Cardiovascular & pulmonary system disorders (ch 8) Flashcards
what is cardiac output?
amount of blood ejected from the heart per minute; dependent upon heart rate and stroke volume
what is stroke volume?
average amount of blood ejected per heart beat.
what is ejection fraction?
percentage of blood emptied from the ventricle during systole; a clinically useful measure of left ventricle function.
what do capillaries do?
connect arteries to veins. have thin, permeable walls.
what is hyperkalemia?
increased potassium ions, decreases the rate and force of heart contraction and produces EKG changes.
what is hypokalemia?
decreased potassium ions, produces EKG changes; arrhythmias, may progress to v-fib
what is hypercalcemia?
increased calcium concentration; increases heart rate.
what is hypocalcemia?
decreased calcium concentration; depresses heart action.
increased peripheral resistance….
increases arterial blood volume and pressure
decreased peripheral resistance….
decreases arterial blood volume and pressure
peripheral resistance is influenced by…
arterial blood volume: viscosity of blood and diameter of arterioles and capillaries.
definition of coronary artery disease (CAD)
atherosclerotic disease process that narrows the lumen of coronary arteries resulting in ischemia to the myocardium. Lipid-laden plaques affect moderate and large-size arteries; characterized by thickening of the intimal layer of the blood vessel wall from the focal accumulation of lipids, platelets, monocytes, plaque, and other debris.
what is angina?
chest pain due to poor blood flow through bv’s in heart. usually lasts less than 20 minutes due to transient ischemia.
angina is caused by…
imbalance in myocardial oxygen supply and demand; brought on by increased demands on heart (exercise, emotional upsets, smoking, extreme temps esp cold, overeating, tachyarrhythmias) and vasospasms.
Stable angina vs unstable angina vs variant angina?!
- Stable: classic exertional angina occurring during exercise or activity; relieved with rest and/or sublingual nitroglycerin.
- Unstable: coronary insufficiency at rest without any precipitating factors or exertion. increases risk for MI or death; pain is difficult to control.
- Variant: caused by vasospasm of coronary arteries in absence of occlusive disease. responds well to nitroglycerin or calcium channel blocker long term.
Myocardial infarction (MI)
prolonged ischemia, injury, and death of an area of they myocardium caused by occlusion of one or more coronary arteries; results in necrosis of heart tissue.
3 types of heart failure are…
- left-sided heart failure (CHF): blood not adequately pumped into system circulation.
- right heart failure: blood not adequately returned from systemic circulation to the heart.
- biventricular failure: severe LV pathology producing backup into the lungs, increased PA pressure, and RV signs of HF.
New York heart Association (NYHA) Functional Classification is the most commonly used system to assess the stage of heart failure. Relates symptoms to everyday activities and the patients QoL. Places patients into categories based on limitations during physical activity. Functional capacity is…
how a patient with cardiac disease feels during physical activity.
NYHA Functional Classification Class I
cardiac disease, but not limitation of physical activity. (no fatigue, dyspnea, or angina pain.)
NYHA Functional Classification Class II
cardiac disease resulting in slight limitation of physical activity. Comfortable at rest. Ordinary activity results in fatigue, palpitation, dyspnea, or angina.
NYHA Functional Classification Class III
cardiac disease resulting in marked limitation of physical activity. Comfortable at rest. Less than ordinary activity causes fatigue, palpitation, dyspnea, or angina.
NYHA Functional Classification Class IV
cardiac disease resulting in inability to carry on any physical activity without discomfort. Symptoms of heart failure or angina may be present even at rest. If any physical activity occurs, discomfort increases.
Occlusive peripheral arterial disease (PAD)
chronic, occlusive arterial disease of medium and large-sized vessel. Diminished blood supply to affected extremities with pulses decreased or absent. Early stages: intermittent claudication; burning/searing/aching/tight pain; pain with walking, relieved by rest. Late stages: rest pain, muscle atrophy, trophic changes (trophic= related to feeding/nutrition); affects primarily LE.
Associated with HTN and hyperlipidemia; patients may also have CAD, diabetes, cerebrovasuclar disease, metabolic syndrome, hx of smoking.
What is claudication?
pain during exercise caused by too little blood flow
Thromboangiitis obliterans (aka Buerger’s disease)
chronic inflammatory vascular occlusive disease of small arteries and veins. Most common in young male smokers. Begins distally and progresses proximally in both LE and UE. Symptoms: pain, paresthesias, cold extremities, diminished temp sensation, fatigue, risk of ulceration and gangrene.
inappropriate elevation of blood glucose levels and accelerated atherosclerosis; neuropathies a major problem; ulcers may lead to gangrene and amputation.
episodic spasm of small arteries and arterioles abnormal vasconstriction reflex exacerbated by exposure to cold or emotional stress; tips of fingers develop pallor, cyanosis, numbness, and tingling; affects mostly females.
distended, swollen superficial veins; tortuous in appearance; may lead to varicose ulcers.
Superficial vein throbophlebitis
clot formation and acute inflammation in a superficial vein; localized pain usually in saphenous vein
Deep vein thrombosis
inflammation of a vein in association with formation of a thrombus; usually occurs in LE. Associated with venous stasis (bed rest; lack of leg exercise), hyperactivity of blood coagulation, and vascular trauma; may be contributing factor to CVA.
Symptoms: progressive inflammation w/ tenderness to palpation; change in LE temperature/color/circumference/tenderness.
chronic venous insufficiency
chronic leg edema; skin pigmentation changes, scaly appearance, itchy.
chronic disorder with excessive accumulation of fluid due to obstruction of lymphatics; causes swelling of the soft tissues in arms/legs. Results from mechanical insufficiency of lymphatic system.
congenital condition with abnormal lymph node or lymph vessel formation (hypoplasia or hyperplasia).