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Health and Disease Wk. 2

by: Tay-La Notetaker

Health and Disease Wk. 2 HES 1823 004

Tay-La Notetaker
GPA 3.41

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These notes cover various topics we talked about during week 2 of class. Pulmonary Anatomy and Physiology, Coronary Heart Diseases, and Cardiovascular Disorders.
Scientific Principles of Health and Disease
Xin Ye
Class Notes
Heart, Lungs, disorders, Pathological, Risk, factors
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This 8 page Class Notes was uploaded by Tay-La Notetaker on Sunday September 4, 2016. The Class Notes belongs to HES 1823 004 at University of Oklahoma taught by Xin Ye in Fall 2016. Since its upload, it has received 36 views. For similar materials see Scientific Principles of Health and Disease in Health and Exercise Science at University of Oklahoma.

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Date Created: 09/04/16
Tay­La Jackson Scientific Principles of Health and Disease Wk. 2 – 8/29­8/31 8/29/2016: Cardiovascular Disorders  Arrhythmias  Defined as an abnormality in the rhythm or beat of the heart. o Can involve o The heart rate o Regularity of the beats o Sites where electrical impulses start o And sequence of activation of heartbeats. o They are classified by 1) when, 2) how and 3) where they occur. o 2) Premature = early o 3) If it is a Supraventricular Arrhythmia – it DIDN’T originate in  the ventricles. Ventricular – DID originate in ventricles.  Bradycardia = slow heart rates = <60 beats p/min. (caused by hypothyroidism,  myocarditis, endocarditis, and electrolyte imbalance.)  Tachycardia = fast heart rates = >100 beats p/min. (heart doesn’t have time to rest which  leads to insufficient supply of blood to the body.)  Supraventricular Tachycardia: originates in atria. o Causes sinus tachycardia, atrial flutter, atrial fibrillation, and paraoxysmal  supraventricular tachycardia.  Ventricular Tachycardia: orig. in ventricle. Causes pre­ventricular contractions  and can lead to Ventricular Fibrillation and that leads to sudden cardia arrest.  Causes:  Heart Disease  Heart Conduction   Heart Valve Problems Disorder  Heart Failure  Hypertension   Unrelated Conditions to Chronic Heart Problems:  Infection and Fever  Drugs (like caffeine, hard drugs, alcohol, amphetamines, etc.)  Physical or emotional Stress  Anemia or Thyroid Disorders  Common Symptoms of Arrhythmias:  While minor electrical disturbances may cause minimal damage, the larger the disturbance the more common the symptoms: o Palpitations o Fluttering /Thumping Chest o Felling Faint o Light­headed o Shortness of breath o Sensation of a racing heart beat o Chest pain, tightness, or discomfort   Wolff Parkinson­White Syndrome  this disease causes an extra electrical pathway between the atrias and the  ventricles. This syndrome is present at birth in 4 of 100,000 people.   Signs and Symptoms  Appear between the ages of 11 and 50.  Palpitations  Dizziness  Light­headedness  Fainting  Exercise Intolerance  Anxiety  More serious symptoms are: chest pain/ tightness, difficulty, and  difficulty breathing.   Treatments:  o Vagal maneuvers (Coughing, bearing down, ice on face) o Medication o Cardioversion: Defibrillation o Radiofrequency Ablation which means Surgery   Cardiac Remodeling  Can occur because of physiological or pathological conditions  Directly involved are the ventricles and the interventricular septum  Athlete’s Heart  Myocardial Infarctions  Extreme amounts of pressure  Inflammatory Heart Muscle Disorder  Inherited Conditions  Factors that contribute to remodeling is blood pressure, cardia myocytes, and  changes in hemodynamic load.   Athlete’s Heart  Physiological changes happen because of intensive, prolonged endurance or  strengthening and can cause the Left Ventricle to increase in mass, thicker walls,  chamber size increases, and a lower resting heart rate.  Signs and symptoms are bradycardias and heart murmurs.  