CARDIOVASCULAR SYSTEM Angie Guggino MS ATC LAT Essential

CARDIOVASCULAR SYSTEM Angie Guggino, MS, ATC, LAT

Essential Question • What is the anatomy, physiology, and basic pathophysiology of the cardiovascular system?

Course Standard 4 • Investigate the anatomy, physiology, and basic pathophysiology of the cardiovascular system, and evaluate and monitor blood pressure and pulse. • 4. 1 Analyze the basic structures and functions of the cardiovascular system. • 4. 2 Identify and explain medical terms related to the cardiovascular system, and utilize • • when documenting in electronic medical record. 4. 3 Research common diseases, disorders, and emerging diseases of the cardiovascular system including the pathophysiology, prevention, diagnosis and treatment (including biomedical therapies) that might be utilized in each. 4. 4 Describe the components of blood, and the functions of each. Research when blood components are prescribed for a patient and why. 4. 5 Identify and describe the functions of the chambers, valves and associated vessels of the heart. 4. 6 Distinguish differences in anatomy and pathology of blood vessels to include arteries, arterioles, capillaries, venules, and veins. 4. 7 Identify and trace the flow of blood through the heart, and provide distinction between the pulmonary and systemic circulation. 4. 8 Name the parts of the conduction system of the heart, and trace the impulses during initiation and conduction. 4. 9 Demonstrate measuring and recording blood pressure and pulse, and identify abnormal results.

Functions • Transportation of oxygen and other nutrients • Removal of carbon dioxide and other waste products • Regulation of body temperature • Maintenance of the body’s acid-base balance • Transportation of hormones • Assists with immune function

What’s in it? • Blood • Heart • Blood Vessels

Divided into Two Circuits • Pulmonary circuit • blood to and from the lungs • Systemic circuit • blood to and from the rest of the body • Vessels carry the blood through the circuits • Arteries carry blood away from the heart • Veins carry blood to the heart • Capillaries permit exchange of nutrients, etc. . .

BLOOD Cardiovascular System

General Information • Was considered the “essence of life” • Type of connective tissue • Females 4 -5 liters • Males 5 -6 liters • Approximately 8% of body weight

Functions of Blood • Transportation • Maintenance • Protection

Components of Blood Liquid matrix Formed elements (cells) • Plasma • Erythrocytes • Pale yellow fluid that • Leukocytes consists of about 91% water • 55% of total blood volume • Thrombocytes • 45% of total blood volume

Blood Grouping or “Type” • Antigens are located on the surface of the Erythrocyte • Antibodies are located in the plasma Blood Type A B AB O Erythrocyte Antigen A Antigen B Antigen A & B Neither Antigen A nor B Plasma Antibody B Antibody A Neither Antibody A nor B Antibody A and B

Rh blood group • People are Rh positive if they have a certain Rh antigen on the surface of their erythrocytes

Diagnostic Blood Tests • Type and Cross-match • Determine ABO and Rh status • Complete Blood Count (CBC) • RBC count • Hemoglobin measurement • Hematocrit measurement • White blood cell count • White Blood Cell Differential Count • Determine the percentage of each of the five kinds of leukocytes

Sickle Cell Disease Under “Quick Links” click on Salem Health Online Password: northcobb 1. What is Sickle Cell Disease? 2. What occurs within the blood vessels with Sickle Cell 3. 4. 5. 6. Disease? How does an individual get Sickle Cell Anemia? What are some signs or symptoms an individual may experience with Sickle Cell Anemia? Which organ is usually the first destroyed with Sickle Cell Anemia? What is the treatment for Sickle Cell Anemia?

Blood and Blood Disorders Salem Health Article 1. Where are blood cells formed? 2. What is the function of hemoglobin? 3. List the three main types of Leukocytes. 4. What is the primary function of lymphocytes? 5. What is bilirubin? 6. List and describe three categories of blood testing. 7. What is the most common blood disorder? 8. What were the 4 humors identified by Hippocrates? 9. What procedure was done to restore the balance of these humors? 10. Who is credited for discovery of the circulation of blood through the body?

THE HEART Cardiovascular System

The Heart Under “Quick Links” click on Salem Health Online Password: northcobb 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. What is the function of the heart? Name three layers of the heart. What is the function of the pericardial sac? What is the name for the valve that regulates blood flow between the right atrium and right ventricle? What is the name for the valve that regulates blood flow between the left atrium and the left ventricle? Describe the flow of blood through the heart starting with its entrance into the right atrium. What is the function of the sinoatrial node? Which nervous system regulates heart rate? What are the most common causes of coronary artery disease? What is atherosclerosis? When does a myocardial infarction occur? What is angina pectoris and why does it occur? What is congestive heart failure? Name three things an individual can do to lessen the probability of having heart problems.

Heart’s position in thorax

Feel your heart beat at apex Heart’s position in thorax In mediastinum – behind sternum and pointing left, lying on the diaphragm It weighs 250 -350 gm (about 1 pound)

What is it? • Cone shaped muscle • Four chambers • Two atria, two ventricles • Double pump – the ventricles • Two circulations • Systemic circuit: blood vessels that transport blood to and from all the body tissues • Pulmonary circuit: blood vessels that carry blood to and from the lungs

How pericardium is formed around heart

Layers of the Heart • The layers from out to in: Epicardium = visceral layer of serous pericardium 2. Myocardium = the muscle 3. Endocardium = lining the chambers 1.

