Cardiac and Lymph patho

MODS definition

progressive dysfunction of two or more body systems from chronic inflammation

MODS triggers

shock, sepsis, burns, surgery and trauma

cardiovascular manifestation of MODS

hypotension, low SVR, myocardial failure

respiratory manifestation of MODS

tachypnea, dyspnea, and ARDS

renal manifestation of MODS

low urine output and renal failure

hematologic manifestation of MODS

thrombocytopenia and DIC

lymph system function

pick up excess fl and return to venous circulation, moves lymphocytes and leukocytes

lymph system features

lymph vessels, lymph nodes and valves

lymph system drainage

right lymph duct drains into right subclavian vein, thoracic duct into left subclavian venous region

lymphodema definition

tissue edema caused by obstructed vessels or removed lymph nodes

lymphodema connection to mastectomy

removal of axillary lymph nodes impair lymph drainage and cause fl retention

shock definition

cardiovascular failure to profuse tissues leading to wide spread impairment

causes of cardiovascular shock

heart can’t pump enough blood b/c ishcemia, MI or failure

cardiovascular shock findings

hypotension, tachycardia, JVD, dysrthymias, and low cardiac output

cause of hypovolemic shock

insufficient fl volume from hemorrhage, burns or vomitting

hypovolemic shock findings

pallor, compensentory vascoconstriction, inc SVR, oliguria and thirst

causes of neurogenic shock

loss vascular smooth muscle from autonomic imbalance

neurogenic shock findings

vasodilation and dec SVR

causes of anaphylactic shock

hypersensitivity reaction to allergen

anaphylactic shock findings

vascodilation and fl shift into intersitial space

causes of septic shock

infection causes systemic inflammation and coagulation from endotoxins

septic shock findings

low arterial pressure, low SVR, leukocytes and altered O2 extraction

right heart function

pump blood to lungs

right heart receives blood from

systemic veins by vena cava

right heart pumps blood into

pulmonary artery

right heart pressure

low pressure

right heart walls

thin

left heart function

pump blood through systemic circulation

left heart receives blood from

pulmonary veins

left heart pumps blood into

aorta

left heart pressure

high pressure

left heart walls

thick

arterial fibrillation ECG finding

loss P wave and irregular HR

arterial kick

normal arterial filling boost

arterial fibrillation patho

uncoordinated arterial contraction

hemodynamic effect of arterial fibrillation

stroke volume and cardiac output dec

arterial fibrillation complication

ineffective blood flow leading to clots

pulmonary embolism acute symptoms

SOB, chest pain, anxiety

pulmonary embolism chronic symptoms

leg swelling, pain, tender, warm

baroreceptor response to high BP

reduces cardiac output and peripheral resistance

baroreceptor response to low BP

inc HR and constricts arterioles

SA node intrinsic factor

60-100 bpm, normal pacemaker

AV node intrinsic factor

40-60 bpm

bundle of his intrinsic factor

20-40 bpm

purkinje fibers intrinsic factor

ventricular myocardial activation

P wave on ECG

arterial depolarization

PR interval on ECG

onset arterial to ventricular activation

QRS complex on ECG

ventricular depolarization

ST interval on ECG

ventricular myocardial depolarization

T wave on ECG

ventricular repolarization

QT interval on ECG

electrical systole of ventricles

preload definition

volume in ventricle at end of diastole

preload effect

determine ventricular stretch and contraction

preload inc factor

venous return

preload dec factor

reduce venous return or dehydration

afterload definition

resistance to ejection during systole

afterload inc factor

hypertension and inc PVR

afterload dec factor

vasodilation

frank sterling law mechanism

inc preload leads to inc myocardial stretch

frank sterling law outcome

inc force of contraction and improve stroke volume

frank sterling law limit

excessive stretch dec cardiac output

what is PCTA

catheter procedure with balloon/stent to open blocked arteries

what is CABG

use graft vessels to bypass blocked arteries

dilated cardiomyopathy

impaired systolic function, ventricular dilation, thin walls, systolic heart failure

hypertrophic cardiomyopathy

thickened myocardium, thick septal wall

restrictive cardiomyopathy

rigid, noncompliant myocardium, impaired ventricular filling, right heart failure

physical cardiac assessment

asses JVD, edema, murmurs, perfusion

ECG cardiac assessment

shows ischemia, infarction, defects and dysthymias

angiography cardiac assessment

fluoroscopic visualization of coronary arteries

CACS cardiac assessment

CT based assessment scoring coronary calcium

arteriosclerosis

hardening and thickening of arteries

atherosclerosis

plaque build up from endothelial injury, LDL, macrophages and fat

peripheral vascular resistance related to cap blood flow and BP

greater resistance opposes flow and inc workload

stroke volume related to cap blood flow and BP

less blood ejected per beat, dec cardiac output

heart size and function related to cap blood flow and BP

pressure and flow required for tissue perfusion

how does epinephrine effect BP

increases BP

how does ADH effect BP

increases BP

how does renin effect BP

increase BP

how does natieretic peptides effect BP

decreases BP

effects of epinephrine

inc contraction, HR, stroke volume, pupil dilation, vasoconstriction, inc RR, glycogen to glucose

effects of acetylcholine

reduce contraction strength, dec HR, slows conduction

chronotrophy

HR regulation

inotrophy

force of contraction