Chapter 30 Alterations Of Cardiovascular Function

Front 1

Arterioscelerosis

Back 1

- Chronic disease of the arterial system
- Abnormal thickening and hardening of the vessel walls
- Smooth muscle cells and collagen fibers migrate to the tunica intima
(can get from hypertension and from FA deposits)

Front 2

Atherosclerosis

Back 2

- Lipid laden marophages in the arterial wall thicken arteries

- plaque development

Front 3

Complicated hypertension

Back 3

- Chronic hypertensive damage to the walls of systemic blood vessels
- Get remodeling of vasculature = greater resistance
- Smooth muscle cells undergo hypertrophy and hyperplasia with fibrosis of the tunica intima and media

Front 4

Malignant Hypertension

Back 4

- Rapidly progressive hypertension
- Diastolic pressure is usually >140 mm Hg
- Can cause cerebral edema or other organ damage
- very small lumen = increased resistance

Front 5

What are some pharmacolgical treatments for Hypertension?

Back 5

- Beta-blockers
- Nitrates
- Inhibiting Angiogension enzymes
- diuretics

Front 6

Orthostatic hypotension

Back 6

- Decrease in both systolic and diastolic blood pressure upon standing (getting light headed)
- Lack of normal blood pressure compensation in response to gravitational changes on the circulation
- Acute orthostatic hypotension = When normal response is sluggish
- Chronic orthostatic hypotension
- Also called Postural Hypotension

Front 7

Postural hypotension

Back 7

- Decrease in both systolic and diastolic blood pressure upon standing (getting light headed)
- Lack of normal blood pressure compensation in response to gravitational changes on the circulation
- Acute orthostatic hypotension = When normal response is sluggish
- Chronic orthostatic hypotension
- Also called Orthostatic hypotension

Front 8

Aneurysm

Back 8

Local dilation or outpouchingof a vessel wall or cardiac chamber

Front 9

False Aneurysms

Back 9

- do not have distension of all three layers of the arterial wall
- involve a break in the inner vessel wall, usually from trauma
-saccular aneurysms (affects only a portion of the circumference of the arterial wall)
(if true or false aneurysms rupture, it will hemmorage)

Front 10

True Aneurysms

Back 10

- Has distension of all three layers of the arterial wall
- Fusiform aneurysms (giant, affects entire circumference of aterial wall)
- circumferential aneurysms

Front 11

3 layers involved in aneurysms

Back 11

tunica media
tunica intima
adventitia

Front 12

Thrombus formation

Back 12

Blood clot that remains attached to the vessel wall

Front 13

Thromboembolus

Back 13

Clot that breaks free

Front 14

Thrombophlebitis

Back 14

inflammation of veins --> clots

Front 15

Arterial Thrombi

Back 15

Will occlude the artery, causing ischemia to tissues supplied by that artery.

(causes cell death) (vein thrombi causes swelling)

Front 16

Venous thrombi

Back 16

- Much more common than aterial
- bloated and red

Front 17

Embolism

Back 17

- circulating mass in blood, not necessarily a clot
- Dislodged thrombus, air bubble, amniotic fluid, aggregate of fat, bacteria, cancer cells, or a foreign substance

Front 18

Peripheral artery disease

Back 18

- Atherosclerotic disease of the arteries that perfuse the limbs

- Intermittent claudication = Obstruction of arterial blood flow in the iliofemoralvessels resulting in pain with ambulation

Front 19

Intermittent claudication

Back 19

Obstruction of arterial blood flow in the iliofemoral vessels resulting in pain with ambulation
(pain when you get up to walk)

-A form of peripheral artery disease

Front 20

Buerger's Disease

Back 20

- AKA thromboangiitis obliterans
(obliverates capillaries!!)
- Occurs in young men who smoke
- Inflammatory disease of peripheral arteries resulting in the formation of nonatherosclerotic lesions
- Obliterates the small and medium-sized arteries in periphery = decreased perfusion of feet, and sometimes hands

Front 21

Thromboangiitis Obliterans

Back 21

- AKA Buerger's Disease
(obliverates capillaries!!)
- Occurs in young men who smoke
- Inflammatory disease of peripheral arteries resulting in the formation of nonatherosclerotic lesions

Front 22

Symptoms of Thromboangiitis Obliterans/ Buerger's Disease

Back 22

- Causes pain, tenderness, and hair loss in the affected area
- Symptoms are caused by slow, sluggish blood flow
- Can often lead to gangrenous lesions

Front 23

Which is caused by some other cause Reynaud (phenomenon/Disease)?

Back 23

Phenomenon
(Secondary to other systemic disease or conditions)

Front 24

Raynaud Disease

Back 24

- Episodic vasospasm in arteries and arterioles of the fingers, less commonly the toes
- a primary vasospasticdisorder of unknown origin

Front 25

Raynaud Disease (primary/secondary) disorder?