Diagnosis is generally a clinical evaluation and treatment is subject to a period  of deconditioning to rule out any other heart problems.  Treatment includes medication and sometimes surgery.   Hypertrophic Cardiomyopathy (HCM)  Genetic, pathological disorder which causes thickening of the heart’s tissue.  Signs and symptoms: o Heart Murmur o Shortness of breath o Chest Pain o Palpitations o Lightheadedness with exertion o Syncope (fainting) o Most common is sudden death  Diagnosis is using genetic testing and echocardiograms.  Treatment is to avoid extreme athletics or risk taking medication or surgery.   ARVC (Arrhythmogenic Right Ventricular Cardiomyopathy)  Inherited heart disease causes defect in myocardium, primarily right  ventricle. Causes ventricle arrhythmias, esp. in children.  Prevalence rate is 1/10,000.  Testing: EKC, Echo, Angiography, CDMI, and genetic testing.  Hypertension  High blood pressure. Person has increased risk of developing morbid  cardiovascular event.  Associated with high mortality and morbidity. High risk of heart failure, stroke,  and complications of advanced atherosclerosis.   Ideal BP: <120/<80  Pre­hypertension: 121­139/81­89  Hypertension: >140/>90   Types of Hypertention:  Essential Hypertension: no identifiable causes. Accounts for 95% of  cases and affects genetics, environmental factors, and diet.  Secondary: caused by specific problems such as renal disease or  endocrine abnormalities.  Isolated: SBP >140/<90 (due to reduced compliance of the aorta with the  increase of a person’s age)  Malignant: rapid developing and has a HBP of >180/>120. Can cause  organ damage.  White Coat Hypertension: cause by a person’s anxiety of going to a  doctor’s office or anything medical.   Risk Factors  Age  Race  Gender  Decreased Potassium Intake  Serum Cholesterol  Increased Sodium Intake  Etc.  Symptoms  Usually none  Severe headache  Vison changes  Nosebleed  Angina­like chest pain  Etc.  Hypertension Pathophysiological  Usually associated with normal cardia output and elevated TPR. o (TPR=peripheral TVR= vascular)  Damages endothelium and predisposes person to atherosclerosis so  the heart has to work harder leading to the left ventricle  hypertrophying.    8/31/2016: Coronary Artery Disease  Coronary Arteries  Arteries pump blood to the body, but the heart also needs its own supply of blood. These arteries supplying blood to the myocardium are the coronary arteries.   Coronary Heart Disease  Caused by the narrowing of the coronary arteries that supply blood and  oxygen to the heart.  Risk Factors include diabetes, poor diet, smoking, physical inactivity,  and excessive alcohol intake.  Development of the Disease: o Atherosclerosis which is the buildup of plaque in major arteries of the body. The underlying process for cardiovascular disease. o Pathogenesis of Atherosclerosis: 1. Endothelial injury 2. Lipids accumulate and precipitate 3. Formation of atheroma 4. Second fibrosis and calcification  (arterial endothelium becomes thick and rigid with irregular contour.)  Manifestation of Heart Disease  Ischemia  Insufficient blood flow to the heart. Results in severe narrowing of the  arteries and mostly occurs when the heart demands a lot of oxygen from  eating, excitement, exercise, and exposure to cold.  Angina Pectoris (chest pain): assoc. with ischemia.  Myocardial Infarction (heart attack)  The death of heart muscle (atheroma ruptures) due to a blood clot that  stops blood flow (occlusion).  Signs and Symptoms: o Pain (angina pectoris) o Nausea/vomiting o Faintness o Sweating  Women: o Fatigue o Shortness of breath o Nausea/vomiting o Abdominal pain  Complications: o Arrhythmias o Heart Failure o Intracardiac Thrombi o Pericarditis=inflammation of the pericardium. o Cardiac Rupture o Ventricular Aneurysm (dilation of the wall of an artery or an  outpouching of a portion of the wall.)  Mortality: o 45% of people die within a year because of the failure to recognize or act on symptoms, or failure to timely transport patient to care  facility. o Sudden death because of ventricle fibrillation.  