2. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-1 The Cardiovascular System PowerPoint® presentation to accompany: Medical Assisting Third Edition Booth, Whicker, Wyman, Pugh, Thompson

3. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-2 Learning Outcomes 27.1Describe the structure of the heart and the function of each part. 27.2Trace the flow of blood through the heart. 27.3List the most common heart sounds and what events produce them. 27.4Explain how heart rate is controlled by the electrical conduction system of the heart.

4. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-3 Learning Outcomes (cont.) 27.5List the different types of blood vessels and describe the functions of each. 27.6Define blood pressure and tell how it is controlled. 27.7Trace the flow of blood through the pulmonary and systemic circulation. 27.8List the major arteries and veins of the body and describe their locations.

5. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-4 Learning Outcomes (cont.) 27.9List and describe the components of blood. 27.10Give the functions of red blood cells, the different types of white blood cells, and platelets. 27.11List the substances normally found in plasma. 27.12Explain how bleeding is controlled. 27.13Explain the differences among blood types A, B, AB, and O.

6. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-5 Learning Outcomes (cont.) 27.14Explain the difference between Rh-positive blood and Rh-negative blood. 27.15Explain the importance of blood typing and tell which blood types are compatible. 27.16Describe the causes, signs and symptoms, and treatments of various diseases and disorders of the cardiovascular system.

7. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-6 Introduction  The cardiovascular system consists of heart and blood vessels  Sends blood to Lungs for oxygen Digestive system for nutrients  CV system also circulates waste products to certain organ systems for removal from the blood

8. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-7 The Heart: Structures  Cone-shaped organ about the size of a loose fist  In the mediastinum  Extends from the level of the second rib to about the level of the sixth rib  Slightly left of the midline

9. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-8 The Heart: Structures (cont.)  Heart is bordered: Laterally by the lungs Posteriorly by the vertebral column Anteriorly by the sternum  Rests on the diaphragm inferiorly

10. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-9 The Heart: Structures (cont.)  Heart coverings Pericardium  Covers the heart and large blood vessels attached to the heart  Visceral pericardium Innermost layer Directly on the heart  Parietal pericardium Layer on top of the visceral pericardium  Heart walls: Epicardium  Outermost layer  Fat to cushion heart Myocardium  Middle layer  Primarily cardiac muscle Endocardium  Innermost layer  Thin and smooth  Stretches as the heart pumps Click for Larger View

11. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-10

12. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-11 The Heart: Structures (cont.)  Four chambers Two atria  Upper chambers  Left and right  Separated by interatrial septum Two ventricles  Lower chambers  Left and right  Separated by interventricular septum Click for View of Heart Atrioventricular septum separates the atria from the ventricles

13. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-12 The Heart: Structures (cont.)  Tricuspid valve – prevents blood from flowing back into the right atrium when the right ventricle contracts  Bicuspid valve – prevents blood from flowing back into the left atrium when the left ventricle contracts  Pulmonary valve – prevents blood from flowing back into the right ventricle  Aortic valve – prevents blood from flowing back into the left ventricle Click for View of Heart

14. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-13 The Heart Labeled

15. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-14 The Heart: Blood Flow Deoxygenated blood in from body Oxygenated blood in lungs Atria ContractVentricles Contract Deoxygenated blood out to lungs Oxygenated blood out to body

16. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-15 The Heart: Blood Flow (cont.) Right Atrium Right Ventricle Pulmonary Semilunar Valve Left Atrium Bicuspid Valve Left Ventricle Pulmonary Valve Tricuspid Valve Aortic Semilunar Valve Lungs Body

17. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-16 The Heart: Cardiac Cycle  Right atrium contracts Tricuspid valve opens Blood fills right ventricle  Right ventricle contracts Tricuspid valve closes Pulmonary semilunar valve opens Blood flows into pulmonary artery  Left atrium contracts Bicuspid valve opens Blood fills left ventricle  Left ventricle contracts Bicuspid valve closes Aortic semilunar valve opens Blood pushed into aorta  One heartbeat = one cardiac cycle Atria contract and relax Ventricles contract and relax

18. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-17 The Heart: Cardiac Cycle (cont.)  Influenced by Exercise Parasympathetic nerves Sympathetic nerves Cardiac control center Body temperature Potassium ions Calcium ions

19. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-18 The Heart: Heart Sounds  One cardiac cycle – two heart sounds (lubb and dubb) when valves in the heart snap shut Lubb – First sound  When the ventricles contract, the tricuspid and bicuspid valves snap shut Dubb – Second sound  When the atria contract and the pulmonary and aortic valves snap shut

20. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-19 The Heart: Cardiac Conduction System  Group of structures that send electrical impulses through the heart  Sinoatrial node (SA node) Wall of right atrium Generates impulse Natural pacemaker Sends impulse to AV node  Atrioventricular node (AV node) Between atria just above ventricles Atria contract Sends impulse to the bundle of His  Bundle of His Between ventricles Two branches Sends impulse to Purkinje fibers  Purkinje fibers Lateral walls of ventricles Ventricles contract Link to Diagram

21. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-20

22. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-21 Apply Your Knowledge Match the following: __ Tricuspid valve A. Two branches; sends impulse to Purkinje fibers __ Bicuspid valve B. Covering of the heart and aorta __ Pericardium C. Between the right atrium and the right ventricle __ SA node D. In the lateral walls of ventricles __ Bundle of His E. Natural pacemaker __ Purkinje fibers F. Between the left atrium and the left ventricle D A E B F C ANSWER:

23. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-22 Blood Vessels: Arteries and Arterioles  Strongest of the blood vessels  Carry blood away from the heart  Under high pressure Vasoconstriction Vasodilation  Arterioles Small branches of arteries  Aorta Takes blood from the heart to the body  Coronary arteries Supply blood to heart muscle

24. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-23 Blood Vessels: Veins and Venules  Blood under no pressure in veins Does not move very easily Skeletal muscle contractions help move blood Sympathetic nervous system also influences pressure  Valves prevent backflow  Venules Small vessels formed when capillaries merge  Superior and inferior vena cava Largest veins Carry blood into right atrium

25. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-24 Blood Vessels: Capillaries  Branches of arterioles  Smallest type of blood vessel  Connect arterioles to venules  Only about one cell layer thick  Oxygen and nutrients can pass out of a capillary into a body cell  Carbon dioxide and other waste products pass out of a body cell into a capillary

26. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-25 Apply Your Knowledge How do arteries control blood pressure? ANSWER: The muscular walls of arteries can constrict to increase blood pressure or dilate to decrease blood pressure.

27. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-26 Blood Pressure  Force blood exerts on the inner walls of blood vessels Highest in arteries Lowest in veins  Systolic pressure Ventricles contract Blood pressure is at its greatest in the arteries  Diastolic pressure Ventricles relax Blood pressure in arteries is at its lowest  Reported as the systolic number over the diastolic number

28. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-27 Blood Pressure (cont.)  Control is based mainly on the amount of blood pumped out of the heart  The amount of blood entering should equal the amount pumped from the heart  Starling's law of the heart Blood entering the left ventricle stretches the wall of the ventricle The more the wall is stretched  The harder it will contract and  tTe more blood it will pump out

29. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-28 Blood Pressure (cont.)  Baroreceptors Also help regulate blood pressure Located in the aorta and carotid arteries High blood pressure in aorta  message to cardiac center in brain  decreases heart rate  lowers blood pressure Low blood pressure in aorta  message to cardiac center in the brain  increases heart rate  increases blood pressure

30. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-29 Apply Your Knowledge What is the difference between the systolic pressure and diastolic pressure? ANSWER: Systolic pressure is the result of the contraction of the ventricles increasing the pressure in the arteries. Diastolic pressure is the result of the relaxation of the ventricles lowering the pressure in the arteries. Good Answer!

31. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-30 Circulation  Pulmonary circuit right atrium  right ventricle  pulmonary artery trunk  pulmonary arteries  lungs  pulmonary veins  heart (left atrium)  Systemic circuit left atrium  left ventricle  aorta  arteries  arterioles  capillaries  venules  veins  vena cava  heart (right atrium)

32. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-31 Circulation (cont.)  Arterial system Carry oxygen-rich blood away from the heart Pulmonary arteries carry oxygen-poor blood Paired – left and right artery of the same name

33. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-32 Circulation (cont.)  Venous system Carries oxygen- poor blood toward the heart  Except pulmonary veins Most large veins have the same names as the arteries they are next to  Hepatic portal system Collection of veins carrying blood to the liver Click for Larger View

34. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-33

35. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-34 Apply Your Knowledge ARTERIES: Pulmonary arteries carry oxygen-poor blood. Do pulmonary arteries carry blood with high levels of oxygen or low levels of oxygen?

36. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-35 Blood  A type of connective tissue Red blood cells (erythrocytes) White blood cells (leukocytes) Platelets – cell fragments Plasma – fluid part of blood Average-sized adult has 4 to 6 liters of blood Amount depends on:  Size of person  Amount of adipose tissue  Concentrations of ions  Females have less than males Average-sized adult has 4 to 6 liters of blood Amount depends on:  Size of person  Amount of adipose tissue  Concentrations of ions  Females have less than males

37. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-36 Blood Components  Hematocrit The percentage of red blood cells Normal is about 45%  White cells and platelets = 1%  Plasma = 55%

38. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-37 Blood Components: Red Blood Cells  Erythrocytes  Transport oxygen throughout the body  Small biconcave-shaped cells  Hemoglobin is a pigment in RBCs Oxyhemoglobin carries oxygen; bright red Deoxyhemoglobin does not carry oxygen; darker red  Carries carbon dioxide, so also called carboxyhemoglobin Anemia – low RBC count  Erythropoietin – regulates production of RBCs

39. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-38 Blood Components: Red Blood Cells (cont.)

40. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-39 Blood Components: White Blood Cells  Granulocytes Neutrophils (55%) –destroy bacteria, viruses, and toxins in the bloodstream (phagocytes) Eosinophils (3%) – get rid of parasitic infections such as worm infections Basophils (1%) – control inflammation and allergic reactions  Agranulocytes Monocytes (8%) – destroy bacteria, viruses, and toxins in blood Lymphocytes (33%) – provide immunity for the body

41. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-40 Blood Components: White Blood Cells (cont.)  WBC count normally 5000 to 10,000 cells per cubic millimeter of blood Leukocytosis  Elevated WBC count  Usually due to infection Leukopenia  Low WBC count  Some viral infections and other conditions

42. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-41 Blood Components: Platelets  Fragments of cells found in the bloodstream  Also called thrombocytes  Important in the clotting process of blood  Normal count 130,000 to 360,000 platelets per cubic millimeter of blood

43. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-42 Blood Components: Plasma  Liquid portion of blood composed mostly of water  Proteins Albumins  Smallest plasma proteins  Pull water in to help maintain blood pressure Globulins – transport lipids and fat-soluble vitamins Fibrinogen – needed for blood clotting  Nutrients Amino acids Glucose Nucleotides Lipids from the digestive tract  Gases – oxygen, carbon dioxide, and nitrogen  Electrolytes  Waste products

44. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-43 Blood: Bleeding Control  Hemostasis – the control of bleeding  Three processes of hemostasis Blood vessel spasm Platelet plug formation Blood coagulation

45. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-44 Platelet plug formation:

46. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-45 Blood Types  Types are distinguished by antigen and antibodies  Agglutination Clumping of red blood cells Antigens on surface of RBCs bind to antibodies in plasma

47. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-46 Blood Types (cont.) Blood TypeAntigen Present Antibody Present Blood That Can Be Received AABA and O BBAB and O AB NoneA, B, AB, and O ONoneA and BO

48. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-47 Blood Types (cont.)  Rh antigen – protein on RBCs  Rh-positive RBCs contain the Rh antigen  Rh-negative RBCs do not contain the Rh antigen  Rh-positive blood is given to Rh-negative person Antibodies form  If Rh-negative person receives more Rh- positive blood Antibodies bind to the donor cells Agglutination occurs

49. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-48 Apply Your Knowledge True or False: __ Hematocrit is the percentage of WBCs in the blood. __ Neutrophils destroy bacteria, viruses, and toxins in the bloodstream. __ Platelets are important to the clotting process. __ Albumin is a small plasma protein that pushes water out of the bloodstream. __ Hemostasis is the control of bleeding. __ A person with type AB blood can only receive type AB blood. __ Blood should be matched for Rh factor. pulls water into RBCs can receive any type of blood T T F T F T F ANSWER:

50. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-49 Chest Pain  Cardiac Myocardial infarction Angina Pericarditis Coronary spasm  Non-cardiac Heartburn Panic attacks Pleurisy Costochondritis Pulmonary embolism Sore muscles Broken ribs Take all complaints of chest pain seriously!

51. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-50 Chest Pain (cont.)  Determine cause Electrocardiogram Stress tests Blood tests Chest x-ray Nuclear scan Coronary catheterization Echocardiogram Endoscopy

52. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-51 Diseases and Disorders of the Cardiovascular System DiseaseDescription AnemiaThe blood does not have enough red blood cells or hemoglobin to carry an adequate amount of oxygen to the body’s cells AneurysmA ballooned, weakened arterial wall ArrhythmiasAbnormal heart rhythms CarditisInflammation of the heart EndocarditisInflammation of the innermost lining of the heart, including valves

53. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-52 DiseaseDescription MyocarditisInflammation of the muscular layer of the heart PericarditisInflammation of the membranes that surround the heart (pericardium) Congestive Heart Failure Weakening of the heart over time; heart is unable to pump enough blood to meet body’s needs Coronary Artery Disease (CAD) Atherosclerosis; narrowing of coronary arteries caused by hardening of the fatty plaque deposits within the arteries Diseases and Disorders of the Cardiovascular System (cont.)

54. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-53 DiseaseDescription HypertensionHigh blood pressure; consistent resting blood pressure equal to or greater than 140/90 mm Hg LeukemiaBone marrow produces a large number of abnormal WBCs MurmursAbnormal heart sounds Myocardial Infarction Heart attack; damage to cardiac muscle due to a lack of blood supply Diseases and Disorders of the Cardiovascular System (cont.)

55. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-54 DiseaseDescription Sickle Cell Anemia Abnormal hemoglobin causes RBCs to change to a sickle shape; abnormal cells stick in capillaries ThalassemiaInherited form of anemia; defective hemoglobin chain causes, small, pale, and short-lived RBCs Thrombophlebitis Blood clots and inflammation develops in a vein Varicose VeinsTwisted, dilated veins Diseases and Disorders of the Cardiovascular System (cont.)

56. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-55 Apply Your Knowledge ANSWER: Anemia is a condition in which a person does not have enough red blood cells or hemoglobin in the blood to carry an adequate amount of oxygen to body cells. The doctor has told your patient she has anemia. How would you explain this to the her? Bravo!

57. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-56 In Summary  Cardiovascular system Transport system for body Heart, arteries, veins, and capillaries  Blood Transport medium RBCs, WBCs, platelets, plasma  Medical assistant Assists patients in understanding prevention and treatments for cardiovascular problems

58. © 2009 The McGraw-Hill Companies, Inc. All rights reserved 27-57 End of Chapter Your work is to discover your world and then with all your heart give yourself to it. ~ Buddha