Chapter 6 Cardiovascular/pulmonary And Lymphatic Systems

Front 1

Baroreceptor Reflex

Back 1

Mechanoreceptors that detect changes in pressure

reflexes that maintains blood pressure are collectively known as baroreflex (arterial baroreceptors and cardiopulmonary receptors)

sympathetic: increased cardiac contractility, increased HR, venoconstriction, arterial vasoconstriction; increased BP via elevated peripheral resistance and cardiac output.

Parasympathetic: decreased HR, small decrease in contractility; decreased BP

Front 2

Bainbridge reflex

Back 2

increase venous return stretches receptors, sends vagal afferent signals to cardiovascular center within medulla.

the signals inhibit parasympathetic activity = increased HR

Front 3

Chemoreceptor reflex

Back 3

Chemosensitive cells located in carotid bodies/aortic body respond to changes in pH status and blood oxygen tension

Front 4

Valsalva maneuver

Back 4

Increased intrathoracic pressure; holding breath when lifting something heavy

Front 5

Aneurysm

Back 5

Localized abnormal dilation of a blood vessel, usually an artery.

Common sites: thoracic and abdominal aorta and vessels within the brain.

s/s: aortic = asymptomatic, may have general abdominal or low back pain. abdominal = may cause pulsations by the navel. cerebral = sudden and severe headache, nausea and vomiting, stiff neck, seizure, loss of consciousness and double vision.

Tx: antihypertensive meds; Lg aortic aneurysm - surgery, replacing aneurysm w/ synthetic fabric graft.

Front 6

Angina Pectoris

Back 6

Short - term pressure or discomfort in superior and inferior points of the heart.

stable: predictable lvls of exertion, exercise or stress.

unstable: intense, lasts longer; less exertion, spontaneously at rest, and/or progressive.

Prinzmetal (variant): coronary artery spasm; associated w/ coronary artery disease.

s/s: pressure, heaviness, fullness, squeezing, burning or aching behind the sternum, may be felt in the neck and back, jaw, shoulders, and arms. Associated w/ difficulty breathing, nausea/vomiting, sweating, anxiety or fear. triggered by strong emotion or exertion. subsides with rest.

Tx: acute - supplemental oxygen, nitroglycerin, rest.

Chronic or recurring - long-acting nitrates, beta blockers, calcium channel blockers. when meds are not effective - stenting/bypass surgery may occur.

Front 7

Atherosclerosis

Back 7

progressive accumulation of fatty plaques on inner walls of arteries. over time restricts blood flow, causing blood clot.

s/s: coronary - angina pectoris may occur. cerebral - numbness/weakness of arms/legs, difficulty speaking/slurred speech, drooping face muscles. peripheral - intermittent claudication.

Tx: lifestyle changes, meds, and surgery.

Front 8

Chronic venous insufficiency (CVI)

Back 8

condition when veins and valves in LE are damaged, cannot get blood back to heart. veins remain filled with blood.

s/s: leg swelling, varicose veins, aching, heaviness/cramping, itching, redness or skin ulcers of LE.

Tx: compression stockings, elevation. w/ persistent LE pain or skin ulcers due to poor circulation - varicose vein stripping may occur.

Front 9

Cor pulmonale

Back 9

aka pulmonary heart disease, hypertrophy of R ventricle caused by altered structure/function of lungs.

s/s: progressive shortness of breath, fatigue, palpitations, atypical chest pain, swelling LE, dizziness, loss of consciousness.

Tx: supp. oxygen, diuretics, anticoagulation.

Front 10

Coronary Artery Disease (CAD)

Back 10

narrowing/blockage of coronary arteries

s/s: angina and shortness of breath

Tx: Lifestyle changes, meds- antiplatelet agents(asprin), ACE inhibitors (Tx for hyperension/congestive heart failure), angioplasty II receptor blockers, statins(lipid-lowering).

Front 11

Deep Vein Thrombosis (DVT)

Back 11

s/s: 50% are asymptomatic, swelling, pain, redness, warmth.

