Lecture 13 - Cardiac Failure, Heart Sounds, & Shock Flashcards Preview

Physiology I > Lecture 13 - Cardiac Failure, Heart Sounds, & Shock > Flashcards

Flashcards in Lecture 13 - Cardiac Failure, Heart Sounds, & Shock Deck (21):
1

This is the primary mechanism for acute compensation of decreased cardiac output.
A. Water/salt retention in the kidney
B. Increased SNS tone
C. Decreased capillary permeability
D. Increased venous dilation

B. Increased SNS tone

2

Long term compensation of decreased cardiac output after MI is accomplished by:
A. Water/salt retention in the kidney
B. Increased SNS tone
C. Decreased capillary permeability
D. Increased venous dilation

A. Water/salt retention in the kidney

3

Sympathetic nervous system response will raise the Psf by _____.

12-14 mmHg (increasing venous return)

4

Summarize the dynamics of circulatory changes following an acute, moderate MI

1) Reduced cardiac output/increased venous pressure from "damming" blood
2) Increased SNS stimulation with increased RAP
3) Fluid/salt retention at kidney

5

Explain the pathophysiology of pulmonary, but not peripheral edema, in heart failure

- Ischemia of the heart, usually in left heart -> decreased CO
- Decreased CO -> increased blood "pooling" in both pulmonic and systemic vasculature
- However, more blood remains stagnant in the pulmonary circulation
- Increasing pulmonary capillary pressure (and decreasing mean aortic pressure) forces fluid into the alveoli (increased filtration through pulmonary capillaries)

6

Digtalis MOA on decompensated heart failure

-Digitalis blocks the normal cardiac Na/K/ATPase
- Na/K/ATPase block -> decreased ECF [Na]
- Decreased ECF [Na] produces less Ca2+/Na+ exchange, "trapping" Ca2+ in the cells
- Increased myocardial intracellular [Ca2+] increases the force of contraction
- Increased contractile strength -> greater inotropy

7

A direct path from artery to vein in AV fistula will ____ TPR and ____ CO. This can cause "High output cardiac failure," resulting in an inability for the heart to pump correctly.
A. decrease; decrease
B. increase; decrease
C. decrease; increase
D. increase; increase

C. decrease; increase

8

Deficiency of Vitamin B1 (Thiamin) produces an inability to _____, which results in decreased blood flow to ____ and increased fluid retention.
A. vasoconstrict; kidneys
B. vasodilate; kidneys
C. vasoconstrict; heart
D. vasodilate; heart

A. vasoconstrict; kidneys

9

Heart sound S1 is caused by:
A. Closure of AV at onset of ventricular systole
B. Closure of semilunar at onset of ventricular systole
C. Closure of AV at end of ventricular systole
D. Closure of semilunar at end of ventricular systole

A. closure of AV at onset of ventricular systole

10

Heart sound S2 is caused by ______:
A. Closure of AV at onset of ventricular systole
B. Closure of semilunar at onset of ventricular systole
C. Closure of AV at end of ventricular systole
D. Closure of semilunar at end of ventricular systole

D. closure of semilunar at end of ventricular systole

11

Mnenomic for the different types of valvular defects.

hARD fall - Aortic regurg - diastolic
ASS bump - Aortic stenosis - systolic
MSD you - Mitral stenosis - diastolic
MRS through - Mitral regurg - systolic

12

A patient presents with mixing of oxygenated blood with deoxygenated blood in central circulation. There is noted cyanosis in the extremities, indicated a failure of blood flow through the systemic circulation. This patient probably has what type of valve defect?

A. Tetrology of Fallot; left-to-right shunt
B. Patent Ductus Arteriosus; Right-to-left shunt
C. Tetrology of Fallot; right-to-left-shunt
D. Patent ductus arteriosis; left-to-right shunt

D. PDA; left-to-right shunt

13

A patient presents with poor oxygenation, an overriding aorta, and pulmonary artery stenosis. What is your diagnosis?

A. Tetrology of Fallot; left-to-right shunt
B. Patent Ductus Arteriosus; Right-to-left shunt
C. Tetrology of Fallot; right-to-left-shunt
D. Patent ductus arteriosis; left-to-right shunt

C. Tetrology of Fallot; right-to-left shunt

14

Generalized inadequate circulation to the body to meet tissue needs.

circulatory shock

15

What factors may decrease venous return, and thereby decrease cardiac output?

Diminished blood volume (hemorrhage)
Decreased vascular tone (venous pooling)
Obstruction to blood flow

16

What factors may decreased the ability of the heart to pump, and thereby decrease cardiac output?

MI, toxic heart, valvular disfunction, arrhythmias, cardiogenic shock

17

The CNS ischemic response is activated by arterial pressures

C. 50 mmHg

18

Cellular deterioration in decompensated shock includes decreased mitochondrial activity secondary to _____ failure. Why is this important?

Na/K/ATPase pump; Without proper Na/K/ATPase activity, the body is unable to move nutrients as needed to maintain cardiac output

19

Shock without loss of blood volume, results from loss of vasomotor tone

neurogenic shock

20

Neurogenic shock is produced by loss of SNS stimulation leading to _______ and decreased TPR.

decreased venous tone

21

Failure of the heart to pump enough blood to satisfy the needs of the body.
A. Cardiac Index
B. Decreased cardiac output
C. Cardiac Failure

C. Cardiac failure