exam 4 Flashcards
(184 cards)
1
Q
hemostasis
A
process of stop bleeding
2
Q
thrombus
A
clot
3
Q
5 major factors affecting hemostasis
A
integrity of small blood vessels
adequate numbers of normal platelets
normal amounts of clotting factors (liver)
normal amounts of clotting inhibitors
adequate amounts of calcium
4
Q
first defense after injury
A
small vessels
5
Q
platelets and injury
A
accumulate and adhere to site
plug hole in vessel
release chemicals for vasoconstriction and aggregation
release substance that initiate blood clotting
6
Q
platelets characteristics
A
survive for 10 days
contractile proteins
become activated
prevent bleeding from capillaries
7
Q
blood coagulation process
A
1) release prothrombin by injured vessel
2) convert prothrombin into thrombin
3) soluble fibrinogen converted into insoluble fibrin strands by thrombin
8
Q
blood clot
A
result of clotting process
meshwork of fibrin threads and blood cells
9
Q
disturbances of blood coagualtion
A
adnormalities of small blood vessels
abnormality of platelet numbers
deficiency of 1+ clotting factors
liberation of thromboplastic material
10
Q
abnormalities of small vessels
A
abnormal bleeding from failure of small vessels to contract after injury
11
Q
abnormality of platelet numbers
A
abnormal platelet formation low platelets injury or disease t bone marrow cancer of bone marrow destruction of platelets via antibodies
12
Q
petechiae
A
small red or blue spots
pinpoint hemorrhages in skin
indicated defective or inadequate platelets
dont blanch
13
Q
hemorrhagic disease
A
presence of petechiae and fever with infection
poor prognosis
14
Q
hemophilia
A
x linked hereditary disease
episodes of hemorrhage in joints and organs
15
Q
von willebrand disease
A
vWF adheres to damaged vessel wall, framework frames
helps maintain normal levels of other clotting factors
16
Q
causes of abnormal blood clotting
A
anticoagulant drugs
inadequate synthesis of vitamen K
inadequate absorption of vitamen K
severe liver disease
17
Q
causes of thrombocytopenia
A
injury or disease to bone marrow
leukemic or cancer cells enter bone marrow
antiplatelet antibody destroys platelets in circulation
18
Q
liberation of thromboplastic material into circulation
A
thromboplastic chemicals released into circulation, intravascular coagulation
shock and tissue necrosis
bacterial infections
19
Q
disseminated intravscular coagulation
A
abnormal state of bleeding and clotting
severe trauma or hemorrhage= shock, bacterial infection
many small clots in capillaries
body releases chemicals to dissolve clots
net effect: hemorrhage
high mortality
20
Q
lab tests for hemostasis
A
platelet count
bleeding time- funktion of capillaries
clotting times
21
Q
clotting time tests
A
PTT vs PT
thrombin time
22
Q
partial thromboplastin time (PTT)
A
measure the time of the first phase of coagulation
lipid and calcium added to blood
23
Q
prothrombin time (PT)
A
measure of time combines second and third phases of coagulation measure coumodin (anticoagulant)
24
Q
thrombin time
A
bypass first two phases of blood coagulation
measure level of fibrinogen
25
pathogenesis of intravascular clotting
slowing or stasis of blood flow
blood vessel wall damage
increased clotting of blood
26
embolus
circulating clot carried into lungs or body
| plugs vessels
27
infarct
tissue necrosis from interruption of blood flow
28
fat embolusim
following severe bone fracture that disrupts fatty bone marrow and adipose tissue
emulsified fat globules sucked into vein and carried into lungs, obstruct lung capillary
may block vessels in brain or organ
29
air emboluism
air sucked into circulation from lung injury or open chest wound
air may enter right chambers and prevents filing of heart of blood, unable to pump
30
foreign particle embolusim
forign matter
injected substances users
injected IV
severe respiratory distress
31
venous thrombosis
clot in leg from prolong bed rest
varicose veins
leg swelling
possible pulmonary embolism
32
clincal manifestations of pulmonary embolism
size and location in artery
| cynosis or shortness of breath= deoxygenation of blood
33
large pulmonary emboli
right side becomes distended with blood
left ventricle unable to pump enough blood to brain and organs
systemic BP falls and go into shock
34
small pulmonary emboli
may pass through arteries or lodge in small arteries
lung segments undergo necrosis
dyspnea, chest pain, cough, bloody spit
35
gold standard for detecting pulmonary embolus
pulmonary angiogram
36
treatment for embolus
anticoagulants
thrombolytic drugs
angioplasty
remove clot
37
arterial thrombosis
may cause injury to vessel wall= ulcers
| blocks blood flow
38
coronary artery
heart attack
39
major leg artery
gangrene
40
cerebral artery
stroke
41
thrombosis by increased clotting
rise in coagulation factors following surgrey or injury
estrogen or contraception pills=synthetic clotting factors
gene mutations
42
edema
