Download File - respiratorytherapyfiles.net

Cardiovascular System
Chapter 5
Cardiovascular System (CV)
• Composed of the heart and blood
vessels
• Arteries
• Capillaries
• Veins
Internal
structures of
the heart
3
BLOOD VESSELS
Heart Intro
• https://www.youtube.com/watch?v=
X9ZZ6tcxArI
Pericardium – Surrounding the heart
• Membrane that
surrounds the heart as
the pericardial sac and
secretes pericardial
fluid.
• Heart is located within
the pericardial sac
Internal
structures of the
heart
Pericardium, outermost layer
• Pericardial cavity
contains serous
fluid, which
reduces friction
between the
pericardial
membranes as
the heart moves
What is being done here?
CV System - Function
• Right Side
for circulating blood to
lungs for oxygenation
(pulmonary circulation)
• Left Side
for circulating blood to
all body systems
(systemic circulation)
CV System - Function
• Disposes of waste
products
• Aids lymphatic
system in
circulating
substances
Valves of the Heart
•Tricuspid valve
between right atrium and right
ventricle
•Pulmonary valve: between right
ventricle and pulmonary artery
Valves of the Heart
• Mitral valve: between left atrium and
the left ventricle
• Aortic valve: between left atrium and
aorta
Pathway of blood through
the heart
15
17
Heartbeat – two phases
• Diastole: relaxation
• Systole: contraction
– The diastole-systole cardiac cycle occurs
between 70-80 times per minute (100,000
times per day).
– The heart pumps 3 ounces of blood with
each contraction. This means that about 5
quarts are pumped per minute (75 gallons
an hour and about 2000 gallons a day).
Heart sounds
Closure of valves associated with
sounds “lubb-dubb, lubb-dubb”
• lubb: closure of the tricuspid and mitral
valves at the beginning of systole
• dubb: closure of the aortic and pulmonary
valves at the end of systole
• Murmor: abnormal heart sound caused by
improper valve closure
Quick Quiz
1. What is the main function of the heart?
2. What heart structures control blood
flow through the heart?
Quick Quiz
1. What is the main function of the
heart?
Pump blood through blood vessels
to all the cells of the body
2. What heart structures control blood
flow to and from the heart?
Heart valves
Define Combining Forms – page 157
1. angi/o:
vessel (ex: angiogram)
2. aneurysm/o:
widening (blood vessel)
3. aort/o:
aorta
4. arteri/o:
artery
Define Combining Forms – page 157
5. arteriol/o:
arteriole
6. ather/o:
fatty plaque
(ex: atherosclerosis)
7. atri/o:
atrium
8. cardi/o, coron/o:
heart
Define Combining Forms – page 157
9. phleb/o, ven/o:
(Ex: phlebotomy)
vein
10. thromb/o:
blood clot
(thrombi/thrombus)
(traveling clot = emboli)
Define Combining Forms – page 158
11. varic/o:
Varicose veins
dilated vein
12. vas/o:
vessel
13. vascul/o:
vessel
14. ventricul/o:
ventricle
What do these terms mean?
• Vasoconstriction:
• Vasodilation:
What would these conditions do to
blood pressure?
Define Suffixes – page 158
13. -cardia:
heart condition
14. -gram:
record, writing
15. -graph:
instrument for
recording
What do these terms mean?
• Tachycardia
• Bradycardia
Define Suffixes
16. -megaly:
enlargement
17. -graphy:
process of recording
18. -oma:
tumor or mass
19. -stenosis:
narrowing/stricture
20. -ectasis:
expansion/dilation
Normal Heart and Cardiomegaly
32
Build Medical Words
rapid heart rate:
tachy/
suture of a widened blood vessel:
aneurysm/o/
inflammation of an arteriole:
/itis
Build Medical Words
1. rapid heart rate: tachy/cardia
2. suture of a widened blood vessel:
aneurysm/o/rrhaphy
3. inflammation of an arteriole:
arteriol/itis
Build Medical Words
pertaining to the atrium and ventricle:
/o/ventricul/
abnormal condition of fatty plaque
hardening:
ather/o/
/osis
destruction or loosening of a thrombus:
/o/
Build Medical Words
pertaining to the atrium and ventricle:
atri/o/ventricul/ar
abnormal condition of fatty plaque
hardening:
ather/o/scler/osis
destruction or loosening of a
thrombus:
thromb/o/lysis
Build Medical Words
narrowing or stricture of an artery:
medical specialist in heart (disease):
Build Medical Terms
narrowing or stricture of an artery:
arteri/o/stenosis
medical specialist in the heart
(disease):
cardi/o/logist
Build Medical Words
enlargement of the heart:
process of recording electrical
activity of the heart:
excision of an embolus:
Build Medical Terms
enlargement of the heart:
cardi/o/megaly
process of recording electrical activity
of the heart: electr/o/cardi/o/graphy
excision of an embolus:
thromb/ectomy
41
CONDUCTION SYSTEM OF THE
HEART
• The pacemaker or SA Node begins wave of
excitation again.
