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Patho 2024 > Cardio and lymph lecture > Flashcards

Cardio and lymph lecture Flashcards

1
Q

Coronary arteries carry O 2 blood to the

A

myocardium

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2
Q

When Coronary arteries become narrow or blocked, the areas of the myocardium supplied by that artery do not receive enough Oxygen this can lead to

A

ischemia and injury
can lead to infarction
aaaand that can lead to disorders like….
Ischemic heart disease (IHD)
Coronary heart disease (CHD)
Coronary artery disease (CAD)

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3
Q

Disorders of the myocardium as a result of insufficient blood supply are collectively
known as

A

Ischemic heart disease (IHD)
Coronary heart disease (CHD)
Coronary artery disease (CAD)

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4
Q

One of the most important risk factors in both coronary heart disease and
cerebrovascular accidents

A

HYPERTENSION (HTN)

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5
Q

HYPERTENSION (HTN) can lead to

A

Cardiac hypertrophy
Heart failure
Aortic dissection
Renal failure

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6
Q

Marks Note: Systolic Pressure

A

System Engage pressure - pressure exerted when the heart contracts

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7
Q

Marks Note: diastolic pressure

A

Disengage pressure (pressure when the heart is relaxed between beats)

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8
Q

Blood pressure is the force exerted against the

A

arterial walls

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9
Q

Systolic

A

pressure exerted when the heart contracts

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10
Q

Diastolic

A

pressure when the heart is relaxed between beats

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11
Q

If kidney fails, the heart will

A

not do well :(

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12
Q

The silent Killer

A

HTN

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13
Q

HTN, Occurs when the relationship between ______ and ______ is
altered

A

blood volume, peripheral resistance

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14
Q

Primary (essential) HTN

A

cause unknown

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15
Q

Secondary HTN

A

cause known
Renal
Endocrine
ETOH abuse
Drug induced
Pregnancy induced
Acute stress

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16
Q

Primary HTN (cause unknow) accounts for what percentage of HTN?

A

90-95% maybe thats why its primary

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17
Q

Primary HTN - Modifiable vs non modifiable

A

Modifiable - can do something about it
* High sodium intake
* Obesity
* DM
* Hypercholesterolemia
Non modifiable - Can’t do anything about it
* Family history
* Age (> 55)
* Gender
* Male (<55)
* Female (>55)
* Ethnicity

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18
Q

Cardiac output is the _______ of blood

A

ejection

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19
Q

Ejection of blood can be a a product of what characteristics of heart

A

rhythm, rate, strength of heart

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20
Q

Peripheral resistance can be due to what things?

A

diameter of vessels, thickness of blood or viscosity of blood

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21
Q

BP = CO x

A

PR
Blood pressure = cardiac output x peripheral resistance

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22
Q

T/F, hyperthyroidism can cause an increase in cardiac output which would increase BP

A

T

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23
Q

an increase in Pereipheral resistance can increase

A

blood pressure

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24
Q

HTN Pathogenesis

A

-Blood flow (CO)
-Peripheral resistance (vessel diameter, blood viscosity)