swelling
accumulation of fluid outside vascular system
ankles
extracellular circulation between capillary and ISF
43
pitting edema
pit or indent formed when tissue is pressed
44
ascites
fluid accumulates in abdominal cavity
45
pathogenesis of edema
increased capillary permeability-inflammation
low plasma protein
lymphatic obstruction
46
factors regulating fluid flwo between capillaries and tissues
capillary BP force fluid out of capillaries
capillary permeability-fluid flow threw wall
osmotic pressure
lymphatic channels
47
osmotic pressure
due to proteins in blood
| pulls fluid into capillaries
48
shock
inadequate tissue perfusion (delivery of oxygenated blod) due to low BP
49
hypovolemic
low blood volume
50
cadriogenic
failure of the heart as a pump
51
septic shock
excessive vasodilation secondary to release of toxins and inflammatory chemicals
52
anaphylactic shock
excessive vasodilation from release of inflammatory chemicals
53
prognosis of shock
early recognition and rapid treatment
drugs to vasoconstrict (restore BP)
IV fluids to restore blood volume
treat underlying cause
54
funktion of the heart
muscular pump
| propels blood to tissues
55
heart disease
diturbance of the funktion
56
pericardium
double layer sac surrounding heart
57
fibrous pericardium
outer connective tissue
58
serous pericardium
parietal and visceral layers
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epicardium
same layer as visceral pericardium
60
myocardium
thick layer of cardiac muscle
| contracts to form beats
61
endocardium
innermost layer lining chambers and valves
| smooth surface for blood flow
62
superior vena cava
recieves blood from regions above heart
| drains into right atria
63
inferior vena cava
recieves blood from regions below the heart
| drains into right atria
64
coronary sinus
collects blood that drains from myocardium
65
pulmonary veins
enter left atria
66
tricuspid valave
right side
67
biscupid/mitral valve
left side
68
pulmonary valve side
right
69
aortic valve side
left
70
pulmonary circulation
pums blood to the lungs
pick up o2
drops off co2
71
systemic circulation
pumps o2 rich blood to body tissues
drop off o2
picks up co2
72
coronary circulation
delievers o2 rich blood to myocardium and takes away co2
| during diastole
73
coronary sinus
cardiac veins that empty into right atrium
74
right coronary artery
supply right side and SA node
75
left coronary artery
supply left side
76
what happens to injured heart tissue
does not regenerate
| forms scar tissue that cannot conduct impulses
77
conduction system
muscle cells that initiate own electrical impulses
| SA node in right atria
78
cardiac cycle
all events with blood flow through the heart during one beat
79
systole
contraction
80
diastole
relaxation
81
cardiac output
amount of blood pumper per minute
82
blood pressure
blood flow in the arteries
83
highest pressure
contraction
| systolic pressure
84
lowest pressure
relax
| diastolic pressure
85
electrocardiogram
meausres electrical activity of heart
86
depolarization
contraction
87
repolarization
relaxation
88
p wave
atrial depolarization
| atrial systole
89
qrs complex
ventricular depolarization
| ventricular systole
90
t wave
ventricular repolarization
| ventricular diastole
91
atrial fibrilitation
atria quiver instead of contracting normally
ventricles beat faster than normal
concern of blood clot
92
ventricular fibriliation
ventricles quiver-incompatible with life
| only treatment-defibriliation
93
heart block
delay or intermissions of impulse transmission from atria to ventricles
94
fetal blood flow diferences
blood in pulmonary trunk shunted away from fetal lungs
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ductus arteriosus
opening between aorta and pulmonary trunk
| after birththe ductus should close
96
foramen ovale
opening in atrial septum covered by flap of tissue
one way valve to bypass lungs
after birth the opening should close
97
abnormal heart development
effect of structural abnormality depends on type and effect on circulation
blood may be shunted between chambers-depends on size of opening
98
L to R shunt
```
systemic to pulmonary
most common
mixes oxygenated with deoxygenated blood
o2 still reaches tissues
bad affect- increase pulmonary pressure-damage to lungs
```
99
R to L shunts
```
pulmonary to systemic
mixes deoxygenated with oxygenated blood in right chaners
decreases 02 to the tissues
activities restricted
cynosis
```
100
4 groups of congenital heart disease
failure of normal fetal bypass channels to close
atiral and ventricular septal defects
abnormalities that obstruct blood flow
abnormal formations of aorta or pulmonary artery or connection
101
failure of fetal bypass channels to close
patent ductus arteriosus-surgery
| patent foramen ovale-asymptomatic/surgrey
102
atrial and ventricular septal defects
small defects- close randomly but surgery
| large defects- surgrey bc of L to R shunt
