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NURS 2514 > week 4 patho: the heart > Flashcards

week 4 patho: the heart Flashcards

1
Q

which side of the heart pushes blood through pulmonary circulation

A

The right side

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2
Q

which side of the heart contains bicuspid valves

A

the left side

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3
Q

which artery of the heart (in coronary circulation) would be the most lethal if there was an issue

A

the left anterior descending

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4
Q

which two arteries in coronary circulation will contribute to dysrhythmias if there was an issue

A

the left anterior descending and the circumflex artery

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5
Q

which arteries of the heart supply blood to the SA node

A

50% right coronary artery and circumflex

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6
Q

define cardiac output

A

how well the heart pumps blood to tissues

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7
Q

what is end diastolic pressure

A

the volume of blood in the ventricles at the end of diastole

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8
Q

what issues would increase preload

A

hypervolemia, regurgitation of cardiac valves, heart failure

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9
Q

define afterload

A

resistance left ventricle must overcome to circulate blood

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10
Q

which issues can increase afterload

A

hypertension, vasoconstriction

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11
Q

what are the important electrolytes of the heart

A

Na, K, Ca

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12
Q

what is collateral circulation

A

hypasses the arteries have to help with blockage, basically rerouting of arteries around narrowing of arteries so blood can get where it needs to go (kind of like varies)

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13
Q

out of the two factors that determine collateral circulation (genetic predisposition/hypercholesteralemia and chronic ischemia) which is more likely to survive

A

chronic ischemia necasse they have years to develop good collateral circulation

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14
Q

what is artherosclerosis

A

formation of gunk in arterial wall, primary cause of coronary artery disease

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15
Q

how occluded does an artery have to be (artherosclerosis) for an individual to show symptoms

A

75% occluded, to which they will show signs of ischemia with exertion

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16
Q

what is the inner most layer of the heart wall called

A

the tunica intima

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17
Q

what are some important things about the endothelium of the heart wall

A

it separates the blood stream from the artery wall, protects the artery wall from toxins

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18
Q

what happens if there is injury to the endothelium of the heart wall

A

injury to the endothelium will release cytokines which trigger inflammatory response, resulting in atherosclerosis

19
Q

what are the four stages of atherosclerosis (simplified)

A

1) tear in lining damages endothelial layer
2) monocytes enter tear and eat LDLs (which also enter tear) making fatty streaks in lining
3) platelets and LDLs release platelet derived growth factor which makes a collagen cap that takes up space and blocks flow
4) collagen can can rupture which blocks artery with thrombus

20
Q

how does tobacco use trigger inflammatory process in the heart

A

tabacco triggers epinephrine which elevates heart rate, LDLs, and causes vasoconstriction

21
Q

how does homocysteinemia cause inflammatory process in the heart

A

it is an inherited metabolic defect that leads to high levels of homocysteine which is a metabolite of methionine, which is toxic to the endothelium

22
Q

why are women not as high of a risk for CAD

A

estrogen is a cardioprotective hormone so females are lower risk of CAD till menopause

23
Q

what is the frenningham risk score

A

its a score that shows your risk for a cardiac event

24
Q

what is the good cholesterol lipoprotein carrier and what is the bad

A

LDL= bad, HDL= good
cholesterol binds to these

25
Q

why is HDL good for you

A

it reduces risk of CAD by removing cholesterol from LDL and stabilising plaques, moves the fat back into the liver to be processed

26
Q

what are foam cells

A

dead macrophages that sit on artery walls after they eat all LDL’s, blocking blood flow

27
Q

what causes angina

A

an imbalance of the arteries ability to supply O2 to the heart muscle and the hearts need for 02

28
Q

what does angina feel like

A

pressure, aching, heaviness, or squeezing (as well as disorientation and acute confusion)

29
Q

what’s the difference between chronic stable angina and vasospastic angina

A

chronic: temporary, reversible, predictable, associated with stable plaque
vasospastic: due to spasms in the artery wall, lumen narrows which reduces blood flow to areas (usually from cocane), its acute and life threatening

30
Q

how does ischemia from CAD cause dyspnea

A

blood can back flow and enter pulmonary circulation

31
Q

what is acute coronary syndrome

A

prolonged ischemia that isn’t immediately reversible, associated with unstable plaque which ruptures and forms a thrombus
usually artery is 90% occluded

32
Q

what differentiates angina from ACS from CAD?

A

this chest pain occurs at rest, usually lasts 15-20 mins and isn’t responsive to rest or medication

33
Q

what usually causes angina for ACS

A

rupture of stable atherosclerotic plaque and partial occlusion by thrombus

34
Q

define myocardial infarction

A

sustained ischemia causing irreversible cell death

35
Q

what’s the difference between a STEMI and an NSTEMI

A

STEMI is a full thickness MI, you can tell because it elevates the ST wave of an EKG
NSTEMI is partial thickness

36
Q

how long can the heart tolerate ischemia during a MI

A

20 minutes before cell death begins

37
Q

what would heart rate and blood pressure look like in a person experiencing MI

A

initially high HR and BP, but as cardiac output decreases then so will BP

37
Q

what clinical manifestations would you see in an older adult experiencing acute MI

A

sudden onset confusion, fatigue, anxious, dizziness (atypical symptoms)

38
Q

why would someone experiencing MI have dyspnea

A

due to pulmonary edema from backup of blood into pulmonary circulation

39
Q

which cardiac enzyme is the most helpful in detecting MI

A

Troponin is elevated in STEMI and NSTEMI, it rises 3-12 hours after onset of MI

40
Q

how to cardiac enzymes help with identifying an
MI

A

Cardiac enzymes are released everytime we have organ damage and cel death and tell us if there’s cardiac damage and how bad it is

41
Q

what happens to necrotic tissue after MI

A

neutrophils and macrophages remove all necrotic tissue, it is replaced with scar tissue after 2-3 months

42
Q

which coronary artery feeds pacemakers of the heart in most people

A

the right coronary artery, circumflex feeds blood to the other half of AV node

NURS 2514 (31 decks)

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