• EKG or ECG (electrocardiogram): The
record used to detect electrical changes in
heart muscle as the heart beats.
42
CONDUCTION SYSTEM OF THE
HEART
43
Electrocardiogram
• P wave = spread of
excitation wave over the
atria just before
contraction;
• QRS wave = spread of
excitation wave over the
ventricles as the
ventricles contract;
•
•
T wave = electrical
recovery and relaxation
of ventricles.
Myocardial Infarction, MI
A heart attack - _______A heart attack
Can be recognized by elevation in the
S-T segment of the ECG.
segment
of the ECG.
45
Electrocardiogram
46
Electrocardiogram
Pathology of the CV
System
DVT
• Formation of a
thrombus, usually in
calf or thigh muscle
• Part or complete
block of blood flow
• May cause pain, but
often asymptomatic
Deep vein
thrombosis
Deep Vein Thrombosis (DVT) - Treatment
Anticoagulants:
Prevent future thrombi formation
Thrombolytics: Also called
Fibrinolytics
Dissolve blood clots
Anti-Platelet
5 CARDIOVASCULAR SYSTEM
Clinically Related Exercise
1. Mr. X is a postsurgical patient who
complains of soreness in his right calf
muscle. The doctor assesses the
right calf and finds it to be warm and
red. What is the likely diagnosis for
Mr. X?
5 CARDIOVASCULAR SYSTEM
Clinically Related Exercise
1. The physician prescribes medication
for Mr. X to dissolve his DVT.
This type of medication is
called a ____________________
Pathology: Blood Vessels
Coronary Artery Disease - CAD
– Atherosclerosis
• thrombotic occlusion
(occlusive/mural)
• ischemia
• necrosis
• infarction
– Acute Coronary Syndromes (ACS)
• unstable angina
• myocardial infarction (MI)
53
Atherosclerosis
Coronary Artery Disease (CAD)
Signs and
Symptoms
• Angina
• Shortness of
breath (SOB)
Common locations of anginal
pain, which may vary in
combination and intensity.
Coronary Artery Disease (CAD)
• Accumulation of plaque in
arterial walls causing
them to harden.
• Complete blockage of
arterial wall caused by
blood clot formation or
ruptured plaque.
• Pieces of plaque break
free, travel to the brain,
and block blood vessels
that supply blood to the
brain.
Atherosclerosis of
internal carotid
artery.
Coronary Artery Disease (CAD)
• Risk factors
–
–
–
–
–
–
–
Smoking
Hypertension, stress
Physical inactivity
Family history
Diabetes
Obesity
High cholesterol
Drug therapies for CAD
• nitrates (nitroglycerin)
• Aspirin
• beta-blockers
• ACE inhibitors
• calcium channel blockers
• statins
58
59
Surgical therapies for CAD
• coronary artery bypass grafting
(CABG)________________
• percutaneous coronary
intervention
(PCI)_____________
• percutaneous transluminal
coronary angioplasty_________
Aneurysm
Signs and Symptoms
• Local dilation of an artery or
chamber of the heart due to
weakening of its walls.
• May cause thrombus formation,
hemorrhage from rupture, or
ischemia.
Aneurysm - Types
•Fusiform – dilation of entire circumference
•Saccular – shaped like a sac, bulging on
only one side
•Dissecting – inner layer tear causes a
cavity to form that fills with blood with each
heartbeat)
AneAneurysms
Aneurysm
• Three common types:
abdominal
thoracic
peripheral artery aneurysms.
• May be asymptomatic
• Symptoms may include mild to severe
weakness, sweating, tachycardia, and
hypotension.
Aneurysm - Treatment
• Depends on the size, location, and
the likelihood of its rupturing, as well
as the general physical status of the
individual.
• Most are treated surgically.
5 CARDIOVASCULAR SYSTEM
Clinically Related Exercise
1. An aneurysm may cause weakness,
sweating, tachycardia, and low blood
pressure, also known as (hypotension,
hypertension, hypothymia).
2. During a physical examination, the
doctor palpates and feels an abnormal
dilation of a blood vessel. This may be
diagnosed as a/an (aneurysm,
carcinoma, tumor).
Varicose Vein
• Defective or
incompetent valves
in veins prevent
blood from flowing
freely toward the
heart.
– Buildup of pressure in
superficial veins
causes varicosities.
Valve function in
competent and
incompetent valves
5 CARDIOVASCULAR SYSTEM
Varicose Veins
Signs and Symptoms
(continued)
• Could be due to inherited defect or to
venous diseases.
