what happens during ventricular diastole? - ANSWER-the ventricles are filling with blood
what happens during ventricular systole? - ANSWER-the
... [Show More] ventricles contract, blood is forced through pulmonary and aortic valves into the pulmonary artery and aorta
client with decreased peripheral pulses with lab results that show hypocalcemia. what is likely the problem?
preload, afterload, or contractility? - ANSWER-contractility
What is the job of the right side of the heart? what kind of blood vessels empty into this side of the heart? - ANSWER--send deoxygenated blood to the lungs
-veins
what is the job of the left side of the heart? what kind of blood vessels does it empty into? - ANSWER--send oxygenated blood to the body
-arteries
flow of blood in the right side of the heart - ANSWER--enters superion/inferior vena cava
-R atrium
-tricuspid valve
-R ventricle
-pulmonic valve
-pulmonary artery
-TO LUNGS
flow of blood through the left side of the heart - ANSWER--pulmonary vein
-L atrium
-bicuspid valve
-L ventricle
-aortic valve
-aorta
-TO BODY
what is the function of the heart? - ANSWER-pump blood through the body to supply oxygen to the tissues and remove CO2
where does the conduction of the heart rhythm start? - ANSWER-SA node
what can problems with the SA node lead to? - ANSWER-Arrhythmia, dysrhythmia, and other rhythm problems in the heart
What is the cardiac output equation? - ANSWER-CO=HRxSV
what is cardiac output? - ANSWER-amount of blood pumped out in 1 minute
what is heart rate? - ANSWER--beats (#) per minute
-60-100 BPM
what is stroke volume? - ANSWER-amount of blood pumped out with one contraction
what is preload? - ANSWER--think VOLUME
-volume loaded into ventricles before contraction
what is preload affected by? - ANSWER--venous return
-blood volume
what is afterload? - ANSWER--think RESISTANCE
-the amount of force needed to empty ventricles during contraction
-heart vs all arteries -> has to be STRONG
what is afterload affected by? - ANSWER--systemic vascular resistance (SVR)
-BP
what is contractility? - ANSWER-strength of cardiac contraction
what is contractility affected by? - ANSWER--electrolytes (Ca+)
-myocardial stretch
-myocardial O2 supply
Patient is hypovolemic
which physiological principle is primarily affected?
Preload, Afterload, or Contractility - ANSWER-preload
Patient has chronic inflammation and constriction of his blood vessels
which physiological principle is primarily affected?
Preload, Afterload, or Contractility - ANSWER-afterload
Patient is retaining fluid and has increased blood volume
which physiological principle is primarily affected?
Preload, Afterload, or Contractility - ANSWER-preload
Patient has recently had an MI and part of his heart muscle is damaged
which physiological principle is primarily affected?
Preload, Afterload, or Contractility - ANSWER-contractility
Patient has an enlarged, weakened left ventricle
which physiological principle is primarily affected?
Preload, Afterload, or Contractility - ANSWER-contractility
Patient has chronic hypertension
which physiological principle is primarily affected?
Preload, Afterload, or Contractility - ANSWER-afterload
Patient has hypercalcemia
which physiological principle is primarily affected?
Preload, Afterload, or Contractility - ANSWER-contractility
Patient is severely hypotensive
which physiological principle is primarily affected?
Preload, Afterload, or Contractility - ANSWER-preload
What is hypertension? - ANSWER--high blood pressure
-140/90
what is primary hypertension and what causes it? - ANSWER--95% of cases
-no identifiable causes
what is secondary hypertension and what causes it? - ANSWER--5% of causes
-specific cause
-chronic renal failure, type 2 diabetes
What are the risk factors for cardiac problems? - ANSWER--family history
-increased age
-smoking
-obesity
-alcohol
-men
-black
-increased Na+
-increased sugar
-increased cholesterol
-increased triglycerides
what causes the complications of hypertension and why are there so many? - ANSWER--blood is moving too fast to deposit enough O2
-body systems are not getting enough oxygen to function properly
symptoms of hypertension - ANSWER-asymptomatic
pathology of hypertension - ANSWER--increased wall thickness
-reduced interior diameter
Complications of hypertension - ANSWER--brain stroke (reduced blood supply to brain)
-vision loss (damaged blood vessels)
-blood vessel damage (atherosclerosis)
-heart attack (muscle thickening from increased work which leads to restricted blood flow)
-bone loss (increases Ca+ in urine)
-kidney failure (damaged vessels cant effectively filter blood)
Arrhythmias/dysrhythmias definition and types - ANSWER-change in rate and rhythm
causes of arrhythmias - ANSWER--electrolytes
-increased age
-cardiac disease
-trauma
s/s of arrhythmias - ANSWER--dizzy
-syncope
-palpitations
-cardiac arrest
tachycardia - ANSWER--HR > 100 bpm
-problem=prevents ventricular filling
-beating SO fast there is no time to fill up
-result = decreased CO because CO=HRxSV
bradychardia - ANSWER--HR <60 BPM
-problem=decreased CO
-decreased CO= decreased HR
-symptomatic?
asystole - ANSWER--no electrical rhythm
-no CO
-CPR
v-fib - ANSWER--erratic contractions of ventricles
-no atria
-no CO
-CPR and electrical shock
deep vein thrombosis (DVT) - ANSWER-A blood clot in a deep vein, most often an extremity
causes of DVT - ANSWER--venous stasis (not moving)-> need to move skeletal muscles for blood in venous system to return to the heart
-venous endothelial damage
-hypercoagulability
risk factors for DVT - ANSWER--bed rest
-increased age
-immobility
-heart failure=too much volume
-pregnancy= increased clotting factors
-hormone therapy-> estrogen= increased clotting factors
s/s of DVT - ANSWER--red
-heat
-swelling
-pain
-+ homans tests for this, but DO NOT DO THIS- could dislodge clot (hold up affected leg and flex foot=PAIN in leg)
what happens in left side heart failure?
