Pathophysiology Final Exam PDF

**[Pathophysiology Test Review]** - - **[Most serious complication of dislodging deep vein thrombosis]** - Deep vein thrombosis can be serious because blood clots in the veins can break loose. The clots can then travel through the bloodstream and get stuck in the lungs, blocking blood flow...

**[Pathophysiology Test Review]** - - **[Most serious complication of dislodging deep vein thrombosis]** - Deep vein thrombosis can be serious because blood clots in the veins can break loose. The clots can then travel through the bloodstream and get stuck in the lungs, blocking blood flow (pulmonary embolism). When DVT and pulmonary embolism occur together, it\'s called venous thromboembolism (VTE). - **[Blood flow through the heart and lung]**. How the blood flows through the heart. - **The [tricuspid valve](https://my.clevelandclinic.org/health/body/21851-tricuspid-valve)** connects your right atrium and right ventricle. - **The [pulmonary valve](https://my.clevelandclinic.org/health/body/24273-pulmonary-valve)** connects your right ventricle and main pulmonary artery (large artery that carries blood to your lungs). - **The [mitral valve](https://my.clevelandclinic.org/health/body/23244-mitral-valve)** connects your left atrium and left ventricle. - **The [aortic valve](https://my.clevelandclinic.org/health/body/22458-aortic-valve)** connects your left ventricle and aorta (large artery that carries blood away from your heart to the rest of your body). **On the right side** 1. Oxygen-poor blood from all over your body enters your right atrium through two large veins, your superior [[vena cava]](https://my.clevelandclinic.org/health/body/22619-vena-cava) and inferior vena cava. These veins drain blood from your upper body and lower body, respectively, and directly empty it into your right atrium. 2. Your tricuspid valve opens to let blood travel from your right atrium to your right ventricle. 3. When your right ventricle is full it squeezes, which closes your tricuspid valve and opens your pulmonary valve. 4. Blood flows through your main [[pulmonary artery]](https://my.clevelandclinic.org/health/articles/21486-pulmonary-arteries) and its branches to your lungs, where it gets oxygen and releases carbon dioxide. **On the left side** 1. Oxygen-rich blood travels from your lungs to your left atrium through large veins called [[pulmonary veins]](https://my.clevelandclinic.org/health/body/23242-pulmonary-veins). These veins directly empty the blood into your left atrium. 2. Your mitral valve opens to send blood from your left atrium to your left ventricle. 3. When your left ventricle is full it squeezes, which closes your mitral valve and opens your aortic valve. 4. Your heart sends blood through your aortic valve to your aorta, where it flows to the rest of your body. **[Chronic arterial obstructions -- signs and symptoms. Manifestations. ]** Obstructive coronary artery disease is the gradual narrowing or closing of arteries that supply the heart with blood. This blockage is usually caused by a build-up of plaque (atherosclerosis). If the blockage gets severe enough, it can limit or block the flow of oxygen-rich blood needed by the heart's muscle. Sometimes a blockage can occur acutely. This is called a heart attack and requires immediate medical attention. Obstructive coronary artery disease is sometimes called coronary heart disease (CHD), though that term can include additional conditions as well. CHD is the leading cause of death in women and men. While men are more likely than women to have a heart attack, women are more likely to die from their heart attack. A gradual process called atherosclerosis causes obstructive coronary artery disease. Fat and cholesterol carried by the blood collect in the arteries and form deposits, called plaques. These plaques can eventually narrow or block arteries. They can also break open, or rupture. If that happens, clots can form, stopping blood flow suddenly and completely (a heart attack). If you have these risk factors, you should consult a doctor and may need regular checkups. Our doctors may recommend lifestyle changes, either as a preventive step or as part of your treatment after diagnosis. **[Factors for obstructive coronary artery disease include:]** Risk Cholesterol deposition (atherosclerosis) or inflammation in damaged inner walls of the arteries is the main cause. The risk factors for inner wall damage include: High blood pressure High blood cholesterol levels Tobacco use or smoking Diabetes Family history of heart diseases Obesity Sedentary lifestyle Age - The older age increases the risk of narrowing arteries Gender: Men are at higher risk Increased stress **[Pain characteristics - Chronic venous insufficiency]** **Symptoms of chronic venous insufficiency include:** Dull aching, cramping or heavy feeling in the legs Leg swelling Pain that worsens when you stand and improves when you put your legs up Tingling sensation in the legs Visible varicose veins on the surface ECG wave complexes.  **[What are the major factors influencing stroke Volume]** Several factors influence stroke volume, including: - **Preload**: Preload refers to the degree of stretch on the cardiac muscle fibers just before contraction. An increase in preload, such as an increase in venous return, leads to greater stretch of the cardiac muscle fibers, resulting in increased force of contraction and consequently, increased stroke volume. - **Afterload**: Afterload refers to the resistance against which the heart must pump blood. An increase in afterload, such as in conditions like hypertension, can impede the ejection of blood from the left ventricle, leading to a decrease in stroke volume. - **Contractility:** Contractility refers to the intrinsic strength of the cardiac muscle contraction. An increase in contractility, often mediated by sympathetic nervous system stimulation or certain medications, enhances the force of contraction and increases stroke volume. - **Heart Rate**: Heart rate is the number of times the heart beats per minute. At higher heart rates, there is less time for ventricular filling during diastole, resulting in decreased stroke volume. **[Primary and secondary hypertension. What can cause secondary hypertension.]** Most of the time, secondary hypertension is caused by problems with the adrenal glands or the arteries supplying the kidneys. Diagnosing and treating the underlying condition often improves or even resolves a person\'s elevated blood pressure. - **Diabetes complications (diabetic nephropathy).** Diabetes can damage the kidneys\' filtering system, which can lead to high blood pressure. - **Polycystic kidney disease.