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zFoundations of Pathophysiology > Topic 8 - CardiovascularDisease > Flashcards

Topic 8 - CardiovascularDisease Flashcards

(73 cards)

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1
Q

What is atherosclerosis?

A

hardening/thickening of artery walls

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2
Q

What are the causes of atherosclerosis?

A

endothelial damage, platelet adhesion to endothelium, LDL accumulation, oxidation and glycation of LDL, fatty streaks, ulceration, rupture

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3
Q

What is ischemic heart disease?

A

-atherosclerosis affecting coronary arteries and the narrowing of coronary vessels

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4
Q

What is ischemia?

A

cell deprivation of blood and oxygen, symptoms = angina, breathlessness

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5
Q

What is myocardial infarction?

A

complete occlusion of coronary arteries and damage to heart muscle

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6
Q

What is the difference between systemic and pulmonary circulation?

A

Systemic: heart and body
Pulmonary: heart and lungs

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7
Q

What is the cardiac cycle?

A

mechanical and electrical events in one beat

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8
Q

What is diastole?

A

relaxation phase, ventricles untwist, lengthen and unthicken for filling

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9
Q

What is systole?

A

contraction phase, ventricles twist, shorten and thicken for rapid blood ejection

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10
Q

What are the diastolic events of the cardiac cycle? (mechanical)

A
  1. ventricles are relaxed and fill passively
  2. atrial systole - atria contract to eject blood into ventricles
  3. isovolumentric ventricular contraction - ventricles contract but valves are closed
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11
Q

What are the systolic events of the cardiac cycle?

A
  1. rapid ejection of blood from ventricles (semi-lunar valves open)
  2. isovolumetric ventricular relaxation - decreased pressure to close semi-lunar valves
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12
Q

What is the entire process of the cardiac cycle?

A
  1. ventricles are relaxed and fill passively
  2. atrial systole - atria contract to eject blood into ventricles
  3. isovolumentric ventricular contraction - ventricles contract but valves are closed
  4. rapid ejection of blood from ventricles (semi-lunar valves open)
  5. isovolumetric ventricular relaxation - decreased pressure to close semi-lunar valves
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13
Q

Define heart rate

A

number of cardiac cycles per minute

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14
Q

Define stroke volume

A

vol of blood pumped from ventricles in one heart beat

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15
Q

Define cardiac output

A

HR x SV, blood pumped out in one min

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16
Q

Define ejection fraction

A

% end diastolic volume (EDV) pumped in one heart beat

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17
Q

What is preload?

A

workload imposed on ventricle prior to contraction

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18
Q

What is the Frank-Starling mechanism?

A

ability of the heart to change force of contraction, therefore SV, in response to changes in venous return.
-the force of contraction of heart is directly proportional to the initial length of muscle fibres

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19
Q

What is afterload?

A

force required to eject blood from the heart

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20
Q

What does afterload depend on?

A
  • systemic vascular resistance

- ventricular wall tension

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21
Q

What is the difference between positive and negative inotropic agents?

A

+ increase contractility

- decreased contractility

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22
Q

What is blood pressure?

A

pressure exerted on arterial walls

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23
Q

What is the formula for blood pressure?

A

cardiac output x total peripheral resistance

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24
Q

What is systolic BP?

