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Questions and Answers
Which of the following conditions can cause altered flow due to mechanical compression?
Which of the following conditions can cause altered flow due to mechanical compression?
Inflammation can only affect venous flow, not arterial flow.
Inflammation can only affect venous flow, not arterial flow.
False (B)
What are the three pathologic processes involved in arteriosclerosis/atherosclerosis?
What are the three pathologic processes involved in arteriosclerosis/atherosclerosis?
Mönckeberg sclerosis, arteriolar sclerosis, and atherosclerosis
Lymphedema is a condition caused by impairment in the circulation of ______.
Lymphedema is a condition caused by impairment in the circulation of ______.
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Match the following conditions with their corresponding type of altered flow:
Match the following conditions with their corresponding type of altered flow:
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What is the underlying pathologic condition that can lead to hypertension, cardiac and renal disease, peripheral arterial disease, and stroke?
What is the underlying pathologic condition that can lead to hypertension, cardiac and renal disease, peripheral arterial disease, and stroke?
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What is the main function of lymph vessels?
What is the main function of lymph vessels?
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Vasospasm is an example of mechanical alteration that affects arterial flow.
Vasospasm is an example of mechanical alteration that affects arterial flow.
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Which of the following factors is modifiable and can help reduce the risk of atherosclerosis?
Which of the following factors is modifiable and can help reduce the risk of atherosclerosis?
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High levels of HDL cholesterol inhibit atherosclerosis.
High levels of HDL cholesterol inhibit atherosclerosis.
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What is the first-line treatment for arteriosclerosis and atherosclerosis?
What is the first-line treatment for arteriosclerosis and atherosclerosis?
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Stress and __________ increase the risk of arterial diseases.
Stress and __________ increase the risk of arterial diseases.
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Which test is NOT used for the diagnosis of arteriosclerosis?
Which test is NOT used for the diagnosis of arteriosclerosis?
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Match the risk factors with their nature (modifiable or nonmodifiable):
Match the risk factors with their nature (modifiable or nonmodifiable):
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Thromboangiitis obliterans is commonly known as Buerger disease.
Thromboangiitis obliterans is commonly known as Buerger disease.
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What is the recommended treatment for Thromboangiitis obliterans?
What is the recommended treatment for Thromboangiitis obliterans?
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What is a thrombus?
What is a thrombus?
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Arterial obstruction results in increased pressure upstream of the blockage.
Arterial obstruction results in increased pressure upstream of the blockage.
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What are the clinical manifestations of venous thrombosis?
What are the clinical manifestations of venous thrombosis?
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The clinical consequence of arterial obstruction is __________.
The clinical consequence of arterial obstruction is __________.
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Which of the following can lead to thrombosis?
Which of the following can lead to thrombosis?
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Match the type of obstruction with its consequence:
Match the type of obstruction with its consequence:
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Phlebitis refers to the inflammation of a vein without a clot.
Phlebitis refers to the inflammation of a vein without a clot.
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What are preventive measures for thrombosis?
What are preventive measures for thrombosis?
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What primarily composes an atherosclerotic plaque?
What primarily composes an atherosclerotic plaque?
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Cessation of smoking can lead to a 50% risk reduction for coronary heart disease within a year.
Cessation of smoking can lead to a 50% risk reduction for coronary heart disease within a year.
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What factors can tobacco injury produce that affect cardiovascular health?
What factors can tobacco injury produce that affect cardiovascular health?
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The process through which low-density serum lipoproteins breach the intimal layer is known as __________.
The process through which low-density serum lipoproteins breach the intimal layer is known as __________.
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Match the risk factors with their effects on arterial health:
Match the risk factors with their effects on arterial health:
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Which of the following interventions can lead to reduced risk for coronary heart disease?
Which of the following interventions can lead to reduced risk for coronary heart disease?
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Hypertension does not contribute to the progression of atherosclerosis.
Hypertension does not contribute to the progression of atherosclerosis.
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Name one disease that can result from atherosclerosis.
Name one disease that can result from atherosclerosis.
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Which of the following treatments can be used to enhance circulation in Raynaud Syndrome?
Which of the following treatments can be used to enhance circulation in Raynaud Syndrome?
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Dissecting aortic aneurysms are not considered a medical emergency.
Dissecting aortic aneurysms are not considered a medical emergency.
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What are the classic signs and symptoms of acute arterial occlusion?
What are the classic signs and symptoms of acute arterial occlusion?
