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Flashcards in TEST 2 Deck (212):
1

blood vessels containing blood flowing to the heart

veins

2

blood vessels containing blood flowing from the heart

arteries

3

from the right ventricle, deoxygenated blood is pumped through WHAT and then WHAT

pulmonary valve then pul artery

4

primary function of the respiratory system

gas exchange

5

right side

into the lungs

6

left side

system

7

main pump of the heart

left ventricle

8

lowest volume system; responsible for the gas exchange

capillaries

9

govern the flow of blood in the vascular system.

principles of blood flow- look over this in book

10

Pressure Difference/Resistance

flow

11

between two ends of a vessel

pressure difference

12

causes of resistance of blood flow

sickle cell anemia, peripheral artery disease, mi

13

Distance measurement speed at which blood flows through the vessel

velocity

14

heart rate should be

60-100

15

the smaller the lumen

the higher the flow

16

velocity, cross-sec, and flow

velocity=flow rate over cross sectional

17

The relationship between the wall tension of a vessel, its intraluminal pressure, and its radius

law of laplace

18

Ability of a blood vessel to be stretched and accommodate an increased volume of blood

distensibility

19

depolarization of atria

P

20

depolarization of ventricles

QRS

21

repolarization of ventricles

ST

22

QT interval

de and repolarization of ventricles

23

baseline is also the

isoelectric line

24

PR segment

Impulse travel through AVN

25

PR interval

Atrial depolarization and travel time

26

Slow repolarization of the Purkrnje fibers

U wave

27

QT interval

Total ventricular activity

28

occurs when the heart contracts to pump blood out

systole

29

occurs when the heart relaxes after contraction

diastole

30

Endothelial relaxing factors

nitric oxide

31

What is the of nitric oxide role and what pharmacological agent produces the effect of nitric oxide.

it is a vasodilator. helping blood vessels to relax and expand when necessary ; nitro glycerin

32

ACE I end in

pril

33

ARBS end in

sartan

34

humoral controls of blood flow

Norepinephrine
Epinephrine
Angiotensin II
Histamine
Serotonin
Bradykinin
Prostaglandins

35

causes vasoconstriction of blood vessels

norepi

36

causes more increase in heart rate and cardiac output through contractibility

epi

37

hormones made by the adrenal glands

Catecholamines

38

angiotension ii is a what

vasoconstriction

39

histamine is a what

vasodilator

40

plays major role in control of bleeding

serotonin

41

serotonin is a what

vasoconstrictor

42

bradykinin is a what

vasodilator

43

bradykinin causes

constriction of venules
dilation of arterioles
increased capillary permeability

44

Prostaglandin E group

vasodilators

45

Prostaglandin F group

vasoconstrictors

46

refers to increased levels of cholesterol in the blood.

Hypercholesterolemia

47

a genetic disorder that affects the body’s connective tissue.

marfan syndrome

48

marfan syndrome clinical manifestations

Long arms, legs and fingers
Tall and thin body type
Curved spine
Chest sinks in or sticks out
Flexible joints
Flat feet
Crowded teeth
Stretch marks on the skin that are not related to weight gain or loss

49

is a recurring progressive, nonatherosclerotic inflammation and thrombosis of small and medium-sized arteries and veins, usually the plantar and digital vessels in the foot and lower leg.

Thromboangitis Obliterans (Buerger)

50

fingers become white due to lack of blood flow; turn blue to keep blood vessels dilate; turn red as blood returns

raynauds

51

what is the predominant symptom of Thromboangitis Obliterans

pain

52

dyspnea, stridor, or a brassy cough caused by pressure on the trachea.
Hoarseness may result from pressure on the recurrent laryngeal nerve, and there may be difficulty swallowing because of pressure on the esophagus

aneurysms of thoracic

53

abdominal aneuryms

Saccular aneurysm-sac on the vessel
Fusiform aneurysm- takes up whole blood vessel

54

slide 106

go over

55

“strangling of the chest”
temporary imbalance
Ischemia limited in duration

Angina pectoris

56

Moderate to prolonged exertion
Frequency, duration, and intensity
Activity tolerance
Treatment: Goal

stable angina

57

Umbrella term for conditions that cause chest pain due to insufficient blood supply to the heart muscle (acute myocardial ischemia).

acute coronary syndrome

58

risk factors for ACS non modifiable


Age

Gender

Family history

Ethnic background

59

risk factors for ACS modifiable

Cholesterol levels

Smoking

Physical inactivity

Hypertension

Serum homocysteine

60

Pain assessment for ACS?

