Patho week 5 ch 18 & 19

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ekruge01
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Patho week 5 ch 18 & 19
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2010-11-01 03:15:04
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  1. What is the blood flow path?
    LV->aorta->arteries->arterioles->capillaries->venules->veins->vena cava->RA
  2. Blood vessels have?
    • 1. smooth endothelial lining
    • 2. ANS innervation of smooth muscle
    • 3. elastic tissue
    • 4. alpha-adrenergic receptors
  3. When alpha-adrenergic receptor s are stimulated by epinephrine, what happens?
    arteriole vasoconstriction
  4. What is the formula for cardiac output?
    Cardiac output (ml/min)=heart rate (per min)X stroke volume (RV&LV output in ml per contraction)
  5. Changes occur in cardiac output when?
    HEART BEGINS TO FAIL
  6. The heart has beta adrenergic receptors that, when stimulated by epinephrine cause?
    • 1. increase in pulse
    • 2. increase in force of contraction
  7. What are the 3 waves of a ECG?
    • 1. p wave
    • 2. qrs wave
    • 3. t wave
  8. what is p wave?
    contraction (depolarization) of atria
  9. what is qrs wave?
    contraction (depolarization) of ventricles
  10. what is t wave?
    relaxation (repolarization) of ventricles
  11. What are ECG waves affected by?
    • 1. drugs
    • 2. electrolyte imbalances
    • 3. heart disease
  12. What are the common drugs used for heart disease?
    • 1. diuretics
    • 2. ACE inhibitors
    • 3. Calcium channel blockers
    • 4. beta-adrengeric blockers
    • 5. nitrates
    • 6. digitalis
  13. What are diuretics?
    • 1. increase sodium excretion
    • 2. increase K loss
  14. What is the most common treatment for heart disease?
    diuretics
  15. What is the path for ACE inhibitors?
    blacks formation of Angiotensin II->decrease in aldosterone secretion->decreased sodium retention-> decreased BP
  16. What are calcium channel blocker's path?
    decrease in P, causes vasodilation->decreased BP
  17. What are beta-adrenergic blockers?
    • 1. decrease P
    • 2. decrease force of contraction
    • THUS:
    • 3. easing stress on heart
    • 4. decreasing BP
  18. What are nitrates?
    vasodilate coronary arteries (EX:Nitroglycerin)
  19. What is digitalis?
    • 1. increases force of contraction
    • 2. decreases P
    • LEADS TO:
    • making beats more efficient
  20. What are the different heart diseases?
    • 1. angina pectoris
    • 2. myocardial infarct
    • 3. atherosclerosis
    • 4. arteriosclerosis
    • 5. cardiac rhythm disorders (bradycardia, tachycardia, asystole, fibrillation, PVC)
    • 6. pericarditis
    • 7. congestive heart failure
  21. What is another name for myocardial infarct? (MI)
    Anterior MI
  22. What is MI?
    total occlusion of coronary artery->cardiac tissue death
  23. What are the S&S of MI?
    • 1. chestpain (may feel like heartburn)
    • 2. sweating
    • 3. nausea
    • 4. pain may radiate to jaw, arm, or back
    • 5. insomnia prior to MI
    • 6. ECG shows changes
    • 7. blood tests show increase cardiac enzyme levels due to muscle damage
  24. (MI) when may pain be minimal?
    • If you are:
    • 1. female
    • 2. elderly
  25. What helps with MI if taken early on?
    ASA
  26. What is the tx for MI?
    • 1. extensive array
    • 2. thrombolytics if caught early on
  27. What is angina pectoris?
    chest pain due to lack of sufficient coronary blood flow (only PARTIAL artery occlusion).
  28. What is the tx for angina pectoris?
    nitroglycerin (NTG)
  29. What are atheromas?
    patches of cholesterol deposits
  30. What is atherosclerosis?
    blood vessels lined with artheromas
  31. What is arteriosclerosis?
    blood vessels lose their elasticity
  32. arteriosclerosis is usually due to?
    old age
  33. arteriosclerosis is also called?
    "hardening of the arteries"
  34. Diuretics cause increased excretion of sodium and water leading to?
    decreased blood volume
  35. What are the adverse effects of diuretics?
    • 1. nausea
    • 2. vomiting
    • 3. orthostatic hypotension
    • 4. dizziness
    • 5. xerostomia
    • 6. hypokalemia
  36. Ace inhibitors prevent decreased blood vessels size, in other words?
    prevents vasoconstriction
  37. What are the adverse effects of ace inhibitors?
    • 1. headache
    • 2. orthostatic hypotension
    • 3. dizziness
  38. Calcium channel blockers decrease?
    myocardial conduction & contractabilty
  39. What are the adverse effects for calcium channel blockers?
    • 1. dizziness
    • 2. fainting
    • 3. headache
    • 4. othostatic hypotension
    • 5. constipation
    • 6. gingival hypertension
  40. beta-adrenergic blockers prevent increased heart rate in response to?
    sympathetic nervous system & cholamines
  41. what are the adverse effects for beta-adrenergic blockers?
