Term
|
Definition
heart rate
conduction
force of contractions |
|
|
Term
| A1 stimulation does what to vessels? |
|
Definition
|
|
Term
| B2 stimulation does what to vessels |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| amount of blood ejected from heart |
|
|
Term
|
Definition
| amount of blood in ventricle at end of diastole |
|
|
Term
|
Definition
| Amount of blood left in ventricle after systole |
|
|
Term
|
Definition
|
|
Term
|
Definition
| mean right atrial pressure; indicator of heart's blood volume |
|
|
Term
|
Definition
| lowest arterial pressure (just before semilunars open) |
|
|
Term
|
Definition
| maximum arterial pressure during systole |
|
|
Term
|
Definition
| Continuous adjustment of vessel diameter |
|
|
Term
| When does blood flow to the coronary arteries? |
|
Definition
|
|
Term
| What happens to coronary blood flow when HR increases? |
|
Definition
| Reduced coronary blood flow as diastolic time is reduced |
|
|
Term
| What cardiac cells are capable of generating action potential? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
Vena Cava
Right Atrium
Tricuspid Valve
Right ventricle
Plumonic valve
pulmonary artery
lungs
pulmonary veins
left atrium
mitral valve
lft ventrile
aortic valve
aorta |
|
|
Term
|
Definition
tricuspid
pulmonic
mitral
aortic |
|
|
Term
| Name the vessles which supply the heart |
|
Definition
- inferior/superior vena cava
- pulmonary veins
|
|
|
Term
| Name the vessles that supply the body |
|
Definition
|
|
Term
| When does the blood fill the coronary arteries? |
|
Definition
Diastole
A faster heart rate reduces diastolic time and decreases coronary blood flow |
|
|
Term
| What is normal ejection fraction? |
|
Definition
|
|
Term
| What is normal cardiac output? |
|
Definition
|
|
Term
|
Definition
| When the normal flow of lymph is blocked or altered |
|
|
Term
| Describe the clinical presentation of lymphedema |
|
Definition
lymph collects in the interstitium
inflammation of subQ adipose tissue
fibrotic changes over time
congestion with thick, brown color |
|
|
Term
|
Definition
|
|
Term
| Ischemia creates a context for injury via 3 mechanisms, what are they? |
|
Definition
- oxygen free radicals
- excitatory amino acids
- inflammation
|
|
|
Term
|
Definition
High Density Lipoproteins
Good cholesterol
Picks up excess, unused cholesterol from cells and brings to liver to process and remove from the body |
|
|
Term
|
Definition
Low density lipoproteins
Bad cholesterol
carries cholesterol to the cells
deposited in walls to become plaque |
|
|
Term
| 3 Systems that transport blood |
|
Definition
arteries
veins
lymphatics |
|
|
Term
| Myocardial ischemia, like any ischemia, is associated with metabolic... |
|
Definition
|
|
Term
Normally, pressure is higher in which side of the heart? |
|
Definition
Left (ventricle): must overcome pressure on aorta and supply entire body with blood |
|
|
Term
|
Definition
influence heart rate
conduction
force of contractions |
|
|
Term
|
Definition
dilate small coronary arteries, increase cardiac output (minor compared to B1), stimulation cause vasodilation in bronchi |
|
|
Term
| Where do coronary arteries stem from? |
|
Definition
|
|
Term
| Influx of which electrolytes allows cardiac myocytes to contract? |
|
Definition
|
|
Term
| Where is the SA node located? |
|
Definition
| located in right atrium near superior vena cava inlet |
|
|
Term
| Where is the AV node located? |
|
Definition
| Posterior septal wall of the right atrium just behind the tricuspid valve. |
|
|
Term
Under normal conditions, the heart rate is under PSNS or SNS control?
|
|
Definition
Parasympathetic, but...
Parasympathetic and sympathetic nervous systems are both controlling the heart in normal conditions (homeostasis)
|
|
|
Term
| What is autoregulation in relation to blood pressure? |
|
Definition
continuous adjustment of vessel diameter
happens second to second
• Vessels dilate = BP decreases
• Vessels constrict = BP increases |
|
|
Term
| _________ is a potent vasodilator produced in endothelial cells of coronary arteries. |
|
Definition
|
|
Term
| When norepi stimulates A1, what happens to vessels? |
|
Definition
|
|
Term
| When norepi stimulates B2 receptors, what happens to vessels? |
|
Definition
|
|
Term
| What are the 4 mechanisms that can alter BP? |
|
Definition
- autonomic nervous system
- baroreceptors
- chemoreceptors
- renal antiotensin adldosterone system & renal function
|
|
|
Term
| How does the autonomic nervous system affect BP? |
|
Definition
balance between sympathetic and parasympathetic.