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Aneurysms are classified as true or _______ aneurysms.
Aneurysms are classified as true or _______ aneurysms.
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Match the types of aneurysms with their prospective locations:
Match the types of aneurysms with their prospective locations:
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Which diagnostic test is most commonly used for diagnosing cerebral aneurysms?
Which diagnostic test is most commonly used for diagnosing cerebral aneurysms?
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Intrinsically produced mediators play a role in Raynaud Syndrome.
Intrinsically produced mediators play a role in Raynaud Syndrome.
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List one treatment used for dissecting aortic aneurysms.
List one treatment used for dissecting aortic aneurysms.
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Which treatment is NOT commonly used for acute arterial occlusion?
Which treatment is NOT commonly used for acute arterial occlusion?
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Incompetent valves can lead to varicose veins and chronic venous insufficiency.
Incompetent valves can lead to varicose veins and chronic venous insufficiency.
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What is a common method for treating venous ulcers?
What is a common method for treating venous ulcers?
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The most commonly affected vein in varicose veins is the __________.
The most commonly affected vein in varicose veins is the __________.
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Which condition can be life-threatening if not treated?
Which condition can be life-threatening if not treated?
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Excessive venous pressures can result in overstretching of heart valves.
Excessive venous pressures can result in overstretching of heart valves.
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Treatment for varicose veins may include __________ and surgical interventions in severe cases.
Treatment for varicose veins may include __________ and surgical interventions in severe cases.
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Match the following conditions with their descriptions:
Match the following conditions with their descriptions:
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Study Notes
Chapter 15: Alterations in Blood Flow
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Learning Objectives
- Explain the development of arterial and venous obstructions.
- Identify the consequences of acute and chronic arterial obstruction.
- Identify the consequences of superficial and deep venous obstructions.
General Mechanisms Causing Altered Blood Flow
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Reduction in blood flow impairs the transport of gases and nutrients, resulting in:
- Hypoxia
- Ischemia
- Venous engorgement
- Venous obstruction
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Blood Vessel Obstructions:
- Obstruction reduces flow downstream and increases pressure upstream.
- Arterial obstructions lead to distal ischemia.
- Venous obstructions lead to edema.
Thrombosis
- Thrombus: A stationary blood clot formed within a blood vessel or heart chamber.
- Causes: Slowing or turbulence of blood flow; damage to vessel walls; medications.
- Arterial thrombosis: Results in ischemia.
- Venous thrombosis: Results in edema.
- Inflammation in a vein: Phlebitis
- Inflammation with a clot in a vein: Thrombophlebitis
Clinical Manifestations of Thrombosis
- Arterial: Intermittent claudication, cool, cyanotic skin, painful ulcer around one toe.
- Venous: None to life-threatening (pulmonary embolism); calf/groin tenderness, swelling, and Homan's sign.
Treatment of Thrombosis
- Anticoagulant therapy to prevent clot enlargement.
- Thrombolytic drugs may be required.
- Additional interventions include antiembolic stockings or sequential compression devices. Ambulation is encouraged.
- Surgery may be an option to remove the thrombus.
Embolus
- Thromboembolus: A clot that travels within the bloodstream.
- Embolus leaving the left ventricle: Ischemic stroke (symptoms vary based on the impacted brain area).
- Embolus leaving the right ventricle: Pulmonary embolism (sudden onset of shortness of breath, increased respiratory rate, chest pain, and sudden death). Treatment involves embolectomy or a filter in the inferior vena cava (Greenfield filter).
Vasospasm
- Sudden constriction of arterial smooth muscles obstructing blood flow.
- Potential causes include hormonal changes, food additives, and environmental factors.
- Associated manifestations include Prinzmetal angina, hemorrhagic stroke, and migraine headaches.
Inflammation
- Can increase the risk of thrombotic processes.
- Vasculitis: Inflammation of the artery's intima.
- Phlebitis: Inflammation of the vein's lining.
- Arteritis: Inflammatory process of autoimmune origin in arteries.
Mechanical Compression
- External forces on the vascular system can cause partial or complete obstruction.
- Causes include trauma, tight casts, dressings, or stockings.
- Compartment syndrome is a possible consequence.
Blood Vessel Structural Alterations
- Types of structural alterations: Valvular incompetence, arteriosclerosis/atherosclerosis, aneurysms, and arteriovenous fistulas.
Lymphatic Vessels
- Changes in capillary or interstitial oncotic pressure increase filtration into tissues.
