Exam 2 Chapter 3 Flashcards
(129 cards)
1
Q
What is required for survival?
A
circulation
2
Q
What are the 2 most important compounds in circulation? What does circulation remove?
A
oxygen and glucose, removes metabolic waste
3
Q
Pressures and endothelial function are regulated by what?
A
circulation
4
Q
Clotting and hemorrhage are balanced by what?
A
homeostasis
5
Q
The process of blood clotting is called?
A
hemostasis
6
Q
What occurs if there is too little blood clotting?
A
hemorrhage (stroke)
7
Q
What occurs if there is too much blood clotting?
A
thromboembolism
8
Q
___________ can cause MI, stroke or pulmonary embolism (PE)
A
thromboembolism
9
Q
What 2 things increase blood volume within tissue?
A
hyperemia and congestion
10
Q
Hyperemia is _________, whereas congestion is ___________.
A
active, inactive
11
Q
What causes arteriolar dilation and an increase in inflow?
A
hyperemia
12
Q
Hyperemia causes tissue ___________.
A
erythema (redness)
13
Q
This type of increased blood volume occurs due to inflammation and exercise.
A
hyperemia
14
Q
Congestion causes decreased _________ outflow.
A
venous
15
Q
Congestion causes tissue ___________.
A
cyanosis (blue)
16
Q
_______ occurs from venous obstruction and is a potential cause of congestive heart failure, DVT, and testicular torsion
A
congestion
17
Q
This type of increased blood volume can either be physiological or pathological.
A
hyperemia
18
Q
This type of increased blood volume can only be pathological.
A
congestion
19
Q
This hyperemic condition is characterized by alveolar capillary engorgement, edema and hemorrhage.
A
acute pulmonary congestion
20
Q
This condition is characterized by fibrosis of alveolar septa.
A
chronic pulmonary congestion
21
Q
This is an example of acute pulmonary congestion.
A
Acute Respiratory Distress Syndrome (ARDS)
22
Q
Alveolar macrophages and _________ are characteristic of chronic pulmonary congestion. Called “heart failure cells”.
A
hemosiderin
23
Q
This is an example of chronic pulmonary congestion.
A
congestive heart failure (CHF)
24
Q
This type of congestion is nicknamed “nutmeg liver”. It is characterized by steatosis, fibrosis, hemorrhage and necrosis.
A
congestive hepatopathy
25
What is the most common cause of hepatic congestion?
congestive heart failure (CHF)
26
2/3 of the body's interstitial fluid is ____________.
intracellular
27
This is the abnormal accumulation of interstitial fluid.
edema
28
Edema can occur within _______ or ____ ______
tissues, body cavities
29
What type of edema is common in the lower extremities? It is also characterized by ascites and hydrothorax.
localized
30
What type of edema is usually subcutaneous and within cavities? Anasarca can also occur.
generalized
31
This is generalized edema due to malnutrition.
anasarca
32
What are the two opposing forces of fluid balance?
hydrostatic pressure and osmotic pressure
33
Hydrostatic pressure is related to _____ ______. It pushes H2O ____.
blood pressure, out
34
Osmotic pressure is related to _______ ________. It pulls water ___.
plasma proteins, in
35
Increased hydrostatic pressure also causes increased ____________ pressure.
intravascular
36
Increased hydrostatic pressure also impairs what?
venous return
37
This is an example of localized impaired venous return.
blood clot (DVT)
38
This is an example of generalized impaired venous return.
congestive heart failure (CHF)
39
Examples of treatment for increased hydrostatic pressure? (4)
1) Restoration of cardiac output
2) Thrombolysis
3) Reduction of sodium intake
4) Diuretics
40
Colloid osmotic pressure and oncomic pressure are additional names for what?
plasma osmotic pressure
41
Plasma protein osmotic pressure is determined by the plasma protein _______
albumin
42
What is the term for decreased serum albumin?
hypoalbuminemia
43
A decrease in osmotic pressure causes what?
generalized edema
44
Cirrhosis, hepatitis, liver failure, and malnutrition are results of this mechanism of reduced plasma osmotic pressure.
decreased production
45
This is caused by the increased loss mechanism of reduced plasma osmotic pressure.
nephrotic syndrome (proteinuria)
46
Lymphadema, retention of sodium (H2O), and inflammation are all additional causes of what?
edema
47
What causes Peau d'orange?
