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Systems Path I Final > Chapter 10: The Heart (Part 1) > Flashcards

Chapter 10: The Heart (Part 1) Flashcards

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1
Q

What is the number one cause of death in the U.S.?

A

Heart Disease

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2
Q

What is the number two cause of death in the U.S.?

A

Cancer

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3
Q

What is the most common type of heart disease?

A

Contractile failure (or systolic dysfunction or pump failure)

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4
Q 
All of the following are examples of heart disease EXCEPT:
A) Contractile Failure
B) Obstruction of flow
C) Shunted Flow
D) Stroke
A

D) Stroke

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5
Q

Define: Heart Failure

A

heart fails to meet tissue demands

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6
Q

What is two causes of heart failure and which is most common?

A

Decreased cardiac demand (MC)

Increased tissue demands

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7
Q

What are some examples of increased tissue demands that can lead to heart failure?

A

hyperthyroidism, severe anemia, AV fistula

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8
Q

What is the name of the condition where increased tissue demands leads to heart failure

A

High-Output (Heart) Failure

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9
Q

What is the prognosis for patients diagnosed with Heart Failure?

A

poor prognosis (disease is progressive)

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10
Q

What other condition is associated with Congestive Heart Failure?

A

Pitting edema (non-inflammatory edema)

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11
Q

Systolic Dysfunction is most closely associated with:

A) Failed relaxation
B) decreased filling of the heart
C) weak contraction
D) Failure to effectively seal

A

C) Weak contraction

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12
Q

What three conditions are associated with Systolic dysfunction?

A

CAD, systemic HTN, and shock

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13
Q

Diastolic Dysfunction is most closely associated with (pick all that apply):

A) Failed relaxation
B) decreased filling of the heart
C) weak contraction
D) Failure to effectively seal

A

A) Failed Relaxation

B) Decreased filling of the heart

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14
Q

What three conditions are associated with Diastolic Dysfunction?

A

1) Myocardial fibrosis/amyloidosis
2) left-sided hypertrophy
3) pericardial tamponade

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15
Q

Valvular Dysfunction is most closely associated with (pick all that apply):

A) Failed relaxation
B) decreased filling of the heart
C) weak contraction
D) Failure to effectively seal

A

D) failure to effectively seal

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16
Q

Define “Forward Heart Failure”

A

insufficient output due to hypoxia

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17
Q

Define “Backward Heart Failure”

A

Venous congestion (dude to increased venous blood volume and pressure)

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18
Q

True or False: Forward failure is almost always accompanied by backward failure.

A

True

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19
Q

Which of the following stimulates cardiac adaptations:

a) Forward Failure
b) Backward Failure
c) all of the above

A

C) All of the above

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20
Q

What are the three explanations of cardiovascular adaptations to heart failure?

A

1) Frank-Starling (law) mechanism
2) Neurohumoral mechanism
3) Structural Changes

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21
Q

The cardiovascular adaptation of increasing stretch to create a stronger contraction is best explained by:

A

Frank-Starling Law

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22
Q

What are the benefits and the cost of the Frank-Starling Mechanism?

A

Benefit: Increased Output
Cost: Increased O2 and Increased Tension

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23
Q

How does the neurohumoral mechanism explain cardiovascular adaptation via the release of norepinephrine?

A

It increases Heart Rate and increases contractility; engages the R-A-A system

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24
Q

How does the neurohumoral mechanism explain cardiovascular adapatation via the release of atrial natriuretic peptide (ANP) hormone?

