Cardiovascular System Heart and Blood Vessels

Functions  Pump  __________ transport system around body  Carries ________ and nutrients to cells, carries away waste products  Lymph system – returns excess tissue fluid to general circulation

Structures  Heart  _____________  Veins  ______________  Blood and lymph are part of circulatory system

Major Circuits  _________________ CIRCULATION – heart and lungs  _________________ CIRCULATION – from the heart to the tissues and cells, then back to the heart

Heart  Muscular organ  Size of a closed fist  Weighs oz  Location – ________ cavity  APEX – conical tip, lies on diaphragm, points left

Heart: Structure  Hollow, muscular, double pump that circulates blood  At rest 2 oz blood with each beat 5 quarts per minute 75 gallons per hour  Ave = 72 beats per minute  100,000 beats per day  __________________ – double layer of fibrous tissue that surrounds the heart  __________________ – cardiac muscle tissue  __________________ – smooth inner lining of heart

Heart Chambers  _____________ divides into R and L halves  Upper chambers – RIGHT ___________ and LEFT _____________  Lower chambers – RIGHT _____________ and LEFT _______________  Four heart ____________ permit flow of blood in one direction

Heart Valves  _____________ VALVE – between right atrium and right ventricle  _____________ VALVE – between left atrium and left ventricle  Semilunar valves - located where blood leaves the heart _____________ VALVE

Major Structures  Superior _______ and inferior vena cava – bring deoxygenated blood to right atrium  Pulmonary artery – takes blood _________ from right ventricle to the lungs for O2  Pulmonary vein – __________ oxygenated blood from lungs to left atrium  Aorta – takes blood ___________ from left ventricle to rest of the body

Heart Physiology  __________ Heart  Deoxygenated blood flows into heart from vena cava  right atrium  tricuspid valve  right ventricle  pulmonary valve  pulmonary artery  lungs (for oxygen)  __________ Heart  Oxygenated blood flows from lungs via pulmonary veins  left atrium  mitral valve  left ventricle  aortic valve  aorta  general circulation (to deliver oxygen)

Heart is a double pump

Coronary Arteries  Provide blood supply to the heart

Control of Heart Contractions  _________ (sinoatrial) NODE = PACEMAKER Located in right atrium SA node sends out electrical impulse Impulse spreads over atria, making them contract Travels to AV Node  _________ (atrioventricular) NODE Conducting cell group between atria and ventricle Carries impulse to bundle of His  ____________________________ Conducting fibers in septum Divides into R and L branches to network of branches in ventricles (Purkinje fibers)  ____________________________ Impulse shoots along Purkinje fibers causing ventricles to contract

Conduction System  Conduction system sets the basic rhythm of the beating heart by generating impulses which stimulate the heart to contract

Heart Contractions  ________________ = contraction phase  ________________ = relaxation phase

Electrocardiogram (EKG or ECG)  The electrocardiogram (ECG, EKG) is used extensively in the diagnosis of heart disease, from congenital heart disease in infants to myocardial infarction and myocarditis in adults. Several different types of electrocardiogram exist.

Electrocardiogram (EKG or ECG)  P = atrial contration  QRS = ventricular contract  T = ventricular relaxation

Electrocardiogram (EKG or ECG)  An electrocardiogram (ECG) test measures the electrical activity of the heart. A normal resting heart rate is beats per minute.

Electrocardiogram (EKG or ECG)  Abnormal rhythm (arrhythmia) called an atrioventricular (AV) block.  P waves show that the top of the heart received electrical activity.  Each P wave is usually followed by the tall (QRS) waves.

Electrocardiogram (EKG or ECG)  ____________ heart rhythms are characterized by a slowness of the heartbeat, usually at a rate under 60 beats per minute

Electrocardiogram (EKG or ECG)  Ventricular ____________ is a rapid resting heart rate initiated within the ventricles, typically at beats per minute

Pulmonary Circulation  Deoxygenated Blood from Body Tissue   Superior/inferior vena cava   Right Atrium   Tricuspid Valve   Right Ventricle   Pulmonary Valve   Pulmonary Artery   Both Lungs   CO2 - O2 exchange Alveolar   Pulmonary Veins   Left Atrium   Mitral Valve   Left Ventricle   Aortic Valve   Aorta - Transporting Oxygenated Blood to Body Cells

Systemic Circulation  Aorta  Arteries  Arterioles Small arteries  Capillaries Smallest blood vessels, can only be seen with a microscope Connect arterioles with venules Walls are one-cell thick– allow for selective permeability of nutrients, oxygen, CO2 and wastes  Venules Small veins  Veins

Arteries vs Veins  Carry _____________ blood ______ from the heart to the capillaries  Elastic, muscular and thick-walled  Transport blood under very high pressure  Carry _____________ blood to the heart  Veins contain a muscular layer, but less elastic and muscular than arteries  Thin walled veins collapse easily when not filled with blood  __________ – permit flow of blood only in direction of the heart

