Maryville NURS 611 Exam 3 2025

Maryville NURS 611 Exam 3 2025 Acute inflammation of the pericardium - -Acute Pericarditis Idiopathic or caused by viral infection - -what is the etiology of pericarditis Drop in Arterial bp by more than 10 mmhg in inspiration - -pulsus paradoxus Arterial BP during expiration exceeds arterial pressure during inspiration by more than 10 mmhg - -What is pulsus paradoxus Dyspnea, tachycardia, jugular venous distention, cardiomegaly, and pulsus paradoxus - -symptoms of cardiac tamponade What test do you do to check the functioning of a valve - -Echocardiogram Enlarged, superficial veins; a twisted, dilated vein w/ incompetent valves - -varicose veins (1) trauma to the saphenous veins that damages one or more valves, or (2) gradual venous distention caused by the action of gravity on blood in the legs - -Causes of varicose veins Condition in which venous circulation is inadequate due to partial vein blockage or leakage of venous valves; primarily affects feet and ankles; discoloration of the skin. Makes it difficult for blood to return to the heart from the legs - -chronic venous insufficiency/ venous insufficiency Pituitary adenoma usually benign and slow growing. Arise from the anterior pituitary. - Hyperpituitarism Endocrine disorder. Occurs when the pituitary gland produces an excessive amount of growth hormone after the completion of puberty - -Acromegaly Slowly progressive disease. Connective tissue proliferation. Hypersecretion of growth hormone - -hypothyroidism -autoimmune thyroiditis (Hashimoto) -Iatrogenic loss of thyroid tissue after surgical or radioactive treatment - -Hypothyroidism 1. Poor concentration, memory, dementia, psychosis, coma 2. Seizures 3. Headaches (pseudotumor cerebri) 4. CN: papilledema, ptosis, tonic pupil, trigeminal neuralgia, facial palsy, tinnitus, hearing loss Nurs 611 Nurs 611 5. Cerebellar ataxia: truncal + gait ataxia limb ataxia, dysarthria, nystagmus 5. NMJ: myasthenia gravis 6. Nerves: carpal tunnel, polyneuropathy, delayed DTR - -neurological manifestations of hypothyroidism A common form of hyperthyroidism resulting from overproduction of thyroxine; caused by a false immune system response (goiter is often formed). Antibodies to TSH receptor that stimulate T3 and T4 production. Diffuse nontender goiter. Proptosis and extraocular muscle dysfunction occurs in 50% of cases. - -Graves (or Graves') disease Type II hypersensitivity where there is stimulation of the thyroid by antibodies directed against the TSH receptor The gland results in hyperplasia of the gland (goiter). Increased synthesis of TH - Grave's Disease In the case of decreased production or excessive loss of albumin , the reduced oncotic pressure leads to excessive movement of fluid and solutes into the tissues and decreased blood volume. - -the effect of low plasma albumin Albumin (approximately 60% of total plasma protein at a concentration of about 4 g/dl) is the most abundant plasma protein. - -What is the most abundant class of plasma protein Because it cannot undergo mitotic division, the erythrocyte has a limited life span of approximately 120 days. - -erythrocytes Basophils contain cytoplasmic granules that hold an abundant mixture of biochemical mediators, including histamine, chemotactic factors, proteolytic enzymes, and an anticoagulant (heparin) - -Granulocytes that contain granules of vasoactive amines, such as histamine, are called Platelets (thrombocytes) are not true cells but are disk-shaped cytoplasmic fragments that are essential for blood coagulation and control of bleeding. - -formed elements of the blood that are not cells but are disk-shaped cytoplasmic fragments essential for blood clotting Only monocytes migrate into a variety of tissues and fully mature into tissue macrophages and myeloid dendritic cells - -Blood cells that differentiate into macrophages A platelet circulates for approximately 10 days and ages. Macrophages of the mononuclear phagocyte system, mostly in the spleen, remove platelets. - -the life span of platelets The spleen is the largest of the secondary lymphoid organs and the site of fetal hematopoiesis. - -Fetal hematopoiesis occurs in which structure? Nurs 611 Nurs 611 Splenic absence from any cause has several secondary effects on the body, among them an increase in morphologically defective blood cells in the circulation, confirming the spleen's role in removing old or damaged cells. - -consequence of a splenectomy The B lymphocyte proliferation