1. Chapter 13
The Heart

2. © 2004 Delmar Learning, a Division of Thomson Learning, Inc.
State Standards
8) Outline basic concepts of normal structure and function of all body systems, and explain how homeostasis is maintained.
19) Understand principles of and successfully perform skills related to Medical Assisting Skills, incorporating rubrics from textbooks or clinical standards of practice for the following:
a. Temperature, pulse, respiration and blood pressure assessment
b. Screening for vision problems
© 2004 Delmar Learning, a Division of Thomson Learning, Inc.

3. © 2004 Delmar Learning, a Division of Thomson Learning, Inc.
Objectives
The student will describe the functions of the Circulatory System
The student will list the components of the circulatory system
The student will describe the structure of the heart
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4. Cardiovascular System and Homeostasis
Maintaining proper homeostasis in the body is dependent on the continuous and controlled movement of blood through thousands of miles of capillaries that permeate every tissue and cell of the body.
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5. FUNCTIONS OF THE CIRCULATORY SYSTEM IN HOMEOSTASIS
Heart pumps and circulates blood to all parts of the body
Blood vessels circulate blood between heart and cells
Blood carries oxygen and nutrients to cells and carries away wastes
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6. © 2004 Delmar Learning, a Division of Thomson Learning, Inc.
Discussion
Applying what you know about the different body systems, which one works closely with the circulatory system? How are all of the systems impacted by a problem with the cardiovascular system?
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7. What makes up the CIRCULATORY SYSTEM?
Heart
Arteries
Veins
Capillaries
Blood
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8. The Heart Research: What is the typical size of a human heart?
Discussion:
What body cavity is the heart located in?
Describe the position of the heart compared to the lungs with medical directional terms

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THE HEART
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10. © 2004 Delmar Learning, a Division of Thomson Learning, Inc.
STRUCTURE OF THE HEART
The heart is a hollow, muscular, double pump
Pericardium – surrounds the heart
Myocardium - cardiac muscle tissue
Endocardium - Smooth inner lining
Septum - Muscular wall separating heart into two halves
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11. © 2004 Delmar Learning, a Division of Thomson Learning, Inc.
Layers of the Heart
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12. © 2004 Delmar Learning, a Division of Thomson Learning, Inc.
Discussion
Apply the medical terminology that you have learned and….
Describe the septum's relation to the two halves of the heart using medical terminology.
Would the endocardium be deep or superficial on the heart?
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STRUCTURE OF THE HEART
Four chambers of the heart
Right atrium
Left atrium
Right ventricle
Left ventricle
Draw this square “heart” in your notes and label the 4 chambers
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Discussion
What divides the heart into right and left sides?
Why are the hearts left and right sides opposite of normal left and right?
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16. © 2004 Delmar Learning, a Division of Thomson Learning, Inc.
STRUCTURE OF THE HEART
Four valves divide the chambers of the heart and permit blood flow in only one direction
Open and close during contraction of the heart
Tricuspid valve
Bicuspid (mitral) valve
Pulmonary valve
Aortic valve
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18. © 2004 Delmar Learning, a Division of Thomson Learning, Inc.
Discussion
What is the purpose of heart valves? What do they prevent?
Applying what you know about medical terminology, which valve has 3 flaps?
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19. Activity
Work with your table partner to draw and label the structures of the heart on p. 261 (you need to use different colored paper to cut out the vessels, and the heart)
Once finished, complete the color a heart activity individually, to learn the path of blood flow through the heart vessels and chambers.
Follow the directions on the handout, you will need a red and blue color in the medium of your choice.

20. Physiology of the Heart
Heart Science
Physiology of the Heart
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21. Physiology of the Heart
State Standards
8) Outline basic concepts of normal structure and function of all body systems, and explain how homeostasis is maintained.
19) Understand principles of and successfully perform skills related to Medical Assisting Skills, incorporating rubrics from textbooks or clinical standards of practice for the following:
a. Temperature, pulse, respiration and blood pressure assessment
b. Screening for vision problems

