Pathophysiology Exam 3 Review Cardiac Pulmonary Renal

Front 1

The majority of the heart is which layer?

Back 1

Myocardium- cardiac myocytes.
Muscular structure.

Front 2

TRUE OR FALSE
Left side of the heart has much greater pressures,

Back 2

TRUE
Because it sends blood to the systemic circulation.

Front 3

Describe the effect of the sympathetic and parasympathetic nervous system on the cardiovascular system?

Back 3

"CHRONOTROPIC EFFECTS"
SNS- Increases cardiac output, increases BP by release of epinephrine, norepinehrine, and dopamine.
PNS- Decreases BP, CO through acetylcholine.

Front 4

Describe the Frank-Starling Law of the Heart

Back 4

The heart is a muscle, the more you expand the heart, the more it will contract.

Front 5

Describe the Inotropic effects on the CV system?

Back 5

Contractility - Inotropic
Increased ejection fraction, Increased CO, Increased BP

Front 6

Major causes of Myocardial Ischemia and Infarction?

Back 6

Narrowing of coronaries, Spasm.
ATHEROSCLEROSIS OF ARTERIES.
Also, HTN, Tachycardia, Coronary Artery Vasospasm,
Severe Hypotension, Hypoxia, Anemia.

Front 7

Describe the layers of the artery?

Back 7

TUNICA ADVENTITIA- outermost
TUNICA MEDIA- Multi-layer smooth muscle cells.
TUNICA INTIMAE- Innermost layer, endothelial cells

Front 8

TRUE OR FALSE
The elasticity of large arteries allows us to have continous flow in diastole, known as diastolic runoff.

Back 8

TRUE

Front 9

TRUE OR FALSE
As we increase in muscularity, we increase the ability of vasoconstriction.

Back 9

TRUE-
ARTERIES ARE ELASTIC AND ABLE TO SNAP BACK. BUT CAPILLARIES ARE NOT ELASTIC BC THEY HAVE NO SMOOTH MUSCLE CELLS.

Front 10

DESCRIBE COR PULMONALE?

Back 10

Lung disease that leads to heart disease. Due to hypoxia. Hypoxic vasoconstriction leads to pulmonary hypertension. RIGHT SIDED HYPERTROPHY AND DILATION. Also known as right sided heart failure.

Front 11

Describe Mitral Stenosis?

Back 11

Fusion of the mitral valve.
Healing process of rheumatic fever. Valve area is less than 1cm squared. Left Atrial enlargement predisposes to atrial fibrillation. Stasis of blood in LA can lead to thrombi. Usually on anti-coagularnt therapy. S/S Dsypnea on exertion. Leads to CHF.

Front 12

AORTIC STENOSIS?

Back 12

AORTIC Stenosis due to rheumatic fever almost always occurs in assoc w mitral valve stenosis.
Can also be caused by progressive calcification of a congenital abnormal biscuspid valve. TRIAD OF S/S-
Angina Pectoris
Dyspnea on Exertion
Syncope
TRANSVALVULAR PRESSURE GRADIENT OF >50 mmHg,

Front 13

Describe Tetrology of Fallot?

Back 13

Pulmonary Stenosis
VSD
Right Ventricular Hypertrophy
Overriding Aorta

Front 14

Define stroke volume?

Back 14

Amount of blood ejected per BEAT

Front 15

DESCRIBE WHAT HAPPENS DURING THE FOLLOWING?
P WAVE
QRS
ST

Back 15

P WAVE- Depolarization of Atrium
QRS- Depolarization of Ventricle
ST- Repolarization of Ventricle

Front 16

Describe and compare the 3 mechanisms of local control of bloodflow?

Back 16

*Metabolic Requirements-local metabolites, endothelium dependent. Inc. conc. of waste products, that area needs more blood flow. Lactic acid, pyruvate, ADP. VASODILATION.
*Autoregulation-Maintain constant flow. When perfusion pressure increases, pressure increases. ex: muscles, INDEPENDENT OF ENDOTHELIUM. VASOCONSTRICTION.
*Shear stress- induce vasodilation, Nitrous Oxide dependent

Front 17

Describe Cheyne-Stokes Respirations?