in response to significant antigen (e.g., during infection) may result in lymph node enlargement and tenderness (reactive lymph node - -During an infection, why do lymph nodes enlarge and become tender Neutrophils are the chief phagocytes of early inflammation. - -Which blood cells are the chief phagocytes involved in the early inflammation process? The erythrocyte's size and shape are ideally suited to its function as a gas carrier. A red blood cell (RBC) is a small disk with two unique properties: (1) a biconcave shape and (2) the capacity to be reversibly deformed - -Which blood cells are biconcave in shape and have the capacity to be reversibly deformed? Without reactivation by methemoglobin reductase, the Fe3+-containing hemoglobin (methemoglobin) cannot bind oxygen. This capability is not true of the other types of hemoglobin mentioned. - -Which hemoglobin is made from oxidized ferric iron (Fe3+) and lacks the ability to bind oxygen? Cobalamin and folate are necessary for the synthesis of DNA and for the maturation of erythrocytes. - -Which nutrients are necessary for the synthesis of DNA and the maturation of erythrocytes? This concept is expressed only in the Frank-Starling law; the cardiac muscle, like other muscles, increases its strength of contraction when it is stretched - -When the volume of blood in the ventricle at the end of diastole increases, the force of the myocardial contraction during the next systole will also increase, which is an example of which law or theory about the heart Pressure changes are important because increased left ventricular filling pressures back up into the pulmonary circulation, where they force plasma out through vessel walls, causing fluid to accumulate in lung tissues (pulmonary edema) - -Continuous increases in left ventricular filing pressures result in which disorder? Pressure in the ventricle must exceed aortic pressure before blood can be pumped out during systole. The aorta is the only structure in which pressure must be less than the amount of blood in the left ventricle for ejection to occur. - -Pressure in the left ventricle must exceed pressure in which structure before the left ventricle can eject blood? This concept is expressed in the Frank-Starling law; the cardiac muscle, like other muscles, increases its strength of contraction when it is stretched. This selection is the only option that accurately describes the result of an increase in preload. - -Within a Nurs 611 Nurs 611 physiologic range, what does an increase in left ventricular end-diastolic volume (preload) result in? Potassium is moved out of the cell during phase 3, with a return to resting membrane potential only in phase 4. The time between action potentials corresponds to diastole. - Which phase of the normal myocardial cell depolarization and repolarization correlates with diastole? The PR interval is a measure of time from the onset of atrial activation to the onset of ventricular activation; it normally ranges from 0.12 to 0.20 second. The PR interval represents the time necessary to travel from the sinus node through the atrium, the atrioventricular (AV) node, and the His-Purkinje system to activate ventricular myocardial cells. - -In the normal electrocardiogram, what does the PR interval represent? The cardiac electrical impulse normally begins spontaneously in the sinoatrial (SA) node because it: - -The electrical impulse normally begins in the SA node because its cells depolarize more rapidly than other automatic cells. This selection is the only option that accurately explains why cardiac electrical impulses normally begin spontaneously in the SA node During the refractory period, no new cardiac action potential can be initiated by a stimulus. This selection is the only option that accurately identifies the period described in the question. - -What period follows depolarization of the myocardium and represents a period during which no new cardiac potential can be propagated? Which complex (wave) represents the sum of all ventricular muscle cell depolarizations? - -Only the QRS complex represents the sum of all ventricular muscle cell depolarizations. What can shorten the conduction time of action potential through the atrioventricular (AV) node - -Catecholamines speed the heart rate, shorten the conduction time through the AV node, and increase the rhythmicity of the AV pacemaker fibers If the sinoatrial (SA) node fails, then at what rate (depolarizations per minute) can the atrioventricular (AV) node depolarize? - -If the SA node is damaged, then the AV node will become the heart's pacemaker at a rate of approximately 40 to 60 spontaneous depolarizations per minute. 