HSC 4555 Pathophysiology Exam 2 Review

This set of flashcards covers key concepts in pathophysiology, focusing on alterations in oxygen transport, blood flow, blood pressure, cardiac function, heart function, and heart failure.

What is the total blood volume for males and females?

Male: 75.5 mL/kg; Female: 66.5 mL/kg.

What percent of blood volume is made up of plasma?

Plasma makes up 55-60% of blood volume.

What is plasma composed of?

Plasma is composed of 92% water and 7% plasma proteins.

True or False: Red blood cells have a nucleus.

False.

What is erythropoietin?

Erythropoietin is a hormone from the kidney that stimulates erythrocyte production.

How many oxygen molecules can one hemoglobin molecule bind to?

Each hemoglobin molecule can bind to 4 oxygen molecules.

What do hemoglobins carry?

Hemoglobins carry oxygen.

Where does the production of hemoglobin take place?

Hemoglobin production takes place in immature RBCs.

What is required for hemoglobin synthesis?

Iron.

What nutritional requirements are needed for normal RBC development?

Protein and Vitamins (B12, Folate, B6, Riboflavin, Niacin, Vit E and C).

What do red blood cells and bone marrow precursors equal?

Erythron.

What does a decrease in hemoglobin decrease in kidneys?

It decreases tissue oxygen tension.

What do RBCs need energy for?

To operate membrane pumps for maintaining ion channels.

Where do RBCs get digested by macrophages?

80-90% in spleen and liver, 10-20% in vessels.

True or False: The 3% dissolved in plasma is measured as PO2.

True.

What does the oxygen-hemoglobin dissociation curve describe?

It describes the relationship between PO2 (pressure) and SO2 (saturation).

In what three forms is CO2 transported?

As dissolved gas (3%), as bicarbonate ion (75%), and in association with hemoglobin forming carbaminohemoglobin (20%).

True or False: Carbaminohemoglobin releases CO2 in the lungs which we exhale out.

True.

What are the RBC disorders?

Anemia (deficit RBC) and polycythemia (excess RBC).

What is the pathogenesis of aplastic anemia?

A stem cell disorder characterized by reduction of hematopoietic tissue and fatty marrow replacement.

What does anemia chronic renal failure cause?

It causes impaired erythropoietin production (EPO).

Anemia in relation to vitamin B12 or Folate deficiency causes a disruption in what?

Disruption in DNA synthesis of blast cells producing megaloblasts (macrocytic).

What is the most common cause of anemia?

Iron deficiency anemia.

True or False: Thalassemia has increased RBC destruction referred to as hemolysis.

True.

For hemolytic newborns, what is clinically relevant?

Rh incompatibility.

Polycythemia can be defined as?

Excess RBC resulting in increased blood viscosity which can lead to hypertension.

What are the three types of polycythemia?

Polycythemia Vera, Secondary Polycythemia, Relative Polycythemia.

What does the circulatory circuit do?

It functions in absorption and delivery of nutrients, oxygen uptake and delivery, and removal of waste products.

How long does it take to move 5 liters of blood through the entire circuit?

Approximately 1 minute.

What do arteries contain in comparison to veins?

Arteries contain elastic tissue, whereas veins contain elastic tissue only in large veins.

What does the intima layer function in?

It protrudes into the lumen creating valves that prevent the backflow of blood.

True or False: Blood flow is measured as a given number of liters or milliliters per second, minute, or hour.

True.

Describe how pressure works in blood flow.

Blood moves from areas of higher pressure (arteries) to areas of lower pressure (veins). Greater pressure difference equals greater blood flow.

What are the determinants of vascular resistance?

Vessel length, vessel radius, and blood viscosity.

True or False: The longer the blood vessels, the higher the resistance and lower the flow.

True.

Where is turbulent flow generated?

At a vessel bifurcation.

What is clinically important in capillaries?

The capillary fluid pressure and plasma colloid osmotic pressure.

What are the controls of blood flow?

Extrinsic mechanisms (central) and intrinsic mechanisms (local).

What happens when systemic vascular resistance is increased?

It causes the heart to work harder to meet metabolic demands of the body.

Thrombosis is initiated by alterations in what?

Blood flow: slow or turbulent flow; blood vessel wall: damage or inflammation to the intimal wall of the vessel; blood coagulability: emergence of a hypercoagulable state.

Arterial thrombosis is classified as?

Clot within an artery reduces flow and increases turbulence, which enhances thrombus enlargement and formation of more thrombi.

True or False: Venous thrombosis symptoms may be absent or may be life-threatening secondary to pulmonary embolism.

