Term
|
Definition
| causing kidney disease due to a reduction in blood flow to the kidneys |
|
|
Term
| What causes pre-renal disease? |
|
Definition
reduction in filtration(reduces fluid/toxins that are eliminated)
due to hypotension
due to hypertension(can cause nephroschlerosis
due to arteriosclerosis of renal artery |
|
|
Term
|
Definition
| Problem within the kidney |
|
|
Term
| What causes intra-renal disease? |
|
Definition
Due to glomerulonephritis
Due to tubulo interstitial disease |
|
|
Term
|
Definition
| Problem caused by something after the fluid has gone through the kidneys |
|
|
Term
| What causes post-renal disease? |
|
Definition
| Due to obstruction (inflammation, deposits, pregnancy, prostatic hyperplasia, tumors posterior to kidney) |
|
|
Term
| How many glomeruli are in the kidney? |
|
Definition
|
|
Term
| How efficient is each kidney? |
|
Definition
|
|
Term
|
Definition
| Inflammation of the glomerulus - interferes with the function of the capillary |
|
|
Term
|
Definition
Quick onset
Quick recovery |
|
|
Term
|
Definition
| most common cause of renal failure - takes so long for a person to feel symptoms - by the time they feel sick, they may have renal failure |
|
|
Term
|
Definition
| no longer put out 400 ml/day |
|
|
Term
|
Definition
feel fine today
but then get this and die in 3 months |
|
|
Term
|
Definition
| all of the kidney is involved |
|
|
Term
|
Definition
| just a small part of the kidney is involved |
|
|
Term
|
Definition
| capillaries, podocyte, and basement membrane grow uncontrollably and cause problems |
|
|
Term
|
Definition
| almost always due to Immune Complexes being in filtered into glomeruli |
|
|
Term
|
Definition
Antigen
Antibody
Complement
attract phagocytes. |
|
|
Term
|
Definition
| foreign substance (virus or bacteria) - BIG |
|
|
Term
|
Definition
| protein specific for the antigen (specific like lock and key) - BIG |
|
|
Term
|
Definition
group of proteins (not specific - will attach regardless)
20 proteins stuck together - BIG |
|
|
Term
|
Definition
sometimes the antibody that gets formed with the antigen might be able to react with something else.
Antigen/antibody complex can also bind to the capillary; this causes it to get stuck |
|
|
Term
| Post streptococcal glomerulonephritis |
|
Definition
The strep bacterial infection causes the tiny blood vessels in the filtering units of the kidneys (glomeruli) to become inflammed.
Makes the kidneys less able to filter urine.
Immune complexes become lodged in the glomerular basement membrane below the podocyte foot processes.
Complement activation leads to destruction of the basement membrane |
|
|
Term
| How soon will you see symptoms? |
|
Definition
| 10-21 days after strep throat |
|
|
Term
| What are signs of Post streptococcal glomerulonephritis? |
|
Definition
Edema
Oliguria(low urine output)
Hematuria(blood in urine)
Elevated BUN
Elevated creatinine
Both BUN and Creatinine |
|
|
Term
| Can children recover from this? |
|
Definition
|
|
Term
| Can adults recover from this? |
|
Definition
Mostly leads to chronic situation: Chronic renal failure
hypertension
hypervolemia
all because of low filtration and oliguria |
|
|
Term
|
Definition
Red cells don't normally pass through finestra in capillaries
Capillaries and Bowman's cells have been broken down by phagocytes
very little blood comes into glomerulus because of swelling practically closes afferent arterioles - blood leaks through - nothing stops it from getting into glomerulus and it will fall right through |
|
|
Term
| What are normal levels of BUN? |
|
Definition
| 6-22 mg/100 ml blood (100ml=10dL) |
|
|
Term
|
Definition
Blood
Urea
Nitrogen
a waste product of protein metabolism (a mild toxin) |
|
|
Term
| What are normal levels of Creatinine? |
|
Definition
| 0.5-1.5 mg/100 ml blood - a product of muscle activity |
|
|
Term
|
Definition
| Waste products that should be excreted |
|
|
Term
| What happens with antibiotic therapy? |
|
Definition
| Antibiotic therapy will kill the bacteria before the patient has a complete immune response to the bacteria. |
|
|
Term
|
Definition
when the body makes antibodies to kill the bacteria.