3 receptors are found in the myocardium and coronary vessels. In the heart, stimulation of these receptors opposes the effects of 1- and 2-receptor stimulation and negative inotropic effect. Thus 3 receptors may provide a safety mechanism that decreases myocardial contractility to prevent overstimulation of the heart by the sympathetic nervous system - -What is the effect of epinephrine on 3 receptors on the heart? Nurs 611 Nurs 611 Left atrial contraction, the atrial kick, provides a significant increase of blood to the left ventricle - -The significance of the atrial kick is that it affects the contraction of the: Occlusion of the circumflex artery during a myocardial infarction would interrupt blood supply to which area? - -The circumflex artery supplies blood to the left atrium and the lateral wall of the left ventricle. The circumflex artery often branches to the posterior surfaces of the left atrium and left ventricle The coronary sinus empties into which cardiac structure? - -The cardiac veins empty only into the right atrium through another ostium, the opening of a large vein called the coronary sinus. Oxygenated blood flows through which vessel? - -Only the four pulmonary veins, two from the right lung and two from the left lung, carry oxygenated blood from the lungs to the left side of the heart. When the ventricles relax, blood fills the cusps and causes their free edges to meet in the middle of the vessel, closing the valve and preventing any backflow. This selection is the only option that accurately explains why the aortic and pulmonic valves close after the ventricles contract. - -During the cardiac cycle, why do the aortic and pulmonic valves close after the ventricles relax? The papillary muscles are extensions of the myocardium that pull the cusps together and downward at the onset of ventricular contraction, thus preventing their backward expulsion into the atria - -the heart's valves, what is a function of the papillary muscles? What is the process that ensures mitral and tricuspid valve closure after the ventricles are filled with blood? - -During ventricular relaxation, the two atrioventricular valves open and blood flows from the higher pressure atria to the relaxed ventricles. With increasing ventricular pressure, these valves close and prevent backflow into the atria as the ventricles contract Which chamber of the heart endures the highest pressures? - -Pressure is greatest in the systemic circulation, driven by the left ventricle. Which cardiac chamber has the thinnest wall and why? - -The two atria have the thinnest walls because they are low-pressure chambers that serve as storage units and conduits for blood that is emptied into the ventricles. This selection is the only option that correctly identifies which heart chambers have the thinnest walls and why that helps cardiac function The major products secreted by the adrenal medulla are the catecholamines epinephrine (adrenaline) and norepinephrine - -Adrenal medulla Nurs 611 Nurs 611 Calcitonin, also called thyrocalcitonin, acts to lower serum calcium levels by inhibiting bone-resorbing osteoclasts, making the other options incorrect. - -What is the action of calcitonin? Target cells for parathyroid hormone are located in the - -Parathyroid hormone acts on its plasma membrane receptor only in the distal and proximal tubules of the kidney's nephron. Which compound or hormone is secreted by the adrenal medulla? - -the catecholamine epinephrine (adrenaline) is the only major product secreted. Insulin transports which electrolyte in the cell? - -Insulin facilitates the intracellular transport of potassium, phosphate, and magnesium. Insulin does not facilitate the transport of the other electrolytes Hyperphosphatemia leads to hypocalcemia - -What effect does hyperphosphatemia have on other electrolytes Which mineral is needed for thyroid-stimulating hormone (TSH) to stimulate the secretion of thyroid hormone (TH)? - -TSH, which is synthesized and stored in the anterior pituitary, stimulates secretion of TH by activating intracellular processes, including the uptake of iodine necessary for the synthesis of TH. Releasing and inhibitory hormones are synthesized in the hypothalamus and are secreted into the portal blood vessels through which they travel to