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27 Cards in this Set
- Front
- Back
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When you Stand |
Blood pools in lower extremities---> Decrease in Venous return, Cardiac output and Mean arterial pressure---> baroreceptor reflex initiated ---->Increased heart rate, contractility, and Total peripheral resistance--->VR, CO and MAP restored |
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Orthostatic hypotension |
-Caused by hypovolemic or impaired baroreceptor
-Blood pressure not returned to normal and syncope may occur |
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Standing motionless |
Increase venous pressure in low extremities ---> Increase venous capillary hydrostatic pressure---> increase filtration----> decrease venous blood volume ---->decrease central venous pressure-----> decrease venous return and cardiac output----> decrease blood flow to brain ----> syncope |
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Skeletal muscle pump |
-Reduces venous pooling -Muscles contract forcing blood to heart - Valves prevent backflow |
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Thoracic muscle pump |
-Reduce venous pooling -respiratory pumps
Deep inspiration---> decrease intrathoracic pressure---> Decrease CVP and RAP--->Increase driving pressure from lower extremities --->Increase venous return |
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During excercise |
-Oxygen consumption increases -Blood flow to active muscles increase -Cardiac output increases -Vasodilation (metabolic theory) -Active muscles extract more oxygen from blood |
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Cardiac period shortened 300-400 ms |
-Slow filling phase is shortened or eliminated -Stroke volume increases -Ventricle and aortic pressure increases |
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Heart rate above 200 bpm |
-systolic phase will shorten and stroke volume will decrease due to filling time
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Long term aerobic conditioning |
-Lowers resting heart rate --->increase vagal tone -enlarges ventricles -stimulate angiogenesis |
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Valsava maneuver (Phase 1) |
-Used to test baroreceptor reflex, MAP, CO -Can lead to hemorrhoids and in heart failure can be fatal
Phase 1: Arterial blood pressure increases as aorta is compressed
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Valsava maneuver (phase 2) |
-Arterial pressure and MAP begin to decline---> reflex increases HR and peripheral vasoconstriction |
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Valsava maneuver (phase 3) |
-Terminate maneuver -Aorta decompressed and intrathoracic pressure returns -Arterial blood pressure falls
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Valsava Maneuver (Phase 4) |
-Pressures increase, VR increase, EDV increase -Increase in CO, MAP -activates baroreceptor ---> bradycardia |
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Shock |
-Decrease in cardiac output -Inappropriate vascular tone -hemorrhage |
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Hypovolemic shock |
-Drop in blood volume -Hemorrhage -dehydration -burns |
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Septic shock |
Bacterial toxins released during infection |
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Cardiogenic shock |
-Reduced cardiac output -MI |
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Anaphylactic shock |
-Allergic reaction -Vasodilation |
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Neurogenic shock |
-loss of vasomotor tone throughout body |
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Compensated shock |
Blood loss of 10-20% ---> Increase HR, contractility, vascular resistance, and decrease venous compliance
-Blood pressure may be normal but SV and CO remain low |
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Decompensated shock |
-Compensation reaches max and then decompensates --->metabolic demands not met--->Ischemia
-Hypotension, Dyspnea, acidosis, cool pale skin, mental confusion |
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Irreversible shock |
-Blood volume below 20% or if decompensation continues -Organ damage or death |
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Left sided Heart failure |
-Decrease CO -Increase pulmonary volume -Increase Pulmonary Hydrostatic pressure -Pulmonary edema -Right heart failure -Left axis deviation |
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Right sided heart failure |
-Decrease pulmonary volume -Decrease left heart volume -Decrease CO -increase systemic capillary hydrostatic pressure -peripheral edema -elevated jugular pressure -Right axis deviation |
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Systolic heart failure |
-Decrease contractility (MI) -Increase Afterload (Aortic valve stenosis and uncontrolled hypertension) |
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Diastolic heart failure |
-Decrease ventricle compliance (Aortic valve stenosis and chronic hypertension) -Decrease preload (Mitral valve stenosis) |
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Cardiac Index |
CI = CO/Body surface area
-normal range - 2.6 - 4.2 -below 1.8 = Cardiogenic shock |
