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Cardiopulmonary > Quiz 3 > Flashcards

Quiz 3 Flashcards

(103 cards)

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1
Q

What is the most common cause of congestive heart failure?

A

-Cardiac Muscle Dysfunction

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2
Q

What does cardiac muscle dysfunction present with?

A

-impaired aerobic capacity and endurance, with cardiovascular pump dysfunction or failure

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3
Q

How does hypertension cause cardiac muscle dysfunction?

A

-increased arterial pressure leads to LV hypertrophy; leads to over stretched contractile fibers and an ineffective pump

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4
Q

What is the second most common cause of cardiac muscle dysfunction?

A

-Coronary Artery Disease

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5
Q

What can occur post CABG that can cause cardiac muscle dysfunction?

A

-post perfusion pump syndrome

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6
Q

Atrial fibrillation can cause what?

A

-Ventricular tachycardia

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7
Q

How can renal insufficiency cause cardiac muscle dysfunction?

A

-it can cause fluid overload= increase BP

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8
Q

What is the primary cause of cardiomyopathy that leads to cardiac muscle dysfunction?

A

-myocardium being replaced by fatty or scar tissue and beings to lose the ability to receive and transmit impulses

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9
Q

What protein is produced in bone marrow that can be deposited in the heart and lead to cardiomyopathy and eventually CMD?

A

-Amyloid

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10
Q

What type of cardiomyopathy referred to the myocardium being stretched causing it to pump ineffectively?

A

-Dilated cardiomyopathy

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11
Q

Dilated cardiomyopathy normally effects what heart chamber?

A

-The LV

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12
Q

Dilated cardiomyopathy also causes a decrease in what?

A

-Mitochondria

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13
Q

Dilated Cardiomyopathy will cause what two things to be elevated?

A

-End Diastolic volume and end diastolic pressure; further dilated the ventricle and decreasing contractility

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14
Q

Decreased energy associated with dilated cardiomyopathy causes what to be decreased?

A

-Stroke Volume (leads to increased HR to compensate)

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15
Q

Excessive nonfunctional cardiac muscle associated with a hypertophic cardiomyopathy can cause what dysfunction?

A

-stiffening of valves

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16
Q

What type of cardiomyopathy is associated with decreased myocardial compliance and decreased stretching of the myocardium leading to decreased end dialstolic volume?

A

-Restrictive Cardiomyopathy

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17
Q

A blocked valve will cause the heart to do what?

A

-Contract more forcefully

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18
Q

Heart valve dysfunctions are associated with what two types of cardiomyopathy?

A

-dilation and hypertrophy

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19
Q

Cardiac tamponade can cause elevated intracardiac pressures causing what?

A

-limited diastolic filling and causes a reduced stroke volume

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20
Q

What can pericarditic cause?

A

-Percardial effusion (elevated fluid levels in the pericardial sac)

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21
Q

What can cause CMD in the right ventricle?

A

-Pulmonary embolism

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22
Q

How can a pulmonary embolism cause CMD of the right ventricle?

A

-IT increased pulmonary pressures, and overworks the RV

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23
Q

Pulmonary pressures greater than what is considered hypertensive?

A

-25 mmHg

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24
Q

For COPD patients, pulmonary pressures greater than what are considered hypertensive?