** In this inherited condition, cysts in the kidneys interfere with kidney function and can raise blood pressure. - **Glomerular disease.** Kidneys remove waste and sodium using tiny filters called glomeruli. In glomerular disease, these filters become swollen. This may raise blood pressure. - **Renovascular hypertension.** This type of high blood pressure is caused by narrowing (stenosis) of one or both arteries leading to the kidneys. Medical conditions affecting hormone levels also may cause secondary hypertension. These conditions include: - **Cushing syndrome.** In this condition, corticosteroid medications may cause secondary hypertension, or hypertension may be caused by a pituitary tumor or other factors that cause the adrenal glands to produce too much of the hormone cortisol. - **Aldosteronism.** The adrenal glands produce too much of the hormone aldosterone. This makes the kidneys retain salt and water and lose too much potassium, which raises blood pressure. - **Pheochromocytoma.** This rare tumor, usually found in an adrenal gland, produces too much of the hormone's adrenaline and noradrenaline. Having this tumor can lead to long-term high blood pressure or short-term spikes in blood pressure. - **Thyroid problems.** When the thyroid gland doesn\'t produce enough thyroid hormone (hypothyroidism) or produces too much thyroid hormone (hyperthyroidism), high blood pressure can result. - **Hyperparathyroidism.** The parathyroid glands control levels of calcium and phosphorus in the body. If the glands release too much parathyroid hormone, the amount of calcium in the blood rises --- which triggers a rise in blood pressure. Other possible causes of secondary hypertension include: - **Coarctation of the aorta.** In this condition, present at birth, the body\'s main artery (aorta) is narrowed (coarctation). This forces the heart to pump harder to get blood through the aorta and to the rest of the body. As a result, blood pressure increases --- particularly in the arms. - **Sleep apnea.** In this condition, often marked by severe snoring, breathing repeatedly stops and starts during sleep, causing a lack of oxygen. - **Obesity.** As body weight increases, the amount of blood flowing through the body increases. This increase in blood flow puts added pressure on artery walls, increasing blood pressure. - **Pregnancy.** Pregnancy can make existing high blood pressure worse or cause high blood pressure to develop (pregnancy-induced hypertension or preeclampsia). - **Medications and supplements.** Various prescription medications --- such as pain relievers, birth control pills, antidepressants and drugs used after organ transplants --- can cause or worsen high blood pressure in some people. **[What is a sign of acute arterial obstruction and what is NOT]** Acute arterial occlusion is a blockage in one of your peripheral arteries that prevents blood from flowing to one of your limbs. It usually occurs in your legs, and blood clots are the most common cause. This is a medical emergency that needs prompt care to restore oxygen to your affected limb and improve your chances of survival. What is age related circulatory system changes. - A **slightly slower heart rate** due to fibrous tissue and fat deposits that develop in the body's natural pacemaker system that controls the heartbeat. The natural pacemaker (the SA node) also loses some of its cells. - The **heart fills more slowly** due to thickening of the heart wall, which can cause the heart chamber to hold less blood. - **Stiffening and thickening of heart valves**, which control the direction of blood flow, and the heart wall. This can decrease the heart's tolerance for exercise and other stressors. - **Slight thickening of capillary walls**, which may cause a slightly slower rate of exchange of nutrients and waste. - **Less flexibility, stiffness, and thickening of the aorta**, which can cause blood pressure to rise and make the heart work harder. - **Decrease in the production of certain white blood cells called neutrophils**, which are important to immunity. This can reduce your ability to resist infection. - **Slower production of red blood cells** during stress or illness, which creates a slower response to blood loss and anemia. Age is a predominant risk factor when it comes to risk of heart failure. In the United States, 50% of all heart failure diagnoses and 90% of all heart failure deaths occur in those aged 70 and above. Researchers credit these numbers with a "convergence of declining cardioprotective systems and increasing disease processes." What this means is that while cardiovascular changes are a normal part of aging, when combined with risk factors for heart disease that *are* modifiable, they can increase your risk of heart failure. For example, high blood pressure, cholesterol levels, diabetes, obesity, and smoking are all risk factors for heart disease that you can address to help lower your risk. **[What causes Vaso constriction]** [Vasoconstriction](https://www.osmosis.org/answers/vasoconstriction) is the narrowing of blood vessels, typically when the muscles of blood vessel walls become constricted, causing the vessel lumen to become smaller. [Vasoconstriction](https://www.osmosis.org/answers/vasoconstriction) can be a reaction to cold, [stress](https://www.osmosis.org/learn/Stress), [cigarette smoking](https://www.osmosis.org/learn/Tobacco_dependence), medications, or underlying medical conditions, such as the [Raynaud phenomenon](https://www.osmosis.org/learn/Raynaud_phenomenon).  Vasoconstriction signs and symptoms: Headaches, lightheadedness, pallor, cyanosis of affected tissues Complications: HJypertension, acute coronary events, ulcer formation, gangrene Various conditions can cause [vasoconstriction](https://www.osmosis.org/answers/vasoconstriction), including exposure to cold, as previously mentioned, and in times of [stress](https://www.osmosis.org/learn/Stress), where the [body](https://www.osmosis.org/answers/fruiting-body-of-aspergillus) produces stress hormones (e.g., [norepinephrine](https://www.osmosis.org/learn/Sympathomimetic_medications:_Nursing_pharmacology)) that narrow blood vessels. [Cigarette smoking](https://www.osmosis.org/learn/Tobacco_dependence) can also tighten blood vessels due to its [vasoconstrictive](https://www.osmosis.org/answers/vasoconstriction) substances, such as [nicotine](https://www.osmosis.org/learn/Drug_misuse,_intoxication_and_withdrawal:_Stimulants:_Pathology_review), which binds to receptors on the surface of the muscles in blood vessel walls stimulating their contraction.  