Back 17

Alternating peroids of deep and shallow breathing and apnea.
(heart failure, strokes, traumatic brain injuries, brain tumors)

Front 18

What is clubbing and the conditions associated with it?

Back 18

Enlargement of distal segment of finger. (cystic fibrosis, lung disease, lung cancer, anything cardiac with chronic hypoxia)

Front 19

TRUE OR FALSE
The most common cause of pulmonary edema is heart failure?

Back 19

TRUE
Other causes include pulmonary hypertension, gas inhalation, and ARDS.

Front 20

Bronchiolitis?

Back 20

Most common in children and caused by a virus.

Front 21

Empyema?

Back 21

PUS in pleural space, complication of resp infection.

Front 22

Common causes of pulmonary fibrosis?

Back 22

ARDS, TB, INHALATION OF TOXIC SUBSTANCES

Front 23

Describe the pathophysiology of asthma?

Back 23

Increased bronchial smooth muscle spasm, increased vascular permeability.
IgE
sob, chest tightening, wheezing.
treat with albuterol, steroids.
avoid allergens that trigger.

Front 24

A person is born with a alpha-antitrypsin deficiency, which condition is most associated with this deficiency?

Back 24

Emphysema.
Emphysema is bullous disease of the lungs. There is destruction of the alveolar walls without evidence of fibrosis. Individuals with an α-antitrypsin deficiency have an increased risk because proteolysis in lung tissues is not inhibited.

Front 25

Most common nosocomial pneumonia?

Back 25

Pseudomonas Aeruginosa

Front 26

Describe the three types of nephrons?

Back 26

Superficial
Midcortical
Juxtamedullary

Front 27

Which cells in the distal tubule reabsorb sodium and water but secrete potassium?

Back 27

Principle Cells

Front 28

Role of intercalated cells?

Back 28

Secrete either hydrogen or bicarb, and reabsorb potassium.

Front 29

TRUE OR FALSE
When a person is hypotensive, the first enzyme released is RENIN?

Back 29

true
then the cascade of events of the renin-angiotensin system occur

Front 30

DEFINE
1-tubular reabsorption
2-Ultrafiltration
3-tubular secretion
4-excretion

Back 30

-Tubular reabsorption is the movement of fluids and solute from the tubular lumen to the peritubular capillary plasma.
-Ultrafiltration is the process of filtration across the glomerular capillaries to form a filtrate of protein-free plasma.
-Tubular secretion refers to substances moving from the plasma of the capillary to the tubular lumen.
-Excretion is the elimination of the substance in the final urine.

Front 31

Which substance controls final urine concentration?

Back 31

ADH
sec. from post. pitiutary,
increases water permeability in the last segment of the distal tubule.

Front 32

Which three factors promote venous thrombosis?

Back 32

Venous stasis.
Venous endothelial damage.
Hypercoagulable states

Front 33

Difference between thrombi and emboli?

Back 33

Thrombi is a clot that remains attached to vessel wall. An emboli circulates.

Front 34

Causes of Aortic Aneursyms?

Back 34

Atherosclerosis is common cause.
Aortic aneurysms are associated with genetic markers, deficiencies in wall collagen, elastin failure, inflammation, increased oxygen radicals, and mechanical shear forces.

Front 35

Reynaud phenomenon?

Back 35

Raynaud phenomenon is characterized by attacks of vasospasm in the small arteries of the fingers. It is characterized by cold, numb digits

Front 36

Hypertension?

Back 36

Approximately 65% of Americans older than the age of 60 have hypertension and less than two thirds of those have adequately controlled hypertension.
** Hypertension is defined as a diastolic pressure of 90 mmHg or greater or a systolic pressure of 140 mmHg or greater.

Front 37

Causes of hypertension?

Back 37

Hypertension is associated with positive family history, gender (men younger than 55 and women after menopause), black race, high dietary sodium, glucose intolerance, cigarette smoking, obesity, heavy alcohol consumption, and low dietary intake of minerals.

Front 38

Complications of hypertension?

Back 38

Complications of hypertension include left ventricular hypertrophy, angina pectoris, congestive heart failure, coronary artery disease, myocardial infarction, and sudden death.

Front 39

Describe Atherosclerosis?

