1. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 1

2. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 2 Functions of the cardiovascular system: ◦ Transports nutrients and oxygen to the body ◦ Transports waste products from the cells to the kidneys for excretion ◦ Distributes hormones and antibodies throughout the body ◦ Helps control body temperature and maintain electrolyte balance

3. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 3  Two-sided, double pump  Weighs less than a pound  Slightly bigger than a fist  Located between the lungs in the thoracic cavity  Positioned partially to the left of the sternum

4. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 4 Four chambers of the heart ◦ Atria  Top two chambers  Blood enters the heart through the atria ◦ Ventricles  Lower two chambers  Blood leaves the heart through the ventricles  Septum ◦ Divides the right and left sides of the heart

5. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 5  Pulmonary circulation ◦ Right side of heart pumps deoxygenated blood to the lungs  Systemic circulation ◦ Left side of the heart pumps oxygenated blood to rest of the body  Blood returns to the right side of the heart from the body to complete the cycle  Hepatic circulation ◦ Path of the blood from the intestines, gallbladder, pancreas, stomach, and spleen through the liver

6. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 6

7. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 7 Four valves of the heart ◦ Prevent blood from flowing back into heart ◦ Atrioventricular  Separate the atria and ventricles ◦ Semilunar valves  Separate the ventricles from the pulmonary artery and aorta

8. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 8

9. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 9  Endocardium ◦ Smooth layer of cells lining the inside of the heart and forming the valves  Myocardium ◦ The thickest layer, consisting of muscle tissue  Pericardium ◦ Double membrane that covers the outside of the heart, providing lubrication between the heart and surrounding structures to prevent tissue damage

10. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 10

11. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 11  Activity of the heart muscle is controlled by the nervous system ◦ Also affected by action of hormones and fluid balance

12. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 12  Heart is the only muscle that can stimulate its own contractions ◦ Sinoatrial cells (SA node) in right atrium  Start the heart ◦ Atrioventricular node (AV node)  Sends impulse into lower portions of the heart ◦ AV bundle or bundle of HIS  Stimulate the Purkinje fibers ◦ Purkinje fibers  Cause the ventricles to contract

13. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 13

14. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 14

15. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 15  Arteries ◦ Carry blood away from the heart  Blood is oxygenated ◦ Have a muscular layer of tissue that helps pump blood out of the body ◦ Aorta is the largest artery in the body, which branches into smaller arteries  Arterioles ◦ Smaller vessels ◦ Blood moves from arterioles to capillaries

16. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 16  Capillaries ◦ Microscopic vessels that carry blood between the arterial and venous vessels ◦ Gases, nutrients, and waste exchanged  Blood gives up oxygen ◦ Blood flows from capillaries into venules

17. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 17  Veins ◦ Venues branch together to form veins ◦ Carry blood back to the heart by gravity  Blood is deoxygenated except for pulmonary vein ◦ Contain values that prevent blood from flowing back ◦ Have a much thinner muscular layer ◦ Superior vena cava and inferior vena cava  Largest veins

18. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 18

19. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 19

20. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 20

21. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 21  Measuring pulse and blood pressure  Listening to heart sounds  Determining cardiac output  Measuring muscle activity with electrocardiography  Inserting a cardiac catheter  Using echocardiography

22. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 22  Pulse ◦ Surge of blood against the walls of the arteries ◦ Eight pulse points on the body ◦ Normal pulse rate for adults is 60 to 90 beats per minute  Blood pressure ◦ Force of blood against the walls of the arteries ◦ Systolic pressure  Ventricles of the heart contract ◦ Diastolic pressure  Ventricles relax ◦ Normal blood pressure  120/80 ◦ Blood pressure varies greatly among people

23. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 23

24. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 24  Heart sounds ◦ Lub-dub sound of the heart ◦ Heard through a stethoscope ◦ Murmurs  Abnormal or extra sound  Classified by timing, intensity, location, pitch, and quality of the sound  May be benign or indicate a disorder ◦ Thrill  Vibration felt by touch over an artery  Caused by an abnormal flow of blood

25. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 25  Electrocardiogram ◦ Measures graphically the pattern of electrical activity in heart contractions  Normal and abnormal heart activities have characteristic wave patterns ◦ Echocardiography  Uses ultrasonic waves to show the structures and motions of the heart  Transducer plots the sound echoes to produce a graphic picture

26. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 26  Cardiac catheterization ◦ Used to measure the pressure in the chambers of the heart, to take blood samples, and to view obstructions in the vessels  A tube is inserted through the blood vessels into the heart  Dye is then released and traced using x-ray

27. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 27  Aneurysm ◦ An area of a blood vessel that bulges because of a weakness in the wall  Atherosclerosis ◦ A narrowing of blood vessels caused by deposits of fatty material containing calcium and cholesterol  Cardiac arrhythmia ◦ A disturbance of the heart’s rhythm caused by a defect in the heart’s pacemaker cells or by damage to heart tissue

28. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 28  Cardiovascular disease ◦ A general term for the combined effects of arteriosclerosis, atherosclerosis, and related conditions called coronary artery disease  Congenital heart disease ◦ A group of disorders that affect about 25,000 newborns each year in the united states  Congestive heart failure ◦ The inability of the heart to pump blood adequately to meet the body’s needs

29. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 29  Hypertension ◦ High blood pressure  Myocardial infarction ◦ Known as a heart attack  Phlebitis ◦ An inflammation of a vein, often with formation of a clot

30. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 30  Rheumatic heart disease ◦ A condition in which the heart muscle and valves are damaged by a recurrent bacterial infection that usually begins in the throat  Varicose veins ◦ A condition in which veins become enlarged and ineffective

31. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 31  Heart replacement and transplants ◦ 1967 - First heart replacement  Approximately 2,300 heart transplants each year in the United States  First artificial heart, Jarvik-7  Connected to an external power source and pump ◦ 2001 AbioCor self-contained artificial heart  Designed to test how long it could extend life for people with end-stage heart failure

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34. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 34 ◦ 2005 FDA approved use of Syn Cardia CardioWest Temporary Total Artificial Heart  Used in patients with irreversible failure of the ventricles  More than 3,000 people are on a waiting list for a heart transplant

35. Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 35  Cholesterol controversy ◦ LDL vs. HDL  Harvard research study  Type of fat in the diet, not the amount, changes the cholesterol level  Limit intake of saturated fats and eliminate trans fats