Study Guide: Chapter 12

Question 1

Which sized arteries are elastic?

Answer 1

Large

Question 2

Which sized arteries are muscular

Answer 2

Medium

Question 3

True or false: Blood normally clots both within and outside of blood vessels.

Answer 3

False; it normally clots on the surface (where the injury is); if it clots inside, it can be deadly (block circulation)

Question 4

What are the 3 main reasons that blood might clot inside a vessel?

Answer 4

1) Blood stasis (assoc. with venous thrombosis)
2) Vessel wall damage (assoc with arterial thrombosis)
3) Increased blood coagulability

Question 5

Which type of clotting inside vessels is caused by blood stasis?

Answer 5

Venous thrombosis

Question 6

Which type of clotting inside blood vessels is caused by vessel wall damage?

Answer 6

Arterial thrombosis

Question 7

intravascular clot

Answer 7

thrombosis

Question 8

detached mobile clot

Answer 8

embolism

Question 9

tissue necrosis

due to blocked blood supply so oxygen-starved tissue dies

Answer 9

infarction

Question 10

death of body tissue due to either a lack of blood flow or a serious bacterial infection

Answer 10

gangrene

Question 11

(inflammation of

vein

Answer 11

phlebitis

Question 12

clot in inflamed vein

Answer 12

thrombophlebitis

Question 13

dilated, twisted veins

Answer 13

varices/varicosities

Question 14

(vein blocked by clot

Answer 14

venous thrombosis

Question 15

True or false: Venous thrombosis can be caused by high BP.

Answer 15

False; veins are under low pressure

Question 16

True or false: Varicose veins are often hereditary and are present in 70% of women over 60 years old.

Answer 16

True

Question 17

Clot in deep veins of the legs

Answer 17

DVT

Question 18

What percentage of people who have a DVT also develop a PE?

Answer 18

25%

Question 19

What percent of DVT patients die from it?

Answer 19

10%

Question 20

What percentage of hospital patients develop DVT if no preventative measures taken?

Answer 20

25%

Question 21

True or false: Most DVTs dissolve naturally.

Answer 21

True

Question 22

How is PE generally treated?

Answer 22

With anticoagulants (rarely use thrombolytics, angioplasty, or surgery/thrombectomy)

Question 23

What effects does a large pulmonary embolism have on the heart?

Answer 23

Causes blood to back up into the R side of heart and prevents enough blood from reaching the left side of the heart. BP falls (shock).

Question 24

Condition that results from an embolism carrying a bacterial infection with it to the lung; results in an infection of necrotic tissues and formation of lung abscess and systemic infection.

Answer 24

Septic pulmonary embolism

Question 25

How is PE diagnosed?

Answer 25

1) D-dimer blood test (d-dimer levels rise with fibrinolysis) 2) Chest xray (may reveal necrotic wedge, but not embolism itself) 3) Ventilation/perfusion scan 4) CT scan (best) or pulmonary angiogram

Question 26

Type of blood test used to dx PE

Answer 26

d-dimer (levels rise with fibrinolysis)

Question 27

What is the best dx tool for diagnosing PE?

Answer 27

CT scan with contrast or pulmonary aniogram

Question 28

Test that detects if lung ventilation is normal but pulmonary blood flow is reduced (which indicates PE)

Answer 28

Ventilation/perfusion scan

Question 29

Test that detects blockage using radiopaque material and x-rays; have to thread a catheter up through heart and into pulmonary artery

Answer 29

pulmonary angiogram

Question 30

How do you treat PE?

Answer 30

Typically with anticoagulants; if its an emergency, thrombolytics can be used (tPA)

Question 31

What causes arterial thrombosis?

Answer 31

Vessel wall injury due to arteriosclerosis.

Question 32

What occurs as a result of arterial thrombosis?

Answer 32

Tissue and organ infarcts

Question 33

What can a leg infarct caused by arterial thrombosis lead to?

Answer 33

Gangrene

Question 34

How does arteriosclerosis cause arterial thrombosis?

Answer 34

1) Vessel wall injury causes ulceration and roughening of the arterial lining. 2) This allows thrombi to form.

Question 35

What factors predispose a person to both arterial and venous thrombosis?

Answer 35

1) Obesity 2) Estrogen/oral contraceptives 3) Older age

Question 36

What are the most common cause of intracardiac thrombosis?

Answer 36

1) Atrial fibrillation 2) Heart failure 3) Heart valve damage 4) Damaged L ventricle lining

Question 37

Where do clots caused by atrial fibrillation form?

Answer 37

Within little atrial appendage heart pouches

Question 38

What happens with clots that form in the heart?

Answer 38

They can be carried back into circulation and cause infarcts anywhere in the body where they get stuck.

Question 39

What leads to pathological clot formation caused by increased coagulability of blood?

Answer 39

1) Following injury or surgery 2) Estrogenic compounds 3) Advanced cancer 4) Hereditary mutations that increase coagulability (e.g., factor V Leiden)

Question 40

What is a mutated form of human factor V that causes hypercoagulability (increased blood clotting)?

Answer 40

factor 5 Leiden

Question 41

Why does the mutant factor V Leiden mutation cause hypercoagulability?

Answer 41

It is not sensitive to protein C inhibition and therefore has prolonged prothrombin to thrombin activation.

Question 42

What are the significant differences between increased thromboplastic material released during advanced cancer and that released in disseminated intravascular disease (DIC)?

Answer 42

1) DIC = thromboplastic materials are released rapidly, using up clotting factors and activating fibrinolysis; this causes hemorrhaging. 2) Advanced cancer can cause thromboplastic material to be released slowly, causing overall thrombosis.

Question 43

What is an example of an embolism caused by fat?

Answer 43

In the case of a bone fracture

Question 44

What is an example of an embolism caused by air?

Answer 44

In a lung injury or injection error.

Question 45

What is an example of an embolism caused by amniotic fluid?

Answer 45

labor/delivery

Question 46

What is an example of an embolism caused by injected particles?

Answer 46

Drug abuser

Question 47

Fluid accumulation in tissues

Answer 47

edema

Question 48

True or false: There is no cure for edema.

Answer 48

True

Question 49

How do you treat edema?

Answer 49

Treat the causes; also elevation, compression support hose, low salt diet, limit time sitting or standing; leg muscle exercises.

Question 50

What can cause edema?

Answer 50

1) Increased capillary permeability 2) Osmotic pressure drop due to low blood protein 3) Increased capillary hydrostatic pressure 4) Lymphatic blockage 5) Heart failure (can cause pulmonary edema)

Question 51

What is a major cause of acute pulmonary edema?

Answer 51

Heart failure

Question 52

What is shock?

Answer 52

When BP and/or blood flow is too low to supply body with adequate blood.

Question 53

When BP and/or blood flow is too low to supply body with adequate blood.

Answer 53

Shock

Question 54

What can cause shock due to decreased blood volume?

Answer 54

Hemorrhaging that causes blood volume to drop.

Question 55

What can cause shock?

Answer 55

1) Decreased blood pressure | 2) Decreased blood volume

Question 56

How do you treat shock?

Answer 56

1) Vasoconstrictors 2) Increase blood volume 3) Eliminate cause

Question 57

Why can anaphylaxis cause shock?

Answer 57

Causes high vasodilation, resulting in lowered blood pressure.

Question 58

How can an MI ore heart failure cause shock?

Answer 58

Heart cannot pump adequately to deliver blood to the body

Question 59

How can sepsis or infection cause shock?

Answer 59

Causes excessive vasodilation, resulting in lowered blood pressure.