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Patho. Phys. Exam 2 Study Guid
UofR APNN Program
Terms in this set (69)
Lobes of the Brian
1. Frontal (cognitive function)
2. Parietal (temp/taste/touch/movement)
3. Temporal (memory)
4. Occipital (vision)
is a restriction in blood supply to tissues, causing a shortage of oxygen that is needed for cellular metabolism (to keep tissue alive).
is generally caused by problems with blood vessels, with result in damage to or dysfunction of tissue.
Transient Ischemic Attack (TIA) or "mini stroke"
→ Temporary episode of neurologic dysfunction (usually resolves in 24 hours or less)
→ Caused by focal brain, spinal cord, or retinal ischemia
→ Etiology: same as ischemic stroke, blood clot blocks blood supply to region of the brain
Cerebrovascular Accident (CVA) aka Stroke
an interruption in the blood supply to a region of the brain or bleeding of a blood vessel in the brain resulting in tissue damage. Rapid onset of neurological deficits lasting longer than 24 hours
Cerebrovascular Accident (CVA) aka Stroke:
→ Signs and symptoms: altered vision, altered speech, and motor impairment
→ Clot buster is used to treat ischemic stroke to dissolve the thrombus
→Clot buster is not used for hemorrhagic because it will cause more bleeding so
What % of strokes are Ischemic strokes?
What % of strokes are hemorrhagic strokes?
During which type of stroke is surgery needed to stop any damage?
Hemorrhagic - emergency surgery must be done to stop the bleeding and stop the destruction of tissue
What does the circulatory system consist of?
It consists of the heart (pump) and interconnected series of tubes that continually move blood throughout the body (blood vessels)
Is the flow from the heart to the lungs and back.
is the flow from the heart to the rest of the body and back.
the passage of blood, a blood substitute, or other fluid through the blood vessels or other natural channels in an organ or tissue.
What are the blood vessels of the body?
arteries, capillaries and veins (the tubes)
Where does the heart sit?
What is the thoracic cavity surrounded by?
Pericardium (pericardial sac) which is a stabilizing enclosure
The cardiac muscle is called:
The innermost membrane of the four heart chambers:
The four chambers of the heart are:
1. right atrium
2. right ventricle
3. left atrium
4. left ventricle
What are the valves of the heart?
tricuspid, pulmonary, mitral, aortic (don't forget - one way circulation of blood through these valves!)
go away from the heart to take oxygenated blood into capillaries that bring oxygen to the tissues
diffuse oxygen out into the tissues and diffuse CO2 in to carry this deoxygenated blood to the veins to take back to the heart. Also are about one cell thick and are designed with the primary role of gas exchange to get nutritious oxygenated blood to the tissues, and remove waste and send deoxygenated blood back to the heart via veins against gravity
from the capillaries take deoxygenated blood back to the heart via pulmonary veins against the flow of gravity so that the deoxygenated blood can be directed back to the lungs by the heart via the pulmonary valve
How does the lympathic system work with the circulatory system?
The lymphatic system assists the circulatory system in order to get rid of fluid in the tissue area
Quick Outline of Blood Flow
→ Oxygenated blood goes into the left atrium from the lungs via pulmonary veins, then to the left ventricle, and finally to the aorta which carries oxygenated blood all over the body except the lungs via arteries.
→ Veins carry deoxygenated blood from the body back to the heart into superior and inferior vena cava then starts the blood flow order again.
What is the blood flow order?
1-Superior & Inferior vena cava
4- Rt Ventricle
7- Lungs-pick up oxygen
8- Pulmonary Veins
9- Lt Atrium
10- Mitral Valve (Bicuspid)
12- Aortic Valve
placenta → umbilical vein → ductus venosus → inferior vena cava→ right atrium→ foramen ovale → left atrium → left ventricle→ aorta → fetal body → right atrium → right ventricle → pulmonary artery → ductus venosus →
oxygen saturation (SpO2) Fetal %
Fetal Shunts to remember:
1. Ductus venosus: by passes the liver
2. Foramen ovale: between right and left atrium
3. Ductus arteriosus: connects pulmonary artery to aorta
What causes Ischemic strokes?
2. Cardiac Disorders
3. Thrombotic Strokes
What causes Hemorrhagic strokes?
1. Subarachnoid Hemorrhage
2. Cerebral Aneurysm
3. Arteriovenous Malformation (AVM)
What does FAST stand for?
F - Face droop
A - Arm Weakness
S - Slurred Speech
T - Time
Conduction system of the heart:
Generates and delivers (conducts) the electricity to all the muscle fibers of the heart resulting in a smooth, complete contraction of the cardiac muscle fibers, which forcefully ejects the blood outside the heart.
