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Cardiovascular Part 1
Patho Test #3
Terms in this set (80)
What is cardiac output?
The volume of blood flowing theough either the systemic or pulmonary circuit
Normal output at "rest" is 5l/ min
What is the formula for CO?
Co= heart rate x stroke volume
What is ejection fraction?
The amount of blood ejected per beat
What is normal EF% for women/ men?
66% women & 58% men
What is the formula for EF?
EF= SV/ EDV
What is ejection fraction an indicator of?
What is preload?
the volume inside the ventricle at the end of diastole.
End - Diastolic Volume (VEDV and Ventricular End- Diastolic Pressure (VEDP) is also called?
What 2 factors determine preload?
1. Amount of venous return to the ventricle
2. Blood left in the ventricle after systole or end- systole volume
_____ is an indicator of systemic Stroke volume resistance (SVR) and _____ is the indicator of Ventricular end - diastolic volume (VEDV) & Ventricular end- diastolic pressure (VEDP)
What is afterload?
the resistance against which the heart contracts and is clinically reflected by systolic blood pressure
If you decrease afterload, what happens to the contraction of the heart?
The heart contracts more rapidly- it increases
If you increase afterload, what happens to the contraction of the heart and work load?
Slows contractions and increases work load
What is systemic vascular resistance (SVR)?
the resistance the body has to over come to push blood
What are some examples of Total peripheral resistance (TPR)?
examples are: Atherosclerosis, smoking, obesity and malnutrition
What is the Frank-Starling law of the heart?
the more the heart fills with blood during diastole, the greater the force of contraction during systole
aka: the more the stretch- the more forceful contraction will occur
More stretch = increase force of contraction
Frank- Starling Law of the Heart
What is an average rate in healthy adults?
What are cardio excitatory and Cardioinhibitory centers for Heart Rate?
Activation of the sympathetic : Increases heart rate
Activation of parasympathetic system: decreases heart rate, controls resting heart rate
What is peripheral vascular resistance determined by?
The blood viscosity and blood vessel length
T/ F The pumping action of the heart determines the flow. Pressure is created when the flow is resisted.
What are some factors that affect cardiac output?
Stroke Volume and Heart Rate
What factors affect Stroke Volume?
Preload Afterload Contractility
Preload has to do with?
End Systolic Volume and Venous return
After load has to do with?
Aortic pressure and Total Peripheral Resistance (TPR)
Contractility has to do with?
End- diastolic volume, sympathetic stimulation and myocardial oxygen supply
Heart rate is managed by?
Central nervous system, autonomic nervous system, neural reflexes, atrial receptors and hormones
What is mean arterial pressure?
average pressure in the arteries in one cardiac cycle
What is pulse pressure?
difference between systolic and diastolic pressure
What is Total Peripheral Resistance?
The overall resistance of the entire systemic circulatory system.
What regulates blood pressure: Arterial pressure?
1. Effects of cardiac output: effects from HR, SV, or both
2. Neural control or resistance: Baroreceptors
3. Arterial receptors: chemoreceptors
What is venous pressure's main determinants?
1. Volume of fluid in the veins
2. Compliance (distensibility) of the vessel walls
What 2 mechanisms affect venous pressure?
Skeletal muscle pump & Respiratory Pump
What is ( END DIASTOLIC VOLUME- END SYSTOLIC VOLUME) x HEART RATE?
What is the formula for BP?
cardiac output x peripheral resistance
What is the leading cause of death in the United States and the World?
What is an elevated systolic blood pressure accompanied by a normal diastolic BP?
Isolated Systolic Hypertension
What is a consistent elevation of systemic arterial blood pressure?
A BP sustained of 140 systolic or higher or 90 diastolic or higher is?
What is normal BP?
Elevated BP is?
Hypertension has 2 stages what are their ranges?
Stage 1= 130-139 systolic 80-89 diastolic
Stage 2= 140 systolic 90 and above diastolic
If a person has a BP of 139/100 what hypertension stage are they in?
Is a person has a BP of 140/80 what hypertension stage are they in?
If they have a bp of 120/72 what are they?
If the have a BP of 125/76 what are they?
What is primary (Essential ) HTN caused by?
Genetic and environmental factors , cause of HTN is unknown
What is secondary HTN caused by?
Is caused by altered hemodynamics from an underlining primary disease or drugs
What increases the risk for myocardial infarction (MI), kidney disease, and stroke?
