Patho
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| involuntary sudden movement or muscular contraction that results from irritation or trauma | Spasm
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| when platelets adhere to each other and the edges of vessels | Platelet Plug
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| cascade of responses, each depending on the other; when the blood is clumping together to form a clot | Blood Coagulation
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| occurs when blood is drawn without contamination by tissue factor. It is triggered when blood is exposed to a foreign surface and factor XII is activated. The process is accelerated by high-molecular weight | Intrinsic Pathway
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| requires the blood to be exposed to a subendothelial tissue factor originating outside the blood. This factor begins a complex series of chemical reactions | Extrinsic Pathway
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| a cluster or coming together of substances; attraction | Aggregation
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| a holding together or uniting; sticking together | Adhesion
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| an agent that prevents or delays blood coagulation | Anticoagulants
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| a parental anticoagulant drug; It is composed of polysaccharides that inhibit coagulation by forming an antithrombin that prevents conversion of prothrombin to thrombin and by preventing liberation of throboplastin from plateletsi | Heparin
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| What is Heparin's antidote? | Protamine Sulfate
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| a drug that inhibits blood clotting by antagonizing the biosynthesis of vitamin K- dependent coagulation factors in the liver; taken to prevent future blood clots | Warfarin (Coumadin)
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| What is Warfarin (Coumadin's) antidote? | Vitamin K
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| INCREASED PLT FUNCTION; an increase in the number of platelets; PLT count >1,000,000; increases PLT adhesion, formation of a PLT or blood clot, and disturbances of blood flow. Causes: arthrosclerosis, high PLT levels | Thrombocytosis
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| PLT count >1,000,000 | Thrombocytosis
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| any rash in which blood cells leak into the skin or mucous membrane, usually at multiple sites. They are often associated with coagulation disorders or thrombosis | Purpura
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| pin point purpura; hemorrhagic spots on the skin that appear in patients with platelet deficiencies | Petechiae
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| a swelling comprising a mass of extravasated blood confined to an organ, tissue, or space and caused by a break in a blood vessel; blood blister | Hematoma
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| an abnormal decrease in the number of platelets | Thrombocytopenia
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| PLT antibodies form increasing destruction; PLT count < 20,000 | ITP- Idiopathic Thrombocytopenia Purpura
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| combination of thrombocytopenia, hemolytic anemia, vascular occlusion, fever, and neurological abnormalities; abrupt onset; may be fatal | TTP- Thrombotic Thrombocytopenic Purpura
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| deficient function of platelets | Thrombocytopathia
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| urine acid in the blood because of unhealthy kidneys | Uremia
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| deficiency of factor VIII; X-linked | Hemophilia A
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| most common hereditary bleeding disorder; autosomal; decreased PLT adhesion and reduction of factor VIII; most are mild and untreated | Von Willebrad Disease
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| paradox in hemostatic sequence; widespread intravascular coagulation followed by massive bleeding d/t the depletion of clotting factors (clot, clot, clot, bleed, bleed, bleed over reaction of clotting cascade) | DIC- Disseminated Intravascular Coagulation
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| bleeding from small vessels d/t structurally weak walls, damage d/t inflammation or immune response; PLT counts and bleeding studies will be normal; may also occur in DIC | Vascular Disorders
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| is caused by excessive production of adrenoncorticotropic hormone in the body; occurs with vascular disorders | Cushing's Disease
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| purpura due to old age | Senile Purpura
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| production of RBC; occurs in bone marrow | Erythropoiesis
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| What are 2 problems with Hemostasis? | inappropriate clotting and the failure of blood to clot
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| What do both the intrinsic and extrinsic pathways result in? (3) | the activation of factor X, the conversion of prothrombin to thrombin, and the conversion of fibrinogen to fibrin
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| where are almost all factors of blood coagulation synthesized? | the liver
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| ___ is nessary for synthesis of prothrombin, factor VII, IX, X, and Protein C | Vitamin K
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| What are 4 natural anticoagulants? | antithrombin III, protein C, protein S, and plasmin
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| What can one do to get Vit K in their diet? | eat green leafy veggies