Lymphadema
48
Retention of sodium (H2O) causes increased __________ ______. This is turn causes an increase in hydrostatic pressure
blood volume
49
Inflammation causes increased ______ _________.
vessel permeability (exudate)
50
Edema impairs what?
wound healing
51
What are the two types of dependent edema?
standing and recumbent
52
On what part of the body is standing dependent edema usually seen?
ankles/legs
53
On what part of the body is recumbent dependent edema usually seen?
sacrum
54
Edema could be a symptom of what severe conditions? (2)
CHF and renal failure
55
What type of edema is inflammatory?
non-pitting
56
What type of edema is non-inflammatory?
pitting
57
What type of edema is transudate or protein poor? There is no osmosis associated with it.
pitting
58
What type of edema is exudate or protein rich?
non-pitting
59
______ occurs with non-pitting edema (but not pitting edema)
osmosis
60
This is the extravasation of blood from vessels.
hemorrhage
61
Hemorrhage is a sign of what?
internal or external bleeding
62
This is the accumulation of blood within tissue.
hematoma
63
Contusions and ecchymosis are two potential causes of what?
hematoma
64
What is the smallest type of mild hematoma?
petechiae
65
This is the middle size of mild hematoma
purpura
66
This is the largest size of hematoma
ecchymosis
67
What normally inhibits thrombosis?
endothelium
68
This is the activation of thrombin:
coagulation cascade
69
The coagulation cascade involves the activation of ___________.
thrombin
70
What forms the primary platelet plug?
clotting
71
What forms the secondary platelet plug?
fibrin
72
Platelets that are exposed to ___ form a clot (primary plug)
vWF
73
The fibrin (secondary) plug is located at the site of injury and is composed of _________.
fibrinogen
74
This is the clot formation inside a vessel. It can happen anywhere in the cardiovascular system.
thrombosis
75
What are two main causes of thrombosis?
acquired or inherited mutations
76
Smoking, pregnancy, oral contraceptives, obesity, cancer, m.i., atheromas, arrhythmia, irregular heart valves, sickle-cell anemia, immobilization, trauma/surgery or varicosities are all causes of:
acquired thrombosis
77
This acquired mutation decreases thrombosis (anti-thrombotic).
factor V
78
This acquired mutation increases thrombosis (thrombotic).
prothrombin
79
What are the three components or Virchow's triad?
1) endothelial injury
2) abnormal flow
3) hypercoagulability
80
An arterial thrombosis occurs at the site of _______ and grows _______ blood flow.
injury, against
81
What type of thrombosis occurs at the site of stasis and grows in the direction blood flow?
venous
82
A venous thrombosis occurs at the site of ________ and grows ________ the direction of blood flow.
stasis, with
83
What are thrombi on heart valves?
vegetations
84
Vegetations can either be ______ or ________.
sterile or infective (bacterial, fungal)
85
What is a thrombotic embolism?
thromboembolism
86
A thrombosis is an ________ and can either be _____ or _______
obstruction/embolism, acute or chronic
87
Congestion, tenderness, and pitting edema are symptoms of what type of thrombosis?
venous (DVT, CHF, trauma, immobility, pregnancy)
88
Infarctions (m.i. Or stroke) are symptoms of what type of thrombosis?
arterial
89
What is the fate of a thrombosis?