They get stuck in the glomerulus and antibiotic will kill the bacteria before you can produce an immune response. |
|
|
Term
|
Definition
Can be Idiopathic(unknown cause)
Can be Secondary to almost any other renal disease
Often Insidious
Combination of Bowman's Capsule - almost completely stops the filtration: glomeruli become bloodless and collapse. |
|
|
Term
| What can Rapidly Prgressive GN cause? |
|
Definition
Nausea
vomiting
edema
malaise
decreased urinary output |
|
|
Term
| What happens if it is caught early enough? |
|
Definition
Prognosis is fairly good
less than 80% of nephrons involved Creatinine in blood is less than 8 mg/dL |
|
|
Term
|
Definition
Transfusion of blood plasma minus the cells
gets the antibodies out with a source that does not have the antibodies; Insidious - may not know you ahve it until you are past this point. |
|
|
Term
|
Definition
| Some patients make antibodies against the "crescent material" formed in RPGN; happens when your immune system sees this as an antigen(foreign substance) |
|
|
Term
| How is Goodpasture's Syndrome treated? |
|
Definition
Plasmapheresis
Steroids
Renal Transplant |
|
|
Term
| What happens in Nephritic Syndrome? |
|
Definition
Decreased filtration
Oliguria
Hematuria
Hypertension
Azotemia |
|
|
Term
|
Definition
Increased nitrogen in blood its mostly BUN
BUN is mildly toxic and is permeable to all membranes, because it is lipid soluble. |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Causes of Nephrotic Syndrome |
|
Definition
Heavy albuminuria (lots of protein in urine)
Hypoalbuminemia (small amount of protein in blood)
Systemic Edema
Hyperlipidemia (HDL and LDL go way up) Susceptibility to infection
Urine volume normal
BP normal |
|
|
Term
| Treatment of Nephrotic Syndrome |
|
Definition
Find out underlying cause and treat that (infection in kidney, cancer)
High protein diet
Vitamin D(synthesis occurs in the kidneys - need to compensate for that)
Diuretic to treat the edema |
|
|
Term
|
Definition
|
|
Term
| What causes pyelonephritis? |
|
Definition
|
|
Term
|
Definition
| ascending(e.coli from fecal contamination, females are more likely due to shorter urethra, males have a longer urethra and prostate glad protects it:secretions, UTIs are often accompanied by something other than just bacteria |
|
|
Term
| What contributes to pyelonephritis? |
|
Definition
Bladder stones
bladder abnormalities
tumors
trauma
vesico-urethra reflux
pregnancy
benign prostatic hyperplasia |
|
|
Term
| Acute Pyelonephritis - symptoms |
|
Definition
Pain in the kidney area
diarrhea
nausea
vomiting |
|
|
Term
| Acute Pyelonephritis - signs |
|
Definition
Fevers
chills
Urinalisys(Hematuria, Pyuria, Urinary casts) |
|
|
Term
| Treatment of Pyelonephritis |
|
Definition
|
|
Term
| Chronic Pyelonephritis - symptoms |
|
Definition
| Absent or mild, person doesn't know something is wrong, chronic inflammation forms scar tissue - can lead to renal failure |
|
|
Term
|
Definition
Caused by Nephrotoxins
Entered kidneys through blood - don't have a way to filter through tubules, so continue to bladder, Concentration of blood is too high and causes issues, Kidneys get more blood delivered than anywhere else except brain, Toxins become approximately 100X more concentrated because 125 ml enters tubules and reabsorption takes place and so there are approximately 2 ml of blood left, Endogenous Toxins, Exogenous Toxins, If serious enough - leads to renal failure |
|
|
Term
|
Definition
Too much urea in blood
BUN is too high
Oliguria - less than 400-450 ml/day will lead to Anuria |
|
|
Term
| What happens in Renal Failure? |
|
Definition
Metabolic acidosis
Hyperkalemia
Hypervolemia
Hyperuricemia
Azotemia
Uremic encephalopathy (brain disease) Gastrointestinal bleeding and vomiting Anemia
Skin may turn yellow
Urtemic frost
Congestive Heart Failure
Pulmonary edema & pulmonary congestion Skeletal disorders |
|
|
Term
| Treatment for Renal Failure |
|
Definition
Kidney transplant
Dialysis (Hemodialysis - treated to clean blood; Peritoneal - through the abdominal cavity) |
|
|
Term
|
Definition
| Thickening and hardening of the arterioles in the kidney |
|
|
Term
| What causes Nephrosclerosis? |
|
Definition
|
|
Term
|
Definition
Can lead to renal failure
Damages blood vessels - constant pressure on walls - causes muscle to hypertrophy and makes the walls thicker and harder, Leads to the formation of fibrin and clotting, Leads to renal ischemia, Kidney secretes renin, Renin will lead to secretion of Angiotensin II and Aldosterone, Microangioplastic anemia - damages red cells going through a damaged artery - red cells are removed by the spleen because they can not repair themselves. |
|
|
Term
| Malignant Hypertension - Treatment |
|
Definition
| Treat high blood pressure and try to prevent it |
|
|
Term
|
Definition
|
|
Term
| Nephrolithiasis (causes, etc) |
|
Definition
Usually form in the pelvis
Urinary Calculi
Precipitation - certain substances in the blood can become so concentrated that they precipitate
These can be very painful - thru ureter
Can lead to obstruction when they are too big
Fluids prevent stones from forming |
|
|
Term
| Treatment for Nephrolithiasis |
|
Definition
Lithotripsy (from the inside)
Extracorporeal (retrieval process) Endoscopic (retrieval process) |
|
|
Term
|
Definition
Secretes seminal fluid (almost half of what is produced)
Prostatitis (inflammation treated with antibiotics), Benign Prostate Hyperplasia (part of aginG), Prostate Cancer (over half males will have prostate cancer at some point (not aggressive) |
|
|
Term
| Benign Prostate Hyperplasia |
|
Definition
Causes narrowing of ureter
Increases frequency of urination
Decreases amount of urine
Increases frequency of pylorinephritis |
|
|
Term
| Ways to evaluate kidney function |
|
Definition
Volume Changes
Appearance of Urine
Edema
Pain
Blood Tests
Diagnostic Testing |
|
|
Term
| What types of volume changes affect kidney function? |
|
Definition
Polyuria
Oliguria
Nocturia
Minimum of 400-450ml/day |
|
|
Term
| What appearance affect kidney function? |
|
Definition
Dark - too concentrated - has blood
Frothy - foaming means there is a lot of protein in urine |
|
|
Term
| What type of pain affect kidney function? |
|
Definition
|
|
Term
| What types of blood tests are there to check kidney function? |
|
Definition
BUN
Creatinine Levels
BUN/Creatinine Ratio
Renal Plasma Clearance Test
Urinalysis |
|
|
Term
|
Definition
Blood, Urea, Nitrogen - amount of urea in the blood
Normal is 6-22 mg/dL
Comes from the breakdown of protein |
|
|
Term
|
Definition
High protein metabolism
Decrease in filtration
Increased reabsorption
(last two contribute to a possible renal problem) |
|
|
Term
|
Definition
waste product of muscle activity (diet can not repair)
Filtered in kidney, but not reabsorbed
Elevated creatinine indicates decreased filtration
Normal levels are 0.5-1.5 mg/dL |
|
|
Term
|
Definition
Normal should be about 15:1
If filtration is decreased, both will go up proportionally
>20:1 = some kind of obstruction and urine cannot get out and therefore it is reabsorbed into blood (BUN levels will go up, but creatinine will stay the same) |
|
|
Term
| Renal Plasma Clearance Test |
|
Definition
A measure of the amount of blood plasma the kidney can clear a specific substance in one minute.
