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46 Cards in this Set
- Front
- Back
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What is arteriosclerosis?
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A thickening & hardening of the arteries, involving the intimal layer & leading to HTN.
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What is atherosclerosis?
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A form of arteriosclerosis, that begins w/endothelial injury & progresses through several stages to become a fibrotic plaque.
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What is the leading contributor to CAD & CVD?
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Atherosclerosis
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What causes HTN?
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Increases in cardiac output or/& total peripheral resistance.
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What are the risk factors for HTN?
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Family hx, male gender, advancing age, black race, obesity, high Na intake, Low magnesium, K or Ca intake, DM, labile blood pressure, smoking, heavy ETOH use.
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What is the pathophysiology of HTN?
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Damage & inflammation of the vessel walls that stimulate the vessels to thicken, harden & become narrow, Narrowing causes vasoconstriction & increases the permeability of the vessel walls, leading to influx of Na, Ca, H2O, plasma proteins. Ca increases smooth muscle contraction.
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What are the hypothesis of the cause of primary HTN?
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1.Overactivity of the sympathetic nervous system. 2.Overactivity of the renin-angiotensin-aldosterone system. 3.Na & H2O retention by the kidneys 4. Hormonal inhibition of Na-K transport across cell walls. 5. Complex interactions involving insulin resistance & endothelial function.
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What causes the clinical manifestations of HTN?
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Damage of organs & tissues outside the vascular system. (Hrt Dz, Renal Dz, CNS problems, Musculoskeletal dysfunction)
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What is orthostatic hypotension?
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A drop in BP that occurs on standing.
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What causes the acute form of orthostatic Hypotension?
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A delay in the normal regulatory mechanisms.
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What causes the chronic form of orthostatic Hypotension?
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They are secondary to specific dzs or are idiopathic.
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What are the clinical manifestations of orthostatic Hypotension?
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Fainting & may involvecardiovascular sx as well as impotence & bowel & bladder dysfunction.
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What is an aneurysm?
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A localized dilation of a vessel wall (the aorta is particularly susceptible)
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What is a thrombus?
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A clot that remains attached to a vascular wall.
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How can arteriosclerosis generate thrombus formation?
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Through roughening of the intima that activates the clotting cascade.
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What is the most common source of arterial thrombotic emboli?
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The heart, as a result of mitral & aortic valvular dz & Afib, followed by myxomas
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What is a myxoma?
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Tumor composed of mucous connective tissue similar to that present in the embryo or umbilical cord. Cells are stellate or spindle-shaped and separated by mucoid tissue.
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What are the tissues affected by a emboli that starts in the heart?
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The lower extremities, the brain & the heart.
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What is a embolus?
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A mobile aggregate of a variety of substances that occludes the vasculature.
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What are some common sources of emboli?
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Clots, air amniotic fluid, bacteria, fat & foreign matter.
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What does an air emboli require?
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A connection between the vascular compartment & a source of air.
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What are the main causes of fat emboli?
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Trauma to the long bones, either through defective fat metabolism p trauma or through the release of fat globules from bone marrow exposed by fx.
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Vasoplastic disorders include what dzs?
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Raynaud dz (involving arterioles of the extremities), Prinzmetal angina (involving coronary arteries), Buerger dz (involving arteries of the hands & feet).
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Name the possible cause of diabetic lesions of the arteries?
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A defect in glycoprotein metabolism that involves the capillary basement membranes in kidneys, retinas, & extremities.
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What are varicosities?
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Areas of veins in which blood has pooled (usually in the saphenous veins).
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What can cause varicosities?
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Damaged valves due to trauma or by chronic venous distention involving gravity & venous constriction.
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What is chronic venous insufficiency?
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Inadequate venous return over a long period of time that causes pathologic ischemic changes in the vasculature, skin, & supporting tissues.
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What can follow the development of chronic venous insufficiency?
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Venous stasis ulcers.
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What is a possible cause of venous stasis ulcers?
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Borderline metabolic state of the cells in the affected extremities.
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Is the pathophysiology of thrombus formation in the veins the sames as thrombus formation in the arteries?
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Yes
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What is superior vena cava syndrome?
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A progressive occlusion of the superior vena cava that leads to venous distention in the upper extremities & head.
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What is usually the cause of superior vena cava syndrome?
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Bronchogenic cancer
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What is usually the cause of Coronary artery dz (CAD)?
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Atherosclerosis.
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What are the risk factors of CAD?
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Dyslipidemia, smoking, HTN, DM, advancing age, obesity, sedentary life-style, psychosocial factors, hyperhomocystimemia & heavy ETOH use.
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What are the 3 risk factors most predictive of CAD?
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Hypercholesterolemia, smoking & HTN.
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What is usually the cause of ischemic heart dz?
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CAD & the resultant decrease in cyocardial blood supply.
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What is angina pectoris?
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CP caused by myocardial ischemia.
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What are some therapeutic interventions for CAD?
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Vasodilators & meds to reduce cardia workload (eg Bblockers), Surgical procedures.
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What are the 3 types of cardiomyopathies?
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Dilated cardiomyopathy, Hypertrophic cardiomyopathy & Restrictive cardiomyopathy.
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What are the 3 clinically useful ways to classify infective endocarditis?
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1. Clinical Course,
2. Host substrate, 3. The specific interfering microorganism. |
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Acute bacterial endocarditis?
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Presents as an acute, fulminating infection, is highly virulent & an invasive organism is implicated, may occur on previously healthy hrt valves.
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Subacute bacterial endocarditis?
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Less virulent organisms involved, usually occurs in pts w/previous underlying valvular damage.
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What Infective Endocarditis' are classified by clinical course?
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Acute bacterial endocarditis & Subacute bacterial endocarditis.
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What Infective Endocarditis' are classified by Host Substrate?
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Native valve endocarditis (60-80% of host substrate IE), Prosthetic valve endocarditis & in IE caused by intravenous drug abuse.
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What is the most common cause of endothelial injury?
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Turbulent blood flow resulting from underlying valvular abnormalities.
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70% of pts w/endocarditis have?
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Evidence of underlying structural or hemodynamic abnormalities.
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