Chambers of the heart • Two atria-divided by interatrial septum • Right atrium • Left atrium • Two ventricles-divided by interventricular septum • Right ventricle • Left ventricle

Valves • Tricuspid valve • RA to RV • Pulmonary or pulmonic valve • RV to pulmonary trunk • Mitral valve (bicuspid valve) • LA to LV • Aortic valve • LV to aorta

Pattern of blood flow • Body to right heart to lungs to left heart to body • Body, then via vena cavas and coronary sinus to RA, to RV, then to lungs via pulmonary arteries, then to LA via pulmonary veins, to LV, then to body via aorta • From body via SVC, IVC & coronary sinus to RA; then to RV through tricuspid valve; to lungs through pulmonic valve and via pulmonary arteries; to LA via pulmonary veins; to LV through mitral valve; to body via aortic valve then aorta

Heartbeat • Systole: contraction • Diastole: filling • Normal rate: 60 -100 bpm • Slow: bradycardia (< 60 bpm) • Fast: tachycardia (> 100 bpm) ***Note: blood goes to RA, then RV, then lungs, then LA, then LV, then body; but the fact that a given drop of blood passes through the heart chambers sequentially does not mean that the four chambers contract in that order; the 2 atria always contract together, followed by the simultaneous contraction of the 2 ventricles

Heart sounds • Called S 1 and S 2 • S 1 is the closing of AV (Mitral and Tricuspid) valves at the start of ventricular systole • S 2 is the closing of the semilunar (Aortic and Pulmonic) valves at the end of ventricular systole • Murmurs: the sound of flow • Can be normal • Can be abnormal

Places to auscultate To hear the sounds: http: //www. med. ucla. edu/wilkes/intro. html

Heart’s Electrical System 1. 2. 3. 4. 5. Sinoatrial Node (SA Node) Atrioventricular Node (AV Node) AV bundle Right and Left Bundle Branch Purkinje fibers

EKG Used to record the heart’s electrical activity

Cardiac Output • The amount of blood pumped by each ventricle in one minute • HR is the number of heart beats per minute • Stroke Volume (SV) is the amount of blood pumped out by a ventricle with each beat • CO is the product of heart rate (HR) and stroke volume (SV) CO = HR x SV • (ml/min) = (beats/min) x (ml/beat) •

Cardiac Output Averages • Average Adult at rest is about 5. 0 L/min • What about exercise? • During intense exercise it can increase to between 20 -40 L/min • How do athletes use the knowledge? • Higher Cardiac Output = More Oxygen to the Cells (cellular respiration) = More energy (ATP)

Teamwork • Explain why the walls of the ventricles are thicker than the walls of the atria. Why does the left ventricle have a thicker wall than the right ventricle?

Teamwork • Endurance-trained athletes often have a decreased heart rate than a non-athlete when both are resting. Explain why an endurance trained athlete would have a decreased heart rate rather than an increased heart rate at rest.

Teamwork • Heart rate and cardiac output were measured in a group of nonathletic students. After 2 months of aerobic exercise training their measurement were repeated. It was found that heart rate had decreased, but cardiac output remained the same for many activities. Explain these findings.

THE BLOOD VESSELS Cardiovascular System

Peripheral Circulatory System • Systemic Vessels • Transport blood through all parts of the body from the left ventricle and back to the right atrium • Pulmonary Vessels • Transport blood from the right ventricle through the lungs and back to the left atrium

Blood Vessels • Arteries • Carry blood away from the heart • Muscular and/or elastic • Capillaries • Very thin for nutrient exchange • Veins • Carry blood back to the heart • Valves that allow blood to flow in one direction

Coronary Arteries and Veins

Blood Pressure • Measure of the force blood exerts against the blood vessel walls • Sphygmomanometer • Korotkoff sounds • Systolic Pressure • Diastolic Pressure

Controlling Factors • Blood Volume • Cardiac Output • Arterial Tone The body wants Homeostasis

Regulation of Blood Pressure • Baroreceptors • Sensory receptors that are sensitive to stretch • Chemoreceptors • Sensory receptors sensitive to oxygen, carbon dioxide, and p. H levels in the blood • In a standing person hydrostatic pressure caused by gravity increase blood pressure below the heart and decreases pressure above the heart Orthostatic Hypotension

Teamwork • Explain why people who are suffering from edema in the legs are told to keep them elevated. • Reduces blood pressure in the venous end of the capillaries in the legs • The force that moves fluid out of the capillary is decreased • More fluid is allowed into the capillaries and carried away • Also increase lymph flow

Arteriosclerosis Under “Quick Links” click on Salem Health Online Password: northcobb 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. What is arteriosclerosis? What is angina? What is ischemia? What are “collaterals” and why does the body develop them? What are the most severe signs of lower extremity arteriosclerosis? What is the usual cause of acute arterial ischemia? Describe what is occurring with TIA’s. What are the significant risk factors for the development of atherosclerosis? What signs or symptoms will occur with atherosclerosis patients and intermittent claudication? What medication is often prescribed to alleviate symptoms of TIA’s?

The End