Nursing > Pathophysiology Test 4 > Flashcards

Pathophysiology Test 4 Flashcards

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1
Q

systole

A
  • ventricular contraction
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2
Q

diastole

A
  • ventricular relaxation
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3
Q

mean arterial pressure

A
  • measure of tissue perfusion
  • determines if all organs are getting perfused
  • should be greater than 60-65
  • MAP of 50 or 45 can lead to organ dysfunction
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4
Q

pulse pressure formula

A
  • the difference of systolic-diastolic pressure
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5
Q

MAP formula

A
  • equals diastolic pressure + (pulse pressure/3)
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6
Q

cardiac output formula

A
  • HR multiplied by stroke volume
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7
Q

blood pressure formula

A
  • cardiac output multiplied by the total peripheral resistance
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8
Q

cardiovacular center

A
  • located in the brain
  • controls the SNS (activation leads to increased HR and BP) and PNS (activation leads to a decreased HR, BP) responses
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9
Q

baroreceptors

A
  • determine changes in blood pressure
  • when there is a drop in BP, these notify the SNS to activate
  • stimulate the SNS if you move too fast from one position to another
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10
Q

chemoactivators

A
  • activate when there are changes in O2 and CO2 levels
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11
Q

natriuretic peptides

A
  • glycoproteins located in the atria, brain tissue, and blood vessels
  • released when vessels are stretched by excess volume (when in hypervolemia)
  • stimulate excretion of salt into the urine decreasing fluid and therefore BP
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12
Q

RAAS

A
  • renin activated angiotensin II and aldosterine
  • retain sodium and water but excrete potassium
  • end result is higher BP because increased volume and vasoconstriction
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13
Q

humoral mechanisms for BP

A
  • Natriuretic peptides
  • Renin-angiotensin-aldosterone system
  • Epinephrine/norepinephrine
  • Antidiuretic hormone
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14
Q

primary hypertension stage

A
  • 90-95%
  • no cause can be identified
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15
Q

secondary hypertension stage

A
  • an elevation in blood pressure due to another disease
  • 5-10%
  • causes can be renal disease, disorders of adrenal hormones, phecochromocytoma
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16
Q

hypertensive crisis stage

A
  • systolic >180 and/or
  • diastolic >120
  • can make blood vessels rupture
  • can lead to hemorrhagic stroke
  • difficult to perfuse organs which can lead to organ failure
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17
Q

orthostatis (postural) hypertension

A
  • drop in BP when moving from a seated or supine position of 20 mm Hg systolic or 10 mm Hg diastolic
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18
Q

hypertension risk factors

A
  • increase in age, more common in men and african americans, family history of hypertension, diet, or cardiac issues (dyslipidemia), tobacco/alcohol use, physical inactivity, metabolic abnormalities, sleep apnea
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19
Q

hypertension treatment

A
  • weight loss, reduced sodium intake, DASH diet, exercise, stop smoking, maintain calcium and potassium levels, take BP medication
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20
Q

long term effects of hypertension

A
  • hypertrophy of the heart
  • agina
  • myocardial infarction
  • heart failure
  • stroke or transient ischemic attack
  • chronic kidney disease
  • peripheral vascular disease
  • retinopathy
  • sexual dysfunction
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21
Q

endothelium function

A
  • selectively permeable barrier
  • modulates blood flow and vascular reactivity
  • regulates thrombosis
  • regulates cell growth
  • regulates inflammatory and immune response
  • maintains extracellular matrix
  • involved in the metabolism of lipoproteins
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22
Q

endothelium dysfucntion

A
  • changes in the normal function of the endothelium in reponse to smoking, dys/hyperlipidemia, diabetes, and obesity
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23
Q

tunica media

A
  • where the vascular smooth muscle cells are located
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24
Q

