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and Blood Pressure Regulation
Triglycerides - correct answer They are used in energy metabolism, are combinations of three fatty acids and a single glycerol molecule. Phospholipids - correct answer Contain a phosphate group, are important structural constituents of lipoproteins, blood-clotting components, the myelin sheath, and cell membranes. Cholesterol - correct answer Not composed of fatty acids, its steroid nucleus is synthesized from fatty acids, and thus, its chemical and physical activity is similar to that of other lipid substances. aqoproteins - correct answer Cholesterol and triglyceride are hydrophobic molecules that are insoluble in plasma, they combine with specific water-soluble proteins so they can travel through the plasma Lipoprotein - correct answer hydrophobic core encapsulated by a stabilizing coat composed of the water-soluble apoproteins and the hydrophilic heads of phospholipids. Transport cholesterol and triglycerides to various tissues for energy utilization, lipid deposition, steroid hormone production, and bile acid formation Sites of lipoprotein synthesis - correct answer small intestine and the liver VLDL - correct answer Delivers hepatic triglycerides to peripheral tissue; secreted by liver
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IDL - correct answer Formed in the degradation of VLDL. Delivers TGs and cholesterol to liver. LDL - correct answer Primary transport molecule for cholesterol. It is removed from the circulation either by it's receptors or by scavenger cells such as monocytes or macrophages. HDL - correct answer Often referred to as the good cholesterol because it facilitates the reverse transport of cholesterol (carrying cholesterol from the peripheral tissues back to the liver). May help protect against atherosclerosis Factors that can raise blood lipid levels include... - correct answer nutrition, genetics, medications, comorbid conditions, and metabolic diseases. Primary dyslipidemia - correct answer Refers to abnormalities in blood lipid and cholesterol levels that develop independent of other health problems or lifestyle behaviors. Usually have a genetic basis, may be a defective synthesis of certain apoproteins. Secondary dyslipidemia - correct answer Associated with other health problems like DM2 and behaviors. Characterized by combinations of the following patterns of blood lipids: increased triglycerides, increased total blood cholesterol, increased LDL cholesterol, and decreased HDL cholesterol.
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blood levels of C-reactive protein (CRP) - correct answer have been demonstrated to be a useful but nonspecific biologic marker of the presence of systemic inflammation. Noted to be present within some atherosclerotic plaque, further implicating the role of inflammation in plaque formation. It's an effective clinical marker of risk for atherosclerotic vascular disease .A high-sensitivity test is recommended as a screening test for cardiovascular risk. Homocysteine - correct answer Derived from the metabolism of dietary methionine, an amino acid that is abundant in animal protein. The normal metabolism of requires adequate levels of folate, vitamin B6, vitamin B12, and riboflavin. Puts people at risk for severe atherosclerosis Pathogenesis of athersclerosis - correct answer Fully developed fibrous plaque, the core contains lipid-filled macrophages and necrotic SMC debris. The "fibrous" cap is composed largely of SMCs, which produce collagen, small amounts of elastin, and glycosaminoglycans. Also shown are infiltrating macrophages and lymphocytes. Clinical Manifestations of Atherosclerosis - correct answer Narrowing of the vessel and production of ischemia Sudden vessel obstruction because of plaque hemorrhage or rupture Thrombosis and formation of emboli resulting from damage to the vessel endothelium Aneurysm formation because of weakening of the vessel wall. Vasculitis - correct answer Group of vascular disorders that cause inflammatory injury and necrosis of the blood vessel wall
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Clinical manifestations of Vasculitis - correct answer Include fever, myalgia, arthralgia, and malaise. Vasculitis may result from - correct answer Direct injury to the vessel, infectious agents, or immune processes, or they may be secondary to other disease states such as systemic lupus erythematosus. Physical agents such as cold, irradiation, mechanical injury, immune mechanisms, and toxins may secondarily cause vessel damage, often leading to necrosis of the vessels.
- correct answer Most common of the vasculitides, is a focal inflammatory condition of medium-sized and large arteries. It predominantly affects branches of arteries originating from the aortic arch, including the superficial temporal, vertebral, ophthalmic, and posterior ciliary arteries Thrombus - correct answer Blood clot that forms on the wall of a vessel and continues to grow until reaching a size that obstructs blood flow. Often arise as the result of erosion or rupture of the fibrous cap of an arteriosclerotic plaque. Occlusion in an extremity causes... - correct answer Sudden onset of acute pain with numbness, tingling, weakness, pallor, and coldness. There often is a sharp line of demarcation between the oxygenated tissue above the line of obstruction and the ischemic tissue below the line of obstruction. Etiology of Atherosclerotic occlusive disease - correct answer Cigarette smoking contributes to the progress and to the development of symptoms of ischemia. People with diabetes mellitus develop more extensive and rapidly progressive vascular disease than do people who do not have diabetes.
