Heart sounds Use a stethoscope

First heart sound Lub Closing of the AV valves Longer Louder

Second heart sound Dub Closing of the semilunar valves at the end of systole Short Sharp

Murmur Abnormal heart sound

Factors Influencing Heart Rate Autonomic nervous system

Factors Influencing Heart Rate Stress

Factors Influencing Heart Rate Hormones Epinephrine norepinephrine

Factors Influencing Heart Rate Age  in infants  in elderly

Factors Influencing Heart Rate Gender Generally higher in females

Factors Influencing Heart Rate Exercise Increases heat rate

Factors Influencing Heart Rate Temperature Increases heart rate

CHF Congestive Heart Failure Weakening of the heart progressive

CHF Congestive Heart Failure Left sided failure Pulmonary symptoms Pulmonary edema

CHF Congestive Heart Failure Right sided failure Peripheral symptoms Edema in distal extremities

Artery Veins Capillaries Blood Vessels

Artery Blood Vessels Carries oxygenated blood AWAY from the heart Thicker walls

Veins Blood Vessels Carries poorly oxygenated blood TO the heart Larger lumen Contains valves

Capillaries Blood Vessels Connects arteries and veins One cell layer thick (tunica intima)

Structures Blood Vessels Tunica Externia Tunica Media Tunica Intima

Structures Blood Vessels Tunica Externia Outer most layer Connective tissue Supports and protects vessel

Structures Blood Vessels Tunica Media Bulky middle coat Mostly smooth muscle Helps change shape

Structures Blood Vessels Tunica Intima Inner most layer Lumen Slick

Function of Arteries Blood Vessels Carry blood away from the heart

Blood Vessels Small arteries: arterioles Largest Artery: Aorta

Function of Veins Blood Vessels Carry blood To heart

Blood Vessels Small: Venules Largest Vein: Vena Cava

Function of capillaries Blood Vessels Connect veins and arteries

Arteries , 10, 11 Carotid 2.Subclavin 3.Coronary 4.Gastric 5.Splenic 6.Hepatic 7.Radial 8.Ulnar 9, 14Femoral 12.Aorta 13.Brachial 15.Popliteal 16.Dorsalis pedis

Veins subclavin 2.brachial 3.splenic 4.Median cubital 5. 13,messenteric 6, 7,jugular 8.Superior vena cava 9axillary 10cardiac. 11, 12. hepatic 14.Ulner 15.Radial 16.Femoral 17.Saphenous 18.popliteal

Veins Blood Vessels Median cubital Used for routine blood draw

Veins Blood Vessels Saphenous Longest vein in body

Veins Blood Vessels Hepatic portal Liver Digestion

Special Circulatory Routes Hepatic Portal Circulation C. Blood flow from pancreas, stomach, small intestines, colon, spleen and liver to heart

Special Circulatory Routes Pulmonary Circulation B. Blood flow from heart to lungs to heart

Special Circulatory Routes Systemic Circulation A. Blood flow from heart to body to heart

Coronary Bypass Surgery CABAG Coronary artery bypass and graft

Fetal Circulation Lungs and digestive system are not yet functioning so nutrient and gas exchange occurs though the placenta

Fetal Circulation Nutrients move from mother ’ s blood to fetal blood

Fetal Circulation 2 umbilical arteries Smaller Carries CO2 and other waste from fetus to placenta

Fetal Circulation Umbilical vein Large Carries blood rich in nutrients and O2 to fetus

Fetal Circulation Placenta The placenta develops from the same sperm and egg cells that form the fetus. For nine months the placenta feeds and nourishes the fetus while also disposing of toxic waste. Without it the baby could not survive.

Fetal Circulation Ductus venosus Shunt Allows most of blood to bypass immature liver and enter into inferior vena cava

Fetal Circulation Foreman ovale Blood from right atrium flows to left atrium though this opening Bypasses lungs Located in septum

Fetal Circulation Ducterious arteriosus Shunt which connects aorta and pulmonary trunk to allow blood into body circulation

Pulse and Blood Pressure TPR and B/P are called Vital signs

Pulse Pulse rate should = Heart rate Average pulse rate

Pulse Pulse is felt where artery comes close to the surface of the skin

Pulse To feel a pulse? Palpate

temporal facial carotid brachial radial femoral popliteal Posterior tibialis Dorsalis pedis Pulse sites

Blood Pressure Is measuring the amount of pressure in the arterial wall when the heart is contracting and when the heart is relaxing

Blood Pressure Normals

Blood Pressure Instrument used to listen Stethoscope

Blood Pressure Instrument used to measure Sphygmomanometer

Blood Pressure Artery most often used brachial

Blood Pressure To listen auscultate

Blood Pressure hypertension High blood pressure

Blood Pressure hypotension Low blood pressure 80 40

Blood Pressure Factors influencing blood pressure Kidneys Major role in regulating B/P  B/P =  Urine output  B/P =  Urine output

Blood Pressure Factors influencing blood pressure Temperature Cold = vasoconstriction =  B/P Hot = vasodilatation =  B/P

Blood Pressure Factors influencing blood pressure Chemicals Drugs: Epinephrine  B/P Nicotine  B/P Alcohol  B/P

Blood Pressure Factors influencing blood pressure Diet  Na,  Fat,  cholesterol =  B/P  Na,  Fat,  Cholesterol =  B/P

Blood Pressure Factors influencing blood pressure Others? Age Gender Race Exercise

Disorders Mitral Valve Prolapse. Leakage of blood into the left atrium MVP

Most common form of valvular heart disease, occurring in 2 – 6% of the population. Causes: UnknownThought to be linked to heredity. May be due to: ischemic damage (caused by decreased blood flow as a result of coronary artery disease) damage to valvular structures during acute myocardial infarction rheumatic heart disease hypertrophic cardiomyopathy (occurs when the muscle mass of the left ventricle of the heart is larger than normal).

MVP Symptoms May not cause any symptoms May cause: Palpitations Chest pain weakness Fatigue Shortness of breath. Prognosis? Usually harmless and does not shorten life expectancy. Healthy lifestyle behaviors and regular exercise are encouraged.

Disorders Coronary Artery Disease A # of disorders involving the cardiac vessels CAD

Hardening of the arteries from lipids and other substances arteriosclerosis Disorders

Section of arterial wall widens due to weakness aneurysm Disorders

Opening of a narrowed portion of a blood vessel with a balloon like instrument angioplasty Disorders

Cerebral vascular accident. Stroke CVA Disorders

Enlarged veins in the legs due to pooling of the blood Varicose veins Disorders

Varicose veins in the rectum hemorrhoids Disorders

Inflammation of a vein Can occur spontaneously or as a result of an I.V. or trauma. The most common site is in the leg veins phlebitis Disorders

Acute phlebitis with clot formation thrombophlebitis Disorders

Blockage of the pulmonary artery (or one of its branches). Usually when a clot from a vein becomes dislodged and travels to the lungs. Pulmonary embolism (PE) Disorders

Heart muscle myocardium Review Heart rate less then 60 beats per minute bradycardia

How many umbilical vessels? 3 Review Wide, weak area in an arterial wall? aneurysm

In the fetus, the left atrium receives most of its blood through the? Foramen ovale Review Circulatory route that runs from the digestive tract to the liver? Hepatic portal

Permits the exchange of nutrients and gases between blood and tissue cells ? capillaries Review Oxygenated blood is located on which side of the heart ? left

Where is the SA node located? Upper right atria Review All arteries carry oxygenated blood. TrueFalse