103
obstruction of blood flow
narrow valve opening-depends on size
| dilate valve opening
104
pulmonary stenosis
obstruct blood flow from right ventricle
105
aortic stenosis
obstructs blood flow from left ventricle
106
coarctation of the aorta
localized narrowing of aorta (close to heart)
pressure and volume of blood decrease
high BP in brachial, low BP in legs
reconstruct aorta
107
tetralogy of fallot
```
pulmonary stenosis
large ventricular septal defect
enlarged aorta that overrides septal defect
right ventricle hypertrophy
cynosis
clubbing fingers and toes
increase blood viscosity
treatment- opening narrowed trunk and close septal defect
```
108
valvular heart disease
rheumatic fever and heart disease
non rheumatic aortic stenosis
mitral valve prolapse
infective endocarditis
109
rheumatic fever
complication of strep
fever and inflammation-heart and joints
acute arthritis=scarring
can repair valves
110
rheumatic heart disease
```
complication of rheumatic fever caused by scarring ofheart valves (mitral and aortic)
backflow of blood
narrowed valve
heart failure
artificial valve
```
111
non rheumatic aortic stenosis
aortic valve has 2 cusps instead of 3
asymptomatic for years but may calcify=rigid
valve replacement
risk factoes: high cholesterol, diabetes, high BP
112
mitral valve prolapse
valve cusps are enlarged
prolapse into left atrium during ventricular systole
backflow of blood or murmur
113
infective endocarditis
bacterial infection of heart valve (mitral or aortic)
subacute- organisms of low virulence that infect abnormal or damaged heart valves
acute-highly virulent organisms that previousl normal heart valves
114
subacute infection endocardities
small deposits of platelets and fibrin accumulat on damged valve-bacteria=inflammation
normally body defenses destroy bacteria
prophylactic antibiotics for dental work
artificial valve
115
acute infective endocarditis
highly pathogenic organism spread in blood from infection elsewhere and infect valve
staph infection
vegetations form on valve
116
coronary heart disease
arteriosclerosis of coronary arteries
arteries narrow and accumulate fatty material
damage to lining of vessels
calcification on walls
end result- yellow, mushy debris that narrows lumen
ulcers
117
atheroma
```
collection of fatty material and debris
new plaques are unstable plaques
degenerative changes are irreversible
permantly narrows
risk factors: elevated blood lipids, high BP, smoking, diabetes
```
118
coronary heart disease symptoms
excessive demands on the heart if active
ischemia
bouts of chest pain
119
myocardial ischemia
reduced blood supply to heart caused by narrowing or obstruction of coronary arteries
120
angina pectoris
bouts of chest pain caused by ischemia
| occurs on exertion and subsides when rest
121
unstable angina
pain occurs more often and longer
122
diagnosing coronary heart disease
coronary angiogram is gold stnadard
catheter in femoral artery to abdominal aorta
dye injected to show location and degree
123
treatment of coronary heart disase
```
drugs to reduce myocardial o2 consumption and improve circulation
stop smoking
control BP
low fat/cholesterol diet
lose weight
exercise
```
124
percutaneous coronary inerventio (PCI)
angioplasty
similar to angiogram but affected artery are dilated with balloon and stent is placed
within 90 minutes of arriving at hospital
125
coronary artery bypass graft (CABG)
patients with severe sclerosis of all major coronary arteries
vein from leg used for bypass
126
severe myocardial ischemia complications
severe and prolonged ishcemia cause heart attack
| cardiac arrest or necrosis of heart muscle
127
4 triggers of heart attack with CAD
sudden blockage of coronary artery
hemorrage into a plaque
arterial spasm
sudden greatly increase myocardial 02 demand
128
ischemia
damage due to lack of blood flow
129
myocardial infacrtion
```
necrosis of heart muscle from severe ischemia
blood is insufficient to sustain muscle
severe chest pain and collapse
thickness of heart wall
L ventricle and septum
```
130
complications of heart attack
arrhythmias
heart failure
intra cardiac thrombi
cardiac rupture
131
cardiac rupture
perforation thru necrotic tissue-blood leaks into pericardial sac and compresses the heart
132
survival of heart attack patients depends on
```
size of onfarct
patients age
complications
preseence of other disease
go to the hospital immediately
```
133
most helpful diagnostic tools for heart attacks
EKG
| blood level of enzymes
134
EKG
reveals abnormalities when blood flow to heart muscle is inadequate
muscle becomes infarcted
135
labs fro heart attack
troponin
| creatine kinase
136
troponin
not detectable in healthy people
| peak in 24 hours
137
creatine kinase
only present when severe damage
138
thromoblytic therapy
dissolving the clot restores blood flow and salvages muscle
done before to much damage occurs
via IV
139
