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Intro. to Pathophysiology
Musculoskeletal, Cardiovascular, Renal, Respiratory
575
Physiology
Undergraduate 4
06/23/2010

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Term
List the 2 main categories of musculoskeletal.
Definition
1. Bones and joints
2. Skeletal muscle
Term
List 5 basic functions of bones.
Definition
1. Hematopoesis
2. Lever
3. Protectoin
4. Stability
5. Storage of minerals and nutrients (fat)
Term
List 4 characteristics of bones.
Definition
1. Innervated
2. Very vascular
3. Dynamic
4. Very organized
Term
What does it mean that bones are dynamic?
Definition
Constantly undergoing remodeling processes
Term
Define heart rate.
Definition
# of beats per minute
Term
Define stroke volume.
Definition
Volume ejected per ventricle per beat
Term
If stroke volume falls, HR (increases, decreases, no change).
Definition
Increases
Term
If stroke volume (increases/decreases/no change), HR increases.
Definition
Decreases
Term
Define cardiac output.
Definition
Volume ejected per ventricle per minute
Term
What is the equation to determine cardiac output.
Definition
HR X SV
Term
Define systole.
Definition
Period of time heart spends in contraction; cardiac contraction
Term
How much time is spent in systole?
Definition
1/3 of time
Term
Define diastole.
Definition
Period of time heart spends in relaxation; cardiac relaxation
Term
How much time is spent in diastole?
Definition
2/3 of time
Term
Why does the heart spend more time in diastole?
Definition
Relaxation requires more active pumping of calcium ions
Term
When speaking of ventricles, always assume we're talking about the (left/right) ventricles. Why?
Definition
Left; they go out to the extremities
Term
Define end systolic volume.
Definition
Ventricular volume after systole; residual volume; volume that doesn't leave after heart contracts
Term
Anything that increases _____ _____ causes ESV to decrease.
Definition
Cardiac contractility
Term
List 3 things that increase cardiac contractility.
Definition
1. Epinephrine
2. Norepinephrine
3. Dopamine
Term
ESV (increases/decreases/no change) if output volume decreases.
Definition
Increases
Term
Define end diastolic volume.
Definition
Ventricular volume after diastole; filling volume
Term
Sterling's law is associated with what?
Definition
EDV
Term
What increases EDV?
Definition
Increased venous return
Term
Increased EDV increases _____, which decreases _____.
Definition
SV; HR
Term
Define ejection fraction.
Definition
Measure of cardiac efficiency
Term
What is the equation for ejaction fraction.
Definition
SV / EDV
Term
How do you find stroke volume?
Definition
EDV-ESV
Term
If SV and EDV both increase or decrease, will the ejaction fraction ration change?
Definition
No
Term
Define mean arterial pressure.
Definition
Average arterial pressure during one systole, diastole cardiac cycle
Term
What is always measure in mmMg?
Definition
MAP
Term
What is the equation for mearn arterial pressure?
Definition
Diastolic pressure + 1/3 (systolic - diastolic)
Term
Define pulse pressure.
Definition
Difference between systolic and diastolic
Term
Define diastolic pressure.
Definition
Average pressure during diastole in arteries
Term
Diastolic pressure is on (top/botton) and systolic pressure is on (top/bottom).
Definition
Bottom; top
Term
Define systolic pressure.
Definition
Average pressure during systole in arteries
Term
Define preload.
Definition
The EDV value.
Term
What does preload do?
Definition
Primes ventricle for max contraction and stretch
Term
Of preload and afterload, which is good? Which is bad?
Definition
Preload is good; afterload is bad
Term
Preload is synonymous with what 2 things?
Definition
1. EDV
2. Venous return
Term
Define afterload.
Definition
Resistance blood sees when it leaves the heart
Term
List 3 things that increase afterload.
Definition
1. Constriction
2. Stenotic valves
3. Anything that causes vasoconstriction
Term
Regarding afterload, list 4 things that can cause vasoconstriction.
Definition
1. Endothelin
2. Thromboxane
3. PG2alpha
4. Serotonin
Term
If afterload increases, _____ decreases.
Definition
SV
Term
Define total peripheral resistance.
Definition
Total resistance blood sees in periphery
Term
TPR is a combination of resistance from what 3 things?
Definition
1. Arteries/arterioles
2. Capillaries
3. Veins
Term
What is the equation for TPR?
Definition
Ra + Rc + Rv
Term
Define central venous pressure.
Definition
Lowest pressure in cardiovascular circuit
Term
What is the location of CVP?
Definition
Right atria
Term
Where does the highest amount of pressure occur in the cardiovascular circuit?
Definition
Top, left ventricle
Term
Heart disorders relate to what 4 main things?
Definition
1. Cardiac muscle cells
2. Coronary blood flow
3. Wall layers
4. Cardiovascular system regulation
Term
What is another word for cardiac muscle cells?
Definition
Myocytes
Term
Myocytes are (myogenic/neurogenic), which means what?
Definition
Myogenic; self-generating
Term
Myocyte nerves can change or modulate, but they can't initiate or stop actions. What is this called?
Definition
Neuromodulated
Term
What neurons are myocytes innervated by?
Definition
Sympathetic and parasympathetic
Term
T/F Myocytes neurons are capable of making their own activity, as in skeletal muscle neurons.
Definition
False; not capable of
Term
List the 2 types of myocytes.
Definition
1. Contractile cells
2. Pacemaker cells
Term
List 3 characteristics of contractile myocytes.
Definition
1. Work-horses
2. Generate force
3. 99% of heart wall
Term
Describe 4 characteristics of the appearance of contractile myocytes.
Definition
1. Striated
2. Uninucleate
3. Branching
4. Intercollated disks
Term
By what method do contractile myocytes pirmarily grow?
Definition
Hypertrophy
Term
Since contractile myocytes grow primarily by hypertrophy, this means that their cell type is what?
Definition
Non-mitotic
Term
Are contractile myocytes regenerative?
Definition
No
Term
Regarding contractile myocytes, physiological hypertrophy results in growth in _____ by means of _____.
Definition
Volume; exercise
Term
Due to physiologiccal hypertrophy of contractile myocytes, at rest, _____ increases.
Definition
SV
Term
Is physiological or pathological hypertrophy non-benificial to contractile myocytes?
Definition
Pathological
Term
Pathological hypertrophy of contractile myocytes results in growth in _____, but a loss of _____.
Definition
Thickness; volume
Term
List 3 receptors specific to contractile myocytes.
Definition
1. Beta 1
2. Stretch receptors
3. Dopamine receptors
Term
A stretch receptor is a type of _____.
Definition
Mechanoreceptor
Term
What do stretch receptros on contractile myocites cause?
Definition
Increased contraction
Term
The increased contraction which results form stretch receptors on contractile myocytes (does/does not) change HR.
Definition
Does not
Term
What do dopamine receptros on contractile myocites cause?
Definition
Increased contraction
Term
The increased contraction which results form dopamine receptors on contractile myocytes (does/does not) change HR.
Definition
Does not
Term
Describe the characteristics of a contractile myocite action potential.
Definition
1. Have a set resting membrane potential and threshold potential
2. Depolarize with Na (Na in)
3. Long refractory period or plateau phase (Ca in from ESF)
4. Repolarize w/ K (K out)
5. Do not hyperpolarize
Term
List 3 functions of the long refractory period/plateau phase in contractile myocytes.
Definition
1. Promotes contraction
2. Changes membrane potential
3. Prevents summation/tetany
Term
The long refractory period/plateau phase of contractile myocytes promotes contraction. How is this related to the action potential?
Definition
It's not
Term
Pacemaker myocytes are also known as what?
Definition
Rate-setters
Term
Pacemaker myocytes make up _____ of the heart wall.
Definition
<1%
Term
List 4 characteristics of appearance of pacemaker myocytes.
Definition
1. Not typical muscle proteins
2. Not striated
3. Uninucleate
4. Connected by gap junctions
Term
Pacemaker myocytes (are/are not) regenerative.
Definition
Are not
Term
List the 2 receptors associated with pacemaker myocytes.
