Perfusion II

Question 0

Hepatic Vein

Answer 0

1. Carries blood through the liver to the Vena Cava

Question 1

Pulmonary Veins

Answer 1

1. Oxygenated blood flows from the lungs into the left atrium through the pulmonary veins

Question 2

Veins

Answer 2

Carry blood to the heart

Question 3

Arteries

Answer 3

Carry blood away from the heart

Question 4

Nitro-glycerin

-Contraindications

Answer 4

1. Nitro-glycerin is contradicted in patients with aortic stenosis

Question 5

Heart Rate Initiation

Answer 5

1. SA node runs at 60-100 BPM’s
2. AV Node runs at 40-60 BPM’s
3. Purkinjee fiber’s run at 20-40 BPM’s

Question 6

Causes of Varicose Veins

Answer 6

1. Gravity
2. Long Periods of Standing
3. Trauma to the saphinous veins

Question 7

Aortic Stenosis

-Contraindicated Medication

Answer 7

1. Nitro-glycerin is contraindicated in patients with aortic stenosis.
2. Vasodilation causes decreased pressure and possible inability to perfuse through stenosed valve

Question 8

Preload

Answer 8

1. The ability of the heart to receive the load

Question 9

After-load

Answer 9

1. Ability of the heart to take off the load

Question 10

Cardiac Output =

Answer 10

1. Stroke Volume X Heart Rate = CO

Question 11

Stroke Volume

-Things that affect Preload

Answer 11

1. Venous return

2. End systolic volume

Question 12

Stroke Volume

-Thinks that affect After-load

Answer 12

1. Aortic Pressure

2. Aortic Valvular function

Question 13

Stroke VOlume

-Things that Affect Contractility

Answer 13

1. End Diastolic Volume
2. Sympathetic stimulation
3. Myocardial Oxygen supply

Question 14

Stroke Volume

-Med’s that affect Contractility

Answer 14

1. Digoxin

Question 15

Things that affect Heart Rate

Answer 15

1. CNS
2. ANS
3. Neural Reflexes
4. Atrial receptors
5. Hormones

Question 16

Where is Vascular Plaque Located?

Answer 16

1. Plaque is normally located in the tunica intima, not on the surface of the lumen

Question 17

Complicated Lesion

Answer 17

1. Rupture of the endothelial lining exposing the plaque and causing activation of platelets
2. Usually cause MI’s

Question 18

Factors Affecting Blood Flow

Answer 18

1. Poiseuille Law (Viscosity of Fluid)
   - Stroke is a risk from Dehydration TEST
2. Pressure
3. Resistance
4. Neural control of total peripheral resistance
   - RAAS

Question 19

Underlying Problem Of Shock

Answer 19

1. Inadequate Tissue perfusion

2. Leads to microcirculatory failure and organ failure

Question 20

Order of Organ Failure

Answer 20

1. 1st organ to go is the Kidney’s

2. Liver is the last organ to go

Question 21

Types of Shock

Answer 21

1. Hypovolemic - Volume
2. Cardiogenic - Pump
3. Distributing - Plumbing

Question 22

Hypovolemic Shock

-External Causes

Answer 22

1. GI loses
2. Loss of limb
3. Vessel disruption
4. Diabetes Insipidus & DKA
5. Burns - loss of albumin
6. Trauma

Question 23

Hypovolemic Shock

-Internal Causes

Answer 23

1. Dissecting Aorta
2. Retroperitoneal bleed (Pt’s returning from Cath Lab)
3. Hemothorax
4. Splenic Rupture
5. Third Spacing

Question 24

What to Look for in Pt's returning from Cath Lab?

Answer 24

1. Retroperitoneal bleed | - Occult bleeding in the retroperitoneal cavity

Question 25

Cardiogenic Shock

Answer 25

1. More than 40% of muscle mass has to be lost for cardiogenic shock to occur (in 80% of pt's) - It matters where the muscle mass is lost 2. Left Ventricular muscle loss is the most serious

Question 26

Cardiogenic Shock | -Things that Cause it

Answer 26

1. Papillary muscle rupture 2. Cardiac Tamponade 3. Tachyarrhythmias 4. Bradyarrhythmias 5. Drugs

Question 27

Distributive Shock

Answer 27

1. Anaphylactic 2. Neurogenic 3. Septic

Question 28

Distributive Shock | -Anaphylactic

Answer 28

1. Systemic Allergic Reaction - Drugs - Food - Insect bites or stings - Chemicals

Question 29

Distributive Shock | -Neurogenic

Answer 29

1. Damage to the SNS -Spinal Cord injury above T7 2. Because there is no SNS response, there is NO COMPENSATION

Question 30

Septic Shock

Answer 30

1. Release of Inflammatory mediators that result in massive vasodilation - Gram Negative Bacteria - E. coli

Question 31

Superior Vena Cava Syndrome | -

Answer 31

1. Progressive occlusion of the SVC that leads to venous distention in the upper extremities and head

Question 32

Superior Vena Cava Syndrome | -What Causes it?

Answer 32

1. Bronchogenic cancer | 2. TB

Question 33

Superior Vena Cava Syndrome | -Clinical Manifestations

Answer 33

1. Edema and venous distention in the upper extremities and face, including ocular beds 2. Pt complains of feeling: - fullness in the head - tightness in shirt collars, necklace, or ring 3. Face and arms may become purple w/ slow cap refill

Question 34

Superior Vena Cava Syndrome | -Diagnosis

Answer 34

1. Chest X-Ray 2. Doppler Studies 3. CT or MRI

Question 35

Superior Vena Cava Syndrome | -Treatment

Answer 35

1. Radiation therapy , surgery, chemotherapy for malignant disorders 2. Bypass surgery using grafts, thrombolysis, ballon angioplasty or stents for NON-MALIGNANT

Question 36

Complicated Hypertension | -Examples

Answer 36

1. Left Ventricular hypertrophy 2. Angina pectoris 3. HF, CAD, MI 4. Sudden death