Quiz 5

Mitral Valve Disorders (3)

Mitral valve stenosis Mitral valve regurgitation Mitral valve prolapse

MONA to alleviate symptoms and decrease impact or size of necrotic area

Morphine Oxygen Nitroglycerin aspirin

Electrical circuit: (1) __ ____ beats heart #-#x / minute. Occlusion of ____ ___ ___ could lead to SA node failure

1. SA node 2. 60-100x 3. right coronary artery

heart failure: Diastolic dysfunction - Impaired _____ of the heart during diastole - Heart cannot ____ - ___ ___ falls → ____ falls

1. filling 2. relax 3. Stroke volume... CO

Chronic stable angina: associated with a ____ coronary obstruction that produces a disparity between ___ ___ ___ and ___ ___ of the myocardium

1. fixed 2. coronary blood flow 3. metabolic demands

Involvement of Heart Muscle in an Infarct: Transmural Infarcts - Involve the ____ thickness of the ventricular wall - Occur when there is ____ of a ____ artery

1. full 2. obstruction of a single

Laplace Law - States that wall tension becomes ____ as the radius increases - Wall tension is also affected by wall ____; it increases as the wall becomes ____ and decreases as the wall becomes ____.

1. greater 2. thickness... thinner ... thicker

Frank starling mechanism: the greater the volume of blood in the heart before contraction, the ____ the volume of blood ____ from the heart - ___ relationship between volume of blood in heart, ___ of fibers at end of diastole, and ____ of ___ during next systole. The greater the stretch, the strong the contraction (like a rubber band). - Excessive stretch works against heart by decreased ___ and can lead to ____

1. greater ... ejected 2. direct ... stretch ... force of contraction 3. SV ... HF

Which of the following may result in the development of a cardiomyopathy? Valvular stenosis Valvular regurgitation MI Ischemia All the above None of the above

All the above

True/False: the electrocardiogram is a reflection of cardiac muscle contraction. You can directly diagnose specific defects in muscle activity.

False

What 2 issues does shock lead to

Impaired oxygen use impaired glucose use

__7___ substances contributes to blood flow

Norepinephrine Epinephrine Angiotensin II Histamine Serotonin Bradykinin Prostaglandins

The seven P's of acute arterial embolism

Pistol shot (acute onset) Pallor Polar (cold) Pulselessness Pain Paresthesia Paralysis

Which type of angina is brought about by exercise or stress? Stable Unstable

Stable Stable angina does not present as a problem until there is an increase in workload

Virchow's Triad Associated with Venous Thrombosis Includes

Stasis of the blood Increased blood coagulability Vessel wall injury

Myocarditis is the Inflammation of the heart muscle and conduction system without evidence of _____ ____

myocardial infarction

4 factors influencing CO and workload of the heart

preload afterload cardiac contractility heart rate

Properties of cardiac conduction 3. _____: ability to conduct impulse 4. _____: extent of which cell can respond to incoming stimulus - If excited before recovery: _____ problem. Responsible for many _____-arrhythmias - Can occur _____ in conduction system

3. Conductivity 4. Refractoriness - re-entry... tachy - anywhere

Pulmonary circulation - ____ heart - ____ ___, ____, and ____

1. Right 2. Pulmonary artery, capillaries, and veins

Phases of Cardiac Potentials - Phase 0: ____ ____ of the action potential - Phase 1: ____ ___ - Phase 2: _____ - Phase 3: ____ ____ period - Phase 4: ____ ____ period

- Phase 0: rapid upstroke of the action potential - Phase 1: early repolarization - Phase 2: plateau - Phase 3: final repolarization period - Phase 4: diastolic repolarization period

Antiplatelet and Anticoagulant Therapy: Aspirin - The preferred antiplatelet agent for preventing platelet aggregation in persons with _____ - Inhibits synthesis of prostaglandin, _____ ___

1 .CAD 2. thromboxane A2 (TXA2)

Heart failure Systolic dysfunction - Impaired ____ of blood from the heart during systole - Ejection fracture measuring cardiac output falls: #-#% - Blood backs up to ____ ____, pressure rises in pulmonary circulation

1 .ejection 2 .55-65 3. pulmonary circulation

Chronic HF - Volume _____ - _____ congestion become more prominent in both ____ and ____ circulations - s/sx present for some period of time, compensatory mechanisms kicks in but fluid volume overload still exists. Compensatory mechanisms good in beginning but if unchecked, will produce problems on its own

1 overload 2. Venous ... pulmonary and systemic

Body only have enough glycogen stores for about # ____ worth of glycogen stores. It could take 10 hours to first identify shock state patient, and by this time, glycogen stores all used up. Gluconeogenesis causes ____ used for fuel → _____ of protein (needed for cell structure, function, repair) → ____ ____ (multi organ dysfunction syndrome is the dysfunction of 2+ organs associated with high mortality rate).

1. 10 hours 2. protein 3. shortage 4. organ failure

AHA guidelines 2017 *** - Elevated BP is considered that SBP which is greater than #-# _____ DBP less than # - Stage 1 HTN is SBP #-# ____ DBP #-# - Stage 2 HTN is SBP greater than # ____ a DBP greater than or equal to # - Normal BP is less than #/# - the AHA wants to state that #/# is the new goal

1. 120-129 and ... 80 2. 130-139 OR... 80-89 3. 140 ... or ... 90 4. 120/80... 110/70

hypertensive emergency - Definition: sudden increase in BP greater than #/# ** - A drastic acute increase in pressure leading to ____ organ failure - We might see ____, major ___ ___, perhaps even death. - If HTN emergency, it needs to be treated emergently

1. 180/120 2. immediate 3. stroke... heart attack

Hypercholesterolemia - Serum cholesterol levels: #mg/dL or greater

1. 240

Atrioventricular (AV) valves → have cusps that open and close 1. Tricuspid: # cusps - Between ____ atria and ventricle 2. Mitral (bicuspid): # cusps - Between ____ atria and ventricle - _____ disorders: difference in # of valves

1. 3 - right 2. 2 - left - Congenital

Junctional arrhythmias - Where ___ ___ replaces ___ ___. Usually due to problem of SA node - #-# BPM - Junctional tachycardia where rate is greater than # - P-waves are usually in front of QRS but here it may but buried ____ QRS or ____ QRS and in ____ of T wave - ____ ___: burns with heat or cold kills tissue that sends out abnormal impulses - _____

1. AV node... SA node 2. 40-60 3. 60 4. into ... behind ... front 5. Ablation therapy 6. pacemaker

Electrical circuit: (2) ____ ___ impulses slow down to allow ___ ___ - Divided into 3 functional regions - Overridden by ____ node because it is firing faster - AV nodes are the only connection between ___ and ___ systems. - #-#x/minute - Back up if SA fails

1. AV node... ventricular filling 2. SA 3. atrial and ventricular 4. 40-60x

Risk factors for HTN: Obesity ____ or ____ obesity. _____, adipocyte derived hormone, can increase sympathetic activity leading to an increase in BP. It can also lead to an increase in _____, a hormone normally produced by adrenal gland. It plays a role in ___, ___, and ____ regulation. Too much aldosterone = holding on to too much ____→ increase in ____ levels and volume → increased BP.

1. Abdominal or central 2. Leptin 3. aldosterone 4. sodium, water and potassium 5. salt 6. water

Manifestations of ST-segment elevation MI - _____ onset - Severe and crushing pain, usually substernal, radiating to the left arm, neck or jaw - Gastrointestinal complaints (nausea and vomiting) - Complaints of ____ and ____ - Tachycardia, anxiety, restlessness, feelings of impending doom - ____, ____, and ____ skin

1. Abrupt 2. fatigue and weakness 3. Pale, cool, and moist

Manifestations of STEMI - _____ onset - Severe and crushing pain, usually ____, radiating to the ___ ___, ___, or ___ - ____ complaints (nausea and vomiting) - Complaints of fatigue and weakness - _____, anxiety, restlessness, feelings of ___ ___ - ___, ___, and ____ skin

1. Abrupt 2. substernal... left arm, neck, or jaw 3. Gastrointestinal 4. Tachycardia... impending doom 5. Pale, cool, and moist

Dissecting aneurysm - ____ onset of excruciating pain. Feels like insides are ripping or tearing. Sensation in ___ or ____. - ____ or __ ___ to diagnosis - Treatment: BP management → ______, decrease ___ drugs, surgical intervention (____ of involved portion of aorta and placement of dacron graft) - Mortality of a ruptured aneurysm is ___ ___. A hole in aorta → short time to exhaust ___ ____

1. Acute .. back or abdominal 2. MRI or ct scan 3. antiHTN-ives... CO ... resection 4. very high... blood supply

Impaired coronary blood flow that may cause: - _____ - Myocardial infarction or heart attack - Cardiac arrhythmias - ____ defects - Heart ____ - Sudden ____

1. Angina 2. conduction 3. failure 4. death

RHF - ______, pitting edema - Decrease of _____ to other organs (brain, kidneys) - ____ as a result of heart failure because of increase of O2 demands - Most commonly caused by a ____ ____ ___ disease - Can result from an increase in ___ ____ ____ pressure that is reflected back into the pulmonary circulation

1. Ascites 2. perfusion 3. MI 4. diffuse hypoxic pulmonary 5. left ventricular filling

Arterial disease of the extremities - ____ ____ disease: sudden event that interrupts arterial flow to the affected tissues or organ - ____ ____: inflammatory arterial disorder that causes thrombus formation - _____ disease and phenomenon: intense vasospasm of the arteries and arterioles in the fingers and, less often, the toes - Could be due to ___ __, ___ __, or ___ ___ - Need ____ treatment to prevent death or loss of function depending on location