Definition
1. Beta 1
2. Muscarinic
Term
Describe the characteristic of a pacemaker myocyte action potential.
Definition
1. No set resing membrane potential
2. Have threshold potential
3. No voltage-gated Na channels
4. Depolarize with Ca
5. Ca in, K out
6. Don't hyperpolarize
Term
"The pacemaker" is described as what?
Definition
The one with the highest depolarization rate
Term
List pacemaker myocytes in order of highest depolarization rate to lowest.
Definition
SA node-->AV node-->Bundle of His-->Perkinje fibers
Term
What is the main function of coronary blood flow?
Definition
Feed the walls of the heart via coronary circulation
Term
Structually, coronary arteries are _____, which means there is a _____ and a _____.
Definition
Paired; left; right
Term
Where do coronary arteries arise from?
Definition
Aorta
Term
What is the pathway of a coronary artery?
Definition
Aorta-->capillary bed-->cardiac veins-->coronary sinus-->right atrium
Term
When is blood delivered to the heart through the coronary arteries?
Definition
Only during diastole, when the heart is relaxing and pipes are open (2/3 of time)
Term
List the 2 ways coronary blood flow is controlled.
Definition
1. Systemically
2. Locally
Term
Systemically controlled coronary blood flow involves what organ?
Definition
Adrenal medulla
Term
What does the adrenal medulla provide systemically for coronary blood flow? What is the result? What are the receptors?
Definition
Epi and norepi; vasodilation; beta 2
Term
Systemically controlled coronary blood flow involves _____ activity.
Definition
Sympathetic
Term
Locally controlled coronary blood flow involves _____ regulation.
Definition
Endothelial
Term
What is the effect of dopamine (released systemically from the adrenal medulla) on coronary blood flow?
Definition
Nothing; dopamine doesn't alter blood flow - it's not vasoactive
Term
Local, endothelial regulatoin of coronary blood flow results in what 2 things?
Definition
1. Vasodilation
2. Vasoconstriction
Term
Local, endothelial vasodilation of coronary blood flow involves what 3 factors/receptors? Which is most common*?
Definition
1. Adenosine*
2. Nitric oxide
3. Prostacyclin
Term
Local endothelial vasoconstriction of coronary blood flow involves what 3 factors/receptors? Which is most common*?
Definition
1. Endothelin* 2. PGF2alpha 3. Thromboxane
Term
List the 3 layers of the heart, inner to outer.
Definition
1. Endocardium
2. Myocardium
3. Epicardium
Term
What is the deepest, chamber-facing layer of the heart?
Definition
Endocardium
Term
List the 2 components of endocardium.
Definition
1. Endothelial cells
2. Pacemaker cells
Term
In endocardium, what are the functions of endothelial cells. What do the endothelial cells of the epicardium not do?
Definition
1. Prevent inflammation
2. Prevent leukocyte adhesion
3. Control vascular remodeling
Do not make vasoactive factors
Term
List the 3 main categories of endocardial disorders.
Definition
1. Endocarditis
2. Valve disorders
3. Rhythm disorders
Term
Endocarditis comes in 2 forms; _____ or _____.
Definition
Acute; chronic
Term
Which form of endocarditis is better?
Definition
Acute
Term
What is acute endocarditis?
Definition
An endogenous bacteria or virus that causes inflammation of the inner layer of heart
Term
What is the manifestation of acute atrial endocarditis?
Definition
Asymptomatic
Term
What is the acute valve or ventricular manifestation of endocarditis? What does this allow?
Definition
Decreased SV; backflow
Term
T/F Acute endocarditis typically results in long-term damage.
Definition
False
Term
What is the treatment for actue endocarditis?
Definition
Antibiotic, antiviral
Term
Define chronic endocarditis.
Definition
Recurrent inflammatory response in one section of the heart wall or valve
Term
List 2 things that chronic endocarditis leads to.
Definition
1. Scar tissue formation
2. Decreased elasticity and stretch
Term
What is the manifestation of chronic atrial endocarditis?
Definition
Asymptomatic
Term
What is the manifestation of chronic valve or ventricular endocarditis?
Definition
Chronic decrease in output, thus chronic decrease in SV
Term
What is the treatment for chronic endocarditis?
Definition
Contractility agent (dopamine agonist); corticosteroid (for immunosuppression); diuretic (low dose ACE inhibitor); treat auto-immune
Term
What is the main function of a heart valve?
Definition
Prevent backflow
Term
List 4 things that any valve disorder can be caused by.
Definition
1. Chronic endocarditis (lupus)
2. Age
3. Myocardial infarcion (heart attack)
4. Infection (rheumatic fever)
Term
Valve disorders (are/are not) genetic.
Definition
Are not
Term
List 2 general treatments of valve disorders.
Definition
1. Treat causes
2. Valve replacement
Term
List the 3 main categories of endocardial valve disorders.
Definition
1. Insufficient
2. Stenotic
3. Prolapse
Term
Describe an insufficient valve disorder.
Definition
Valve does not close completely
Term
An insufficient valve disorder results in what?
Definition
Backflow, which causes turbulance in the atria, and decreases SV and cardiac output
Term
Where does an insufficient valve disorder typically occur?
Definition
AV valves
Term
Backflow resulting from insufficient valve disorders causes (atrial/ventricular) backflow.
Definition
Atrial
Term
Describe an insufficient valve disorder heart murmur.
Definition
Low pitch (whir, whoosh, rumble); heard after the lub
Term
which of the 3 valve disorders has specific stand-alone causes?
Definition
Stenotic
Term
Define stenosis.
Definition
Narrowing
Term
Describe stenotic valve disorder.
Definition
Valve that doesn't open all the way
Term
What results from a stenotic valve disorder?
Definition
Increased resistance, high afterload, which decreases SV and cardiac output
Term
Which valves are most likely effected in stenotic valve disorders?
Definition
SL valves
Term
Describe the heart murmur of a stenotic valve disorder.
Definition
High pitch (whistle) heard after lub
Term
List 5 specific causes of stenotic valve disorders.
Definition
1. Hypertension
2. Smoking
3. Dyslipidemia
4. Physical inactivity
5. Heart failure
Term
What is a prolapse valve disorder?
Definition
Valve burps backwards but typically holds its seal
Term
What does a prolapse valve disorder cause?
Definition
Change in pressure gradient; by increasing ventricular volume it decreases ventricular pressure, which decreases SV and cardiac output
Term
What does a prolapse valve disorder most commonly affect?
Definition
Mitral AV valve (left bicuspid)
Term
Which valve disorder does not typically cause heart murmurs. In what case can it cause heart murmurs?
Definition
Prolapse; if it becomes insufficient or leaky
Term
List 4 endocardial rhythm disorders.
Definition
1. Premature ventricular contraction (PVC)
2. Atrial flutter
3. Wolff-Parkinson-White syndrome
4. Bundle branch block
Term
Define PVC.
Definition
An extra heartbeat caused by an abnormal electrical impulse starting in ventricles
Term
List causes/risk factors of PVC.
Definition
1. Age
2. Alcohol
3. Caffeine
4. Pseudoephredine
5. Coronary artery disease
6. Heart failure
7. Stress
8. Valve disorders
9. Ectopic focus
Term
What is an ectopic focus?
Definition
A bundle of pacemakers located in the wrong place
Term
List manifestations of PVC.
Definition
1. May have little impact
2. Strong, skipped heartbeat
3. Racing heartbeat
Term
List treatment options for PVC.
Definition
1. Avoid risk factors
2. Beta blockers
3. Calcium channel blockers
4. Cardiac ablation
Term
What do beta blockers do for PVC?
Definition
Slow down HR and make pacemaker cells depolarize less fast
Term
What is the purpose of cardiac ablation?
Definition
Kill ectopic focus cells (in rhythm disorders)
Term
Define an atrial flutter.
Definition
An abnormal heart rhythm that occurs in atria of heart and is usually associated w/ tachycardia; many mini atrial contractions
Term
What is a cause of atrial flutter?
Definition
Re-entrant rhythm
Term
List symptoms of atrial flutter.