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Diagnosis and Treatment for Buergers disease - correct answer It is mandatory that the person stop smoking cigarettes or using tobacco. Even passive smoking and nicotine replacement therapy should be eliminated. Raynaud disease or phenomenon - correct answer Functional disorder caused by intense vasospasm of the arteries and arterioles in the fingers and, less often, the toes. This is a common disorder affecting 3% to 5% of the population and is more common in women than men. Etiology and Pathogenesis - correct answer Excessive vasoconstrictor response to stimuli. In contrast to other regional circulations that are supplied by vasodilator and vasoconstrictor fibers, the cutaneous vessels of the fingers and toes are innervated only by sympathetic vasoconstrictor fibers. Clinical manifestations - correct answer ischemia because of vasospasm causes changes in skin color that progress from pallor to cyanosis, a sensation of cold, and changes in sensory perception, such as numbness and tingling. The color changes usually are first noticed in the tips of the fingers. Trophic changes may develop when it's extreme Diagnosis and Treatment - correct answer Diagnosis is typically based on history of vasospastic attacks supported by other evidence of the disorder. Treatment measures are directed toward eliminating factors that cause vasospasm and protecting the digits from trauma during an ischemic episode. Aneurysms - correct answer Abnormal localized dilation of a blood vessel. Can occur in arteries and veins, but they are most common in the aorta.
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true aneurysm - correct answer Aneurysm is bounded by a complete vessel wall. The blood in a true aneurysm remains within the vascular compartment. False aneurysm or pseudoaneurysm - correct answer Represents a localized dissection or tear in the inner wall of the artery with formation of an extravascular hematoma that causes vessel enlargement. Unlike true aneurysms, only by the outer layers of the vessel wall or supporting tissues bound false aneurysms berry aneurysm - correct answer True aneurysm that consists of a small, spherical dilation of the vessel at a bifurcation.1,4 This type of aneurysm usually is found in the circle of Willis in the cerebral circulation. fusiform aneurysm - correct answer True aneurysm that involves the entire circumference of the vessel. Characterized by a gradual and progressive dilation of the vessel. These aneurysms, which vary in diameter (up to 20 cm) and length, may involve the entire ascending and transverse portions of the thoracic aorta or may extend over large segments of the abdominal aorta. saccular aneurysm - correct answer true aneurysm that extends over part of the circumference of the vessel and appears saclike Aortic Aneurysms - correct answer Outpouchings or dilations of the arterial wall.
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Average pulse pressure - correct answer 40 mm Hg - difference between systolic and diastolic pressures. Mean arterial pressure - correct answer pressure forcing blood into tissues, averaged over cardiac cycle. About 90-100 in adults. = CO x PVR Body maintains its blood pressure by ... - correct answer adjusting CO to compensate for changes in PVR and (b) adjusting PVR to compensate for changes in CO. The cardiovascular center, which contains the vasomotor and cardiac control centers, work by - correct answer Transmitting parasympathetic impulses to the heart through the vagus nerve and sympathetic impulses to the heart and blood vessels through the spinal cord and peripheral sympathetic nerves. ANS control of blood pressure is... - correct answer mediated through intrinsic circulatory reflexes, extrinsic reflexes and higher neural control centers. Circulatory intrinsic reflexes - correct answer Include baroreceptor and chemoreceptor reflexes, controlled within the circulatory system and are essential for rapid and short-term regulation of blood pressure. Extrinsic reflexes sensors - correct answer Found outside the circulation, include blood pressure responses associated with factors such as pain and cold.
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Hypothalamus - correct answer SNS responses are channeled though this, examples of higher neural control include blood pressure responses caused by variations in mood and emotion. Baroreceptors/Pressoreceptors - correct answer pressure-sensitive receptors located in the walls of blood vessels and the heart. Respond to changes in the stretch of the vessel wall by sending impulses to the cardiovascular centers in the brain stem to effect appropriate changes in HR, strength of cardiac contraction, and vascular smooth muscle tone. Arterial chemoreceptors - correct answer Monitor blood levels of oxygen, carbon dioxide, and hydrogen ions. Main function is to regulate ventilation, they also communicate with cardiovascular centers in the brain stem and can induce widespread vasoconstriction. Renin-angiotensin-aldosterone system - correct answer Plays a central role in blood pressure regulation. It release occurs in response to increased SNS activity or decreased blood pressure, extracellular fluid volume, or extracellular sodium concentration. Angiotensin II - correct answer functions in both short- and long-term regulation of blood pressure. It is a strong vasoconstrictor, particularly of arterioles and, to a lesser extent, of veins. Constriction of the arterioles increases the PVR, thereby contributing to the short-term regulation of blood pressure Vasopressin - correct answer Released from the posterior pituitary gland in response to decreased blood volume or decreased blood pressure. Has a direct vasoconstrictor effect.