22. © 2004 Delmar Learning, a Division of Thomson Learning, Inc.
OBJECTIVES
The student will demonstrate understanding of the physiology of the heart by
Calculating cardiac output
Determining the connection between cardiac output and blood pressure
Demonstrating taking blood pressures
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23. PHYSIOLOGY OF THE HEART
Two major functions occur with each heart beat
Systemic circulation
Right heart: Blood is taken to the lungs for oxygen
Left heart: Blood is taken from lungs to be circulated throughout body
Coronary circulation
The heart receives its blood supply from the coronary artery
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24. © 2004 Delmar Learning, a Division of Thomson Learning, Inc.
Discussion
Why would the heart need its own blood supply separate from blood circulating around the body?
What happens to the heart tissues if this blood flow is disrupted?
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25. © 2004 Delmar Learning, a Division of Thomson Learning, Inc.
Systemic Circulation
The heart is the main organ responsible for circulating the blood throughout the body efficiently
Blood leaves the heart through arteries and returns to the heart from veins
Gas exchange happens in the tissues by way of the capillaries
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26. © 2004 Delmar Learning, a Division of Thomson Learning, Inc.

27. Discussion
Applying what you know about the anatomy of the heart and what you just learned about the function of arteries and veins, which type of vessel carries oxygenated blood? Deoxygenated blood?
Which type of vessel would have a pulse that you can feel? Why?

28. PHYSIOLOGY OF THE HEART
Stroke volume:
Amount of blood ejected with each beat of the heart (usually 60ml)
Cardiac output:
The amount of blood ejected from heart per minute
Stroke volume x heart rate=cardiac output
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29. © 2004 Delmar Learning, a Division of Thomson Learning, Inc.
Discussion
Calculate the following Cardiac Outputs.
SV of 60ml, HR of 89
SV of 80ml, HR of 53
SV of 60ml, HR of 74
How should you be labeling your answers?
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30. Cardiac Output and Blood pressure
Cardiac Output and blood pressure are directly related.
An increase in cardiac output results in an increased blood pressure.
Discussion
How do we measure blood pressure?
What tools do we need?
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31. Activity
Complete Station 4 Blood pressure in the cardiac lab activities tab located on the class website. This will be an introduction to this vital signs skill, we will go over BP more when we cover taking vital signs.
Follow the directions, I will be walking around and instructing you as well.
Complete these review questions
Station 4
13.What is blood pressure and how is it measured?
14.Why is high blood pressure a health concern?

32. © 2004 Delmar Learning, a Division of Thomson Learning, Inc.
Health Science
Heart Sounds
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33. Heart Sounds State Standards
8) Outline basic concepts of normal structure and function of all body systems, and explain how homeostasis is maintained.
19) Understand principles of and successfully perform skills related to Medical Assisting Skills, incorporating rubrics from textbooks or clinical standards of practice for the following:
a. Temperature, pulse, respiration and blood pressure assessment
b. Screening for vision problems

34. Objectives
Students will demonstrate knowledge of normal heart sounds by
Determining the mechanism of how the heart sounds are made
Determine the best places to hear heart sounds
Auscultating Heart sounds on a partner

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SOUNDS OF THE HEART
Lubb dupp sounds - Sounds made by the valves during the cardiac cycle
Lubb - sound made when the tricuspid and bicuspid valves close between the atria and ventricles
Dupp - Caused by semilunar valves in the aorta and the pulmonary artery closing
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36. © 2004 Delmar Learning, a Division of Thomson Learning, Inc.
Heart Sounds
Lubb
1st sound heard (closing of the tricuspid and bicuspid valves)
Referred to as S1 and heard loudest at the apex of the heart.
Discussion:
Where is the apex of the heart?
Point to it on your own chest.
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37. © 2004 Delmar Learning, a Division of Thomson Learning, Inc.

38. © 2004 Delmar Learning, a Division of Thomson Learning, Inc.
Heart Sounds
Dubb
2nd sound (closing of the pulmonary valves and the aortic valves) S2
Discussion
Where are the pulmonary and aortic valves located in relation to the apex of the heart? Use medical directional terms.
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39. .

40. Normal Heart Sounds Video
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41. Abnormal Heart Sounds Murmurs Turbulent blood flow in the heart
Due to improper closing of the valves S3
The third heart sound or S3 is a rare extra heart sound that occurs soon after the normal two "lub-dub" heart sounds (S1 and S2). S3 is associated with heart failure.