Definition
1. Leg/abdominal swelling
2. Effort intolerance
3. Thrombus formation
4. Varicose veins
Term
Why does leg/abdominal swelling occur in atrial flutter?
Definition
Venous return decreases so there's venous backflow
Term
Why does throbus formation occur in atrial flutter?
Definition
Venous backflow and venous stasis
Term
List treatment options for atrial flutter.
Definition
1. Anticoagulants or antiplatelet agents
2. Cardioversion
3. Cardiac ablation
Term
Define cardioversion.
Definition
Resetting heartbeat
Term
What is Wolff-Parkinson-White syndrome?
Definition
Presence of an extra, abnormal electrical pathway in heart leads to very fast heartbeat
Term
What is the cause of Wolff-Parkinson-White?
Definition
Ectopic focus; abnormal gene
Term
List symptoms of Wolff-Parkinson-White.
Definition
1. Intolerance to exercise
2. Fast HR
3. Sensations of rapid flutterings or pounding heartbeat
4. Dizziness
5. Lightheaded
6. Fainting
Term
What is the treatment for Wolff-Parkinson-White?
Definition
Cardiac ablation
Term
List characteristics of Buncle Branch Block.
Definition
1. Little change in rhythm
2. Slower excitation on one side
3. Delayed contraction on one side
4. Atria in unison, but ventricles not, so valves also out of unison
5. Lub, lub, dub, dub
Term
Valve openings and closings are entirely dependent on _____ activity.
Definition
Ventricular
Term
List treatment options for bundle branch block.
Definition
1. Calcium channel blocker
2. Sodium/potassium ATPase inhibitor
3. Dopamine
Term
The treatment for bundle branch block is based on the need to do what?
Definition
Increase contractility and decrease HR
Term
What does a sodium/potassium ATPase inhibitor do for bundle branch block?
Definition
Delays resetting of membrane potential
Term
What is the system for bone organization?
Definition
Osteon/haversion system
Term
What is the osteon/haversion system?
Definition
Functional unit of bone; smallest piece of bone that does all bone functions
Term
List the 5 cell types of bone.
Definition
1. Osteocyte
2. Osteoblast
3. Osteoprogenitor
4. Bone lining
5. Osteoclast
Term
What is the most abundant bone cell?
Definition
Osteocyte
Term
Which bone cell is concidered an adult cell?
Definition
Osteocyte
Term
Which bone cell maintains the bony matrix?
Definition
Osteocyte
Term
Regarding the matrix, why is bone so unique?
Definition
It's calcified
Term
Define blast.
Definition
Not terminally differentiated or grown-up
Term
Which bone cell is an immature osteocyte?
Definition
Osteoblast
Term
Which bone cell makes bony matrix?
Definition
Osteoblast
Term
Once an osteoblast has done it's job in making bony matrix, it is considered an _____.
Definition
Osteocyte
Term
What is an osteoprogenitor?
Definition
A stem cell destined to become an osteoblast
Term
What bone cell is an inactive osteocyte?
Definition
Bone lining
Term
Can bone lining regain osteocyte-like features?
Definition
Yes if it's in an active place
Term
What is an ideal location in which bone lining could regain osteocyte-like features?
Definition
Bone near joint surfaces
Term
What bone cell performs resorption of matrix?
Definition
Osteoclast
Term
Define resorption.
Definition
Breakdown
Term
Which bone cell began as a monocyte?
Definition
Osteoclast
Term
Which bone cell is not born in bone?
Definition
Ostoclast
Term
Which bone cell has the most unique "cell line"?
Definition
Osteoclast
Term
How do hormones regulate bone?
Definition
By regulating cell types that live in bone
Term
List 2 hormones that regulate bone.
Definition
1. PTH (parathyroid hormone)
2. Calcitonin
Term
What does PTH doe to regulate bone?
Definition
Releases calcium from bone
Term
Of the hormones that regulate bone, which is released when plasma calcium is too low? What activity does it increase?
Definition
PTH; osteoclast
Term
Related to bone, what does PTH cause in small intestines?
Definition
Increased absorption of calcium
Term
Related to bone, what does PTH cause in kidneys?
Definition
Increased reabsorption of calcium
Term
Calcitonin increases _____ activity when plasma calcium is too _____.
Definition
Osteoblast; high
Term
Of the 2 bone regulating hormones, which one is used less often?
Definition
Calcitonin
Term
Regarding bone, what does calcitonin cause in small intestines and kidneys?
Definition
Small intestines - decreased absorption of calcium; kidneys - decreased absorption of calcium
Term
List the 2 types of bone growth.
Definition
1. Endochondral ossification
2. Intramembranous ossification
Term
Which type of bone growth involves bone replacing cartilage skeleton?
Definition
Endochondral ossification
Term
By which type do most bones grow?
Definition
Endochondral ossification
Term
Everything except for _____ _____ and _____ grows by endochondral ossification.
Definition
Skull bones; clavical
Term
Describe the growth of bone related to periosteum in endochondral ossification.
Definition
Periosteum surrounds cartilage that becomes skeleton, but doesn't regulate growth
Term
Which bones grown by intramembranous ossification?
Definition
Flat bones (skull bones and clavical)
Term
Describe intramembranous ossification bone growth in relation to periosteum.
Definition
Bone grows withing finite membrane space b/c membrane is there first; bone is built with membrane around it
Term
Define periosteum.
Definition
Membrane that surrounds all bones
Term
List 3 factors that regulate peak bone mass.
Definition
1. Physical activity
2. Diet
3. Gender
Term
What gender typically has higher peak bone mass and why?
Definition
Males; anabolic testosterone, more bone remodeling forces, more muscle mass, more wreckless activity
Term
List 6 skeletal disorders.
Definition
1. Neoplasms
2. Growth disorders
3. Infection
4. Metabolic disorders
5. Arthritis
6. Osteonecrosis
Term
T/F Skeletal neoplasms very rarely metastasize.
Definition
False; very easily
Term
Why do skeletal neoplasms metastasize so easily?
Definition
Bone is very vascular
Term
List the 2 types of skeletal neoplasms.
Definition
1. Benign
2. Malignant
Term
List characteristics of benign skeletal neoplasms.
Definition
1. -oma, encapsulated, non-necrotic, non-angeogenic, act like parent tissue
2. Local discomfort after activity or at joint surface
3. Within periosteum
Term
What is the treatment for a benign skeletal neoplasm?
Definition
Surgery, some radiation
Term
List characteristics of malignant skeletal neoplasms.
Definition
1. -sarcoma, not encapsulated, fast-growing, necrotic areas, angeogenic
2. Deep, radiating bone pain at night
3. Beyond periosteum
Term
What is an example of a benign skeletal neoplasm?
Definition
Osteoma
Term
What is an example of a malignant skeletal neoplasm.
Definition
Osteosarcoma
Term
What is the treatment for a malignant skeletal neoplasm?
Definition
Local radiation, chemo
Term
List the 3 main categories of skeletal growth disorders.
Definition
1. Asymmetrical endochondral ossification
2. Too much bone
3. Too little bone
Term
What is asymmetrical endochondral ossification?
Definition
Inability to replace cartilage with bone
Term
Asymmetrical endochondral ossification can be a developmental disorder during growth due to what?
Definition
Vitamin deficiencies and osteoporosis
Term
List manifestations of asymmetrical endochondral ossification.
Definition
1. Limb specific knock knees, bowed legs, hemihypertrophy
2. Scoliosis
3. Kyphosis
4. Lordosis
Term
Define scoliosis.
Definition
Lateral curvature in spine
Term
Define kyphosis.
Definition
Too much anterior thoracic curvature
Term
Define lordosis.
Definition
Too much posterior lumbar curvature
Term
List 2 types of growth disorders that involve too much bone.
Definition
1. Paget's disease
2. Osteophytes
Term
Paget's disease involves overactive _____.
Definition
Osteoblasts
Term
Overactive osteoblasts increase likelihood of getting what?
Definition
Neoplasms
Term
What does Paget's disease result in?
