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lecture 10 Patho
Cardiac Disease : Part 1
Terms in this set (100)
What are the two systems that blood circulates through?
Pulmonary and Systematic circulation
What system pumps blood to and from the lungs?
What system pumps blood to and from different parts of the body?
How many chambers are in the heart?
What type of pump system is the heart?
a 2 pump system
what separates the 2 sides of the heart and keep oxygen rich blood from mixing with oxygen poor blood?
What are the upper chambers of the heart called?
What receive blood that is returning to the heart?
The blood is transferred from ___ to ____
atria to ventricles
what valve separates the atrium from the ventricle?
What are the names of the two atrioventricular valves?
Tricuspid and Bicuspid (mitral) valves
Where is the tricuspid valve located?
between the right atrium and ventricle
where is the bicuspid (mitral) valve located?
between the left atrium and ventricle
what is the semilunar valves function?
to monitor blood flow leaving the ventricles
What are the names of the two semilunar valves?
pulmonary and aortic valve
What does the cardiac cycle consist of?
diastole and systole
What is a phase during which the chamber muscles relax and fill with blood?
What is the contraction phase when the blood is ejected out of the chamber; direction of flow is dictated by the sequential opening and closing of the heart valves?
What is the outside layer of the heart?
What layer is the parietal pericardium?
What layer is the connective tissue layer?
what layer is the middle layer?
what layer consists of mostly cardiac muscle?
what layer is the innermost layer?
what layer consists of endothelium ?
What is the external or outer layer of the heart; this is where the coronary arteries and veins are found?
what is the middle and thickest layer of the heart and is responsible for the contraction of the heart?
what is the protective sac that surrounds the heart?
what type of fluid is within the pericardium?
what is the function of serous fluid in the pericardium?
It is to prevent friction as the heart beats.
___ has a function to restrict excessive movements of the heart as a whole and to serve as a lubricated container in which the different parts of the heart can contrast.
What are the two basic types of cardiac cells?
pacemaker and myocardial cells
where are myocardial cells found?
what is the primary function of myocardial cells?
contraction and relaxation
where are the pacemaker cells found?
electrical conduction system
what is the primary function of pacemaker cells?
generation and conduction of electrical impulses
what is responsible for the spontaneous generation and conduction of electrical impulses?
pacemaker (electrical) cells
what is found in the electrical conduction system of the heart?
pacemaker (electrical) cells
what is an abnormal electricity in the heart resulting in abnormal muscle function; may affect rate of rhythm; may be asymptomatic or lethal; may be due to single extra site firing off an extra beat, multiple chaotic firings or electrical flow cycling within heart tissue?
this is how many times heart beats per minute; or number of electrical impulses fired per minute; normal 60-100
What condition do you have if the heart rate is slower than 60 beats/minute?
What condition do you have if the heart rate is faster than 100 beats/minute?
this is measured by interval between beats: regular, regularly irregular, irregularly irregular.
What condition will have an atria quiver (fibrillate) chaotically instead of rhythmically?
What conditions will have blood not circulating efficiently, weakness, shortness of breath, lightheadedness, palpations & chest pain; also can lead to blood clots?
This condition fires off chaotically >300 times/second; NO contraction generated - only twitching of atrial tissue. Fortunately, only about 1/2 to 1/3 of impulses get into ventricles, so ventricular rate tends to be about 300/2-3 = about 150-100 beats/min.
blood during this condition does not circulate and tends to form clots which may embolize and be source of strokes. Pt must receive anti-coagulants to protect against embolic strokes.
What is the tx of AFIB?
if possible conversion back to sinus rhythm
if unable to convert to SR, then rate control and anti-coagulation
During this condition the ventricles twitch rapidly and chaotically, unable to pump blood. can lead to death if not treated within a few moments.
this condition does not contract, only twitch; cause of cardiac arrest- sudden cardiac death.
What is the only tx for ventricular fibrillation?
What condition will have the loss of consciousness within seconds, brain death within minutes, and death within 2-5 minutes?
This conditions cause can be spontaneous, but can have an increased risk due to cardiac ischemia, enlarged heart muscle, drugs and myocarditis.
What is name of the volume of blood put out of the heart each minute; stroke volume x heart rate?
what is the name of the amount of blood pumped out of ventricle with each beat?
normal= 70 ml
This is determined by the volume of blood in the ventricle at the end of diastole and the force of contraction. the greater the volume and/or the stronger the contraction, the larger the _____
the name of the number of beats/minute
normal= 72 beats/min
Normally ventricle does not pump out all the blood it contains; is measured by ECHO (ultrasound).
what is the amount of blood in heart at end of diastole - amount of blood left in heart after systole?
normal = 50-65 %
what factors affect cardiac output?
sympathetic nervous system hormones and parasympathetic nervous system hormones
What causes an increase in HR and increase in contractility during stress, exercise, fear, anxiety, etc?
adrenaline and noradrenaline
what hormones are of the sympathetic nervous system?
adrenaline and noradrenaline
what hormone decreases HR and contractility?
acetylcholine via the vagus nerve
What is the mechanism of passing out when frightened since low CO results in temporary brain ischemia.