True.

What is the major reason for arterial disease?

Atherosclerosis.

What is atherosclerosis an underlying condition of?

Hypertension, renal disease, cardiac disease, and peripheral arterial disease.

Where are aneurysms mostly found?

Frequently found in cerebral circulation and thoracic and abdominal aorta.

Alterations in venous flow can be accompanied with?

Edema, venous stasis, inflammation, ulcers, and pain.

True or False: Lymphedema is most common in the U.S. because of lymph node removal and radiation.

False; secondary lymphedema is more common.

Systemic arterial blood pressure is the result of what?

The physiologic result of cardiac output and the resistance to the ejection of blood from the heart.

What is the difference between systolic and diastolic pressure?

Systolic pressure is when blood is ejected from ventricles (high), and diastolic pressure is sustained pressure when ventricles relax (lower).

What is used clinically as part of cardiovascular assessment?

Mean Arterial Pressure (MAP) is the calculated average pressure within the circulatory system.

Which Korotkoff sounds are classified as systolic and diastolic pressure?

Phase I: initiation of a clear tapping sound (systolic pressure); Phase V: disappearance of sound (diastolic pressure).

According to the American Heart Association, what are the guidelines for hypertension grade 1 and 2 for both pressures?

Grade 1: Systolic (130-139mmHg), Diastolic (80-89mmHg); Grade 2: Systolic (≥140mmHg), Diastolic (≥90mmHg).

What mediates the short term regulation mechanism of blood pressure?

The sympathetic branch of the autonomic nervous system.

What activates the vasomotor center directly and indirectly?

Directly activated by various stimuli or indirectly via pressure sensitive baroreceptors.

Do beta receptors of the heart increase or decrease heart rate?

Beta receptors increase heart rate.

When the kidney is stimulated by low arterial pressure, what happens?

Release of renin, which activates angiotensinogen to angiotensin 1.

What is the function of aldosterone?

To cause reabsorption of sodium, and water passively follows.

What is the most common primary diagnosis in the U.S.?

Hypertension.

Describe hypertensive crisis.

Systolic over 180 and diastolic over 120.

True or False: Primary essential hypertension is often caused by unknown reasons.

True.

What does the silent killer refer to?

Primary hypertension, as damage occurs before diagnosis.

What constitutes a hypertensive emergency?

A sudden increase in either or both systolic and diastolic pressure with evidence of end-organ damage.

Describe the circulatory system.

Left-sided heart chambers produce the force to propel blood through the systemic circulation.

What supplies blood to the heart muscle?

Coronary arteries.

Describe the cardiac cycle.

Each heartbeat consists of ventricular contraction (systole) followed by relaxation (diastole).

What does blood flow equal to?

Blood flow = pressure/resistance.

What are the two determinants of coronary vascular resistance?

Artery diameter and varying degrees of external compression.

What are the two general cardiac myocytes?

Working cells (mechanical pumping functions) and electrical cells (transmit electrical impulses).

How do heart cells store excess ATP?

As creatine phosphate (CP) via the enzyme creatine kinase (CK).

True or False: Both cardiac contraction and relaxation require energy.

True.

Describe the determinants of stroke volume.

Preload, contractility, afterload.

What is cardiac output (CO)?

The amount of blood pumped out of the heart each minute.

What is stroke volume (SV)?

The amount of blood ejected from the ventricle with each contraction.

What is the hallmark of diastolic dysfunction with preserved ejection fraction?

The hallmark is low cardiac output, congestion, and edema formation with normal ejection fraction.

What is increased preload defined as?

A compensatory mechanism that enhances the ability of the myocardium to contract more forcefully.

What is the difference between forward and backward heart failure?

Forward failure is insufficient cardiac pumping; backward failure is the congestion of blood behind the pumping chamber.

True or False: Biventricular heart failure is most often the result of primary left ventricular failure that has progressed to right sided heart failure.

True.

What is the cardinal sign associated with left heart failure?

Pulmonary congestion.

True or False: Beta blockers inhibit SNS effects.

True.

What are dysrhythmias significant for?

Indicating an underlying pathophysiologic disorder and impairing normal cardiac output.

What are factors that cause dysrhythmia?

Hypoxia, electrolyte imbalance, trauma, inflammation, and drugs.

What is the difference between tachycardia and bradycardia?

Tachycardia is fast heart rate; bradycardia is slow heart rate.

What is the difference between sinus arrhythmia and sinus arrest?

Sinus arrhythmia is variability in heart rate; sinus arrest is a flat trace for a few seconds.

True or False: Escape rhythms are associated with low cardiac output.

True.