Definition
Short, dense bones
Term
What is the most commonly affected bone in Paget's disease? Are all bones affected?
Definition
Tibia; no
Term
What are problems related to Paget's disease?
Definition
Bones get too thick and dull, aching pain
Term
In Paget's what is the reason for dull, aching pain?
Definition
Too much mass inside periosteum
Term
What is a treatment for Paget's disease?
Definition
Shave off extra bone
Term
What are osteophytes?
Definition
Bone spurs
Term
Where do osteophytes typically occur?
Definition
Where bones are stressed (fracture, joint trauma, broken bone)
Term
Why do osteophytes occur in the heels (heel spurs)?
Definition
Very large tendon connected to heel bone
Term
What is the treatment for osteophytes?
Definition
Shave off spur
Term
What is the name for a growth disorder that results in too little bone?
Definition
Osteogenesis imperfecta
Term
Define osteogenesis imperfecta.
Definition
Inability to properly cross-link collagen fiber in bony matrix
Term
Bones of osteogenesis imperfecta lack strength in what direction?
Definition
Longitudinally
Term
How is osteogenesis imperfecta diagnosed?
Definition
At birth, when baby has multiple fractures coming out of birth canal
Term
T/F Osteogenesis imperfectat occurs in varying levels.
Definition
True
Term
What is the treatment for osteogenesis imperfecta?
Definition
Make everything else about the bone stronger
Term
What is the word for a skeletal infection?
Definition
Osteomyelitis
Term
Almost all osteomyelitis is caused by _____ infection.
Definition
Bacterial
Term
List 2 types of osteomyelitis.
Definition
1. Endogenous
2. Exogenous
Term
List the characteristics of endogenous osteomyelitis.
Definition
1. Bone infected from pathogen already in body
2. Carried by blood or lymph
3. Bone pain
4. Treatment is antibiotics
Term
List the characteristics of exogenous osteomyelitis.
Definition
1. Bone infected from pathogen that outside body; requires access
2. Commonly from open fracture
3. Bone pain
4. Treatment is antibiotics
Term
List an example of a skeletal metabolic disorder.
Definition
Osteoporosis
Term
What skeletal metabolic disorder is the most common?
Definition
Osteoporosis
Term
Osteoporosis results in the overall loss of what?
Definition
Bone density
Term
T/F In osteoporosis, the ratio of mineralized to non-mineralized content changes; everything decreases at varying rates.
Definition
False; does not chage; same rate
Term
List manifestations of osteoporosis.
Definition
1. Fractures
2. Brittle bones
3. Decrease in height
Term
What are the 3 most common locations of osteoporosis?
Definition
1. Vertebral bodies
2. Femur head
3. Colles fracture
Term
What is a colles fracture?
Definition
A distal radius ulna fracture
Term
How is osteoporosis diagnosed?
Definition
Based on change in mineral bone content
Term
List the 2 categories of osteoporosis.
Definition
1. Primary
2. Secondary
Term
Define primary osteoporosis.
Definition
Changes occur at level of bone cell
Term
In primary osteoporosis, what is happening at the level of bone cell?
Definition
Clast activity is increasing, blast activity is decreasing, or both
Term
List the 2 categories of primary osteoporosis.
Definition
1. Type I
2. Type II
Term
Who does type I primary osteoporosis affect?
Definition
Post-menopausal women
Term
How is type I primary osteoporosis natrually prevented in most pre-menopausal women?
Definition
Estrogen keeps clast activity low
Term
Type I primary osteoporosis is an absolute increase in _____ activity.
Definition
Clast
Term
List risk factors for type I primary osteoporosis.
Definition
1. Genetics
2. Family history
3. Low calcium intake
4. Physical inactivity
5. Complexion
Term
Why is complexion a risk factor for type I primary osteoporosis?
Definition
Inability to synthesis vitamin D
Term
List treatments for type I primary osteoporosis.
Definition
1. Wt. bearing exercise
2. Estrogen supplement
3. Diet
4. Bisphosphenate
Term
What is a side effect of estrogen supplementation?
Definition
Can increase risk of breast cancer and decrease risk of cervical/uterine cancer
Term
What do bisphosphenates do?
Definition
Suppress activity of clasts
Term
Who does type II primary osteoporosis affect?
Definition
Senile
Term
Which type of osteoporosis does everyone get as they age?
Definition
Type II primary
Term
Type II primary osteoporosis is characterised by an absolute decrease in _____ activity.
Definition
Blast
Term
T/F In type II primary osteoporosis, blast cell # decreases and thus matrix output per cell decreases.
Definition
False; blast cell # remains normal, but matrix output per cell decreases
Term
Define secondary osteoporosis.
Definition
Side effect of something else
Term
List causes of secondary osteoporosis.
Definition
1. Radiation
2. Chemo
3. Hormone disorders
4. Smoking
5. Heavy alcohol use
6. Cancer
7. Leukemia
Term
List 2 hormone disorders that can cause secondary osteoporosis.
Definition
1. Hypogonadism
2. Hyperparathyroidism
Term
What is multiple myeloma and how does it cause secondary osteoporosis?
Definition
Bone stem cell cancer; tumor cells make osteoclast activating factor
Term
How do leukemias cause secondary osteoporosis?
Definition
Decrease osteoblast activity
Term
What is the most common form of arthritis?
Definition
Osteoarthritis
Term
Osteoarthritis is more specifically a _____ disorder.
Definition
Joint
Term
Define osteoarthritis.
Definition
Progressive breakdown of joint surfaces, which causes inflammation
Term
All joint surfaces are made of what? This covers every surface involved in _____ _____.
Definition
Articular hyaline cartilage; movable articulation
Term
Osteoarthritis is most often caused by what 3 things?
Definition
1. Overuse
2. Trauma
3. Obesity
Term
Unlike Rheumatoid, osteoarthritis is usually _____.
Definition
Unilateral
Term
Describe the speed of osteoarthritis.
Definition
A progressive, slow, continuous breakdown of joint surfaces
Term
When is osteoarthritis inflammatory?
Definition
Typically only after use
Term
Regarding inflammation, how is osteoarthritis different from Rheumatoid?
Definition
Swelling isn't an inherent part of process; no connection with immune; not auto-immune
Term
What is the leading cause of joint replacement?
Definition
Osteoarthritis
Term
List treatments for osteoarthritis.
Definition
1. NSAIDs (anti-inflammatories)
2. Analgesic meds
3. Wt. reducing devices
4. Decreased body mass
5. Joint replacement
Term
What is osteonecrosis?
Definition
Bone death
Term
This skeletal disorder can be caused by any of the other bone disorders and is ultimately caused by loss of blood flow to the bone.
Definition
Osteonecrosis
Term
What happens if a section of bone dies?
Definition
It weakens
Term
List the 2 most common treatments for osteonecrosis.
Definition
1. Surgery
2. Joint replacement
Term
List the 2 types of osteonecrosis.
Definition
1. Traumatic
2. Non-traumatic
Term
What is the most common cause of osteonecrosis and what is it characterized by?
Definition
Traumatic; fracture
Term
List 3 examples of non-traumatic osteonecrosis.
Definition
1. Neoplasm
2. Blood clot
3. Other bone disorders
Term
Somatic pathways are _____ and _____ only.
Definition
Excitatory; nicotinic
Term
T/F Somatic neurons can innervate many cells, but somatic motor end plates can innervate only 1 cell.
Definition
True
Term
Somatic neurons are tropic to what? What does this mean?
Definition
Tropic; if you cut the nerve, no matter what occurs externally, the muscle cell decreases in size
Term
Define tropic.
Definition
Something that releases a growth factor to regulate ability for regrowth/repair/regeneration
Term
How does skeletal muscle growh?
Definition
Hypertorphy
Term
Skeletal muscle shrinks by _____.
Definition
Atrophy
Term
List examples of physiological skeletal muscle atrophy.
Definition
1. Laziness
2. Bed rest
3. Cast
4. Disuse
5. Space flight
Term
List examples of pathological skeletal muscle atrophy.
