Term
|
Definition
| Increase of venous return(preload) or arterial return (afterload) |
|
|
Term
|
Definition
all 4 valves shut
Heart is full of preload
ventricles start to contract
Possibly S1 |
|
|
Term
|
Definition
Atrioventricular valves closing
Mitral and Tricuspid |
|
|
Term
|
Definition
Closure of Pulmonic and Aortic Valves
Also Called Semilunar Valves |
|
|
Term
|
Definition
| forces open the Semilunar valves |
|
|
Term
|
Definition
|
|
Term
| Right or left Coronary Artery Perfuse |
|
Definition
|
|
Term
| Right Coronary artery perfuse |
|
Definition
| Right Ventricle and Posterior heart |
|
|
Term
| Left anterior descending coronary artery perfuses |
|
Definition
Left side of heart
apex
septum
aka: widowmaker |
|
|
Term
| Beta 1 receptors in heart |
|
Definition
| Inc. heartrate and inc. contractility |
|
|
Term
|
Definition
| Cause bronchodilation and mild vasodilation |
|
|
Term
|
Definition
|
|
Term
| Beta 1 receptors in the kidney |
|
Definition
|
|
Term
| Sympathetic nervous cardiac stimulation |
|
Definition
SA node and BV's: inc. HR and vasocontriction
Adrenal medulla: release epi and norepi |
|
|
Term
| Epi and Nor epi stimulate Caridac |
|
Definition
|
|
Term
| Parasympathetic nervous stimulation |
|
Definition
Vagal nerve causes decrease in HR by slowing SA node
Ex: Valsalva maneuver, carotid sinus massage |
|
|
Term
|
Definition
Sensitive to arterial pressure
inc. pressure = decr. HR and peripheral vasodilation
temporary effects |
|
|
Term
|
Definition
| Respond to incr. PaCO2 or dec. PaO2 and or dec. PH to incr. cardiac activity |
|
|
Term
| Left main Coronary artery perfuses |
|
Definition
| Lateral and posterior Heart |
|
|
Term
| 3 components of Stroke Volume |
|
Definition
Preload
Contractility
Afterload |
|
|
Term
|
Definition
| Amount of blood in ventricles |
|
|
Term
|
Definition
|
|
Term
|
Definition
| pressure on the ventricles from PVR and SVR |
|
|
Term
|
Definition
| Atherosclerosis-->progressive narrowing of the arteries-->thrombus formation, coronary vasospasm, and endothelial cell dysfunction. |
|
|
Term
|
Definition
| HTN, Male > 45, female >55, family hx, obesity, DM(sugar loves plaque), Atherogenic diet, inactivity, Cigarrette use, thrombogenic state |
|
|
Term
|
Definition
High density lipoprotiens.
transports fats back to liver |
|
|
Term
|
Definition
Low " "
Mostly Cholesterol |
|
|
Term
|
Definition
Very " " "
mostly Triglycerides |
|
|
Term
|
Definition
Stenosis of coronary vessels
predicable
inc. O2 workload of heart |
|
|
Term
|
Definition
|
|
Term
| Prinzmetal (Variant) angina |
|
Definition
unpredictable
Caused by Coronary vasospasm |
|
|
Term
|
Definition
|
|
Term
Unstable angina
or
Crescendo angina |
|
Definition
Much worse than normal but has not caused infarction. Not responding to Tx well. Lasts longer
|
|
|
Term
|
Definition
| Atherosclerotic plaque ruptures-->blood seeps into lipid core-->Core expands-->platelets adhere and form plug-->clotting cascade activated-->thrombus grows-->lumen occludes-->ischemia-->necrosis |
|
|
Term
|
Definition
Atherosclerosis-->dec. perfusion to endocardium-->ischemia-->necrosis
Plug doesn't form so no clot |
|
|
Term
|
Definition
dying from necrosis
replaced with fiber |
|
|
Term
| Zone of injury (penumbra) |
|
Definition
|
|
Term
|
Definition
|
|
Term
| anaerobic metabolism in myocardium |
|
Definition
| cells make less ATP and more Lactic acid |
|
|
Term
| infarction (immediate effect) |
|
Definition
ischemia leads to anaerobic metabolism-->lactic acidosis
reduced ATP |
|
|
Term
|
Definition
| impaired ability of cardiac cells to contract |
|
|
Term
|
Definition
lactic acidosis--> inc. cell vulnerability to lysosomal enzymes in cell.