Back 25

Primary

Front 26

Episodic vasospasm in arteries and arterioles of the fingers, less commonly the toes

Back 26

Raynaud Disease or phenomenon

Front 27

Raynaud phenomenon

Back 27

is secondary to other systemic diseases or conditions
(Smoking, triggered by cold)
- Collagen vascular disease (scleroderma), smoking, pulmonary hypertension, myxedema, and environmental factors (cold and prolonged exposure to vibrating machinery)

Front 28

Varicose veins

Back 28

A vein in which blood has pooled
- Distended, tortuous, and palpable veins
- Caused by trauma or gradual venous distention i.e., from standing long periods of time

Front 29

Chronic venous insufficiency

Back 29

Inadequate venous return over a long period due to varicose veins or valvular incompetence

Front 30

Venous stasis ulcers

Back 30

Necrotic tissue from ischemic cellular death

Front 31

Stabile angina

Back 31

recurrent pain from chronic coronary artery obstruction

(A type of Coronary Artery Disease)

Front 32

Prinzmetalangina

Back 32

pain from abnormal coronary artery vasopsasms (unpredictable)

(A type of Coronary Artery Disease)

Front 33

Silent ischemia

Back 33

myocardial ischemia without pain

(A type of Coronary Artery Disease)

Front 34

Angina pectoris

Back 34

chest pain from coronary ischemia

(A type of Coronary Artery Disease)

Front 35

What role does mental stress have on mycardial ischemia?

Back 35

It can induce ischemia in predisposed individuals
- stimulates sympathetic nervous system

Front 36

Myocardial ischemia

Back 36

local, temporary deprivation of the coronary blood supply

Front 37

Transient ischemia

Back 37

- sudden short term blockage of coronary artery
----> Unstable angina – result of reversible ischemia, sign of possible future attacks

Front 38

Unstable angina

Back 38

result of reversible ischemia, sign of possible future attacks

(A kind of transiet Ischemia)

Front 39

Sustained ischemia

Back 39

Long term blockage or coronary artery

------> Myocardial infarction –result of sustained term ischemia
------> Myocardial inflammation and necrosis

Front 40

Myocardial infarction

Back 40

Sudden and extended obstruction of the myocardial blood supply

result of sustained term ischemia

Front 41

Subendocardial infarction

Back 41

- affects only the inner 1/3 to 1/2 of heart wall

- Inner wall more sensitive because blood supply goes first to outer wall

Front 42

Transmural infarction

Back 42

-More serious

- affects more than 1/2 of the heart wall

Front 43

Myocardial Infarction leads to 3 things

Back 43

1.) Cellular injury or cellular death
2.) Structural and functional changes (stunning, hibernating and remodeling)
3.) Repair –MI triggers massive inflammatory response --> attempted wound repair

Front 44

Myocardial stunning

Back 44

myocardial cells stop contracting for hours or days even after perfusion restored

(results from Myocardial Infarction)

Front 45

Hibernating myocardium

Back 45

tissue that has long term ischemia changes metabolism to prolong myocytesurvival

(results from Myocardial Infarction)

Front 46

Myocardial remodeling

Back 46

changes happen in myocytes distant from the ischemic area

(results from Myocardial Infarction)

Front 47

Acute pericarditis

Back 47

Causes severe chest pain that worsens with respiratory movements and with lying down

Front 48

Pericardial effusion

Back 48

accumulation of fluid within pericardium, slow or quick

Front 49

Tamponade

Back 49

pressure from outside fluid prevents filling of heart chambers

(associate with pericardial effusion)

Front 50

Constrictive pericarditis

Back 50

Thicker membrane of pericardium, difficult for heart to expand

Front 51

Cardiomyopathies

Back 51

- Dilated cardiomyopathy(congestive cardiomyopathy, a weak and enlarged because it gets doesnt pump blood effectively)

(Increased BP because increased heart size!)

Front 52

Hypertrophic cardiomyopathy

Back 52

- Asymmetrical septal hypertrophy = an autosomal dominant disorder

- Hypertensive (valvular hypertrophic) cardiomyopathy

Front 53

Asymmetrical septal hypertrophy

Back 53

- Walls so thick the chambers are almost non-existent
- an autosomal dominant disorder

(A form of hypertrophic cardiomyopathy)

Front 54

Hypertensive (valvular hypertrophic) cardiomyopathy

Back 54

A form of hypertrophic cardiomyopathy

(increase size due to increased BP)

Front 55

Aortic stenosis

Back 55

A narrowing of the last valve of the heart, not all blood gets pumped through

Front 56

Mitral Stenosis

Back 56

A narrowing of the valve going into the left ventrical and effects blood flow

Front 57

Valvular stenosis dysfunction

Back 57

Narrowing of valves

Front 58

Valvular regurgitation

Back 58

Leakage of valves

(Weakens or balloons)

Front 59

What are the 3 types of Valvular regurgitations?