- This results in edema, and impairment in lymph circulation.
Alterations in Arterial Flow
- Obstruction: Artherosclerosis/atherosclerosis, inflammation, vasospasm, thrombi/emboli, acute occlusion, mechanical alterations, and arteriovenous fistulas/aneurysms.
Arteriosclerosis/Atherosclerosis
- Three pathologic processes include Mönckeberg sclerosis, arteriolar sclerosis, and atherosclerosis.
- Atherosclerosis underlies hypertension, cardiac disease, renal disease, peripheral disease, and stroke. The goal is modifiable risk reduction.
Atherosclerosis Details
- Low-density lipoproteins breach the intimal layer.
- Oxidization of lipids causes further damage to the vessel.
- Platelets aggregate, releasing growth factors, stimulating smooth muscle cell growth.
- Smooth muscle cells proliferate within the damaged endothelium.
- Resulting plaque is composed of smooth muscle cells, lipoproteins, and inflammatory debris, decreasing the lumen and affecting blood flow.
- Complications can include hypertension, cardiac disease, renal disease, peripheral arterial disease, stroke, and myocardial infarction.
- Modifiable risk reduction focuses on smoking cessation, physical activity, managing blood pressure and cholesterol levels, managing stress levels, reducing glucose intolerance and obesity.
- Diagnosis uses Doppler flow, plethysmography, ankle-brachial index, exercise/stress test, and angiography.
Treatment
- First line treatment is non-pharmacological: weight reduction, smoking cessation, exercise, low-fat diet. If unsuccessful, medications are added. Surgical options include balloon/laser angioplasty, stents, and CABG.
- Thromboangiitis Obliterans (Buerger Disease): Rare inflammatory condition causing obstruction in small and medium arteries/veins, requiring smoking cessation and prostaglandins.
- Raynaud Syndrome: Extreme vasoconstriction of digits in response to cold or stress, requiring biofeedback, relaxation techniques, calcium-channel blockers, sympatholytics, and prostaglandins for treatment.
Alterations in Venous Flow
- Incompetent valves: Obesity, pregnancy, and right heart failure can lead to varicose veins, chronic venous insufficiency, and deep vein thrombosis with edema, ulcers, and pain.
- Valvular incompetence: Excessive venous pressures cause valve overstretching, resulting in backflow and venous insufficiency. Treatment focuses on smoking cessation and regular exercise.
- Varicose veins: Impaired venous return causes increased capillary pressure, edema, and darkened, raised, and tortuous veins. Often affect the greater saphenous vein. Treatment is directed toward increasing venous flow and reducing venous pressure, sometimes with sclerotherapy or surgery.
- Chronic venous insufficiency: Valvular incompetence leads to deep vein problems, with venous stasis ulcers being common. Treatment involves compression therapy and controlling infection.
- Deep vein thrombosis: Most often caused by thrombi in deep veins, often in the lower extremities. Symptoms may be absent. Aggressive anticoagulation therapy is used. Previous occurrences of DVT are a risk factor for future problems.
Alterations in Lymphatic Flow
- Lymphedema: Obstruction/alterations in lymphatic flow cause swelling, particularly in extremities. Primary lymphedema has a congenital or lymphatic system dysfunction root cause. Secondary lymphedema stems from diseases or surgical procedures. Treatment often includes external compression therapy, exercise, and surgical resection (if applicable).
Acute Arterial Occlusion
- Absence of arterial circulation needing immediate intervention. May be caused by thrombi/emboli or compression. Classic indicators (6 P's) include pallor, paresthesia, paralysis, pain, polar, and pulselessness.
- Treatment options include loosening tight dressings, cutting casts, anticoagulant/thrombolytic therapy, bypass surgery, and embolectomy or amputation in severe cases.
Aneurysms
- Localized arterial dilations; categorized as true (involving all layers of the vessel) or false aneurysms (weakened vessel wall). Often found in cerebral circulation, thoracic, or abdominal aorta. Dissecting aortic aneurysms require urgent medical/surgical treatment.
- Symptoms include increasing intracranial pressure, hemorrhagic stroke, sudden tearing pain radiating to the back or abdomen, and shock. Diagnosis can use CT, MRI, or angiography.
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Description
This quiz covers the critical concepts of blood flow alterations as discussed in Chapter 15. It focuses on the development and consequences of arterial and venous obstructions, along with the mechanisms leading to altered blood flow, such as thrombosis. Understand how these conditions affect gas transport and nutrient delivery in the body.