Back 39

Arteriosclerosis is a chronic degeneration of blood vessel walls. A plaque is caused by collagen over a fatty streak. Fatty streaks are composed of a large number of lipid-laden foam cells that deposit on the vessel wall.

Front 40

TRUE OR FALSE?
Majority of the heart is myocardium (muscular structure)?

Back 40

TRUE
MYOCARDIUM-cardiac myocytes
Endocardium-squamos endothelia
parietal pericardium-mesothelia
visceral pericardium-mesothelia

Front 41

Describe the different controls of the cardiovascular system?
(chronotropic vs inotropic)

Back 41

CHRONOTROPIC-
Affects the RATE of the heart.
Inc. HR=INC. C.O. AND INC.BP
SNS increases these through the release of epi, norepi, dopamine.
PNS- dec. each of those through rel of ACH.
*INOTROPIC
affects the CONTRACTILITY of the heart. INC. strength or muscles, INC. CO, INC. BP,
SNS INC. RATE AND CONTRACTILITY
AND
PNS DEC .RATE AND DEC. CONTX. THRU ACH AND VAGUS NERVE.

Front 42

Describe the neuro controls vs the local controls of CV system?

Back 42

Neuro controls= the chemoreceptors in the medulla oblongata measure levels of CO2 AND PH.
the chemoreceptors in the carotid and aortic bodies, measure CO2, PH, O2 LEVELS.

Front 43

Describe the different types of lung receptors?

Back 43

1- IRRITANT= Epithelium of conducting airways and proximal airways, pick up noxious stimuli and cause broncho-constriction, inc. vent. rate.
2- STRETCH= Serve as protection. Active at high volumes. Dec. vent rate and volume (exercize)
3. J RECEPTORS= Located near capillaries, sensitive to pulm/cap pressure, cause rapid shallow breathing, bradycardia and hypotension in response to red. cap. pressure

Front 44

S/S OF LEFT SIDED HEART FAILURE?
S/S OF RIGHT SIDED HEART FAILURE?

Back 44

LEFT-Pulmonary edema, Sob, orthopnea, dyspnea on exertion, gallop rhythms and murmurs, wheezing.

RIGHT- Pitting peripheral edema, ascites, hepatomegaly, jugular venous distension.

Front 45

Describe the FRANK-STARLING LAW OF THE HEART?

Back 45

States that the stroke volume of the heart increases in response to an increase in the volume of blood filling the heart (the end diastolic volume). The increased volume of blood stretches the ventricular wall, causing cardiac muscle to contract more forcefully (the so-called Frank-Starling mechanisms). The stroke volume may also increase as a result of greater contractility of the cardiac muscle during exercise, independent of the end-diastolic volume. The Frank-Starling mechanism appears to make its greatest contribution to increasing stroke volume at lower work rates, and contractility has its greatest influence at higher work rates.

Front 46

Describe the 3 mechanisms of local control of blood flow?

Back 46

1-metabolic regulation (local metabolites) lactic acid, pyruvate, ADP, usu. precap, sphnicters get dilated. Increased conc. of waste products so increased bld flow to wash them away. *endothelium dependent*
2-autoregulation- maintains a constant flow, when perf. pressure increases, pressure increases, ex: muscles, myogenic receptors.
*independent of endothelium*
3-shear stress- induce vasodilation, Nitrous oxide dependent,
*endothelium dependent*

Front 47

Difference between stable and unstable plaques?

Back 47

When stable, people can exercize but can't push past a certain point or feel pain.
Unstable- could burst whenever, prone to rupture, core is rich in oxidized LDL,
thin fibrous cap.

Front 48

What are the three cell types of the glomerulus?

Back 48

1- endothelial (fenestrated) capillaries allow for rapid filtration
2- Podocytes (outside of endothelial cells) unusual shape, sit in ultra-filtrate, foot processes interleave
3-mesangial cells- smooth muscle cells can contract (less filtration) or relax (more filtration) these cells are the MATRIX that holds the glomerulus together.

Front 49

Describe the role of ANP and BNP?

Back 49

ANP- If the heart sees a volume overload, it will excrete ANP, which tells the kidneys to INCREASE Na excretion, thereby dec. volume.
BNP also signals the kidneys to release Na, but comes from brain, and used more diagnostically than anp.