Alpha 1 receptors stimulate in smooth muscle will cause vasoconstriction, decrease vessel diameter, increase BP (ANS) |
|
|
Term
| How do baroreceptors affect BP? |
|
Definition
| Baroreceptors sense changes in stretch/BP. When an increase in stretch is detected a signal is sent to the vasomotor center which will initiate changes to lower BP by increaseing PSNS. |
|
|
Term
| What are baroreceptors sensitive to? |
|
Definition
Changes in mean arterial pressure.
ex: increased mean arterial pressure there will be increased stretch |
|
|
Term
| What side of the heart pumps unoxygenated blood? |
|
Definition
|
|
Term
| What side of the body pumps oxygenated blood? |
|
Definition
|
|
Term
| What are the two types of heart valves? |
|
Definition
- atrioventricular valves (AV)
- ventricular / semilunar valves
|
|
|
Term
| What type of valves are the mitral and tricuspid valves? |
|
Definition
|
|
Term
| What type of valves are the aortic and pulmonic (pulmonary) valves? |
|
Definition
|
|
Term
| Where do the three main coronary arteries originate from? |
|
Definition
|
|
Term
| Which coronary artery branches into the left anterior descending and circumflex arteries? |
|
Definition
| left main (located on the front) |
|
|
Term
| Which coronary artery travels down the anterior portion of the septal groove between the right and left ventricles and branches several more times to supply blood to the anterior portion of the septum and the anterior muscle mass of the left ventricle? |
|
Definition
| left anterior descending (located on teh front) |
|
|
Term
| Coronary artery that travels in the area between the left atrium and ventricle, on the posterior surface, and supplies blood to the latral wall of the left ventrical |
|
Definition
|
|
Term
| Coronary artery that travels in the groove between the right atrium and the ventricle and branches off to supply blood to the posterior portions of the heart (including posterior interventricular septum) |
|
Definition
| Right coronary artery (located in the front) |
|
|
Term
| Coronary artery located on the posterior right ventrical, this artery eventually branches from the right coronary artery. |
|
Definition
| Right posterior descending artery (located on the back) |
|
|
Term
| What two coronary arteries are located on teh posterior of the heart |
|
Definition
- left circumflex
- right posterior descending
|
|
|
Term
| What vessel supplies coronary blood flow? |
|
Definition
|
|
Term
| Path of coronary blood flow |
|
Definition
- left bentrical
- coronary arteries
- coronary veins
- drains into right atrium
|
|
|
Term
| _______ reduces diastolic time and decreases coronary blood flow. |
|
Definition
|
|
Term
3 receptors stimulation affects
(the three of 4 we need to know for patho at this point) |
|
Definition
|
|
Term
Stimulation of B2 affects what one thing?
|
|
Definition
|
|
Term
| Stimulation of A1 affects what three things? |
|
Definition
- vasoconstriction
- decreases vessel diameter
- increased BP
|
|
|
Term
Name the effected receptor (B1, B2, or A1)
Vasodilation |
|
Definition
|
|
Term
Name the effected receptor (B1, B2, or A1)
Conduction
|
|
Definition
|
|
Term
Name the effected receptor (B1, B2, or A1)
Force of Contractions |
|
Definition
|
|
Term
Name the effected receptor (B1, B2, or A1)
Decreased Vessel Diameter
|
|
Definition
|
|
Term
Name the effected receptor (B1, B2, or A1)
Heart Rate
|
|
Definition
|
|
Term
Name the effected receptor (B1, B2, or A1)
Vasoconstriction |
|
Definition
|
|
Term
Name the effected receptor (B1, B2, or A1)
Increased BP |
|
Definition
|
|
Term
| During cardiac contraction, which electrolytes INFLUX? |
|
Definition
|
|
Term
| During cardiac contraction, which electrolyte EFFLUXES? |
|
Definition
|
|
Term
| Which risk factors can be changed by the patient? |
|
Definition
|
|
Term
| Which risk factors can't be changed by the patient? |
|
Definition
|
|
Term