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Vasculitis - correct answer Inflammation of the blood vessel wall resulting in vascular tissue injury and necrosis. Arteries, capillaries, and veins may be affected. The inflammatory process may be initiated by direct injury, infectious agents, or immune processes. Aneurysms - correct answer Represent an abnormal localized dilatation of an artery because of a weakness in the vessel wall. As it increases in size, the tension in the wall of the vessel increases, and it may rupture. The increased size of the vessel may also exert pressure on adjacent structures. Hyperlipidemia - correct answer Excess of lipids in the blood. Lipids are classified as triglycerides, phospholipids, and cholesterol. Diagnosis and treatment of an aortic aneurysm - correct answer Diagnostic methods include use of ultrasonography, echocardiography, CT scans, and MRI. Surgical repair frequently is the treatment of choice. Aortic Dissection - correct answer diagnosis in which the arterial wall splits apart, acute life-threatening condition Aortic dissection risk factors - correct answer hypertension and degeneration of the medial layer of the vessel wall. There is a history of hypertension in most cases. Marfan syndrome, pregnancy
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Clinical Manifestations - correct answer dissecting aneurysm is the abrupt presence of excruciating pain, described as tearing or ripping. Diagnosis and treatment of aortic dissection - correct answer Based on history and physical examination supported by diagnostic studies such as vascular imaging, CT and MRI. The treatment of dissecting aortic aneurysm may be medical or surgical depending on the type and whether it is acute or chronic. varicose veins - correct answer Dilated, tortuous veins of the lower extremities are common and often lead to secondary problems of venous insufficiency. Incidences rise with age and is more common in females Etiology and Pathogenesis - correct answer Prolonged standing and increased intra- abdominal pressure are important contributing factors in the development. - increases venous pressure and causes dilation and streching. Clinical manifestations of Primary varicose veins - correct answer Unsightly appearance. In many cases, aching in the lower extremities and edema, especially after long periods of standing, may occur. The edema usually subsides at night when the legs are elevated. Chronic Venous Insufficiency - correct answer Pathophysiologic of persistent venous hypertension on the structure and function of the venous system of the lower extremities.
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Clinical Manifestations of Venous Throbosis - correct answer Common signs and symptoms of venous thrombosis are those related to the inflammatory process, including pain, swelling, and deep muscle tenderness. Fever, general malaise, and an elevated white blood cell count and erythrocyte sedimentation rate are accompanying indications of inflammation. There may be tenderness and pain along the vein. Diagnosis of DVT - correct answer Include venography, ultrasonography, and plasma d-dimer assessment. Whenever possible, venous thrombosis should be prevented in preference to being treated. Treatment of DVT - correct answer Prevent the formation of additional thrombi, prevent extension and embolization of existing thrombi, and minimize venous valve damage. Elevation of the legs can help prevent stasis of venous blood flow. Heat may be applied to the leg to relieve venospasm. Anticoagulation drug therapy or surgical removal be be done in certain cases. Hypertension - correct answer Sustained condition of elevation of the blood pressure within the arterial circuit. Etiology of hypertension - correct answer Excess body weight, Excess dietary sodium Reduced physical activity Inadequate fruit, veggie and potassium intake Excess alcohol consumption
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Risk factors of hypertension - correct answer Age, gender, race, family history, genetics, diet, dyslipidemia, tobacco, alcohol consumption, fitness level, obesity, insulin resistance, metabolic abnormalities, OSA secondary hypertension - correct answer elevation in blood pressure because of another disease condition. - Cocaine, amphetamines, sympathomimetic agents (decongestants, anorectics), erythropoietin, and licorice. Kidney disease (i.e., renovascular hypertension), disorders of adrenal cortical hormones, pheochromocytoma, coarctation of the aorta, and use of oral contraceptive agents. Renal hypertension - correct answer Kidney assumes in blood pressure regulation. Decreased urine formation, retention of salt and water, and hypertension are common complications of acute kidney disorders such as acute glomerulonephritis, acute renal failure, and acute urinary tract obstruction. Disorders of Adrenocortical Hormones - correct answer Can also give rise to hypertension because of hormonally induced renal retention of salt and water. Pheochromocytoma - correct answer Tumor of chromaffin tissue, which contains sympathetic nerve cells that stain with chromium salts and release catecholamine Coarctation of the Aorta - correct answer Congenital condition in which there is a narrowing in the area of the arch of the aorta. The aortic narrowing increases the resistance to blood flow, causing the left ventricle to increase pressure in the attempt to overcome the resistance.
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orthostatic hypotension - correct answer abnormal drop in blood pressure on assumption of the standing position. Etiology of orthostatic hypotension - correct answer Approximately 500 to 700 mL of blood is rapidly shifted to the lower part of the body, with an accompanying decrease in central blood volume and arterial pressure. Maintenance of blood pressure during position change is quite complex. Risk factors for Orthostatic hypotension - correct answer Age, reduced blood volume, bed rest, impaired mobility, drug-induced hypotension, disorders of the ANS Diagnosis of Orthostatic hypotension - correct answer Can be assessed with the auscultatory method of blood pressure measurement. Treatment of orthostatic hypotension - correct answer Primarily directed toward alleviating the cause and helping people learn ways to cope with the disorder and prevent falls and injuries. Medications that predispose to postural hypotension should be avoided.
