PTA NPTE Exam (Cardiovascular/Pulmonary) Latest Updated

Apex - ANSWER-lowest part of heart formed by inferolateral part of the left ventricle Base - ANSWER-Upper border of heart involving the LA, RA, and proximal greater vessels Endocardium - ANSWER-Endothelial tissues lining the interior chambers and valves Myocardium - ANSWER-Thick contractile Middle layer of muscle cells that form the bulk of the wall Epicardium - ANSWER-Serous layer of pericardium that contains epicardial coronary arteries and veins, autonomic nerves, and lymphatics Pericardium - ANSWER-Double walled connective tissue sac that surrounds the outside of the heart and the great vessels Aorta - ANSWER-Largest artery and central conduit of blood from the heart to the body. Begins in the upper left ventricle, descends into the thorax (thoracic aorta), then into the abdominal cavity ( abdominal aorta) Superior vena cava - ANSWER-Vein returns venous blood from the head neck arms to the R atrium Inferior vena cava - ANSWER-Veinr eturns blood from the lower body to RA Pulmonary Arteries - ANSWER-carry deoxygenated blood to the R ventricle and L and R lungs Pulmonary veins - ANSWER-Cary oxygenated blood from the lungs to the left atrium Blood Flow path - ANSWER-Venous blood from Superior and Inferior vena cava enters RA, Tricuspid valve, Closes, RV contracts into pulmonary valve, trunk, then arteries to RL lungs, Oxygenated blood returns to LA, Mitral valve, LV contraction to the aortic valve, body Sinoatrial node - ANSWER-pacemaker of the heart and part of the cardiac conduction system along with the Atrioventricular node Barorecepter Reflex - ANSWER-Mechanoreceptors that detect change in pressure Bainbridge reflex - ANSWER-Are on the walls of the RA and when stretched by venous return increase heart rate chemoreceptor reflex - ANSWER-chemosensitive cells in the corotid bodies and aortic bodies respond to changes in ph and blood oxygen Valsalva maneuver - ANSWER-increased intrathoracic pressure, central venous pressure, and decreased venous return which results in decrease cardiac output and blood pressure and increases heart rate Atrial Systole - ANSWER-contraction of the R/L atria pushing blood into the ventricles Atrial Diastole - ANSWER-Period between atrial contractions in which the atria are repolarizing Ventricular systole - ANSWER-Contraction of the R/L ventricles pushing blood into the pulmonary arteries and aorta ventricular Diastole - ANSWER-period between contractions when ventricles are repolarizing Preload - ANSWER-Tension in the ventricular walls at the end of diastole. Reflects venous filling pressure that fills the left ventricle during diastole Afterload - ANSWER-Forces that impede blood flow out of the heart ex. viscocity of blood, compliance of aorta Stroke Volume + norms - ANSWER-Volume of blood ejected from the Left Ventricle Normal is 60-80 ml Cardiac output + norms - ANSWER-Amount of blood pumped from the L or R ventricle per minute. SV x HR = CO normal is 4.5-5L for men, can increase to 25ml during exercise Venous return - ANSWER-Blood returning to the R atrium each minute similar to value of CO White Blood Cells Types - ANSWER-Neutrophils: Help protect body agianst infections by ingesting bacteria Lymphocytes: 3 kinds,T that are natural killer cells agianst viral infections and cancer cells, B lympcytes that produce antibodies Monocytes: Ingest dead or damaged cells Eosinophils: killes paracytes, cancer cells, involved with allergic responses Basophils: involved in allergic responses Aneurysm - ANSWER-A dilation of a blood vessel usually an artery Etiology: Congenital Defect, weakness in the wall of the vessel due to chronic hypertension, connective tissue disease (marfan syndrome), trauma, infection Sxs: Vary based on site, Aortic Aneurysms are asymptomatic but may include LBP or abdominal pain, Abdominal aortic aneurysms can cause pulsations near navel, cerebral aneurysm may be sudden headache, nausea and vomiting, stiff neck, seizure Tx: Antihypertensive medications for HTN, surgery for large aortic aneurysms Angina Pectoris - ANSWER-A Pain in the chest due to pressure or discomfort resulting from myocaridal ischemia, Stable Angina-Occurs at predictable level of exertion, exercise or stress and responds to rest or nitroglycerine Unstable Angina: Usually is more intense, lasts longer, is caused by less exertions, occurs spontaneously at rest, is progressive Prinzmetal (variant) Angina: Due to coronary artery spasm due to coronary artery diesease Etiology: Inadequete blood flow and oxygenation of the heart due to coronary artery disease Sxs: Pressure,, heaviness, squeezing, burning in the sternum or neck jaw shoulders arms, heaviness breathing, vomiting, sweating, angina, triggered by exertion or stress Tx: Supplemental O2, Nitroglycerine rest, Long acting is treated with nitrates beta blockers and calcium channel blockers Atherosclerosis - ANSWER-Accumulation of fatty plaques on the inner walls of the arteries that can restrict blood flow and cause a clot Etiology: Unknown but may begin with damage or injury to the inner wall of the artery from hypertension, high cholestrol, smoking or diabeties. Plaques made of cholestrol harden narrowing arteries and impeding bloodflow. Sxs: Angina Pectoris, Cerbreal arteries affected may cause weakness of the arms or legs or difficulty speaking, peripheral arteries affected may cause intermittent claudication Tx: Lifestyle changes, medications, antihypertensiives, antilipidemics, antiplatelets Chronic Venous Insufficiency (CVI) - ANSWER-Condition in which the veins and valves of the LE are damage and cannot