Definition
1. Metabolic disorders
2. Musculary dystrophy
3. Dennervation injuries
Term
Lis the 3 main categories of skeletal muscle disorders.
Definition
1. Muscular dystrophy
2. Metabolic disorders
3. Age-related changes
Term
List the 2 most severe forms of muscular dystrophy.
Definition
1. Duchenne
2. Becker
Term
Define Duchenne muscular dystrophy.
Definition
Progressive muscle weakness, delayed motor skills and atrophy
Term
What is the more common and severe form of muscular dystrophy?
Definition
Duchenne
Term
In which form of muscular dystrophy is muscle mass lost and muscle tissue replaced with scar tissue?
Definition
Duchenne
Term
What is a word for the replacement of muscle tissue with scar tissue?
Definition
Metaplasia
Term
Metaplasia in Duchenne causes very _____ muscles.
Definition
Stiff
Term
Which form of muscular dystrophy is genetic x-linked?
Definition
Duchenne and Becker
Term
What is first affected in Duchenne?
Definition
Adductors
Term
Which form of muscular dystrophy is sometimes accompanied by mental retardation?
Definition
Duchenne
Term
Duchenne and Becker are both caused by a specific mutation in the _____ gene. This gene helps make _____, which does what?
Definition
DMD; dystrophin; links actin to cytoskeleton of muscle cell
Term
Describe the diagnosis and progression of Duchenne.
Definition
Diagnosed early with very rapid progression; early death (twenties)
Term
Which form of muscular dystrophy results in wheelchair dependency by adolescence?
Definition
Duchenne
Term
Is there a cure for Duchenne or Becker?
Definition
No
Term
What diagnostic tool is associated with both Duchenne and Becker?
Definition
Gower's maneuver
Term
Define Becker muscular dystrophy.
Definition
Progressive muscle weakness and atrophy
Term
Which form of muscular dystrophy is milder and has more varied symptoms?
Definition
Becker
Term
What is first affected in Becker?
Definition
Quads and hamstrings
Term
List manifestations of Becker.
Definition
1. Muscle weakness
2. Toe walking
3. Frequent falls
4. Difficulty breathing
Term
Describe the progression of Becker.
Definition
Slower progression; later death (40s-50s)
Term
List 5 metabolic disorders of skeletal muscle.
Definition
1. Acid maltase deficiency (Pompe's)
2. McArdle's
3. Myoadenylate deaminase deficiency
4. Tarui's disease
5. Debrancher enzyme deficiency (Cori's)
Term
Define acid maltase deficiency or Pompe's.
Definition
Glycogen storage disorder
Term
List manifestations of acid maltase deficiency or Pompe's.
Definition
1. Lack of muscle tone
2. Enlarge liver and heart
3. Difficulty swollowing
4. Large protruding tongue
5. Die young by heart/respiratory
6. Progressive weakness of diaphram and trunk
Term
When is onset of acid maltase deficiency or Pompe's?
Definition
Infancy/adolescence
Term
Like Pompe's, McCardles is also a _____ _____ disorder.
Definition
Glycogen storage
Term
T/F McArdle's is always noticed.
Definition
False; sometimes unnoticed until high intensity exercise
Term
McArdles's is a lack of what? Which is responsible for what?
Definition
Muscle phosphorylase; glycogen breakdown
Term
List manifestations of McArdle's.
Definition
1. Fatigue
2. Muscle cramps
3. Muscle wasting
Term
Which 3 skeletal muscle metabolic disorders don't significantly change lifespan?
Definition
1. McArdle's
2. Myoadenylate deaminase deficiency
3. Tarui's disease
Term
Define myoadenylate deaminase deficiency.
Definition
Genetic defect in myoadenylate deaminase enzyme that affects cell's ability to recycle ATP
Term
List manifestations of myoadenylate deaminase deficiency.
Definition
1. Exercise intolerance
2. Cramps
3. Muscle pain
Term
What is Tarui's disease?
Definition
Metabolic muscle disease that interferes with CHO processing
Term
Tarui's disease is a genetic defect of what? Why is this enzyme important?
Definition
Phosphofructo-kinase enzyme; rate limiting step in glycolysis that determines how fast we make ATP; can't make ATP without it
Term
List manifestations of Tarui's disease.
Definition
1. Exercise intolerance
2. Pain and cramps
3. Rust-colored urine
Term
What is rust-colored urine a sign of?
Definition
Muscle breakdown
Term
What is the recommendation fo Tarui's disease?
Definition
Avoid strenuous exercise and high CHO meals
Term
Define debrancher enzyme deficiency or Cori's.
Definition
Genetic defect in debrancher enzyme that interferes with processing of CHOs for energy production
Term
What does Cori's interfere with. What does this mean?
Definition
Breakdown of glycogen in muscle and liver; can't use glycogen
Term
List manifestations of Cori's.
Definition
1. Weakness
2. Low blood sugar
3. Seizures
4. Enlarged liver
5. Growth retardation
Term
Those with Cori's are intolerant to what?
Definition
Not eating regular meals
Term
Define sarcopenia.
Definition
Overall loss of muscle mass
Term
List age-related changes to skeletal muscle.
Definition
1. Thicker sarcolemma
2. Muscle related CT gets stiffer
3. Fast-twitch fibers lost over slow-twitch
4. Slower reaction time
Term
The plasma membrane of skeletal muscle is called _____.
Definition
Sarcolemma
Term
Although CT associated with muscle gets stiffer with age, _____ tend to stay pliable.
Definition
Myofibers
Term
Why does reaction time slow with age?
Definition
B/c of neuronal communication and skeletal muscle function
Term
List manifestations of age-related skeletal muscle changes.
Definition
1. Slower diffusion
2. Harder to get rid of waste products
3. Faster fatigue
4. Longer recovery
5. Lower work cpaacity
Term
List treatments for age-related skeletal muscle changes.
Definition
1. Wt. bearing exercise
2. Resistance training
Term
What are the treatments for age-related changes to skeletal muscle based on?
Definition
Delaying onset by maintaining activity (type I fibers)
Term
T/F In aging, force output per muscle cell stays high as long as muscle is being used.
Definition
True
Term
The myocardium houses _____ cells.
Definition
Contractile
Term
Which heart wall is the thickest?
Definition
Myocardium
Term
List 2 myocardial disorders.
Definition
1. Myocardial infarction
2. Heart failure
Term
What is a myocardial infarction?
Definition
Heart attack
Term
What is happening in a myocardial infarction?
Definition
Muscle wall is dying because it's not getting enough oxygen
Term
What type of injury is a myocardial infarction?
Definition
Ischemic
Term
What are the risk factors for myocardial infarction?
Definition
Same as for stroke
Term
List atrial versus ventricular manifestations of myocardial infarction.
Definition
Atrial - asymptomatic; ventricular - decreased SV
Term
In heart disorders, why are atrial manifestaions often times asymptomatic?
Definition
Atria are just receiving chambers
Term
How is myocardial infarction diagnosed?
Definition
By looking at cardiac enzymes in plasma (which are normally in cells)
Term
List treatments for myocardial infarction.
Definition
1. Anticoagulant
2. Lipid lowering agent
3. Anti-hypertensive
4. Contractility agent (dopamine agonist)
Term
Define heart failure.
Definition
Loss of myocardial contractility
Term
List the 2 types of heart failure.
Definition
1. Systolic
2. Diastolic
Term
Which typeo of heart failure is most common?
Definition
Systolic
Term
What happens in systolic heart failure?
Definition
Cells are unable to generate adequate force to maintain cardiac output
Term
What is the most superficial layer of the heart?
Definition
Epicardium
Term
The epicardium is continuous with what?
Definition
Visceral pericardium
Term
Epicardium is primarily composed of _____.
Definition
CT
Term
List the 2 main types of cardiovascular system regulation.
Definition
1. Short term
2. Long term
Term
Short term cardiovascular system maintenance is based on what?
Definition
Beat to beat maintenance of pressure
Term
Short term cardiovascular system regulation relies on the _____.
Definition
Baroreflex
Term
Baroreflex is mediated by sets of _____, which are types of _____.