History

Pain assessment

Cardiovascular assessment

Psychosocial assessment

Laboratory assessment

Radiographic assessment

Diagnostic assessments

61

Psychological assessment for ACS

(major defense mechanism) DENIAL

62

MONABATH

Morphine
Oxygen
Nitroglycerin
ASA

Beta-blockers
ACE-I
Thrombolytics
Heparin

63

Contraindications to thrombolytics….absolute

Active internal bleeding
Known allergey to streptokinase products
Recent head trauma
Known bleeding discorders
Suspected aortic dissection
Increased BP 200/120 mm Hg
Pregnancy or recent delivery
CVA within past 2 months
Recent spinal or cerebral surgery, cranial neoplasm
Prolonged Cardiopulmonary resuscitation

64

Contraindications to thrombolytics….relative

Endocarditis or pericarditis

Hemostatic defects

Severe uncontrolled hypertension

Trauma within 10 days

Current use of oral anticoagulants

Active peptic ulcer disease

65

signs of infective endocarditis

osler node
janeway lesion

66

infection of the heart valves in the endocardium

infective endocarditis

67

involving pink rings on the torso and inner surfaces of the limbs which come and go for as long as several months. It is found primarily on extensor surfaces

Erythema Marginatum

68

sac surrounding the heart

pericardium

69

Acute Pericarditis: Clinical Manifestations

chest pain, friction rub, ecg changes

70

first-line therapy for acute perdicard

aspirin or NSAIDS

71

the accumulation of fluid in the pericardial cavity, usually as a result of an inflammatory or infectious process that includes pericarditis.

Pericardial Effusion

72

Cardiac Tamponade: Becks Triad

JUGULAR VENOUS DISTENSION, muffled heart sounds, low bp

73

right side heart failure clinical manifestations

congestion of peripheral tissue, liver congestion, gi tract congestion

74

left side heart failure clinical manifestations

decreased cardiac output, pulmonary congestion, impaired gas exchange, pulmonary edema

75

treating congestive heart failure

Upright position
Nitrates
Lasix- urinate less pressure in body
Oxygen
Ace i
Digoxin
Fluids - decrease
Afterload- decrease
Sodium restriction
Test - Digoxin levels, ABGs, potassium levels

76

whats the main test for congestive hf

ABGs- blood test

77

compensatory mech for hf

slide 191

78


Loss of whole blood

Loss of plasma

Loss of extracellular fluid

hypovolemic shock

79

inability of the heart to maintain cardiac output necessary to meet body needs. extra strain on the heart causes decrease tissue perfusion

cardiogenic shock

80

respiratory airways

gas exchange takes place in alveoli

81

is used each day to humidify the air we breathe.

1 pint

82

why is it important to drink water when you have a fever

water vapors increase so you lose water in the resp tract; resp secretions thicken and this prevents the cilia from movement;impairing the protective function of the mucociliary defense system

83

what type of alveolar cells provide surface area for gas exchange

i

84

what type of alveolar cells provide surface tension; helps with destruction of pathogens; surfactant secreting

ii

85

slow down

parasym

86

flight or fight

sym

87

innervation of lungs airway constriction; increases respiratory secretions

parasym

88

How easily lungs can be inflated

compliance

89

Impedance to flow that the air encounters as it moves through the airways

airway resistance

90

what does gas exchange require

matching of ventilation and perfusion ; equal amounts of air and blood enter the respiratory portion of lung

91

the volume of air which is inhaled that does not take part in the gas exchange,

dead space

92

blood that moves from the left to the right side of the circulation without being oxygenated

shunt

93

ABG (partial blood gases)

ph 7.35-7.45
PCO2-35-45

HCO3- 22-26

PaO2- >80

94

pco2 is what

carbon dioxide

95

hco3

bicarbonate

96

Hemoglobin’s ability to bind oxygen

affinity

97

Hemoglobin binds oxygen more readily when its affinity is WHAT and releases it more readily when its affinity is WHAT

increased
decreased

98

Affinity is also influenced by

pH
Carbon dioxide concentration
Body temperature

99

a right shift in graph means

decreased oxygen affinity of hemoglobin allowing more oxygen to be available to the tissues.

