patho final

Hydrostatic Pressure

  • Definition: Pressure that blood exerts in capillaries.

  • Fluid Movement: Fluid moves out through pores into interstitial spaces.

Heart Failure Effects

Backward Effect

  • Cause: Weak left ventricle leads to a backup of hydrostatic pressure.

  • Affected Areas: Left atrium, pulmonary veins, and pulmonary capillaries.

  • Result: Hydrostatic pressure increases in the lungs, leading to fluid accumulation in the pulmonary interstitium, often causing pulmonary edema.

Symptoms (SIS) of Left Ventricular Failure:

  • Cough: Pink frothy sputum indicates pulmonary edema.

  • Pulmonary Crackles: Widespread coarse, loud crackles suggest pulmonary issues.

  • Dyspnea: Difficult or labored breathing.

  • Cyanosis: A bluish discoloration due to lack of oxygen.

  • Orthopnea: Shortness of breath when lying flat.

  • Sounds: Observed through stethoscope.

  • Paroxysmal Nocturnal Dyspnea (PND): Sudden shortness of breath that awakens patients at night.

Forward Effect

  • Weak left ventricle affects forward pumping of blood into the aorta, peripheral, and cerebral arteries.

  • Kidneys' Response: Sensing low circulation due to weak pumping, they release renin, activating the Renin-Angiotensin-Aldosterone System (RAAS).

Symptoms of Forward Effect:

  • Cool, pale extremities.

  • Decreased peripheral pulses.

  • Confusion or disorientation.

  • Sounds: Observed through stethoscope.

  • Edema: Fluid accumulation in tissues.

  • Nocturia: Increased urination at night.

Right Ventricular Failure

Backward Effect

  • Cause: Weak right ventricle causes backup of hydrostatic pressure into the right atrium, superior vena cava, and jugular veins, leading to venous congestion.

  • Affected Areas: Inferior vena cava, gastrointestinal tract, peritoneal cavity, hepatic and splenic veins.

Symptoms (SIS) of Right Ventricular Failure:

  • Jugular Vein Distention: Visible swelling of jugular veins (JVD).

  • Swelling: Generalized edema due to fluid retention.

  • Weight Gain: Often due to fluid retention.

  • Gastrointestinal Symptoms: Anorexia and indigestion.

  • Ascites: Accumulation of fluid in the abdominal cavity, causing abdominal swelling.

  • Hepatojugular Reflux: Increased jugular vein distention when applying pressure to the liver.

  • Hepatomegaly: Enlargement of the liver.

  • Splenomegaly: Enlargement of the spleen.

  • Ankle/Sacral Edema: Swelling in lower extremities.

  • Sounds: S4 heart sound observed through stethoscope.

    Risk Factors for Heart Failure: · Age (65+) · Sleep apped · Ethnicity (AA) · Congenital Heart defects · Family History · Alcohol abuse · Diabetes · Kidney Condition · Obesity · Hypertension - - Ischemic stroke: result from an obstruction in cerebral flow by thrombus /embolus. arteriosclerosis Two main etiologies : atrial fibrillation 1 . ) A thromboembolism commonly J cause obstruction of a branch of a cerebral carotid stenosis. artery . Commonly, a piece of arteriosclerotic plaque break away from an area of carotid artery stenosis and travels up to a branch of the middle cerebral artery. 2) The left atrium undergoes atrial fibrillation with stasis of blood & clot formation. The clot travels from the left atrium into the left ventricle into the aorta & upward into the carotid artery into a cerebral artery. SIS: · Motor & sensory loss is evident on the opposite side of the body · Hemiparesis (weakness) Hemiplegia (paralysis) · If left hemisphere undergoes Ischemia, will suffer aphasia.(osability to und