Definition
Baroreceptors; mechanoreceptors
Term
Baroreceptors receive information about _____. In other words, they're _____ receptors stimulated by volume.
Definition
Volume; pressure
Term
Baroreflex receptors are located in areas that are designed to have _____, so they're not considered weak spots.
Definition
Stretch
Term
What does it mean if baroreflex receptors are over-stretched? Under-stretched?
Definition
Over means blood volume and systemic pressure are too high; uncer means blood volume and systemic pressure are too low
Term
List characteristics of over-stretched baroreflex responses.
Definition
1. Activates parasympathetic
2. Decreases HR only
3. Not dramatic b/c hypertension not acute crisis
Term
List characteristics of under-stretched baroreflex responses.
Definition
1. Activates sympathetic alpha 1
2. Increases HR
3. Increases contractility and SV
4. Vasoconstriction and venoconstriction to increase venous return and preload
5. Dramatic response b/c hypotension is acute crisis
Term
List the 2 locations of baroreflex receptors.
Definition
1. Aortic arch
2. Carotid sinus
Term
Which baroreflex receptor monitors what's going to body?
Definition
Aortic arch
Term
Which baroreflex receptor monitors what's going to brain?
Definition
Carotid sinus
Term
Long term CV system regulation is done so by the _____ system.
Definition
Endocrine
Term
Long-term CV system regulation relies on the ability to change _____ and _____.
Definition
Pressure; volume
Term
List 2 systems that aid in long term endocrine CV system regulation.
Definition
1. RAA system
2. ANP/BNP system
Term
The RAA system is great if...
Definition
...you have a healthy heart
Term
RAA stands for what?
Definition
Renin, angiotensin, aldosterone
Term
RAA system promotes (increases/decreases) in pressure, volume and sodium.
Definition
Increases
Term
Describe the pathway of the RAA system.
Definition
Angiotensinogen is converted by renin to angiotensin I which is converted by angiotensin converting enzyme (ACE) to angiotensin II
Term
List 3 characteristics of angiotensinogen.
Definition
1. Made in liver constantly
2. No stimulus
3. Plasma protein
Term
What is the "on" switch in the RAA system?
Definition
Renin
Term
List 2 characteristics of renin.
Definition
1. Stimulated by low Na/plasma volume/mean arterial pressure
2. Made in kidneys
Term
List 2 characteristics of angiotensin converting enzyme (ACE).
Definition
1. Made in pulmonary capillaries
2. Constituatively expressed
Term
List effects of angiotensin II.
Definition
1. Adrenal cortex releases aldosterone, which increases Na reabsorption
2. Arterial vasoconstriction increases pressure/resistance/afterload
3. Hypothalamus increases thirst
4. Hypothalamus/posterior pituitary increase vasopressin, which vasoconstricts and increases water reabsorption
Term
What do ANP and BNP stand for?
Definition
Arterial natriuretic peptides; brain (ventricle) natriuretic peptides
Term
What do ANP/BNP promote?
Definition
Decrease in Na/volume/pressure
Term
ANP/BNP decrease _____ activity.
Definition
Sympathetic
Term
ANP/BNP decrease the release of what? This eliminates what?
Definition
Renin; RAA system
Term
Which endocrine regulation system is a long term regulator of hypertension?
Definition
ANP/BNP system
Term
Which endocrine regulation system is a long term regulator of hypotension?
Definition
RAA system
Term
List reasons why capillaries are good at exchange.
Definition
1. Slow flow
2. High resistance
3. High surface area
4. Thin membrane (1 cell thick)
Term
Define bradycardia.
Definition
Normal but slow
Term
Define tachycardia.
Definition
Normal but fast
Term
Which 2 cardiac rhythm disorders both show signs of re-entrant rhythms?
Definition
1. Atrial flutter
2. Wolff-Parkinson-White
Term
List manifestations of heart failure.
Definition
1. Decreased SV and cardiac output
2. Swelling
3. Elevated HR
4. Shortness of breath/fatigue/weakness/activity intolerance
Term
What causes swelling in heart failure?
Definition
Backflow
Term
What causes shortness of breath/fatigue/weakness/activity intolerance in heart failure?
Definition
Decreased cardiac output
Term
Compensatory responses for heart failure come in what 2 forms?
Definition
1. Short term
2. Long term
Term
In the short term, if cardiac output falls due to heart failure, the _____ turns on _____ responses.
Definition
Baroreflex; sympathetic
Term
List the short term compensatory responses for heart failure.
Definition
1. Vasoconstriction
2. Increased HR
3. Increased afterload
Term
Short term vasoconstriction as a result of heart failure causes _____ which is (good/bad).
Definition
Resistance; bad
Term
What is the long term compensatory response for heart failure?
Definition
RAA system
Term
What does the RAA system do for heart failure?
Definition
Adds volume and afterload to a system that can't keep up
Term
List 3 blanket treatments for heart failure.
Definition
1. Diuretic
2. Contractility agent
3. Peripheral agent
Term
List 5 diuretic agents used for heart failure.
Definition
1. ACE inhibitor
2. Renin inhibitor
3. Aldosterone antagonist
4. Ang II blocker
5. Loop diaretics
Term
What does an ACE inhibitor do?
Definition
Inhibits conversion of Ang I to Ang II; stops the RAA system
Term
Where do loop diaretics act?
Definition
In loop of Henley
Term
What is a specific contractility agent used for heart failure?
Definition
Dopamine agonist
Term
List 5 peripheral agents used to treat heart failure.
Definition
1. Compression hose
2. Nitric oxide donor
3. Beta 2 agonist
4. Adenosine
5. Low dose anti-coagulant
Term
What is a peripheral agent used to treat venous stasis/thrombus formation?
Definition
Low-dose anti-coagulant
Term
What is the difference b/w systolic and diastolic heart failure?
Definition
Systolic - inability to generate adequate contraction during systole
Diastolic - inability to adequately fill ventricles during diastole
Term
During diastolic heart failure, are the ventricles able to relax?
Definition
Yes
Term
What form of heart failure is most common?
Definition
Systolic heart failure
Term
List 2 problems associated w/ diastolic heart failure.
Definition
1. Too much fluid
2. Mechanical obstruction
Term
Of systolic heart failure, which is more common?
Definition
Left side (pulmonary congestion/edema)
Term
What is another name for right side systolic heart failure?
Definition
Systemic venous congestion
Term
The epicardium has _____/_____ disorders.
Definition
Epicardial; pericardial
Term
List an example of an epicardial/pericardial disorder.
Definition
Pericarditis
Term
What is pericarditis?
Definition
Inflammation of one or both layers of the pericardial layers
Term
What are the 2 forms of pericarditis?
Definition
1. Acute
2. Chronic
Term
T/F Pericarditis is a more permanent disorder.
Definition
False; tends to come and go
Term
What is a risk factor for pericarditis in general? Why?
Definition
Obesity; causes inward pressure
Term
How is pericarditis diagnosed?
Definition
1. Chest pain
2. Scratch heart sounds
Term
What causes the scratchy heart sounds in pericarditis?
Definition
Pericardial effusion
Term
What is pericardial effusion?
Definition
Buildup of fluid in pericardial space b/w visceral and parietal layers
Term
What is the treatment for pericardial effusion?
Definition
Pericardiocentesis (drain fluid)
Term
Which form of pericarditis does not cause long-term damage, is 80% viral/idiopathic, and isn't treated?
Definition
Acute
Term
Define idiopathic.
Definition
No know cause
Term
Chronic pericarditis is typically _____ to something else.
Definition
Secondary
Term
What does chronic pericarditis cause?
Definition
Scar tissue
Term
What is a primary cause of heart failure? What is it called when it causes HF?
Definition
Chronic pericarditis; restrictive pericarditis
Term
List 3 risk factors for chronic pericarditis.
Definition
1. Long-term tumor (lungs)
2. Tuberculosis
3. Auto-immune
Term
What is the treatment for chronic pericarditis?
Definition
Treat cause
Term
Arteries have _____ layers of smooth muscle.
Definition
4+
Term
Arteries have _____ layers.
