77 terms

Pathophysiology ch 18 study guide (Completed) :)

what does an increased secretion of epinephrine result in?
stimulates beta-receptors and increases both the heart rate and contractility
Heart rate is increased by?
Sympathetic innervation.
The first arteries to branch off the aorta are the?
right and left coronary artery
Which drugs decrease sodium and fluid retention in the body?
A drug that is taken on a continuing basis and reduces platelet adhesion would be?
Anticoagulatns or "blood thinners". Example Asprin.
A partial obstruction in a coronary artery will likely cause?
Angina Pectoris?
Cigarette smoking is a risk factor in coronary artery disease because smoking?
promotes thrombus formation.
Modifiable factors that increase the risk for artherosclerosis include?
*Obesity or diets high in cholesterol and animal fat.
*Cigarette smoking.
*Sedentary lifestlye, which predisposes to sluggish blood flow and obesity.
*Presence jof diabetes mellitus.
*Poorly controlled hypertension, which causes endothelial damage
*Combination of some oral contraceptives and smoking
*Combination of high blood cholesterol and high blood pressure.
What is atherosclerosis?
can be used as a general term for all types of arterial changes. It is best applied to degenerative changes in the small arteries and arterioles, commonly occurring in individuals over age 50 and those with diabetes.
info about myocardial infarction.
Primary cause of death in American male and female and primary cause of disability.
Angina is what?
chest pain. It occurs when there is a deficit of oxygen for the heart muscle. Most commonly pain occurs when the demand for oxygen increase suddenly and the heart can not adapt.
Myocardial infarction is what?
when a coronary artery is totally obstructed leading to prolonged ischemia and infarction. Most common cause is atherosclerosis, usually thrombus.
Infarction develops one of three ways:
1. The thrombus may build up to obstruct the artery.
2. vasospasm may occur in presence of partial occlusion
3. part of thrombus breaks off forming an embolus that lodges in small artery.
basic pathophysiology of a myocardial infarction.
when a coronary artery is totally obstucted leading to prolonged ischemia and infarction.
Early signs of myocardial infarction include:
*Pain: sudden chest pain that radiates to the left arm, shoulder, jaw, or neck is the hallmark of infarction.
*Pallor and diaphoresis, nausea, dizziness and weakness and dyspnea
*Marked anxiety and fear
*low grade fever.
Calcium-channel blocking drugs have what action?
Some drugs such as diltiazem are more selective for the myocarium and reduce both conduction and contractility. Calcium channel blockers block the movement of calcium ions into the cardiac and smooth muscle fiber.
A myocardial infarction is best confirmed by?
Typical changes occur in the ECG during the course of a myocardial infarction, which confirms the diagnosis and assist in monitoring progress.
The most common cause of death following a myocardial infarction is?
usually owing to ventricular arrhythmias and fibrillation (Cardiac Dysrhytmias)
Cardiac Arrest or Standstill
No conduction or activity in the heart at all. Lack of contractions. Loss of respirations and consciousness. Patient is clinically dead. Within 4-6 minutes patient will be biologically dead.
List some causes of left-sided heart failure
Infarction of left ventricle, aortic valve stenosis, hypertension, hyperthyroidism
The best definition of congestive heart failure is?
Occurs when the heart is unable to pump sufficient blood to meet the metabolic needs to the body.
CHF usually occurs as a complication of?
another condition.
is CHF acute or chronic?
May present as an acute episode but usually is a chronic condition.
Significant signs of right-sided congestive heart failure is:
*dependent edema in the feet or legs or areas such as buttocks
*hepatomegaly and splenomegaly
*distended neck veins
*flushed face
Paroxysmal nocturnal dyspnea
left heart failure. hemoptysis (a frothy, blood-stained sputum) and Rales (bubbly sounds of fluid in the lungs)
Failure of the left ventricle will cause increased pressure in the?
pulmonary capillaries
Which drugs improve cardiac efficency by slowing the heart rate and increasing the force of cardiac contractions?
digitalis drugs
A beta-blocking drug will have what effects on the CV system
Keep it from increasing of heart arrythmia. Beta-blockers such as metoprolol or atenolol are used to treat hypertension and dysrhytmias, as well as to reduce the number of angina attacks.
List the signs of aortic stenosis
Chest pain (angina) or tightness
Feeling faint or fainting with exertion
Shortness of breath, especially with exertion
Fatigue, especially during times of increased activity
Heart palpitations — sensations of a rapid, fluttering heartbeat
Heart murmur
(couldn't find it in book, so got the information from the Mayo Clinic)
An incompetent mitral valve will cause?
it is a failure of a valve to close completely, allowing blood to regurgitate or leak backward. "leaky valve"
In Tetralogy of Fallot, unoxygenated blood enters the systemic circulation primarily because?
promoted byt he position of the aorta, over the septum or VSD.
Cyanosis occurs in children with Tetralogy of Fallot because?
The oxygen dificit is great; hence, there are marked systemic effects and cyanosis.
Septic emboli are common complications of infective endocarditis because?
Septic emboli from the vegetations that cause vascular occlusion or infection and abscesses in other areas of the body, will result in additional manifestations depending on the location of the secondary problem.
Uncontrolled hypertension is likely to cause ischemia and loss of function in the?
kidneys, brain, and retina.
Essential hypertension is diagnosed when?
Develops when the blood pressure is consistently above 140/90.
The primary reason for amputation of gangrenous toes or feet in patients with peripheral vascular disease is to?
to prevent spread of the infection into the systemic circulation and to relieve the severe pain of ischemia.