Additionally, [vasoconstriction](https://www.osmosis.org/answers/vasoconstriction) can result from using certain medications, such as [nasal decongestants](https://www.osmosis.org/learn/Medications_to_control_airway_secretions:_Nursing_pharmacology) (e.g., [pseudoephedrine](https://www.osmosis.org/learn/Medications_to_control_airway_secretions:_Nursing_pharmacology)), which constrict nasal vessels, causing decongestion of the nasal mucosa; as well as [nonsteroidal anti-inflammatory drugs](https://www.osmosis.org/learn/Antiplatelet_agents:_Nursing_pharmacology) ([NSAIDs](https://www.osmosis.org/learn/Antiplatelet_agents:_Nursing_pharmacology)), which are used for a variety of inflammatory conditions, including [arthritis](https://www.osmosis.org/learn/Musculoskeletal_system:_Musculoskeletal_disorders) and the common cold. Moreover, [vasoconstriction](https://www.osmosis.org/answers/vasoconstriction) can be a sign of an underlying medical condition, like the [Raynaud phenomenon](https://www.osmosis.org/learn/Raynaud_phenomenon), which is a condition characterized by [vasoconstriction](https://www.osmosis.org/answers/vasoconstriction) of arterioles, or small arteries, near the skin. This condition most often affects the fingers and toes, which changes the [color](https://www.osmosis.org/learn/Colorectal_cancer:_Nursing) of the affected digits to white, blue, and red. The most common triggers for Raynaud phenomenon are emotional stress and exposure to cold temperatures. Raynaud phenomenon can be primary (i.e., occur on its own) or secondary to other diseases, including connective tissue disorders (e.g., [systemic lupus erythematosus](https://www.osmosis.org/learn/Systemic_lupus_erythematosus) and [scleroderma](https://www.osmosis.org/learn/Scleroderma)), as well as vasculitides, such as [Buerger disease](https://www.osmosis.org/learn/Buerger_disease:_Nursing) and [Takayasu](https://www.osmosis.org/learn/Vasculitis:_Pathology_review) arteritis. **[Systemic vascular resistance (decreased and increased) what happens to blood flow ]** What happens when systemic vascular resistance decreases? This reduction in systemic vascular resistance decreases afterload and leads to an increase in cardiac output. The subsequent increase in cardiac output leads to an increased oxygen delivery to the periphery supporting the increased basal metabolic rate and oxygen consumption. **Vascular resistance** is the resistance that must be overcome for [blood](https://en.wikipedia.org/wiki/Blood) to flow through the [circulatory system](https://en.wikipedia.org/wiki/Circulatory_system). The resistance offered by the systemic circulation is known as the **systemic vascular resistance** or may sometimes be called by another term **total peripheral resistance**, while the resistance caused by the [pulmonary circulation](https://en.wikipedia.org/wiki/Pulmonary_circulation) is known as the **pulmonary vascular resistance**. [Vasoconstriction](https://en.wikipedia.org/wiki/Vasoconstriction) (i.e., decrease in the diameter of [arteries](https://en.wikipedia.org/wiki/Artery) and [arterioles](https://en.wikipedia.org/wiki/Arteriole)) increases resistance, whereas [vasodilation](https://en.wikipedia.org/wiki/Vasodilation) (increase in diameter) decreases resistance. [Blood flow](https://en.wikipedia.org/wiki/Blood_flow) and [cardiac output](https://en.wikipedia.org/wiki/Cardiac_output) are related to [blood pressure](https://en.wikipedia.org/wiki/Blood_pressure) and inversely related to vascular resistance. Systemic vascular resistance (SVR). SVR=MAP -- CVP/CO X 80 SVR reflects changes in the arterioles, which can affect emptying of the left ventricle. For example, if the blood vessels tighten or constrict, SVR increases, resulting in diminished ventricular compliance, reduced stroke volume and ultimately a drop in cardiac output **[Know what the primary functions of the circulatory system. Gas exchange, nutrient delivery, etc]** The blood circulatory system (cardiovascular system) delivers nutrients and oxygen to all cells in the body and takes away waste. It consists of the heart and the blood vessels running through the entire body. The arteries carry blood away from the heart; the veins carry it back to the heart. The heart pumps oxygenated and deoxygenated blood on different sides. The types of blood vessels include arteries, capillaries and veins. Blood consists of: **Red blood cells** -- to carry oxygen **White blood cells** -- that make up part of the immune system **Platelets** -- needed for clotting **Plasma** -- blood cells, nutrients and wastes float in this liquid. The heart pumps blood around the body. It sits inside the chest, in front of the lungs and slightly to the left side. The heart is a double pump made up of four chambers, with the flow of blood going in one direction due to the presence of the heart valves. The contractions of the chambers make the sound of heartbeats. **The right side of the heart** The right upper chamber (atrium) takes in deoxygenated blood that is loaded with carbon dioxide. The blood is squeezed down into the right lower chamber (ventricle) and taken by an artery to the lungs where the carbon dioxide is replaced with oxygen. **The left side of the heart** The oxygenated blood travels back to the heart, this time entering the left upper chamber (atrium). It is pumped into the left lower chamber (ventricle) and then into the aorta (an artery). The blood starts its journey around the body once more. **Blood vessels** Blood vessels have a range of different sizes and structures, depending on their role in the body. **Arteries** Oxygenated blood is pumped from the heart along arteries, which are muscular. Arteries divide like tree branches until they are slender. The largest artery is the aorta, which connects to the heart and picks up oxygenated blood from the left ventricle. The only artery that picks up deoxygenated blood is the pulmonary artery, which runs between the heart and lungs. **Capillaries** The arteries eventually divide down into the smallest blood vessel, the capillary. Capillaries are so small that blood cells can only move through them one at a time. Oxygen and food nutrients pass from these capillaries to the cells. Capillaries are also connected to veins, so wastes from the cells can be transferred to the blood. **Veins** Veins have one-way valves instead of muscles, to stop blood from running back the wrong way. Generally, veins carry deoxygenated blood from the body to the heart, where it can be sent to the lungs. The exception is the network of pulmonary veins, which take oxygenated blood from the lungs to the heart. **Blood pressure** Blood pressure refers to the amount of pressure inside the circulatory system as the blood is pumped around. **Common problems** Some common problems of the circulatory system include: **Aneurysm** -- a weak spot in the wall of an artery **Atherosclerosis** -- a narrowing of the arteries caused by plaque deposits **Heart disease** -- lack of blood supply to the heart because of narrowed arteries **High blood pressure** -- can be caused by obesity (among other things) **Varicose veins** -- problems with the valves that stop blood from running backwards. **[When pt experiencing anaphylactic shock what do you see happening in the pt.]