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| What lab test is used for Heparin? | PTT
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| What lab test is used for Coumadin? | PT
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| Which anticoagulant is used to prevent future clots? | Coumadin
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| What anticoagulant is used to slow down growth of present clots? | Heparin
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| What are some causes of Thrombocytosis? | Causes-artherosclerosis, DM, smoking, high cholesterol, high plt levels
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| What are 2 hypercoagulability states? | > PLT function (thrombocytosis) and > clotting activity
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| What are some causes of > clotting activity? | Causes-pregnancy, oral contraceptives, post op, immobility, congestive heart failure, and malignancy
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| What are some TX for > clotting activity? | TX-prophylaxis; stop smoking w/ birth control meds, coumadin, ASA, and heparin
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| At what level are the PLT when bleeding occurs? | <20,000
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| What is the normal PLT count? | 150,000- 400,000
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| What are the S/S of a PLT deficit? | S/S-hemorrhage, bruising, petechiae, purpura, hematoma, bleeding of the mucous membranes
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| What is the PLT count for Thrombocytopenia? | <100,000
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| What are the causes of Thrombocytopenia? | Causes-decreased production, increased plt pooling in spleen, or deceased plt survival
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| What are some drugs that are culprits of thrombocytopenia? | quinine, quinidine, and aome sulfa drugs
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| shape that > surface for O2 and allows the cell to change shape | biconcave disk
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| must have ____ for hgb synthesis | Fe- iron
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| low levels of ____ indicate the need for oral supplement of iron | ferritin
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| production of RBC; regulated by erthytopoietin; occurs in bone marrow | erythropoiesis
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| what is a RBC average life span? | 120 days
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| What is a RBC facilitated by? (3) | spleen, live, and bone marrow
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| during destruction of RBC _____ prodction > causing jaundice | bilirubin
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| what is the RBC count for men? | 4.2-5.4
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| What is the RBC count for women? | 3.6-5.0
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| What is the hgb count for men? | 14-16.5
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| what is the hgb count for women? | 12-15
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| what is the hematocrit (hct) count for men? | 40-50
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| what is the hematocrit (hct) count for women? | 37-47
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| abnormally high RBC, which makes the heart work overly hard to move blood | polycythemia
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| what is the HCT for men and women with polycythemia? | men- >54.....women- >51
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| what are the 3 types of polycythemia? | relative, primary, secondary
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| the hct rises b/c of a loss of plasma volume w/o corresponding decrease in RBCs | relative polycythemia
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| a proliferative disease of the pluriplotent cells; overall increase in RBCs, WBCs, and PLTs | primary polycythemia
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| what is another term for primary polycythemia? | polycythemia vera
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| physiological increase in erythropoietin | secondary polycythemia
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| what are the causes of relative polycythemia? | Causes- r/t water deprivation, excessive diuretic use, or GI loss
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| what is the TX for relative polycythemia? | fluid volume replacement
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| what is the common ages to see primary polycythemia? | 40-60
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| what are the S/S of primary polycythemia? | S/S-HA, dizziness, difficulty hearing, HTN, venous stasis, itching & painful fingers & toes, night sweats & wt loss
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| what is the TX for primary polycythemia? | TX-phlebotomy, chemo, & radiation
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| Commonly associated w/ hypoxia (high altitudes, chronic heart failure, lung disease, & smoking) | secondary polycythemia
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| what is the TX for secondary polycythemia? | TX-relieve hypoxia (O2 adm, breathing tx, ect)
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| what is a common cause of jaundice in an infant and is harmless and self-limiting? | hyperbilirubinemia in the newborn
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| what is the TX for hyperbilirubinemia in the newborn? | bilirubin lights or sun exposure
