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241

non-St elevation MI =

NSTEMI
- fatty material is deposited in vessel wall

242

ST-elevation MI =

STEMI = full occlusion ; no blood is getting through

243

What is atherosclerosis?

- one type of ARTERIOsclerosis
- A progressive process affecting large and middle sized arteries

244

What are the consequences associated with atherosclerosis?

- narrow size (smaller diameter) of artery
- blockage
- stiffness (less reactivity)
-TURBULENT flow

245

What are the 3 layers of the arterial wall?

1. tunica intima
2. tunica adventitia
3. tunica media

246

Tunica intima =

endothelium that lines the lumen of the vessels

247

tunica adventitia =

collagen fibers

248

tunica media =

smooth muscle cells and elastic fibers

249

The initial injury of atherosclerosis involves:

1. excess levels of low-density lipoproteins LDL in blood penetrate blood vessels and become trapped
2. LDL oxidizes, releasing anions (oxidative stress)

250

In atherosclerosis, endothelial dysfunction causes:

oxidative stress
- chemical & adhesion factors attract monocytes & platlets

251

What is the normal function of smooth muscle?

1. smooth muscle emigration from media to intimal. Macrophage activation
2. macrophages and smooth muscle cells engulf lipids
3. smooth muscle proliferation, collagen and other ECM deposition, extracellular lipid.
*DEVELOP A CAP THAT WILL KEEP THEM (?) somewhat stable

252

What are foam cells?

lipid enhanced macrophages

253

smooth muscle cells engulf foam cells, & lipids -->

fatty streak

254

fibrous cap over:

fatty streak
2 types of caps

255

What are two types of plaque?

stable and unstable

256

what is stable plaque?

has a thick calcified cap and a smaller fatty core. It is the primary cause of hardened and narrowed arteries (atherosclerosis)

257

What is unstable plaque?

has a thin calcified cap covering a larger fatty core. Is more likely to rupture which can trigger a heart attack or stroke.

258

Which is more likely to rupture, stable or unstable plaque?

unstable

259

An embolism is an example of what type of plaque?

unstable

260

What is coronary artery disease?

atherosclerosis of coronary vessels alters myocardial perfusion

261

When does myocardial perfusion occur?

during periods of muscle relaxation (diastole)

262

What is ischemic heart disease?

imbalance of myocardial supply & demand. (heart is not getting O2 that it needs)

263

What influences supply?

-coronary blood flow O2
-carrying capacity of blood

264

What influences demand?

- increased with HR
-increased contractile state (activity, fright)
-increased systolic tension (HTN, cold)

265

The right coronary artery is:

inferior

266

The left anterior descending is:

anteroseptal

267

The left anterior descending (distal):

anterioapical

268

circumflex is:

anterolateral

269

The right coronary artery is:

posterior

270

What are 5 clinical conditions:

1. chronic stable angina
2. unstable angina
3. myocardial infarction
4. cardiac muscle dysfunction
5. sudden cardiac death