Front 50

Describe the causes of acute glomerulonephritis?

Back 50

Acute glomerulonephritis commonly results from inflammatory damage to the glomerulus as a consequence of immune reactions including deposition of circulating immune complexes, antibodies reacting in-situ to planted antigens, and antibodies directed against the glomerular basement membrane.

Front 51

Nephrotic Syndrome?

Back 51

The excretion of at least 3.5g protein in the urine per day primarily bc of glomerular injury w increased capillary permeability and loss of membrane negative charge.
S/S hypoproteinuria, hyperlipidemia, and edema.

Front 52

Role of juxtoglomerular cells?

Back 52

Secrete renin, located around the afferent arteriole. They are continguous with the sodium sensing cells of the macula densa of the distal convoluted tubule.

Front 53

Role of loop of henle?

Back 53

transport solutes and water, contributing to the hypertonic state of the medulla.

Front 54

Role of distal tubule?

Back 54

Adjusts acid/base balance by excreting acid into the urine (H+) and forming new bicarbonate ions.

Front 55

Describe the GFR?

Back 55

GFR is the filtration of plasma per unit of time and is directly related to the perfusion pressure of renal blood flow.
Autoregulation and and RBF and sympathetic neural regulation of vasoconstriction maintain a constant GFR.

Front 56

Describe the four phases of inflammatory response in pneumococcal pneumonia?

Back 56

1- consolidation
2-red hepatization
3-gray hepatization
4-resolution

Front 57

What does ST segment depression signal?

Back 57

Myocardial ischemia, reversible within 20 minutes

Front 58

Role of sodium ions in cardiac conduction?

Back 58

Conducts depolarization, + charges thru the myocardium. Generates a positive charge causing an upward deflection.

Front 59

Role of calcium ions in cardiac conduction?

Back 59

Slow conduction through the AV node, contraction of the myocardium.

Front 60

How is afib treated?

Back 60

blood thinners (for cardioversion), if stable, cardizem/ca channel blockers, possibly pacemaker.

Front 61

_______ occurs when secretions block a bronchiole or bronchus and the distal lung tissue collpases leading to hypoventilation

Back 61

Atelactasis

Front 62

Inspiration is an active process, stimulated by chemoreceptors in the_____?

Back 62

Aorta.
Expiration is passive, relies on the elastic recoil properties of the lungs.

Front 63

Best tool to diagnose cardiomyopathy?

Back 63

TEE

Front 64

Describe the phases of the cardiac cycle...

Back 64

1. Atrial systole
2. Isovolumetric ventricular contraction. Ventricular volume remains constant as pressure increases rapidly.
3. Ejection
4. Isovolumetric ventricular relaxation.
Both sets of valves are closed, and the ventricles are relaxing.
5. Passive Ventricular filling.
The AV valves are forced open, and the blood rushes into the relaxing ventricles.

Front 65

Describe the conduction system of the heart...

Back 65

Specialized cardiac muscle cells in the wall of the heart rapidly conduct an electrical impulse throughout the myocardium. The signal is initiated by the SA node (pacemaker) and spreads to the rest of the atrial myocardium and to the AV node. The AV node then initiates a signal that is conducted through the ventricular myocardium by way of the AV bundle (of his)
and Purkinje fibers.

Front 66

Location of the SA node?

Back 66

Located at the junction of the right atrium and superior vena cava, just above the tricuspid valve. The SA node lies 1mm beneath the visceral pericardium, making it vulnerable to injury and diseases, esp. pericardial inflammation. SA node is innervated by sympathetic and parasympathetic nerve fibers. The SA node's p cells are pale and assumed to be the site of impulse formation.

Front 67

What are the four factors that affect cardiac output directly?

Back 67

Preload, afterload, myocardial contractility, and heart rate.
PRELOAD- pressure generated at the end of diastole
AFTERLOAD- resistance to ejection during systole.
Both preload and afterload depend on the heart as well as the vascular system. Contractility and heart rate are influenced by neural and humoral mechanisms.

Front 68

Describe the Frank-Starling Law of the Heart?

Back 68

Cardiac muscle increases its strength of contraction when it is stretched.
the volume of blood in the heart at the end of diastole, (the length of the muscle fibers) is directly related to the force of contraction during the next systole.