3 Layers of Arteries/Veins
|
|
Definition
- Tunica Intima
- Tunica Media
- Tunica Adventitia
|
|
|
Term
| Do veins or arteries have a larger tunica media and why? |
|
Definition
- Arteries
- Arteries are more "elastic" than veins, so the muscular portion is larger
|
|
|
Term
| Middle Layer of Veins/Arteries and Composition |
|
Definition
- Tunica Media
- Muscular Cells
|
|
|
Term
| Outermost Layer of Veins/Arteries and Composition |
|
Definition
- Tunica Aventitia
- Connective Tissue
|
|
|
Term
| Innermost Layer of Veins/Arteries and Composition |
|
Definition
- Tunica Intima
- Endothelial Cells
|
|
|
Term
| Blood vessels that are capacitance vessels |
|
Definition
|
|
Term
Blood vessels with ANS stimulation
|
|
Definition
|
|
Term
| Blood vessels with inflammatory mediators |
|
Definition
|
|
Term
| Blood vessels that act as blood reservoirs |
|
Definition
|
|
Term
| Blood vessels that vasodilate and vasoconstrict |
|
Definition
|
|
Term
| Blood vessels that contain one-way valves to prevent pooling of blood due to gravity |
|
Definition
|
|
Term
| Blood vessels affected by skeletal muscle contraction |
|
Definition
|
|
Term
| At rest ____% of blood supply can be in the veins |
|
Definition
|
|
Term
| _____ are less elastic than _____ |
|
Definition
|
|
Term
_____ carry O2-rich blood
|
|
Definition
Arteries (except pulmonary artery)
|
|
|
Term
Veins carry _____-rich blood
|
|
Definition
|
|
Term
| Pulmonary artery carries ___ blood to the lungs |
|
Definition
|
|
Term
| In lymphedema, lymph collects in the _____ |
|
Definition
|
|
Term
| 4 clinical manifestations of lymphedema |
|
Definition
- Inflammation
- Hypertrophy of subQ adipose tissue
- Fibrotic changes over time
- Congestion with thick, brown skin
|
|
|
Term
| The ability of organs to retain a constant blood pressure despite factors that may change the flow of blood, either internally or externally |
|
Definition
|
|
Term
|
Definition
| peripeheral vascular resistance |
|
|
Term
| Balance between SNS and PSNS systems |
|
Definition
|
|
Term
|
Definition
- aortic arch
- internal carotids
|
|
|
Term
| When are baroreceptors stimulated? |
|
Definition
| When the walls of the arteries are stretched by an increased BP |
|
|
Term
Impulses from the baroreceptors inhibit the _____ center of the brain. This leads to _____ in the periphery and a drop in _____.
|
|
Definition
- Vasomotor
- Vasodilation
- CO
|
|
|
Term
When the pH and/or PaCO2 are affected, what do the chemoreceptors do?
|
|
Definition
| Stimulates the PSNS to decrease HR and dromotropy |
|
|
Term
| How do RAAS and renal function affect BP? |
|
Definition
| Preserve sodium volume, increasing fluid volume and increasing BP |
|
|
Term
|
Definition
· Uncontrollable risks:
o Age
o Gender
o Family history
· Controllable risks:
o Hypertension
o Cigarette smoking
o Diabetes
o Obesity
o Physical inactivity
o Poor diet (atherogenic)
o Thrombogenic state
· Lipid risk factors
o Total cholesterol >200
o LDL >130
o Triglycerides >150
o HDL <40
|
|
|
Term
Ischemia creates a context for injury via what triad?
|
|
Definition
- Oxygen Free Radicals
- Excitatory Amino Acids
- Inflammation
|
|
|
Term
Which intracellular electrolyte accumulates in the face of ischemia?
|
|
Definition
|
|
Term
| Which cholesterol is "good"? |
|
Definition
|
|
Term
| Which cholesterol is "bad"? |
|
Definition
|
|
Term
|
Definition
| High density lipoproteins |
|
|
Term
|
Definition
|
|
Term
Picks up excess, unused cholesterol from cells and brings it back to the liver for processing and removal from the body
|
|
Definition
|
|
Term
| Carries cholesterol to cells |
|
Definition
|
|
Term
Deposited in walls to become plaque |
|
Definition
|
|
Term
| What is the significance of foam cells in artherosclerosis? |
|
Definition
| Foam cells form lipid core with fibrous cap |
|
|
Term
What do foam cells produce that are considered the first sign of artherosclerosis?
