Pathophysiology: Cardiovascular pt. 2

Hemodynamics

___ is the principles of pressure, flow, and resistance as they relate to circulatory system

systole

___ is the contraction of the heart

contraction

systole is the ___ of the heart

body (systemic)

systolic is the contraction of the ventricles carrying O2 to the ___

diastolic

___ is the relaxation of the ventricles

relaxation

diastolic is the ___ of the ventricles

heart

diastolic is the relaxation of the ventricles carrying O2 to the ___

pressure, flow, resistance

Hemodynamics is the principles of ___, ___, and ___ as they relate to circulatory system

-volume

-pressure

-resistance

-flow

what are the 4 most important factors of the circulatory system?

-volume

-pressure

The circulatory system functions under optimal conditions if there is a sufficient ___ to fill the vascular compartment and enough ___ to facilitate blood flow to all tissues of the body.

-vascular compartment

-tissues

The circulatory system functions under optimal conditions if there is a sufficient volume to fill the ___ and enough pressure to facilitate blood flow to all ___ of the body.

-blood flow

-resistance

___ is dependent upon the pressure difference between the two ends of a vessel and the ___ that blood must overcome as it travels through vessels.

Cardiac Output (CO)

___ is the amount of blood (in liters) the heart pumps in 1 minute [4-8L.min]

4-8L.min

what is the Cardiac Output (CO) of blood per minute in liters

Cardiac Output = Stroke Volume X Heart Rate [CO = SV X HR]

what is the equation to find Cardiac Output?

preload and afterload

Stroke volume is dependent upon ___ and ___

Ejection Fraction

___ is the % of blood ejected by the left ventricle each pump

beat

ejection fraction measure the % of blood that is ejected with each ___

55-70%

What is a normal ejection fraction?

ejection fraction and CO

___ and ___ are correlated and have a direct relationship

100%

no ones ejection fraction is ___ because some of the blood has to stay in the heart

blood volume

preload = ___

preload

___ is the pressure (amount of stretch) in the ventricles after filling up with blood

amount of stretch

Preload is the pressure (___) in the ventricles after filling up with blood

baroreceptors

___ sense the stretch of the ventricles after filling up with blood (preload)

Frank Starling's Law

___ states that when there is an increase in stretch [venous return] = increased force of contraction [stroke volume] when all other factors remain constant

increase in stretch [venous return] = increased force of contraction [stroke volume]

what does Frank Sterling's Law state?

-stretch

-contractility

Franks Sterling's Law states that the greater the ___ the greater the ___

increased fluid volume = increased preload

what is an example of increased preload?

decreased fluid volume = decreased preload

what is an example of decreased preload?

increase

if there is an increase in fluid volume, then there is an ___ in preload

decrease

if there is a ___ in fluid volume, then there is a decrease in preload

correlate

fluid volume and preload ___ with eachother

end of diastole

preload is the VOLUME of blood in ventricles at ___

preload

___ is the VOLUME of blood in ventricles at end of diastole

balloon

preload is like a ___ filling with blood from the venous return

volume

preload = ___

resistance

afterload = ___

afterload

___ is the amount of pressure that the left ventricle must generate to force (eject) blood

into the systemic circulation

force (eject)

afterload is the amount of pressure that the left ventricle must generate to ___ blood

into the systemic circulation

aorta

the Left Ventricle encounters afterload (resistance) from the ___

-constricted vessels = more resistance

-baby coming out of vagina

what are 2 examples of increased afterload

-dilated vessels = less resistance

-lifting low weights

what are 2 examples of decreased afterload?

decreased afterload

which afterload will be easier for the left ventricle to contract and eject blood?

ventricular hypertrophy

___ occurs due to pumping against high pressures. this causes the heart to have thicker walls and narrower vessels. may have irreversible damage (pathological)

thicker walls and narrower vessels

ventricular hypertrophy occurs due to pumping against high pressures. this causes the heart to have ___ and ___. may have irreversible damage (pathological)

cardiac contractility

___ is the ability of the heart to muscle (myocardium) to contract and change its force of contraction without any change in resting (diastolic) pressure.

-myocardium

-diastolic

cardiac contractility is the ability of the heart to muscle (___) to contract and change its force of contraction without any change in resting (___) pressure.