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| what are the causes of hyperbilirubinemia in the newborn? | May be caused by hypoxia, breast feeding, hemolytic disease, bowel or biliary obstruction, liver disease...Prematurity, Asian ancestry, & maternal diabetes increase risk
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| what is hemolytic DX of the newborn? | erythroblastosis fetalis (rh incompatibility: mom Rh-, baby Rh+)
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| transports blood thru the lungs for gas exchange | pulmonary (central)
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| transports blood thru the body | systemic (peripheral)
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| Includes R. side of the heart, pulmonary artery, pulmonary capillaries, & pulmonary vein | pulmonary (central)
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| Includes L. side of the heart, aorta, arteries, capillaries, veins, and vena cavas | systemic (peripheral)
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| ____ vein is the only vein that carries oxygenated blood | Pulmonary vein
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| low pressure system | pulmonary (central)
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| high pressure system | systemic (peripheral)
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| ____ are closer the the heart, therefore have higher ____ | arteries....pressure
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| _____ function for cellular exchange | capillaries
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| principals governing pressure, flow, and resistance in the circulatory system | Hemodynamics
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| thick walled; transports blood away from the heart; has more stretch; pulsates | arteries
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| thin walled; transports blood back to the heart; valves aid in pushing the blood against gravity; low pressure system | veins
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| includes capillaries, venules, and arteriole | Microcirculation
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| single-cell thick; connect the venules and arterioles | Capillaries
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| increase in blood flow to meet needs like in exercise (functional); when blood flow has been occluded and then restored, local blood flow increase (reactive) | Hyperemia
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| what are 4 substances that effect blood flow? | histamine, serotonin, kinins, prostaglandins
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| b/t the blood and the vascular smooth muscle; serves as a physical barrier for those vasoactive substances; plays a role in cellular exchange | Endothelium
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| compensatory mechanism to deal w/ a blood flow occlusion; slow, gradual process | Collateral circulation
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| what are 2 things that play apart in the endothelial control of the blood flow? | Nitric oxide and Angiotension II
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| speeds things up; Epinephrine and norepinephrine | sympathetic
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| slows things down; vagal stimulation; Acetylcholine | parasympathetic
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| increases BP | dopamine
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| impairment can lead to ischemia and infarction | arterial circulation
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| CHF | congestive heart failure
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| BCP | birth control pills
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| stationary blood clot | thrombosis
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| what are some causes of thrombosis? | Causes-polycythemia, dehydration, plt aggregation, CHF, shock, dysrhythmias (Afib), trauma, surgery, anesthesia, BCP, smoking, arteriosclerosis/atherosclerosis, immobilization
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| ateries are ____ in color and are ____ with no pulse | pale blue....cold
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| veins are _____ in color and are ____ with a large pulse and are swollen | red...warm
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| thrombosis in the aterials results in___ | blood not getting to an area
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| thrombosis in the venous results in ___ | blood not getting out of an area and back to the heart
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| what are some TX options for Thromobosis? | TX-prevention, anticoagulants (coumadin & heparin), anti plt aggregregates (ASA, plavix)
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| traveling clot | embolism
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| What are the causes of embolism? | the same as thrombosis= Causes-polycythemia, dehydration, plt aggregation, CHF, shock, dysrhythmias (Afib), trauma, surgery, anesthesia, BCP, smoking, arteriosclerosis/atherosclerosis, immobilization
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| what are some complication of embolism? | CVA (stroke), PE (pulmonary empolis), MI (Heart attack)
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| what is the TX for embolism? | TX-embolectomy, filters
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| sudden constriction of an artery | vasospasm
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| what can a vasospasm cause? | hypoxia or even necrosis
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| what are the causes of vasospasms? | Causes-unknown, cold, hormones, food, and stress
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| vascular disorders that cause inflammatory injury of the blood vessels of any type and origin; classified by vessel size | Vasculitides