|
|
Definition
|
|
Term
As the vessel lumen narrows, explain the roles of platelets, clotting cascade, and thrombus risk
|
|
Definition
| Platelets cluster around the arterial wall and recruit more platelets. Vasoactive enzymes activate the clotting cascade which can cause a thrombus to form. |
|
|
Term
| Who is at greatest risk for a silent MI? |
|
Definition
|
|
Term
Name 5 causes of endothelial injury that can lead to atherosclerosis
|
|
Definition
- Smoking
- HTN
- Hyperlipidemia
- Viruses
- Immune Reactions
|
|
|
Term
| State of transient myocardial ischemia without cell death |
|
Definition
|
|
Term
| What is the difference between angina pectoris and MI? |
|
Definition
| Cell death occurs in MI, but not angina pectoris |
|
|
Term
| Cardiac myocytes store how much ATP? |
|
Definition
|
|
Term
| How long can cardiac myocytes withstand hypoxia? |
|
Definition
|
|
Term
|
Definition
| Prinzmetal Variant Angina |
|
|
Term
Prinzmetal variant angina is unrelated to _____ or _____
|
|
Definition
|
|
Term
| Difference between prinzmetal and regular angina |
|
Definition
Atherosclerosis is not necessarily present in prinzmetal
|
|
|
Term
| Cause of prinzmetal variant angina |
|
Definition
|
|
Term
| Clinical manifestations of angina |
|
Definition
- Substernal Chest Pain
- Increased HR and BP
- EKG Changes Can be Present
- Usually Precipitated by Physical Activity
|
|
|
Term
| What changes might be present in EKG? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Which EKG change indicates that reperfusion therapy might work? |
|
Definition
|
|
Term
| What does ST segment elevation tell the clinician? |
|
Definition
| STEMI that might benefit from reperfusion therapy |
|
|
Term
| Another Name for Acute Coronary Syndrome |
|
Definition
|
|
Term
Ischemic myocardial necrosis resulting from a reduction in blood supply to a portion of the myocardium
|
|
Definition
|
|
Term
Most MIs are caused by what?
|
|
Definition
- Thrombotic occlusion related to severe coronary atherosclerosis
- Instability of already-formed plaques
- Plaque rupture
|
|
|
Term
| MI related to entire thickness of ventricular wall |
|
Definition
|
|
Term
MI related to subendocardial infarct
|
|
Definition
|
|
Term
| How much of the ventricular wall is involved in a Non-Q Wave MI? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| In the context of ACS, time is _____! |
|
Definition
|
|
Term
What is the first action if a patient feels chest pain?
|
|
Definition
|
|
Term
| Most cell death from MI is _____ and ____ (percentages) |
|
Definition
- 80% apoptosis
- 20% necrosis
|
|
|
Term
Explain the role of baroreceptors in compensation during MI
|
|
Definition
- Reduced impulses by baroreceptors
- Baroreceptors stimulate SNS (Epi/NE)
- SNS leads to vasoconstriction and/or increased HR, increased dromotropy, incresed inotropy
- This leads to increased ventricular tension/cardiac hypertrophy, which leads to increased SV and CO
|
|
|
Term
Explain the role of RAAS in compensation during MI
|
|
Definition
- RAAS leads to fluid retention, increased preload, increased ventricular tension/cardiac hypertrophy
- These lead to increased SV and increased CO
|
|
|
Term
| If SNS leads to vasoconstriction, where do baroreceptors and RAAS intersect? |
|
Definition
Increased Preload (at which point, baroreceptors increase ventricular tension/cardiac hypertrophy, which leads to increased SV and CO)
|
|
|
Term
| 8 Clinical Manifestations of MI |
|
Definition
- Prolonged Chest Pain (> 30 minutes)
- Pallor or Cyanosis, SOB, Diaphoresis, Nausea, Restlessness, Feeling of Apprehension/Doom
- Radiating Pain
- EKG Changes (ST or T changes)
- BP Changes
- Crackles in Lungs
- Coronary Angiography Reveals Lesions
- Depressed LV Function
|
|
|
Term
|
Definition
| Infarcted cells become electrically silent |
|
|
Term
| Is a Q wave instantaneous in development? |
|
Definition
| No, it takes time to develop |
|
|
Term
What can a Q wave tell us?
|
|
Definition
|
|
Term
|
Definition
Open passively during diastole when atrial pressure > ventricular pressure |
|
|
Term
|
Definition
When contraction causes the ventricular pressure to be > than atrial pressure
|
|
|
Term
| When do ventricular valves open? |
|
Definition
| When ventricular pressure > aorta/pulmonary pressures |
|
|
Term
| When do ventricular valves close? |
|
Definition
| When ventricular pressure is < than aorta/pulmonary pressures |
|
|
Term
| What is the pressure gradiant of mitral stenosis? |
|
Definition
| Atrial pressure > ventricular pressure |
|
|
Term
| Explain the progression of mitral stenosis |
|
Definition
| Thickening of LA (mitral valve leaflets) > Chamber enlarges > Hypertrophy > Incr pulmonic vascular pressure > Chronic pulmonary HTN > RV hypertropy > Right HF |
|
|
Term
Mitral stenosis causes failure of which side of the heart?
|
|
Definition
|
|
Term
Mitral Valve Disease is a disease of which side of the heart?
|
|
Definition
|
|
Term
What is the hallmark symptom of mitral stenosis?
|
|
Definition
|
|
Term
| In mitral stenosis, which part of the heart changes to compensate? |
|
Definition
| left atrium enlargement and hypertrophy |
|
|
Term
| In mitral stenosis what happens to the mitral valve? |
|
Definition
| The orafice narrows to 1 cm2 |
|
|
Term
| During mitral regurg, which part of the heart changes to compensate? |
|
Definition
Backflow from Left Ventricle to Left Atrium. Both Left Atrium and Left Ventricle dilate/hypertrophy to compensate
|
|
|
Term
What happens to the mitral valve during prolapse?