    • 1. bradycardia
    • 2. dizziness
    • 3. fatigue
    • 4. orthostatic hypotension
    • 5. sexual dysfunction
  42. What are the warning signs of a heart attack?
    • 1. feeling of pressure, heaviness, or burning in the chest, especially with increased activity
    • 2. sudden SOB, sweating, weakness, fatigue
    • 3. nausea, indigestion
    • 4. anxiety/fear
  43. What is the normal pulse at rest?
    60-80
  44. What is bradycardia?
    decreased P
  45. What are the effects of bradycardia?
    • 1. stroke volume increased
    • 2. possibly reduced cardiac output
  46. What is tachycardia?
    increased P
  47. What are the effects of tachycardia?
    1. possibly reduced cardiac output
  48. What is fibrillation?
    weak contactions, irregular beats
  49. What are the effects of fibrillation?
    no filling, no output-cardiac standstill
  50. What is aystole?
    cardiac standstill
  51. What is Premature Ventricular Contraction (PVC)?
    additional ectopic beats
  52. What are the effects of PVC?
    may induce fibrillation
  53. What is pericarditis?
    inflammation of the pericardial membrane
  54. What is pericarditis due to?
    • 1. trauma
    • 2. infection
    • 3. MI
  55. Pericarditis has S&S similar to MI except?
    • 1. pain may increase with deep breath
    • 2. murmur(friction rub) often aucsculated
    • 3. fluid/scar tissue may form around the heart
  56. In pericarditis, fluid/scar tissue may for around the heart, what is needed then?
    needle aspiration, may lead to congestive heart failure
  57. What is endocarditis?
    inflammation/infection of valves of heart
  58. What heart disease often follows other heart diseases?
    CHF
  59. What is CHF?
    weakened heart->inefficient pumping->blood backflows to lungs/rest of body
  60. What are the S&S of CHF?
    • 1. cough (first sign)
    • 2. weight gain of over 2 lbs per night
    • 3. increase in BP, then decrease as the heart fails
    • 4. increased P, but weak and thready
    • 5. oliguria
    • 6. cardiogenic shock->death if untreated
  61. All shocks except neurogenic shock results in?
    • 1. decreased BP
    • 2. increased P
    • 3. decrease urine output
    • 4. organ failure->death if untreated
  62. What is ventilation?
    exchange of air between atmosphere and lungs
  63. What is tidal volume?
    amt of air inhaled and exhaled with normal breath (500ml)
  64. what is expiratory reserve volume?
    amt of air exhhaled after forced expiration, after a normal exhalation (1500 ml)
  65. What is residual volume?
    amt of air left in lungs between breaths...needed to keep aveoli open
  66. Respiratory rate is controlled by?
    • 1. neurons in brainstem which connect to diaphragm and accessory muscles
    • 2. chemoreceptors in carotid arteries and aorta which respond to changing levels of O2 and CO2
  67. what is hypercapnea?
    increased CO2 in blood
  68. What is hypoxemia?
    decrease in O2 in blood
  69. what is hypoxia?
    decreased O2 in tissues
  70. CO2 acts as a vasodilator and acid so it leads to?
    decrease pH of blood
  71. What are arterial blood gases? (ABG)
    measurement of oxygen/carbon dioxide and pH in blood by drawing a sample of blood from an artery
  72. What are the interventions to help with respiratory disorders?
    • 1. chest physiotherapy (remove thick secretions&reduce infections)
    • 2. oxygen
  73. What are the drugs to help with respiratory disorders?
    • 1. decongestants (vasoconstriction in nasal mucosa)
    • 2. expectorants (thin respiratory secretions for easy removal)
  74. What are the surgeries that help with respiratory disorders?
    • 1. thoracentesis (removal of excess fluid from pleural cavity)
    • 2. tracheotomy
  75. What is IRDS?
    lack of surfactant is aveoli
  76. what is IRDS usually due to?
    premature birth
  77. What are the tx for IRDS?
    • 1. treat mother with steroids prior to delivery
    • 2. neonate put in ICU and given surfactant in lungs
  78. What is laryngotracheobronchitis? (LTB)
    • "Croup"
    • spasms of bronchial smooth muscles
  79. What is bronchiolitis usually due to?
    Respiratory Syncytial Virus (RSV)
  80. What is asthma?
    obstruction of airway with allergic reaction (bronchioconstriction)
  81. What was TB called in the older days?
    "Consumption"
  82. What are the S&S of TB?
    • 1. hemoptysis (blood in sputum)
    • 2. night sweats
  83. what is pneumonia?
    viral or bacterial infection of the lungs
  84. what are the S&S of pneumonia?
    • 1. fever
    • 2. cough
    • 3. decreased breath sounds
    • 4. increased WBC if bacterial
    • 5. fatigue
  85. When are people at higher risk of getting pneumonia?
    • AFTER:
    • 1. stroke
    • 2. post-op
    • 3. immune suppressed
  86. What is important to note about COLD/COPD?
    do not give them to much oxygen as it stops their stimulus to breathe

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