Value varies depending on substance.
U = concentration in urine
P = concentration in plasma
V = volume of urine/minute (set at 2 ml/min) |
|
|
Term
| How do you calculate clearance? |
|
Definition
|
|
Term
|
Definition
Bacteria
White blood cells
Pyuria
RBCs (indicates an infection, stone, glomerulonephritis)
Proteinuria
Urinary casts
Specific gravity tests to determine concentration of urine |
|
|
Term
|
Definition
| The density of a substance divided by the density of water - has no units. |
|
|
Term
| Range of Specific Gravity |
|
Definition
1.006-1.022 (SG of plasma is 1.01)
If solute is water, SG is 1
Determines whether or not the kidneys can adjust the concentration of the urine. |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Can see vascular network of kidney - can see major artery |
|
|
Term
|
Definition
up through urethra - through bladder - through ureter: stains and dyes everything from minor calyxes back
(Die is eventually eliminated in both) |
|
|
Term
|
Definition
|
|
Term
| What are functions of blood? |
|
Definition
Transportation
Protection
Regulation |
|
|
Term
| What is transported in blood? |
|
Definition
O2
Nutrients
Hormones
Blood Cells (Phagocytes and other WBCs)
Waste (CO2, metabolic wastes) |
|
|
Term
| How does blood used in protection? |
|
Definition
Clotting
Immunity (Lymphocytes) |
|
|
Term
|
Definition
Fluid volume (8% is blood)
pH (major component Carbonate/Carbonic Acid)
Temperature
Electrolytes |
|
|
Term
| Where does blood come from in an adult? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| cells that are undifferentiated that can become something more specialized |
|
|
Term
|
Definition
can become any human cell (seen in only first 4 days after conception)
Helps with gas exchange and waste exchange. |
|
|
Term
|
Definition
| Can become one of several types of specialized cells but not just anything. |
|
|
Term
|
Definition
Myoblast (muscle cell)
Hemocytoblast (in bone marrow can form blood cells) |
|
|
Term
|
Definition
can give rise to only one kind of cell.
Erythroblast - form red blood cells.
Give rise to millions of Erythroblasts. |
|
|
Term
|
Definition
|
|
Term
| What does Anemia result in? |
|
Definition
A low hematocrit
Low Hemoglobin (Hg) - healthy male between 14-18 g/dL; healthy female between 12-16 g/dL. |
|
|
Term
| Signs and Symptoms of Anemia |
|
Definition
Pallor - pale/ashen looking
Weakness
Lethargy
Exercise Intolerance
Cardiac Arrythmia |
|
|
Term
| Adaptive Responses to Anemia |
|
Definition
Redistribute blood flow
Increase cardiac output (increases workload of heart - chronic anemia could lead to heart failure)
Synthesis of more 2.3 - DPG by the RBCs |
|
|
Term
| 2.3 Diphosphoglycerate (DPG) |
|
Definition
Normally secreted when pH drops.
pH is lower in lungs
pH is higher in tissues |
|
|
Term
|
Definition
Excess RBCs
healthy male = 5-5.5 million/mm3
healthy female = 4.5 million/mm3 |
|
|
Term
| What happens as a result of Polycythemia? |
|
Definition
Blood becomes too viscous and then wants to clot when its not supposed to.
Lead to thrombosis |
|
|
Term
| Things needed for erythropoiesis |
|
Definition
Hemocytoblasts
Erythropoietin
Vitamin B12
Intrinsic Factor
Folic Acid
Vitamin B6
Iron |
|
|
Term
|
Definition
Aplastic Anemia
Pernicious Anemia
Iron Deficiency Anemia
Hemolytic Anemia |
|
|
Term
|
Definition
fewer stem cells in bone marrow.
Due to viruses, drugs, radiation.
May require a bone marrow transplant. |
|
|
Term
|
Definition
Lack of intrinsic factor
Low Vitamin B12
Gastritis, chronic ulcers, gastrectomy.