• May occur from conditions, such as
pregnancy or jobs requiring
prolonged standing or heavy lifting.
• Person may be asymptomatic even
though the varicose vein condition is
severe.
Varicose Veins
• Swollen, tortuous, and
knotted veins, usually
occur in the lower legs.
• As the condition
progresses, veins thicken
and feel hard to the
touch.
• Develop gradually, with a
feeling of fatigue in the
legs followed by a dull
ache.
Varicose veins
More vocabulary for CV system
1. arrhythmia:
2. bruit:
1. arrhythmia: irregularity or loss of
rhythm of the heartbeat; also called
dysrhythmia
2. bruit: soft blowing sound heard on
auscultation caused by turbulent
blood flow
5 CARDIOVASCULAR SYSTEM
Vocabulary Challenge Exercise
3. heart block:
4. heart failure (HF):
heart block: interference with normal
transmission of electrical impulses
through the conducting system of
the heart
4. heart failure (HF): inability of the
heart to pump blood effectively
enough to meet the body’s metabolic
needs
Vocabulary
5. hypertension:
6. ischemia:
hypertension: consistently elevated
blood pressure that is higher than
140/90 causing damage to the blood
vessels and ultimately the heart
ischemia: inadequate supply of
oxygenated blood to a body part due
to an interruption of blood flow
Diagnostic Procedures
• Cardiac
Catheterization:
• Catheter is guided
into the heart via a
vein or artery.
Catheter insertion in
femoral vein or
artery
Diagnostic Procedures
Cardiac enzymes
• Test to measure levels of enzymes
released into the blood during an MI.
• CK, CPK, Troponin
Holter Monitoring
• Records ECG readings,
usually 24 hours, on a
portable tape recorder
to document
arrhythmias and link
them to activities or to
symptoms, such as
chest pain.
Stress test
•Exercise tolerance test to determine the
heart’s response to physical exertion
(stress).
•ECG is recorded under controlled
exercise stress conditions using a
treadmill.
•Nuclear stress test uses a radioisotope
to evaluate coronary blood flow.
Doppler Ultrasonography (US)
• US used to assess blood
flow through blood
vessels and the heart.
• Handheld US transducer
emits sound waves as it
is placed on the carotid
artery to produce
images of blood flow.
Diagnostic Procedures
Troponin I
• Blood test that measures levels of
proteins released into the blood
when myocardial cells die (damaged
heart muscle).
___________________________
• Recording of electrical activity of the
heart.
Vocabulary
1. record of electrical (activity) of the
heart:
2. separation or destruction of a blood
clot:
Voacabulary
record of electrical (activity) of the
heart:
electrocardiogram
4. separation or destruction of a blood
clot:
thrombolysis
Vocabulary
3. abnormal condition of arterial (walls)
hardening:
4. process of recording (radiography)
vessels after injection of a contrast dye:
Vocabulary
abnormal condition of arterial (walls)
hardening: arteriosclerosis
process of recording (radiography)
vessels (after injection of a contrast
dye): angiography
Medical and Surgical Procedures
Automatic
implantable
cardioverterdefibrillator (AICD)
• Device implanted in
a patient who is at
high risk for
developing a
serious arrhythmia
Automatic implantable
cardioverter-defibrillator
(AICD)
Angioplasty
• Any endovascular
procedure that
reopens narrowed
blood vessels.
– Restores blood
flow, usually using
balloon dilation.
Coronary artery
bypass graft (CABG)
Medical and Surgical Procedures
Coronary artery
bypass graft
(CABG)
• Vein taken from leg
or other part of the
body is grafted
onto the heart to
circumvent an
obstruction in a
coronary artery.
Coronary artery
bypass graft (CABG)
Pharmacology
Beta blockers
• Decrease heart rate and dilate
arteries by blocking beta
receptors.
Nitrates
• Treat angina pectoris and
hypertension.
Pharmacology
Nitrates
• Treat angina pectoris.
• Dilate veins, which decreases the
amount of work the heart must do.
• Dilate arteries to decrease blood
pressure.
Pharmacology
Statins
• Lower cholesterol levels in the
blood.
• Reduce cholesterol production in
the liver.
– Block the enzyme that produces
cholesterol.
Pharmacology
Thrombolytics
• Lyse (break apart) blood clots.
• Used in acute management of
myocardial infarction (MI).
• Used to treat ischemic stroke.
5 CARDIOVASCULAR SYSTEM
Clinically Related Exercise
1. Mrs. T is diagnosed with deep vein
thrombosis in her lower leg. She is
prescribed a drug that dissolves a blood
clot. It is known as a (beta blocker,
nitrate, thrombolytic).
2. Mr. B is diagnosed with
hypercholesterolemia and advised to
follow a low-fat diet. He is prescribed a
drug that reduces cholesterol levels and is
known as a (beta blocker, nitrate, statin).