Study Guide for Exam 3 Pathophysiology Summer 2015
Chapter 22:
Pericardium: describe the pericardium, function of pericardium
Pericardium: is a double-walled membranous sac that encloses the heart
Function: 1. Prevents displacement of the heart during gravitational
acceleration or deceleration
2. Serves as a physical barrier that protects the heart against
infection and inflammation from the lungs and pleural space
3. Contains pain receptors and mechanoreceptors to elicit reflex
changes in blood pressure and heart rate.
The Great Vessels
Describe the flow of blood through the heart.
- The right heart receives venous blood from the systemic circulation
through the superior and inferior venae cavae, which enter the right
atrium. Blood leaves the right ventricle and enters the pulmonary
circulation through the pulmonary artery. This artery divides into
right and left branches to transport un-oxygenated blood from the
right heart to the right and left lungs. The pulmonary arteries
branch further into the pulmonary capillary bed, where oxygen and
carbon dioxide exchange occurs.
Which part of the heart receives blood from the systemic circulation
- The right side of the heart receives blood from the systemic
circulation
- Left side- blood flows through the aorta and into the systemic
arteries
Rhythmicity:
SA node
- SA node sets the pace because normally it has the fastest rate. The
SA node depolarizes spontaneously 60 to 100 times per minute.
AV Node
- If the SA node is damaged, the AV node will become the heart’s
pacemaker at a rate of about 40 to 60 spontaneous depolarization
per minute.
Review how the electrical impulse travels through the heart.
- Sympathetic and parasympathetic nerve fibers innervate all parts
of the atria and ventricles and the SA and AV nodes. The
sympathetic and parasympathetic nerves affect the speed of the
cardiac cycle (heart rate or beats per minute). Sympathetic nervous
activity enhances myocardial performance. Stimulation of the SA
, node by the sympathetic nervous system rapidly increases heart
rate. It released norepinephrine or circulating catecholamine
interact with B-adrenergic receptors on the cardiac cell membranes.
The overall effect is an increased influx of Ca++, which increases
the contractile strength of the heart and increases the speed of
electrical impulses through the heart muscle and the nodes.
Normal EKG
P wave (define)
-The P wave represents atrial depolarization
PR Internal (Define)
- A measure of time from the onset of atrial activation to the
onset of ventricular activation (normally 0.12 to 0.20
second). The PR interval represents the time necessary for
electrical activity to travel from the sinus node through the atrium,
AV node, and His-Purkinje system to activate ventricular myocardial
cells.
QRS complex (define)
- QRS complex is the sum of all ventricular cell
depolarizations
QT interval (define)
- Sometimes called the “electrical systole” of the ventricles. It lasts
about 0.4 second but varies inversely with the heart rate.
Chapter 23:
Atherosclerosis (define) a disease of the arteries characterized by the
deposition of plaques of fatty material on their inner walls. Hardening and
narrowing of the arteries. This process silently and slowly blocks arteries, put
blood flow at risk. It is also the usual cause of heart attacks, strokes, and
peripheral vascular disease.
Clinical: coronary artery disease; stable plaques in the heart’s arteries
causes angina (chest pain on exertion). Plaque rupture and clotting causes
heart muscle to die (heart attack) myocardial infarction. Cerebrovascular
disease; ruptured plaques in the brain’s arteries causes strokes with the
potential for permanent brain damage. Peripheral artery disease; narrowing
in the arteries of the legs caused by plaque causes poor circulation.
Manifestations: damage to the endothelium caused by high blood pressure,
smoking, or high cholesterol. That damages lead to the formation of plaque.
, When bad cholesterol (LDL) crossed the damaged endothelium, the
cholesterol enters the wall of the artery. Over the years the cells becomes
the plaque in the wall of the artery. As the narrowing become severe, they
choke off blood flow and can cause pain and blockage. Blockage can
suddenly rupture causing blood to clot inside an artery at the site of rupture.
- Atherosclerosis can stay within an artery wall. The plaque grows to
a certain size and stops. Since this plaque doesn’t block blood flow,
it may never cause symptoms.
- Plaque can grow in a slow, controlled way into the path of blood
flow. Eventually, it causes significant blockages. Pain on exertion (in
the chest or legs) is the usual symptom.
- Plaques that suddenly rupture, allowing blood to clot inside an
artery, in the brain (stroke), in the heart (heart attack).
Evaluation: health life style can prevent the buildup of plaque that causes
atherosclerosis, which is the bad cholesterol build up in the arties.
LDL good fat should be higher
HDL bad fat should be lower
Trans fat is bad, mono unsaturated fat is better
<200 total cholesterol; LDL should be higher than your HDL to equal to 200.
Treatment: Lifestyle changes, reducing the lifestyle risk factors that lead to
atherosclerosis will slow or stop the process. Diet, exercise, and no smoking,
they won’t remove blockages but they will lower the risk of heart attacks and
strokes.
Medication, taking drugs for high cholesterol and high blood pressure will
slow and lower your risk of heart attacks and stroke.
Blood Pressure (normal range)
- S/D
- Normal <120 SBP and / >80 DBP
- Prehypertension 120-139 SBP or/ 80-89 DBP
- Hypertension 1 140-159 SBP or/ 90-99 DBP
- Hypertension 2 >160 SBP or/ >100 DBP
Hypertension (defines, understand the difference, Risk Factors, complications
of, symptoms of)
Primary
- Results from a sustained increase in peripheral resistance
(arteriolar vasoconstriction) an increase in circulating blood volume,
or both.