irreversible necrosis starts in endocardium and moves to epicardium. |
|
|
Term
|
Definition
| infarcted area is yellow and soft surrounded by connective tissue |
|
|
Term
|
Definition
necrotic tissue degrades
susceptible to rupture |
|
|
Term
|
Definition
| necrotic tissue is replaced by tough fibrous scar tissue |
|
|
Term
|
Definition
Obstruction in LAD artery
most common |
|
|
Term
|
Definition
Obstruction in Right coronary artery
posterior wall of LV and post. 1/3 of septum |
|
|
Term
|
Definition
Obstruction in left circumflex artery
Lateral wall of LV |
|
|
Term
|
Definition
obstruction in right coronary artery
RV
may manifest as nausea |
|
|
Term
|
Definition
| fatigue, nausea, back paid, abd. discomfort |
|
|
Term
|
Definition
ST elevation
T wave inversion or peaks
"tombstone T's" |
|
|
Term
|
Definition
myoglobin (usually peaks before blood draw)
CK-MB (24hrs)
Cardiac troponins I & T (24hrs)
|
|
|
Term
|
Definition
| preload and afterload buildup, heart gives out |
|
|
Term
MI Tx
most important concept |
|
Definition
|
|
Term
|
Definition
| Dec. myocardial O2 demand and inc. myocardial O2 supply |
|
|
Term
MI Tx
actions to dec. O2 demand |
|
Definition
reduce pre/afterload
control HR
restrict activity
pain meds
inc. O2 supply |
|
|
Term
|
Definition
dilation of all 4 heart chambers
Etiology: ETOH, genetics, preg. viral |
|
|
Term
| dilated cardiomyopathy pathogenesis |
|
Definition
| vent. dilate-->inc. cardiac workload-->myocardium degenerates-->replaced with fibrous tissue-->contractile failure-->slowly progressive may lead to emboli. |
|
|
Term
| dilated cardiomyopathy clinical manifestations |
|
Definition
| same as heart failure. fatigue and weakness |
|
|
Term
| hypertrophic cardiomyopathy |
|
Definition
thickened hyperkinetic ventricular mass
etiology: genetic |
|
|
Term
| hypertrophic cardiomyopathy pathogenesis |
|
Definition
| vent. outflow obstruction or impaired diastolic filling-->red. stroke vol.-->dec. cardiac output-->risk for sudden death after vigorous activity |
|
|
Term
| hypertrophic cardiomyopathy clinical manifestations |
|
Definition
| sudden death, dyspnea, angina, maybe asymptomatic |
|
|
Term
| restrictive cardiomyopathy |
|
Definition
stiff, fibrotic ventricles
etiology: diseases that inc. fibrosis, genetics, virus, malnutrition, autoimmune |
|
|
Term
| restrictive cardiomyopathy pathogenesis |
|
Definition
| vent. fibrose-->become stiff and noncompliant-->reduced diastolic filling and stroke volume--> CHF |
|
|
Term
| restrictive cardiomyopathy clinical manifestations |
|
Definition
| excercise intolerance, dyspnea, weakness |
|
|
Term
|
Definition
| same as for CHF: diuretics, BB's, CCB's, NTG test, O2, antidysrhythymics, anticoagulants, avoid ETOH, sometimes NA restr... digoxin? |
|
|
Term
|
Definition
inflammation of pericardium
etiology: infection, immunologic response, MI, uremia, cardiac surgery, neoplasm, trauma, radiation |
|
|
Term
| pericarditis clinical manifestations |
|
Definition
| pain that radiates to back, dysphagia(hard to swallow), fever, inc. WBC, malaise and inc. HR, friction rub, anxiety. |
|
|
Term
| diagnose pericardial friction rub |