Slowly developing - stored in liver |
|
|
Term
|
Definition
Not enough iron in diet
Faulty iron metabolism |
|
|
Term
|
Definition
| Due to destruction of RBC |
|
|
Term
| Intrinsic Hemolytic Anemia |
|
Definition
Sickle Cell Anemia
Thallasemia |
|
|
Term
|
Definition
Due to a recessive (have to get from both parents) autosomal (not on x or y) gene.
Produces a defective hemoglobin (hemoglobin S - bad beta chain)
Protective to malaria. |
|
|
Term
| What can Sickle Cell Anemia lead to? |
|
Definition
Ischemia
Pain
Necrosis
Hyperkalemia
Anemia |
|
|
Term
|
Definition
Due to a recessive autosomal gene.
Protective to malaria. |
|
|
Term
|
Definition
|
|
Term
|
Definition
Thallasemia Minor
1/2 as many beta chains as they should have. |
|
|
Term
|
Definition
Thallasemia Major.
No beta chain. |
|
|
Term
| Extrinsic Hemolytic Anemia |
|
Definition
Immune Hemolysis
Autoimmune Hemolysis
Mechanical Hemolysis |
|
|
Term
|
Definition
| Due to antibodies attacking RBC and their removal by phagocytes |
|
|
Term
| What causes Immune Hemolysis? |
|
Definition
Incompatable transfusion
Fetal Maternal Incompatability (Rh factor) |
|
|
Term
|
Definition
Someone develops antibodies against their own red cells.
Idiopathic - don't know what causes it
Cross-reaction with another antigen. |
|
|
Term
|
Definition
Hemolytic Anemia - something physically breaks red cells.
Artificial heart valves.
Dialysis machines.
Microangiopathic hemolytic anemia - arterioles are so tiny that when red cells try to go through, they become destroyed |
|
|
Term
|
Definition
Overactive spleen
Spleen is principal organ for destroying red blood cells.
Usually due to splenomegaly (enlarged spleen)
Usually due to Portal Hypertension |
|
|
Term
|
Definition
When we have excess red blood cells (opposite of anemia)
Increases viscocity of blood |
|
|
Term
|
Definition
| An increased hematocrit due to reduced plasma volume |
|
|
Term
|
Definition
Overproduction of RBCs
Secondary Absolute Polycythemia
Primary Absolute Polycythemia
Polycythemia Vera |
|
|
Term
| Secondary Absolute Polycythemia |
|
Definition
| Due to elevated erythropoietin |
|
|
Term
| What can cause secondary absolute polycythemia? |
|
Definition
Altitude hypoxia
Tissue hypoxia due to lung disease or heart disease
Smoking - CO2 in smoke
Renal tumors |
|
|
Term
| Primary Absolute Polycythemia |
|
Definition
| Over active bone marrow (not due to excess erythropoietin) decreases. |
|
|
Term
| What can cause primary absolute polycythemia? |
|
Definition
|
|
Term
|
Definition
Cause is unclear
Hematocrit > 70 (45-52)
Hemoglobin > 20 (13-18)
Plethora - excess fluid - sluggish circulation |
|
|
Term
|
Definition
To cut the veins
Drain blood or remove blood - will treat the plethora |
|
|
Term
|
Definition
| Hydroxyurea - destroys hemocytoblasts - drug |
|
|
Term
| What does plethora cause? |
|
Definition
severe headaches
dizziness
spenomegoly
maybe bleeding
may have abnormal platelets
maybe thrombosis
(due to viscosity) |
|
|
Term
|
Definition
Leukopenia
Leukemia
Lymphoma |
|
|
Term
|
Definition
Decrease in leukocytes - Neutropenia (70% are neutrophils)
More likely to get sick.
Main cell involved in inflammation - neutrophils. |
|
|
Term
| How do you determine if it is neutropenia? |
|
Definition
|
|
Term
| How do you determine agranulocytosis? |
|
Definition
|
|
Term
| What is Leukopenia caused by? |
|
Definition
|
|
Term
| What is the treatment for Leukopenia? |
|
Definition
chemotherapy
radio therapy
anti-tumor therapy
auto-hypersplenism
Goal is to reduce protection from infection and other diseases. |
|
|
Term
|
Definition
Cancer involving uncontrolled growth of precursors of WBC
Instead of dividing and maturing, they divide and divide and don't ever stop.
Don't become mature WBC.
Continue to grow and grow and crowd out other cells - quit making platelets and bone marrow is full of immature WBCs. |
|
|
Term
| What are the most common cells in Leukemia? |
|
Definition
| Leukocytes - but any WBC can cause leukemia. |
|
|
Term
| What happens in the later stages? |
|
Definition
| Tumors can metastasize into other parts of the body. |
|
|
Term
| Acute Lymphocytic Leukemia |
|
Definition
|
|
Term
|
Definition
Solid malignant tumor of the lymphoid tissue.