A dissecting aortic aneurysm develops when?
when there is a tear in the intima, allowing blood to flow along the length of the vessel between the layers of the arterial wall.
Shock is defined as?
results from a decreased circulating blood volume, leading to decreased tissue perfusion and general hypoxia.
Shock may follow myocardial infarction when?
Cardiogenic shock.
Mechanism: When there is decreased pumping capability of the heart.
Compensation for shock is indicated by?
as soon as blood pressure decreases:
Define anastomoses
direct connections, exist between small branches of the left and right coronary artyeries near the apex, as well as in orhter ares in which branches are nearby.
Define preload
refers to the amount of blood delivered to the heart by venous return
Define afterload
the force required to eject blood from the ventricles and is determined by the peripheral resistance to the opening of the semilunar valves.
Name some powerful vasoconstrictors occuring naturally in the body
*angiotensin II
Describe the action of beta 1 receptors in the body
are an important site of action for some drugs, such as beta blockers. Because beta blockers fir the receptors and prevent normal SNS stimulation, they are used to block any increases in rate and force of contractinos after the heart has been damaged.
What is the purpose of an ECG?
is useful in the initial diagnosis and monitoring of arrythmias, myocardial infarction, infection, and pericarditis.
coronary vasodilator. The drug may relieve vasospasm in the coronary arteries but primarily acts to reduce systemic resistance, thus decreasing the demand for oxygen.
USE: Angina attacks and prophylaxis
ACTION:Reduces cardiac workload, peripheral and coronary vasodilator
ADVERSE EFFECTS: Dizziness, headache
why cigarette smoking is so detrimental to health?
It is a risk factor in coronary artery disease because it promotes thrombus formation. (May be more reasons, just don't have the patience to look them up right now...lol)
Describe the action of diuretic drugs
removes excess sodium and wat4er from the body throught hte kidneys by blo9cking the reabsorption of sodium or water.
Different diuretic drugs
hydrochlorothiazide, a mild diuretic, and furosemide, a more potent drug. Spironolactone is an example of a "potassium-sparing" diuretic.
HDL (high-density lipoprotein)
Good lipid. it has low lipid content and is used to transport cholesterol away from the peripheral cells to the liver, where it undergoes catabolism and excretion.
LDL (low-density lipoprotein)
Bad lipid. it has a high lipid content and transports cholesterol from the liver to the cells, is the dangerous component of elevated serum levels of lipids and cholesterol.
Right heart failure
systemic adema
Left heart failure
pulmonary adema
Right heart
Right atrium=RA
Right ventricle=RV
Pulmonary artery=PA
Pulmonary vein=PV
Tricuspid Valve
Pulmonary Semilunar Valve
Left heart
LA=Left atrium
LV=Left ventricle
SVS=Superior Vena Cava
IVC=Inferior Vena Cava
Mitral Valve
Right heart failure due to lung disease is called CP
Describe heart failure
occurs when the heart is unable to pump sufficient blood to meet the metabolic needs of the body. Usually occurs as a complication of another condition
what are two basic effects when the heart can not maintain its pumping capability?
1. Cardiac output or stroke volume decreases, resulting in less blood reaching the various organs and tissues, a "forward" effect.
2."Backup" congestion develops in the circulation behind the affected ventricle.
Describe the blood flow in congenital anamolies.
From high pressure to low pressure
Describe the blood flow in ventricular septal defect
Flow only in one direction from the high pressure area to the low pressure area.
Define a cyanotic lesion
when venous blood mixes with arterial blood, permitting significant amounts of unoxygenated hemoglobin in the blood to bypass the lungs and enter the systemic circulation.
Describe mitral valve prolapse
abnormally enlarged and floppy valve leaflets that ballon backward with pressure or to posterior displacement of the cusp, which permits regurgitation of blood.
Describe a porcine valve
pig heart valve used to replace defective human valve.
Describe infective cardiac disease
Streptococcus viridans (part of the normal flora of the mouth); and the acute, in which normal heart valves are attacked by highly virulent organisms, such as Staphylococcus aureus, which tend to cause severe tissue damage and may be difficult to treat successfully.
Rheumatic heart disease is caused by?
when scarred valves or arrhythmias compromise heart function.
refers to the development of a thrombus in a vein in which inflammation is present.
a localized dilation and weakening of an arterial wall.
Hypovolemic shock
results from loss of blood or loss of Plasma from the circulating blood.
Cardiogenic shock
is associated with cardiac impairment, such as acute infarction of the left ventricle, or arrhytmias
Septic shock
may develop in persons with severe infection, particularly infections with gra-negative endotoxins, such as Escherichia coli, Klebsiella pneumoniae, and Psuedomonas.
Describe the cardiovascular status during progressive shock
Lethargy, weakness, cool moist, pale skin, Low BP, Tachycardia, Weak thready pulse, Tachypnea, Oliguria, Metabolic acidosis secretion.
Describe Raynaud's syndrome
periodic vasospasm in fingers and toes, accompained by pain.
BMP Basic Metabolic Panel
K+, Na+, Cl, CO2, glucose, creatine, BUN-->Blood Urea Nitrogen
Rheumatic heart disease
an acute systemic inflammatory condition that appears to result from an abnormal immune reaction occurring a few weeks after an untreated infection
Rheumatic heart disease occurs
in children 5-15 years of age. The inflammation involves the heart and other parts such as joints and skin.