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| what are the S/S of vasculitides? | S/S-fever, myalgia, arthralgia, and malaise
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| what are the causes of vasculitides? | Causes-direct injury, infectious agents, immune process (SLE), physical agents (cold, irradiation, mechanical injury, and toxins)
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| algia | pain
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| 5 p's | pain, pulse, pallor, paratisea, and paralisis
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| pressure in the muscle fascia impairing circulation; can lead to permanent loss of function; may be caused by a tight cast or dressing, thermal injury, trauma, infiltration of IV fluids, postischemic swelling, & venous obstruction | compartment syndrome
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| what are the S/S of compartment syndrome? | S/S-unrelenting, deep, throbbing pain; tenseness and tenderness; taunt skin; parasthesia; muscle weakness
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| what is the DX for compartment syndrome? | DX-early ID is critical; assessment including the 5 P’s; Doppler; direct pressure measurements of the compartment
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| what is the TX for compartment syndrome? | TX-pressures > 30mmHg; remove pressure, fasciotomy
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| fractures commonly result in ___ | compartment syndrome
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| HRT | hormone replacement therapy
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| type of arteriosclerosis or hardening of the arteries; fatty lesions on the artery wall | Atherosclerosis
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| Risk factors-men>45, women>55 or premature menopause w/o HRT, family hx of premature CAD, smoking, HTN, low HDL, hyperlipidemia, DM, maybe chlamydia, pneumoniae, herpes, and CMV | Atherosclerosis
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| what are 3 types of Atherosclerosis? | fatty streaks, fibrous athermatous plague, complicated lesions
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| what are some complication of Atherosclerosis? | vessel occlusion-necrosis....thrombus-MI, PE,stroke
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| what are the S/S of Atherosclerosis? | S/S-depends on the location; s/s of impaired tissue perfusion
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| abnormal dilatation of a blood vessel, usually arteries; most commonly the aorta | Aneurysms
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| small spherical dilatation of a blood vessel junction; common in the circle of Willis in the brain | Berry
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| involves the entire circumference of the vessel; characterized by a gradual and progressive dilatation of the vessel | Fusiform
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| extends over a part of the circumference of the vessel and appears sac-like | Saccular
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| false aneurysm; usually progressive; acute, life-threatening; occurs w/ a previous vessel dilatation | Aortic dissection
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| Causes-conditions that weaken or degenerative changes in the vessel wall; congenital defects (Marfan’s, aortic valve defects, aortic coarctation), trauma, infections, and atherosclerosis3 | Aortic dissection
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| What are the S/S of an aortic dissection? | S/S-sudden presence of excruciating pain at site of dissection, syncope, hemiplegia, paralysis, heart failure (when valves are involved)
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| What are some complication of an aortic dissection? | Complications-untx=rupture; death
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| What is the DX for an aortic dissection? | DX-H & P, aortic angiogram, TEE, CT, MRI
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| what is the TX for an aortic dissection? | TX-surgical repair; medical-control HTN, meds to lessen systolic force
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| what are 3 types of aneurysms? | berry, fusiform, saccular
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| what are 2 types of aortic aneurysms? | dissection and an aortic aneurysm
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| any part of the thoracic or abdominal aorta | aortic aneurysms
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| Causes-athersclerosis & degeneration of the vessel media (most common); many also have HTN | aortic aneurysms
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| What are the S/S of an aortic aneurysms? | S/S-most are asymptomatic; a pulsating mass may be indicative; abd-may compress the lumbar nerve causing lower back pain radiating down the legs; may obstruct the renal, iliac, mesenteric, or vertebral arteries; clots may form; thoracic-substernal, etc
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| what is the DX for aortic aneurysm? | DX-routine exam or vessel rupture; CT, MRI
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| what is the TX for aortic aneurysm? | TX-surgical intervention w/ Dacron
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| These disorders are similar to those of coronary and cerebral arteries; they produce pain, ischemia, impair function, and may cause infarcts and necrosis | PVD: Arterial Disorders of the Extremities
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| sudden event that interrupts arterial blood flow to tissue or an organ; usually caused by a clot, but may be trauma or arterial spasms | Acute arterial occlusion
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| - Occlusion of the blood in the lower extremities...usually involves the popliteal and femoral arteries | Atherosclerosis occlusive disease (Ateriosclerosis Obliterans)