** Symptoms of anaphylaxis include: skin reactions such as [hives](https://www.healthline.com/health/hives), [flushed skin](https://www.healthline.com/health/skin-blushing-flushing), or [paleness](https://www.healthline.com/health/paleness) sudden feeling of warmth feeling like you have a [lump in your throat](https://www.healthline.com/health/lump-in-throat) or [difficulty swallowing](https://www.healthline.com/health/difficulty-in-swallowing) [nausea](https://www.healthline.com/symptom/nausea), [vomiting](https://www.healthline.com/symptom/vomiting), or [diarrhea](https://www.healthline.com/symptom/diarrhea) [abdominal pain](https://www.healthline.com/symptom/abdominal-pain) a [weak](https://www.healthline.com/symptom/weak-pulse) and rapid pulse runny nose and [sneezing](https://www.healthline.com/symptom/sneezing) [swollen tongue](https://www.healthline.com/symptom/tongue-swelling) or [lips](https://www.healthline.com/health/swollen-lips) [wheezing](https://www.healthline.com/symptom/wheezing) or [difficulty breathing](https://www.healthline.com/symptom/shortness-of-breath) a sense that something is wrong with your body tingling hands, feet, mouth, or scalp If anaphylaxis has progressed to anaphylactic shock, the symptoms include: difficulty breathing [dizziness](https://www.healthline.com/symptom/dizziness) [confusion](https://www.healthline.com/symptom/confusion) sudden feeling of weakness [loss of consciousness](https://www.healthline.com/symptom/fainting) **[Difference between stable and unstable angina. What will you see?]** **Stable angina** follows a pattern and occurs during physical exertion. [**Unstable angina** doesn\'t follow a pattern and can occur without physical exertion. It is more dangerous and may be a warning sign of an imminent heart attack](https://www.bing.com/ck/a?!&&p=c41acd01c359e1139a0fdbdfa75913e538b85a316c8a11c89ce12384d41d4251JmltdHM9MTczMzI3MDQwMA&ptn=3&ver=2&hsh=4&fclid=217b4b48-d34c-66f9-21a4-58cdd2e66729&psq=difference+between+stable+and+unstable+angina&u=a1aHR0cHM6Ly93d3cudmVyeXdlbGxoZWFsdGguY29tL3N0YWJsZS12cy11bnN0YWJsZS1hbmdpbmEtNzk2Nzk1NA&ntb=1) **Stable Angina** - Chest pain near the heart - Caused by the heart not getting enough blood flow and oxygen - Symptom of heart disease - Less serious, more common - Not always an emergency - Predictable - \"Stable\" consistent pattern - Triggered by exertion, exercise, strong emotions, anxiety, eating a big meal, etc. - Rest, relaxation, and calmness typically relieve symptoms - Usually lasts one to five minutes; rarely lasts longer than 15 minutes - Not classified as acute coronary syndrome (ACS) **Unstable Angina** - Chest pain near the heart - Caused by the heart not getting enough blood flow and oxygen - Symptom of heart disease - More serious, deadlier - Always an emergency - Unpredictable - \"Unstable\" nonexistent pattern - Not triggered by any predictable factors (often occurs out of the blue while reclining or sleeping) - Rest and relaxation do not quickly resolve symptoms - Often lasts longer than 15 minutes; can last 30 minutes or more - Classified as acute coronary syndrome (ACS) **Symptoms of left sided heart failure.** Left sided heart failure results in an accumulation of blood in the vessels that usually carry blood away from the lungs. - coughing, particularly during physical activity - shortness of breath - breathlessness while lying down or at nighttime - leg swelling - increased abdominal width - weight gain - upper right torso pain Shortness of breath ([dyspnea](https://www.medicalnewstoday.com/articles/314963)) tops the list of the most common symptoms of heart failure. Dyspnea occurs most often [during physical activity](https://www.medicalnewstoday.com/articles/dyspnea-on-exertion). It can also happen at night, prompting a person to get up from lying down to breathe more easily.Top of FormBottom of Form [Coronary artery disease](https://www.medicalnewstoday.com/articles/184130) and [long-term high blood pressure](https://www.medicalnewstoday.com/articles/150109) are the leading causes of left sided heart failure. [Heart attack](https://www.medicalnewstoday.com/articles/151444) can also cause this type of heart failure. **[Symptoms of Aortic stenosis.]** Aortic valve stenosis is a type of heart valve disease, also called valvular heart disease. The aortic valve is between the lower left heart chamber and the body\'s main artery, called the aorta. In aortic valve stenosis, the valve is narrowed and doesn\'t open fully. This reduces or blocks blood flow from the heart to the aorta and to the rest of the body. Symptoms of aortic valve stenosis may include symptoms may show up when narrowing of the valve is severe and may include: - - - - - Chest pain or tightness with activity. Feeling faint or dizzy or fainting with activity. Shortness of breath, especially with activity. Fatigue, especially during times of increased activity. Rapid, fluttering heartbeat. **[Symptoms of right sided heart failure.]** Fluid buildup leading to swelling (edema) in feet, ankles, legs, lower back, gastrointestinal tract, and liver (causing ascites). Breathlessness, Chest pain and discomfort, weakness and lethargy, fatigue. **[Compensatory responses to hypertrophy in right ventricle what is this in response to.] Pressure or volume overload** [Compensatory responses to hypertrophy in the right ventricle are an adaptive measure to maintain cardiac output and reduce wall stress](https://www.bing.com/ck/a?!&&p=9d9e8641b7732ae66f66cefd65a2bdd237e0e023f260dd60b9b9b220092e4656JmltdHM9MTczMzI3MDQwMA&ptn=3&ver=2&hsh=4&fclid=217b4b48-d34c-66f9-21a4-58cdd2e66729&u=a1aHR0cHM6Ly93d3cuZnJvbnRpZXJzaW4ub3JnL3Jlc2VhcmNoLXRvcGljcy8xMjEzNy9jYXJkaWFjLWh5cGVydHJvcGh5LWZyb20tY29tcGVuc2F0aW9uLXRvLWRlY29tcGVuc2F0aW9uLWFuZC1waGFybWFjb2xvZ2ljYWwtaW50ZXJ2ZW50aW9ucw&ntb=1). [These responses can be in response to pressure or volume overload](https://www.bing.com/ck/a?!&&p=9d9e8641b7732ae66f66cefd65a2bdd237e0e023f260dd60b9b9b220092e4656JmltdHM9MTczMzI3MDQwMA&ptn=3&ver=2&hsh=4&fclid=217b4b48-d34c-66f9-21a4-58cdd2e66729&u=a1aHR0cHM6Ly93d3cuZnJvbnRpZXJzaW4ub3JnL3Jlc2VhcmNoLXRvcGljcy8xMjEzNy9jYXJkaWFjLWh5cGVydHJvcGh5LWZyb20tY29tcGVuc2F0aW9uLXRvLWRlY29tcGVuc2F0aW9uLWFuZC1waGFybWFjb2xvZ2ljYWwtaW50ZXJ2ZW50aW9ucw&ntb=1). Confirm and diagnosis myocardial infarction. **[Tests to diagnose a heart attack or MI include:]** - **Electrocardiogram (ECG or EKG).