|
|
Definition
| Balloons up into the Left Atrium |
|
|
Term
| What causes aortic stenosis? |
|
Definition
- Age-related Calcification
- Obstruction of aortic outflow from Left Ventricle (systole)
|
|
|
Term
Which part of the heart changes to compensate during aortic stenosis?
|
|
Definition
| Left Ventricle Hypertrophy |
|
|
Term
What happens to the heart during aortic stenosis? |
|
Definition
Increase afterload leads to left Heart Failure and pulmonary complications
|
|
|
Term
Which side of the heart fails from aortic stenosis?
|
|
Definition
|
|
Term
| What causes aortic regurg? |
|
Definition
o Blood leaks back into left ventricle from aorta
o Left ventricle volume overload leads to hypertrophy, dilation, increase systolic blood pressure
|
|
|
Term
Which side of the heart fails during aortic regurg and why?
|
|
Definition
|
|
Term
What is a hallmark symptom of aortic regurg during ausculation?
|
|
Definition
| High-pitched blowing murmur heard during ventricular diastole |
|
|
Term
| Which portion of BP incr because of aortic regurg? |
|
Definition
|
|
Term
What causes Rheumatic HD? |
|
Definition
|
|
Term
|
Definition
- Inflammatory
- Acute
- Carditis on all layers
|
|
|
Term
| Where is inflammation in rheumatic HD (2 areas)? |
|
Definition
|
|
Term
What does the inflammation cause in RHD? |
|
Definition
- Valvular Swelling
- Erosion
- Platelet/Fibrin Clumps on Valve Leaflets
|
|
|
Term
The responsible organism in RHD is B-hemolytic strep, but what causes the damage?
|
|
Definition
|
|
Term
Where are signs of inflammation seen in RHD?
|
|
Definition
|
|
Term
Who is at risk for infective endocarditis? |
|
Definition
- History of RHD
- Congenital HD
- MVP
- Prosthetic Valves
|
|
|
Term
What are the complications of infective endocarditis?
|
|
Definition
- Embolization
- Valvular Insufficiency
- Myocardial Abscess
- Renal Disease
|
|
|
Term
| Inflammation of the myocardium |
|
Definition
|
|
Term
|
Definition
Usually viral, but also from penicillin hypersensitivity and autoimmune activation
|
|
|
Term
| What causes the damage in myocarditis? |
|
Definition
| Autoimmune response causing Ab attack against own heart tissue |
|
|
Term
| Generic name for cardiac dysfunction |
|
Definition
|
|
Term
Cardiomyopathy is the leading cause of _____
|
|
Definition
|
|
Term
| 2 Types of Cardiomyopathy |
|
Definition
- Dilated (Congestive) CM
- Hypertrophic CM
|
|
|
Term
| Causes of Dilated/Congestive CM |
|
Definition
- All 4 chambers dilated
- Can occur after childbirth in young women
- Alcohol-related (metabolites are toxic to cardiac muscle)
- Post-viral
|
|
|
Term
Causes of Hypertrophic CM |
|
Definition
- Thickened, hyperkinetic ventricular mass
- Genetic? Defective myosin, toponin genes
|
|
|
Term
| Which type of CM could be genetic? |
|
Definition
|
|
Term
| Non-inflammatory fluid fills the pericardial sac |
|
Definition
|
|
Term
Fluids that might accumulate in the sac during pericardial effusion
|
|
Definition
- Serous
- Serosanguinous
- Chylous (lymph)
- Blood (secondary to penetrating trauma)
|
|
|
Term
What is the normal volume of fluid in the pericardial sac?
|
|
Definition
|
|
Term
During effusion, how much fluid might be in the pericardial sac?
|
|
Definition
|
|
Term
Large, sudden accumulation of fluid in pericardial sac
|
|
Definition
|
|
Term
| In cardiac tamponade, fluid causes _____ and filling is impaired |
|
Definition
External Compression of Chambers
|
|
|
Term
| Clinical manifestations of cardiac tamponade |
|
Definition
- Systemic Venous Congestion (distended neck vein)
- Decreased SV
- Increased HR
- Pulsus Paradoxus
|
|
|
Term
| Waxing/waning of BP with respiration |
|
Definition
|
|
Term
In pulsus paradoxus, how much does the BP fluctuate?