Front 69

LaPlace's law?

Back 69

Wall tension is related directly to the product of intraventricular pressure and internal radius and inversly to the wall's thickness. *RADIUS has the most effect on wall tension.

Front 70

Describe the BAINBRIDGE REFLEX and the BARORECEPTOR REFLEX?
(the two important neural reflexes that affect heart rate and rhythm)

Back 70

BAINBRIDGE- Causes the change in the heart rate after IV infusions of blood or other fluid. The changes in heart rate is caused by volume receptors in the atria that are innervated by the vagus nerve
BARORECEPTOR REFLEX-facilitates both blood pressure changes and heart rate changes. It is mediated by tissue pressure receptors.
in the aortic arch and carotid arteries.If BP is dec., the baroreceptor reflex accelerates heart rate and causes vessels to constrict. Can also lower BP when it is too high.

Front 71

Describe the path of bloodflow into the heart for both systemic and pulmonary circulation?

Back 71

Unoxygenated (VENOUS) blood from the systemic circulation enters the right atrium through the superior and inferior vena cava. From the atrium the blood passes through the right AV valve into the right ventricle. The blood then flows from inflow to outflow tract, then through pulmonic semilunar valve into the pulmonary artery, which delivers it to the lungs for oxygenation.
Oxygenated blood from the lungs enter the left atrium
through the four pulmonary veins. ( two from left lung two from right lung) From the left atrium the blood passes thru the left AV valve, (mitral valve) into the left ventricle.
In the ventricle the blood flows from the inflow tract to the outflow tract then through the aortic semilunar valve into the aorta, which delivers it to the systemic arteries of the entire body.

Front 72

DIASTOLE?
SYSTOLE?

Back 72

Diastole-the myocardium relaxes and the chambers fill with blood.
Systole- The myocardium contracts, forcing blood out of the ventricles.

Front 73

How do myocardial cells differ from skeletal cells?

Back 73

Myocardial cells can transmit action potentials faster bc of intercalated disks, synthesize more ATP, and have readier access to ions in the interstitium. Enable the myocardium to work constantly.

Front 74

TRUE OR FALSE
Total Peripheral Resistance, or the resistance to flow within the entire systemic circulatory system, depends on the COMBINED LENGTHS AND RADII OF ALL THE VESSELS WITHIN THE SYSTEM, AND ON WHETHER THE VESSELS ARE ARRANGED IN SERIES (GREATER RESISTANCE) OR IN PARALLEL (LESSER RESISTANCE)

Back 74

TRUE

Front 75

What is the difference between stable and unstable plaques?

Back 75

STABLE- Has a small fatty core and a thick fibrous cap.
UNSTABLE- Large soft fatty core and a thin fibrous cap (more prone to thrombosis)

Front 76

Tension Pneumo?

Back 76

One way valve is formed by an area of damaged tissue.

Front 77

Emphysema?

Back 77

Part of COPD.
Barrel chest.
Destruction of lung tissue around alveoli.
Alpha 1 anti-trypsin deficiency,
Smoking as cause.
Diagnosed by pulm. function test, XRAY,

Front 78

Some causes of pulmonary edema?

Back 78

Increased force in capillary hydrostatic pressure, Inc. capillary permeability, decreased oncotic force in blood.
Failure of left ventricle of the heart.
Dyspnea, pink frothy sputum.
SOB.
Crackles, presence of third heart sound.

Front 79

Aortic Regurgitation?

Back 79

Leaking of aortic valve that causes blood to flow in the reverse direction during ventricular diastole, from the aorta into the left ventricle.
Causes decrease in diastolic end pressure in aorta, and inc. in pulse pressure (bounding pulse)
Can develop pulm edema.

Front 80

Mitral Regurgitation?

Back 80

Abnormal leaking of blood from left ventricle to left atrium.
s/s CHF symptoms
caused by mitral valve prolapse, or can be acutely caused by endocarditis
ACUTE-
Inc. SV of left ventricle, (inc EF) pulmonary congestion
on exam: high pitched homosytolic murmur after first heard sound, PRESENCE OF THIRD HEART SOUND

Front 81

Nephrotic vs. Nephritic?