** This first test done to diagnose a heart attack records electrical signals as they travel through the heart. Sticky patches (electrodes) are attached to the chest and sometimes the arms and legs. Signals are recorded as waves displayed on a monitor or printed on paper. An electrocardiogram (ECG) can show if you are having or have had a heart attack. - **Blood tests.** Certain heart proteins slowly leak into the blood after heart damage from a heart attack. Blood tests can be done to check for these proteins (cardiac markers). - **Chest X-ray.** A chest X-ray shows the condition and size of the heart and lungs. - **Echocardiogram.** Sound waves (ultrasound) create images of the moving heart. This test can show how blood moves through the heart and heart valves. An echocardiogram can help identify whether an area of your heart has been damaged. - **Coronary catheterization (angiogram).** A long, thin tube (catheter) is inserted into an artery, usually in the leg, and guided to the heart. Dye flows through the catheter to help the arteries show up more clearly on images made during the test. - **Cardiac computed tomography (CT) or Magnetic resonance imaging (MRI).** These tests create images of the heart and chest. Cardiac CT scans use X-rays. Cardiac MRI uses a magnetic field and radio waves to create images of your heart. For both tests, you usually lie on a table that slides inside a long tubelike machine. Each test can be used to diagnose heart problems. They can help show the severity of heart damage. **[Different types of anginas.]** There are four types of anginas: **Stable angina (above)** **Unstable angina (above)** **Microvascular angina** - Microvascular angina is a type of angina (chest pain) that happens because of problems in the small blood vessels bringing oxygenated blood to the heart. If the heart muscle doesn't get enough oxygen, it will be damaged and start to die. Small vessels spasm and the vessels don't widen the way they should. Microvascular angina can be treated with medicine and lifestyle changes. **Variant or Prinzmetal angina** -- is also called vasospastic angina. Symptoms include chest pain episodes that happen during the night and when you're at rest. Coronary artery disease is associated with what? What is a usual cause for and what can it lead to. Blockage? Constriction? What can it lead to? angina? MI? Coronary artery disease (CAD) is a common type of heart disease. It affects the main blood vessels that supply blood to the heart, called the coronary arteries. In CAD, there is reduced blood flow to the heart muscle. A buildup of fats, cholesterol and other substances in and on the artery walls, a condition called atherosclerosis, usually causes coronary artery disease. The buildup, called plaque, makes the arteries narrow. **[Glasglow coma scale. Know the numbers. Learn how to add it up]**. Eye response, Motor response, verbal response, pupil response are the 4-component assessed. The Glasgow Coma Scale (GCS) is a system to "score" or measure how conscious you are. It does that by giving numbered scores for how awake you are, your level of awareness and how you respond to basic instructions. Consciousness has 3 components they are awake, alert, orientated. The scale is used as part of a neurological exam. It's used for any situation where you might have a decrease in how conscious Glasgow Coma Scale Poster **[Stroke on right side and left side of brain what does this mean and present as]** [Left-sided stroke](https://www.bing.com/ck/a?!&&p=3ad039aac2500a4ca91c1be9b964b1677591cde4ba3feb1b9db1377a757534e9JmltdHM9MTczMzI3MDQwMA&ptn=3&ver=2&hsh=4&fclid=217b4b48-d34c-66f9-21a4-58cdd2e66729&psq=difference+between+left+and+right+stroke&u=a1aHR0cHM6Ly93d3cudmVyeXdlbGxoZWFsdGguY29tL2xlZnQtc2lkZWQtc3Ryb2tlLTUyMTM3MTc&ntb=1): - - - - - - **[Normal range for intracranial pressure]** Normal intracranial pressure ICP ranges from 7 to 15 mm/Hg, while it doses not exceed 15 mm/Hg in the vertical position. Overnight sleep monitoring is considered the "gold standard\" in conscious patients. Typically, ICP lowering therapy initiates when pressure exceeds 20 to 25 mm/Hg. Patent airway, circulation, this is prioritized. Then we will administer meds after. Its in order. Just remember that. So, when someone is having a seizure. **[Dementia and Alzheimer's what are the changes in the brain]** In Alzheimer's: neurofibrillary tangles, amyloid plaques, loss of neuronal connections and cell dysfunction, chronic inflammation, vascular issues such as beta amyloid deposits in the brain arteries atherosclerosis (hardening of the arteries) and mini strokes. The brain typically shrinks to some degree in healthy aging, but surprisingly, does not lose neurons in large numbers. In Alzheimer's, however, damage is widespread, as many neurons stop functioning properly, lose connections with other neurons, and eventually die. Alzheimer's disrupts processes vital to neurons and their networks, including communication, metabolism, and repair.At first, Alzheimer's usually damages the connections among neurons in parts of the brain involved in memory, including the entorhinal cortex and hippocampus. It later affects areas in the cerebral cortex responsible for language, reasoning, and social behavior. Eventually, many other areas of the brain and surrounding neurons are damaged and stop working normally. Over time, a person with Alzheimer's gradually loses their ability to live and function independently. Ultimately, the disease is fatal. Early [signs and symptoms of Alzheimer's disease](https://www.healthline.com/health/alzheimers-disease-symptoms) include: - forgetting names and recent events - neglecting personal care - mood and personality changes - disorientation Though [depression](https://www.healthline.com/health/dementia/dementia-and-depression) can be an early indicator of Alzheimer's disease, it's not part of the disease itself. People may need treatment for depression as a separate disorder. Doctors [occasionally misdiagnose](https://pmc.ncbi.nlm.nih.gov/articles/PMC8612610/) depressed older adults as having Alzheimer's disease or another type of dementia. Alzheimer's disease involves [brain cell death](https://www.healthline.com/health/alzheimers-and-brain). People are more likely to experience confusion and mood changes as the disease progresses. They also have difficulty speaking and walking. Dementia: **Vascular dementia** ------------------------------- The [second most common](https://www.alzheimers.gov/alzheimers-dementias/vascular-dementia) type of dementia is [vascular dementia](https://www.healthline.com/health/dementia/vascular-dementia). A lack of