chapter 11 cardiovascular system
DESCRIPTION
Chapter 11 CARDIOVASCULAR SYSTEM. The heart is a muscle that pumps blood. Blood vessels carry the blood. PRACTITIONERS. Cardiology (cardi/o = heart) Cardiologist Interventional cardiologist Performs procedures and inserts devices Cardiac surgeon - PowerPoint PPT PresentationTRANSCRIPT
Chapter 11Chapter 11CARDIOVASCULAR SYSTEMCARDIOVASCULAR SYSTEM
The heart is a muscle that pumps The heart is a muscle that pumps blood. blood.
Blood vessels carry the blood.Blood vessels carry the blood.
PRACTITIONERSPRACTITIONERS
Cardiology (cardi/o = heart)Cardiology (cardi/o = heart)
Cardiologist Cardiologist Interventional cardiologistInterventional cardiologist
Performs procedures and inserts devices Performs procedures and inserts devices
Cardiac surgeonCardiac surgeon
Cardiovascular surgeon (vascul/o = Cardiovascular surgeon (vascul/o = vessel)vessel)
Treats vesselsTreats vessels
HEART FACTSHEART FACTS Located in center of thoracic cavityLocated in center of thoracic cavity
Between the lungs & behind the sternumBetween the lungs & behind the sternum Size of your fistSize of your fist
Points (bottom, apex) left Points (bottom, apex) left
Three-layered wallThree-layered wall Pericardium – outer layer of fibrous tissuePericardium – outer layer of fibrous tissue Myocardium – middle layer of thick Myocardium – middle layer of thick
muscle (my/o)muscle (my/o) Endocardium – inner layer of epithelial Endocardium – inner layer of epithelial
cells cells
Anatomy & Physiology of Anatomy & Physiology of Heart and Surrounding Heart and Surrounding
Structures Structures
HEART ANATOMYHEART ANATOMY Septum (sept/o = partition)Septum (sept/o = partition)
Separates the two sides of the heart (L & R)Separates the two sides of the heart (L & R) 4 chambers4 chambers
Atria (atrium) – 2 upper chambers (atri/o)Atria (atrium) – 2 upper chambers (atri/o) Ventricles – 2 lower chambers (ventricul/o)Ventricles – 2 lower chambers (ventricul/o)
Valves connect upper and lower chambersValves connect upper and lower chambers Bicuspid valve – left side (bi = two) Bicuspid valve – left side (bi = two)
Also called mitral valveAlso called mitral valve Tricuspid valve – right sideTricuspid valve – right side Open and close togetherOpen and close together Prevent blood from flowing back into the atriaPrevent blood from flowing back into the atria
HEART ANATOMY (con’t)HEART ANATOMY (con’t) 2 additional valves in ventricles2 additional valves in ventricles
Pulmonary valve –opening of pulmonary Pulmonary valve –opening of pulmonary arteryartery
Aortic valve –opening of the aortaAortic valve –opening of the aorta Work at the same time Work at the same time
Name the valves
(#5 is not a valve)
1. Pulmonary Valve2. Tricuspid Valve3. Mitral (Bicuspid) Valve4. Aortic Valve5. Heart Apex
Check your labels!
INTERNAL VIEW OF HEARTINTERNAL VIEW OF HEART
HEART ACTIONHEART ACTION Heart contracts to pump bloodHeart contracts to pump blood
Systole – contraction phase Systole – contraction phase Diastole – relaxation phase Diastole – relaxation phase
Heartbeat consists of:Heartbeat consists of: Contraction by atria, then ventriclesContraction by atria, then ventricles Together = cardiac cycleTogether = cardiac cycle
Average heart beat is 72/minAverage heart beat is 72/min Cardiac output = volume of blood Cardiac output = volume of blood
pumped in 1 min. pumped in 1 min.
Regulation of Cardiac Cycle- controlled by the cardiac center within the medulla oblongata. The cardiac center signals heart to increase or decrease its rate according to many factors that the brain constantly monitors.
