1. The Cardiovascular System
Rehab Careers

2. Standard
Outline the gross and cellular anatomy and physiology of the musculoskeletal, neurological, and cardiovascular systems. Review the gross anatomy of the other systems studied in previous courses.

3. Objective By the end of class, student will be able to
Recognize main functions of the heart
Identify the 4 chambers of the heart
Understand Temp, Pulse, Respirations

4. Physiology Also known as Circulatory System
Carries blood around the body
Transports nutrients and oxygen to cells all over the body
Transports wastes (urea, carbon dioxide, salt) to excretory organs
It is composed of the heart, lungs, and blood vessels

5. Key Terms Pulmonary – means anything dealing with the lungs
Cardiac – means anything dealing with the heart
Heart: a muscular organ that pumps blood to the lungs and the body.
Lungs: organs that take in oxygen from the air and remove carbon dioxide from the body.

6. The Heart
Muscular organ
Size of a closed fist
Weighs oz

7. CARDIOLOGY
A PERSON’S HEART WILL BEAT APPROXIMATELY 100,000 TIMES A DAY, EVERY DAY
IMAGINE TRYING TO SQUEEZE A TENNIS BALL 70 TIMES A MINUTE…..THAT IS WHAT YOUR HEART DOES EVERYDAY

8. Chambers and Valves Upper chambers – RIGHT ATRIUM and LEFT ATRIUM
Lower chambers – RIGHT VENTRICLE and LEFT VENTRICLE
Four heart valves permit flow of blood in one direction

10. VALVES Tricuspid – 3 flaps or cusps – prevents backflow into R atrium
Pulmonary – 3 flaps – prevents backflow into R ventricle
Mitral (bicuspid) – 2 flaps – prevents backflow into L atrium
Aortic – prevents backflow into L ventricle

11. CARDIAC CYCLE Creates Heart sounds Heard through stethoscope
“LUB-DUB” sound
1st sound – longest and loudest closure of Tricuspid and Mitral valves
2nd sound – closure of aortic and pulmonary valves
If valves do not close properly – you will hear an extra sound called a heart murmur

12. Pulse Wavelike pulsation of heartbeat in arteries
Palpate superficial artery with pads of three middle fingers
Veins do not pulsate
Counting a patient’s pulse is a method of determining the patient’s heart rate. Count the patient’s pulse for 1 minute.

13. Factors Affecting Pulse
Normal heart rate decreases with age
Newborn heart rate is higher than an adult’s heart rate
Athletic people will have decreased rate
Heart rate increases with exercise, emotion, stress, fear, and anxiety
Heart rate is affected by pregnancy, hyperthyroidism, and medications
Fever increases heart rate
Many factors affect pulse rate. Think of all the things that increase your heart rate and decrease your heart rate.

14. Heart Rate Measured in beats per minute Normal Heart Rate
Adults –
Abnormal Heart Rates
<60 BPM – Bradycardia
>100 BPM – Tachycardia
Your heart rate is: 70 BPM (70 beats per minute)

15. Heart Rate State if normal, bradycardia, tachycardia 176 BPM 44 BPM

16. Pulse Sites Many pulse points in the body
Any area where pulse can be felt
May be done to evaluate circulation in body area
Count heart rate
Compressed to control bleeding
Pulse points can also be used to control bleeding in the event of an injury or accident.

17. Major Pulse Sites Temporal Carotid Brachial Radial Femoral Popliteal
Pedal - Dorsalis pedis and posterior tibialis
Head—neck—arm—wrist—upper leg—knee—foot

18. Carotid
Carotid—groove between the larynx and sternocleidomastoid muscle at side of neck

19. Brachial
Brachial—antecubital space of arm (the bend)

20. Pulse Points
Radial—distal part of forearm, inner aspect of wrist, base of thumb
The most common site to count a patient’s pulse is in the wrist area of the arm. This is the radial artery.