Thymus gland
Spleen
Lymph Nodes |
|
|
Term
| What happens in lymphoma? |
|
Definition
| Loose normal lymphocyte function suppressed immune response - more susceptible to diseases, infection.... |
|
|
Term
|
Definition
chemotherapy
radiation
sometimes bone marrow transplants |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Blood clot, abnormal condition or state |
|
|
Term
| What happens in thrombosis? |
|
Definition
Clot formation (hemostasis and clot formation)
Less likely to occur in arteries than veins
Can happen in arteries - but something has to stimulate that. |
|
|
Term
|
Definition
Vasoconstriction
Platelet Activation - will adhere to the damaged vessel and form a platelet plug (will get sticky when activated)
Form a clot - last step - turns fibrinogen to fibrin (a sticky fibrous protein) becomes the backbone of the clot. |
|
|
Term
|
Definition
|
|
Term
| Factors that promote thrombosis |
|
Definition
Endothelial damage
Abnormal blood flow
Hypercoagulation of blood |
|
|
Term
|
Definition
| damage to the internal lining of the blood vessel. Not a cut/tear/rip - other damage. |
|
|
Term
| What happens in Arteries from endothelial damage? |
|
Definition
Hemodynamic stress due to BP changes - lots of stress on endothelial cells. HTN makes it worse.
Arteriosclerosis - hardening of artery
Trauma or where you break the vessel |
|
|
Term
| What happens in Veins from endothelial damage? |
|
Definition
Toxins (endo/exo) spend most of time in blood in veins - exposed about 6-7 times longer and at a higher concentration than arteries.
Longterm irritation due to IVs/Ports - Iatrogenic
Trauma to veins |
|
|
Term
|
Definition
Reduction in flow rate or stasis (blood quits flowing)
In Arteries
In Veins
Tumors - outside blood vessel can push in on wall of blood vessel and reduce flow.
Aneurysms - pouches/pockets/outgrowths on arteries. |
|
|
Term
| Abnormal blood flow (in arteries) |
|
Definition
Increase in viscosity
Cardiac Damage
Obstruction |
|
|
Term
| Abnormal blood flow (in veins) |
|
Definition
Increase in viscosity
Decrease physical activity
Varicose veins - veins in which valves don't work |
|
|
Term
| Hypercoagulation of blood |
|
Definition
Oral contraceptives
Tumors
Burns |
|
|
Term
|
Definition
Resolution
Organization
Propagation
Form an embolus |
|
|
Term
|
Definition
| Thrombis will be dissolved - with no permanent damage - no serious damage |
|
|
Term
|
Definition
| clot will eventually be phagocitized - scar tissue formed in the vessel which may cause arteriosclerosis and occlusion or partial occlusion. Tend to cause turbulent blood flow which promotes clot formation. |
|
|
Term
|
Definition
| Thrombis just grows longer and longer and bigger and bigger - usually in veins |
|
|
Term
|
Definition
| A floating or circular clot - thromboembolus - moving, and circulating blood clot |
|
|
Term
| Sequale of Thrombosis (this is what follows thrombosis) |
|
Definition
|
|
Term
|
Definition
Death of tissue due to lack of blood.
Cerebral - stroke
Myocardial - heart attach
Pulmonary - lung attack |
|
|
Term
|
Definition
Floating mass.
Thromboembolus - mass of blood clot circulating in blood - dangerous because sooner or later it will get stuck some place. |
|
|
Term
|
Definition
| Will cause infarction - most common in heart, brain, kidney, spleen, lower limbs (common - large blood supply) |
|
|
Term
|
Definition
| Will eventually make their way into the right side of the heart - IVC and SVC - will cause a pulmonary infarct if really big it might get stuck in Pulmonary Valve. Can lead to CHF if a long term problem |
|
|
Term
| What therapy is there for Thromboembolus? |
|
Definition
Anti-platelet therapy
Anti-coagulant therapy (block formation of fibrin) - Heparin
Plasmin - enzyme that dissolves clot - can give plasmin activators to dissolve the clots.
Thrombectomy - cut out thrombis
Vena Cava Filters - will catch the thrombis - will keep it from going to heart. |
|
|
Term
|
Definition
bone marry is mostly fat - yellow is 95% fat and red is 75% fat.
bone marrow is quite vascular.
A bone fracture can release the fat and the fat is now floating in blood.
Usually resolved easily
Can cause infarct in brain if they get there. |
|
|
Term
|
Definition
Wound in thorax - gunshot, etc.
Causes a bubble of air in blood; also when giving shots if air is not out of syringe. |
|
|
Term
| What happens if there is a bubble of air of 125ml or more? |
|
Definition
| Causes problems when it gets to heart because when squeezing blood out, air is compressed and there is no pressure - doesn't push much blood out. |
|
|
Term
| What is the treatment for air embolus? |
|
Definition
| Lay patient on left side - so you can keep blood flow going and it takes a little air with it, so eventually its broken up into little air bubbles and will be absorbed. |
|
|
Term
| What is the innermost structure of Artery? |
|
Definition
| Tunica Intima (Tunica interna) |
|
|
Term
|
Definition
Tunica Intima
Tunica Muscularis. Layer of smooth muscle that is circularly oriented arranged around the artery; lots of elastic fibers.
Tunica Adventitia (Tunica Externa)
Small lumen when compared to vein.
Regular shaped lumen.
Elastic tissue, thick muscle wall. |
|
|
Term
| How much blood is in the arteries? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
Tunica Intima
Tunica Media (vein has a thin tunica media)
Tunica Adventitia (relatively thick)
Large lumen compared to an artery.
No elastic tissue, no thick muscle wall.