100

a left shift in graph means

increased oxygen affinity of hemoglobin allowing less oxygen to be available to the tissues

101

what nerve stimulates the diaphragm

phrenic nerve

102

3 upper respiratory viruses in adults

common cold
influenza
rhinosinusitis

103

Occur in early fall and late spring in persons between ages 5 and 40

rhinovirus

104

Occur in children younger than 3

parainfluenza

105

occur in winter and spring in children younger than 3

Respiratory syncytial virus

106

Occur in winter and spring

Coronaviruses and adenoviruses

107

facial pain, headache, purulent nasal discharge, decreased sense of smell, fever

acute rhino sinusitis

108

nasal obstruction, fullness in the ears, postnasal drip, hoarseness, chronic cough, loss of taste and smell, unpleasant breath, headache

chronic rhinosinusitis

109

influenza has 3 divisions what are they

URI- rhinotracheitis
viral pneumonia
respiratory viral infection followed by bacterial

110

how to differentiate between influenza and common cold

influenza is profound malaise

111

Transmission is by aerosol (three or more particles) or direct contact.

influenza

112

URI is a division of influenza (rhinotracheitis) a clinical manifestation

PROFOUND MALAISE

113

clinical manifestation of this division of influenza;
fever, tachypnea, tachycardia, cyanosis, hypotension

viral pneumonia

114

survivors of viral pneumonia might have what

stiffening of the lungs..not good

115

causative organisms of a Respiratory viral infection followed by a bacterial infection.

S. pneumoniae
S. aureus
H. influenza
M. catarrhalis

116

children with reyes syndrome should not be given what? and why

aspirin
kids being treated from a viral infection and fever and are given aspirin could result in reyes syndrome

117

Pneumococcal Pneumonia is caused by

s. pneumoniae

118

legionnaires disease is caused by

gram-negative rod, Legionella pneumophila.

119

characterized by patchy involvement of the lung alveolar septum and pulmonary interstitium

primary atypical pnemoniae

120

most causative organism of primary atypical pneumoniae

m. pneumoniae

121

community acquired pneumonia

infection that begins outside the hospital or is diagnosed within 48 hours after admission to the hospital in a person who has not resided in a long-term care facility for 14 days or more before admission.

122

most common cause of community acquired pneumonia

bacterial or viral
s. pneumonia

123

key components of VAP (ventilator associated pneumonia)

Elevation of the head of the bed
Daily “sedation vacations” and assessment of readiness to extubate
Peptic ulcer disease prophylaxis
Deep venous thrombosis prophylaxis

124

causative organism of tuberculosis

Mycobacterium tuberculosis hominis

125

type of necrosis tuberculosis will cause

caseous necrosis

126

clinical manifestations of pulmonary tb

night sweats, coughing up blood (hemoptysis)

127

what test is done for pulmonary tb

a culture OR The Mantoux tuberculin skin test (TST) or the TB blood test

128

how to know if tb is positive

read 48-72 hours after; looking for induration-how big is it, feel raised area, hard

129

histoplasmosis comes from

poop from birds; fungi H. capsulatum

130

what is the lung cancer called

Bronchogenic carcinoma; arises from epithelial cells of the lining

131

manifestations of lung cancer

coughing up blood, chest pain worse with deep breathing, hoarseness,

132

blueness

cyanosis

133

decrease in blood oxygen levels so not oxygenating tissues

hypoxemia

134

manifestations of hypoxemia

hypotension, bradycardia, retinal hemorrhage

135

PO2 less than than 60 mm Hg

hypoxemia

136

increase in carbon dioxide levels of the atrial blood; respiratory acidosis

hypercapnia

137

manifestations of hypercapnia

respiratory acidosis; sleepy; decrease muscle contraction (vasodilation)

138

PCO2 greater than 50 mm Hg

hypercapnia

139

lines the thoracic wall and superior aspect of the diaphragm.

parietal pleura

140

covers the lungs

visceral pleura

141

space between the two layers contains a thin layer of serous fluid.

pleural cavity

142

fluid in the pleural cavity

pleural effusion

143

serous fluid in the pleural cavity

hydrothorax

144

pus in the pleural cavity

empyema ; yogurt

145

what can happen in the body when pneumothorax occurs

medial stenum shift

146

Air enters the pleural cavity.
Air takes up space, restricting lung expansion.

pneumothorax

147

Incomplete expansion of the lung

Atelectasis

148

tachypnea, tachycardia, dyspnea, cyanosis, signs of hypoxemia, diminished chest expansion, absence of breath sounds, and intercostal retractions.

manifestations of atelectasis

149

treatment of atelectasis

chest tube to expand the lung

150

inflamed airways in lungs; makes them swollen and sensitive

asthma

151

when does cough occur for asthma

at night, sometimes in the early am

152

external environment causes it; mast cells release histamine as an inflammatory mediator

extrinsic atopic asthma

153

internal environment; Respiratory infections
Epithelial damage, IgE production

intrinsic nonatopic asthma

154

what can cause intrinsic asthma

smoking, medications, sulfites, viral cold

155

COPD types

emphysema
Chronic obstructive bronchitis
Bronchiectasis

156

affects the air spaces and destruction of lung tissue; destruction to alveoli

emphysema

157

increase muscus product; obstruction of airways

Chronic obstructive bronchitis

158

path of emphysema

α1-antitrypsin inactivates the trypsin before it can damage the alveoli.
A genetic defect in α1-antitrypsin synthesis leads to alveolar damage.