Definition
Circumferential
Term
Arteries are always lined with what?
Definition
Endothelial cells
Term
Compared to veins, arteries have...
Definition
1. Smaller lumens
2. More regular shape
3. Higher pressure
4. Higher resistance
Term
Arteries typically belong to what side?
Definition
Left/systemic circulation
Term
What is the main function of an artery?
Definition
Move (typically oxygen rich) blood away from heart
Term
List arterial receptors and if they're excitatory or inhibitory.
Definition
1. Beta 2 i
2. Alpha 1 e
3. PGF2alpha e
4. Thromboxane e
5. Adenosine i
6. Serotonin e
7. Endothelin e
8. Prostocyclin i
9. Histamine i
10. Bradycinin i
11. Stretch e
12. Vasopressin e
13. Ang II e
14. Thermo hot i
15. Thermo cold e
Term
List 4 arterial disorders.
Definition
1. Hypertension
2. Arteriosclerosis
3. Aneurysm
4. Thrombus
Term
What is hypertension?
Definition
High arterial pressure
Term
Is hypertension an acute crisis?
Definition
No
Term
What is the value for hypertension?
Definition
Greater than 140/90
Term
T/F Hypertension is only high systolic and diastolic.
Definition
False; can be high systolic, high diastolic, or both
Term
When is hypertension most dangerous? Why?
Definition
High diastolic; keeps systemic pressure high when system should be resting
Term
Hypertension is a risk factor for the development of an _____.
Definition
Aneurysm
Term
What autoregulators work overtime during hypertension?
Definition
Brain and kidneys
Term
How is hypertension usually diagnosed?
Definition
Routine physical
Term
List 6 treatments of hypertension.
Definition
1. Beta 1 blockers
2. Low Na/fat diet
3. Aerobic exercise
4. Diuretic (ACE inhibitor, beta blocker)
5. Ca channel blocker
6. Beta 2 agonist
Term
What are the 2 forms of hypertension?
Definition
1. Primary
2. Secondary
Term
Primary hypertension is AKA...
Definition
...idiopathic hypertension
Term
Which form of hypertension is most common?
Definition
Secondary
Term
Unlike primary HT, secondary hypertension...
Definition
...has a cause or is a side effect of something else
Term
List 13 causes of secondary HT.
Definition
1. Na
2. Obesity
3. Dyslipidemia
4. Age
5. Inactivity
6. Gender
7. Genetics
8. Family history
9. Smoking
10. Race
11. Caffeine/nicotine
12. Diet
13. Endocrine disorders
Term
List 5 endocrine disorders that can cause secondary HT.
Definition
1. Too much vasopressin
2. Too much ADH (perineoplastic syndrome)
3. Too much aldosterone
4. Too much renin
5. Too little Ca (hypoparathyroidism)
Term
What is arteriosclerosis?
Definition
Hardening of arteries
Term
What is a common cause of arteriosclerosis?
Definition
Age
Term
What is the most common form of arteriosclerosis?
Definition
Atherosclerosis
Term
What is atherosclerosis?
Definition
Hardening of arteries b/c of atheromas or fatty deposits
Term
What is the treatment for atherosclerosis?
Definition
Lipid lowering agent
Term
Arteriosclerosis results in a loss of _____.
Definition
Compliance
Term
What are the treatments for arteriosclerosis? What manifestations are you treating for?
Definition
1. Beta 2 agonist
2. Low-dose ACE inhibitor
Hypertension
Term
What does a loss of compliance in arteriosclerosis cause?
Definition
Big fluctuations in pressure in capillaries; decreased capillary function; increased MAP; hypertension
Term
The (fewer/more) the layer of smooth muscle cells, the (less/more) reactive the vessel.
Definition
Fewer; more
Term
Arterioles consist of _____ layers of smooth muscle.
Definition
1-3
Term
Where do arterial aneurysms occur?
Definition
Anywhere pressure is high; large arteries
Term
Arterial aneurysms aren't usually seen until _____.
Definition
Rupture
Term
Risk factors for arterial aneurysm are the same as they are for _____.
Definition
Hypertension
Term
If caught, what is the treatment for an arterial aneurysm?
Definition
Vessel clamp
Term
What does an arterial thrombus begin with?
Definition
Endothelial damage
Term
What are the 2 types of arterial thrombus?
Definition
1. Stable
2. Thromboembolus (breaks off and moves)
Term
What are treatments for arterial thrombus?
Definition
1. Anticoagulant
2. Lipid lowering agent
Term
Capillaries have _____ layers of endothelial cells.
Definition
1
Term
List characteristics of capillaries.
Definition
1. Low diffusion distance
2. High diffusion rate
3. No smooth muscle
4. No capacity to change diameter
5. High surface area
6. High resistance
7. Slow flow
Term
Capillaries are maximized for _____.
Definition
Exchange
Term
List the 2 bulk flow (fluid) movements in capillaries. Define each.
Definition
1. Ultrafiltration - fluid moves from inside capillary to interstitial space
2. Reabsorption - fluid moves from interstitial space to inside capillary
Term
What happens on the arterial side of a capillary?
Definition
Ultrafiltration
Term
What happens on the venous side of a capillary?
Definition
Reabsorption
Term
What is the net movement across a capillary?
Definition
Ultrafiltration
Term
List the 4 capillary forces. What does each do?
Definition
1. Capillary hydrostatic pressure - ultrafiltration
2. Interstitial fluid hydrostatic pressure - reabsorption
3. Capillary oncotic pressure - reabsorption
4. Interstitial fluid oncotic pressure - ultrafiltration
Term
Which of the 4 capillary forces is small?
Definition
Interstitial fluid oncotic pressure
Term
List the 2 fluid forces/push pressures.
Definition
1. Capillary hydrostatic pressure
2. Interstitial fluid hydrostatic pressure
Term
List the 2 protein forces/pull pressures.
Definition
1. Capillary oncotic pressure
2. Interstitial fluid oncotic pressure
Term
What is the only capillary force that changes across a capillary?
Definition
Capillary hydrostatic pressure
Term
List a capillary disorder.
Definition
Lose too much fluid/excess ultrafiltration
Term
Excess ultrafiltration of a capillary is always _____ to blood moving through a capillary.
Definition
Secondary
Term
List 2 types of excess ultrafiltration.
Definition
1. Hypoproteinemia
2. Hypertension
Term
What is hypoproteinemia?
Definition
Too few proteins inside capillary/decreased capillary oncotic pressure
Term
What is the most abundant plasma protein?
Definition
Albumin
Term
Hypoproteinemia usually causes _____.
Definition
Hypoalbuminemia
Term
What cannnot keep up in hypoproteinemia?
Definition
Lymph
Term
List causes of hypoproteinemia.
Definition
1. Liver disorders
2. Immune complex glomerulonephritis
Term
List symptoms of hypoproteinemia.
Definition
1. Hypotension
2. Edema
Term
In terms of capillary disorders, what is hypertension?
Definition
Increased hydrostatic pressure
Term
List characteristics of veins.
Definition
1. Big lumen
2. Irregularly shaped lumen
3. Thinner walls
4. Less smooth muscle
5. One-way valves
6. High capacitance
7. Lower pressure circuit
Term
What does capacitance mean w/ regards to veins?
Definition
Store a lot of blood in veins b/c slow moving
Term
List 4 venous disorders.
Definition
1. Varicose veins
2. Chronic venous insufficiency
3. Superior vena cava syndrome
4. Venous thrombus
Term
What are varicose veins?
Definition
Weakened venous valves that leads to weakened venous walls and pooling blood
Term
List causes/risk factors of varicose veins.
Definition
1. Standing long time
2. Age
3. Gender
4. Family history
5. Obesity
6. Pregnancy
7. Phlebitis
8. Leg injury
9. Poor circulation
Term
List symptoms of varicose veins.
Definition
1. Cosmetic
2. Aching, itching
3. Thrombophlebitis
Term
What is phlebitis?
Definition
Superficial vein inflammation
Term
What is thrombophlebitis?