Tx: anticoagulant, thrombolytic agents, compression stockings to reduce blood pooling.

Front 12

Heart failure

Back 12

aka congestive heart failure; heart cannot maintain normal cardiac output for bodies demands for blood and oxygen. blood backing up into liver, abdomen, LE, and lungs.

s/s: shortness of breath, fatigue, weakness, swelling in LE, swelling in abdomen, rapid/irregular heartbeat, cough/wheezing, weight gain/fluid retention.

Tx: repairing heart valve, meds (anticoagulants, antihypertensives, digitalis o increase contraction strength), devices, lifestyle changes

Front 13

Hypertension

Back 13

adults = > 140/90

children = > 95th percentile

s/s: asymptomatic until organs are involved, CNS (confusion, cortical blindness, hemiparesis, seizures), cardiovascular (chest pain, dyspnea), renal involvement.

Tx: Lifestyle changes, meds (diuretics, beta blockers, calcium channel blockers, ACE inhibitors, angiotension II receptor blockers, and direct vasodilators).

Front 14

Myocardial Infarction (MI)

Back 14

aka heart attack, blood flow in artery is severely blocked or completely cut-off.

s/s: chest pressure/sqeezing/pain, shortness of breath, discomfort UE/shoulder/neck or back, nausea/vomiting, dizziness, sweating, and palpitations.

Tx: meds (anticoagulant, thrombolytic agents, pain relievers, antihypertensives, cholesterol-lowering), surgery (stenting/bypass), lifestyle changes.

Front 15

Peripheral Arterial Disease

Back 15

stenotic, occlusive, and aneurysmal diseases of the aorta and peripheral arteries

s/s: fatigue, aching, numbness, or pain in buttocks/thigh/calf/foot at rest or walking; poorly healing wounds on legs; distal hair loss; trophic skin changes and hypertrohpic nails.

Tx: asymptomatic = quit smoking/lipid lowering meds/control of diabetes and hypertension; intermittent claudication = revascularization/surgery; supervised exercise training for a min 30 to 45mins, 3x per week, min 12 weeks.

Front 16

Valvular Heart Disease

Back 16

damage to 1 or more heart valves, regurgitation(blood leaks backward through valve) or stenosis(leaflets thicken/stiffen/fuse together not allowing adequate blood flow) of blood flow.

s/s: heart palpitations, shortness of breath, chest pain, coughing, ankle swelling, fatigue.

Tx: mod = meds to reduce workload of heart, regulate heart rhythm, prevent clotting. meds: digitalis, diuretics, antiplatelet, anticoagulant, beta blockers, calcium channel blockers. severe = balloon valvuloplasty/surgery to repair/replace affected valve.

Front 17

Asthma

Back 17

chronic inflammation of airways caused by hypersensitivity to various stimuli

s/s: mild = wheezing, chest tightness, slight shortness of breath; severe = dyspnea, flaring nostrils, diminished wheezing, anxiety, cyanosis, inability to speak. respiratory failure if untreated.

Tx: reduce exposure to known triggers, meds (anti-inflammatory agents, bronchodilators), PT ( caregiver education, airway clearance, breathing exercises, relaxation, endurance/strength training). anti-inflammatory agents interrupt bronchial inflammation, have preventative action. bronchodilators dilate airways by relaxing bronchial smooth muscle.

Front 18

Bronchitis

Back 18

inflammation of bronchi, hypertorphy of mucus secreting glands, increased mucus secretion, insufficient oxygen due to mucus blockage. chronic = productive cough for three months over course of 2 years.

s/s: persistent productive cough, accessory muscle use with breathing, wheezing, dyspnea, cyanosis, increased pulmonary artery pressure. chronic = cough worse in morning/damp weather, experience frequent respiratory infections.

Tx: acute = rest, fluids, breathing warm and moist air, cough suppressents, acetaminophen or asprin. chronic = antibiotics, anti-inflammatory agents, bronchodilaters, lifestyle changes, pulmonary rehab.