A

It causes diuresis and vasodilation

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25
What is the structural change that can occur in the heart as as result of cardiovascular adaptation to heart failure? What is the cost?
cardiac hypertrophy Cost: Increased O2 consumption
26
Are you more likely to see an increase in pressure or an increase in volume with Cardiac Hypertrophy?
Increase in pressure
27
Are you more likely to see an increase in pressure or an increase in volume with Dilated Cardiac Myopathy?
Increase in volume
28
Which type of Cardiac Hypertrophy is associated with increased pressure, HTN, and valvular stenosis? (pick all that apply) a) Pathologic hypertrophy b) Physiologic hypertrophy c) Eccentric hypertrophy d) Concentric hypertrophy
a) Pathologic hypertrophy | d) Concentric hypertrophy
29
Which type of Cardiac Hypertrophy is associated with increased blood volume, bradycardia, and increased capillary density? (pick all that apply) a) Pathologic hypertrophy b) Physiologic hypertrophy c) Eccentric hypertrophy d) Concentric hypertrophy
b) Physiologic hypertrophy | c) Eccentric hypertrophy
30
Left-sided heart failure is seen following what conditions?
HTN, CAD, valve disorders, cardiomyopathies
31
Which part of the heart undergoes hypertrophy during left-sided heart failure?
Left ventricle hypertrophies
32
What happens to cardiac output during left-sided heart failure?
It decreases; causes the activation of the R-A-A system
33
What condition results from the activation of the R-A-A system during left-sided heart failure?
Pulmonary edema
34
What signs and symptoms are associated with left-sided heart failure?
cough, dyspnea, rales, orthopnea and tachycardia
35
What is orthopnea?
Shortness of breath that occurs when lying down
36
How can orthopnea be relieved?
sleep at an angle or sit in a chair
37
What is the most common cause of developing right-sided heart failure
left sided heart failure
38
What are the possible causes of right-sided heart failure?
pulmonary HTN, lung pathology, valve disorder, left-to-right shunt
39
What pathologies are seen with right-sided heart failure?
ascites, hepatosplenomegaly
40
Why are pathologies such as ascites and hepatosplenomegaly seen in right-sided heart failure?
congestion and edema of peripheral tissues due to back up in systemic and portal veins.
41
True or False: There is significant pulmonary congestion in right-sided heart failure.
False; there is minimal pulmonary congestion
42
Can congential heart disease be genetic, developmental or both?
Both
43
Which structural malformation in congenital heart disease is the most mild? Most lethal?
Most Mild- Cardiac Walls | Most Lethal- Aorta
44
What are the risks for congenital heart disease?
prematurity, trisomies, teratogens, maternal diabetes, fetal infection
45
Which septal defects make up over half of congenital heart disease?
ventricular septal Defects (VSD) = 42% | Atrial Septal Defects (ASD0 = 10%
46
If the blood bypasses the lungs this is known as: A) Right-to-left shunt B) Left-to-right shunt C) Obstructed Flow
Right to left shunts
47
The characteristic feature of cyanosis in the face and lips is seen in which congential heart disease?
Right-to-left shunts
48
What are two examples where Right-to-left shunts are seen?
1) Tetralogy of Fallot | 2) Transposition of Great Arteries
49
Which is more common: Left-to- Right shunts or Right-to-Left shunts?
Left-to-right shunts
50
Pulmonary hypertension is seen in: A) Right-to-left shunt B) Left-to-right shunt C) Obstructed Flow
B) left-to-right shunts
51
ASDs, VSDs, and PDA are all congenital heart disease examples of:
Left-to-right shunts
52
Valvular stenosis is seen in: A) Right-to-left shunt B) Left-to-right shunt C) Obstructed Flow
C) Obstructed flow
53
Obstructed flow can lead to:
aortic coarctation
54
Which is the most common heart structural abnormality: | VSD or ASD
VSD
55
Which is most commonly asymptomatic? VSD or ASD
ASD
56
Which may spontaneously close? VSD or ASD
VSD
57
Which may be diagnosed in adulthood? VSD or ASD
ASD
58
What four diagnostic abnormalities must be present to have Tetralogy of Fallot?
1) VSD 2) Right Ventricular Outflow Obstruction (ie Pulmonary Stenosis) 3) Overriding Aorta 4) Right Ventricular Hypertrophy
59
In Tetralogy of Fallot, an overriding aorta is an example of which kind of shunt?
Right-to-left shunt | Rt. Ventricle to Aorta
60
What is the most common congenital heart disease to cause cyanosis?
Tetralogy of Fallot
61
What is the prognosis for Tetralogy of Fallot?
variable severity, may worsen with age
62
What is characteristic about the x-ray of the heart in patients with tetralogy of fallot?
boot shaped heart
63
The disease where arteries connect to wrong locations is known as?
Transposition of the Great Arteries
64
In Transposition of the Great Arteries, the right ventricle connects to:
the aorta
65
In Transposition of the Great Arteries, the left ventricle connects to:
pulmonary artery
66
Why is transposition of the great arteries a life threatening condition?
It separates pulmonary and systemic circulation
67
Is transposition of the great arteries compatible with postnatal life?
No (postnatal cyanosis)
68
If transposition of the great arteries were to be treated, what is required?
shunting | PDA, VSD, or surgical repositioning
69
Who is more likely to have an aortic coarctation, males or females?
males (2x)
70
What genetic condition increases the likelihood of developing an aortic coarctation?
Turner Syndrome (45, X)
71
Which type of aortic coarctation is pre-ductal and is proximal to a PDA?
Infantile
72
Which type of aortic coarctation is post-ductal and is near the ligamentum arteriosum?
Adult
73
Which type of aortic coarctation is usually discovered early and more severe?
Infantile
74
Which type of aortic coarctation is more commonly asymptomatic?
Adult
75
What are some of the features of aortic coarctation?
Upper extremity HTN, decreased blood flow to lower extremities and systolic murmurs/thrills
76
What signs and symptoms are present on a patient with aortic coarctation that might indicate a reduction in blood flow to the lower extremities?
cyanosis and claudicator
77
What physical abnormality is present in over half of patients diagnosed with aortic coarctation?
Bicuspid Aortic Valve
78
A group of conditions involving myocardial ischemia is known as:
Ischemic Heart Disease
79
How does the heart receive energy?
via oxidative phosphorylation
80
Within 1-2 minutes, what happens to an ischemic heart?
dysfunction
81
Within 20-40 minutes, what happens to an ischemic heart?
infarction
82
What disease makes up about 90% of Ischemic Heart Diseases?
Coronary Artery Disease
83
Which coronary artery is most commonly affected by heart disease?
Anterior Interventricular Artery
84
What are the four stages of CAD progression?
Fatty streaks, atheromas, significant luminal stenosis, thrombosis

Systems Path I Final (4 decks)

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