Irregular shaped lumen - will take up shape based on space. |
|
|
Term
| How much blood is in the veins? |
|
Definition
|
|
Term
|
Definition
| Yes - valves open in one way only - force down and this closes valve. |
|
|
Term
| What happens when valves are not functioning? |
|
Definition
| form Varicose Veins - more likely to happen in veins near the surface where it is easy to see. |
|
|
Term
|
Definition
| Hardening of the arteries. |
|
|
Term
| What are the types of Arteriosclerosis? |
|
Definition
Senile Arteriosclerosis
Medial Calcific Arteriosclerosis
Atherosclerosis |
|
|
Term
|
Definition
| as we get older, we grow more fibrous connective tissue and that tissue has a lot of collagen in it. So we grow more collagen in the wall of the artery (btwn intima and media) |
|
|
Term
| Medial Calcific Arteriosclerosis |
|
Definition
Idiopathic
Calcium deposits in the Tunica Media |
|
|
Term
|
Definition
| Due to build up of fatty plaques (btwn media and intima) |
|
|
Term
|
Definition
hardening of the arterioles - deliver blood to tissue.
If they get sclerotic, then they can't conduct blood - BP goes up. |
|
|
Term
| What causes Arteriolosclerosis? |
|
Definition
Diabetes Mellitus
Hypertension |
|
|
Term
| What contributes to Hypertension causeing Arteriolosclerosis? |
|
Definition
Age
Gender (males higher)
Smoking
Obesity
Races
Stress
Genetic Factors |
|
|
Term
|
Definition
|
|
Term
|
Definition
Treat cause and get BP to drop.
Usually due to renal proglem (through renin-angiotensin-aldosterone cycle) |
|
|
Term
|
Definition
Due to increased vasoconstriction (caused by autonomic nervous system)
Faulty Na+ metabolism (unrelated to kidneys) |
|
|
Term
| Risk Factors of Atherosclerosis |
|
Definition
HTN
Obesity
Hyperlipidemia
Smoking
Age
Gender (males higher)
Alcohol consumption (1-2 oz/day good)
Diabetes Mellitus
Gentics |
|
|
Term
|
Definition
LDL - blood vessel cells absorb this lipid and they build up in vessels.
HDL - to liver and then metabolized
Cholesterol - high levels are correlated to atherosclerosis - when one goes up, the other goes up. |
|
|
Term
| What happens when cholesterol gets high? |
|
Definition
| Atherosclerosis is more common. |
|
|
Term
| How early can Atherosclerosis start? |
|
Definition
| As early as 10 years old. |
|
|
Term
| Sequale of Atherosclerosis |
|
Definition
Infarct (Cerebral, Myocardium)
Promotes Emboli and Thrombosis
Ischemia - decreases blood flow
Aneurysms - weaked spots in the wall of an artery. |
|
|
Term
| What results from an Ischemia? |
|
Definition
Slow wound healing.
Pain caused by anaerobic respiration - usually chest pain; intermittent claudication due to blocked artery (in legs)
once someone quits walking, they will go back to aerobic respiration since there is no need for anaerobic respiration |
|
|
Term
|
Definition
weakened spots in the wall of an artery.
Fusiform Aneurysm
Sacular
Dissecting |
|
|
Term
|
Definition
looks like a bubble in artery
Can rupture and break |
|
|
Term
|
Definition
Looks like a sac on one side
If small - might be called a berry aneurysm (2-3cm in diameter) |
|
|
Term
|
Definition
| Happen often in aorta - damage to Tunica intima and will dissect the Tunica media and will pull the wall apart. |
|
|
Term
|
Definition
| Dissects out so much that it completely tears the blood vessel open and now blood is being pumped out of aorta into abdominal cavity or mediastanum (quickly fatal) |
|
|
Term
|
Definition
| Will push inwards if it can't go outwards - will push the aorta closed - less blood is getting to tissures into that part of the body. |
|
|
Term
| Backs up to the Aortic Valve |
|
Definition
Keeps it from opening
Wouldn't be able to pump blood - or if you do, its a little amount (quickly fatal) |
|
|
Term
|
Definition
|
|
Term
|
Definition
Infection
Toxins
Autoimmune |
|
|
Term
|
Definition
|
|
Term
|
Definition
Infection
Toxins
Autoimmune
Thrombosis (thrombophlebitis) |
|
|
Term
|
Definition
| Fill up with blood due to valves not working - veins expand. |
|
|
Term
| What causes Varicose Veins? |
|
Definition
Breakdown of valves.
