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General Principles of Physiology and Pthophysiology
Paramedic Care Principles & Practice Vol. 1 Ch. 8
61
Health Care
Professional
04/03/2012

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Term
DNA
Definition
-inherited traits are determined by molecules of deoxyribonucleic acid
-form genes
Term
Diseases
Definition
-some thought to be purely genetic
*may be caused by a single defective gene or by several defective genes or chromosomes
-Multifactorial
*combination of family history and environmental factors
Term
3 clinical factors
Definition
-host, agent and environment
Term
Host
Definition
-genetic disposition, gender and ethnic origin
-may interact with a specific agent, in a specific environment to cause illness
Term
Agent
Definition
-may be a bacterium, toxin, gunshot or other pathophysiological process
Term
Environment
Definition
-may be defined by the local climate, socioeconomic or demographic features, culture, religion, and associated factors
Term
Effects on population
Definition
-incidence, prevalence and mortality
Term
Incidence
Definition
-the number of new cases of the disease that are reported in a given period of time, usually 1 year.
Term
Prevalence
Definition
-proportion of the total population who are affected by the disease at a given point of time
Term
Mortality
Definition
-the rate of death from the disease
Term
Immunologic disorders
Definition
-rheumatic fever, allergies and asthma
-more prevalent among those with a family history of the disorder but also involve other risk factors
Term
Immunologic disorders
Definition
-rheumatic fever, allergies and asthma
-more prevalent among those with a family history of the disorder but also involve other risk factors
Term
Rheumatic fever
Definition
-inflammatory reaction to an infection, but is not an infection
-hereditary factor, but inadequate nutrition and crowded living conditions are contributing factors
Term
Allergies
Definition
-often have family history factor
-triggered by exposure to allergens and can usually be controlled by avoiding or reducing the presence of allergens as well as with medications
Term
Asthma
Definition
-propensity for airway-narrowing response to various stimuli
Term
Cancer
Definition
-wide variety of family history and environmental factors are included among the risk factors
Term
Endocrine disorders
Definition
-most common is diabetes mellitus
-Type I, must take insulin daily because the pancreas produces no to almost no insulin, required for cellular utilization of glucose
-Type II accounts for 80% of all cases
-associated with a decreased insulin receptor response or a decrease in insulin production
-Majority of Type II diabetics are obese
Term
Hematologic disorders
Definition
-many causes, such as gene alteration and histocompatibility (tissue interaction) dysfunctions.
Include hemophilia, hemochromatosis and anemia
Term
Cardiovascular disorders
Definition
-heredity a major risk factor
-include prolongation of the QT interval, mitral valve prolapse, coronary artery disease, hypertension and cardiomyopathy
Term
Renal disorders
Definition
-caused by a wide variety of factors (primarily hypertension) which may eventually require dialysis.
Term
Rheumatic disorders
Definition
-may have both genetic and environmental disorders
-Gout
Term
Gastrointestinal disorders
Definition
-variety of causes and the causes of some disorders are unknown
-lactose intolerance, Crohn's disease, peptic ulcers, cholecystitis, obesity
Term
Neuromuscular disorders
Definition
-variety of causes
-huntington's disease, MS, Alzheimer's
Term
Psychiatric disorders
Definition
-genetic and biological causes being studied and increasingly understood
-schizophrenia, manic-depressive illness, bipolar disorders
Term
Perfusion
Definition
-the supplying of oxygen and nutrients to the body tissues as a result of the constant passage of blood through the capillaries
Term
Hypoperfusion
Definition
-inadequate perfusion of the body tissues, resulting in an inadequate supply of oxygen and nutrients to the body tissues.
-also called shock
Term
Components of the circulatory system
Definition
-the pump (heart)
-the fluid (blood)
-the container (blood vessels)
Term
Pump
Definition
-receives blood from the venous system, pumps it to the lungs for oxygenation and then it pumps it to the peripheral tissues
Term
Stroke volume
Definition
-70 mL
-the amount of blood ejected by the heart in one contraction
-factors affecting: preload, cardiac contractile force, afterload
Term
Preload
Definition
-the amount of blood delivered to the heart during diastole
-depends on venous return
Term
Cardiac contractile force
Definition
-affected by preload
-the greater the volume of preload, the more the ventricles are stretched, the greater the stretch the greater the cardiac contraction (Frank-Starling mechanism)
Term
Afterload
Definition
-the resistance a contraction of the heart must overcome in order to eject blood
-determined by the degree of peripheral vascular resistance
-the greater the arterial resistance, the less the stroke volume
Term
Cardiac output
Definition
-the amount of blood pumped by the heart in one minute
*Stroke volume x Heart rate = CO
Term
Blood pressure
Definition
-Cardiac output x peripheral vascular resistance
Term
Peripheral vascular resistance
Definition
-the resistance of the vessels to the flow of blood
-increased when vessels constrict, decreased when they dilate
-governed by; the length of the vessel, the diameter of the vessel and blood viscosity
Term
Compensatory mechanisms and negative feedback loops
Definition
-barorecpetors in the carotid sinuses and the aortic arch closely monitor blood pressure, and send messages to the brain that help to regulate changes in blood pressure
Term
The fluid
Definition
-blood
Term
The container
Definition
-blood vessels
Term
Microcirculation
Definition
-comprised of the small vessels; the arterioles, capillaries and venules.
-responsive to local tissue needs
precapillary sphincter responds to local tissue needs
Term
Blood flow regulation
Definition
-flow through vessels regulated by peripheral vascular resistance and pressure within the system
Term
Natriuretic peptides
Definition
Fli-substances with endocrine functions that affect the circulatory system
-two substances play role in perfusion
-Atrial Natriuretic Peptide
*manufactured, stored and released by atrial muscle cells in response to such things as atrial distention and sympathetic stimulation
-Brain Natriuretic Peptide
*manufactured, stoed and released by ventricular muscle cells in response to ventricular dilation and sympathetic stimulation
Term
Fick Principle
Definition
-adequate concentration of inspired oxygen
-appropriate movement of O2 across alveolar/capillary membrane into the arterial bloodstream
-adequate number of red blood cells to carry the oxygen
-proper tissue perfusion
-efficient off-loading of oxygen at the tissue level
Term
Causes of hypoperfusion
Definition
-inadequate pump
*inadequate preload
*inadequate cardiac contractile strength
*inadequate heart rate
*excessive afterload

