Patho Study Guide III

Patho Study Guide III - Pathophysiology Study Guide: Exam...

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Pathophysiology Study Guide: Exam III Cardiac – 28 questions Heart failure (difference bet. right and left, what happens) – 6 Inability of heart to properly function as a pump in providing enough oxygen to the body in order to carry out metabolic processes, accounts for most frequent hospitalizations for those over 65 o Causes – MI, valve problems, arrhythmias, hypertension, anemia, hypo or hyperthyroidism, volume overload o Preload – myocardial fiber length of the left ventricle at end of diastole, determined by the end-diastolic volume o Afterload – stress or tension that develops in the ventricular wall during systole o Systolic HF – difficulty emptying left ventricle which implies impairment in the ability of myocardium to contract o Decrease in CO = decrease in BP stimulation of the SNS = increased rate and force of ventricular contraction o Decrease in CO = renin-angiotensinogen aldosterone = increase in blood volume and BP o Frank-Starling law of heart – increase in diastolic fiber length = increased force of heart recoil = increase in stroke work and volume (the more you stretch a fiber, the more vigorously it will respond ) o Hypertrophy and/or dilation (ventricular remodeling) – before symptoms of HF, involves hypertrophy of myocytes (not as efficient in contracting) larger ventricular mass change in shape of ventricle and makes it a less effective pump, most reliable measure of how disease is progressing (how big ventricle is) o Diastolic HF – ventricles can’t fill properly , associated with left ventricular hypertrophy and systemic hypertension o LVEDP (left ventricular end diastolic pressure) >20 mm Hg, so left atrium pressure has to be increased to get blood into ventricle, then it backs up into the lungs Forward HF – decrease in oxygen Backward HF o Symptoms related to lungs = left-sided heart failure (high pressure in lungs) Impairs the pumping of blood from pulmonary circulation into arterial circulation Decrease in CO, increase in left atrial and left ventricular and end-diastolic pressures , congestion in the pulmonary circulation Causes – acute myocardial infarction and cardiomyopathy Signs & symptoms - dyspnea on exertion, rales (sound heard at base of lungs first), coughing, S3 sound, orthopnea (have to be sitting to breathe), pulmonary edema o Systemic effects = right-sided heart failure (follows left HF because of increased pressure put on right ventricle, can get right without the left if you have long-standing pulmonary disease = cor pulmonale) Impairs the ability to move deoxygenated blood from the systemic circulation into the pulmonary circulation , a damming back of blood occurs leading to its accumulation in the systemic venous system increase in right atrial, right ventricular, and systemic venous pressures Causes – stenosis or regurgitation of the tricuspid or pulmonic valves, right ventricular infarction, cardiomyopathy, persistent left-sided failure
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This note was uploaded on 04/18/2008 for the course HS 032 taught by Professor Rugemer during the Spring '07 term at BC.

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Patho Study Guide III - Pathophysiology Study Guide: Exam...

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