Chapter 18 Part 2
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What is pericardial effusion
accumulation of noninflammatory fluid in the pericardial sac
- composition of usual fluids:
What is cardiac tamponade, what are the symptoms
when fluid accumulation in pericardial sac is large/sudden it can lead to external compression of the heart chambers such that filling is impaired
- -reduced SV
- -compensatory ^ in HR
What is percarditis?
acute or chronic inflammation of pericardium
What is Acute pericarditis?
- idiopathic, presumed viral
- -uncomplicated form resolves spontaneously
- -complicated forms: pericardial effusion, or persistent/recurrent inflammation
- -presents as chest pain
What are the 2 forms of chronic pericarditis?
- adhesive mediastinopericarditis
- constrictive pericarditis
What is adhesive mediastinopericarditis?
- Chronic pericarditis
- -pericardial sac is destroyed and external aspect of heart adheres to surrounding mediastinal structures
What is contrictive pericarditis?
- type of chronic pericarditis
- -pericardial sac become dense, nonelastic, fibrous, and scarred
name 2 primary pathologic processes of differ congenital heart anomalies?
- -shunting of blood thru abnormal pathways in heart/great vessels
- -obstruction to blood flow bcuz of abnormal narrowing, interfering with blood flow leading to ^workload of affected chamber
development of the following contributes to heart defects.
- -atrial septum
- -ventricular septum
- -main outflow tract to pulmonic and aortic arteries
What is the common heart disorder in children?
- congenital heart disease
- -0.8% of all live births
- may attributed to:
- -maternal rubella during 1st trim
- -exposure to cardiac teratogens (smoke)
- -genetic influences
- -advanced maternal age
What is acyanotic congenital defects? Name them
disorders that result in L to R shunting of blood or obstruction to flow are generally acyanotic
- -atrial septal defect
- -venricular septal defect
- -patent dustuc arteriosus
- coarctation of aota
- -pulmonary and aortic stenosis/atresia
What does ASD stand for
atrial septal defect?
What is ASD
- atrial septal defects occur at location of foramen ovale, causing L to R shunt
- -long-term ^ in pulmonary blood flow may eventually lead to pulmonary hypertension, R ventricular hypertrophy, and reversal of flow to a R-to L shunt
What is ventricular septal defect? (VSD)
- common congenital cardiac anomaly
- -locatedi n membranous septum, near bundle of His
- -^ pulmonary blood flow result in pulmonary hypertension, R ventricular hypertrophy, and reversal of the shunt (which is initially is L to R due to higher pressure naturally found in L ventricle compared to R ventricle)
What is Patent ductus Arteriosus?
- cause low blood oxygen tension may contribute to continued patency (ID by harsh grinding systolic murmur/thrill)
- results in pulmonary hypertension, and can lead to R sided HF
What is pulmonary atresia?
blood must enter the lungs by traveling thru a septal opening and a patent ductus arteriosus
What is pulmonary stenosis
usually due to abnormal fusion of the valvular cusps and can lead to R ventricular hypertrophy
What is cyanotic congenital defects
disorders that result in R to L shunting of blood result in cyanosis
What are the disorders of cyanotic congenital defects
- -tetralogy of fallot
- -transposition of great arteries
- -truncus arteriosus
- -tricuspid atresia
Teralogy of fallot
- 4 features.
- -ventricular septal defect
- -aorta positioned above ventricular septal opening
- -pulmonary stenosis that obstructs R ventricular outflow
- -R ventricular hypertrophy
Transposition of Great arteries
- aorta arises from R ventricle and the pulmonary artery arises from L ventricle
- -results in 2 separate, noncommunicating circulations
- -incompatible with life unless mixing of blood occurs thru other defects (shunts)
- failaure of pulmonary artery and aorta to separate;
- results in formation of one large vessel that receives blood from both R and L ventricles
- results in systemic cyanosis
- -high pulmonary blood flow may cause pulmonary hypertension and R ventricular hpertrophy
- -associated with underdevelopment of R ventricle and an atrial septal defect
- -allows blood to bypass R ventricle
- -patent dustuc arteriosus is required to perfuse lungs
- -cyanosis present at birth, mortality high
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