What are some risk factors of hypertension?
Gender >70 females >55 males
DM/ insulin resistance
LOW k+, LOW mag+, LOW Cal+
What is the pathology of hypertension?
leads to obesity, adipokines, insulin resistance or dysfunction of SNS, RAA and natriuretic hormones or inflamation
then leads to vasoconstriction / Renal salt and water retention
Increase in Peripheral Resistance Increase in Blood Volume
----- sustained HTN----
leads to vascular remodeling and atherosclerosis
1. Retinal changes
2. Renal disease (nephrosclerosis)
3. Cardiac Disease (CAD and congestive HF)
4. Neurologic disease (stroke, dementia, encephalopathy)
What is the role of the sympathetic nervous system activity?
Increase HR= HTN
Increase Insulin Resistance= Endothelial dysfunction-narrowing of the vessels and vasospasms= HTN
Vascular remodeling- narrowing of Vessels and Vasospasm= HTN
Procoagulants effects- narrowing of the vessels and vasospasms= HTN
What is caused by a systemic disease that raises peripheral vascular resistance and or cardiac output?
What is hypertrophy and hyperplasia with associated fibrosis of the tunica intima and media?
in a process called Vascular Remodeling
What is a rapidly progressive HTN with a diastolic pressure >140 and can lead to encephalooathy?
Malignant Hypertension (Hypertensive Crisis)
What are some clinical manifestations of HTN?
None- some have elevated BP
called a (Silent disease)
How is a diagnosis of HTN made?
1. Measurement of BP on at least 2 separate occasions averaging 2 readings at least 2 mins apart
2. Pt must be seated with arm support at heart level
3. After 5 min or rest
4. No smoking or caffeine intake for 30min before
What is a decrease in the systolic BP on standing by 20 or more and 10 or more, respectively?
Orthostatic (Postural) Hypotension
What is the lack of normal BP compensation in response to gravitational changes on the circulation, leading to pooling and vasoialation?
Orthostatic (Postural) HTN
A clinical manifestation of Orthostatic (Postural) HTN is?
Fainting upon standing
What is the activation of the coagulation cascade caused by roughing of the tunica intima by atherosclerosis?
Arterial Thrombus Formation
What is a bolus of matter that circulates in the blood stream and then lodges, obstructing blood flow?
Bolus of matter that circulates in the bloodstream obstructing blood flow could be a variety of matter including?
1. dislodged thrombus
2. air bubble
3. amniotic fluid
4. aggregate fat
6. cancer cells
7. Foreign substance
Where can arterial emboli originate from?
After a MI
What is an occlusion of a coronary?
What is occlusion of cerebral artery?
What can lead to ischemia or infarction or necrosis distal to the obstruction?
What is the thickening and hardening caused by the accumulation of lipid- laden macrophages in the arterial wall?
What causes plaque development throughout the body?
What is the leading cause of coronary artery and cerebrovascular disease?
What is the progression of Atherosclerosis?
1. Endothelium injury
2. Inflammation of the endothelium
3. Cytokines released
4. Cellular proliferation
5. Macophage migration
6. Low- density lipoproteins (LDL) oxidation (foam cell formation with oxidative stress
7. Fatty streak
8. Fibrous plaque
9. Complicated Plaque
Atherosclerosis: endothelial injury, leading to endothelium to ______ making normal antithrombic and vasodilatory substances such as _____ ______ and prostaglandins. Then Lipid deposition make Leukocytes and ____ adhere to the endothelium and release cytokines. Oxidation and phagocytosis of LDL make _______ causing smooth muscle prolif or fatty streak accumulates foam cells causing vessel damage and calcification = ______ which cause ulceration, rupture or thrombosis.
A person has atherosclerosis. Which pathophysiology process has occured?
Macrophages release enzymes and toxic oxygen radicals that create oxidative stress.
What is an atherosclerotic disease of the arteries that perfuse limbs, especially lower extremities?
Peripheral Arterial Disease
Peripheral Arterial disease is most prevalent in people with?
Diabetes or who SMOKE
What is the obstruction of arterial blood flow in the iliofemoral vessels, resulting in pain with ambulation?
What is any vascular disorder that narrow or occludes the coronary arteries?
Coronary Artery Disease
What is the most common cause of coronary artery disease?
What are some modifiable risk factors of Coronary Artery Disease?
What are some nonmodifiable risk factors of Coronary Artery Disease?
3. Male gender
4. Female after menopause*
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