1. Atherosclerotic occlusive disease 2. Thromboangiitis obliterans 3. Raynaud 4. blood clot, fat emboli, or foreign body 5. immediate

One-way valves: 2 _____ valves and 2 ____ valves are pressure valves that ensure one-way flow

1. AtrioVentricular 2. semilunar

Properties of cardiac conduction 1. _____: ability of certain cells to spontaneously make impulse. Ectopic impulse leads to ____ ___ 2. _____: ability of cells to respond to an impulse. ____ myocardial cells lose this

1. Automaticity... premature contraction 2. Excitability... Injured

Sinus bradycardia - ____ can decrease firing from SA nodes - ___ ___ stimulation can decrease firing from SA node and therefore conduction through AV node - Can be normal in _____, only of concern if pt is ____ (fainting spells or syncope)

1. BB 2. Vagal nerve 3. athletes... symptomatic

Disorders of ventricular conduction and rhythm - ____ ____ blocks where impulse blocked - ____ not affected but normal progression of depolarization - Impulse travels through ____ instead of conduction pathway - ____ impulsation - QRS is ____

1. Bundle branch 2. Rhythm 3. muscle 4. Prolongs 5. wider

Electrical circuit: (4) ____ of ____ - ____ and ___ ____ conduction system - ____ fibers of left and right side - Ejection of blood from left ventricular is complete and efficient by fast pumping - Almost simultaneous with ____

1. Bundle of HIS 2. Right and left ventricular 3. Dual 4. atrial

Populations Affected by Silent Myocardial Ischemia - Persons who are asymptomatic without other evidence of ____ - Persons who have had a ____ ___ and continue to have episodes of silent ischemia - Persons with _____ who also have episodes of silent ischemia

1. CAD 2. myocardial infarct 3. angina

Heart rate - Controlled by ___ and ___ NS, neural ____, atrial ____, and atrial ____ affect HR - Higher HR = ____time spent in diastole and relaxation (filling with blood) → does fill as efficiently or effectively as it should. Volume is decreased and CO goes down. Atria here will ___ as well to improve CO. normally atria are passive. - Running up stairs: CO going ____ but rate of exercise may be maintained by ____.

1. CNS and autonomic... reflexes.. receptors... hormones 2. less .. contract 3. down .. atria

Cardiogenic shock - In the presence of adequate intravascular volume, we still see decrease of ____ and tissue _____ - Seen in post-MI, HF, ____ ___ dysfunction, massive ____, dysrhythmias like ___ ____ - Often _____ and carries a #% mortality rate

1. CO ... hypoxia 2. acute valvular... PE... v tach 3. irreversible... 70

Constrictive Pericarditis - ____ ___ tissue develops between the ____ and ____ layers of the serous pericardium. - Cardiac output and cardiac reserve become ____. - s/sx: _____, ____ edema, dyspnea on ____, and fatigue, ____ sign

1. Calcified scar... visceral and parietal 2. fixed 3. Ascites, pedal... exertion... Kussmaul

______ circulation: Blood that is in the heart and pulmonary circulation _____ circulation: Blood that is outside the central circulation

1. Central 2. Peripheral

Arterial Blood Pressure - _____ pressure, #-# mm Hg - Propel blood to all other tissues of the body (i.e., ____ circulation)

1. Higher ... 90-100 2. systemic

Long-term regulation of blood flow - ____ ____ - ____ ____

1. Collateral circulation 2. Anastomotic channels

Forces that allow exchange of fluid between interstitial space and vascular space - ____ ____ ___ pulls fluid back into vascular space - ____ ____ - ____ is the smallest protein and most abundant. Whatever is left over gets picked up by the lymphatic system.

1. Colloidal osmotic pressure 2. Osmotic pressure 3. Albumin

Third-degree AV block - ____ AV block - Atria and ventricles ____ - Tune of ____ pacemakers in conduction systems - ____ often time much slower - Affects CO → _____ - ____ or ___ ___ attack - Treatment: placement of _____

1. Complete 2. disassociated 3. separate 4. Ventricles 5. decreased 6. Syncope or stokes adams 7. pacemaker

2nd degree type 2 - Mobitz 2 - _____ ___ ____ with appearance of non conductive __ ____

1. Constant PR interval 2. P wave

Revascularization interventions - ____ ____ ____ ____ - ____ ____ ____: Placement of stent - _____: use of balloons and lasers to open lumen of vessel

1. Coronary artery bypass grafting (CABG) 2. Percutaneous coronary intervention (PCI) 3. Atherectomy

Left-sided HF or congestive HF - _____ CO, elevated ____ ___ pressure - Increased ____ and ____ enlarges left ventricle → lack of ____ → enlarged ventricle becomes non-functionable - Increased ____ and arrhythmias

1. Decreased ... pulmonary venous 2. workload and preload... oxygen 3. HR

Venous insufficiency - _____ ___ ___: Causes deformity of the valve leaflets - ____ ____: Loss of unidirectional blood flow - Combination of both conditions - Stasis ____ - Venous ____

1. Deep vein thrombosis (DVT) 2. Valvular incompetence 3. dermatitis 4. ulcers

Hypovolemic shock - ____, ___, diuretic drug use - Increase in ____ and increase in ___ ___ ___ in effort to improve CO - Spleen may be involved to back up blood volume → throws in ____ ___ to help with volume - Kidneys can increase production of ____ to hold onto volume

1. Diaphoresis, DI 2. HR ... systemic vascular resistance 3. sequestered RBCs 4. ADH

Turbulent flow - _____ flow - The blood moves ____ and ____ in blood vessels.

1. Disordered 2. crosswise and lengthwise

Treatment to Improve the pump - _____: Reverse total blood volume and circulatory congestions - ___ ___ to decrease metabolic demand - ____ - _____ drugs to strengthen myocardial contractility and cause arterial vasodilation - _____ helps to increase CO and decrease afterload

1. Diuretics 2. Bed rest 3. O2 4. Inotropic 5. Vasodilators

Diagnosis for HF - _____: can show tachycardia, signs of ischemia. Most common test for HF because it gives idea about ____ of ____ (LV) - Blood test: ____ (elevated over 100) used as a ____ and ___ tool. When we treat HF, we expect decrease in BNP - ____ __-___ to see size of heart

1. ECG... size of ventricles 2. BNP ... diagnostic and prognostic 3. Chest x-ray

Diagnosis of MI - ____ is critical for wave changes, particular with elevation or not of S-T segment - ____ can give idea of wall motion to see if heart muscle is moving well - Blood tests looking for ____ levels (protein found in cardiac muscle. When cardiac muscle dies, it releases troponin), increased ____, ____

1. EKG 2. Echocardiogram 3. troponin ... WBC.... hyperglycemia

_____: continuous lining with myocardium and blood vessels - Thin, #-layered membrane of the heart

1. Endocardium 2. 3

Brugada syndrome - ____ all the time, ____ discomfort, cardiac _____ - ECG: ____ ST segments, ___ ___ ___ block. Frequent issues with ____ ____

1. Fainting ... chest .. arrest 2. elevated ... right bundle branch... Ventricular tachycardia

Types of lesions associated with atherosclerosis - ___ ____: thin, flat yellow intimal discolorations that progressively enlarge - ___ ____ ___: the accumulation of intracellular and extracellular lipids, proliferation of vascular smooth muscle cells, and formation of scar tissue - ____ ___: contains hemorrhage, ulceration, and scar tissue deposits

1. Fatty streaks 2. Fibrous atheromatous plaque 3. Complicated lesion

Treatment Measures to Correct and Reverse Shock - ____ resuscitation - Restore ___ ___ - Improve ____ ___ - _____ stability

1. Fluid 2. blood flow 3 oxygen delivery 4. Hemodynamic

Causes of disorders of the cardiac conduction system - Congenital defects or degenerative changes in the conduction system - Myocardial ischemia and infarction - ____ and ___ imbalances - Effects of ____ ingestion

1. Fluid and electrolyte 2. drug

Focus on atherosclerosis is more on ____ than ____ ** - If ____ HDL and LDL → still will get atherosclerosis - Statins _____ HDL levels while not necessarily ____ LDLs - Regular ____ and moderate ____ consumption increase levels of HDL - _____, ____ ___ alcohol consumption, and ____ syndrome lead to decreased HDL levels

1. HDL than LDL 2. low 3. increase ... lowering 4. exercise ... alcohol 5. smoking... too much... metabolic

Myocardial O2 and demand 3 determinants - ____ ___: most important - LV ____ - ____ pressure or myocardial wall ___ or ___

1. Heart rate 2. contractility 3. Systolic ... stress or tension

____, ___, ___, and ___ ____ are the most common organs affected in HTN. These organs are highly vascular and therefore we see damage here more often - manifestations are Angina, heart attacks, stroke, kidney failure, PAD, retinopathy

1. Heart, kidneys, eyes, and blood vessels

Risk factors for HTN - Tobacco - Alcohol consumption: ____ consumption leads to HTN. ____ use is beneficial - Insulin ____ and ____ syndrome - Fitness level. Increased exercise = decreased BP

1. High ... Moderate 2. resistance and metabolic

Diagnostic methods - ECG - Signal-averaged ECG - ____ monitoring: External monitors - ___ ___ testing - _____ studies: where wires are put into heart to precipitate or cause rhythm issue to see what's happening - ____ ___

1. Holter 2. Exercise stress 3. Electrophysiology 4. QT dispersion

Causes of secondary HTN - Primary ____ - ____ disease - _____ - Oral contraceptive drugs

1. Hyperaldosteronism 2. Cushing's 3. Pheochromocytoma

Forces Determining the Movement of Fluid - ____ ____ pressure - ___ ____ pressure - ____ ___ ___ pressure - ____ ____ ___ pressure

1. Intracapillary fluid 2. Interstitial fluid 3. Plasma colloidal osmotic 4. Interstitial colloidal osmotic

Pericardium Functions - ____ the heart from other thoracic structures - Maintains its position in the ____ - Prevents it from ____ - Contributes to _____ the distensibility between the # ____ during ____; they both fill ____

1. Isolates 2. thorax 3. overfilling 4. coupling ... two ventricles... diastole... equally

Metabolic activity regulates blood flow - ___, ___ ___, ___, and ____ are released from working myocardial cells - ____ has most vasodilating effect. It is considered a crucial mediator for ____ blood flow.

