TEST 2 Flashcards
(212 cards)
1
Q
blood vessels containing blood flowing to the heart
A
veins
2
Q
blood vessels containing blood flowing from the heart
A
arteries
3
Q
from the right ventricle, deoxygenated blood is pumped through WHAT and then WHAT
A
pulmonary valve then pul artery
4
Q
primary function of the respiratory system
A
gas exchange
5
Q
right side
A
into the lungs
6
Q
left side
A
system
7
Q
main pump of the heart
A
left ventricle
8
Q
lowest volume system; responsible for the gas exchange
A
capillaries
9
Q
govern the flow of blood in the vascular system.
A
principles of blood flow- look over this in book
10
Q
Pressure Difference/Resistance
A
flow
11
Q
between two ends of a vessel
A
pressure difference
12
Q
causes of resistance of blood flow
A
sickle cell anemia, peripheral artery disease, mi
13
Q
Distance measurement speed at which blood flows through the vessel
A
velocity
14
Q
heart rate should be
A
60-100
15
Q
the smaller the lumen
A
the higher the flow
16
Q
velocity, cross-sec, and flow
A
velocity=flow rate over cross sectional
17
Q
The relationship between the wall tension of a vessel, its intraluminal pressure, and its radius
A
law of laplace
18
Q
Ability of a blood vessel to be stretched and accommodate an increased volume of blood
A
distensibility
19
Q
depolarization of atria
A
P
20
Q
depolarization of ventricles
A
QRS
21
Q
repolarization of ventricles
A
ST
22
Q
QT interval
A
de and repolarization of ventricles
23
Q
baseline is also the
A
isoelectric line
24
Q
PR segment
A
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