Aorta  Largest _________ in the body  First branch is coronary artery  Aortic arch  Many arteries branch off the descending aorta

Vena Cava  Largest _________ in the body  Superior and Inferior portions  Subclavian veins  Jugular veins – located in the neck  Femoral veins

Blood Vessels

Blood Pressure  Surge of blood when heart pumps creates pressure against the walls of the arteries  SYSTOLIC PRESSURE – measured during the contraction phase  DIASTOLIC PRESSURE – measured when the ventricles are relaxed  Average systolic = 120  Average diastolic = 80

Pulse  Alternating expansion and contraction of an artery as blood flows through it  Pulse sites: BRACHIAL CAROTID RADIAL POPLITEAL PEDAL

Disorders of the Heart  ___________________ (or dysrrhythmia) – any change from normal heart rate or rhythm  BRADYCARDIA – slow heart rate (<60 bpm)  TACHYCARDIA – rapid heart rate (>100 bpm)  _______________ – indicates defect in heart valve – valves fail to close properly, causing gurgling or hissing sound.  MITRAL VALVE PROLAPSE – mitral valve closes imperfectly – Symptoms occur in response to stress, including fatigue, PALPITATIONS (heart feels like it is racing) headache, chest pain, and anxiety

Heart Attack  Myocardial Infarction (heart attack)  Blockage in coronary arteries cuts off blood supply to heart muscle causing that area of tissue to die  Causes - Smoking, obesity, stressful life style, hypertension, family history, elevated cholesterol and triglycerides, aging  Symptoms - Severe crushing pain that radiates to neck, jaw, and left arm; dyspnea; cold, clammy skin; pressure or heaviness in chest; nausea; change in blood pressure  Tx – “Clot-busting” drugs if in process of having MI; bedrest; pain medications; oxygen; anticoagulants;

Heart Attack

Angioplasty  The coronary arteries supply blood to the heart muscle. The right coronary artery supplies both the left and the right heart; the left coronary artery supplies the left heart.

Angioplasty

 Patient is awake and pain-free (local anesthesia), a catheter is inserted into an artery at the top of the leg (the femoral artery)

Angioplasty  A catheter is advanced over a guidewire, into the blood vessel. This catheter is then guided to the aorta and the guidewire is removed. Once the catheter is placed in the opening of the coronary arteries, the doctor injects dye and takes a series of X-rays.

Angioplasty  A guidewire is advanced across the blocked section of the coronary artery and a balloon -tipped tube is positioned so the balloon part of the tube is beside the blockage. The balloon is then inflated for a few seconds to compress the blockage against the artery wall. Then the balloon is deflated.

Angioplasty  A device called a stent may be placed. A stent is a latticed, metal scaffold that is placed within the coronary artery to keep the vessel open.

 Once the catheter has been positioned at the coronary artery origin, contrast media is injected and a series of X-rays (film) are taken to check for any change in the arteries. Following this, the catheter is removed and the procedure is completed.

Diseases of the Heart  ___________________ – inflammation of outer membrane covering the heart – Symptoms are chest pain, cough, dyspnea (difficulty breathing), tachycardia, and fever Immediate medical care is critical Tx – bedrest, oxygen, medication  _____________________________________ Ventricles unable to contract effectively and blood pools in the heart ___________________ in lower extremities Blood backs up into lungs Tx – drugs to strengthen heart beat (digoxin) and diuretics to reduce fluid

Heart Surgery  ANGIOPLASTY – procedure to help open clogged vessels – may also be called “balloon surgery.”  STENT - Tiny, expandable stainless steel tube that holds coronary artery open following angioplasty  CORONARY BY-PASS – usually, a healthy vein from the leg removed and attached before and after the coronary obstruction, creating an alternate route for blood supply to the myocardium

Disorders of Blood Vessels  ARTERIOSCLEROSIS – arterial walls thicken, lose elasticity  ___________________________ – fatty deposits form on walls of arteries  ANEURYSM – ballooning of an artery, thinning and weakening  PHLEBITIS – inflammation of lining of vein, accompanied by clotting of blood – symptoms are edema, pain and redness  _________________________ – traveling blood clot  VARICOSE VEINS – swollen, distended veins – heredity or due to posture, prolonged periods of standing, physical exertion, age and pregnancy  HEMORRHOIDS - rectal varicose veins

Blood Pressure Disorders  ______________________ – Low blood pressure, systolic <100  __________________ High blood pressure “Silent killer” – usually no symptoms Condition leads to strokes, heart attacks, and kidney failure 140/90 or higher Higher in African-Americans and post- menopausal women Risk factors = smoking, overweight, stress, high fat diets, family history Tx = relaxation, low fat diet, exercise, weight loss, medication

Circulatory System Terminology  cardi/o; card/o  phleb/o  arteri/o  angi/o  ven/o  vas/o  hem/o; hemat/o  capill/o  heart  veins  arteries  blood vessels  veins  blood vessels  blood  capillaries

Careers  Cardiologist  Cardiovascular Technologist  Echocardiographer  Varied Nursing careers