Rectum and Anal canal - no valves in veins - called hemorrhoids - get varicose when there is too much pressure and causes it to expand. |
|
|
Term
|
Definition
| Fill chest with air and close the larynx and epiglottis and while we keep it closed, we contract our abdomen and chest and compressed air pushes out (by putting air in, it provides support)(retard blood flow and increase pressure on rectal veins) |
|
|
Term
| When do we use the Valsalva Maneuver? |
|
Definition
Delivery a baby
Hard time completing a bowel movement
Strain to urinate
Pick up something heavy |
|
|
Term
|
Definition
Right into 3 branches
Left into 2 branches
Only arterial system that carries deoxygenated blood. |
|
|
Term
|
Definition
| Strings of the heart come off of the AV valves - function to keep the flaps from turning inside out |
|
|
Term
|
Definition
| lines inside of heart - simple squamous epithelium and connective tissue - picture in textbook |
|
|
Term
|
Definition
| Consists of epicardium (visceral pericardium) and parietal pericardium |
|
|
Term
|
Definition
| Rests on the myocardium - thin layer (outside the heart) |
|
|
Term
|
Definition
| Consists of the serious layer and the fibrous layer |
|
|
Term
| Connective Skeleton of Heart |
|
Definition
Electrical insulator between atria and ventricles
Functions as a Valve Seat
Anchors the fibers so they can pull against each other. |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Creates autorhythmic action potential (myogenic) fibers create their own action potentials. |
|
|
Term
| What is the inherent rate of the pacemaker? |
|
Definition
|
|
Term
| What controls the heart rate? |
|
Definition
|
|
Term
|
Definition
Sympathetic
Parasympathetic |
|
|
Term
|
Definition
releases epinephrine and norepinephrine into the heart muscle and speeds it up. Cardiac nerves are the nerves that do this.
Pressure sensors help to determine if blood pressure needs to change. |
|
|
Term
|
Definition
releases acetylcholine into the heart muscle - oozes out of the nerves and filters around and influences the heart muscle - comes from the vagus nerve - slows the heart.
Negative chronotrope - will change the timing of the heart and cause it to go slower. |
|
|
Term
|
Definition
| Amount of blood pumped out of heart per minute |
|
|
Term
|
Definition
CO = SR X SV
SR = Stroke Rate
SV = Stroke Volume |
|
|
Term
|
Definition
Increase stroke rate - impacted by pos and neg inotropic
Increase stroke volume |
|
|
Term
| Factors influencing Stroke Volume |
|
Definition
PreLoad
Contractility of muscle
Afterload |
|
|
Term
|
Definition
measure of the amount of blood going into the ventricles
More blood to pump
Frank-Starling Law - the more the myocardium is stretched, the harder it contracts. |
|
|
Term
|
Definition
Inotrope - change strength of myocardium contraction.
Positive - Ca++, Epinephrine
Negative - Acetylcholine, K+, certian body toxins. |
|
|
Term
|
Definition
|
|
Term
|
Definition
Increase Cardiac Output
Dilation
Hypertrophy
Tachycardia |
|
|
Term
|
Definition
Ventricles can dilate - get bigger and hold more volume
Makes room for more blood.
Makes a stronger contraction (Frank-Starling Law) |
|
|
Term
|
Definition
| Heart muscle fibers themselves get bigger - myocardium increases its mass |
|
|
Term
|
Definition
|
|
Term
| What does decompensation lead to? |
|
Definition
|
|
Term
|
Definition
Pericardial Effusion
Pericarditis |
|
|
Term
|
Definition
Excess fluid in the pericardial cavity.
Normal volume is 15-50 ml
Can hold up to 2000 ml - not good for the heart because it compresses the heart. |
|
|
Term
|
Definition
| If Pericardial Effusion is serous |
|
|
Term
|
Definition
| If Pericardial Effusion is blood |
|
|
Term
|
Definition
| Inflammation of Pericardium |
|
|
Term
| What does an Elevated ST segment show? |
|
Definition
|
|
Term
| What causes Pericarditis? |
|
Definition
| Usually a viral infection. |
|
|
Term
| What is a sign of Pericarditis? |
|
Definition
Pain in the chest - near collarbone and will radiate to the back.
Hurts to lay down and also when you breathe. |
|
|
Term
| What is treatment for Pericarditis? |
|
Definition
IBP
If viral - very responsive to anti-inflammatories. |
|
|
Term
|
Definition
Inflammation of the heart muscle - several causes and usually bacterial infection.
Very serious - sudden heart failure and death.
Starts from somewhere else in body - like a respiratory infection. |
|
|
Term
| How is Myocarditis diagnosed? |
|
Definition
| By the fact that the ventricles are enlarged - an EKG will show and an echocardiogram will show this. |
|
|
Term
| What is treatment for Myocarditis? |
|
Definition
| Give antibiotics and cross your fingers. |
|
|
Term
|
Definition
Inflammation of endocardium - effects lining and valves.
Usually a bacterial infection.
Starts from somewhere else in body - like a respiratory infection.
Serious effect on the valves - bc there is no blood supply to the valves - they do not have their own capillaries, etc. |
|
|
Term
| What does Endocarditis cause? |
|
Definition
| Valve disease (heart murmur) |
|
|
Term
| Can antibiotics treat Endocarditis? |
|
Definition
| No - there is no way to carry the antibiotics there. |
|
|
Term
|
Definition
| Valve is stiff, narrow, and hard to open. Heart has to work harder and faster to pump blood to body - sounds like a swishing sound. |
|
|
Term
| Valvular Incompetence or Valvular Regurgitation |
|
Definition
These valves don't shut well. If valves don't shut completely, then blood will flow back into the previous chamber and less blood volume out - pumps faster and harder - sounds flappy - like a flag on a flagpole.