1. K+, lactic acid, CO2, adenosine 2. Adenosine ... coronary

STEMI - S-T elevation present - ____ vessels: ___ and ____ occlusion

1. Larger 2. LAD, circumflex

Systemic circulation - ____ heart - ____ and its branches - Capillaries supplying the ____ and ____ tissues - ___ ____ system and the ___ ___

1. Left 2. Aorta 3. brain and peripheral 4. Systemic venous... vena cava

False aneurysm: ___ ___ with the formation of a ____ that represents a ____ or ____.

1. Local tear 2. hematoma 3. bulge or dilation

Venous Blood Pressure - ____ pressure, # mm Hg - Propel blood through the lungs (i.e., ____ circulation)

1. Lower ... 12 2. pulmonary

Anaphylactic shock - Similar to neuro and hypovolemic - _____ cells reaction will release a large number of ____ ____ causing large immune and vasogenic s/sx → ____ related to ____ - _____ and ____ - Trouble breathing

1. Mast ... vasoactive cytokines... vasodilation ... vasoedema 2. Bronchoconstriction and laryngospasm

_____: actual pump of the heart. Contracts and relaxes 60-100x/minute - ____ portion forms the ____ of the ___ and ____

1. Myocardium 2. Muscular ... wall ... atria and ventricles

Clinical manifestations of atherosclerosis: - ____ of the vessel and resulting ____ - Sudden Vessel ____ due to plaque ___ or ___ - ____ and formation of ____ resulting from damage to the vessel endothelium - _____ formation due to weakening of the vessel wall

1. Narrowing ... ischemia 2. obstruction ... hemorrhage or rupture 3. Thrombosis ... emboli 4. Aneurysm

Disruptions Occurring with Valvular Heart Disease - ____ of the valve opening, so it does not ____ properly - Distortion of the valve, so it does not close properly --> ____ or ____ valve: permits ____ flow to occur when the valve should be closed

1. Narrowing ... open 2. Incompetent or regurgitant... backward

Venous circulation - ____ way valves in large veins - Limited ____ - ____ muscle pump - ____ driving pressure - ____-walled vessel

1. One 2. contractility 3. Skeletal 4. Decreased 5. Thin

Veins (deoxygenated blood) collect blood from body tissues and returns it to the heart - ____ vessels - ____ way valves

1. Passive 2. One

_____: A double-layered serous membrane - Forms a ____ covering around the heart holding it in a ____ position and providing ___ protection and a barrier to ____

1. Pericardium 2. fibrous ... fixed ... physical .. infection

___ and ____ Dependent on the heart and the vasculature. ___ ____ and ___ ____ are strictly cardiac factors

1. Preload and afterload 2. Cardiac contractility and heart rate

Disorders of AV conduction: First degree AV block - ____ of ____ interval (____ of P wave to _____of R wave)

1. Prolongation of PR 2. beginning 3. beginning

Acute HF - _____ congestion due to elevated ___ ___ ___ pressures, with or without a ____ cardiac output - ____ and ____ retention do not occur

1. Pulmonary... left ventricular filling... low 2. Sodium and water

Electrical circuit: (3) ___ ___ conduct impulses to ____ and ____ ___ - Only discharge #-#x/minute - Back up of SA and AV node if both fails - This will impact ____ --> ____ CO

1. Purkinje fibers... R and L ventricles 2. 15-40x 3. CO .. less

Pharmacologic treatment of HTN - Targets ____ system, decrease ___ and ___ - First line: ____ (block impulses in heart and decrease HR) and ____ (decrease volume): reduce mortality and morbidity

1. RAAS .. resistance and CO 2. BB ... diuretics

_____ disease-_____HTN plays largest role in secondary HTN, because they play a major role in regulating blood pressure. - If RAAS system out of whack and too much _____ __, it causes ____ ___ - Most common issue is renal ____ ___. ____ can occur in renal arteries → decreased _____→ decreased function of kidney → kidney secrete more _____→ follows above pathway.

1. Renal .. renal 2. angiotensin 2.. arterial constriction 3. artery occlusion.. Dyslipidemia .. perfusion ... renin

Adaptive and maladaptive mechanisms in heart failure - ______-_____-____ mechanism - _____ nervous system - _____ peptides - ______ - Myocardial _____ - _____ can result in HF

1. Renin-angiotensin-aldosterone 2. Sympathetic 3. Natriuretic 4. endothelins 5. hypertrophy 6. Remodeling

Relative Refractory Period - Greater than normal stimulus response - _____ returns the membrane potential to below the ____, although not yet at the ____ ___ ____. - Begins when the transmembrane potential in phase # reaches the ____ potential level - Ends just before the terminal portion of phase #

1. Repolarization ... threshold... resting membrane potential 2. 3.. threshold 3. 3

P: represents activity in ____ __ and therefore ____ ____ QRS: ____ ___ or ____ T: ____ ___ or ____

1. SA node... atrial depolarization 2. ventricular depolarization or contraction 3. ventricular repolarization or relaxation

Shock S/sx - Confusion - _____ - Decreased CO, decreased ____ __ - _____pnea - Respiratory _____ before respiratory _____ - _____ of organs and tissues: Insuff. Supply of nutrients and oxygens

1. SOB 2. urinary output 3. Tachypnea 4. alkalosis ... acidosis 5. Hypoperfusion

Risk factors for CAD - age, gender, family history - Dyslipidemia - Smoking - DM - HTN - ____ lifestyle - _____issues - ____ high levels - ____ ___ high levels - infections of ____, ____, and ____ - Adipoteins

1. Sedentary 2. Congenital 3. Fibrinogen 4. C-reactive protein 5. Chlamydia, h pylori, syphilis

Varicose vein - ____, ____, and ____ factors are high risk factors - ____ because plasma is pushed through vessel wall - If chronic blood pooling, skin changes that overlie the area → ____→ compromised blood ____→ tissue ____→ ___ ___ ___ (can become chronic) - Treatment: ____ ___, leg ____, ____ therapy, ____ of veins

1. Smoking, obesity, and hereditary 2. Edematous 3. swelling ... perfusion .. hypoxia .. venous stasis ulcer 4. compression stockings... elevation... laser ... stenting

Risk factors associated with venous stasis - Bed rest - Immobility - ____ ___ injury - Acute ___ ___ - ___ ___ failure - ____ - Venous ____

1. Spinal cord 2. myocardial infarction 3. Congestive heart 4. Shock 5. obstruction

nonpharmacologic treatment of angina and MI - Smoking cessation in persons who smoke - ____ reduction - Regular ____ program - Limiting dietary intake of ____ and ____ ___ - Weight reduction if obesity is present - Avoidance of ____ or other stresses that produce vasoconstriction

1. Stress 2. exercise 3. cholesterol and saturated fats 4. cold

Baroreceptors - ____ sensitive receptors - Monitor ___ ___

1. Stretch 2. blood pressure

Cardiac contractility - Is really the ___ ____ - End diastolic volume (preload) → too much can ____ contraction - ____ stimulation → positive inotropes are ____, ____, ____ and ____. ____is a negative inotrope

1. Stroke volume 2. decrease 3. Sympathetic ...epinephrine and norepinephrine, Thyroid hormone, and dopamine... Acetylcholine

Heart rate - ____ and ____ innervates the heart. - With ____ or ____ stim: increase HR. - ____ decreases HR through vagal nerve stimulation. - ____ ____ stimulates vagal nerve to lower HR - ____ and ____ through neuro reflexes

1. Sympathetic and parasympathetic 2. sympathetic or adrenergic 3. parasympathetic 4. Bearing down 5. Baroreceptors and pressoreceptors

Metabolic changes that occur in _____ → proatherogenic - More prone to _____ - Number for normal range of HDL, LDL, etc are ____ because the DM promotes atherosclerosis

1. T2DM 2. dyslipidemia 3. different

Arteries (oxygenated blood) - _____-walled vessels with large amounts of ____ fibers - Stretch during cardiac ____ and recoil during ____

1. Thick... elastic 2. systole ... diastole

Medical management following infarct - _____ therapy - Decrease workload of heart by decreasing ____ - Stabilize rhythm with ____ and relieve ____ - Relieve chest pain with _____ (____)

1. Thrombolytic 2. HR 3. antiarrhythmic .. occlusion 4. vasodilators (nitroglycerin)

Disorders of the Heart Valves resulted by: - Congenital defects - _____ - ____ damage - ____ changes - _____

1. Trauma 2. Ischemic 3. Degenerative 4. Inflammation

Composition of Blood Vessels - ____ _____ or ___ (outermost covering): Composed of fibrous and connective tissues that support the vessel - ____ ___ (middle layer): Largely a smooth muscle layer that constricts to regulate and control the diameter of the vessel - ____ ____ (inner layer): An elastic layer that joins the media and a thin layer of endothelial cells that lie adjacent to the blood

1. Tunica externa or adventitia 2. Tunica media 3. Tunica intima

atrial fibrillation - _____ _____ of atria - ___ ____ arising in atria causing fibrillation. Atrial cells cannot ____ or ____ for next incoming stimulus - ___ ____ are non-discernable (fibrillatory f waves) - ____ do not know which ____ to respond to - Ventricular response rate can be _____

1. Uncoordinated contraction 2. Reentrant circuits... repolarize or relax 3. P waves 4. Ventricles stimulus 5. varied

Compliance - C = #/# - A change in volume (V) causes ____ of an increase in transmural pressure (P) in a more ____ vessel. - A ____ is 24 times more compliant than its corresponding ____.