blood flow to the brain causes it. Vascular dementia can occur as you age. This can be related to [atherosclerotic disease](https://www.healthline.com/health/atherosclerosis), diabetes, high blood pressure, and more. [Strokes](https://www.healthline.com/health/stroke/stroke-and-dementia) are the most common cause of vascular dementia. Depending on the cause, symptoms of vascular dementia can appear slowly or suddenly. Confusion and disorientation are common early signs. Later, people find it hard to complete tasks or concentrate for long periods. Vascular dementia can cause vision problems and sometimes hallucinations. Discrete events may often cause vascular dementia. It tends to appear and worsen in a [stepwise fashion](https://www.healthline.com/health/dementia/vascular-dementia-stages) than the progressive decline that happens in Alzheimer's disease. Risk factors for vascular dementia are numerous and include: - increasing age - history of stroke - history of heart attacks - [high cholesterol](https://www.healthline.com/health/high-cholesterol) - diabetes - [lupus](https://www.healthline.com/health/lupus) - high blood pressure - [atypical heart rhythms](https://www.healthline.com/health/abnormal-heart-rhythms) Dementia with Lewy bodies ------------------------- Protein deposits in nerve cells cause dementia with Lewy bodies (DLB). These deposits interrupt chemical messages in the brain, causing memory loss and disorientation. People may also refer to DLB as [Lewy body dementia (LBD)](https://www.healthline.com/health/dementia/lewy-body-dementia), but DLB is just one type of LBD. - experience visual hallucinations - have difficulty falling asleep at night - fall asleep unexpectedly during the day - faint or become lost or disoriented DLB shares many symptoms with Parkinson's and Alzheimer's diseases. For example, many people develop trembling in their hands, have difficulty walking, and feel weak. Lewy bodies can be present in the brains of those with Alzheimer's and often in those with Parkinson's as well. **Parkinson's disease dementia vs. dementia with Lewy bodies** Both PDD and DLB involve Lewy bodies, and both come under the category of "Lewy body dementia." When motor symptoms are the first to appear, followed by dementia, doctors typically diagnose PDD. When cognitive symptoms are the first to appear, doctors typically diagnose DLB. **Frontotemporal dementia** [Frontotemporal dementia (FTD)](https://www.healthline.com/health/frontotemporal-dementia) involves several types of dementia that affect only the front and side parts of the brain. These areas control language and behavior. FTD is sometimes referred to as [Pick's disease](https://www.healthline.com/health/picks-disease), though that is just one form of FTD. FTD typically affects people ages [45 to 65 years](https://www.nhs.uk/conditions/frontotemporal-dementia/). Scientists don't know what causes FTD. However, they know it runs in families. They have identified [specific gene mutations](https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.13363) in people with the disease. FTD can cause loss of inhibitions and motivation and can cause compulsive behavior. It also causes people to have problems with speech, including forgetting the meaning of common words. FTD can have more severe effects on speech than Alzheimer's. Unlike Alzheimer's, memory problems associated with FTD tend to occur later in disease progression. FTD is the most common form of dementia that occurs in people with [amyotrophic lateral sclerosis (ALS)](https://www.healthline.com/health/dementia/als-and-dementia). Mixed dementia Mixed dementia is a situation in which a person has more than one type of dementia. Mixed dementia is very common, and the most common combination is vascular dementia and Alzheimer's. Mixed dementia can cause different symptoms in different people. Some people experience memory loss and disorientation first, while others have behavior and mood changes. Most people with mixed dementia have difficulty speaking and walking as the disease progresses. **[What classic symptoms of Parkinson's.]** Parkinson\'s symptoms may include: - - - - - - - - Secondary injury to brain trauma and then following it is secondary. Know what that means Common cause of ischemic stroke. Seizure disorders. Ranges when it becomes a life-threatening thing. Know what that is Modifiable risk factor for hypertension: stopping smoking, diet modifications, Different types of head injuries. What are they. **[Ecg is the recording of what.]** -- electrical conductivity of the heart. **[Secondary hypertension why do we get this?]** Many health conditions can cause secondary hypertension. Several kidney diseases may cause secondary hypertension, including Diabetes complications (diabetic nephropathy), polycystic kidney disease, glomerular disease, renovascular hypertension, also, cushing syndrome, aldosteronism, pheochromocytoma, thyroid problems, hyperparathyroidism. Coarctation of the aorta, sleep apnea, obesity, pregnancy, medications & supplementation. This hypertension could cause damage to arteries, aneurysm, heart failure, weakened and narrowed blood vessels in the kidneys, thickened, narrowed or torn blood vessels in the eyes, metabolic syndrome, trouble with memory or understanding. **[What is cardiomyopathy characterized by?]** Cardiomyopathy symptoms can include: - - - - - - - - - - Type of cardiomyopathy: - - - - - **[Clinical manifestations of DVT]** Deep vein thrombosis (DVT) symptoms can include: Leg swelling Leg pain, cramping or soreness that often starts in the calf Change in skin color on the leg --- such as red or purple, depending on the color of your skin A feeling of warmth on the affected leg Deep vein thrombosis can occur without noticeable symptoms. Dementia is an umbrella term for other disease: vascular dementia, Alzheimer's, **[What causes hydrocephalus?]