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Pathology II > Chapter 10 Part 1 > Flashcards

Chapter 10 Part 1 Flashcards

0
Q

_________ is the number one cause of death in the U.S.

A

Heart disease

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1
Q

The heart pumps ______ ml or ______ gallons of blood per day

A

7,500 liters or 2,000 gallons

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2
Q

___________ is the most common mechanism of heart failure

A

-Contractile (pump failure)

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3
Q

Congestive heart failure

A
  • Venous “congestion”
  • Can be due to decreased CO *MC or increased tissue demands
  • 5 million Americans are affected
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4
Q

What can cause an increase in tissue demands, leading to congestive heart failure?

A
  • Severe anemia
  • Hyperparathyroidism
  • Fistula
  • “High output failure”
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5
Q

Most common cause of congestive heart failure

A

Decreased cardiac output

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6
Q

Causes of decreased cardiac output

A
  1. Systolic Dysfunction: weak contraction
  2. Diastolic Dysfunction: failure of relaxation/filling
  3. Valvular Dysfunction: Stenosis/endocarditis
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7
Q

Risks factors for systolic dysfunction

A
  • Systemic hypertension
  • Decreased pH
  • CAD
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8
Q

Diastolic dysfunction can lead to:

A
  • Myocardial fibrosis
  • Amyloidosis
  • Left-sided hypertrophy
  • Pericardial tamponade
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9
Q

Two forms of heart failure

A
  1. Forward failure
  2. Backward failure
    * Forward failure is almost always combined with backward failure
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10
Q

Forward failure is due to ____________, whereas backward failure is due to __________

A
  • Forward failure (right): insufficient output

- Backward failure (left): venous congestion

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11
Q

Frank-Starling Mechanism

A
  • Myocardial adaptation
  • “Compensated heart failure”
  • Increased ventricular stretch=stronger contraction
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12
Q

Cost and benefit of the Frank-Starling mechanism

A
  • Benefit: Increased output

- Cost: Increased O2, increased tension

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13
Q

Neurohumoral mechanisms

A
  • Norepinephrine (NE)

- Atrial Natriuretic Peptide (ANP)

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14
Q

What does Norepinephrine do?

A
  • Increase HR
  • Increase contractility
  • Increase BP (R-A-A system)
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15
Q

What does Atrial Natriuretic Peptide do?

A
  • Balances NE

- Vasodilation

16
Q

Myocardial adaptations:

A
  1. Frank-Starling Mechanism
  2. Neurohumoral Mechanisms
  3. Cardiac Hypertrophy
17
Q

T/F: Ventricular hypertrophy can be physiological or pathological

A
  • True, physiological = an athlete’s heart

- Increased chamber size and wall thickness are all proportional

18
Q

Causes of left sided heart failure:

A
  • CAD
  • Hypertension
  • Valve disorders (mitral & aortic)
19
Q

T/F: left ventricular failure involves left ventricular hypertrophy and possible dilation of the left artria

A

True

20
Q

Signs and symptoms of left-sided heart failure

A
  • Dyspnea
  • Rales
  • Orthopnea
  • Cough
  • Tachycardia
21
Q

Right sided heart failure most commonly results from ____________

A

Left sided heart failure (backward failure)

22
Q

Pulmonary hypertension can lead to ____________

A

Cor pulmonale

23
Q

Congenital heart disease

A

-Structural malformations in cardiac walls or great vessels of the heart

24
Q

90% of congenital heart disease cases are _________, but can also be genetic or due to environmental factors.

A

Idiopathic

25
Q

Most common malformation in congenital heart disease

A
  • Septal defects
  • Ventricular: 42%
  • Atrial: 10%
26
Q

Right-to-left shunts are less common and cause blood to bypass the ________

A
  • Lungs

- Causes cyanosis (“dusky blue”)

27
Q

Left-to-right shunts are more common and cause ___________

A

-Pulmonary hypertension

28
Q

Most common congenital heart disease to cause cyanosis

A

-Tetralogy of Fallot (right to left shunt)

29
Q

Tetralogy of Fallot malformations

A
  1. Ventricular septal defect
  2. Pulmonary stenosis
  3. Overriding aorta
  4. Right ventricular hypertrophy
30
Q

A “boot-shaped” heart is indicative of __________

A

Tetralogy of Fallot

31
Q

Transpostion of the great arteries

A
  • When arteries connect to the wrong ventricles
  • Right ventricle–>aorta
  • Left ventricle–>pulmonary artery
  • Separates pulmonary and systemic circulation
  • Right to left shunt
32
Q

Examples of left-to-right shunts

A
  • Atrial septal defects (ASD)
  • Ventricular septal defects (VSD) *MC
  • Patent ductus arteriosus (PDA)
33
Q

Aortic Coarctation

A

Congenital narrowing of the aorta

34
Q

> 50% of aortic coartation patients also have a _____________

A

Bicuspid aortic valve

35
Q

T/F: Aortic coarctation can be Infantile (post-ductal) or adult (pre-ductal)

A

False

  • Infantile is PRE-ductal (proximal to PDA)
  • Adult is POST-ductal (infolding near ligamentum arteriosum)
36
Q

T/F: Ischemic heart disease is the leading cause of death in the U.S.

A

True

Pathology II (4 decks)

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