1. V/P 2. less ... compliant 3. vein ... artery

Atherosclerotic occlusive disease 1. You will see 7 P's here - ____ or ___ pulses in affected extremity - Extremity may be ____ to touch - Extremity may ____ or look pallor - Decrease blood supply → ischemia → death of tissue → can result in _____ 2. Treatment: treat ____ factors, stop ____ immediately, control ____ , control ____

1. Weak or absent 2. cool 3. blanch 4. gangrene 5. CV ... smoking .. cholesterol... BP

Main Atrial Pressure Waves Occurring During the Cardiac Cycle - __ wave : Caused by atrial contraction - ___ wave: Occurs as the ventricles begin to contract, and their increased pressure causes the AV valves to bulge into the atria - ___ wave: Results from a slow buildup of blood in the atria toward the end of systole when the AV valves are still closed

1. a 2. c 3. v

Absolute Refractory Period - No stimuli can generate another ____ ___. - Includes phases #, #, #, and part of phase #. - The cell cannot ____ again.

1. action potential 2. 0, 1, 2.... 3 3 .depolarize

Risk factors for HTN - Age: Older = larger risk factor - race: More severe and prevalent in ___ ____. - gender: More prevalent in ____ - Family history and genetics: 50% diagnosed have a family hx - Dietary factors: BP rises to eliminate excess ____. ____ increases resistance to blood flow

1. african americans 2. men 3. salt... Dyslipidemia

Atrial fibrillation - Increases in relation to _____. - Can occur in people without ____, or in ____, ___, ____, or ____ - You can live with a fib → ____ CO

1. age 2. disease... CAD, HTN, HF, and hyperthyroidism 3. decreased

Berry aneurysm - Most often found in the ___ of ____ in the brain circulation - Consists of a ____, ___ vessel dilation

1. circle of willis 2. small , spherical

Antiplatelet and Anticoagulant Therapy: Platelet Receptor Antagonists - Target a single step in the ____ process - Block the receptor involved in the ___ ____ ___ for platelet adhesion, activation, and aggregation - Treat ____ ___ ___

1. aggregation 2. final common pathway 3 acute coronary syndrome

Protein breakdown done anaerobically → ____ and ____ formation, both are toxic to cells. Protein breakdown liberates _____→ pyruvic acid → ____ ____. ____ _____ due to protein use → circulatory volume compromised

1. ammonia and urea 2. alanine --> lactic acid 3. Interstitial edema

Thromboangiitis obliterans (buerger disease) - Inflammatory ____ disorder that causes ____formation - Can extend to ____ or ____ - Seen in heavy ____, and tobacco ____ - _____ is major issue here due to ischemia - Cyanosis in ____ position - Skin appears ____ and ___ with limited ____ growth and malformed ____ - Treatment: ____

1. arterial ... thrombus 2. veins or nerves 3. smokers... chewers 4. Pain 5. dependent 6. shiny and thin... hair... nails 7. vasodilation

Dissecting aneurysm - Type A: more common and serious. Involve ___ or ___ ___ - Type B: do not involve ascending aorta - ___ and __ ___ condition - Involves ____ into the vessel wall with ____ ___ (dissection) of the vessel wall to form a blood-filled channel

1. ascending or descending aorta 2. Acute and life threatening 3. hemorrhage ... longitudinal tearing

Increased pressure can damage endothelium. This is the first step in the ____ process. Increased pressure = increased work of ____ ___ - ____ as an adaptive response. - LV has to push against enormous ____ and ____ itself and becomes hypertrophic. Bigger is not better here. It can lead to ___ or ___ ___

1. atherosclerotic ... LV 2. Hypertrophy 3. pressure ... remodels ... HF or pump failure.

aneurysm s/sx depending on location - Thoracic: ___, ___, or ___ pain. Respiratory symptoms like ___ - Abdominal: ___ or ___ pain. Most patients are ____. On physical exam, it is possible to have a abdominal _____. On CT scan, we can see ___ and ____

1. back, neck, or substernal... dyspnea 2. abdominal or back... asymptomatic... pulsation... atherosclerosis and calcification

Septic shock - Shock beginning with seemingly a simple infection → enters blood stream (_____) → ____ ___ ____: HR, WBC → _____ - ____ immune system turned on by toxins released by bacteria - Early stages: increased ____ causing systemic ____ with ____ and ____ CO - Later: depression of ____ ____ → ____ CO. _____ and tissue hypoperfusion → SIRS

1. bacteremia... systemic inflammatory response syndrome... MODS 2. Innate 3. NO ... vasodilation ... tachycardia ... increased 4. myocardial contractility... decreased ... Hypotension

When we stand up, normally ____ sense a position change → increases HR. In orthostatic hypotension, sense of baroreceptors does not occur ____ enough, blood ____ in ____ extremities

1. baroreceptors 2. fast 3. pools 4. lower

Ventricular tachycardia - Originates below ____ of ___ of ____ - QRS tight together and "_____" looking; ____ QRS - ____ ____ in CO - Rate can be very rapid - Could be all the same shape: _____; or Different shapes: _____ - Rhythm can be life threatening as it could lead to ventricular ____ or ____

1. bifurcation of bundle of HIS 2. bizarre... Wide 3. Severe decrease 4. monomorphic... polymorphic 5. flutter or fibrillation

all infarctions have ____ ____ (central area of necrosis surrounded by area of injury; longer of time, larger area of middle area of necrosis = less functionable tissue → does not ____ ___; tissue turns into ____ tissue that cannot function like original tissue = decrease in ____ and ____ goes down and remains down and can lead to ____)

1. bulls eye 2. slough off 3. scar 4. contractility and CO 5. HF

Cardiac reserve: maximum percentage of increase in ____ ____ achieved above ___ ___ level

1. cardiac output 2. normal resting

Blood pressure = ___ ___ x ___ ____ ___ - ____ is variable. - ____ is variable but to a much lesser degree. - ____ is regulated by the baroreceptor reflex in order to maintain pressure and perfusion.

1. cardiac output × peripheral vascular resistance 2. CO 3. BP 4. PVR

The evaluation of coronary blood flow and myocardial perfusion: cardiac _____ is the most accurate test because we are actually ____ arteries by putting catheters into arteries, injecting ____, and using ____. We most commonly look at the ____ side through the arterial system. We are visualizing the pt's arteries and what's inside in terms of occlusion. Sometimes we look at pressures in the ____ side of the heart through the venous system.

1. catheterization (angiography) 2. visualizing 3. dye 4. fluoroscopy 5. left 6. right

Shock - CV system fails to perfuse the tissues adequately - Affects ____ ___. Cell not getting enough ____ or cannot use the oxygen → shifts to ____ metabolism → uses up ____ faster and cannot be replaced - ATP needed for ____ ___ pump → ____ and ____ accumulate inside side and _____ leaving → cells of ___ and ___ system affected

1. cellular metabolism... oxygen ... anaerobic ... ATP 2. sodium potassium... sodium and chloride... potassium .. NS and CV

Laminar blood flow - Layering of blood components in the ____ of the bloodstream - Reduces ____ forces and prevents ____ ___ from coming in contact with the vessel wall

1. center 2. frictional ... clotting factors

Low density lipoproteins (LDLs) - Main carrier of ____ - LDL receptors are located in the ____→ phagocytize of LDL when binds and releases ___ ____ - LDL is also phagocytized by scavenger pathway via ___ ___ that have receptors that can bind to LDLs - _____ relationship of amount of LDLs, receptors, and amount of cholesterol

1. cholesterol 2. hepatocytes ... free cholesterol 3. scavenger cells 4. Direct

High density lipoproteins (HDLs) - Responsible for picking ____ and carrying it back to the ____ where the liver breaks it down and excretes it in ____ and into our ____ - 50% _____ - Identified as being protective against ____ - Reduces ___ ___ and ____

1. cholesterol ... liver .. bile ... feces 2. protein 3. atherosclerosis 4. oxidative stress and inflammation

Atherosclerotic occlusive disease is ____ in nature - Risk factors similar to ____ - Related to ____ and ___ - ____ onset of s/sx - #% occlusion before onset of symptoms - Most common complaint: ____ ___ - pain in legs with walking and stair climbing

1. chronic 2. atherosclerosis 3. smoking and DM 4. Gradual 5. 50 6. intermittent claudication

Cardiac Tamponade: Slow or rapid _____ of the heart due to accumulation of ____, ___, or ___ in the pericardial sac. Pericardial ____can lead to this condition.