Definition
Vein inflammation from blood clot
Term
List treatments of varicose veins.
Definition
1. Compression hose
2. Leg elevation
3. Exercise
4. Laser therapy
5. Sclerotherapy
6. Surgery/stripping
Term
What is sclerotherapy?
Definition
Liquid injection scars veins
Term
What is chronic venous insufficiency?
Definition
Veins can't pump enough blood back to heart b/c of bad valves
Term
List causes of chronic venous insufficiency.
Definition
1. DVT (deep vein thrombosis)
2. Phlebitis
3. Genetic
4. Obesity
Term
List manifestations of chronic venous insufficiency.
Definition
1. Varicose veins
2. Edema
3. Hyperpigmentation of legs
4. Itching
5. Aching
6. Leg ulcers
Term
List treatments for chronic venous insufficiency.
Definition
1. Ted hose
2. Sclerotherapy
3. Stripping
4. Valve repair
5. Avoid long standing/sitting
6. Exercise
Term
What's superior vena cava syndrome?
Definition
Gradual obstruction of SVC which causes decreased venous return above diaphragm and ends in death
Term
List causes of SVC syndrome.
Definition
1. Lung cancer
2. Obesity
3. Thrombosis
4. TB
Term
List symptoms of SVC syndrome.
Definition
1. Dyspnea
2. Trunk/upper extremity swelling
3. Blue tinge
4. Bulging jugular veins and eyes
Term
What is dyspnea?
Definition
Labored breathing
Term
List treatments for SVC syndrome.
Definition
1. Surgery
2. Radiation
3. Glucocorticoids, diuretics
4. Wt. loss
Term
What's a venous thrombus?
Definition
Accumulation of clotting factors/platelets near venous valve
Term
What disorder has causes based on the Triad of Virchow?
Definition
Venous thrombus
Term
Describe Triad of Virchow.
Definition
1. Venous stasis
2. Venous endothelial damage
3. Hypercoagulable state
Term
List manifestations of venous thrombus.
Definition
1. Pain
2. Redness
3. Extremity edema
4. Unilateral
Term
Venous thrombus (is/is not) usually accompanied w/ clinical symptoms b/c vein is (deep/superficial).
Definition
Is not; deep
Term
List treatments for venous thrombus.
Definition
1. Ambulation
2. Pneumatics (air)
3. Prophylactic anticoagulants
4. Thrombolytic therapy
Term
The blood mainly functions as a _____ _____.
Definition
Transport medium
Term
List 6 components of blood.
Definition
1. Water
2. Proteins
3. Cells
4. Ions
5. Nutrients
6. Waste
Term
List 6 plasma proteins.
Definition
1. Albumin
2. Ig
3. Clotting factors
4. Anti-clotting factors
5. Transport proteins
Term
List 2 functions of albumin.
Definition
1. Create oncontic pressure
2. Transportation
Term
List 3 plasma cells.
Definition
1. Leukocytes
2. Erythrocytes
3. Platelets
Term
What is the biggest plasma cell?
Definition
Leukocyte
Term
Another name for RBCs.
Definition
Erythrocytes
Term
What's the size of erythrocyte?
Definition
7.5 micrometers
Term
Which plasma cell's differentiation is regulated by EPO? TPO?
Definition
EPO-erythrocytes
TPO-platelets
Term
What is the smallest plasma cell?
Definition
Platelets
Term
Which plasma cells are anucleate and lack organelles?
Definition
Erythrocytes, platelets
Term
What is the lifespan of a erythrocyte?
Definition
120 days
Term
Where are erythrocytes born?
Definition
Bone marrow
Term
Erythrocytes are full of _____.
Definition
Hemoglobin
Term
Where do erythrocytes die?
Definition
Liver and spleen
Term
What plasma cells stay inside pipes?
Definition
Erythrocytes and platelets
Term
Erythrocytes transport _____ and some _____.
Definition
O2; CO2
Term
What are platelets?
Definition
Cell fragments of megakaryocytes
Term
What are megakaryocytes?
Definition
Non-circulating cells in bone marrow
Term
What percentage of EPO is made in the liver and targets bone?
Definition
80%
Term
What percentage of EPO is in the liver as leftover from fetal life?
Definition
20%
Term
All TPO is made by the _____.
Definition
Liver
Term
Platelets are (granular/agranular).
Definition
Granular
Term
List 4 components of platelet granules.
Definition
1. Serotonin-vasoconstricts
2. ThromboxaneA2-vasoconstricts
3. ADP-short term clotting factor
4. Thromboplastin-long term clotting factor
Term
List for plasma ions. Which is most important/abundant*?
Definition
1. Sodium*
2. Calcium
3. Chloride
4. Potassium
Term
List for plasma ions. Which is most important/abundant*?
Definition
1. Sodium*
2. Calcium
3. Chloride
4. Potassium
Term
List 3 plasma nutrients.
Definition
1. Glucose
2. Free fatty acids
3. AAs
Term
What 2 things determine the level of plasma nutrients?
Definition
1. Mobilizing hormones
2. Storage hormones
Term
List 3 nutrient mobilizing hormones.
Definition
1. Glucagon
2. Cortisol
3. Epi/norepi
Term
List 3 nutrient storage hormones.
Definition
1. Insulin
2. Testosterone
3. Growth hormone
Term
What is plasma waste a side effect of?
Definition
Muscle metabolism
Term
List 2 plasma wastes.
Definition
1. Creatine
2. Urea
Term
List 2 things associated with blood disorders.
Definition
1. Hematocrit
2. Hemoglobin
Term
Define hematocrit.
Definition
% of total blood that's packed w/ RBC or RBCs per total volume
Term
List the layers of hematocrit, starting from the bottom.
Definition
1. RBCs
2. Buffy coat
3. Plasma
Term
List 2 things that makeup the buffy coat.
Definition
1. Leukocytes
2. Platelets
Term
List 8 things that can change hematocrit. Do they increase or decrease it?
Definition
1. Elevation i
2. Acute exercise i
3. Chronic exercise i
4. Pregnancy i
5. Dehydration i
6. Plasma donation i
7. hemorrhage d
8. Post-surgical bleeding d
Term
Define hemoglobin.
Definition
How much in RBCs
Term
What are blood disorders based on?
Definition
# of RBCs or hemoglobin
Term
List 2 blood disorders.
Definition
1. Polycythemia
2. Anemia
Term
What's polycythemia?
Definition
Too many RBCs or too much hemoglobin
Term
Polycythemia makes blood too (thin/thick) and hematocrit too (low/high).
Definition
Thick; high
Term
List 2 risk factors of Polycythemia.
Definition
1. EPO secreting tumor
2. Bone marrow tumor
Term
List 2 risks associated with polychythemia.
Definition
1. Heart attack
2. Stroke
Term
Define anemia.
Definition
Too few RBCs or not enough hemoglobin
Term
List 6 types of anemia.
Definition
1. Pernicious anemia
2. Iron deficiency anemia
3. Hemolytic anemia
4. Sickle cell
5. Microcytic
6. Macrocytic
Term
This blood disorder causes auto-immune destruction of intrinsic factor cells.
Definition
Pernicious anemia
Term
In pernicious anemia, you can't make RBCs and _____ falls
Definition
Hematocrit
Term
Which anemia is the most common nutritional deficiency involving iron?
Definition
Iron deficiency anemia
Term
Which anemia is auto-immune and targets own RBCs?
Definition
Hemolytic anemia
Term
What does hemolytic anemia cause?
Definition
Hemolysis
Term
Define hemolysis.
Definition
Rupturing of RBCs
Term
This anemia is more common in African Americans.
Definition
Sickle cell
Term
What happens to RBCs in sickle cell anemia?
Definition
RBCs born completely normal->go to lungs->get O2->go to tissue->unload O2->confirmational change makes them sickle
Term
In this anemia, cells get stuck in capillaries and can cause clots.
Definition
Sicke cell
Term
List characteristics of microcytic/macrocytic anemia.
Definition
1. RBCs are too small/big
2. Dysfunctional
3. Hematocrit doesn't change
4. Cell # normal
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