•Muscle Activity
•Body Temperature
•Blood ion levels (potassium & calcium)
BLOOD FLOW THROUGH THE BLOOD FLOW THROUGH THE HEARTHEART
Pulmonary circulationPulmonary circulation Right side of heart carries blood to lungsRight side of heart carries blood to lungs Return of de-oxygenated blood from the Return of de-oxygenated blood from the
bodybody Blood flow to pick up oxygenated blood in Blood flow to pick up oxygenated blood in
lungslungs
Systemic circulationSystemic circulation Left side of heart carries blood to body Left side of heart carries blood to body Oxygenated blood returns from lungsOxygenated blood returns from lungs Oxygenated blood sent out to body cells Oxygenated blood sent out to body cells
via aorta via aorta
CONDUCTION SYSTEMCONDUCTION SYSTEM Works like an electrical circuitWorks like an electrical circuit
Signal flows fromSignal flows from SA node –begins process SA node –begins process
Pacemaker of heartPacemaker of heart Determines rhythm Determines rhythm
AV nodeAV node Right and left bundle branches (Bundle of Right and left bundle branches (Bundle of
His)His) Purkinje fibersPurkinje fibers
CONDUCTION SYSTEM CONDUCTION SYSTEM
Plasma (55% of the blood)Plasma (55% of the blood) A straw-colored fluid which is about 90% water and 10% A straw-colored fluid which is about 90% water and 10%
dissolved gases, salts, nutrients, enzymes, hormones, dissolved gases, salts, nutrients, enzymes, hormones, waste products and plasma proteinswaste products and plasma proteins
Cells (45% of the blood)Cells (45% of the blood) RBC’s RBC’s
Most numerous (5-6 million)Most numerous (5-6 million) Contain hemoglobin, which is the iron-containing protein that Contain hemoglobin, which is the iron-containing protein that
binds oxygenbinds oxygen WBC’s (leukocytes) (4,000-10,000)WBC’s (leukocytes) (4,000-10,000)
They are the army of the circulatory systemThey are the army of the circulatory system May increase dramatically when the body is fighting an May increase dramatically when the body is fighting an
infectioninfection Platelets (250,000 – 400,000)Platelets (250,000 – 400,000)
Help in blood clotting by clumping together at the injury to Help in blood clotting by clumping together at the injury to prevent blood from flowing out of the cutprevent blood from flowing out of the cut
Parts of the Blood
BLOOD VESSELSBLOOD VESSELS VesselVessel
Vas/oVas/o Angi/oAngi/o
Arteries (arteri/o)Arteries (arteri/o) Carries blood away from the heartCarries blood away from the heart Largest artery is the aortaLargest artery is the aorta
Get smaller – form arterioles (arteriol/o)Get smaller – form arterioles (arteriol/o)
Arterioles change into capillaries Arterioles change into capillaries Nutrients and gases are exchangedNutrients and gases are exchanged
VESSELS (con ‘t) VESSELS (con ‘t) Venous systemVenous system
Carries blood back to heartCarries blood back to heart Capillaries form into tiny venules Capillaries form into tiny venules Veins (ven/o , phleb/o)Veins (ven/o , phleb/o) Largest = superior and inferior venae cavaeLargest = superior and inferior venae cavae
Veins have one-way valves to prevent back flow of Veins have one-way valves to prevent back flow of bloodblood
Lumen: central opening of vesselLumen: central opening of vessel
Pulse: artery expanding and contractingPulse: artery expanding and contracting
Arterial system helps maintain body’s blood Arterial system helps maintain body’s blood pressure: constrict and dilate to keep an even pressure: constrict and dilate to keep an even pressure gradientpressure gradient
PULSE POINTS (palpable PULSE POINTS (palpable pulses)pulses)
HEART FACTSHEART FACTS Heart has a circulatory system to nourish the Heart has a circulatory system to nourish the
heart muscle heart muscle Called coronary circulation (coron/o = circle or Called coronary circulation (coron/o = circle or
crown)crown) Right and left coronary arteriesRight and left coronary arteries
Decreased blood flow leads to heart tissue death Decreased blood flow leads to heart tissue death Myocardial infarction (heart attack) Myocardial infarction (heart attack)
Blood pressure (BP) Blood pressure (BP) Hypertension = Elevated BPHypertension = Elevated BP
Increased resistance in vessels – Poor blood flowIncreased resistance in vessels – Poor blood flow HypotensionHypotension
Too little blood flowing to organs Too little blood flowing to organs Read: systolic pressure (#) /diastolic pressure (#) Read: systolic pressure (#) /diastolic pressure (#)
Goal is ~ 120/80 Goal is ~ 120/80
WELLNESS & ILLNESSWELLNESS & ILLNESS Listen to the heart with a stethoscopeListen to the heart with a stethoscope
Lub - dub = S1, S2 Lub - dub = S1, S2 S1 – closing of AV valves as ventricles contract S1 – closing of AV valves as ventricles contract
(systole)(systole) S2 – closing of semilunar valves closing in S2 – closing of semilunar valves closing in
relaxation diastole relaxation diastole
Listen to specific areas of heart for:Listen to specific areas of heart for: Abnormal heart soundsAbnormal heart sounds Valve defects Valve defects
Heart Sounds - Opening and Closing of Valves, "Lub Dub"