1. compression 2. fluid, pus, or blood 3. effusion

DVT Treatment: early mobility and prevention, ___ ___, anticoagulants, promote venous blood flow by walking Extreme cases: surgical strategies such as ___ ___

1. compression stocking 2. removing clot

Disorders of the venous circulation - Produce ____ of the affected tissues - Predispose to ____ formation because of the stagnation of flow and activation of the clotting system

1. congestion 2. clot

Systole: period during which the ventricles are ____ Diastole: period during which the ventricles are ___ and ___ with blood

1. contracting 2. relaxed and filling

Antiplatelet and Anticoagulant Therapy: Ticlopidine and clopidogrel - May be used when aspirin is _____ - ____ inhibits the binding of ____ to its receptor on the platelets; no effect on ____ synthesis

1. contraindicated 2. Irreversibly... ADP ... prostaglandin

Atherosclerosis can take on many forms but it is a major contributor to ____ and ____ disease. Arteries of ___, ___, ___, ____ ___, and ___ ___ are the most commonly affected

1. coronary and cerebrovascular 2. heart, brain, kidneys, Small intestine, and lower extremities

Impaired glucose delivery or uptake/use - Mechanisms seen in shock state contribute to use of glucose: increase ____ release, increase ____ hormone release, increased release of ____ → _____ and ____ ____ (any patient, either DM or not) - Shift in cellular metabolism including ____, ____, and ____

1. cortisol ... thyroid ... catecholamines ... hyperglycemia and insulin resistance 2. gluconeogenesis, lipolysis, and glycogenolysis

MI Cardinal symptom: persistent ___ ___ pain - Women experience pain of MI differently than men. Women complain of _____, pain between ___ ___ - N/V, ____, ____ extremities (peripheral vasoconstriction), diaphoretic, anxiety (described as impending doom - pts feel like they might die), restless - ____ in BP due to catecholamines, ____ HR, extra heart sounds (___ + ___)

1. crushing substernal 2. indigestion ... shoulder blades 3. SOB... cool 4. Increase ... increased ... S3 + S4

Cardiomyopathies either are confined to the heart or are part of generalized systemic disorders, often leading to cardiovascular _____ or progressive heart _____-related disability.

1. death 2. failure

Cardiac contractility - Myocardial oxygen supply: O2 and CO2 in coronary artery will affect contractility. If O2 decreases, contractility is ____. A little bit of ____ can be beneficial to the heart. - ___ ___ available to participate in contractile process effects contractility

1. decreased.... hypoxemia 2. Calcium ions

Superficial thrombosis can lead to ____ thrombi. DVT usually in _____ extremities but can be in ____. Can lead to ___ ___ ___ or travel. DVT associated with ____ of blood, increased blood ____, and vessel wall ____. s/sx: Pain, swelling, ____muscle tenderness, inflammation, fever, malaise, and high ____. Diagnosis by ____

1. deep 2. lower ... upper 3. chronic venous insufficiency 4. stasis ... coagulability... injury 5. deep ... WBC 6. ultrasound

Causative factors of orthostatic hypotension - Fluid ____ - Medications - Aging - Defective function of ____ - Effects of ____

1. deficit 2. ANS 3. immobility

Angina Treatment - Cardiac catheterization is ____ and for treatment to put in ____ or ____ angioplasty crush up plaque against sides of vessels to pack it into vessel wall to make lumen large - ___ ____ or ___ ___ ___ surgery. Arteries taken from ____ or ____. ____ vessel disease (occlusion in LAD, circumflex, and right artery) --> Best for coronary artery bypass surgery

1. diagnostic ... stent or balloon 2. Bypass grafting... coronary artery bypass... leg or arm... Triple

causes of unstable angina - Atherosclerotic plaque ____ - Platelet _____ - Secondary ____

1. disruption 2. aggregation 3. hemostasis

Veins are capable of _____ (expand and hold onto a lot of blood → reservoir) - ______ nervous system: constricts to conserve blood - ____ way valves that prevent retrograde flow - Delivery of blood depends on ____ ____ generated from ejection of blood from ____. it has to be adequate to get the blood all the way to the ____. When it gets to the capillaries, it's called microcirculation.

1. distention 2. Sympathetic 3. one 4. pressure pulsations... LV... capillaries...

Right sided HF or cor pulmonale - Pulmonary _____, weight ____, _____ of viscera, ____ ____ ___ - ____ ____ - Heart becomes enlarged on both sides. Heart starts to deviate from its normal position in the chest. On x-ray, huge heart in middle of _____

1. edema.. .gain... congestion.... jugular vein distention 2. Cor pulmonale 3. mediastinum

Adaptive and maladaptive mechanisms in heart failure - Preload: volume and pressure inside of ventricle at ____ of ____ determined by amount of blood returning to ventricle after ____ and ___ - Frank-starling mechanism: the greater the ____ from preload, the _____ the contraction. But too much preload = too much stretch and ____ ____ will fall → HF

1. end of diastole... diastole and contracting 2. stretch .. stronger ... stroke volume

Treatment of anaphylaxis: _____ to cause vasoconstriction and reverse airway constriction - _____ to reverse hypovolemia - ____ and ____ - Remove the antigen if possible

1. epinephrine 2. Fluids 3. Corticosteroids and antihistamine

Angina often occurs after emotional _____, exposure to ____, large ____, ____. Can develop during ____ and wakes pt up

1. excitement 2. cold 3. meals 4. exercise 5. sleep

Very low density lipoproteins (VLDLs) are used by body in periods of _____ (beneficial) - Broken down into ____ density lipoproteins (IDLs) → recycled into ____ and ____ - Carries large amounts of ____

1. fasting 2. intermediate ... VLDLs and LDLs 3. triglycerides

Metabolic syndrome by definition: diagnosis is 3 out of these 4 problems - Elevated ___ ___ ___ or current treatment for diabetes - Elevated ___ ___ or current treatment for HTN - Elevated ____ ____ - - - increased abdominal fat deposits - Dyslipidemia - meaning increased _____ and/or decreased ____ cholesterol or receiving current treatment for dyslipidemia

1. fasting blood sugar 2. blood pressure 3. waist circumference 4. triglycerides ... HDL

Dyslipidemia - Contributes to ___ ___, ____, ___, and ____ - Triglycerides: used in _____ _____ - Phospholipids: important structural constituents of _____, blood ____ components, the ____ ____, and cell membranes - Cholesterol: chemical activity similar to other ____ substances

1. heart attacks, CAD, PAD, stroke 2. energy metabolism 3. lipoproteins... clotting .. myelin sheath 4. lipid

MODS - Risk factors: sepsis, prolonged periods of hypotension, ____ dysfunction, ____ bowel, advanced ____, severe trauma, ____ abuse - Progressive dysfunction of 2+ organ systems resulting from an uncontrolled _____ response to severe ____ or ____

1. hepatic .... infarcted ... age.. alcohol 2. inflammatory ... illness or injury

Microcirculation - Capillary—interstitial fluid exchange - Controlled by the ____ and ____ pressures

1. hydrostatic and osmotic

Target organ damage - Heart - ____ - Brain - ____ and ____ impairment - Peripheral vascular - _____ - Kidney - _____ - ____ complications

1. hypertrophy 2. dementia and cognitive 3. atherosclerosis 4. nephrosclerosis 5. Retinal

Factors Affecting Postnatal Pulmonary Vascular Development - Prematurity - Alveolar ____ - ____ disease - ____ ____ defects

1. hypoxia 2. Lung 3. Congenital heart

Vasculitis - Inflammation of blood vessel wall resulting in vascular ___ and ____ - ____, ___, and ____ may be affected - The inflammatory process may be initiated by ____ injury, ____ agents, or ____ processes

1. injury and necrosis 2. Arteries, capillaries and veins 3. direct... infectious ... immune

Edema 1. Definition: Excess ____ fluid in the tissues 2. Causes - ____ of any of the factors that control movement of water between the ____ compartment and the ___ spaces - Disproportionate increase in ____ ____ pressure or permeability, decreased ___ ____ ___ pressure, or impaired lymph flow

1. interstitial 2. Imbalance ... vascular ... tissue 3. capillary fluid.. capillary colloidal osmotic

Shock - As water drawn into _____ space, volume of vascular system goes down → ____ - Cells overburden with water and start to ____→ ____ enzymes - Compensatory mechanisms of shock: lead to impaired oxygen problem and not easily resolved: ___ ___ ___ of kidneys, ____, and ____

1. interstitial ... hypotension 2. burst ... lysosomal enzymes 3. Acute tubular necrosis... ARDS, and DIC

Development of atherosclerosis 1. LDL enters ____ through intact endothelium 2. Intimal LDL is oxidized into ____ ___ 3. Oxidized LDL causes ____ and entry of ____ and __ ___ across endothelium 4. Monocytes differentiate into ____ and then consume large amounts of ____, transforming into ____ cells 5. Foam cells release ____ ___ (____) that encourage atherosclerosis

1. intima 2. proinflammatory lipids 3. adhesion ... monocytes and T lymphocytes 4. macrophages ... LDL... foam 5. growth factors (cytokines)

MI - ____ cell damage - Progresses beyond ____ - O2 demand goes up and metabolism shifts to ____ - Myocardial cellular ____ - ____ release --> arrhythmias

1. irreversible 2. ischemia 3. anaerobic 4. death 5. Catecholamine

Within about 10 seconds, myocardial cells become ____. Within minutes, they can loose ability to ____. If last more than 20 minutes, myocardial cells are lost ____. If coronary arteries cannot compensate then ____ will occur.

1. ischemia 2. contract 3. forever 4. infarction

Atrial fibrillation Symptoms can be varied - Some people do not ____ they are in a-fib - _____ - ____ mentation, decreased ___ ___, ____ ____→ represent declined CO - Predisposition to ____ formation due to residual blood left in atria and ventricles - _____ as initial sign

1. know 2. Palpitations 3. Slowed ... urine output... pulmonary edema 4. thrombus 5. Stroke

Specific Arterial Involvement in Atherosclerosis - In ____ vessels, the important complications are those of thrombus formation and weakening of the vessel wall. - In _____-sized arteries, ischemia and infarction due to vessel occlusion are more common.