21. The measurement of core body heat
TEMPERATURE
The measurement of core body heat

22. Temperature Body temperature regulated by hypothalamus
Important part of homeostasis
Physiologic factors affect temperature
Average body temperature—98.6
“Normal” 98.6
Usually over means infection/illness
Time of day affects temperature: temperature is lower in the am and higher in the pm
A patient’s temperature is a sign of homeostasis or infection or illness.

23. Temperature Terminology
Hypothermia- low body temperature, below 95 degrees rectally. Death occurs if temperature is less than 93 degrees for a period of time.
Hyperthermia- high body temperature, over 104 degrees. Fever is a temperature above 101 degrees. Pyrexia is another term for fever. Febrile means “with fever”. Afebrile means “without fever”

24. ROUTES TO MEASURE TEMPERATURE
Oral: By mouth
Rectally: By rectum
Axillary: Under the arm in the armpit
Tympanic: In the ear

25. RESPIRATION
The mechanical act of breathing in air (inspiration) and expelling air (expiration) from the body

26. Respirations
Respiration is “the process of taking in oxygen and expelling carbon dioxide from the lungs and respiratory tract”.
Normal adult respiratory rate is breaths per minute.
Respiratory rate should be counted for seconds just following pulse assessment.
Why following pulse? Act like you are continuing to check pulse. If patient knows you are assessing breathing, they may change their rate of breathing.
You are counting the number of times their chest rises and falls.

27. Documentation
Character or respirations should be noted. This refers to depth and quality. Deep, shallow, labored and difficult all refer to character.
Rhythm should also be addressed. This is regularity of respirations. Are they regular and even or irregular?
When you assess your partner you need to write these down.

28. Respirations Inspiration and expiration
Diaphragm is muscle involved with breathing
Only vital sign that can be easily controlled by a healthy adult
The medical assistant counts respirations by watching the patient’s chest rise and fall. Each inspiration and expiration count as one respiration.

29. RESPIRATION Measured in breaths per minute
Normal range is breaths per minute
Greater than 24 is tachypnea
Less than 12 is bradypnea
Watch for rate, depth, quality of breath, and difficulty in breathing

30. Temperature, Pulse, Respirations

31. Practice TPR

32. O2 Saturation Measured in percent using a pulse oximeter
Normal Range % for healthy adults
Breathing room air contains 21% oxygen.
Anyone who is not achieving the critical blood oxygen saturation level of 90% may need oxygen

33. O2 Sat
Non invasive process involves inserting a finger (can be used on the ear or a toe as well) into the device where a red light calculates the redness of the blood pulsing through the finger. 

34. O2 Saturation
Oxygen saturation levels measure the degree to which the hemoglobin contained in the red blood cells (erythrocytes) has bonded with oxygen molecules. Oxygen is taken in by the lungs when we breathe in

35. PAIN PAIN is personal Everyone’s pain level will be different
How do we quantify it?

36. Pain Scales
Numeric: 1-10
Wong-Baker Faces

37. PAIN SCALE

38. How to assess Pain
Ask Patient: 1. Are you having any pain? Where is it located? If they say yes, proceed to next question 2. On a scale of 0 to 10 with O being no pain and 10 being the worst pain you can imagine, how much does it hurt right now? 3. What is the quality of your pain? Is it burning, stabbing, gnawing, shooting, cramping?

39. Descriptive Pain Words
Aching.
Cramping.
Fearful.
Gnawing.
Heavy.
Hot or burning.
Sharp.
Shooting.

40. How to assess pain
4. Does it radiate anywhere else? 5. What relieves your pain? 6. When does your pain start? How often does it occur? Has its intensity changed? How long does it last?

41. TERMS Eupnea - Normal breathing
Orthopnea - Sitting upright to breath more easily
Apnea - No breath
Hyperpnea - Fast, deep breathing
Tachypnea - Fast, shallow breathing
Bradypnea - Slow breathing
Dyspnea - Painful or difficult breathing
Tachycardia - Pulse rate in excess of 100 bpm
Bradycardia - pulse rate less than 60 bpm