Back 81

Nephrotic- Proteinuria
severe edema, hyperlipidemia.
Nephritic- Acute onset hematuria, mild proteinuria, azotemia, inc. bun, inc. creatinine, htn.

Front 82

Glomerulonephritis vs. Glomerulonephropathy?

Back 82

glomerulonephritis- Inflammatory, antibody causes
glomerulonephritis- NON inflamm. problem.

Front 83

3 cell types in glomerulus?

Back 83

endothelial (fenestrated)
outside of endothelial is the podocyte (foot processes for filtration slit)
mesangeal cells- specialized smooth muscle cells, make up the matrix, hold glomerulus together

Front 84

Describe the blood flow to glomerulus?

Back 84

Blood flow comes in from the afferent arteriole into the glomerulus, 20% of blood coming into glom. will leave as ultra-filtrate, and flow into bowmans space.

Front 85

Why is creatinine a good indicator of renal function?

Back 85

Because it is freely filtered.
100% excreted, endogenous.
GFR and creatinine have inverse relationship, as GFR decreases, more creatinine remains in the system.

Front 86

Describe what happens to the kidneys in lupus?

Back 86

TYPE 3 hypersensitivity.
Immune complexes bind to MHC3. Immune complexes deposit in glomerulus, cells attack it.

Front 87

Describe chronic renal failure?

Back 87

Stage 1-normal gfr
Stage 2-gfr 60-89
Stage 3-gfr 30-59
stage 4-gfr 15-29
stage 5-gfr-15ml/min= ESRD

Lose nephrons, activate angiotensin II, glomerular capillary HTN, proteinuria, renal scarring, systemic hypertension.
PLASMA CREATININE GOOD INDICATOR.
*ACE inhibitors first line of treatment.

Front 88

Describe acute renal failure?
Pre- renal?
Intra-renal?
Post-renal?

Back 88

Decreased renal function (measured by GFR), retention of nitrogenous wastes (azotemia),
accompanied by oliguria or anuria.
evolves in hospital,
1-25% crit. ill patients
pre-renal= Decreased renal perfusion
Intra-renal=Parenchymal, can't make urine
Post-renal= Obstruction to urine flow.
IF BUN IS INCREASED, THE
BUN: CREATININE RATIO IS DIAGNOSTIC OF CAUSE OF ARF.
Normally ratio 10 and 20
if >20, pre-renal
if ratio <10, intra-renal
if 10-20, post renal

Front 89

Diabetic glomerulonephropathy?

Back 89

Nodules glycosylated due to high levels of glucose. Mesangeal matrix increased. Micro-aneurysms.

Front 90

Describe the juxtoglomerular apparatus?

Back 90

Found between the vascular pole of renal corpuscle and DCT.
Regulate renal blood flow.
Composed of : DCT, JG CELLS, AND AFFERENT ARTERIOLE.
JG cells secrete renin in response to dec. in renal perfusion, beta-adrenergic stimulation, dec. of NaCl reapsorption in macula densa

Front 91

Role of aldosterone?

Back 91

Adrenal glands stim secretion of aldosterone so kidney increases renal Na reabsorption, and increases urinary K excretion.
It acts on the DCT.

Front 92

Proximal Convoluted tubule?
Loop of Henle?
Distal Convoluted tubule?
Collecting Tubule?

Back 92

PCT-Very metabolically active, Na/K ATPase, to pump Na put of cell. Reabsorbtion of :NaCl (majority), glucose, K, amino acids, HCO3, Urea. Secretion of:
H+, foreign subs, org anions, org cations, ISOTONIC.
LOH- Conc. of urine.
Descending-water reabsorp.
NaCl diffuses in.
Ascending loop- Na+ reabsorbed. water stays in.
Urea secretion in thin segment.
DCT-Reabsorption of NaCL, H20 (ADH required), Secretion of K, Urea, H+, NH3, some drugs.
CT-Reabsorption of H20 (ADH required) Reabsorption or secretion of Na, K+, H+, NH3+, Urea secretion in the medulla, final concentration.