1. larger 2. medium

2 main coronary arteries coming off "___ ___." There is a small short stub coming off ____→ left main → 2 major left sided arteries → ____ ____ ____ artery and ___ ___ branches - Supply ___ ___ and front/anterior portion of ____

1. left main 2. aorta 3. left anterior descending... left circumflex 4. left ventricle... septum

Systemic circulation: ____ side of heart to pump blood throughout the body except the lungs. It supplies nutrients to the body. It is a _____ pressure system because the blood has to go throughout the body

1. left side 2. high

Semilunar valves → look like a half moon. - Aortic: Between the ___ ___ and aorta. Controls ___ blood flow - Pulmonic: Between the ___ ___ and pulmonary artery. Controls ____ blood flow.

1. left ventricle... systemic 2. right ventricle... pulmonary

Surgery for HF - Option for HF related to ___ ___ remodeling - LV hypertrophy can be ____ ___ to decrease size and pump blood more efficiently - Heart ____ - ____ ____ ___ until heart available for transplantation

1. left ventricular 2. cut out 3. transplant 4. Ventricular assist device

Gastrointestinal Complications - Loss of appetite, nausea, vomiting - Superficial mucosal _____of the stomach and duodenum - Development of sepsis and shock - ____

1. lesions 2. Ischemia

Aneurysm - Abnormal ___ ___ of a blood vessel - Can include ____ of ____ - Can occur in veins or arteries, but much more likely in ____ - Outpouching grows, vessel wall becomes ___ and ___ due to pressure. Can be life threatening depending on the ____ involved. ___ is the most susceptible to aneurysm because its under constant stress and pressure. ¾ of aortic aneurysm will be located in ____ area. - Main cause: _____ and ____ of vessel media

1. localized dilation 2. chamber of heart 3. arteries 4. thinner and ruptures... artery ... Aorta... abdominal 5. atherosclerosis ... degeneration

Sinus tachycardia - Fever, stress, anxiety, blood ____ - Caused by enhancement of ____ usually due to ____ stimulation like ____ - ____ and ____ cause sinus tachycardia. - If of short duration: ____ unless ____ - Heart does not ____ as efficiently as it needs to, and CO ____

1. loss 2. automaticity ... sympathetic ... epinephrine 3. Hyperthyroidism and HF 4. benign unless symptomatic 5. fill ... falls

HF Can result from CAD, MI, mechanical problems of heart disrupting ventricular filling, blood volume too _____ (hemorrhage), excessive cardiac workload due to volume _____, too much _____ overload (HTN-sive pt), _____ valve ______ increases pressure of left ventricle pumping against, ______ (increases metabolic demand), ______ (blood volume or where hemoglobin affected) with decrease of O2 to heart muscle, increased ____ and ____ retention, _____thyroidism, ______ due to increased circulating blood volume, dysrhythmias

1. low 2. overload 3. pressure 4. aortic valve stenosis 5. infections 6. anemia 7. sodium and water 8. hyperthyroidism 9. pregnancy

Risk factors for HTN: OSA People with sleep apnea do not often want to use the ____. When we go to sleep and sleep well, we go through ____, our BP is at our lowest. In OSA, pts do not sleep well because they have periods of ____ that wake them up. Their blood pressure never gets to a ___ level. These patients are constantly at a ____ level of pressure. This can lead to atherosclerosis.

1. machine 2. REM 3. apnea 4. low 5. higher

Obstructive shock - Circulatory shock that results from _____ obstruction of the ____ of blood through the ____ circulation - Causes: dissecting aortic aneurysm, cardiac _____, _____, atrial myxoma, and _____ of abdominal contents into the thoracic cavity

1. mechanical.. flow ... central 2. tamponade... pneumothorax... evisceration

Autonomic Control Centers for Cardiac Function and Blood Pressure - Located bilaterally in the ____ ____ - The medullary cardiovascular neurons are grouped into three distinct pools that lead to ____ innervation of the heart and blood vessels and ____ innervation of the heart.

1. medulla oblongata 2. sympathetic... parasympathetic

Shock - pH of cells lead to ____ ____ → failure of certain enzymes needed for ___ and ____ - Lactic acid leads to impairment of ____ ___ of blood → deoxygenation of cells

1. metabolic acidosis... repair and division 2. oxygen capacity

Cardiac output - Amount of blood the heart pumps each ____ - Determined by 1. CO = # x # - Stroke volume: the amount of blood pumped with each ____ - Variable by body ____ and ____ of the body at any given time - #-# L/Minute at any given time 2. Venous ____ and ____

1. minute 2. SV x HR - beat - size and need - 4-6 3. return and contractility

Cardiomyopathies: A heterogeneous group of diseases of the ____ associated with _____ and/or _____ dysfunction that usually (but not invariably) exhibit inappropriate ventricular _____ or ____ and that are due to a variety of causes that frequently are genetic.

1. myocardium 2. mechanical and/or electrical 3. hypertrophy or dilatation

Coarctation of the aorta: The aorta arches over the heart. With coarctation of the aorta ____ the arch → ____ in BP in these children. We only see HTN in level ____ coarctation. There is an increase in pressure in ____ ____. We se a higher BP when we take blood pressure in ____ extremities vs ____ extremities. Provider will require BP in ____ and ___ extremities. There will be a pressure difference.

1. narrows 2. increase 3. above 4. subclavian arteries 5. higher ... lower 6. upper and lower

Foam cell macrophages will eventually die and leave behind some ____ tissue and ___ ___ that embeds in the vessel wall. This is a problem of ____ build up. This is the part of the ___ ___. Once fatty streak, then fatty streak starts to turn into a ___ ____. The plaque can actually ____ and ____ into the vessel → results in ____ tissue in the vessel. The scar tissue is the last step of the ___ ___.

1. necrotic ... cellular debris 2. plaque 3. fatty streak 4. Fibrous plaque 5. ulcerate and bleed 6. scar 7. complicated lesion

Ventricular fibrillation - CO is ___-___ - ____ intervention required - Described as being ____ without ____ wave forms or intervals - Could be _____ or ____ - Rhythm that is ____ with life - Treatment: ___-____ ____ - Results of severe ____ disturbance (_____)

1. non-existent 2. Immediate 3. chaotic ... identifiable 4. fine or coarse 5. incompatible 6. non-synchronized shock 7. electrolyte ... potassium

Disorders of AV conduction: Second-degree AV block - Intermittent failure of conduction of # or more impulses from ____ to ____ - Looks like _____ but every once in a while there is a __ ____ not conducted

1. one... atria to ventricles 2. NSR ... P wave

Goals of treatment for angina are to decreases myocardial ___ ___ and increase ____ - Get HR ____ so we can use things like ____ - Increase o2 supply by ____ arteries so that more blood can get through with ____ (____ ____, ____)

1. oxygen demands... supply 2. down ... BBs 3. dilating ... nitrates .. (sublingual nitroglycerin, isosorbide)

Treatment of Cardiomyopathy depends on - Medication - Implanted _____ - _____ - ____ ____ devices - ____ - The goal of treatment is often ____ ____, and some patients may eventually require a heart _____.

1. pacemakers 2. Defibrillators 3. Ventricular assist 4. Ablation 5. symptom relief... transplant

4 valves: when closed, blood cannot flow back. Held together by ____ muscles and ___ ___ → if ruptured (as in a huge ___ ___), the valve flails and blood ____ flows → need ___ ___ surgical correction → blood cannot move forward.

1. papillary ... chordae tendineae 2. heart attack 3. back 4. immediate emergent

Chronic pericarditis - No ____ identified - ____ disorders

1. pathogen 2. Autoimmune

Secondary HTN: Elevation of blood pressure that results from some other disorder, such as kidney disease - Can increase ___ ___ __ or ____ - Affects ____, ____ glands, or ____ system - Can be related to coke, amphetamines, _____, oral contraceptives (known to cause ____ retention. High sodium = high water → high BP). - May be corrected by ____ or specific ____ treatment

1. peripheral vascular resistance or CO 2. kidneys, adrenal glands, or vascular system 3. decongestants... sodium 4. surgery .. medical

Varicose vein - Vein that blood has ____ - Most are ____ but can lead to secondary problems of venous circulation - Damage to vein valves due to prolonged ____ - The 1 way valves become _____, leads to ____ of blood and ____ of vein - ____ is factor

1. pooled 2. benign 3. standing 4. incompetent.. backflow ... distention 5. Gravity

Lipoprotein: hydrophobic ____ bound to a ___ - Allows hydrophobic lipid to travel through ____ - _____ does most of the work with lipids. It synthesizes and releases LDLs and HDLs

1. triglyceride .. cholesterol 2. plasma 3. Liver

Major risk for atherosclerosis - Hypercholesterolemia - Cigarette smoking - Hypertension - Family history of _____ ___ in a first-degree relative - Age (men # years and older; women # and older) - HDL cholesterol under # mg/dL - ____ levels → marker of increased periods of stress and inflammation - _____ levels related to endothelial damage

1. premature CHD 2. 45 .. 55 3. 40 4. CRP (C-reactive protein) 5. Homocysteine

movement of blood through heart - Governed by ____, ____, and ____ - Pressure difference between 2 ends of a vessel. This determines the actual pressure