Modifiable RF: o Hypertension o Smoking o Type 2 Diabetes o Phys. Inaction o Environmental Smoke Exposure o Etc.   Cholesterol in Blood:  Fatty, waxy substance found in cell membranes carried into your body by the  foods you eat into your blood stream.    HDL = BAD      LDL=GOOD  Diagnosis: ECG, Coronary Angiography (examination of blood vessels), blood,  Cardia Imaging, and Exercise Stress Test.   Pulmonary Anatomy and Physiology  Main functions of the respiratory system are to provide oxygen and eliminate  carbon dioxide.  Composed of 2 lungs (2 lobes on left lung; 3 lobes on right), and airways.  Lungs are located in the thorax, which is composed of the rib cage, intercostal  muscles, and the diaphragm.   Airways  1) Conducting Zone (extends from trachea to beginning of bronchioles­no gas  exchange with blood)  2) Respiratory Zone (extends from bronchioles – gas exchange ­ alveoli are  here)  Alveoli (extensive capillarization in alveoli walls. Very thin blood­gas  walls here for separating O2 with CO2.)  Capillaries: red is O2 and blue is CO2              Exchange of Gases 1. At lungs and tissue occurs by diffusion and is dependent on partial  pressure gradient. Gas is proportional to its concentration. 2. Gas exchange will occur from a high pressure to a low one. 3. CO2 is highest in cells and lowest in atmosphere.   Components of Respiratory Function ­Dissolved in  1. Pulmonary Ventilation (air comes into the lungs from the atmosphere) 2. External Respiration (exchange of oxygen and carbon dioxide between  Hemoglobin has  lungs and blood) 10%) high affinity for3. Gas Transport (from lungs to tissue through circulation) oxygen. Only 25%  ­Bound to  ­Bound to  of oxygen is  4. Intehemoglobin ation (exchange of hemoglobin een blood and cells  wher(approx. 97%)iration goes on. (approx. 20%) unloaded from  hemoglobin to tisue ­bicarbonate  (approx. 70%)   The air that stays in your lung is called “dead space”  Air flow is determined by pressure gradient and airway resistance and is inversely proportionate to airway resistance.   Inspiratory muscles cause increase size of thoracic cavity decreasing pressure. o Diaphragm o External Intercostal o Scalene Muscles (neck)  Expiration is a 2­part process: o Inspirations = muscle relax o Elastic recoil of lung tissue   Airway Mechanics   Air flow requires pressure.  When you breathe in, the volume of your lungs increase and the pressure  decreases and vice versa when you breathe out.espiration=out  Compliance is how easily the lungs stretch while breathing.  2 components: Tissue Elasticity and Surface Tension  Elasticity is the ability for your lungs to return to normal size and shape.   Lung Volumes and Capacity  Tidal Volume (volume of air in breath)  Minute Ventilation (breath in and out per minute)  Total Lung Capacity (total amount of air can be held in lungs)  Vital Capacity (largest amount of air exhaled after maximal inspiration)   Residual Volume (Volume of air remaining in lungs after complete exhalation)   Forced Expiratory Volume  The amount of air expired during the first second of a maximal exhalation.  2 types of Lung Disorders  Obstructive (emphysema or bronchial asthma) a. With this disease the respiratory airways are narrowed.   Restrictive (pulmonary fibrosis) a. Respiratory airway movements are impaired.  Hyperventilation  Increased ventilation and leads to increased levels of O2 and decreased  levels of CO2.  Dyspnea  Difficult or labored breathing. A person will be unable to respond to  demand for ventilation. This can lead to heart failure, emphysema, and  chronic bronchitis.   Breathing is an involuntary action of the lungs and body and the brain controls the rate of ventilation.   Energy Cost of Breathing  Normal Cost of breathing is less than 2 percent of the oxygen we consume into  our lungs. Exercise increases ventilation to meet metabolic needs and leads to an  increase cost of breathing.  IMPORTANT: Cost of breathing increases with disease rates.


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