Chapter 22:
Pericardium: describe the pericardium, function of pericardium
Pericardium: is a double-walled membranous sac that encloses the heart
Function: 1. Prevents displacement of the heart during gravitational
acceleration or deceleration
2. Serves as a physical barrier that protects the heart against
infection and inflammation from the lungs and pleural space
3. Contains pain receptors and mechanoreceptors to elicit reflex
changes in blood pressure and heart rate.
The Great Vessels
Describe the flow of blood through the heart.
- The right heart receives venous blood from the systemic circulation
through the superior and inferior venae cavae, which enter the right
atrium. Blood leaves the right ventricle and enters the pulmonary
circulation through the pulmonary artery. This artery divides into
right and left branches to transport un-oxygenated blood from the
right heart to the right and left lungs. The pulmonary arteries
branch further into the pulmonary capillary bed, where oxygen and
carbon dioxide exchange occurs.
Which part of the heart receives blood from the systemic circulation
- The right side of the heart receives blood from the systemic
circulation
- Left side- blood flows through the aorta and into the systemic
arteries
Rhythmicity:
SA node
- SA node sets the pace because normally it has the fastest rate. The
SA node depolarizes spontaneously 60 to 100 times per minute.
AV Node
- If the SA node is damaged, the AV node will become the heart’s
pacemaker at a rate of about 40 to 60 spontaneous depolarization
per minute.
Review how the electrical impulse travels through the heart.
- Sympathetic and parasympathetic nerve fibers innervate all parts
of the atria and ventricles and the SA and AV nodes. The
sympathetic and parasympathetic nerves affect the speed of the
cardiac cycle (heart rate or beats per minute). Sympathetic nervous
activity enhances myocardial performance. Stimulation of the SA
, node by the sympathetic nervous system rapidly increases heart
rate. It released norepinephrine or circulating catecholamine
interact with B-adrenergic receptors on the cardiac cell membranes.
The overall effect is an increased influx of Ca++, which increases
the contractile strength of the heart and increases the speed of
electrical impulses through the heart muscle and the nodes.
Normal EKG
P wave (define)
-The P wave represents atrial depolarization
PR Internal (Define)
- A measure of time from the onset of atrial activation to the
onset of ventricular activation (normally 0.12 to 0.20
second). The PR interval represents the time necessary for
electrical activity to travel from the sinus node through the atrium,
AV node, and His-Purkinje system to activate ventricular myocardial
cells.
QRS complex (define)
- QRS complex is the sum of all ventricular cell
depolarizations
QT interval (define)
- Sometimes called the “electrical systole” of the ventricles. It lasts
about 0.4 second but varies inversely with the heart rate.
Chapter 23:
Atherosclerosis (define) a disease of the arteries characterized by the
deposition of plaques of fatty material on their inner walls. Hardening and
narrowing of the arteries. This process silently and slowly blocks arteries, put
blood flow at risk. It is also the usual cause of heart attacks, strokes, and
peripheral vascular disease.
Clinical: coronary artery disease; stable plaques in the heart’s arteries
causes angina (chest pain on exertion). Plaque rupture and clotting causes
heart muscle to die (heart attack) myocardial infarction. Cerebrovascular
disease; ruptured plaques in the brain’s arteries causes strokes with the
potential for permanent brain damage. Peripheral artery disease; narrowing
in the arteries of the legs caused by plaque causes poor circulation.
Manifestations: damage to the endothelium caused by high blood pressure,
smoking, or high cholesterol. That damages lead to the formation of plaque.
, When bad cholesterol (LDL) crossed the damaged endothelium, the
cholesterol enters the wall of the artery. Over the years the cells becomes
the plaque in the wall of the artery. As the narrowing become severe, they
choke off blood flow and can cause pain and blockage. Blockage can
suddenly rupture causing blood to clot inside an artery at the site of rupture.
- Atherosclerosis can stay within an artery wall. The plaque grows to
a certain size and stops. Since this plaque doesn’t block blood flow,
it may never cause symptoms.
- Plaque can grow in a slow, controlled way into the path of blood
flow. Eventually, it causes significant blockages. Pain on exertion (in
the chest or legs) is the usual symptom.
- Plaques that suddenly rupture, allowing blood to clot inside an
artery, in the brain (stroke), in the heart (heart attack).
Evaluation: health life style can prevent the buildup of plaque that causes
atherosclerosis, which is the bad cholesterol build up in the arties.
LDL good fat should be higher
HDL bad fat should be lower
Trans fat is bad, mono unsaturated fat is better
<200 total cholesterol; LDL should be higher than your HDL to equal to 200.
Treatment: Lifestyle changes, reducing the lifestyle risk factors that lead to
atherosclerosis will slow or stop the process. Diet, exercise, and no smoking,
they won’t remove blockages but they will lower the risk of heart attacks and
strokes.
Medication, taking drugs for high cholesterol and high blood pressure will
slow and lower your risk of heart attacks and stroke.
Blood Pressure (normal range)
- S/D
- Normal <120 SBP and / >80 DBP
- Prehypertension 120-139 SBP or/ 80-89 DBP
- Hypertension 1 140-159 SBP or/ 90-99 DBP
- Hypertension 2 >160 SBP or/ >100 DBP
Hypertension (defines, understand the difference, Risk Factors, complications
of, symptoms of)
Primary
- Results from a sustained increase in peripheral resistance
(arteriolar vasoconstriction) an increase in circulating blood volume,
or both.