Front 19

Chronic obstructive pulmonary disease (COPD)

Back 19

group of lung diseases that block airflow due to narrowing of bronchial tree. emphysema/chronic bronchitis. progression = alveolar destruction/ subsequent air trapping. increase total lung cap/ residual volume.

s/s: excessive mucus production, chronic productive cough, wheezing, shortness of breath, fatigue, reduced exercise cap.

Tx: meds (bronchodilators, inhaled steroids, supplemental oxygen, sup oxygen, antibiotics. surgery (bullectomy, lung transplantation). lifestyle changes.

Front 20

Cystic Fibrosis (CF)

Back 20

Autosomal recessive genetic disease of exocrine glands, effects lungs/pancreas/liver/intestines/sinuses/sex organs. CF = inherit two faulty CF genes, one from each parent.

s/s: vary with progression. salty tasting skin, persistent/productive coughing, frequent lung infections, wheezing, shortness of breath, poor growth/weight gain spite good appetite, frequent greasy/bulky stools.

Tx: meds (antibiotics, nutritional supplements, pancreatic enzyme replacements, mucolytics, bronchodilators), PT (airway clearance, breathing techniques, assisted cough, ventilatory muscle training), general exercise (except w/ severe lung disease)

Front 21

Emphysema

Back 21

alveolar walls gradually destroyed. alveoli turned into large, irregular pockets w/ gaping holes in walls. elastic fibers that hold open bronchioles are destroyed, collapse during exhalation, not letting air escape lungs. alveoli permanently overinflated and dead space increases within lungs.

s/s: shortness of breath, wheezing, chronic coughing, orthopnea, barrel chest, increase accessory muscle use, increased respiration rate, fatigue, reduced exercise capacity.

Tx: meds ( bronchodilators/inhaled steroids/supplemental oxygen/antibiotics[bacterial infection present]), surgery(lung volume reduction/bullectomy/lung transplantation), lifestyle changes, pulmonary rehab(airway clearance/breathing exercises/endurance and strength training)

Front 22

Pneumonia

Back 22

inflammation of the lungs

s/s: fever, cough, shortness of breath, sweating, shaking chills, chest pains that fluctuates w/ breathing, headache, muscle pain, fatigue.

Tx: bacterial/mycoplasma pneumonia = antibiotics. viral pneumonia = antiviral agents. fungal pneumonia = Antifungal agents. lifestyle remedies = rest and drinking plenty of liquids.

Front 23

Pulmonary edema

Back 23

Fluid collects in alveoli within lungs, making it difficult to breath. acute is a medical emergency.

s/s: suddenly or slowly = extreme shortness of breath/difficulty breathing, feeling of suffocating/drowning, wheezing/gasping, anxiety, restlessness, sense of apprehension, coughing, frothy, blood-tinged sputum, chest pain(if cardiac cause), rapid/irregular pulse.

Tx: supplemental oxygen, medications

Front 24

Pulmonary Embolism (PE)

Back 24

one or more arteries in the lungs are blocked, life threatening.

s/s: sudden shortness of breath, chest pain worse w/ deep breathing, coughing, eating/bending?, coughing up bloody/blood-streaked sputum, wheezing, LE swelling, excessive swelling, rapid/irregular pulse, lightheadedness/fainting.

Tx: prompt Tx w/ anticoagulants and thrombolytic agents greatly reduce risk of death, surgery(remove clot, insert filter into Inferior vena cava), prevention measures(compression stockings, pneumatic compression, physical activity, drinking fluids)

Front 25

Restrictive lung dysfunction (RLD)

Back 25

abnormal reduction in lung expansion and pulmonary ventilation.

s/s: dyspnea on exertion, persistent non-productive cough, increased respiratory rate, hypoxemia, decreased vital capacity, abnormal breath sounds, reduced exercise tolerance.

Tx: depending on etiology(antibiotics for pneumonia, Tx of edema, reversal of CNS depression), mechanical ventilation, supplemental oxygen, nutrition support, pulmonary rehab(airway clearance, breathing exercises, respiratory muscle training, endurance/strength training)