1. pressure, resistance, and flow

Foam cell development: Once this transformation happens, this is a ____ part of the process because it keeps LDL ____ of foam cells and not ____. Measurement of LDL will be ____ because its not in plasma but rather foam cells

1. protective 2. inside 3. circulation 4. lower

Manifestations of left heart failure: - Result of ____ ____ congestion and inadequate perfusion of the systemic circulation - Include dyspnea, _____, cough of ____ sputum, fatigue, decreased ____ ___, and edema - Physical examination often reveals _____ edema (_____, inspiratory crackles, ____ ___), ____ or ____, an ___ gallop, and evidence of underlying CAD or hypertension

1. pulmonary vascular 2. orthopnea... frothy ... urine output 3. pulmonary ... (cyanosis... pleural effusions)... hypotension or hypertension... S3

Circulatory system works together with lymphatic system to use heart as a _____ to accomplish its functions

1. pump

Afterload (resistance to ejection of blood from heart): the pressure it must generate to ____ the blood ____ of the heart - The load that the muscle must move during ____. - Ventricle must overcome pressure in ____ to pump blood out of LV - Increase in aortic pressure → ____ in afterload (systemic vascular resistance) like in HBP or aortic stenosis

1. pump ... out 2. contraction 3. aorta 4. increase

Heart failure: Low output - Disorders that impair ____ of the heart - _____ vasoconstriction with ____, ____, and sometimes ____ extremities

1. pumping 2. Systemic... cold, pale... cyanotic

Treatment for atrial fibrillation is all about ____ ___ and ____ at first - Attempts to _____. Electrical cardioversion to stop heart and restart heart in NSR - patients may spontaneously convert back to NSR within # ____

1. rate control and anticoagulation 2. cardiovert 3. 24 hours

Orthostatic hypotension (postural hypotension): "Sustained ____ in systolic pressure of at least # mmHg more or a ____ of diastolic pressure of # mmHg within # minutes of standing or head-up tilt on a tilt table for at least 60 degrees"

1. reduction 2. 20 3. reduction 4. 10 5. 3

Long term adaptations - Cardiac ______: ventricular ____ - Over long term, is detrimental to function of heart

1. remodeling... hypertrophy

Arterioles - Serve as _____ vessels for the circulatory system - Act as ___ ___ through which blood is released as it moves into the capillaries

1. resistance 2. control valves

Adaptive and maladaptive mechanisms in heart failure - Afterload: _____ to ejection of blood from ____. ventricle has to overcome _____ pressure to pump blood out. When increased pressure in aorta = _____ afterload pressure = systemic resistance _____

1. resistance... LV... aortic ... increased ... increase

Unstable angina pain has a more persistent and severe course and is characterized by at least one of three features: - It occurs at ____ (or with minimal exertion), usually lasting more than # minutes (if not interrupted by _____). - It is severe and described as ____ ____ and of ___ onset. - It occurs with a pattern that is more ____, ___, or ____ than previously experienced.

1. rest ... 20 .. nitroglycerin 2. frank pain ... new 3. severe, prolonged, or frequent

Endothelial dysfunction describes potentially ____ changes in endothelial function that occur in response to environmental stimuli - Products that cause inflammation: ____, ____, ____ - Hemodynamic _____ - ____ products - _____

1. reversible 2. Cytokines, bacteria, viruses 3. stresses 4. Lipid 5. Hypoxia

Transient ischemia can cause ____ changes → pt is at risk for ____. With intervention, we can restore blood flow and tissue can heal. If untreated, we will see necrosis. Myocardium will revert to ____ metabolism and ___ ___ will start to accumulate, which ____ cellular pH → causes pain. Acidosis can rapidly impair function of ____ ___ (chamber responsible for contracting and pumping out blood to rest of body. Wall motion of chamber will become abnormal → ____ blood ejected → ____ in CO

1. reversible ... infarction 2. anaerobic ... lactic acid... reduces 3. left ventricle 4. less ... decrease

Pulmonary circulation is the _____ side of the heart. Where the right side of the heart pumps blood to lungs. This is a ____ pressure system, which allows for ____ ____ to happen → moves ____ through respiratory system, allows blood to stay in lungs for gas exchange

1. right 2. low 3. gas exchange 4. slowly

Heart Failure - Can effect ____ ventricle, but usually ____ sided HF happens first - Either Classified as ____ ____, ___ ___, acute, chronic, left sided, right sided - Problem with _____. When myocardium does not pump effectively related to metabolic needs of body, we see pump failure.

1. right ... left 2. high output, low output 3. pump

Aorta → Right coronary artery → supplies blood to ___ ___ and posterior ___ ___ - Provides blood to ___ and ___ nodes, important for myocardial infarction

1. right ventricle... left ventricle 2. SA and AV

During the ischemia, anaerobic metabolism movement → acidosis → pain. There is a phenomenon where pts will not feel pain, termed ____ ____. The _____ pt suffers from this (___ ____). Diabetic will have ischemic events that are never noticed until actual ____.

1. silent ischemia 2. diabetic 3. myocardial neuropathy 4. infarction

myocardium cells are similar to those of ____ muscle. Myocardial cells are arranged in a lattice opposed to skeletal muscle which is more ____. Differs in ability to store calcium. Cardiac muscle required a ____ influx of calcium but it does not ____ it very well. Myocardial muscle needs more ____ calcium because it cannot hold onto the ____ form.

1. skeletal 2. longitudinal 3. constant 4. store 5. extracellular 6. intracellular

Raynaud disease and phenomenon - Causes over the top vasoconstriction in times where we should have ___ or ___ vasoconstriction as in the cold - Pallor to cyanosis, pain, numbness, tingling - Once pain is over, intense ____ to fingers (hyperemia), ___, ____ - Treatment: ____ fingers and toes, don't ____, don't go in ____

1. slight or normal 2. redness ... throbbing, paresthesia 3. protect ... smoke... cold

The lesions will compromise the lumen of the vessel. Blood flow will ____ down. This causes an obstruction to the blood flow and turns ____ because it has to make way through uneven edges. ____ and ____ occurs and leads to further occlusion of the vessel. Plaque can be ____ or ____ (can lead to rupture, ulceration, and bleeding)

1. slow 2. turbulent 3. Thrombosis and inflammation 4. stable or unstable

Disseminated Intravascular Coagulation (DIC) - Widespread activation of the coagulation system with resultant formation of fibrin clots and thrombotic occlusion of ___ and ____sized vessels - Systemic formation of thrombin

1. small and midsized

Pharm treatment of arrhythmias - Class I drugs: act by blocking the fast ____ channels - Class II agents: beta-adrenergic blocking drugs that act by blunting the effect of _____ nervous system stimulation on the heart - Class III drugs act by extending the ___ ____ and ____ - Class IV drugs: act by blocking the slow ____ channels, thereby depressing phase # and lengthening phases # and #

1. sodium 2. sympathetic 3. action potential and refractoriness 4. calcium ...4... 1 and 2

printz medal angina due to ____ of coronary artery - Common to ____ and can be brought about by emotion ___ and ____ - Not due to _____

1. spasm 2. women ... stress, cold 3. plaque

Age and HTN - As we age, vessels become ____ - Elastic arteries replaced with ____ - Increased _____ pressure and less able to maintain ___ or ____ pressure - ____ systolic and ____ diastolic pressures - ____ ____ is the difference between systolic and diastolic. In aging, we see ____ gap between systolic and diastolic

1. stiff 2. collagen 3. systolic... diastolic or resting pressure 4. High ... low 5. Pulse pressure... higher

Aging Process and Cardiac Function - Increased vascular ____ - Reduced responsiveness to ___ ___ stimulation that limits the heart's capacity to maximally increase ____ ___ and _____ - Left ventricular _____ - Heart ____ decreases

1. stiffness 2. beta adrenergic... heart rate and contractility 3. hypertrophy 4. compliance

Manifestations of Rheumatic Fever 1. Acute Stage - History of an initiating _____ infection - Involves ____ _____ tissue of the ____, ___ ___, ____, and ____ tissues 2. Recurrent Phase: Extension of the ____ effects of the disease 3. Chronic Phase: _____ deformity of the heart _____

1. streptococcal 1b. mesenchymal connective.. heart, blood vessels, joints, and subcutaneous tissues 2. cardiac 3. Permanent ... valves

MODS Patho: release of ____ ____ due to activation of _____ system, vascular endothelial damage due to toxins, inflammatory mediators - Hypotension - Hypoperfusion - _____ - ____ because platelets and tissue thromboplastin activated - _____ state

1. stress hormones... neuroendocrine 2. ARDS 3. DIC 4. Hypercoagulant

Fibrous skeleton: Provides _____ support and ____ force for electrical impulse

1. structural 2. isolating

MODS - Imbalance between O2 ____ and ____. Amount of O2 consumed becomes dependent on circulation ability to deliver → inadequate → tissue ____ with ___ ___ → Multi organ failure - ____ is an early sign. Hypoxia and issue related to shock with impairment of oxygen → leads to ____ ___

1. supply and demand... hypoxia with cellular acidosis 2. ARDS ... organ failure

Heart failure: High output - Extensive need for cardiac output - Function of heart might be _____ (increase Ejection Fraction #-#% sometimes → heart cannot keep up with this demand) - Excessive ____ needs

1. supranormal ... 75-80 2. metabolic

Short term adaptations - Increased _____ activity - Release of ____ from kidney - Affected cells will undergo ____ metabolism - Increased Extraction of oxygen from _____ cells - ____ ___ ____ length increases, ventricular muscle ____, and increases ____

1. sympathetic 2. renin 3. anaerobic 4. peripheral 5. End diastolic fiber.. dilated... FOC