|
|
Definition
Systolic that is ≥ 10 mmHg between inspiration and expiration (sign of decreased Left Ventricular output and Heart Rate is usually slightly increased)
|
|
|
Term
Acute and chronic inflammation in the pericardium
|
|
Definition
|
|
Term
| Pericarditis that is secondary to MI |
|
Definition
|
|
Term
| Clinical signs of acute pericarditis |
|
Definition
- Fever
- Pericardial Friction Rub
|
|
|
Term
Fluid inolved in acute pericarditis
|
|
Definition
- Serous
- Fibrinous
- Purulent
- Hemorrhagic
- Caseous
|
|
|
Term
Pericarditis caused from healed acute pericarditis
|
|
Definition
|
|
Term
3 Causes of Chronic Pericarditis
|
|
Definition
- Healed Acute Pericarditis
- Adhesive Mediastinopericarditis
- Constrictive
|
|
|
Term
| What causes adhesive mediastinopericarditis |
|
Definition
- Pericardial sac destroyed and heart adheres to mediastinum
- Can happen after heart surgery
|
|
|
Term
| What causes constrictive pericarditis |
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Definition
| Secondary to TB, with caseous involvement |
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Term
What is the treatment for constrictive pericarditis?
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Definition
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|
Term
What might one hear on auscultation with pericarditis?
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Definition
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Term
| In the embryonic heart, what is the function of the foramen ovale and ductus arteriosus? |
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Definition
| Permit blood flow to bypass the lungs |
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Term
Where is the foramen ovale located and what is the direction of blood flow?
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Definition
- Between the Right Atrium and Left Atrium
- Flow is Right Atrium to Left Atrium
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Term
| Where is the ductus arteriosus located and what is the direction of blood flow? |
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Definition
- Connects Pulmonary Artery and Aorta
- Flow is Pulmonary Artery to Aorta
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Term
| What happens to cause the closure of the foramen and ductus in a fetus (besides birth)? |
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Definition
Pressure gradient reverses when lungs inflate (changes from R-L to L-R). This reversal of pressure helps with closure.
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Term
Abnormal path of blood wich allows unoxygenated blood from right heart to enter left heart and systemic circulation without passing through the lungs first. You see cyanosis and decreased PaO2
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Definition
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Term
Abnormal path of blood which allows oxygenated blood from left heart (aorta) to enter right side |
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Definition
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Term
Which shunt deals with unoxygenated blood?
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Definition
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Term
| Which shunt deals with oxygentated blood? |
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Definition
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Term
2 manifestations with Right-to-Left Shunt
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Definition
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Term
Why is there no cyanosis with Left-to-Right shunt?
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Definition
Recirculated through lungs
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Term
What happens with a Left-to-Right shunt over time?
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Definition
over time leads to right ventricular hypertrophy due to increased right heart pressure |
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Term
In which shunt would we see cyanosis?
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Definition
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Term
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Definition
- Atrial-Septal Defect (ASD)
- Ventricular-Septal Defect (VSD)
- Coarctation of the Aorta
- Patent Ductus Arteriosus (PDA)
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Term
| Which acyanotic defect is the most common? |
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Definition
| Ventricular-Septal Defect (VSD) |
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Term
| Foramen Ovale stays open to some degree |
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Definition
Atrial-Septal Defect (ASD)
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Term
L>R pressure after birth leads to right HF
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Definition
Ventricular-Septal Defect (VSD) |
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Term
Narrowing/stricture impedes blood flow |
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Definition
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Term
| Pulmonary artery (deoxy) remains connected to aorta (oxy) |
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Definition
| Patent Ductus Arteriosus (PDA) |
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Term
|
Definition
- Tetrology of Fallot
- Transposition of Great Arteries
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Term
| 4 Defects in Tetrology of Fallot |
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Definition
- VSD
- Over-riding Aorta
- Pulmonary Stenosis
- RV Hypertrophy
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Term
Cyanosis from over-riding aorta that receives deoxy blood |
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Definition
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Term
Aorta positioned above the VSD opening
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Definition
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Term
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Definition
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Term
| 2 separate, but non-communicating, circulations |
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Definition
| Transposition of the Great Arteries |
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Term
| In transposition of the great arteries, from where do the aorta and pulmonary artery arise? |
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Definition
- Aorta - arises from RV, not LV
- Pulmonary - arises from LV, not RV
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Term
| Is transposition of great arteries fatal? |
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Definition
| Yes, unless septal defects are also present |
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Term
Cyanotic or acyanotic?
Atrial-Septal Defect
|
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Definition
|
|
Term
Cyanotic or acyanotic?
Coarctation of the Aorta
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Definition
|
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Term
Cyanotic or acyanotic?
Tetrology of Fallot |
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Definition
|
|
Term
Cyanotic or acyanotic?
Ventricular-Septal Defect
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Definition
|
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Term
Cyanotic or acyanotic?
Transposition of the Great Arteries |
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Definition
|
|
Term
Cyanotic or acyanotic?