|
Definition
| Hold breath to make sure it's not pleural |
|
|
Term
|
Definition
| symptomatic, reverse the cause, pericardial window? |
|
|
Term
|
Definition
| Collection of fluid in pericardial sac |
|
|
Term
| Pericardial effusion etiology |
|
Definition
| serous(CHF, hypoprotienemia), serosanguinous(blunt chest trauma, CPR), chylous(obstructed lymph drainage), blood(penetrating trauma to the heart) |
|
|
Term
| pericardial effusion clinical manfiestations |
|
Definition
| inc. HR, diaphoresis, fever, distant heart sounds(fluid between you and them), pulsus paradoxus(BP drops on inhalation), rub may disappear. |
|
|
Term
| pericardial effusion diagnostics |
|
Definition
| echocardiogram and analysis of fluids. norm. 30-50 ml but can hold up to 1-2 liters w/o symptoms if accumulates slowly. if small amount accum. rapidly s/s of pericarditis. if rapid or very large can develop cardiac tamponade. |
|
|
Term
|
Definition
|
|
Term
| Cardiac tamponade pathophysiology |
|
Definition
| external comp of heart chambers-->dec. filing of chambers-->systemic backup of blood and cardiovascular collapse-->death |
|
|
Term
| cardiac tamponade clinical manifestations |
|
Definition
| Red. SV, inc. HR, venous congestion, pulsus paradoxus, distant heart, dull CP, EKG and CXR changes. |
|
|
Term
|
Definition
pericardiocentesis or simply monitoring
Tx cause of effusion |
|
|
Term
|
Definition
|
|
Term
|
Definition
| inc. pulmonary Fx, inc. cardiac Fx, inc. erythropoiesis, inc. SNS (inc. HR, inc. CO, blood shunted to vital organs) |
|
|
Term
|
Definition
| dec. RBC, dec. Hgb, dec. Hct, |
|
|
Term
|
Definition
mean corpuscle volume (size of RBC)
mean corpuscle hemoglobin (weight of hemoglobin in RBC)
mean corpuscle hemoglobin concentration (concentration of hemoglobin in RBC) |
|
|
Term
| general effects of anemia |
|
Definition
| vasoconstriction-shunting. pallor. tachypnea. dyspnea. tachycardia. angina-less O2. transient murmers-thin blood. HF. HA. night cramps-RLS. light-headed. tinnitus-blood. syncope-less O2 to brain. |
|
|
Term
| three major etiologies of anemia |
|
Definition
1. Dec. RBC production
2. inherited hemolytic disorders
3. RBC destruction |
|
|
Term
| iron deficiency anemia etiologies |
|
Definition
dec. iron intake
inc. requirement for iron
excessive iron loss-hemmorrhage
hemodialysis-pulls iron off? |
|
|
Term
| iron deficiency anemia Labs |
|
Definition
Decreased: RBC, Hgb/Hct, MCV, MCH, MCHC, serum iron.
Normal: WBC, Platelets,
Increased: total iron binding capacity |
|
|
Term
| Iron deficiency anemia clinical manifestations |
|
Definition
usually none
pallor, weak, fatigue, irritable, HA, Pica |
|
|
Term
| iron deficiency anemia Tx |
|
Definition
inc. oral iron
treat cause
possibly iron dextran IV |
|
|
Term
|
Definition
| dec. hematopoitic tissue in bone marrow and pancytopenia (all values go down) |
|
|
Term
| aplastic anemia etiologies |
|
Definition
| toxins, radiation, immunologic injury from disease or drugs |
|
|
Term
| aplastic anemia clinical manifestations |
|
Definition
RBC, Hgb/Hct-weak, lethargy, dizzy, fatigue, palpitations, dyspnea, neutropenia.