A

-20 mmHG

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25
Increased pulmonary pressures lead to what?
-RV hypertrophy
26
Spinal cord injuries to what segment typically cause CMD?
-Cervical
27
Why do C-spine SCIs cause CMD?
-It can cause an imblanace in sympathetic and parasympathetic stimulation
28
What are the two most common congenital heart abnormalities?
-bicuspid valve abnormality, and leaflet abnormalities associated with mitral valve prolapse
29
Who does aging cause a decreased cardiac output?
-altering contraction and relaxation of cardiac muscle
30
Decreased vascular elasticity associated with aging will have what effect on the cardiovascular system?
-Increased BP
31
LV hypertrophy associated with aging have what effect on the heart?
-Decreased ventricular compliance
32
Decreased adrenergic responsiveness associated with aging will have what effect on the cardiovascular system?
-Decreased exercise HR
33
Decreases in the rate of calcium pumped by the sarcoplasmic reticulum associated with aging will have what effect on the heart?
-Prolonged times for relaxation
34
Prolonged time to peak contraction force of cardiac muscle contraction associated with aging will have what effect on the heart?
-Prolonged times of contraction
35
Decreased myocardial twitch force associated with aging will have what effect on the myocardium?
-reduction in contraction velocity
36
Decreased rate of ATPase hydrolysis associated with aging will have what effect on the myocardium?
-Reduction in shortening velocity
37
Decreased myosin ATPase activity associated with aging will have what effect on the myocardium?
-reduction in shortening velocity
38
Diastolic dysfunction associated with aging will have what effect on the heart?
-impaired ventricular filling with potential to increase cardiac preload and CHF
39
Decreased lean body mass associated with aging can cause what effects on the cardiovascular system?
-decreased muscle strength and peak oxygen consumption
40
What is the most common manifestation of heart failure?
-Pulmonary edema
41
What is the most common cause of pulmonary edema?
-LV failure
42
How can Heart failure affect the brain?
-It will increase sympathetic stimulation
43
How can heart failure effect the liver?
-it can cause hypoperfusion and venous congestion-leading to cirrhosis
44
Heart failure can cause what dysfunction in the MSK system?
-atrophy (it decreased nutrition and ultimately a reduction in exercise tolerance
45
What 7 things effect the stretch of cardiac muscle (frank starling mechanism)?
- Atrial contribution to ventricular filling - Total blood volume - body position - intrathoracic pressure - intrapericardial pressure - venous tone - pumping action of skeletal muscle
46
What two chemicals are release fom arterial and cardiac myocytes in response to stretch?
-ANP and BNP
47
What are the effects of ANP and BNP?
-they decrease chemicals to reduce fluid volume
48
Increased levels of BNP are associated with what 3 conditions?
-Heart disease, heart failure, and acute coronary syndrome
49
ANP produced by atrial stretch receptors reaches the kidneys to have what effect?
-Increases diureses to decrease fluid volume
50
Decreased in CO increase sympathetic stimulation, this activates the RAS system to increase production of what?
-ADH
51
The activation of the RAS system will lead to what changes?
-increased ADH which inturn increases venous return and increases preload (produces greater CO)
52
What negative effects can an increase of ADH cause?
-An increase of peripheral edema
53
Pulmonary dysfunction can stem from what two sources?
-Cardiogenic or noncardiogenic
54
What occurs in stage I of LV failure that cuases pulmonary edema?
-intersitial edema results from elevated capillary pressures (13-18 mmHg), which forces fluid plasme into the interstitial area
55
What occurs in stage two pulmonary edema caused by LV failure?
-early alveolar edema occurs when capillary hydrostatic pressure is significantly elevated (18-28 mmHg), causing fluid to cross the alveolar membrane
56
in stage III pulomnary edema caused by LV failure, what occurs?
-Complete alveolar flood occurs when pressure reach > 28 mmHGm and can possibly flood large airways
57
What capillary pressures are associated with stage I pulmonary edema?
-13-18 mmHg
58
What capillary pressures are associated with stage II pulmonary edema?
-18-28 mmHg
59
What capillary pressures are associated with stage III pulmonary edema?
->28 mmHg
60
Alpha-1 adrenergic receptors have what effects on the heart?
-Increase ionotrophic effects (increased contractility)
61
Alpha 2 adrenergic receptors activate the inhibitory G protein that has what effects on the heart?
-Decrease ionotrophic effects (decreased contractility)