lipid examples

A
  • cholesterol and triglycerides
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25
lipidproteins
- carries of lipids in the blood
26
apoliproteins
- lipid-protein complexes that help lipids move between blood and cells
27
VLDL (very low density lipoprotein)
- triglycerides - play a role in antherosclerosis and cholesterol issues
28
HDL (high density lipoprotein)
- transports cholesterol from non-hepatic tissues bacl to liver and protects against atherosclerosis
29
LDL (low density lipoprotein)
- transports cholesterol TO non-hepatic tissues (tissues and blood vessels) and contributes to atherosclerosis
30
Five types of lipids
- chylomicrons, VLDL, IDL, HDL, LDL
31
labs for hypercholesteremia
- want to keep LDL below 100 - total cholesterol less than 200 - HDL greater than 60
32
atherosclerosis
- an accumulation of fibrofatty material in the intimal wall of large and medium arteries - a progressive disease influenced by diet, lifestyle, and genes - can lead to decreased perfusion, issues with coronary artery disease (arteries), peripheral arterial disease (extremities), and strokes (carotid arteries and brain)
33
atherosclerosis risk factors
- age, smoking, obesity, high cholesterol levels, hypertension, diabetes (double risk)
34
atherosclerosis clinical manifestations
- usually none until the condition is severe because the body compensates well - arterial blockage and decreased perfusion occurs - tissue hypoxia, cyanosis, altered mental status, stroke symptoms
35
atherosclerosis complications
- rupture of plaques which can form a thrombus, leading to an MI or ischemia leading to injury and death of cells, or aneurysm - severe weakening and dilation of blood vessel wall making it prone to rupturing
36
atherosclerosis process
- endothelial injury - inflammatory cells migrate and enguld lipids - form foam cells which are macrophages which eat lipids - foam cells accumulate and develop a necrotic core - fibrous plaque covers the area and grows which stretched the blood vessels and make it calcifed and hardened - this results in an increased risk of rupture, bleeding, and thrombus formation
37
3 types of athersclerosis lesions
- fatty streaks (we all have) - fibrous plaques - complicated lesions (signifigantly calcified plaques/broken off obstructions)
38
risk factors for epithelial dysfunction
- smoking, hyperlipidemia, diabetes, lifestyle
39
peripheral artery disease
- occurs in larger arteries aside from the brain and heart due to athersclerosis or inflammatory process
40
peripheral artery disease symptoms
- gradual onset, intermittent claudication (calf pain), decrease in leg muscle size, numbness, dependent rubor, cool extremities, absent/weak pulse, gangrene because of decreased perfusion
41
peripheral arterial disease diagnosis
- diagnosed through physical exam and ultrasound of blood vessels - could also use MRI - angiography (dye injected into bloodstream to see blood flow) - blood pressure measurements
42
peripheral arterial disease treatment
- decreasing risk - managing symptoms - can do vascular surgeries if necessary
43
Burger's Disease (Thromboangiitis Obliterans)
- inflammatory disorder which leads to thrombosis in arteries and veins (typically in legs and feet) - unknown cause - more common in younger patients, under 30, smoking, genetics
44
Burger's Disease (Thromboangiitis Obliterans) smyptoms
- pain in the arch of the foot, intermittent claudication, decreased pulses in foot, thin and shiny skin, thin/absent hair and nails, tissue ulceration which leads to gangrene
45
Burger's Disease (Thromboangiitis Obliterans) diagnostic
- diagnosed through arteriography, ankle-arm ration, ultrasound, MRI, CT
46
Burger's Disease (Thromboangiitis Obliterans) treatment
- stop smoking, surgery, and medication
47
Reynaud Phenomenon
- vasoscpastic - blood vessels get small and bloodflow is obstructed - generally occurs in hands and fingers - unknown cause, but common in younger women and those who live in colder climates - mediated by stress which stimulates SNS (vasoconstriction)
48
Reynaud Phenomenon symptoms
- pallor, cyanosis, hyperemia (increase in blood flow), redness, cold, numbness, or parethesia
49
Reynaud Phenomenon diagnosis
- cold water immersion
50
Reynaud Phenomenon treatment
- eliminating cause and medications that decrease vasospasms - can sometimes involve surgery
51
Aneurysm
- an area of vessel dilation caused by weakness in the arterial wall - when occuring in an artery, more severe - happens often in aorta - types: berry, fusiform, dissecting
52
berry aneurysm
- a small dilation in a bifurcation - localized little pouch
53
fusiform aneurysm
- entire circumference of vessel dilates, gradual, progressive dilation - can expand longitudinally or horizontally
54
dissected aneurysm
- life threatening - a rupture or tear in the blood vessel wall
55
aneurysm symptoms
- can vary be location - blood vessels increase in size, see changes in BP and HR
56
aneurysm diagnosis
- MRI, CT scans, ultrasounds to see blood vessels
57
aneurysm treatment
- reduce risk of rupture by decreasing BP - surgery
58
AAA (abdominal aortic aneurysm)
- can be fixed by EVAR (endovascular aortic repair)
59
venous disorders
- venous pressure system is a lower pressure system - valves help maintain direction of blood back to the heart - movement of muscular system helps with venous return - disorders are anything that messes up this system
59
varicose veins
- dilated, tortuous veins in the lower extremities - primarily superficial, secondary if deep veins - Dilation of veins and malfunction of valves due to hypertension in venous system
59
varicose veins risk factors
- prolonged standing, female, increasing age, obesity, increased abdominal pressure, pregnancy
60
varicose veins symptoms
- edema, swelling, aching of legs, warm skin, twisted veins on the legs
61
varicose veins complications
- venous insifficiency - initially do not cause many problems - severe edema, discoloration, chornic venous stasis ulcers
62
varicose veins diagnosis
- physical examn, doppler for blood flow, angiography
63
varicose veins treatment
- compression socks, sclerotherapy, SCDs, surgical treatment - improve flow and prevent injury
64
superficial veins
- collected blood from skin, subQ tissues
65
deep veins
- have more support - surrounded by bones, muscle, and connective tissue
66
venous thrombosis (thrombophlebitis)
- blood clot causes inflammatory response and a decrease in blood flow - virchow's triad: risk factors for blood vlot (venous stasis, increased blood coagulability, vascular wall injury)
67
venous thrombosis (thrombophlebitis) risk factors
- immobility
68
venous thrombosis (thrombophlebitis) symptoms
- pain distal to blood clot, swelling, tenderness of muscles
69
venous thrombosis (thrombophlebitis) diagnosis
- ultrasounds, venography, d-dimer which is elevated in the presence of a clot
70
venous thrombosis (thrombophlebitis) treatment
- prevention (TED hose, SCDs, heparin) - repositioning - anticoagulants - gradual ambulation
71
venous thrombosis (thrombophlebitis) complication
- pulmonary embolism
72
Nursing
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