fever, chills, infections-WBC
platelets lower-epistaxis |
|
|
Term
|
Definition
stop toxic agent, radiation or reverse causitive disease process
admin platelets or PRBC's
prevent infection and bleeding
meds to inc. hematopoiesis (neupogen, epogen) |
|
|
Term
|
Definition
decrease in B-12 or folate
disrupts synthesis of RBC in bone marrow, abnormal large RBC formed.
not enough intrisic factor or not enough intake (e.g. vegans) |
|
|
Term
| pernicious anemia etiologies |
|
Definition
lack of B-12 (genetic lack of intrinsic factor, decreased intake (e.g. vegans)
lack of folate (dietary, alchoholism, cirrhosis, preg., infancy, fad diet) |
|
|
Term
| pernicious anemia Lab values |
|
Definition
Down: RBC, Hgb, Hct, serum B-12, WBC, platelets
up: MCV, MCH, MCHC |
|
|
Term
| pernicious anemia clinical manifestations |
|
Definition
| paranoid, dementia, confusion, dec. LOC, irritability, hallucinations, parethesias (numbness or tingling) of the extremities, spastic ataxia, heart congestion, pedal edema, nocturia, tachypnea, dyspnea, tachycardia, wt loss, glossitis, arthralgia, diarrhea, birth defects from low folate, megaloblastic madness |
|
|
Term
|
Definition
Parenteral B-12
oral folate |
|
|
Term
|
Definition
| genetically defective hemoglobin that causes RBC to morph into sickle-shapes when O2 is low |
|
|
Term
| sickle cell disease progression |
|
Definition
| sickle cells occlude vasculature, resulting in stasis, thrombosis, and emboli. sickle cells die young leading to anemia. many organs become infarcted or necrotic. acute hemolytic or vascular occlusion crisis. |
|
|
Term
| sickle cell manifestations |
|
Definition
| acute hemolytic or vascular occlusion crisis, spenomegaly, hepatomegaly, cirrhosis, bone growth disturbances, necrosis of bones, pulmonary emboli, fever, pain, sudden death. |
|
|
Term
|
Definition
down: RBC, Hgb, Hct
norman: MCV, MCH, MCHC
RBC breakdown products: inc. bilirubin, urobiligen (jaundice)
leukocytosis or normal WBC
Hemoglobinuria |
|
|
Term
|
Definition
supportive
crisis: prevent dehydration, acetaminophen for fever, splenectomy for spleen complications
transfusions
stem cell transplant |
|
|
Term
Hemolytic disease of the newborn
etiologies |
|
Definition
| RH incompatibility. RH negative mother develops antibodies during first preg. to antigens on cells of Rh+ fetus. maternal antibodies cross into fetal circulation and destroy fetal cells |
|
|
Term
| hemolytic disease of newborn lab values |
|
Definition
down: RBC, Hgb, Hct
normal: MCV, MCH, MCHC, platelets
up: WBC, bilirubin,
positive coomb's test or cord RBC
|
|
|
Term
| HDN clinical manifestations |
|
Definition
jaundice, petechial hemorrhage, hepatomegaly, splenomegaly, HF (pulmonary edema, pleural effusions, ascites, edema), Kernicterus (jaundice leading to heart problems).
many infants die in utero |
|
|
Term
|
Definition
Rhogam given to mother before or after delivery to prevent sensitization to infants RBC
pregnancy not baby |
|
|
Term
|
Definition
| amniocentesis and fetal blood sampling |
|
|
Term
|
Definition
exchange blood transfusions
early delivery |
|
|
Term
| anemia from acute blood loss etiologies |
|
Definition
trauma or disease process
e.g. gastric ulcer, heavy menstruation |
|
|
Term
| acute blood loss anemia labs |
|
Definition
Down: RBC, Hgb, Hct, plt, WBC
normal: MCV, MCH, MCHC |
|
|
Term
| acute blood loss anemia clinical manifestations |
|
Definition
| if slight hemorrhage, none. tachycardia is first sign, dec. BP, orthostatic hypotension, shock, death |
|
|
Term
| acute blood loss anemia Tx |
|
Definition
blood volume replacement
treat underlying disease |
|
|