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25
Increased peripheral resistance as a result of the narrowing of the _______ is the single most common characteristic
arterioles
26
T/F Increased peripheral resistance as a result of the narrowing of the Veins is the single most common characteristic
FALSE Increased peripheral resistance as a result of the narrowing of the ARTERIOLES is the single most common characteristic
27
Peripheral resistance can be regulated by
-Autonomic regulation Norepinephrine is released in response to stress Epinephrine is secreted → increased cardiac contraction, increased cardiac output, vasoconstriction -Renin-angiotensin system Vasoconstriction causes decrease blood flow to the kidneys Renin is secreted and angiotensin is formed Causes vasoconstriction within the renal system – increases peripheral resistance Angiotensin stimulates aldosterone production Promotes sodium and water retention in the kidney causing intravascular volume
28
Renin-angiotensin system
Vasoconstriction causes decrease blood flow to the kidneys Renin is secreted and angiotensin is formed Causes vasoconstriction within the renal system – increases peripheral resistance Angiotensin stimulates aldosterone production Promotes sodium and water retention in the kidney causing intravascular volume
29
arteriosclerosis
Arteriole becomes less distensible Greater resistance to blood flow Accelerates degenerative changes in the walls of arteries
30
T/F, Prolonged hypertension leads to elastic tissue within the arterioles being replaced with fibrous collagen tissue
True
31
T/F, Prolonged hypertension leads to elastic tissue within the arterioles being replaced with awesome 100% repaired collagen tissue
F, Fibrous T/F, Prolonged hypertension leads to elastic tissue within the arterioles being replaced with FIBROUS collagen tissue
32
Narrowing or complete obstruction of the lumina
Progressively – atherosclerosis Completely – thrombus
33
Weakening of the walls can lead to
Dilation Rupture
34
in ARTERY: Lesions at the Tunica, can block the lumen, weakens the lumen, loss of elasticity
basically i believe, a blockage will weaken walls and lose elasticity
35
T/F, Arteriosclerosis is a broad term, atherosclerosis is a more specific term and will be used interchangeably
T
36
Arteriosclerosis / atherosclerosis basically means decreased _____ to parts of body
blood flow
37
ATHEROSCLEROSIS
Generic term for thickening and loss of elasticity of arterial walls Atherosclerosis is a specific type of arteriosclerosis, but the terms are sometimes used interchangeably Atherosclerosis refers to the buildup of fats, cholesterol and other substances in and on the artery walls which restricts blood flow
38
T/F Atherosclerosis is a specific type of arteriosclerosis, but the terms are sometimes used interchangeably
T
39
Atherosclerosis
Atherosclerosis refers to the buildup of fats, cholesterol and other substances in and on the artery walls which restricts blood flow
40
ATHEROSCLEROSIS Characterized by intimal lesions that protrude into and obstruct the vascular lumina
Weakens the underlying media Atherosclerosis = build up of stuff > lesion >protrude into lumina (space of the vessels)
41
ATHEROSCLEROSIS Primarily affects the elastic arteries, and large/medium muscular arteries and can lead to
Myocardial infarction Cerebral infarction Aortic aneurysms Peripheral vascular disease (gangrene of the LEs)
42
ATHEROSCLEROSIS happens by a
Intimal thickening and lipid accumulation giving rise to an atheroma Atherosclerotic plaque
43
ATHEROSCLEROTIC PLAQUE
Three principal components: -Smooth muscle cells, macrophages, and leukocytes -ECM with collagen, elastic fibers -Intra and extracellular lipids Foam cells – large lipid laden cells derived from monocytes Evidence of neovascularization The plaques continue to change and progressively enlarge through cell death, synthesis, and remodeling
44
ATHEROSCLEROTIC PLAQUE 3 principal components
-Smooth muscle cells, macrophages, and leukocytes -ECM with collagen, elastic fibers -Intra and extracellular lipids
45
ATHEROSCLEROSIS Pathogenesis
Chronic inflammatory response of the arterial wall initiated by injury to the endothelium Harmful substances in the blood or the result of high blood pressure
46
ATHEROSCLEROSIS Epidemiology
Genetic predisposition Hyperlipidemia (> 200mg/dL) LDL (BAD) (≥ 130 mg/dL) HDL (GOOD) (≤ 39 mg/dL) Triglycerides (> 150 mg/dL) HTN Cigarette smoking Diabetes
47
ISCHEMIC HEART DISEASE
Group of closely related syndromes caused by an imbalance between myocardial oxygen demand and blood supply Most common cause is a narrowing of the lumina of the coronary arteries Most often termed coronary artery disease (CAD) One of four syndromes may develop: Angina pectoris Acute myocardial infarction Sudden cardiac death Chronic ischemic heart disease with congestive heart failure
48
Angina pectoris has intermittent
chest pain
49
Atherosclerosis is a narrowing of the
lumina
50
ischemic heart disease may lead to one of four syndromes
Angina pectoris Acute myocardial infarction Sudden cardiac death Chronic ischemic heart disease with congestive heart failure
51
MYOCARDIAL INFARCTION (MI)
Development of myocardial necrosis caused by local ischemia Pathogenesis Coronary artery thrombus Atherosclerotic plaque serves as the source for the generation of the thrombus Location of the MI is determined by the site of vascular occlusion
52
Dead heart tissue = decrease in blood flow and a decrease in
oxygen for heart muscle
53
MI Morphology
LAD (40-50%) R coronary artery (30-40%) Left circumflex (15-20%)
54
MI of the LAD - left anterior descending artery
the WIDOW MAKER, this area pushes blood out to the entire body
55
The widow maker, where would this clot occur
this clot would be at the LAD Way for me to remember: the LAD died, and the widow was LEFT by herself and she was DOWN
56
MI PAIN PATTERNS
chest, neck, L shoulder, medial arm, right below chest, upper back Women can have very minor feelings that would actually be an MI Women can have unexplained anxiety - and like a feeling of DOOM coming
57
CONGESTIVE HEART FAILURE (CHF)
Multisystem derangement that occurs when the heart is no longer able to eject the blood delivered to it by the venous system Inadequate cardiac output accompanied by congestion of the venous circulation Failing ventricle unable to eject normal volume of venous blood delivered to it Increased blood in the ventricle at the end of diastole Increased end diastolic pressure Elevated venous pressure
58
CHF 4 types
Systolic – contractile failure of the myocardium Diastolic – increased pressures are required to maintain adequate cardiac output despite normal contractile function Heart failure with preserved ejection fraction Left side – left ventricle can no longer maintain normal cardiac output Right side – right ventricular dysfunction due to left sided failure or pulmonary disease (cor pulmonale)
59
EJECTION FRACTION
Amount, percentage, of blood that is pumped (or ejected) out of the ventricles with each contraction
60
if pt doesnt die from heat attack will probably in up with CHF, ejection of blood decreased, decrease in overall
cardiac output
61
CHF means a back up of the
venous system
62
EJECTION FRACTION percentages
Ejection Fraction (EF) 55% to 70% Pumping Ability of the Heart: Normal Ejection Fraction (EF) 40% to 54% Pumping Ability of the Heart: Slightly below normal Ejection Fraction (EF) 35% to 39% Pumping Ability of the Heart: Moderately below normal Ejection Fraction (EF) Less than 35% Pumping Ability of the Heart: Severely below normal
63
CHF is a positive feed back loop
LV Dysfunction causes, Decreased cardiac output > Decreased Blood Pressure and Decreased Renal perfusion > Stimulates the release of renin, Which allows conversion of Angiotensin to Angiotensin II. Angiotensin II stimulates Aldosterone secretion which causes retention of Na + and water, increasing filling pressure >> repeats
64
CHF is a positive feed back look and will continue because there heart is pumping out a decreased amount of cardiac output
This continues to make the system feel like something is wrong that it can just adjust buuuut the shit aint working right at the heart
65
CHF symptoms
Anxiety, confusion, nausea and vomiting, tachycardia, hypotension, decreased urine output, lower leg edema hypoxia, jugular venous distention, infarct, hepatosplenomegaly, weak pulse, cool moist skin, pale grey or cyanotic skin, dyspnea orthopenea crackles wheeze cough, ascites

Patho 2024 (1 decks)

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