Back 59

- aortic regurgitation
- mitral regurgitation
- tricuspid regurgitation

Front 60

Rheumatic fever

Back 60

(lymphatic response against same antigens on heart)
- Diffuse, inflammatory disease caused by a delayed immune response to infection by the group A β-hemolytic streptococci (has shared antigen on heart
- Febrile illness = Inflammation of the joints, skin, nervous system, and heart
- If left untreated, rheumatic fever causes rheumatic heart disease

Front 61

Febrile illness

Back 61

Inflammation of the joints, skin, nervous system, and heart

Front 62

Carditis

Back 62

(Symptom of Rheumatic fever)
Inflammation of the heart

Front 63

Polyarthritis

Back 63

(Symptom of Rheumatic fever)
multiple joint inflammation

Front 64

Chorea

Back 64

(Symptom of Rheumatic fever)
sudden, irregular, involuntary movements. Usually self limiting, and may occur several months after infection

Front 65

Erythemamarginatum

Back 65

(Symptom of Rheumatic fever)
distinctive rash on the trunk

Front 66

Symptoms of Rheumatic Fever

Back 66

Carditis
Polyarthritis
Chorea
Erythemamarginatum

Front 67

Is endocarditis common?

Back 67

NO!

Only for immunocompromised or heart has undergone damage

Front 68

The step by step development of Endocarditis goes as follows:

Back 68

- prepared endocardium
- Blood-born microoganism adherence
- Proliferation of the microorganism


(remember endocarditis makes pustules too!)

Front 69

Which heart disease relies on Blood-born microorganism adherence?

Back 69

Endocarditis

(remember endocarditis makes pustules too!)

Front 70

What are some agents of endocarditis?

Back 70

Bacteria, viruses, fungi, rickettsiae and parasites

Front 71

What are the the complications of AIDs that can be expected?

Back 71

Myocarditis
Endocarditis
Pericarditis
Cardiomyopathy - altered heart muscle

Front 72

What is heart failure?

Back 72

General term used to describe several types of cardiac dysfunction that result in inadequate perfusion of tissues with blood-borne nutrients

(perfusuion = getting nutrients & O2 to the heart)

Front 73

Systolic means...?
Diastolic means...?

Back 73

Heart contraction Heart relaxation

Front 74

What are the different kinds of heart Failure? (4 kinds)

Back 74

Systolic heart failure
Diastolic heart failure
Right heart failure
High output failure
(Dysrhythmias is kinda a subcategorie)

Front 75

What is systolic heart failure?

Back 75

Inability of the heart to generate adequate cardiac output to perfuse tissues
(cant pump as well, dont get blood back to heart) (A result of hyper tension)
(very hard to recover from!)

Front 76

What is diastolic heart failure?

Back 76

Pulmonary congestion despite normal stroke volume and cardiac output

(wont fill properly)
(problem that comes from the lungs)

Front 77

Which heart failure is a result of a problem coming from the lungs?

Back 77

diastolic heart failure

(heart doesnt fill properly)

Front 78

If you have a mitral stenois, what will happen in the left atria?

Back 78

Wont empty correctly, and will cause pulmonary edema from back flow, and Left ventrical output decreases

Front 79

Right heart failure also means....?

Back 79

A lung disease

(most commonly caused by a diffuse hypoxic pulmonary disease)

Front 80

What cause right heart failure/lung disease?

Back 80

most commonly caused by a diffuse hypoxic pulmonary disease

can result from an increase in left ventricular filling pressure that is relected back into the pulmonary circulation. (Goes backwards)

Front 81

What is High-Output failure?

Back 81

inability of the heart to supply the body with blood-born nutrients(ie. anemia), despite adequate blood volume and normal elevated myocardial contractility
(normal volumes and contractions but no nutrients delivered)

Front 82

What is a Dysrhythmia?

Back 82

- Disturbance of the heart rhythm
- Range from occasional “missed” or rapid beats to severe disturbances that affect the pumping ability of the heart
- Can be caused by an abnormal rate of impulse generation or abnormal impulse conduction

Front 83

What condition is the following?

-Range from occasional “missed” or rapid beats to severe disturbances that affect the pumping ability of the heart

Back 83

Dysrhythmias

Front 84

Dysrhythmias can be caused by an abnormal rate of impulse _________ or abnormal impulse _________.

Back 84

Can be caused by an abnormal rate of impulse GENERATION or abnormal impulse CONDUCTION

Front 85

Which condition would have the following?

Tachycardia (acceleration), flutter, fibrillation, bradycardia (deceleration), premature ventricular contractions (PVCs), premature atrial contractions (PACs), asystole

Back 85

Dysrhythmias

Front 86

How is a fibrulation worse than a flutter?

Back 86

Different regions are not synchronized (contraction and relaxation)

Front 87

What would be a condition where a patient has pain breathing while laying down?

Back 87

Pericarditis

Front 88

If you have polyarthiritis, what condition do you likely have?

Back 88

Rheumatic fever