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First Cariopulm Patho Exam
Cardiopulm Patho
69
Pathology
Graduate
10/10/2014

Additional Pathology Flashcards

 


 

Cards

Term
CAD FACTS
Definition
Plaque producing process that puts the heart at risk for disease
Term
Heart Disease Process
Definition
Starts as ischmeic heart disease, which leads to cardiac muscle dysfunction, which can then cause CHF
Term
Ischemic Heart Disease
Definition

Arterial Structure - intima, media, adventitia

Coronary Blood Flow

Collateral Circulation

Atherosclerosis - lipid deposition, endothelial injury, inflammartory process

Clinicl Manifestations of CAD

Term

Clinical Manifestations of CAD

 

Definition

Sudden Death

Angina - stable, unstable, and variant

Myocardial Infarction 

Term
Treatment of Ischemic Heart Disease
Definition

Pharmacologic - beta blockers, ACE inhibitors

Lifestyle modification

Percutaneous Transluminal Coronary Angioplasty

Stent

Atherectomy

Coronary Artery Bypass Graft

Term
Cardiac Muscle Dysfunction Definition
Definition

Classification of diseases that result in dysfunction of the myocardium's ability to contract and expel blood (systole)

-may also affect the myocardiums ability to accept blood

-this leads to a diminished CO of the heart

Term
Cardiac Causes of Cardiac Muscle Dysfunction
Definition

Hypertension

Dysrhythmia

Cardiomyopathy - dilated, hypertrophic, restrictive

 

Term
Non-cardiac Causes of Cardiac Muscle Dysfunction
Definition

Spinal Cord Injury

Aging

Renal Insufficiency

Term
Congestive Heart Failure Definition
Definition
Heart is unable to contract to provide cardiac output to meet the body's metabolic demands for O2, nutrients, and to remove waste
Term
Right Sided CHF
Definition

This takes longer to occur.

Point of origin is the systemic circulation

Backs up out of the vena cava 

Volume is gravity dependent

The swelling will be B/L and symmetrical LE edema 

 

Term
Symptoms of Right Sided CHF
Definition

Fatigue

Peripheral Edema

Ascites (rx is lasix)

Weight gain (in the belly)

Term
Left Sided CHF
Definition

Occurs first

Has higher pressure and forces

Venous return comes back and EF comes down so the RV goes up

The vasculatur doesn't stop filling the heart and the overstretch continues, the volume keeps coming in, but the heart is full so the fluid spills over to the point of origin aka the lungs (fills the alveoli)

Term
Symptoms for Left Sided CHF
Definition

Dyspnea

Fatigue

Cough

Orthopnea (change postition and get SOB)

Tachycardia

Weight gain

Term
CHF Systolic
Definition
Impaired ability of the myocardium to contract and expel blood
Term
CHF Diastolic
Definition
Impaired abiliy of the ventricles to relax and accept blood from the atria
Term
Treatment of Cardiac Muscle Dysfunction
Definition

Correct causitive factor

Need to address cardiac performance

Medications - digitalis, beta blockers, ACE inhibitors

Pacemakers

Control of water levels

COnditioning exercises

Energy conservation

Surgical 

Term
Cor Pulmonale
Definition
Right sided heart failure secondary to pulmonary dysfunction
Term
Cardiac Valvular Disease
Definition

Prolapse

Regurgitation

Stenosis 

Term
Prolapse
Definition

When the valve is closed and creates a nice tight seal the retrograde of bulging of leaflets, no real leakage.

More common in women 

Usually mitral valve

Term
Regurgitation
Definition

incomplete leaflet closure, retrograde leak

Greater resistance in the ventricles

What you hear is the heart murmur

Mitral valve

Term
Stenosis
Definition

leaflet thickening and stiffening, increased force required

Becomes very hypertrophied and fibrotic

At risk for cardiac muscle dysfucntion because have deminished EF and compromised CO

Aortic valve, will need to be replaced

Term
Inflammatory Disease
Definition

Pericarditis

Myocarditis

Endocarditis 

Term
Pericarditis
Definition

Inflammation of the pericardial sac

May be infectious, autoimmune, or associated with other systemic disease (RA, Lupus)

Wide range of symptoms

Pain may be relieved when lean forward

May lead to pulmonary effusions, cardiac tamponade

Term
Myocarditis
Definition

Inflammation of the myocardial wall

Caused by many different pathogens

Pt may complain of dyspnea, palpations, nondescriptive chest pain, fatigue

(can progress to cardiac muscle dysfunction)

Term
Endocarditis
Definition

Infection of heart valves

Clinical manifestations variable due to involvment of other organ systems by bacteria

Symptoms similar to flue or CHF

May require a heart transplant 

Prophylactic antibiotics (Dentist!)