keep blood flowing towards the heart. Veins remain filled with blood. Etiology: Weak or damaged valves inside the veins, risk factors are females, obesity, pregnancy, and prolonged sit/stand Sxs: leg swelling varicose veins, aching, heaviness or cramping, skin ulcers of the leg or ankles, redness Tx: Compression stockings, elevation of the legs to decrease chronic swelling, varicose veins Cor Pulmonale - ANSWER-Pulmonary Heart disease, hypertrophy of the Right ventricle due to altered structure or function of the lungs Etiology: Pulmonary hypertension from chronicall increased resistance in pulmonary circulation Sxs: Progressive Shortness of breath especially with exertion, fatigue, palpations, atypical chest pain, swelling ot the LE diziness, syncrope Tx: Supplemental o2, diurectics, anticoagulations Coronary Artery Disease - ANSWER-Narrowing or blockage of the coronary arteries due to atheromatous plaques diminishing blood flow Etiology: Damage or injury into the inner layer of the coronary artery, once the inner wall is damaged fatty plaques made of cholestrol accumulate at the site of injury. When a plate ruptures, plateletes will clump at the site to try and repair the artery, the clump can block the artery leading to a heart attack. Risk factors are High LDL cholestrol, Low HDL cholestrol, type 2 DM, smoking, obesity, hypertension Sxs: Angina, shorness of breath, and complete blockage resulting in a Heart attack Tx: modification of atherclerosis risk, smoking cessation, weight loss, heart healthy diet, regular exercise, antiplatelete agents, ace inhibitors, engiotensin 2 receptor blockers Deep Vein Thrombosis - ANSWER-Blood clot of the deep veins usually in the LE, Clot can break loose and travel to lungs resulting in a pulmonary emobolism Etiology: any condition that impairs normal circulation or blood clotting, risk factors are prolonged sitting or bed rest, pregnancy, cancer, birth control, hormone replacement, obesity, smoking Sxs: 50% are asymptomatic, swelling pain redness, warmth tx: Anticoagulants and thrombolytic agents, compression stockings to reduce blood pooling Heart Failure (CHF) - ANSWER-Progressive condition in which the heart cannot maintain cardiac output for the body's demands for blood and oxygen. Develops after other conditions have damaged or weakened the heart. Ventricles weaken and dilate for ineffective pump, can affect either side but begins with Left ventricle. Blood may back into the liver, abdomen, LE's, or lungs. Etiology: Coronary artery disease, Hypertension, DM, Myocaridal infraction, abdnormal heart valves, cardiomyopathy Sxs: Shortness of breath, fatigue, weakness, swelling of legs, feet, abdomen, irregular heartbeat, persistent cough or wheezing, weight gain from fluid retention Tx: Anticoagulants, Antihypertensives, digitalis to increase stregnth of contraction, surgery, Smoking cessation, reduce sodium, healthy weight, moderate exercise Hypertension - ANSWER-Arterial hypertension is elevation of Systolic pressure >=140mmhg diastolic >=90mmhg. Hypertension in children is equal to the 95th percentile of blood pressure distribtion Etiogy: primary hypertension has no known cause, Hypertension with a cause usually renal disease is secondary hypertension Sxs: Often asymptomatic untill complications develop, Severe hypertensions >120mmhg DBP can cause CNS symptoms seizures, corticol blindness, hemiparesis and cardiovascular symptoms (Chest pain, dyspnea, and renal involvement) tx: Lifestyle modifications indluding physical activity, weight loss, smoking cessation, less sodium and alcohol, better diet, Diuretics, beta blockers, ace inhibitors, angiotensin 2 blockers, vasodilators Classification of Hypertension in adults - ANSWER-Normal SBP/DBP <120/<80 Prehypertensive 120-139/80-89 Stage 1 hypertension 140-159, 90-99 stage 2 hypertension >=160, >=100 Myocardial Infraction - ANSWER-Blood flow through one or more of the coronary arteries is severely reduced or cut off completely. This causes necrosis to the myocardium supplied by the blocked artery. Etiology: Ruptured atherosclerotic plaque or blood clot that blocks blood or spasm of coronary artery Sxs: Chest Discomfort with pressure, squeezing, Shortness of breath,, discomfort in upper body (arms, neck back), nausea, vomitting, dizziness, sweating,palpaitation Tx: Anticoagulants and thrombolytic agents, antihypertensives, coronary angioplasty with stenting, lifestyle changes like smoking, exercise Peripheral artery disease - ANSWER-Senotic occulsive diseases of the aorta and peripheral arteries Etiology: caused primarily by atherosclerosis and thromboembolic processes that alter the struture and function of the aorta and its branches Sxs: Fatigue, aching, numbnesss in the buttock, thigh, leg , calf at rest or when walking, poorly healing wounds on legs, distal hair loss Tx: Smoking cessation, lipid lowering meds, control of diabetes, hypertension with beta blockers, exercise of 30-45 min 3 ties a week for 12 weeks Valvular Heart disease - ANSWER-Damage to one or more of the heart valves results in regurgitation or stenosis of blood flow. REgurgitation blood leaks backwards, stensosis when the leaflets thicken or stiffen and do not open wide. Etiology: Congenital defecits, Calcific degenration, infection, endocarditis, coronary artery disease, Myocardial infraction, rheumatic fever Sxs: vary based on type and severity of valve disease, but may include heart palpitations, shortness of breath, chest pain, coughing, ankle swelling Tx: Digitalis, diuretics, antiplatelets, anticogulants, beta blockers, calcium channel blockers Asthma - ANSWER-Chronic In