Stethoscope - instrument to listen and measure heart sounds
FETUSES & NEWBORNSFETUSES & NEWBORNS At birth, lungs inflate and aeration At birth, lungs inflate and aeration
beginsbegins Congenital heart defectsCongenital heart defects
Impaired cardiac functionImpaired cardiac function ASD: opening between atriumASD: opening between atrium VSD: opening between ventriclesVSD: opening between ventricles PDA: persistent fetal circulationPDA: persistent fetal circulation Coarctation of aorta: narrowing of Coarctation of aorta: narrowing of
descending portion of aortadescending portion of aorta
CHILDRENCHILDREN
MurmursMurmurs Innocent murmursInnocent murmurs Functional murmurs Functional murmurs
ADULTS –Risk FactorsADULTS –Risk Factors Risk factors for heart diseaseRisk factors for heart disease
Cannot be controlled:Cannot be controlled: Age, family history, genderAge, family history, gender
Can be modified/treated/controlled:Can be modified/treated/controlled: SmokingSmoking Physical ActivityPhysical Activity Body mass Index: keep less than 25 (weight)Body mass Index: keep less than 25 (weight) Blood pressure: keep less than 120/80Blood pressure: keep less than 120/80 Blood glucose: keep less than 140 (random)Blood glucose: keep less than 140 (random) CholesterolCholesterol
Keep total below 200Keep total below 200 HDL, LDL, triglyceride levels HDL, LDL, triglyceride levels
ADULTSADULTS PROBLEMSPROBLEMS
Arteriosclerosis (scler/o = hardening) Arteriosclerosis (scler/o = hardening) Affects walls of small vesselsAffects walls of small vessels
Angina pectorisAngina pectoris Severe pain in chest (and may radiate)Severe pain in chest (and may radiate)
Decreased blood flow to heartDecreased blood flow to heart
Abnormalities in vesselsAbnormalities in vessels AneurysmAneurysm
Ballonlike swelling of an arteryBallonlike swelling of an artery Atherosclerosis (ather/o = pasty material) Atherosclerosis (ather/o = pasty material)
Blockage caused by lipid deposits Blockage caused by lipid deposits
SENIORSSENIORS Aging changesAging changes
Elevated BPElevated BP Normal calcification of vesselsNormal calcification of vessels
Coronary heart diseaseCoronary heart disease General termGeneral term
Congestive heart FailureCongestive heart Failure Poor pumping ability of heart – poor body Poor pumping ability of heart – poor body
perfusionperfusion Arrhythmias (rhythm = beat)Arrhythmias (rhythm = beat)
Irregular heart rhythmIrregular heart rhythm Ectopic beats (ecto = outer)Ectopic beats (ecto = outer)
Heartbeat outside regular rate and rhythm Heartbeat outside regular rate and rhythm Outside SA node regulationOutside SA node regulation
GENERAL TERMSGENERAL TERMS Bradycardia (brady = slow)Bradycardia (brady = slow)
Tachycardia (tachy = rapid)Tachycardia (tachy = rapid)
Cardiomegaly (megal/o = enlargement)Cardiomegaly (megal/o = enlargement)
Vasoconstriction Vasoconstriction Narrowing of a vesselNarrowing of a vessel
VasodilationVasodilation Widening of a vesselWidening of a vessel
Varicose VeinVaricose Vein Dilated and twisted veins, usually in legs Dilated and twisted veins, usually in legs
TESTSTESTS Blood testing Blood testing −− lipid risk panel lipid risk panel
Electrocardiogram (ECG)Electrocardiogram (ECG) Ultrasound of heartUltrasound of heart
EKGEKG Tracing electrical activity of the heartTracing electrical activity of the heart Identify heart muscle changes Identify heart muscle changes
Interpreting EKGsAn EKG is printed on paper covered with a grid of squares.Notice that five small squares on the paper form a larger square. The width of a single small square on EKG paper represents 0.04 seconds. - A common length of an EKG printout is 6 seconds; this is known as a "six second strip."
HEART RHYTHMSHEART RHYTHMS EKG tracingsEKG tracings
PROCEDURESPROCEDURES Interventional cardiologyInterventional cardiology
Cardiac catheterization (angiogram)Cardiac catheterization (angiogram) To determine flow of blood through heart and To determine flow of blood through heart and
main vesselsmain vessels Use catheter and dyeUse catheter and dye
Balloon Angioplasty (PTCA)Balloon Angioplasty (PTCA) Balloon catheter inserted into blocked coronary Balloon catheter inserted into blocked coronary
artery, then inflated to push plaque against artery, then inflated to push plaque against vessel wallsvessel walls
EndarterectomyEndarterectomy Removal of plaque from an arteryRemoval of plaque from an artery
Common in carotidsCommon in carotids Coronary bypass graft (CABG)Coronary bypass graft (CABG)
Cardiac vessels replaced with healthy ones Cardiac vessels replaced with healthy ones
DRUGSDRUGS Improve function of heart muscleImprove function of heart muscle
Beta-blockers, antiarryhythmics, DigoxinBeta-blockers, antiarryhythmics, Digoxin
Eliminate access fluidEliminate access fluid Diuretics (Lasix) – CHFDiuretics (Lasix) – CHF
Ensure flow of blood through vesselsEnsure flow of blood through vessels AnticoagulantsAnticoagulants
Decrease blood pressureDecrease blood pressure AntihypertensivesAntihypertensives
Decrease serum cholesterol levelsDecrease serum cholesterol levels HypolipidemicsHypolipidemics