Front 93

OBSTRUCTIVE VS RESTRICTIVE LUNG DISEASE

Back 93

OBSTRUCTIVE:
COPD, ASTHMA, CHRONIC BRONCHITIS, EMPHYSEMA.
*INC IN TLC, FVC NORMAL,
FEV1 DECREASED, FEV1/FVC% DECREASED.
-RESTRICTIVE:
PNEUMONIA, PULMONARY EDEMA, PULMONARY FIBROSIS, ARDS.
*FVC DECREASED, FEV1 NORMAL, FEV1/FVC% NORMAL.

Front 94

true or false
IF PRELOAD increases STROKE VOLUME increases and if AFTERLOAD increases stroke volume decreases.

Back 94

TRUE

Front 95

PLEURAL EFFUSION?

Back 95

A pleural effusion is a buildup of fluid between the layers of tissue that line the lungs and chest cavity.
Two different types of effusions can develop:

Transudative pleural effusions are caused by fluid leaking into the pleural space. This is caused by increased pressure in, or low protein content in, the blood vessels. Congestive heart failure is the most common cause.

Exudative effusions are caused by blocked blood vessels, inflammation, lung injury, and drug reactions.
S/S CHEST PAIN, COUGH, FEVER, HICCUPS, TACHYPNEA, SOB.

Front 96

FLAIL CHEST?

Back 96

Usu. follows blunt trauma.
Rib fractures, crushing injuries.
Can be associated with pulmonary contusion.
Awake patients will complain of pain on palpation of the chest wall or on inspiration. A flail chest is identified as paradoxical movement of a segment of the chest wall - ie indrawing on inspiration and moving outwards on expiration.
Medical EMG.

Front 97

Infective endocarditis?

Back 97

Inflammation of inner tissue of heart. Ususally bacterial.
Can be a result of valve damage.
SUBACUTE- Subacute bacterial endocarditis is often due to STREP. Progresses over weeks to month.
ACUTE-fulminant illness over days to weeks, usually caused by STAPH AUREUS.
A common mnemonic:
FROM JANE
Fever
Roth's spots
Osler's nodes
Murmur
Janeway lesions
Anemia
Nail hemorrhage (splinter hemorrhages)
Emboli

Front 98

HYPERLIPIDEMIA?

Back 98

PRIMARY= due to genetics
SECONDARY= (acquired) due to other underlying causes i.e. diabetes
s/s type 1- abdominal pain (pancreatitis) hepatosplenomegaly
s/s type 2- Xanthelasma, arcus senilis, tendon xanthomas.
treat with STATINS

Front 99

Oxyhemoglobin Dissociation Curve?

Back 99

The oxyhaemoglobin dissociation curve relates oxygen saturation (sO2) and partial pressure of oxygen in the blood (pO2), and is determined by what is called "haemoglobin's affinity for oxygen"; that is, how readily haemoglobin acquires and releases oxygen molecules into the fluid that surrounds it.
INCREASED AFFINITY (shift to left) -hgb doesnt want to let go of O2 easily (exercizing, acute alkalosis)
DECREASED AFFINITY- (shift to right) let go of 02 easily, acute acidosis, high CO2, hypermetabolic state (marathon)

Front 100

Cell types of loop of nephron?

Back 100

PCT- cuboidal cells. (very metab active/lots of mitochondria) NA/K ATPase
LOH-squamos
THICK ASCENDING-columnar
DCT- intercalated

Front 101

FORCES THAT FAVOR FILTRATION, FORCES THAT OPPOSE?

Back 101

FAVOR=HYDROSTATIC PRESSURE
OPPOSE=GLOM. CAP. ONC. PRESSURE, BOWMAN SPACE HYDROSTATIC PRESSURE

Front 102

STROKE VOLUME?
CARDIAC OUTPUT
EJECTION FRACTION?
PERIPHERAL VASCULAR RESISTANCE?

Back 102

SV=EDV-ESV normal range 55-100. amount of blood per beat.
CO= cardiac output is the amt of blood pumped by ventricle in one minute.CO=SV X HR
Normal range 4-8l/min
EF=volumetric fraction of blood pumped out with each beat EF=SV/EDV. normal range 55-70%
TPR=Mean arterial pressure minus mean venous pressure divided by cardiac output.

Front 103

true of false
stable angina is caused by stenosis of coronary arteries

Back 103

TRUE