1) enlarge (propagation)
2) embolize
3) dissolve
4) organize (ingrowth of cells)
5) recanalization
90
What are the main features of a thrombosis? (3)
cause, size, site
91
Older thrombi exhibit more organization...they contain in-growths of what materials?
endothelia, smooth muscle, and fibroblasts
92
_______ is a detached, intravascular mass that travels and can become lodged, _______ vessels.
embolism, occluding/blocking
93
Embolisms can occur in what 3 forms?
solid, liquid, gaseous
94
_________ _______ is an embolic occlusion of a pulmonary artery
pulmonary embolism
95
95% of pulmonary embolisms are caused by what?
DVT (femoral vein, thigh)
96
What percentage of pulmonary embolisms are clinically silent?
80%
97
What percentage of pulmonary embolisms are fatal?
2%
98
Dyspnea, tachypnea, cough, chest pain, cyanosis, hypoxia, and collapse are all symptoms of what pathology?
pulmonary embolism
99
A pulmonary embolism can cause pulmonary hypertension. This can cause what?
cor pulmonale (sudden cardiac death)
100
What are the risk factors for a pulmonary embolism?
1) previous pulmonary embolism (30% reoccur)
2) bed rest
3) burns
4) CHF
5) cancer
6) surgery (knee, hip)
101
This is an embolism within the arterial system.
systemic thromboembolism
102
What percentage of systemic thromboembolisms arise from cardiac mural thrombi?
80%
103
What fraction of cardiac mural thrombi occur in the left ventricle?
2/3
104
Cardiac mural thrombi occur in the left ventricle following what?
M.I.
105
What fraction cardiac mural thrombi occur in the left atrium, causing dilation?
1/4
106
Cardiac mural thrombi occur in the right atrium following what?
mitral stenosis
107
These are other causes of systemic thromboembolisms (20%).
aortic aneurysms and atheromas
108
Severity of systemic thromboembolisms depends on _________
location
109
75% of systemic thromboembolisms arise from the _____ _______ and 10% come from the ____.
lower extremity, CNS
110
What occurs when emboli cross from the venous system to the arterial system?
paradoxical embolism
111
Paradoxical embolisms originate as what before crossing into the arterial system?
DVT
112
What two defects are causes of paradoxical embolisms?
atrial (patent foramen ovale) or ventricular septal defects
113
What is the result of a paradoxical embolism?
stroke
114
What type of shock is caused by pump failure?
cardiogenic
115
M.I. (MC), arrythmia, cardiac tamponade, and P.E. are all examples of causes of this what of shock?
cardiogenic
116
What type of shock occurs due to a loss of blood/plasma?
hypovolemic
117
Hemorrhage, severe burns and dehydration are potential causes of what type of shock?
hypovolemic
118
What kind(s) of shock cause traditional symptoms: cyanosis (cool/clammy) and SNS stimulation?
cardiogenic and hypovolemic
119
What type of shock is caused by infections which lead to systemic immune reactions?
septic
120
What is involved with septic shock? It causes vasodilation and stasis
endothelial activation
121
What type of shock occurs due to CNS trauma, spinal anesthesia, or ADR?
neurogenic
122
Depression of medulla (vasomotor) or SNS ganglia, severe vasodilation, syncope and bradycardia are all symptoms of what type of shock?
neurogenic
123
What type of shock causes severe vasodilation (edema) and bronchocostriction?
anaphylactic
124
Anaphylactic shock is _____-mediated (Type I Hypersensitivity).
IgE
125
Anaphylactic shock occurs as a response to what?
allergies
126
What stage of shock utilizes compensatory mechanisms? The SNS accommodates to perfuse vital organs.
nonprogressive
127
What stage of shock involves hypoperfusion and anaerobic metabolism?
progressive
128
Progressive shock leads to what? (further impairs cardiac function)
acidosis
129
What stage of shock is due to severe cell/tissue damage? It leads to widespread membrane damage and organ failure. It is lethal.
irreversible