Parts of the conduction system
→ SA node
→ AV node
→ bundle of His
→ bundle branches
→ Purkinje fibers
high viscosity = high resistance and lower flow (pressure goes from high to low)
low viscosity = low resistance and higher flow
Series vs. Parallel
In a series circuit, all components are connected end-to-end, forming a single path for current flow. In a parallel circuit, all components are connected across each other, forming exactly two sets of common points.
a smooth pattern of flow (peace)
Irregular flow with random variations in pressure. (Chaotic)
the ability of tissues to regulate their own blood supply despite a change in perfusion pressure. minute to minute basis.
circulation formed by smaller blood vessels branching off from or near larger, occluded blood vessels
What dilates the arterioles?
- Decreased oxygen
- Increased acid
- Increased carbon dioxide
- Increased potassium
- Increased osmolarity
- certain chemicals: histamines, kinins, prostaglandins, sodium, magnesium.
What constricts the arterioles?
- Low vascular volume
- certain prostaglandins
- renin-angiotensin system
- sympathetic simulation
equation for blood pressure
BP = CO (Cardiac Output) x PVR (Peripheral resistance)
equation for cardiac output
CO = HR (Heart Rate) x SV (Stoke Volume)
The amount of blood ejected from the heart in one contraction.
total peripheral resistance
resistance of the muscular arteries to the blood being pumped through them
-decreased blood pressure causes the juxtaglomerular cells of kidneys to secrete renin which converts angiotensinogen (inactive) to angiotensin I (active) which is then converted into angiotensin II by angiotensin-converting enzyme (ACE)
-Angiotensin II stimulates the adrenal cortex to secrete aldosterone
- leads to absorption of Na and increased blood pressure
-once blood pressure is restored, there is a decreased drive to stimulate renin release
Coronary Artery Disease
-obstruction of blood flow through the coronary arteries
-typically from ATHEROSCLEROSIS
-contributes to angina, mycardial infarction, or death
Conditions related to untreated hypertension
- CAD and Cardiac Death
- Renal Failure
- Loss of Vision
- Aneurysms and dissections
decreases serum sodium levels and blood volume. Patients are started on mild ones such as thiazide or potassium-sparing. Ex: Lasix (Furosemide) this is a stronger non-potassium sparing.
decrease heart rate and strength contraction and dilate arteries by blocking beta receptor. Ex: Propranolol. Think anything ending in -olol. Check BP prior to giving patient. Safest to take while pregnant.
Blocks conversion of angiotensin I to angiotensin II. Ex. (-pril drugs) you will know when someone is on one when they have a dry cough benazepril (Lotensin)
Angiotensin II Receptor Blockers
Blocks effects of angiotensin on blood vessel. (Angiotensin is a peptide hormone that causes vasoconstriction and an increase in blood pressure)
Calcium Channel Blockers
relaxes muscle contraction or other autonomic vessels
medications that cause dilation of blood vessels and acts mainly on vascular smooth muscles.
low blood pressure that occurs upon standing up
shock resulting from blood or fluid loss
Shock caused by inadequate function of the heart (low CO), or pump failure.
Shock that occurs when there is a block to blood flow in the heart or great vessels, causing an insufficient blood supply to the body's tissues.
- anaphylactic - IgE immune repsonce
- Neurogenic - spinal cord injury
no damage to heart muscle; basic reflexes surrounding the pain help restore blood flow
Episodes of ischemia/chest pain that occurs while a person is at rest and not exerting himself.
Caused by spasm of the blood vessels, not just by vessel narrowing.
Immediate actions for MI
M - Morphine 2-4mg IV
O - Oxygen
N - Nitroglycerin SL Q5 min x 3
A - Aspirin 325 mg tablet to chew
Inhibit platelet adhesion and aggregation by blocking receptors sites on platelet membrane.
Hypothermia Protocol for Acute MI
Purpose is to decrease metabolic demand of cells while maintaining acceptable energy levels.
Treatment guidelines ACC/AHA
Moderate or High Intensity Statin Therapy for:
Recommended textbook explanations
Hole's Essentials of Human Anatomy & Physiology
David N. Shier, Jackie L. Butler, Ricki Lewis
Essentials of Human Anatomy and Physiology
Elaine N. Marieb, Suzanne M. Keller
Seeley's Essentials of Anatomy and Physiology
Andrew Russo, Cinnamon VanPutte, Jennifer Regan
Hole's Human Anatomy & Physiology
David N. Shier, Jackie L. Butler, Ricki Lewis
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