42. Abnormal Heart Sounds Continued
The fourth heart sound or S4 is an extra heart sound that occurs immediately before the normal two "lub-dub" heart sounds (S1and S2)
It is caused by the atria contracting forcefully in an effort to overcome an abnormally stiff ventricle
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43. © 2004 Delmar Learning, a Division of Thomson Learning, Inc.
Discussion
Using Hash marks for the heart sounds how would you illustrate S3?
How would you illustrate S4?
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44. © 2004 Delmar Learning, a Division of Thomson Learning, Inc.
Abnormal Heart Sounds
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45. Activity
With a Partner Complete the Station 2 heart sounds activity in the cardiac lab located on the class website. Do not do the counting pulse activity
Individually Complete these review questions
Station 2
6. What are you actually hearing when you listen to the heartbeat?
7. What creates each sound S1 and S2
8. Did you hear any extra sounds will listening to your partner?

46. CIRCULATION AND BLOOD VESSELS
Chapter 14
CIRCULATION AND BLOOD VESSELS

47. State Standards
8) Outline basic concepts of normal structure and function of all body systems, and explain how homeostasis is maintained.
19) Understand principles of and successfully perform skills related to Medical Assisting Skills, incorporating rubrics from textbooks or clinical standards of practice for the following:
a. Temperature, pulse, respiration and blood pressure assessment
b. Screening for vision problems

48. Objectives Students will identify the types of vessels.
Students will identify characteristics of the different types of vessels.
Students will label the different layers of the vessels
Students will demonstrate knowledge of pulse points by identifying and taking the pulse of a partner.

49. © 2004 Delmar Learning, a Division of Thomson Learning, Inc.
Types of Vessels
Arteries
Capillaries
Veins
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50. Draw this Artery and Label the layers correctly
Arteries have 3 layers. Research the 3 layers and Add this diagram to your notes
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51. © 2004 Delmar Learning, a Division of Thomson Learning, Inc.
Discussion
Applying what you know about the pumping of the heart and blood pressure, why would arteries need to be thick walled?
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52. © 2004 Delmar Learning, a Division of Thomson Learning, Inc.
Capillaries
Capillaries - smallest blood vessels that have extremely thin walls to allow substances to pass to surrounding cells and tissues
Exit-nutrients, oxygen, White blood cells
Enter-waste products such as CO2 and nitrogen
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53. © 2004 Delmar Learning, a Division of Thomson Learning, Inc.

54. © 2004 Delmar Learning, a Division of Thomson Learning, Inc.
Veins
Veins - carry deoxygenated blood away from capillaries to heart
Thinner walled than Arteries
Muscular
Contain Valves to prevent the backflow of blood
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56. Label the vessels as either an Artery or Vein
What 2 things allow you to tell the difference between the 2?
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57. Discussion Why can veins have a thinner wall than arteries?
Applying what you know about arteries and blood pressure in the vessels, why do veins have valves and Arteries do not?

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PULSE
Pulse - alternating expansion and contraction of an artery as blood flows through it
Feels like alternating, beating throbs
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59. PULSE Pulse is taken at seven locations: Brachial artery
Common cartoid artery
Femoral artery
Dorsalis pedis artery
Popliteal artery
Radial artery
Temporal artery

60. Discussion What are you actually feeling at the pulse points?
What vital sign would this correlate with?
Work together with a partner to point out the pulse points. Use your book or Ipad

61. Activity
This is an introduction to taking a pulse, we will cover this more in depth when do our vital signs lessons.
Use the fingertips of your pointer and middle fingers over the pulse area.
What finger would you not use? Why?
With a partner complete the taking a pulse activity under the cardiac lab activities tab (DO NOT CHECK THE FEMORAL PULSE)
Also count the apical pulse with a stethoscope.
After you record your readings take turns doing 50 jumping jacks. Record the changes in the pulse rate

62. Individual Questions
Describe what the pulse felt like when first palpated.
What happens to the pulse if you push down too hard?
Were some pulses easier to find than others? Why do you think this is so?
What changes did you note in the speed and quality of the pulses after exercising?
What should a normal resting pulse for an adult be?
What should a normal exercising pulse be?
Turn in these questions as your exit ticket