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Biology 253 > Pulm Vascular Disorder: Pulmonary Embolism > Flashcards

Pulm Vascular Disorder: Pulmonary Embolism Flashcards

1
Q

What is Pulm Embolism?

A

thrombus within pulmonary arterial bed

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2
Q

Embolism ______ blood flow within _______

A

obstructs

vessels

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3
Q

Pulm Embolism has a high _______ rate (%?)

A

mortality

30

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4
Q

What happens if embolus fully obstructs a large vessel?

A

death will occur

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5
Q

Embolism is the _______ and the result is the _______

A

process

embolus

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6
Q

Etiology of Pulm Embolism (4)

A
  1. usually DVT
  2. fracture
  3. air
  4. amniotic fluid
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7
Q

Etiology: How does DVT contribute to Pulm Embolism? What veins are associated?

A

formation of thrombus in the deep veins that embolizes and reaches the pulm circuit

Iliac, femoral, popiteal, great saphenous veins of leg

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8
Q

When is DVT life-threatening?

A

when the thrombus breaks down and form an embolus which travel to a vital organ circulation

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9
Q

Describe how an embolus travel to the pulm circuit starting from the inferior vena cave.

A

inferior v. c. –> R. atrium–> R. ventricle–> pulm artery–> pulm capilleries–> pulm veins–> clot gets caught in the smaller vessles of pulm circuit

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10
Q

How does a bone fracture lead to Pulm Embolism?

A

bone fracture–> fat in bone marrow released—> fat enter the circulation and moves as an emboli—> reaches pulm circuit –> resulting in obstruction

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11
Q

Bone is richly ________

A

vascularized

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12
Q

How does air lead to Pulm Embolism?

A

air from syringe or tubing enter the circulation and moves as an emboli—> reaches pulm circuit resulting in obstruction

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13
Q

How does amniotic fluid lead to Pulm Embolism?

A

amniotic fluid rupture during delivery (vessels are severed too) and enter circulation –> cause an obstruction in pulm circuit

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14
Q

Fig. 29.15 What is the saddle embolus named after? What is it?

A

named after the saddle like appearance of an embolus

created by a thrombus setting at an area where pulm vessels bifurcate, attracting platelets, and causing the thrombus to increase in size

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15
Q

Patho: How does it cause obstruction? What does it result in?

A

embolus from DVT getting into the arterial blood –> obstruct the vessels –> perfusion impaired

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16
Q

Patho: What does decrease perfusion and thrombus attract? What does it do and release? Why?

A

decrease perfusion–> platelet attracted to the site of thrombus d/t vessel abnormality —> platelet degranulates –> release mediators to attract more platelets–> constriction of bronchi and pulmonary artery–> hemodynamic instability

17
Q

Patho: NS reflexively cause ___________ triggered by _____ d/t prob with the a/w. It is a _____ not ________.

A

bronchoconstriction

brain

reflex

Beneficial

18
Q

Patho: ventilation:perfusion imbalance leads to ______ and systemic ________

A

hypoxemia and hypoxia

19
Q

Patho: Why is there less blood being pumped into systemic circuit?

A

there is a decrease CO d/t obstruction in the lungs —> less blood flow into L side of heart

20
Q

Patho: What is surfactant? Why is there decrease surfactant? What does it result in?

A

surfactants are secretion from cell lining of the alveoli to prevent walls sticking to one another during exhalation

with impede circulation, there is decrease fluid available to form surfactant

T2 alveolar cells that produce surfactant are ischemic and decrease fxn–> decreasing surfactant levels –> atelectasis

21
Q

Patho: Pulm Embolism leads to _____ _____ _____. Why?

A

Right Heart Failure

obstruction in pulm circuit–> right ventricles is pumping against increase resistance–> increase workload of R. side of heart —> R-sided HF

22
Q

Manifestations depends on ____ and _______. Why?

A

size and vessel

large vessels = no circulation in pulm circulation–> major consequence

small vessels = less severe consequence

23
Q

Manifestations Pulm Embolism (5)

A
  1. dyspnea
  2. tachypnea
  3. chest pain
  4. tachycardia
  5. fever w/ or w/o infection
24
Q

Why does dyspnea occur?

A

impaired GE—> hypoxia –> dyspnea

25
Q

What are comp mech (2)? Explain

A
  1. tachypnea is a comp mech to hypoxemia and hypoxia

2. tachycardia is a comp mech to inadeq. perfusion and decrease CO

26
Q

Why causes chest pain?

A

d/t inadequate venous return to the L side of heart –> lack of perfusion in pulm circulation–> forms angina

27
Q

Diagnosis (7)

A
  1. hx and px
  2. ABGs
  3. D-dimer
  4. LDH3
  5. lung scan (131 I-HAS, IV)
  6. chest CT
  7. Pulm Angiogram
28
Q

What do ABGs measure?

A

pH, pCO2, and pHCO3 in arterial blood

29
Q

What is D-dimer? How does it dx Pulm Embolism? Is it a serum marker?

A

D-dimer is one of the protein fragment when blood clot get dissolved in breakdown of fibrin

used to rule out Pulm Embolism, DIC, and DVT

YES

30
Q

What is LDH3? What is the 3? How does it dx Pulm Embolism?

A

protein called lactate dehydrogenase which is released when cells die

3 = subclass specifically for alveolar tissues

Used as a marker for cellular damage in lung –> increase LDH3 = increase damage

31
Q

How is the lung scan used for dx? What is 131 I-HAS, IV? More or less invasive?

A

albumin is labelled with iodine 131 and allowed to flow freely thru circulation into pulm circulation and isotope can be detected @ point of obstruction

131 I = isotope of iodine (labelled)

HAS = human serum albumin

provide adequate info

NONINVASIVE

32
Q

How is Pulm angiogram used? More or less invasive?

A

catheter inserted into the coronory arteries of the pulm circuit –> contrast medium to detect the obstruction in the flow of blood

More invasive but effective and direct

33
Q

Treatment of Pulm Embolsim (4)

A
  1. stat intervention = better prognosis
  2. maintain cardiopulmonary function eg remove clots
  3. thrombolytics and anticoagulation –> to dissolve thrombus and to control platelets
  4. address underlying cause eg DVT

Biology 253 (39 decks)

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