Patent Ductus Ateriosus
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Definition
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Term
| Heart can't meet metabolic demands, due to impaired systole (contraction), diastole (relaxation), or both |
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Definition
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Term
Left/Right Forward/Backward Effects?
Results in insufficient CO with diminished delivery of O2 and nutrients to peripheral tissues and organs |
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Definition
Left Heart Failure Forward Effects
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Term
Left/Right Forward/Backward Effects?
Due to congestion in the systemic venous system
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Definition
| Right Heart Failure Backward Effects |
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Term
Left/Right Forward/Backward Effects?
Cause low output to left ventricle leading to low CO |
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Definition
Right Heart Failure Forward Effects |
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Term
Left/Right Forward/Backward Effects?
Results in accumulation of blood within the pulmonary circulation, pulmonary congestion, and edema |
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Definition
Left Heart Failure Backward Effects |
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Term
List Left HF Forward Effects |
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Definition
- Fatigue
- Oliguria
- Incr HR
- Faint Pulses
- Restlessness
- Confusion
- Anxiety
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Term
List Left HF Backward Effects |
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Definition
- Dyspnea on Exertion
- Orthopnea
- Cough
- Proxysmal Nocturnal Dyspnea
- Cyanosis
- Casilar Crackles
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Term
List Right HF Forward Effects |
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Definition
§ Fatigue
§ Oliguria
§ Increased heart rate
§ Faint pulses
§ Restlessness
§ Confusion
§ Anxiety
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Term
| List Right HF Backward Effects |
|
Definition
- Hepatomegaly
- Ascites
- Splenomegaly
- Anorexia
- SubQ Edema
- Jugular Vein Distension
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Term
Decreased myocardial contractility occurs in which type of HF?
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Definition
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|
Term
Ineffective filling occurs in which type of HF?
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|
Definition
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Term
| Is systolic HF more or less common than diastolic HF |
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Definition
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Term
Systolic HF is considered forward or backward failure?
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Definition
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|
Term
Diastolic HF is considered forward or backward failure?
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|
Definition
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Term
| Systolic HF leads to what? |
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Definition
- Decreased inotropy
- Decreased contractile force
- Decreased EF
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Term
In systolic HF, the heart is unable to eject adequate amounts of blood into circulation and does not empty itself sufficiently, resulting in _____
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Definition
| Diminished Tissue Perfusion |
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Term
| During diastolic HF, the _____ can be normal |
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Definition
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Term
| In diastolic HF, the ventricles cannot relax enough to fill adequately, leading to decreased CO and _____ |
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Definition
Congestion where the blood came from
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Term
Is the EF reduced or increased in systolic HF?
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|
Definition
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Term
|
Definition
- Incr SNS
- Incr RAA Stimulation
- Shift from Aerobic to Anaerobic Metabolism
- Hypertrophy/Ventricular Remodeling
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Term
Incr SNS leads to what 3 things?
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|
Definition
- Incr Inotropy
- Incr Chronotropy
- Vasoconstriction (through Epi/NorEpi)
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Term
Incr RAA stimulation leads to what?
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|
Definition
- Fluid retained
- Helps incr preload and incr force of contraction
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Term
What principle helps RAA stimulation incr preload and force of contraction?
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|
Definition
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|
Term
When the shift from aerobic to anaerobic metabolism occurs, what does this do to the Hgb dissociation curve and why?
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|
Definition
Right shift, causing Hgb to release more O2 |
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Term
What is the significance of the Starling principle?
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|
Definition
| Attempts to pump the incr blood, but if it can't pump it all out, LV and end-diastolic volume incr, which stretches the myofibril cells. This stretching causes the heart to enlarge. |
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Term
| Pulmonary stenosis or pulmonary HTN can lead to HF in which side? |
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Definition
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Term
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Definition
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Term
What happens to autoregulatory mechanisms in shock?
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|
Definition
Failure of the microcirculation to autoregulate blood flow correctly will lead to shock
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|
|
Term
|
Definition
- Anaerobic Metabolism
- Hydropic Swelling
- Cell Damage
- Inflammation
- Widespread Vasodilation
- Failure of Compensatory Mechanisms
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Term
In anaerobic metabolism, increased _____ leads to acidosis
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|
Definition
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|
Term
In glycolysis, lactate is created by _____ in the absence of _____
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|
Definition
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|
Term
Hydropic swelling is secondary to _____
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|
Definition
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|
Term
Cell damage is caused by formation of _____
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|
Definition
|
|
Term
| Oxygen free radicals do what 4 things? |
|
Definition
- Are unstable
- Attack cell membranes
- Denature proteins
- Damage DNA
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|
|
Term
| Name 4 oxygen free radicals |
|
Definition
- Superoxide (O2-)
- Peroxide (H2O2)
- Hydroxyl Radicals (OH-)
- Singlet O
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|
|
Term
Peroxide occurs from what two elements leaking in hydropic swelling? |
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Definition
|
|
Term
Inflammatory cytokines ala macrophages lead to?