62
Beta-1 adrenergic receptors have what effects on the heart?
- stimulates increased HR and contractility
63
Beta-2 adrenergic receptors have what effects on the cardiopulmonary system?
-promotes vasodilation and muscle relaxation of bronchial tracts
64
What G protein sends stimulatory signals to the catalytic unit to increased myocardial contraction?
-Gs
65
What G protein sends inhibitory signals to the catalytic unit to decreased myocardial contraction?
-G1
66
What is the catalytic unit made of?
-Adenylate cyclase
67
What sympathetic complex begins to fail with CHF?
-RCG complex
68
Why does the RCG complex begin to fail with CHF?
-because of insensitivity of the heart to beta adrenergic stimulation
69
What hematological conditions can CHF cause?
-Polycythemia, anemia, hemostasis or thrombocytopenia
70
CHF patients without myopathy tend to have a decrease in what?
-Average diameter of type I and type II muscle fibers
71
CHF patients with myopathy tend to experience what?
-type I and type II muscle fiber atrophy
72
CHF patients may see a decrease in what up to 50%?
-Isometric maximal muscle strength
73
What pancreatic functions can be compromised due to CHF?
- reduced blood flow to panreas - impairs insulin secretion and causes glucose intolerance - Increased Acetyl-CoA
74
Abnormalities in sympathetic neural function can cause dysfunction of the stomach and intestines causing what?
-Malnutrition and anorexia
75
Patients with CHF may see what 3 blood abnormalities?
- Decreased production of erythropoietin - decreased synthesis of 1,25-dihydroxyxholecalciferol - impaired intermediary metabolism
76
What is the definition of CHF?
-a chronic, progressive condition affecting the ability of the heart to pump the blood and maintain adequate circulation of blood in the tissues resulting in heart failure
77
What type of heart failure causes inefficient ejection of blood?
-Systolic heart failure
78
What 2 things will systolic heart failure decrease?
-stroke volume and ejection fraction
79
What will systolic heart failure increase?
-systolic volume
80
Systolic heart failure leads to heart failure with what?
-reduced ejection fraction
81
What type of heart failure impairs the ability of the heart to receive blood?
-Diastolic heart failure
82
Diastolic heart failure leads to impairments in what two ventricular functions?
-filling and relaxation
83
Diastolic heart failure leads to a rise in what?
-Diastolic pressure
84
Daistolic heart failure leads to heart failure with preserved what?
-Ejection fraction
85
What are some symptoms of left sided heart failure?
-dyspnes, dry cough, pulmonary rales, enlarged heart, pleural effusion, peripheral cyanosis, increased respiration
86
Right sided heart failure will have what symptoms?
-Edema, bloating, increased central venous pressure, liver/spleen enlargement, peripheral cyanosis, increased right arterial pressure, peripheral effects
87
Why does CHF cuase dyspnea?
-it cuases poor gas transport
88
How can you combat orthopnea associated with CHF?
-Elevated the upper body while sleeping
89
What heart sound is seen with CHF?
-S3
90
What causes the S3 heart sound?
-a non-compliant left ventricle
91
A 6 minute walk test score of less that 468 indicates what?
-poor short term survival
92
What responses to exercises may we see with a patient with CMD or CHF?
- rapid rise in HR with submaxive exercise - lower peak O2 consumption - decreased rise in systolic BP in response to exercise - Possible increased DPN - easily provoked Dyspnea, fatigue and possible angina - lower maximal workload - increased HR and contractility
93
What outcome measure can be used to assess quality of life of patient with CHF?
-Minnesota living with HF questionnaire
94
What condition is commonly associated with functional decline?
-depression
95
What might we see in the lab results with a CHF patient?
-proteinuria, elevated unrine specific gravity, BUN, creatine levels, and decreased erythrocyte sedimentation rate
96
What liver enzymes may be elevated in CHF patients?
-AST and bilirubin
97
What will CHF do to PaO2 and O2 saturation?
-Decrease it
98
What will CHf do to PaCO2 levels?
-increase it
99
What radiologic rindings may you see in a CHF patient?
-Large heart, presence of pulmonary edema
100
What dietary changes may be made for a CHF patient?
-Decreasing sodium and fluid intake
101
When is a ICD implant indicated for a CHF patient?
-When EF is less than or equal to 35% and when mild to moderate symptoms are present
102
What type of breathing techniques facilitate improved exercise tolerance?
-Diaphragmatic breathing
103
what should you educate a CHF patient on?
-energy prevention

Cardiopulmonary (7 decks)

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