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Pathophysiology Comprehensive Summary

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This is a comprehensive and detailed summary on the textbook pathophysiology by Lee-Ellen et al, chapters16,18-20 are covered in this document. *Essential!! * For effective study!!

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  • Chapters 16,18-20
  • August 22, 2024
  • 8
  • 2021/2022
  • Summary
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Pathophysiology

Definition:
 HTN (primary vs secondary vs orthostatic vs malignant) : High Blood Pressure
o Primary hypertension:
 NO known etiology---idiopathic disorder
 Most common form of disease in ADULTS (from age 18)
 Associated w/ positive family history of hypertension, obesity and lifestyle
factors ; can risk development of other diseases like stroke
 Non-modifiable: increasing age and family history
 Modifiable: some lifestyle changes
 Childhood (intrauterine): occurred because of maternal smoking etc
 Known as a “silent killer” bc it can cause end-organ damage (damaged
organs before diagnosis)
o Secondary Hypertension:
 Has a SPECIFIC identifiable cause (ex: drugs, foods, chemicals)
 Most common form in INFANTS & CHILDREN
 Becomes a risk factor for renal disorders and coarctation of the
aorta; kidney’s can’t excrete sodium effectively (RAAS) & SNS
 Intervention: removing the cause, drug therapy
o Orthostatic Hypotension
 hypotension caused by standing up from a sitting/lying position
o Malignant Hypertension
 extremely high blood pressure that develops rapidly and causes some
type of organ damage.
 Caused by secondary hypertension or uncontrolled primary hypertension

 Sepsis
o Most common cause of death in ICU from underlying diseases like trauma,
peritonitis, cancer and immunodeficiency dis.

 Cardiac tamponade
o Accumulation of pericardial fluid that can be life threatening
o It causes compression of the heart chambers that heart filling is affected
o The pressure prevents the heart's ventricles from expanding fully and keeps your
heart from functioning properly.
o Si/sx: reduced stroke volume and bc of that, heart rate INCREASES
o Fluid must be drained
 Sleep apnea
o a common and serious sleep disorder that causes you to stop breathing
during sleep. The airway repeatedly becomes blocked, limiting the amount of
air that reaches your lungs.
 Orthopnea reperfusion therapy

, o medical treatment to restore blood flow, either through or around, blocked
arteries, typically after a heart attack (myocardial infarction (MI)). Reperfusion
therapy includes drugs and surgery.
 Catheterization
o Takes direct measurements of pressures within cardiac chambers to determine
important structural and hemodynamic (flow of blood) characteristics
o It was associated with risks—bleeding etc.—replaced with noninvasive ways
 Antiplatelet drugs
 Stroke volume vs end-diastolic volume vs end systolic volume
 Sympathetic vs parasympathetic nervous system

Chapter 16
 Blood pressure:
o Factors creating BP, measurement of BP
 Factors creating BP
 BP= (Cardiac Output) x (Systemic Vascular Resistance)
o CO: the amount of blood ejected from heart every minute
 (CO=SV x HR)
 Stroke Volume: blood leaving the heart every
contraction and it is determined by the preload
 Heart Rate: SNS--Beta receptors stimulation (INC.
HR); PSNS--Vagal nerve stimulation (DEC HR)
o SVR: radius of arteries—constricts and dilates
 Alpha stimulation=vasoconstrict=INC. SVR=INC BP
 Measurement of BP
 Direct Measurement:
o Uses a catheter within an artery; hemodynamic
monitoring; most ACCURATE method
 Indirect Measurement
o Uses a sphygmomanometer and stethoscope at the
brachial artery; EASIEST method
o systolic vs diastolic vs pulse pressure
 Systolic pressure:
 peak in pressure, heart muscle CONTRACTION, SV is the major
influence affecting the pressure
 Diastolic Pressure:
 Minimum pressure heart muscle RELAXATION, SVR is the major
influence affecting the pressure
 Pulse Pressure:
 PP=Systolic-Diastolic
o MAP = CO x TPR (systemic vascular resistance)
o Control: quick vs slow
 Quick:

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