how are preload, afterload, and contractility impacted? - ANSWER--typically blood flows from lungs to body
-failure=blood doesn't empty from heart and backs up back into the lungs
-preload= increased
-afterload= increased
-contractility= decreased
what happens in right side heart failure?
how are preload, afterload, and contractility impacted? - ANSWER--typically blood flows from body to the lungs
-failure=blood gets pooled in heart and backs up into the body
-preload= increased
-afterload= increased
-contractility= decreased
Causes of right sided heart failure - ANSWER--Left heart failure
-COPD
what is HF compensation? what are the components? - ANSWER--decreased CO=body tries to help!
-nervous system
-heart
-renal
HF compensation: Nervous system - ANSWER--increased HR
*BUT increased HR= decreased ventricular filling= decreased CO
-peripheral vasoconstriction (sends blood to the core)
HF compensation: heart - ANSWER--dilate chambers
-hypertrophy
-Need more O2!!
-result= decreased contractility
HF compensation: renal - ANSWER--decreased blood flow
-leads tp RAAS
-Angio II -> vasoconstriction (increase afterload)
-aldosterole -> aldosterone (increase preload)
-BOTH increase BP
How does the RAAS system work? - ANSWER--dehydration/hemorrhage
-decreased blood volume
-decreased BP
-juxtaglomerular cells (kidneys) get mad because they are getting less O2 and release renin
-tells liver to release angiotensinogen
-combine and make angiotensin I which goes to the lungs
-ACE enzyme converts angio I to angio II
-angio II causes vasoconstriction (increased BP)
-angio II tells adrenal cortex to release aldosterone to keep Na+/water and force K+ out
-this causes increased blood volume, which increased blood pressure
when is the RAAS system good? - ANSWER-when you are dying
why is it bad if hypertension causes the RAAs system? - ANSWER--BP is high, gas exchange is not occurring as effectively because blood is moving too fast
-RAAS system increases blood pressure to try to get more O2 to kidneys, which makes the problem even worse
what is the point of ACE inhibitors? - ANSWER-block ACE enzyme from converting Angio I to Angio II to stop blood pressure increase
why is it bad if heart failure causes the RAAS system? - ANSWER--heart fails, less CO reaching kidneys
-RAAS system initiates vasoconstriction and blood volume increase
-heart has to work even harder after failing
why is the RAAS system initiated for a good reason? - ANSWER--dehydration
-hemorrhage
-decreased blood volume
how does angiotensin I become angiotensin II? - ANSWER-it is converted by ACE enzyme
what are the 2 outcomes of angiotensin II? - ANSWER--vasoconstriction
-tells adrenal cortex to release aldosterone which causes increased blood volume
what is the end result of the RAAS system? - ANSWER-vasoconstriction+increased blood volume=increased BP
What is atherosclerosis? - ANSWER-a disease of the arteries characterized by the deposition of plaques of fatty material on their inner walls.
pathogenesis of atherosclerosis - ANSWER--injury
-LDL accumulation on damaged area
-macrophages come to ingest LDLs
-macrophages become foam cells (worthless blobs) after eating LDLs and becomes a fatty streak
-body tries to help by containing the damage: muscle cells cap off damaged area which forms a fibrous cap (plaque)
-decreased diameter in vessels decreases blood flow
-cap bursts
-thrombus (blood clot)
-embolism (plaque breaks off and travels through body)
what is the #1 cause of atherosclerosis? - ANSWER-hypertension- blood is moving so fast, molecule damages interior of arterial walls
coronary artery disease/ acute coronary syndrome - ANSWER-umbrella term for angina and MI
what are the main causes of coronary artery disease? - ANSWER--atherosclerosis of the coronary arteries
-arteriosclerosis (hardening/thickening of vessel walls)
what is angina? - ANSWER--chest pain that involves the heart
-decreased oxygen to the heart via the coronary arteries
stable angina - ANSWER--common with physical/emotional stress
-episodes are alike if repeated
- <5 minutes long
-relieved with rest or meds
unstable angina - ANSWER--occurs at rest
- >5 minutes
-unrelieved by rest or meds
what is unstable angina a hop skip and jump away from? - ANSWER-Myocardial infarction
What is a myocardial infarction (MI)? - ANSWER--heart attack
-occlusion of a coronary artery that causes necrosis
-necrosis and worthless muscle under the block
what are the causes of myocardial infarction? - ANSWER--atherosclerosis
-embolism
s/s of myocardial infarction - ANSWER--asymptomatic, GERD (women mostly)
-L arm pain
-jaw and back pain
-elephant on chest
-hypertension initially -> leads to hypotension
-tachycardia
how is myocardial infarction treated? - ANSWER-stent placement
causes of L sided heart failure - ANSWER--ventricular remodeling
-eg. MI->necrosis-> ventricle needs to change shape to adapt but doesn't work as effectively
-increased volume (preload)
-increased afterload (HTN)
risk factors for L sided heart failure - ANSWER--cardiac disease (eg. HTN->MI)
-renal failure (causes RAAS)
-congenital heart defect
s/s of L sided heart failure - ANSWER--frothy sputum (dawn dish soap surfactant)
-dyspnea
-orthopnea (difficulty breathing while laying down)
-weight gain (retaining fluid)
-increased urine output (kidneys [Show Less]