Term
Cardiac Transplantation
Definition

Devervated heart - the SNS will not be reconnected and the ANS will lose the ability to quickly change your HR. Need long warm up and cool down

Ischemia and rejection may only become apparent during increased activity 

Exercise at 3 months indicative of capability at 12 months 

Term
Disorders of the blood and vascular system
Definition

Anemia

Blood pressure

Hypertension 

Peripheral Vascular Disease 

Term
Peripheral Vascular Disease
Definition

Occlusive disorders

Vasomotor disorders

Leukocyte Disorders (WBCs)

Term
Anemia Definition
Definition

Reduction in O2 carrying capacity of blood

-decreased hemoglobin and hematocrit

Men Hgb <14, Hct <41%

Women: Hgb <12, HCT<37%

Term
Anemia Causes
Definition

Blood Loss - NSAIDs (GI bleed)

Increased destruction of RBC

Decreased destruction of RBC

Term
5 main types of Anemia
Definition

GI blood loss

Chronic or inflammatory disease

Malnutrition

Infectious disease

Neoplastic disease

Term
Anemia symptoms
Definition

Fatigue (malaise)

Weakness

DOE

Pallor

Tachycardia

CNS signs

Term
Treatment for Anemai
Definition

Transfusion

Supplements (Iron)

O2

Splenectomy

Immunosupressive agents

Erythropeitin

Bone marrow transplant 

Term
Anemia concern for exercise
Definition

Expect fatiguability

May need to alter exercise RX

Be careful of bruising and bleeding

Possible delayed wound healing

CNS changes

Tachycardia may be the first sign

NO exericse is Hgb <8

Term
What is Blood Pressue (BP)
Definition

Systolic BP is the only direct

way to measure Cardiac Output

 

Diastolic is a reflection of Total peripheral resistance

Term
BP Short term mechanisms
Definition

Barorecptors - pressure receptors, participate when we exercise

Chemoreceptors - chemical receptors that measure the concentration of things in our blood

CNS

ANS - parasympathetic lowers BP, sympathetic increases BP

Renin-angiotensin-aldosterone 

Term
BP long term mechanisms
Definition
Via the precise control of fluid by the kidneys
Term
Hypertension
Definition

90% is essential

>140

>90

 

Term
Hypertension Symptoms
Definition

Asymptomatic

Headache

Vertigo

Facial flushing

Blurred vision (may be a TIA)

Term
PVD Occlusive disorders
Definition

Peripheral Artery Disease

Thrombus

Venous Thromboembolic Disease (DVT)

VaricousVeins

Chronic Venous Insufficiency

 

Term
PVD Vasomotor Disorders
Definition

Raynaud's Disease

Thrombocytopenia

Leukocyte Disorders (WBCs)

Lymphedema 

Term
DVT Definition
Definition

Partial or complete occlusion of a vein by a thrombus 

May be superficial (less concerning), or deep (more concerning)

More proximal is worse

Best treatment is prevention 

Term
DVT RIsk factors
Definition

Bedrest, sedintary, inactive

Cigarette smoking/tobacco

Fractures (the immobility portion)

Up to 6 months postpartum

Medication

Obestiy

Recent surgery

Sitting for long periods of time

Term
DVT increased risk
Definition

Hypercoaguable blood - Type A

Cancer

Polycythemia- become hypoxemic 

Term
Diagnosing a DVT
Definition

Homans sign - don't use!

Wells Clinical Decision RUle

Doppler Ultrasound

Venography

D-dimer level 

Term
Clinical Decision Making with DVT
Definition

Is patient receiving adequate medical treatment?

Will ambulation increase risk of acute PE?

If PE occurs, can the pt withstand it?

Do the effects of bedrest outweight the effects of ambulation?

Is there evidence of existing PE?

What was thier risk factor?

What was their Wells SCore?

