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Pa Tho Physiology Cardio&Renal

Pa Tho Physiology Cardio&Renal

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Published by xiang jin

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Categories:Topics, Art & Design
Published by: xiang jin on Aug 01, 2010
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10/25/2012

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Coronary Artery Disease: Ischemic Heart disease
-Leading cause of death and disability in the United States-One of every three men-One of every two women-Application of cpr-Better medical control of emergencies-Control of hypertension-Lower cholesterol diets-Coronary artery disease (CAD)-Men have higher incidence-Almost totally caused by atherosclerosisRisk factorsA.Alterable:-Diet-Smoking-Hypertension-Stress-Sedentary Living-Diabetes Mellitus-AlcoholB.Unalterable-Age-Sex-Race-Genetic HeritageAlterable Risk FactorsA.Diet-Main factor in development of CAD-High serum plasma cholesterol-Foods high in saturated fat content-Low-density lipoprotein (LDL)-High-density lipoprotein (HDL)-Exercise; age (children and premenopausal women); diet-HyperlipidemiaB.Cigarette Smoking-Most preventable-Risk of cerebrovascular accident is also decreased-Decreased fibrinogen levels-Decreased HDL-Increases LDL cholesterol
-
Alters O
2
transport in myocardium
 
C.Hypertension-Can be decreased with antihypertensive drugs, diet and exercise-Elevation of the systolic pressureD.Stress/Behavioral Factors-Type A Behavioral Pattern-Stressful life events-Job problems-Limited social support-Lifestyle changes-May be associated with diet and smokingE.Sedentary Living-Regular, moderate or vigorous physical activityF.Diabetes Mellitus-Alteration in carbohydrate and fat metabolism-Body weight-Blood sugar levelsG.Alcohol-Correlated with high blood pressure-Increased smoking behavior, alcoholism, obesity, systemic problems-Increased serum HDL levelsUnalterable Risk FactorsA.Age-more commonB.Sex differences-Increased incidence in men-Female hormones are protectiveC.Racial Differences-Little conclusive evidence-Blacks have an equal incidence of CAD; higher incidence of hypertension-Asians have lower incidenceD.Genetic Heritage-Strong factorPathogenesis of coronary Artery Disease-Fatty streak-Fibrous plaque or atheroma-Atheromatous plaque (white)
 
-Occludes the lumen of artery-Core of plaque becomes necrotic-Hemorrhage and calcification-Thrombosis-Lesions = 75% occluding-Total occlusion does not cause ischemia because of collateralcirculation-Channels dilate-Bifurcations, curvatures, tapering of arteries-Resistance to blood flow increases-Compromised myocardial muscle blood supply
-
Decreased O
2
uptake-Myocardial ischemia, angina pectoris results
-
Necrosis
SYSTEMIC HYPERTENSION
-consistent elevation of systemic arterial blood pressure-sustained systolic blood pressure of 140 mm Hg or greater systolic pressureor a diastolicpressure of 90 mm Hg or greater
Two Blood Pressure Measures:
Systolic
 
– pressure of the blood as a result of contraction of the ventricles,that is, thepressure of the height of the blood wave
Diastolic
 
– pressure when the ventricles are at rest, the lower pressure,present at alltimes within the arteries
Pulse Pressure
difference between the diastolic and systolicpressures
Determinants of Blood Pressure:
Pumping Action of the Heart 
When the pumping action of the heart is weak, less blood is pumpedinto arteries (lower cardiac output), and the blood pressure decreases. Whenthe heart’s pumping action is strong and the volume of blood pumped intocirculation increases (higher cardiac output), the blood pressure increases.
Peripheral Vascular Resistance
Peripheral resistance can increase blood pressure. The diastolicpressure especially is affected. Some factors that create resistance in the

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