Study Guide: Chapter 12 Flashcards

1
Q

Which sized arteries are elastic?

A

Large

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2
Q

Which sized arteries are muscular

A

Medium

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3
Q

True or false: Blood normally clots both within and outside of blood vessels.

A

False; it normally clots on the surface (where the injury is); if it clots inside, it can be deadly (block circulation)

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4
Q

What are the 3 main reasons that blood might clot inside a vessel?

A

1) Blood stasis (assoc. with venous thrombosis)
2) Vessel wall damage (assoc with arterial thrombosis)
3) Increased blood coagulability

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5
Q

Which type of clotting inside vessels is caused by blood stasis?

A

Venous thrombosis

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6
Q

Which type of clotting inside blood vessels is caused by vessel wall damage?

A

Arterial thrombosis

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7
Q

intravascular clot

A

thrombosis

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8
Q

detached mobile clot

A

embolism

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9
Q

tissue necrosis

due to blocked blood supply so oxygen-starved tissue dies

A

infarction

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10
Q

death of body tissue due to either a lack of blood flow or a serious bacterial infection

A

gangrene

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11
Q

(inflammation of

vein

A

phlebitis

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12
Q

clot in inflamed vein

A

thrombophlebitis

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13
Q

dilated, twisted veins

A

varices/varicosities

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14
Q

(vein blocked by clot

A

venous thrombosis

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15
Q

True or false: Venous thrombosis can be caused by high BP.

A

False; veins are under low pressure

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16
Q

True or false: Varicose veins are often hereditary and are present in 70% of women over 60 years old.

A

True

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17
Q

Clot in deep veins of the legs

A

DVT

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18
Q

What percentage of people who have a DVT also develop a PE?

A

25%

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19
Q

What percent of DVT patients die from it?

A

10%

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20
Q

What percentage of hospital patients develop DVT if no preventative measures taken?

A

25%

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21
Q

True or false: Most DVTs dissolve naturally.

A

True

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22
Q

How is PE generally treated?

A

With anticoagulants (rarely use thrombolytics, angioplasty, or surgery/thrombectomy)

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23
Q

What effects does a large pulmonary embolism have on the heart?

A

Causes blood to back up into the R side of heart and prevents enough blood from reaching the left side of the heart. BP falls (shock).

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24
Q

Condition that results from an embolism carrying a bacterial infection with it to the lung; results in an infection of necrotic tissues and formation of lung abscess and systemic infection.

A

Septic pulmonary embolism

25
Q

How is PE diagnosed?

A

1) D-dimer blood test (d-dimer levels rise with fibrinolysis)
2) Chest xray (may reveal necrotic wedge, but not embolism itself)
3) Ventilation/perfusion scan
4) CT scan (best) or pulmonary angiogram

26
Q

Type of blood test used to dx PE

A

d-dimer (levels rise with fibrinolysis)

27
Q

What is the best dx tool for diagnosing PE?

A

CT scan with contrast or pulmonary aniogram

28
Q

Test that detects if lung ventilation is normal but pulmonary blood flow is reduced (which indicates PE)

A

Ventilation/perfusion scan

29
Q

Test that detects blockage using radiopaque material and x-rays; have to thread a catheter up through heart and into pulmonary artery

A

pulmonary angiogram

30
Q

How do you treat PE?

A

Typically with anticoagulants; if its an emergency, thrombolytics can be used (tPA)

31
Q

What causes arterial thrombosis?

A

Vessel wall injury due to arteriosclerosis.

32
Q

What occurs as a result of arterial thrombosis?

A

Tissue and organ infarcts

33
Q

What can a leg infarct caused by arterial thrombosis lead to?

A

Gangrene

34
Q

How does arteriosclerosis cause arterial thrombosis?

A

1) Vessel wall injury causes ulceration and roughening of the arterial lining.
2) This allows thrombi to form.

35
Q

What factors predispose a person to both arterial and venous thrombosis?

A

1) Obesity
2) Estrogen/oral contraceptives
3) Older age

36
Q

What are the most common cause of intracardiac thrombosis?

A

1) Atrial fibrillation
2) Heart failure
3) Heart valve damage
4) Damaged L ventricle lining

37
Q

Where do clots caused by atrial fibrillation form?

A

Within little atrial appendage heart pouches

38
Q

What happens with clots that form in the heart?

A

They can be carried back into circulation and cause infarcts anywhere in the body where they get stuck.

39
Q

What leads to pathological clot formation caused by increased coagulability of blood?

A

1) Following injury or surgery
2) Estrogenic compounds
3) Advanced cancer
4) Hereditary mutations that increase coagulability (e.g., factor V Leiden)

40
Q

What is a mutated form of human factor V that causes hypercoagulability (increased blood clotting)?

A

factor 5 Leiden

41
Q

Why does the mutant factor V Leiden mutation cause hypercoagulability?

A

It is not sensitive to protein C inhibition and therefore has prolonged prothrombin to thrombin activation.

42
Q

What are the significant differences between increased thromboplastic material released during advanced cancer and that released in disseminated intravascular disease (DIC)?

A

1) DIC = thromboplastic materials are released rapidly, using up clotting factors and activating fibrinolysis; this causes hemorrhaging.
2) Advanced cancer can cause thromboplastic material to be released slowly, causing overall thrombosis.

43
Q

What is an example of an embolism caused by fat?

A

In the case of a bone fracture

44
Q

What is an example of an embolism caused by air?

A

In a lung injury or injection error.

45
Q

What is an example of an embolism caused by amniotic fluid?

A

labor/delivery

46
Q

What is an example of an embolism caused by injected particles?

A

Drug abuser

47
Q

Fluid accumulation in tissues

A

edema

48
Q

True or false: There is no cure for edema.

A

True

49
Q

How do you treat edema?

A

Treat the causes; also elevation, compression support hose, low salt diet, limit time sitting or standing; leg muscle exercises.

50
Q

What can cause edema?

A

1) Increased capillary permeability
2) Osmotic pressure drop due to low blood protein
3) Increased capillary hydrostatic pressure
4) Lymphatic blockage
5) Heart failure (can cause pulmonary edema)

51
Q

What is a major cause of acute pulmonary edema?

A

Heart failure

52
Q

What is shock?

A

When BP and/or blood flow is too low to supply body with adequate blood.

53
Q

When BP and/or blood flow is too low to supply body with adequate blood.

A

Shock

54
Q

What can cause shock due to decreased blood volume?

A

Hemorrhaging that causes blood volume to drop.

55
Q

What can cause shock?

A

1) Decreased blood pressure

2) Decreased blood volume

56
Q

How do you treat shock?

A

1) Vasoconstrictors
2) Increase blood volume
3) Eliminate cause

57
Q

Why can anaphylaxis cause shock?

A

Causes high vasodilation, resulting in lowered blood pressure.

58
Q

How can an MI ore heart failure cause shock?

A

Heart cannot pump adequately to deliver blood to the body

59
Q

How can sepsis or infection cause shock?

A

Causes excessive vasodilation, resulting in lowered blood pressure.