Both lead to CHF |
|
|
Term
| What is treatment for Endocarditis? |
|
Definition
|
|
Term
|
Definition
Decrease in blood supply to heart muscle
Arteriosclerosis - most common cause - in coronary arteries. |
|
|
Term
| Other contributing factors to Myocardial Ischemia: |
|
Definition
Cold
Nicotine
Caffeine
Anxiety
Physical Exertion
Wind |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What is treatment for Angina Pectoris? |
|
Definition
Nitrates
Nitroglycerine
Ca++ Channel Blockers
Beta Blockers |
|
|
Term
|
Definition
pain increases
people who have angina pectoris often experience crescendo angina. |
|
|
Term
|
Definition
If blood supply is cut off enough to myocardial cells it causes death.
Dead cells are never replaced by new muscle cells.
Scar tissue forms - but not contractile - heart becomes less effective pump |
|
|
Term
| What are symptoms of Myocardial Infarct? |
|
Definition
Pain - may be referred
Nausea - vomiting
Oliguria - low urinary output/low filtration
Fever |
|
|
Term
| What are signs of Myocardial Infarct? |
|
Definition
Abnormal EKG - can determine where damaged tissue is.
Blood tests - cardiac troponin |
|
|
Term
| Sequalae to Myocardial Infarct |
|
Definition
Arrythmia (Ventricular Fib is worse)
Cardiogenic Shock - caused by the heart not being able to pump enough.
Thrombosis
Rupture of Heart (Myomalasia cordis, Aneurysm in heart)
CHF |
|
|
Term
|
Definition
Ischemia
Volume Imbalances
Restriction of Heart - pericardial effusion or chronic pericarditis
Vascular Pathology (arteriosclerosis, excess vasodilation)
Left side heart failure
Right side heart failure
Valve Problems |
|
|
Term
| Left Side Heart Failure (causes) |
|
Definition
Pulmonary congestion and edema
Cerebral Hypoxia
Decreased Renal Ouput
May cause Righ Side Heart Failure |
|
|
Term
| Right Side Heart Failure (causes) |
|
Definition
Liver Congestion (through IVC)
Distended Neck Veins (through SVC)
Usually Caused by Cor Pulmonale - heart failure caused by congestive lungs |
|
|
Term
|
Definition
Artificial Valve
Strengthen heart and decrease afterload
Diuretics
Give anti-arrhythmia drugs (if arrhythmic)
Digitalis - positive inotropes |
|
|
Term
| Atrial Natriuretic Hormone |
|
Definition
|
|
Term
|
Definition
| Condition present at birth |
|
|
Term
| What are some congenital heart defects? |
|
Definition
Atrial Septal Defect
Ventricular Septal Defect
Tetralogy of Fallot - 4 things wrong |
|
|
Term
|
Definition
Ventricular Septal Defect
Pulmonary Stenosis
Extraposed Aorta (Aorta has been moved to the right)
Right Ventricular Hypertrophy |
|
|
Term
|
Definition
Preductile or invantile - the ductus arteriosis stays open
Causes CHF, cyanosis - must be corrected |
|
|
Term
|
Definition
|
|
Term
|
Definition
Dilated Cardiomyopathy (idiopathic, prognosis wide variability)
Hypertrophia Cardiomyopathy (usually genetic)
Restrictive Cardiomyopathy
Rheumatic Cardiomyopathy |
|
|
Term
| Several types of Shock based on cause |
|
Definition
Hypovolemic shock
Cardiogenic Shock
Distributive Shock
Obstructive Shock |
|
|
Term
|
Definition
| Serious disorder caused by inadequate circulation; affects all of the body |
|
|
Term
|
Definition
| Not enough fluid in body to maintain circulation; hematogenic shock if due to loss of blood |
|
|
Term
|
Definition
| Decreased pumping ability of heart. |
|
|
Term
|
Definition
| Plenty of fluidin body, but not in the right place (Neurogenic - nerves, Vasogenic - blood vessels) |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Something blocks vessel and can't circulate (embolism) |
|
|
Term
| Symptoms of Shock(General effects of shock) |
|
Definition
Weak, rapid pulse
Low BP
Pallor (pale) |
|
|
Term
| Metabolism effects of shock |
|
Definition
| Anaerobic respiration -> lactic acid -> vasodilation and lower BP -> makes shock worse |
|
|
Term
| Pulmonary effects of shock |
|
Definition
Poor circulation through lungs
Less O2 in blood and more CO2 in blood
(more anaerobic respiration and more acidity from CO2 means lower pH which leads to vasodilation
Thrombosis in lungs. |
|
|
Term
|
Definition
poor circulation through kidneys
renal failure
toxins build up in kidneys
toxins build up in blood
cause vasodilation |
|
|
Term
| Gastrointestinal effects of shock |
|
Definition
Decrease blood to GI tract
Mucosa will deteriorate in GI tract
Bacteria can then grow inside
This produces toxins and causes vasodilation |
|
|
Term
| Myocardial effects of shock |
|
Definition
| Myocardial depressant factor caused by pancreas tissue breakdown because it is getting less blood. |
|
|
Term
| Are these negative or positive feedback? |
|
Definition
| Positive feedback which makes shock worse. |
|
|
Term
| Types of shock based upon final outcome |
|
Definition
Non-progressive
Progressive
Irreversible |
|
|
Term
|
Definition
| Compensating mechanisms or therapy will stop it and it will not progress |
|
|
Term
|
Definition
Some permanent organ damage
Don't die from shock |
|
|
Term
|
Definition
Doesn't matter what is done, positive feedback mechanisms have gone to far.
Causes Death. |
|
|