** Hydrocephalus is the buildup of fluid in cavities called ventricles deep within the brain. The excess fluid increases the size of the ventricles and puts pressure on the brain. Cerebrospinal fluid usually flows through the ventricles and bathes the brain and spinal column. But the pressure of too much cerebrospinal fluid can damage brain tissues and cause a range of symptoms related to brain function. A head that is larger than usual. A rapid increase in the size of an infant\'s head. A bulge or tense soft spot on the top of the head. **Physical symptoms** Nausea and vomiting. Sleepiness or sluggishness, known as lethargy. Irritability. Poor eating. Seizures. Eyes fixed downward, known as sunsetting of the eyes. Problems with muscle tone and strength. The causes of hydrocephalus (excess fluid in the brain) are poorly understood. Congenital hydrocephalus can be caused by spina bifida and other genetic conditions. In children and adults, hydrocephalus is caused by injury or disease. These include subarachnoid hemorrhage, venous thrombosis, meningitis, brain tumors, head injury, and stroke. Be able to explain what happens in MS and describe some of the types of MS and the management. Be able to explain what the Glasgow coma scale is what and how and why we use it and how we go about the assessment. Matching terms is about dementia, what we might find, confusion and comatose. (two examples) there are 6 matches to term to definition. Angiotensin-renin system when and what and how does it alter your bp. When is it triggered to alter your blood pressure. **[Condition or event and relate to systolic]**: having high cholesterol, diabetes, being inactive, having a BMI greater than 30, using tobacco, eating processed foods that contain a lot of fat and salt. **[Modifiable things for atherosclerosis]** Diet, exercise, cholesterol, BMI, tobacco use. Exposure to ambient air pollution, adequate sleep, psychosocial stress, **[Shock and renin angiotensin will activate and when in shock what happens]** alterations in the renin--angiotensin--aldosterone system during septic shock can occur at three distinct levels: 1. Impaired generation of angiotensin II, possibly attributable to defects in angiotensin-converting enzyme activity; 2. Enhanced degradation of angiotensin II by peptidases; and/or 3. Unavailability of angiotensin II type 1 receptor due to internalization or reduced synthesis. These alterations can occur either independently or in combination, ultimately leading to an uncoupling between the renin--angiotensin--aldosterone system input and downstream angiotensin II type 1 receptor signaling.  **[Types of shock: ]** **1) Distributive Shock** is characterized by a significant drop in peripheral vascular resistance and, as a result, [hypotension](https://www.medicinenet.com/low_blood_pressure/article.htm). **Six subclassifications of DISTRIBUTIVE SHOCK.** **Septic -- potentially fatal, when bp drops dangerously low following an infection. Toxins created by bacteria can trigger inflammatory cascade in the body, affect the liver, and kidney function, rupture small blood vessels and cause fluids inside organs to leak into the surrounding tissues. This can impair hearts capacity to pump blood to organs such as brain, liver, etc. Septic shock is mostly seen in conditions with compromised immunity.** **Neurogenic shock -- occurs due to lack of equilibrium between parasympathetic and sympathetic stimulation. It can be potentially fatal. It is typically seen after a spinal cord injury or even serious brain damage. This** occurs when sympathetic fibers are disrupted, basal vascular sympathetic tone causes the muscles to contract is lost. This leads to an unopposed parasympathetic tone that causes relaxation of the blood vessel walls for a long period. This results in severe hypotension and bradycardia, which can cause brain damage and other organ damage due to a lack of sufficient blood circulation. Understanding the physiologic and anatomic changes that occur during neurogenic shock can aid in the direction of proper resuscitation efforts. The physiologic goals should be to reverse hypotension, prevent hypoxia and improve the blood circulation of the damaged central nervous system and other vital organs. **Anaphylactic shock -** is a severe life-threatening condition, which is a medical emergency. Anaphylactic shock is caused by the release of chemical compounds in the body because of a reaction to an antigenic stimulus. This usually occurs if a person is previously sensitized to such reactions. This stimulation could be caused by food, medications, blood products, insect venom, or pollen contact. If a person goes into anaphylactic shock, there could be respiratory symptoms, itching severe skin rash, or the person may faint because the pulse drops off. **Endocrine shock** - Adrenal failure caused by mineralocorticoid deficiency (Addisonian crisis), and myxedema can cause hypotension and shock. Vasodilation can occur in mineralocorticoid deficit due to increased vascular tone and aldosterone deficiency-mediated hypovolemia. Although thyroid hormone plays a role in blood pressure regulation, the specific mechanism of vasodilation in myxedema patients is unknown. Concomitant myocardial depression or pericardial effusions are likely to contribute to hypotension and shock. **Drug and toxin-induced shock** - Overdoses of drugs, snake bites, insect bites that contain venom, transfusion reactions, heavy-metal poisoning, and infections associated with toxic shock syndrome are all examples of drug or toxin reactions that can be associated with shock or systemic inflammatory response syndrome. **Systemic inflammatory response syndrome (SIRS)** - SIRS is a clinical syndrome defined by a strong inflammatory response, which is usually triggered by a substantial body insult that could be infectious or non-infectious. Most patients with SIRS in the emergency room are not in shock and will not acquire shock during their stay. However, if SIRS is present, the doctor will monitor the patient for disease severity development. **2) Cardiogenic Shock** Cardiogenic shock is a condition in which the circulatory system fails due to decreased cardiac output caused by left, right, or biventricular failure. Cardiogenic shock can develop because of acute ischemia or nonischemic cardiac event or because of the advancement of underlying heart disease. Acute MI is the most prevalent cause of cardiogenic shock, accounting for up to 70 percent of cases and occurring in 5 to 10 percent of patients with acute myocardial infarction. Cardiogenic shock can cause severe cellular and metabolic malfunction, multisystem organ dysfunction, and death. **Three subclasses of cardiogenic shock** A\) **Cardiomyopathic** - The shock is caused by cardiomyopathic causes, such as myocardial infarction, acute exacerbation of heart failure, cardiac arrest, prolonged ischemia, or cardiopulmonary bypass. B\) **Arrhythmic** -- atrial and ventricular tachyarrhythmias and Atrial and ventricular tachyarrhythmias and bradyarrhythmia can cause hypotension, which frequently contributes to states of shock. When cardiac output is badly harmed by major rhythm disruptions, a person may go into cardiac arrest. **C) Mechanical -** Severe aortic or mitral valve insufficiency and acute valvular defects caused by the rupture of a papillary muscle or chordae tendineae (mitral valve defect) or retrograde dissection of the ascending aorta into the aortic valve ring or an abscess of the aortic ring are mechanical causes of cardiogenic