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| Most common in men 60-70; Smoking and DM worsens | Atherosclerosis occlusive disease (Ateriosclerosis Obliterans)
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| What are the S/S for Atherosclerosis occlusive disease (Ateriosclerosis Obliterans)? | S/S-intermittent claudication; numbness; thinning of the skin & less subq tissue and hair; brittle nails; ft often cool w/ weak pulses; limb blanches w/ elevation & becomes deep red when in dependent positions; progressing to ischemic pain at rest; ulcera
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| What are the DX for Atherosclerosis occlusive disease (Ateriosclerosis Obliterans)? | DX-skin inspection, Doppler, extremity BPs, nuclear imaging, & contrast angiogram
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| What is the TX for Atherosclerosis occlusive disease (Ateriosclerosis Obliterans)? | TX-maintain skin integrity, slow walking will encourage collateral, fempop bypass, thromboenderectomy, PTCA
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| Vasculitis of the medium size arteries of the lower extremities; Inflammatory component that involves | Thromboangitis obliterans-AKA Burger’s disease
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| Mostly men 25-40; Smoking increases risk | Thromboangitis obliterans-AKA Burger’s disease
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| What are the S/S for Thromboangitis obliterans-AKA Burger’s disease? | S/S-pain distal to the occlusion; in severe cases is may be present at rest; increased sensitivity to cold; decreased/absent distal pulses; cyanosis; thin, shiny skin; thick, malformed nails; progressing to ulceration & gangrene
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| What is teh DX for Thromboangitis obliterans-AKA Burger’s disease? | DX-skin inspection, Doppler, extremity BPs, nuclear imaging, & contrast angiogram
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| What is the TX for Thromboangitis obliterans-AKA Burger’s disease? | TX-stop smoking; must achieve vasodilatation & prevent injury; surgical intervention
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| Functional disorder caused by intense vasospasms of the arteries & arterioles in the fingers & occasionally the toes; Disease occurs w/o a cause & phenomena is a result of another cause | Raynaud’s
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| Occurs in usually otherwise healthy women; It is brought on by cold or extreme emotions | Raynaud’s
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| what is the cause of Raynaud’s? | Cause is unknown; may be r/t an overactive sympathetic nervous system
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| Associated w/ previous vessel injury-frostbite, vibration, extreme temp, occupational trauma, collagen diseases, neurological disorders, & chronic arterial occlusive disorders | Raynaud’s
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| Often the 1st s/s of a collagen disorder like scleraderma & SLE | Raynaud’s
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| What are the S/S of Raynaud’s? | S/S-pallor to cyanosis; a sensation of cold, changes of sensory perception, hyperemia after episode, may affect the entire hand of just a portion, nails become brittle, arthritis may develop, ulceration & gangrene is rare
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| What is the DX for Raynaud’s? | DX-hx of vasospasmic episodes w/o presence of other disorders; laser-Doppler velocimetery, & CT
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| What is teh TX for Raynaud’s? | TX-elimination of triggers (cold, emotional stress, vasoconstrictors), no smoking, vasodilators, surgical interruption of sympathetic pathways
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| dilated, tortuous veins of the lower extremities; usually associated w/ venous insufficiency | Varicose Veins
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| More common after 50, in the obese, & women; usually have a family hx, prolonged standing & increased intra-abdominal pressure (lifting) | Primary Varicose Veins
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| saphenous veins | Primary Varicose Veins
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| What are the S/S of Varicose Veins? | S/S-aches, edema, unsightly enlarge veins
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| What is teh DX for Varicose Veins? | DX-inspection, Doppler ultrasonic flow probe, angiogram
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| What is the TX for Varicose Veins? | TX-little can be done to restore venous tone and function; avoid activities that worsen, AED hose, sclerotherapy; surgery in severe cases
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| results from impaired flow to the deep veins; most common cause is DVT, but also congenital or acquire AV fistulas, congenital venous malformation, and pressure on the abd veins (pregnancy and tumors) | Secondary Varicose Veins
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| maybe caused by DVT, valvular incompetence, or both | Chronic venous insufficiency
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| What are the S/S of Chronic venous insufficiency? | S/S-venous congestion, edema, necrosis of subq fat, brown pigmentation of skin in the lower extremities, lymphatic insufficiency, stasis dermatitis, stasis ulcers, stiffening of the ankle jt, and loss of muscle mass and strength
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| What are the S/S for DVT? | S/S-edema, pain, ?Homan’s sign
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| venous obstruction caused by a clot usually in the deep veins of the lower extremities | DVT
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| What are the TX for DVT? | TX-DO NOT MASSAGE, anticoagulant therapy, embolectomy