What hormones are from the parasympathetic nervous system?
acetylcholine and syncope
cardiac output x systemic vascular resistance = __
what is the total blood flow through systemic or pulmonary circulation per min?
what is the persistent elevation of systolic (>140 mmHg) or diastolic (>90 mmHg) blood pressure?
There is a direct relationship between hypertension and ___
An governmental organization dedicated to the evaluation of research involving the clinical significance of blood pressure. they periodically make recommendations for BP goals and treatment regimens for hypertension.
joint national commission
JNC said 18-59 with no comorbidities and people over 60 with either diabetes or chronic renal disease have BP of
JNC said people >60 with no diabetes or chronic renal disease have BP of
What condition has a systolic BP of 120-139 mmHg or diastolic BP of 80-89 mmHg?
what are the two types of hypertension?
primary (essential or idiopathic) and secondary
This type of hypertension has no identifiable, reversible cause and can be treated but not cured.
this type of hypertension is due to an identifiable process, cure the cause and hypertension is cured.
This type of hypertension has an elevated BP without identifiable cause, 90-95% of all cases
This type of hypertension has stress and increases SNS activity; produced increased vasoconstriction, increase HR, increase renin releases, angiotensin II causes direct arteriolar constriction, promotes vascular hypertrophy and induces aldosterone secretion.
This type of hypertension has water and sodium retention; certain demographics are associated with "salt sensitivity"; obesity, increasing age, AA ethnicity, people with diabetes, renal disease.
What are the risk factors for primary hypertension?
family history, obesity, ethnicity, sedentary lifestyle, stress, ago, alcohol, cig smoking, diabetes, etc.
This hypertension have an elevated BP with specific cause, the contributing factors are coarctation of aorta, renal disease, endocrine disorders, neurologic disorders, cirrhosis, and sleep apnea?
This is referred to as the "silent killer" and is frequently asymptomatic until target organ disease occurs or recognized on routine screening.
what are the two hypertensive crises?
hypertensive urgency and emergency
this hypertensive crises BP is 160-180/110-120; no obvious target organ damage, but will happen if pt not treated. should be treated in ER or office using oral tx and follow up next day.
this hypertensive crises has severe hypertension without end-organ damage, usually treated with oral antihypertensive agents, BP should be lowered within 1-2 days
this hypertensive crises has BP >180/120; already with organ damage. should be treated immediately in hospital setting using IV therapy.
this condition consists of "hardening" of the arteries; formation of fatty/fibrous lesions in the artery wall; pathologic cause of coronary artery disease, most strokes and peripheral vascular disease
what are the three concentric layers of a vessel wall?
intima, media and adventitia
__ walls are thicker than corresponding ___ at the same level of branching to accommodate pulsatile flow and higher blood pressure
arterial wall are thicker than veins
this is a disease of large and medium-sized muscular arteries and is characterized by endothelial dysfunction, vascular inflammation and the buildup of lipids, cholesterol, calcium and cellular debris within the intima of the vessel wall.
this disease is characterized by intimal lesions called atheromas that protrude into vascular lumina.
this disease is a slow and progressive building up of plaque, fatty substances, cholesterol, cellular waste products, calcium and fibrin in the inner lining
what are the three components to atherosclerotic lesion?
fatty streak, injury to intima, deposition
what component to lesion development has the deposition of fat under intima without any protrusion into vessel lumen; present in infants?
what component to lesion development has hydrostatic pressure, lipids, bacteria, etc; then local inflammation with macrophages, smooth muscle cells and foam cells invading area; begin to grow into vessel lumen?
injury to intima
what component to lesion development has the deposition of fats, proliferation of SMCs, fibrous scar deposition and calcium deposits under a fibrous cap; center may become necrotic; plaque growth into lumen of vessel continues?
what are the non-modifiable risk factors of atherosclerosis?
age, gender, family history
What are the modifiable (controllable) risk factors of atherosclerosis?
hyperlipidemia, hypertension, smoking, diabetes, infections, obesity, etc.
this disease can cause gradual impairment in blood flow and ischemia; eventual occlusion of the vessel and infarction; weakened arterial wall, then aneurysm and possible rupture.
what is a balloon-like bulge in wall of artery; usually at site of atheroma; may block other arteries, form clot in bulge, rupture and hemorrhage?
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