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|
Definition
|
|
Term
| Widespread vasodilation leads to? |
|
Definition
- Hypotension
- Decr O2 consumption by tissues, impaired tissue perfusion
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|
|
Term
Widespread vasodilation is caused by?
|
|
Definition
| Incr activity of nitric oxide |
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|
Term
| What happens when compensatory mechanisms fail? |
|
Definition
| Tissue damage activates clotting cascade |
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Term
|
Definition
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|
Term
| Shock marked by hypotension and marked tissue hypoxia |
|
Definition
|
|
Term
Shock where homeostatic mechanisms temporarily maintain perfusion even though CO has fallen
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|
Definition
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|
Term
Cause of hypovolemic shock
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Definition
Inadequate circulation blood volume precipitated by hemorrhage, burns, dehydration, or leakage of fluids into interstitial spaces
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Term
Hypovolemic shock is caused by a loss of how much fluid?
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|
Definition
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|
Term
What is the SNS response in hypovolemic shock?
|
|
Definition
- Elevated HR
- Vasoconstriction
- Incr contractility
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Term
| Anaphylactic shock is caused by? |
|
Definition
| Excessive mast cell degranulation mediated by IgE Ab in response to Ag |
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|
Term
| In anaphylactic shock, cross-linking of Ag/IgE leads to _____ |
|
Definition
Vasoactive Substance Release
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|
|
Term
4 Vasoactive Substances Released in Anaphylactic Shock
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|
Definition
- PG
- Histamine
- LT
- Bradykinin
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|
|
Term
Does anaphylactic shock result in hyper- or hypotension? |
|
Definition
| Hypotension (due to vasodilatory mediators released by mast cells) |
|
|
Term
| Clinical Signs of Anaphylactic Shock |
|
Definition
- Urticaria
- Bronchoconstriction
- Stridor/Wheezing
- Itching
- Peripheral Vasodilation
- Incr Capillary Permeability
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|
|
Term
Enzyme released with cardiac muscle damage that allows a test for persons with chest pain to see if MI has occurred |
|
Definition
Creatine Kinase MB (CK-MB)
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|
|
Term
CK-MB is only elevated within what timeframe?
|
|
Definition
|
|
Term
| Remain elevated longer than CK-MB and can be tested for MI |
|
Definition
|
|
Term
Tests for these are less helpful with a new MI
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|
Definition
|
|
Term
| Where are troponins released from in cardiac cell injury? |
|
Definition
|
|
Term
| What does a lipid panel include? |
|
Definition
- Total Cholesterol
- LDL
- HDL
- Triglycerides
- VLDL (sometimes)
- non-HDL (sometimes)
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|
|
Term
Contractility of the heart
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|
Definition
|
|
Term
|
Definition
|
|
Term
| Conduction velocity of the heart |
|
Definition
|
|
Term
The volume of blood in the chamber just prior to systole
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|
Definition
|
|
Term
| Initial stretching of the heart prior to contraction |
|
Definition
|
|
Term
The impedance or resistance that must be overcome in order to eject blood from a cardiac chamber
|
|
Definition
|
|
Term
What is the primary determinant of left ventricular afterload?
|
|
Definition
| Systemic vascular resistance |
|
|
Term
The tension or stress developed in the wall of the left ventricle during ejection |
|
Definition
|
|
Term
| Generalized term for pathologic conditions resulting in decr distensibility of arteries |
|
Definition
|
|
Term
Hardening of the arteries
|
|
Definition
|
|
Term
A type of arteriosclerosis characterized by proliferation of smooth muscle cells and lipid collection within the walls of arteries, resultings in narrowed lumina and impaired ability to dilate
|
|
Definition
|
|
Term
|
Definition
|
|
Term
No ST segment elevation, but + biomarkers
|
|
Definition
|
|
Term
| Obstruction to blood flow through cardiac valves that open incompletely |
|
Definition
|
|
Term
| Retrograde blood flow through a cardiac valve when the valve is supposed to be closed |
|
Definition
|
|
Term
| A collection of signs and symptoms that form together (but not a disease) |
|
Definition
|
|
Term
| What is responsible for infective endocarditis |
|
Definition
Bacteria
usually strep or staph |
|
|
Term
| In pulsus paradoxus you would have ___________ stroke volume and __________ heart rate. |
|
Definition
decreased stroke volume
increased heart rate |
|
|
Term
| What is the treatment for pulsus paradoxus? |
|
Definition
|
|