-inadequate fluid
*hypovolemia

-inadequate container
*dilated container w/o change in fluid volume (inadequate systemic vascular resistance)
*leak in container
Term
2 characteristics of impaired cellular metabolism
Definition
-impaired oxygen use
-impaired glucose use
Term
Aerobic metabolism
Definition
-the second stage of metabolism, requiring the presence of oxygen
-breakdown of glucose yields a high amount of energy
-aerobic means "with oxygen"
Term
Anaerobic metabolism
Definition
-first stage of metabolism, which does not require oxygen
-breakdown of glucose produces pyruvic acid and yields very little energy
-anaerobic means "without oxygen"
Term
Change from aerobic to anaerobic metabolism
Definition
-when cells don't receive enough O2 or cannot use it effectively
-far less efficient means of producing energy
Term
Compensation
Definition
-decrease in arterial blood pressure by the baroreceptors, activates several body systems that attempt to reestablish a normal blood pressure
-endocrine system secretes epinephrine and norepinephrine , causing increased heart rate, increased cardiac contractile force and arteriolar constriction
Term
Compensated shock
Definition
-the body's compensatory mechanisms are able to maintain normal perfusion
Term
Decompensated shock
Definition
-when the body's compensatory mechanisms are no longer available to maintain normal perfusion
*hallmark is fall in BP
-progressive shock
Term
Irreversible shock
Definition
-no medical intervention can reverse the condition and death is inevitable
Term
Types of shock
Definition
-cardiogenic
-hypovolemic
-neurogenic
-anaphylactic
-septic
Term
Cardiogenic shock
Definition
-caused by insufficient cardiac output
-inability of the heart to pump enough blood to perfuse all parts of the body
-major difference is presence of pulmonary edema with difficulty breathing
Term
Hypovolemic shock
Definition
-caused by decreased blood or water volume
-loss of intravascular fluid volume
-internal or external hemorrhage, traumatic injury, long-bone or open fractures, severe dehydration from vomiting/diarrhea, plasma loss from burns, excessive sweating, DKA
Term
Obstructive shock
Definition
-caused by an obstruction that interferes with return of blood to the heart
-PE, cardiac temponade, tension pneumothorax
Term
Distributive shock
Definition
-caused by abnormal distribution and return of blood
-vasodilation, vasopermeability, or both (neurogenic, anaphylactic, septic)
Term
Osmotic diuresis
Definition
-greatly increased urination and dehydration due to high levels of glucose that cannot be reabsorbed into the blood from the kidney tubules, causing a loss of water into the urine
Term
Neurogenic shock
Definition
-resulting from brain or spinal cord injury that causes an interruption of nerve impulses to the arteries with loss of arterial tone, dilation, and relative hypovolemia
Term
Anaphylaxis
Definition
-life-threatening allergic reaction
Term
Septic shock
Definition
-develops as a result of infection carried by the bloodstream, eventually causing dysfunction of multiple organ systems
Term
MODS
Definition
-progressive impairment of two or more organ systems resulting from an uncontrolled inflammatory response to a severe illness or injury
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