159

emphysema is aka

pink puffer

160

characteristics of pink puffer

increase co2, can get in, purse lip breathing, barrel chest,

161

chronic irritation of the airways; mucus hyper secretion; productive cough

chronic bronchitis

162

chronic bronchitis is aka

blue bloaters

163

Increase respiration to maintain oxygen levels
Dyspnea; increased ventilatory effort
Use accessory muscles; pursed-lip breathing

pink puffers; emphysema- prob w alveoli

164

Cannot increase respiration enough to maintain oxygen levels
Cyanosis and polycythemia
Cor pulmonale

blue bloaters ; bronchitis- mucus

165

right sided heart failure, is an enlargement of the right ventricle due to high blood pressure in the arteries of the lungs usually caused by chronic lung disease

cor pulmonae

166

MAIN lab test that indicates severity of heart failure and normal value

BNP test. brain natriuretic peptide

167

affects the cells that produce mucus, sweat, and digestive juices. It causes these fluids to become thick and sticky.

cystic fibrosis

168

high concentrations of sodium in sweat ; less sodium in resp mucus so it becomes thick

cystic fibrosis

169

what is a hallmark of cystic fibrosis

salty skin. Normally, salt is carried to the skin by perspiration. Once the skin is cool, the salts are reabsorbed into the body.

170

blood clot in the lung

pul emb

171

shortness of breath, anxiety, chest pain

pul em

172

most common form of WHAT DVT (deep venous thrombus)

pulmonary embolism

173

prevention of deep vein thrombosis

early ambulation
anticoagulant
TED hose
Pneumatic compression stockings or boots

174

what is considers pulmonary hypertension

elevated mean arterial is greater than 25 at rest

175

if it precedes lung or breathing problems it is considered what

cor pulmonale

176

Risk Factors Atherosclerosis non modifiable

male
Genetic disorders of lipid metabolism
Family history of premature coronary artery disease
increasing age

177

Risk Factors Atherosclerosis modifiable

Cigarette smoking
Obesity
Hypertension
Hyperlipidemia with elevated low-density lipoprotein and low high-density lipoprotein cholesterol
Diabetes mellitus

178

blackened of arteries, thickening of blood vessels

atherosclerosis

179

when does atherosclerosis happen

can begin in the late teens; rapid progressive around 30s

180

a peaked t wave is what

hyperkalemia (high potassium)

181

inverted t wave is what

ischemia

182

stretch on ventricle after diastole

preload

183

pressure that ventricles eject blood

after load

184

what is a side effect of pril

dry cough

185

for hyperlipidemia, what is optimal for LDL

<100

186

for hyperlipidemia, what total cholesterol is desirable

<200

187

for hyperlipidemia, what is the low and high of HDL

<40 -LOW
>60- HIGH

188

an irregular yellow patch or nodule on the skin, caused by deposition of lipids.

xanthoma

189

a condition marked by a line of opacity close to the border of the cornea, from which it is separated by a narrow band of clear cornea

arcus lipoides

190

t wave inversion

zone of ischemia

191

st elevation

zone of injury

192

abnormal q

zone of necrosis

193

Atherosclerotic blockages found in the lower extremities.

peripheral artery disease

194

manifestation of PAD

claudication

195

why is claudication important

atherosclerosis leads to restriction of blood flow, coronary disease and strokes. leads to pain in calf, heart attacks that reduces life expectancy

196

strongest risk factors of PAD

smoking and diabetes mellitus

197

intrinsic rate for sa node

60-100

198

intrinsic rate for av node

40-60

199

why is av node aka gatekeeper

impulse comes from SA node it holds onto that impulse for 1/10 of a second allows the atrium to squeeze in systole

200

intrinsic rate of perkingje fibers

20-40

201

help to hold the heart structure

chordinae tendinae and papillary muscles

202

STEMI

ST elevated MI

203

full thickness MI; taken up all three of layers

STEMI

204

not all three layers

NONSTEMI

205

actin and myosin

tip of actin is troponin

206

sacromere

unit of muscle cell

207

inhibits sliding action of the muscle to contract

troponin

208

electrolyte that helps move off the troponin so the two can contract

calcium

209

troponin are very specific to what

myocardial injury

210

if troponin are elevated what does this mean

sarcomere has been injured

211

4 characteristics of cardiac cell

excitability
automaticity
contractility
conductivity

212

2 things to have a heartbeat

mechanical and electrical activity