Plaque rupture susceptible to certain hemodynamic factors - Surge of ____ factors like _____→ abrupt rise in BP, HR, or force of contraction - ____ ___ hours: sympathetic activity wakes up → changes in platelet aggregation, fibrinolytic activity → favors thrombosis - ____ ____ in lipid core express tissue factor due to disruption → extrinsic coagulation pathway activated → platelets adhere to endothelium → release of ADP and thrombin → more platelet aggregation - _____: forms bridge between platelets

1. sympathetic .. catecholamine 2. Early morning 3. Foam cells 4. Fibrinogen

vasculitis s/sx: pain, fever, myalgia, and malaise, ____ ___ (also includes ____ arteries and _____ arteries. Focal necrosis and granuloma type of inflammation. Sudden onset of _____ , ____ over artery, ____ of vision. 10% of people with vasculitis will develop a ___ ___ ___)

1. temporal arteritis 2. vertebral 3. ophthalmic 4. headache 5. tenderness 6. blurriness 7. thoracic aortic aneurysm

Involvement of Heart Muscle in an Infarct: Subendocardial Infarcts - Involve the inner one ____ to ____ of the ventricular wall - Occur more frequently in the presence of severely ____ but still patent ____ ___

1. third to half 2 narrowed ... arterial ductus

Fusiform and saccular aneurysms - Most often found in the ___ and ____ ____ - Characterized by ___ and ___ enlargement of the aorta

1. thoracic and abdominal aorta 2. gradual and progressive

Autoregulation of blood flow is mediated by changes in blood vessel ____ due to changes in flow through the ____ or by local ___ ___. - Lack of ____ - Accumulation of tissue ____ - _____ Control - _____

1. tone ... vessel ... tissue factors 2. oxygen 3. metabolites 4. Endothelial 5. Hyperemia

Endothelial cells - Controls the ____ of molecules across the vascular wall - Control of platelet ____ and blood ____ - Modulation of blood ____ and vascular ____ - Metabolism of _____ - Regulation of _____ and ____ reactions - Influence the ____ of other cell types

1. transfer.. 2. adhesion... clotting 3. flow ... resistance 4. hormones 5. immune and inflammatory 6. growth

myocardium Actin and myosin filaments slide across each other during contraction, which requires _____. Troponin is a protein needed for ____ and ____. ____ facilitates extracellular calcium to make it intracellular calcium needed for contraction and relaxation - Troponin __ and __: Indicates myocardial damage, like heart attack. - Troponin C

1. troponin 2. contraction and relaxation 3. Digoxin 4. T and I

Valvular heart disorders produce blood flow _____ and often are detected through ____ ____. - _____ is still the most widely used diagnostic test to check for structure and function of the heart. It uses _____ signals that are inaudible to the human ear.

1. turbulence ... cardiac auscultation 2. Echocardiography ... ultrasound

Acute coronary syndromes - Represent the spectrum of ischemic coronary disease ranging from ___ ___ through ____ ____ - Abrupt changes in ___ and ___ occurs → occludes vessel even further → ischemia → necrosis

1. unstable angina through myocardial infarction 2. plaque and thrombosis

Neurogenic shock - Known as _____ shock - Widespread ____ because ____ under-stimulation and ____ over-stim - Traumatic brain injury, spinal cord injury, ___ ____, ____ overdose, medulla injury

1. vasogenic 2. vasodilation ... sympathetic ... parasympathetic 3. general anesthesia.. heroin

Raynaud disease and phenomenon - Functional disorder caused by intense ____ of the ___ and ____ in the ____ and, less often, the ____ - 2 different processes 1. Disease is primary: Less intense 2. Phenomenon is secondary: Can cause ____

1. vasospasm of the arteries and arterioles... fingers ... toes 2. necrosis

RHF: Pools on left and right side → backs up causing pressure and congestion in ___ ___ and ____ circulation → increased pressure in venous system (____ ___ ___) → extends to ____ and ____ veins (____ and ____ engorged and impaired). Rise in capillary pressure forcing excess fluid into interstitial spaces → tissue edema in ____ ____

1. vena cava and systemic 2. jugular vein distention 3. hepatic and visceral... (liver and spleen) 4. lower extremities

Left-sided HF or congestive HF Allows blood to pool in _____ and _____ and eventually backs up to ____ ____ and ____ - Patients overloaded and experience pulmonary symptoms: ____ or dyspnea on ____ - Rise in ____ ___ pushing salt and water into interstitial spaces: ____ ____ (coughing, _____, pulmonary vasculature increased in ____ ___ pressure, increased ____ levels)

1. ventricle... atrium.. pulmonary veins and capillaries 2. SOB... exertion 3. capillary pressure... pulmonary edema.. crackles... pulmonary artery... CO2

MI - Possible ____ arrhythmias due to conduction system issues - ___ damage → ____ affected (down) → other organs suffer, including heart which uses 5% of CO - ____ acidosis - We need to interrupt this cycle by reestablishing ___ ___

1. ventricular 2. LV ... CO 3. Respiratory 4. blood flow

Preload (____ ____): volume of blood it pumps out - Dependent on the heart and the vasculature - All about the ____ - Refers to volume and pressure inside ____ on ____ - Load imposed on heart ____ contraction - Determined by amount of blood returning to ventricles on ____ and after ____ or ____

1. ventricular filling 2. stretch 3. ventricle on diastole 4. before 5. relaxation ... systole or contraction

Long QT syndrome and torsades de pointes - QT prolonged resulting in torsades de pointes (a special type of ___ ____ where QRS is ____ size, ____ rate, QRS seemingly wrapping itself around isoelectric line) - Unstable and fatal if not spontaneously converted or treatment - Treatment: ___ ____ - Antiarrhythmic drugs can cause ____ ___ syndrome

1. ventricular tachycardia... variable ... fast 2. IV magnesium 3. long QT

True aneurysm - Bound by entire ____ ___ and blood remains in ____ component - ___, ___, ___ aneurysms

1. vessel wall.. vascular 2. Berry, fusiform, and saccular

Supernormal Excitatory Period - A ____ stimulus can evoke a response. - Extends from the terminal portion of phase # until the beginning of phase # - Cardiac ____ develop.

1. weak 2. 3 ... 4 3. arrhythmias

2nd degree AV block type 1 - Mobitz 1 or _____ - ____ ____ so that P wave appears with no subsequent ____ that follows → repeating pattern

1. wenckebach 2. Progressive elongation... QRS

Acute Lung Injury (ALI)/Acute Respiratory Distress Syndrome (ARDS) - Potentially lethal form of pulmonary injury that may be either the cause or result of shock - Rapid onset of profound dyspnea that usually occurs # to # hours after the initiating event

12 to 48

Classification of coronary heart disease includes (2)

Acute coronary syndromes Chronic ischemic heart disease, known as stable angina

Which of the following is regulated by osmotic and hydrostatic forces? Capillaries Veins Arteries Lymphatic system Venules All of the above

All of the above All follow the principles of fluid dynamics and are influenced or regulated by osmotic and hydrostatic forces.

Blood flow is not based on which of the following properties? Pressure Vessel compliance Volume Contraction of the heart Distensibility of vessels All of the above

All of the above All the above are contributing factors to the flow of blood

Aortic Valve Disorders (2)

Aortic valve stenosis Aortic valve regurgitation

DVTs may be the direct result of ______. Smoking Hypersensitivity reaction Hypercholesterolemia Bed rest

Bed rest Bed rest can cause DVT formation due to blood stasis and lack of skeletal muscle pumping

Which of the following conditions will result in pathological changes arising from pulseless electrical activity? Pericardial effusion Cardiac tamponade Pericarditis

Cardiac tamponade Cardiac tamponade is the result of restricted movement of the muscle and will inhibit ventricular contraction. The conduction is intact, but there will be little or no SV.

Types of Cardiomyopathies (5)

Dilated Hypertrophic Restrictive Arrhythmogenic right ventricular Peripartum

True or false: Cardiac output is a direct reflection of how well blood is flowing through the arteries and veins

False: CO is a measure of blood flow out of the heart, but does not reflect the flow through the circuit as there are many factors affecting flow once you get out of the heart.

Acute pericarditis is based on clinical manifestations. - ECG, chest radiography, and echocardiography - ____ ____

Friction rub

Which of the following is considered the "good cholesterol. Chylomicrons very-low -density lipoprotein (VLDL) Intermediate-density lipoprotein (IDL) Low-Density lipoprotein (LDL) High-density lipoprotein

High-density lipoprotein Due to its function of taking cholesterol from the tissues and moving it to the liver for metabolic breakdown

Sinus arrhythmias will have a greater effect on the total heart than atrial arrhythmias because _____. They will not be different, and each is equally harmful The sinus node will directly cause a fibrillation The sinus node will stimulate the rest of the heart directly into a new rhythm The sinus node will not activate the atrioventricular node

The sinus node will stimulate the rest of the heart directly into a new rhythm

____ ___: contains the first two, controlling sympathetic-mediated acceleration of heart rate and blood vessel tone ____ ___: contains the third, which controls parasympathetic-mediated slowing of heart rate

Vasomotor center Cardioinhibitory center

Which of the following is not a risk factor for atherosclerosis? Hypercholesterolemia Cigarette smoking HTN Venous stasis Age (men greater than or equal to 45 years; women greater than or equal to 55 years) HDL cholesterol less than 40 mg/dL

Venous stasis Venous stasis is responsible for disorders in the venous system and is not related to atherosclerosis

Hyperlipidemia: Elevation in lipids including one or all of ____, ___, ____

triglycerides, phospholipids, and cholesterol