PVD & Dissection

Question 1

What effect does increase peripheral vascular resistance have on the heart

Answer 1

Increases the afterload = increase how much the heart has to work / pump against

Question 2

What factors increase SVR

Answer 2

Atherosclerosis
HTN
Blood Viscosity
vasoconstriction / dilation

Question 3

What is normal systolic BP

Answer 3

120mmHg

Question 4

Where are baroreceptors located

Answer 4

carotids
aorta

Question 5

What is elevated systolic BP

Answer 5

120-129mmHg

Question 6

What is stage 1 HTN systolic BP

Answer 6

130-139mmHg

Question 7

What is stage 2 HTN systolic BP

Answer 7

> 140mmHg

Question 8

What is stage 1 HTN diastolic pressure

Answer 8

80-89mmHg

Question 9

What is stage 2 HTN diastolic pressure

Answer 9

> 90mmHg

Question 10

How does the body balance out blood pressure

Answer 10

baroreceptors and feedback info from those receptors

Question 11

What do the baroreceptors stimulate with increased BP

Answer 11

Increase vagal stimulation which will cause the release of acetylcholine

Question 12

What receptors are stimulated on the SA and AV nodes when acetylcholine is released

Answer 12

M2 = decrease HR, decrease CO and decrease BP

Question 13

What will be inhibited during times of HTN to decrease the production of catecholamine

Answer 13

adrenal medulla

Question 14

What happens in the kidneys during times of HTN

Answer 14

Pressure will increase within the glomerular filtration which will increase Na+/H2O secretion = decrease BP

Question 15

What is the most common type of hypertension

Answer 15

essential

Question 16

What factors increase HTN

Answer 16

sympathetic activation = B1 activation with increase HR = Increase CO = Increase BP

Question 17

Why does Nicotine cause HTN

Answer 17

Nicotine causes release of catecholamines

Question 18

Why does obstructive sleep apnea cause HTN

Answer 18

hypoxemia and hypercarbia cause catecholamine release

Question 19

What are hypertensive vasculopathies

Answer 19

vascular remodeling
endothelial dysfunction
inflammation

Question 20

What is malignant hypertension

Answer 20

bp>180/110

Question 21

What is hypertensive emergency indicative of

Answer 21

acute end organ damage secondary to elevated BP

Question 22

What is a hypertensive urgency

Answer 22

Stable end organ disease

Question 23

What type of hypertension has no end organ damage but has highly elevated BP

Answer 23

Severe uncontrolled HTN

Question 24

What are some downstream effects of chronic HTN

Answer 24

Ischemic heart diease
AKI/CKD
Encephalopathy
Hypertensive retinopathy
atherosclerosis
SAH/Ruptured aneurysm/lacunar infart

Question 25

Where does a dissection occur in the aorta

Answer 25

Separation of tunica intima and media allowing for an accumulation of blood

Question 26

What are dissections most commonly associated with

Answer 26

HTN Smoking advanced age hyperlipidemia

Question 27

What causes an aortic dissection

Answer 27

a supply/demand mismatch= stiffening of vascular wall = increase stress & decrease compliance, increase risk of endothelial damage = increased risk of dissection

Question 28

What are some risks for dissection

Answer 28

CT disorders bicuspid aortic valve coarctation of aorta

Question 29

What kind of trauma can cause an aortic dissection

Answer 29

acceleration/deceleration injuries

Question 30

How will an aortic dissection present

Answer 30

abrupt onset of chest /abdominal pain described as tearing widened mediastinum pulse/ BP difference in extremities

Question 31

What vessel layers are effected by an aortic aneurysm

Answer 31

all layers

Question 32

What are the causes of aortic aneurysms

Answer 32

CT disorders Trauma Aortits **atherosclerosis

Question 33

What is a ruptured AAA presentation

Answer 33

abdominal / back pain hypotension pulsatile abdominal mass

Question 34

What can chronic venous disease lead to

Answer 34

varicose veins

Question 35

What pressure is considered critical in compartment syndrome

Answer 35

10-30mmHg

Question 36

What is ABI

Answer 36

ankle brachial index *take BP in both places and compare to determine the severity of PVD ankle BP/Brachial BP

Question 37

What might a patient with critical PVD present with

Answer 37

persistent claudication gangrene skin breakdown

Question 38

What is the initial treatment of claudication

Answer 38

walking program **allows for angiogenesis