shock (aortic insufficiency). **3. Hypovolemic Shock** Hypovolemic shock (hypovolemia) occurs due to decreased intravascular volume or decreased preload, which lowers cardiac output. Hypovolemic shock can be caused by the same factors that cause hypovolemia, but the severity and symptoms are much more pronounced. Some common signs of hypovolemic shock include rapid heart rate, low blood pressure, confusion or loss of consciousness, cold and clammy skin, and reduced urine output. Hypovolemic shock is classified into two types. **B non-hemorrhagic shock:** Non-hemorrhagic shock can result from decreased intravascular volume due to fluid loss other than blood. Volume depletion can occur from a variety of anatomic locations due to salt and water loss and include diarrhea, vomiting, external drainage, heatstroke, burns, severe dermatologic conditions, including Stevens Johnson's syndrome, excessive drug -- induced or osmotic diuresis, hypoaldosteronism, fluid in cavities cause by post operative complications and trauma, intestinal obstruction, crush injury, pancreatitis, cirrhosis. **4. Obstructive shock (2 categories)** **B) Mechanical -** - Constrictive pericarditis - Tension pneumothorax - Pericardial tamponade - Restrictive cardiomyopathy Circulatory shock. What is it. **[Hypovolemic shock what are the compensatory mechanisms that help preserve circulation]** The renin-angiotensin-aldosterone cascade. **[Know difference between cardiogenic, hypovolemic, neurogenic shock]** see above **[Know DIC and what it is. Know the signs and symptoms]** Disseminated intravascular coagulation (DIC) is a rare blood clotting disorder DIC symptoms may include: - Uncontrollable bleeding from several areas of your body. - [Bruising](https://my.clevelandclinic.org/health/diseases/15235-bruises). - [Confusion](https://my.clevelandclinic.org/health/symptoms/25206-confusion), memory loss or change of behavior. - Difficulty breathing ([dyspnea](https://my.clevelandclinic.org/health/symptoms/16942-dyspnea)). - [Fever](https://my.clevelandclinic.org/health/symptoms/10880-fever) that's more than 103 degrees Fahrenheit (39.4 degrees Celsius). **What causes DIC?** To understand what causes DIC, it may help to understand how your body makes [blood clots](https://my.clevelandclinic.org/health/diseases/17675-blood-clots). Your [liver](https://my.clevelandclinic.org/health/articles/21481-liver) makes clotting factors (proteins) that stick to [platelets](https://my.clevelandclinic.org/health/body/22879-platelets) in your blood to form a blood clot. Normally, blood clots stop or slow bleeding and start your body's healing process. But In DIC, your body develops more blood clots than you need. - There are two stages of DIC: First, small blood clots start to block your [[blood vessels]](https://my.clevelandclinic.org/health/body/21640-blood-vessels). This cuts off the blood supply to major organs. Second, your platelets and clotting factor run out, leaving your body without a way to control bleeding. Medical conditions that can cause DIC include: - [[Sepsis]](https://my.clevelandclinic.org/health/diseases/12361-sepsis). - [[Cancer]](https://my.clevelandclinic.org/health/diseases/12194-cancer), especially certain types of [[leukemia]](https://my.clevelandclinic.org/health/diseases/4365-leukemia). - [[Pancreatitis]](https://my.clevelandclinic.org/health/diseases/8103-pancreatitis). - [[Liver disease]](https://my.clevelandclinic.org/health/diseases/17179-liver-disease). - Severe tissue injury, including [[burns]](https://my.clevelandclinic.org/health/diseases/12063-burns) and head injuries. - Serious complications from pregnancy and delivery. - Medical treatments that can cause DIC: blood transfusion reactions. Severe immune system reactions to organ transplants or recent surgery or anesthesia. - Without treatment, DIC can cause stroke, shock or excessive bleeding. - **[What is a common factor with all types of shock ]** - - - - - - - - - - - - - - **[Neurotransmitters involved in Parkinson's disease]**. (dopamine and acetylcholine) Parkinson\'s disease (PD) is most frequently associated with characteristic motor symptoms that are known to arise with degeneration of dopaminergic neurons. It is an imbalance between acetylcholine and dopamine. It is a neurological disorder that affects movement control. In Parkinson\'s disease, neurons of the substantia nigra progressively degenerate as a result, the amount of DA available for neurotransmission in the corpus striatum is lowered. The biochemical imbalance manifests with typical clinical symptoms that include resting tremor, rigidity, bradykinesia, i.e., a gradual slowness of spontaneous movement, and loss of postural reflexes or, in other words, poor balance and motor coordination. The disturbance of dopamine metabolism in Parkinson\'s disease is accompanied by an analogous reduction of the activity of the synthesizing enzymes [[tyrosine hydroxylase]](https://www.sciencedirect.com/topics/neuroscience/tyrosine-hydroxylase) and dopa [[decarboxylase]](https://www.sciencedirect.com/topics/neuroscience/carboxy-lyases) in the basal ganglia and substantia nigra. **[amino tropic lateral sclerosis signs and symptoms aka Lou Gehrig's disease]** ALS is often called Lou Gehrig\'s disease after the baseball player who was diagnosed with it. The exact cause of the disease is still not known. A small number of cases are inherited. ALS often begins with muscle twitching and weakness in an arm or leg, trouble swallowing or slurred speech. Eventually ALS affects control of the muscles needed to move, speak, eat and breathe. There is no cure for this fatal disease. is a nervous system disease that affects nerve cells in the brain and spinal cord. ALS causes loss of muscle control. Symptoms: rouble walking or doing usual daily activities. Tripping and falling. Weakness in the legs, feet or ankles. Hand weakness or clumsiness. Slurred speech or trouble swallowing. Weakness associated with muscle cramps and twitching in the arms, shoulders and tongue. Untimely crying, laughing or yawning. Thinking or behavioral changes. ALS affects the nerve cells that control voluntary muscle movements such as walking and talking. These nerve cells are called motor neurons. There are two groups of motor neurons. The first group extends from the brain to the spinal cord to muscles throughout the body. They\'re referred to as upper motor neurons. The second group extends from the spinal cord to muscles throughout the body. They\'re referred to as lower motor neurons. ALS causes both groups of motor neurons to gradually deteriorate and then die. When motor neurons are damaged, they stop sending messages to the muscles. As a result, the muscles can\'t function.