
71
treatment of neurogenic shock
maintain sympathetic nervous system
72
which types of shock reduce cardiac output
1. cardiogenic shock | 2. hypovolemic shock
73
which types of shock cause vasodilation
1. anaphylactic shock 2. neurogenic shock 3. septic shock

Physiology (6 decks)

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