Term
Starling's Hypothesis
Definition

Determines if edema will be present or not

-balance between absorpition and filtration 

-edema is on the side of more filtration 

Term
TIdal Volume
Definition
Up and down volume you see everyday
Term
Vital Capacity
Definition

Big capacity breath

Deep breath in

Term
Functional Residual Capacity (FRC)
Definition

amount of air left in your lungs at the end of a normal exhalation.

Gives you a steady stream of O2 at any point of respiratory cycle

Term
Pulmonary disorders
Definition

Obstuctive DIsorders

Restrictive Disorders 

Term
Obstructive Disorders Definition
Definition

Diseases which produce an obstruction to airflow 

Decrease in the size of the bronchial lumen

Loss of elastic recoil

Tendency for bronchiolar collapse

Air trapping resulting in hyperinflation (increases dead space, FRC is higher, Tidal volume is smaller, elevated WOB)

Term
Sg/Sx of Obstructive disorders
Definition

Chronic COugh

Mucous Production

Wheezing

Dyspnea

Suscpetible to infections

Increased WOB

PFT changes - decreased expiratory flow rates, increased residual volume

Term
Obstructive Pulmonary Disorders
Definition

Chronic Bronchitis

Emphysema

Bronchiectasis

Asthma

Cystic Fibrosis

Term
Chronic Bronchitis Definition
Definition
Cough production of sputum present for at least 3 months out of the year for two consecutive years
Term
Chronic Bronchitis
Definition

Begins with disease in the large airways and progresses to smaller

Result of exposure to an irritant

Smoke causes them to produce more mucus and paralyzes the cilia

Hypertrophy and hyperplasia of goblet cells

Increased WOB - hypercapnia 

V/Q mismatch (shunt)

CO2 retention

Blue bloaters

Hypertrophy of SCM

Risk of Cor Pulmonale

 

Term
Chronic Bronchitis Sg/Sx
Definition

Stocky build 

Cyanosis

Prolonged exhalation

Chronic Cough

Wheezing

Retractions

Dyspnea

Peripheral edema

Desaturation with exercise

Term
Chronic Bronchitis Treatment
Definition

Avoid irritants

FLuids

Medication

Breathing retraining

Exercise

O2

Airway clearing techniques 

Term
Emphysema Definition
Definition
Abnormal and Permanent Dilation of airspaces distal to the terminal bronchioles
Term
Emphysema Sg/Sx
Definition

Dyspnea

Barrel chest

Increased use of accessory muscles

Thin

Difficulty with exhalation

Cor Pulmonale

Decreased breath sounds

Term
Emphysema Treatment
Definition

-this is a dry disease

Fluids

O2

Meds - to keep bronchdilated

Airway clearance

Breathing retraining

COndtioning 

Term
COPD
Definition

Chronic Bronchitis 

+

Emphysema 

Term
Asthma Definition
Definition
Increased responsiveness of the smooth muscle that lines the trachea, bronchii and bronchioles to some trigger
Term
Asthma Attack
Definition

Rapid RR

Increased use of accessory muscles

Audible wheezing

Chest tightness

Frequent cough

Hypoxemia

Hypercapnia

Cyanosis

Death 

-Acute bronchospasm, inflammatory phase

Term
Cystic Fibrosis Sg/Sx
Definition

Persistant cough or wheezing

Recurrent infections

Poor weight gain

salty sweat

barrel chest

clubbing

Term
Restrictive Lung Dysfunction
Definition

Volume of gas exchange reduced

-trouble getting air in, their volumes are deminished, something is limiting the volume, so no air trapping

-tidal volume and vital capcity will be smaller

-FRC and flow rates will be fine

-need to breath faster, increased WOB

-significantly elevated RR

-decreased volumes and capacities 

Term
Causes of Restrictive Disorders
Definition

Adult Respiratory Distress Syndrome (ARDS)

Idiopathic Pulmonary Fibrosis

Atelectasis

Pneumonia

Pleural Effusion

Pulmonar edema

Pulmonary embolism

Pneumothorax

Scoliosis

Term
Traumatic Causes of Restrictive Lung Dysfunction
Definition

Rib fractures

Chest wounds (potential for pneumothorax)

Burns (scar will become a stricture)

Term
Obstructive vs. Restrictive Pulmonary Dysfunction
Definition

Obstructive:

-problem with exhalation

-decreased flow rates

-hyperinflation

-increased WOB

Restrictive:

-problem with inhalation

-decreased volujmes and capacities

-problem with compliance

-increased WOB

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