future thrombus
those who had MI have higher risks of clots
| sudden death from arrhythmias
140
aspirin
interfers with platelet funktion
prevents them from clumping and clotting
increase chance of hemorrhage
141
blood lipids
elevated blood lipids important for pathogenesis of atherosclerosis
triglycerides and cholesterol
sugar elevated triglycerides
142
cholesterol adn CAD
high cholesterol diets leads to evelvate blood levels and premature athersclerosis
143
LDL
bad cholesterol
| transports cholesterol from blood into cells
144
HDL
good cholesterol
removes cholesterol from cells and takes it to liver for excretion
protects against CAD
145
hypertension
```
high BP
excessive vasoconstriction of arterioles
heart pumps more forcefully=damage
heart will fail bc increased workload
narrow renal arteries
wear out vessels
arterioles thicken
```
146
treatments for high BP
drugs to dilate peripheral arteries
147
heart failure
heart unable to pump adequate amounts of blood to tissues
back up of blood in veins or lungs
edema
148
treatments for heart failure
diurectics
meds for forced contractions
meds that lower BP
149
aneurysms
dilation or arterial wall outpouching of portion of wall
| result of arteriosclerosis
150
arteriosclerotic aneurysms
atheromatous deposits damage aortic wall, reduce elastictiy and weak
wall balloons outward
inside will calcify and clot
fatal if rupture
151
dissecting aortic aneurysms
one or more layers of aortic wall separate and form tears
blood forced between layers
severe chest and back pain
fatal unless caught early
152
disease of veins
```
venous thrombosis
leg veins
inflammation
excessive dilation
varicose veins
```
153
thrombosis in veins
post-op patients in bed
may form pulmonary embolism
early walking
154
varicose veins
ssuperficil veins become dilated and valves faulty
| blood pools in veins
155
complications of varicose veins
stasis of blood in veins=poor oxygen
skin becomes thin, prone to infection
may rupture
156
treatment of varicose veins
stockings and elevation of legs to promote venous return
| sugrey
157
trachea
rigid tube with C-shaped cartilage rings
158
carina
split of the trachea
159
alveoli
tiny air filled sacs for gas exchange
produce surfactant
covered in pulmonary capilarries
160
ventilation
movement of air into and out of lungs
| breathing
161
respiration
gas exchange between blood and tissure or blood and lungs
162
gas exchange via
diffusion
| high to low pressure
163
requirements for efficient gas exchange
large capillary surface area
unimpeded diffusion across membrane
normal pulmonary blood flow
normal pulmonary alveoli
164
pulmonary funktion tests
measure volume of air that can be moved into adn out of lungs under normal conditions
165
vital capacity
max volume of air expelled after max inspiration
166
pleura
thin membrance covering lungs and surface fo chest wal
167
pleural cavity
potential space between ungs and chest wall
168
intrapleural pressure
pressure of pleural cavity
has to be less than the pressure in lungs for alveoli to expand
increase pressure=lung collapse
169
pnemothorax
escape of air into pleural spce due to lung injury or disease
stab or gun shot=air enters chest
170
tension pneumothorax
positive pressure in pleural cavity
air enter sna dcannot escape
chest tube entered to release air
171
atelectasis
collapse of lung
| obstructive atelectsis caused by bronchial obstruction from mucus
172
pneumonia
inflammation of the lung
| exudate in lung, fills alveoli
173
classification of pneumonia
etiology
anatomic distribution of inflammation
predisposing factors
174
tuberculosis
```
contagious bacterial infection
breath in toxic bacteria
lesion in lungs=body produce antibodies and form tubercle (dead bacteria and lung tissue)
necrosis occurs, tubercle coughed up
antibiotics
```
175
drug resistant tuberculosis
resistance strains of organisms emerge
176
bronchities
inflammation of bronchial mucosa
177
chronic obstructive pulmonary disease
combo of emphysema and chronic bronchitis
178
pulmonary emphysema
destruction of alveolar structure of lungs with cycstic spaces
dysonea
179
chronic bronchitits
chronic inflammation of terminal bronchioles
180
anatomic derangement in COPD
```
inflammation and narrowing of terminal bronchioles
swelling of bronchial mucosa
dilation of pulmonary air spaces
diffusion of gases
loss of lung elasticity
```
181
pathogenesis of COPD
inflammatory swelling of mucosa
leukocytes accumulate in bronchioles and alveoli
coughing
retention of secretions
182
bronchial asthma
spasmodic contraction of smooth muscle on walls of bronchi
dyspnea and wheezing
treat with drugs to dilate bronchioles
183
neonatal respiratory distress syndrome
respiratory distress after birth
inadequate surfactant in lungs=alveoli collaspe
preemies
184
pulmonary fibrosis
thickening of alveolar septa from irritant gases and particles
lungs rigid restricting breathing
decreased diffusion