A

pressure during ventricular contraction

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25
What is diastolic BP?
pressure during ventricular filling
26
What is the role of ADH in blood pressure?
- causes retention of water by kidney - vasoconstrictor - increased blood volume - alters permeability of DCT
27
What is the role of the RAAS system in blood pressure?
low Na+ --> renin released by kidneys --> angiotensin I --> angiotensin II by ACE (angiotensin converting enzyme) --> aldosterone released
28
What is hypertension?
constant elevation of systemic arterial blood pressure, resulting from sustained TPR and increased blood volume
29
What are the three types of hypertension?
primary/idiopathic - most common, systolic and diastolic hypertension secondary - caused by underlying disease isolated systolic/diastolic
30
What are some risk factors of hypertension?
low K+ in diet, alcohol, diabetes, age, race, family history, gender, high cholesterol, obesity, physical inactivity, smoking, high Na+ intake
31
What are the consequences of hypertension?
stiffness of arteries, left heart failure, stroke, kidney failure, blindness
32
What is the use of an ECG?
diagnostic tool that detects electrical disturbances and abnormalities in heart rhythm
33
What are the phases of the electrical activity of the heart?
depolarisation (Na+ influx)) --> rapid repolarisation (K+ out) --> plataeu (balanced movement) --> repolarisation (overall -ve) --> diastolic depolarisation (resting membrane potential)
34
What is the P wave?
atrial depolarisation, contraction
35
What is the QRS complex?
ventricular depolarisation, commencement of ventricular systole, masks atrial repolarisation
36
What is the T wave?
ventricular repolarisation, -ve membrane potential
37
What are the layers of blood vessels?
tunica adventitia: CT --> collagen tunica media: smooth muscle, elastic fibres tunica intima: direct contact with blood, endothelium
38
What is the pathogenesis of atherosclerosis?
- intra-aterial fat deposts enter into intima | - it hardens and causes occlusion to blood flow
39
What is pathophysiology of atherosclerosis?
1. injury to tunica media - dysregulated parainflammatory response 2. macrophages 3. macrophages oxidise to foam cells 4. foam cells -> fatty streaks 5. plaque formation --> blockage, emobolism
40
What are some examples of injurious environments for atherosclerosis?
smoking, hypertension, diabetes, increased LDL, decreased HDL, insulin resistance, infection, oxidative stress
41
What is the progression of atherosclerosis?
injury - inflammation - macrophages - foam cells - fatty streak - fibrous plaque - complicated plaque or embolism
42
What is coronary artery disease?
any vascular disorder which narrows/occludes coronary arteries
43
What are some risk factors of coronary artery disease?
hypertension, smoking, diabetes, obesity, sedentary lifestyle, infection
44
What is the process of coronary artery disease?
decreased myocardial blood supply - ischaemia - acute coronary syndrome - infarction
45
What is heart failure?
inability of the heart to adequately pump blood to meet metabolic requirements
46
Systolic heart failure
-inability for heart to pump blood efficiently
47
Left sided heart failure
blood backed up to lungs
48
What are the causes of systolic left sided heart failure? left
coronary atherosclerosis: plaque buildup - less blood to heart tissue - damage to myocardium - death or scar tissue long standing hypertension: harder for LV to pump blood into hypertensive state, hypertrophy of LV (greater demand for oxygen), increased bulk squeezes coronary arteries dilated cardiomyopathy: chamber grows in size, can work for a little while but muscle becomes weaker and thinner until failure, eccentric hypertrophy
49
What is diastolic heart failure? Left
concentric hypertrophy, less room for blood, no change in ejection fraction, decreased preload
50
What are the causes of diastolic heart failure?
- aortic stenosis: narrowing of aortic opening - restrictive cardiomyopathy - stiffer and less compliant - RAAS system - increased preload: increased fluid retention - increased contraction strength (Frank-Starling), BUT fluid leaks into lungs and builds up: difficult gas exchange, increased pressure, pulmonary oedema
51
What is right-sided heart failure?
- often caused by left-sided heart failure - inability for RV to provide enough blood to supply pulmonary circulation - caused by L to R cardiac shunt (hole between left and right) --> high to low pressure
52
What is diastolic right sided failure?
concentric hypertrophy of RV - smaller volume
53
What is systolic right sided failure?
chronic lung disease, increased pressure in pulmonary vessels
54
What are the symptoms of right-sided heart failure?
liver failure, pitting oedema in legs/sacrum
55
What are risk factors for heart failure?
circulating LDL (hyperlipidemia), hypertension, diabetes, insulin resistance, increased sodium intake, smoking, hypertrophic cardiomyopathy
56
What is an aneurysm?
excessive, localised enlargement of an artery or balloon-like buldge of blood, caused by weakening of arterial walls
57
Where are aneurysms common?
common in areas of weakness, vulnerability, high pressure
58
What are the types of aneurysms?
Fusiform: symmetrical Sacular: hangs off to one side Extra-vascular haematoma: weakened area, hole in artery
59
What are the signs and symptoms of an aneurysm?
severe pain, pulsating mass in area of pain, hypotension in ruptured aneurysm
60
What is a thombosis?
coagulated mass of aggregated platelets, RBC and fibrin that form locally
61
What is an embolism?
piece of thombus that has broken free inside a vessel and circulates around the body
62
What is haemostasis?
process involving platelets and factors in response to blood vessel injury in order to decrease blood loss
63
What is the difference between a primary and secondary haematoma?
1: platelet plug creation 2: reinforcement by fibrin
64
What does haemostasis involve?
platelets, blood proteins (clotting factors), vasculature
65
What is the role of platelets?
contribute to regulation of blood flow (vasoconstriction), initiate interactions (platelet plug), initiate clotting cascade (stabilise plug), initiate repair process
66
How is a platelet activated?
when a vessel is damaged, through: adhesion, activation, degranulation, aggregation
67
What is a clot?
a meshwork of protein (fibrin) to stabilise a plug and trap other cells
68
What are the purposes of a clot?
plug damaged vessel, trap microorganisms, framework for healing
69
What is the process fora clot development?
1. release clotting factors from injured tissue and platelets 2. formation of thombin 3. formation of fibrin
70
What are the two parts of the coagulation cascade?
1. intrinsic (contact activation) | 2. extrinsic (tissue factor)
71
When do the two parts of the coagulation cascade join?
factor X is the common pathway
72
Intrinsic/contact activation
activated by presence of abnormal/damaged vessel
73
Extrinsic/tissue factor
tissue factor released by damaged endothelium

zFoundations of Pathophysiology (10 decks)

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