60-100 bpm

What is the normal heart rate for an adult?

heart rate

___ is the frequency of cardiac cycle; it influences cardiac output and workload of the heart

cardiac output and workload

heart rate is the frequency of cardiac cycle; it influences ___ and ___ of the heart

diastole

The heart fills during ___ which; increases in heart rate decrease the amount of time for filling

heart rate

The heart fills during diastole; increases in ___ decrease the amount of time for filling

perfused

the heart rest between beats to fill up with blood, and the myocardium gets ___

myocardial oxygen demand

___ is amount of oxygen the heart NEEDS to perform its work

Myocardial Oxygen Supply

___ is amount of oxygen the heart GIVES when preforming its work

systole

myocardial oxygen demand is related with ___

diastole

Myocardial Oxygen Supply is related with ___

increase in oxygen supply

people with heart disease will have an increase in myocardial oxygen demand and will also have an ___

heart rate

myocardial oxygen demand is based on ___, more muscle is working

the more O2 is needed

what is an example as to why myocardial oxygen demand would increase?

supply, HR, breathing, and vasodilations

what 4 things does Myocardial Oxygen Supply influence?

faster

the ___ your heart pumps, the less time it has to fill up and get O2

-O2 demand

-O2 supply

a person with either lung/ heart disease will experience increase heart beats and increased breathing causing an imbalance leading to an increase in workload and a increase in ___ and a decrease in ___

acute pericarditis

___ is inflammation of the pericardium

pericardium (outer layer of heart)

acute pericarditis is inflammation of the ___

-capillary permeability

-pericardial space

Acute Pericarditis causes an increase in ___ of the pericardium allowing plasma proteins and fibrinogen to escape into the ___

plasma proteins and fibrinogen

Acute Pericarditis causes an increase in capillary permeability of the pericardium allowing ___ and ___ to escape into the pericardial space

Exudate (serous, sanguinous, fibrinous)

___ forms in the pericardial space with Acute Pericarditis

-bacterial infections

-cancer

-Connective tissue diseases

-Drug toxicities

-Fungal infections

-MI / Cardiac surgery

-Radiation

-Trauma

-Uremia

-Viral infections

what are the 10 causes of Acute Pericarditis

-bacterial infections

-fungal infections

-viral infections

what are the 3 main causes of Acute Pericarditis

-pain that worsens with respiration

-Pericardial friction rub

-Electrocardiogram (ECG) changes

what are the 3 manifestations of Acute Pericarditis

Pericardial friction rub

Acute pericarditis

___ is a scraping or grating noise heard when pericardium has friction against pericardial sac; suggestive of ___

decreased

Pericardial friction rub is a sound made when fluid in the pericardial sac has ___

pericardial effusion

___ is accumulation of fluid in the pericardial cavity

30-50 mL of thin, clear, straw colored fluid in the pericardial sac

what is the normal range for pericardial effusion and what are some characteristics about it

pericardial cavity

pericardial effusion is accumulation of fluid in the ___

3rd space

pericardial effusion is a ___ accumulation

"edema of the heart"

pericardial effusion is also known as "___"

-cardiac surgery

-inflammation

-myocardial infarction

-neoplasms

-trauma

what are the 5 causes of pericardial effusion

inflammation

what is the underlying cause of pericardial effusion resulting in all other causes

-small fluid increases are usually asymptomatic (no symptoms)

-rapid fluid increases produce LIFE THREATENING symptoms

what are the 2 manifestations of pericardial effusion

cardiac tamponade

___ is a condition that compresses the heart

compresses the heart

cardiac tamponade is a condition that ___

fluid or blood

cardiac tamponade causes increase in pressure by ___ or ___ in the pericardial sac

life-threatening

cardiac tamponade is a ___ disorder of the pericardium

compresses the heart and is not allowed to fully eject blood and causes death

what does cardiac tamponade do?

-cancer

-cardiac rupture

-cardiac surgery

-trauma

what are the 4 causes of cardiac tamponade that are all about bleeding

-decrease in stroke volume (SV)

-decrease in cardiac output (CO)

-decrease in venous return

-hypotension

-increase in Central Venous Pressure (back up of blood in heart)

-Jugular Vein Distention (veins that distend bc cannot drain blood)

-Pulsus Paradoxus (change in BP with respiration)

-tachycardia

what are the 8 manifestations of Cardiac Tamponade

arterial system

with Cardiac Tamponade causes in inability to eject blood which leads to a decrease in the ____

fixed with a needle

how is Cardiac Tamponade fixed?

preload

with Cardiac Tamponade there is a decrease in ___because you don't have the room to fill

pump

with Cardiac Tamponade, the heart is trying to ___ but it can't

-acute pericarditis

-pericardial effusion

-cardiac tamponade

what are the 3 disorders of the pericardium?

coronary artery disease (CAD)

___ is a heart disease that is caused by impaired blood flow of the myocardium

myocardium

coronary artery disease (CAD) is a heart disease that is caused by impaired blood flow of the ___

Atherosclerosis (hardening of arteries)

what do we see happen to the arteries with coronary artery disease (CAD)

-angina

-myocardial infarction (heart attack)

-dysrhythmias

-heart failure

-death

coronary artery disease (CAD) may lead to what 5 things?

1. nonmodifiable

2. modifiable

what are the 2 risk factors with coronary artery disease (CAD)

-left coronary artery (left main)

-right coronary artery (RCA)

what are the 2 main arteries in coronary circulation?