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| caused by obstruction of lymph (removal or destruction of nodes) | Lymphedema
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| What are the S/S of Lymphedema? | S/S- brawny edema, skin changes (thick, rough skin)
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| What is the TX for Lymphedema? | TX-pneumatic compression, massage, diuretics will not help much
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| the work part of BP | systolic (100-140)
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| the rest part of BP | diastolic (60-90)
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| difference b/t the systolic and the diastolic? | pulse pressure (~40)
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| average pressure in the arterial system during ventricular contraction and relaxation | mean arterial pressure (90-100)
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| BP= ___X___ | Cardiac Output (OP) X Peripheral Vascular Resistance (PVR)
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| ejection of blood into the aorta | Systolic BP
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| The variability is controlled by the amount of blood that is ejected & the elasticity of the aorta | Systolic BP
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| Rises w/ large blood volume & rigid aortas | Systolic BP
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| Maintained by the energy that has been stored in the aorta during systole | Diastolic BP
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| Depends on the elasticity of the aorta & large arteries, ability to store energy, microcirculation blood flow control, & function of the aortic valve. | Diastolic BP
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| Increased PVR & sympathetic stimulation increases diastolic | Diastolic BP
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| ______ of blood in the aortic valve decreases diastolic | Regurgitation
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| Represents the difference b/t the blood volume ejected into aorta and arterial system | pulse pressure (~40)
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| It rises with increased blood volume and vise versa | pulse pressure (~40)
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| 1/3 of the pulse pressure | Mean arterial pressure
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| Indicator of tissue perfusion | Mean arterial pressure
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| Meant to correct temporary imbalances-exercise and position changes | Short-Term BP Regulation
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| Survival mechanism | Short-Term BP Regulation
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| 2 mechanisms of Short-Term BP Regulation | Neural and Humoral
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| Control center located in the reticular formation of the lower pons and the medulla; major site for the autonomic nervous system; cardiac center | Neural Short-Term BP Regulation
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| Transmit parasympathetic and sympathetic impulses | Neural Short-Term BP Regulation
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| What is Neural Short-Term BP Regulation mediated through? (3) | Intrinsic Reflexes, extrinsic reflexes, and chemoreceptors
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| baroreceptors are pressure sensitive & are located in the vessel walls and the heart; regulate BP by sending messages to the brain stem | Baroreflex- Neural Short-Term BP Regulation (intrinsic mediator)
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| what are the 2 intrinsic mediators of Neural Short-Term BP Regulation? | baroreflex and chemoreceptor
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| What are the 4 things associated with extrinsic neural mediators? | 1. factors associated with pain and cold...2. spread out and inconsistant...3. processed thru the hypothalmus...4. responses to mood and emotion
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| sensitive to changes in O2, CO2, and H in the blood...Located in the carotid bodies (in the junction of two common carotids) & the aortic bodies...Can induce vasoconstriction | Arterial chemoreceptors (Neural Short-Term BP Regulation)
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| an enzyme that is synthesis, stored, and released in the kidneys in response to an increase in sympathetic nervous system activity or decreased BP, extracellular fluid volume, or extracellular Na | Renin
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| Released from the pituitary gland in response to decreased blood volume and blood pressure, increased osmolality of body fluids, & other stimuli; Vasoconstrictor | Antidiuretic hormone (vasopressin)
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| In HTN, this mechanism gets out of control | Renin-angiotension-aldosterone
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| what 2 hormones deal with humoral short-term BP regulation? | Antidiuretic hormone (vasopressin) and Renin-angiotension-aldosterone
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| Kicks in to compensate d/t the short-term mechanisms inability to maintain changes over time. | Long-term BP regulation
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| Makes changes by adjusting fluid excretion in the kidneys | Long-term BP regulation
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| Fall in BP= ________ | decreased water excretion and vise versa
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| Too much fluid in tissue=__________ | vasoconstriction to prevent more fluid entering the space and vise versa
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