1、Cardiovascular System,CHAPTER 10,Cardiovascular System Overview,Responsibilities of cardiovascular system Pumping blood to the body tissues and cells Supplying oxygen and nutrients to tissues and cells Removing carbon dioxide and other waste products of metabolism from tissues and cells,Cardiovascul
2、ar System,Heart Center of the circulatory system Enclosed by pericardium Parietal pericardium Visceral pericardium Pericardial cavity Three layers of the heart Epicardium Myocardium Endocardium,Heart,Chambers Right atrium and left atrium Upper chambers Receiving chambers Right ventricle and left ven
3、tricle Lower chambers Pumping chambers,Heart,Partitions Interatrial septum Separates right and left sides of atria Interventricular septum Separates right and left sides of ventricles,Circulation Through the Heart,Deoxygenated blood Enters right atrium from superior vena cava Brings blood from head,
4、 thorax, upper limbs, and abdominal viscera Also enters right atrium from inferior vena cava Brings blood from the trunk, lower limbs, and abdominal viscera,Circulation Through the Heart,Deoxygenated blood travels: From right atrium through tricuspid valve into right ventricle From right ventricle t
5、hrough pulmonary valve into right and left pulmonary arteries From pulmonary arteries to lungs Pulmonary arteries are the only arteries that carry deoxygenated blood Exchange of gases takes place in the lungs,Oxygenated blood Enters left atrium from lungs via pulmonary veins Pulmonary veins only vei
6、ns in body that carry oxygenated blood From left atrium through mitral valve into left ventricle From left ventricle through aortic valve into aorta From aorta to arteries to each body part and region,Circulation Through the Heart,Circulation Through the Heart,Pulmonary circulation Circulation of bl
7、ood from the heart to the lungs for oxygenation and back to the heart Systemic circulation Circulation of blood from the heart to all parts of the body and back to the heart,Circulation Through the Heart,Coronary arteries Arise from aorta near its origin at left ventricle Supply blood to heart muscl
8、e Heart muscle has a greater need for oxygen and nutrients Heart uses approximately 3 times more oxygen than other body organs,Conduction System of the Heart,Sinoatrial Node (SA Node) sets rhythm for entire heart SA Node = pacemaker of the heart Impulse from SA node causes atria to contract Impulse
9、travels from SA node to Atrioventricular node (AV node),Conduction System of the Heart,Impulse from AV node travels to ventricles through Bundle of His Bundle of His divides into right and left bundle branches Bundle branches terminate in Purkinje fibers Purkinje fibers fan out into the muscles of t
10、he ventricles Purkinje fibers cause ventricles to contract,Arteries Large, thick-walled vessels Carry blood away from the heart Arterioles Thinner walls than arteries Transport blood on to capillaries Capillaries Extremely thin walls = single layer Allow for exchange of materials between blood and t
11、issue fluid surrounding body cells,Supporting Blood Vessels,Supporting Blood Vessels,Venules Smallest veins Collect deoxygenated blood from cells for transport back to heart Veins Thinner walls than arteries Thicker walls than capillaries Transport blood from venules to heart,Cardiac Cycle,One Cardi
12、ac Cycle = One Complete Heartbeat Diastole Relaxation phase of heartbeat Ventricles relax and fill with blood Systole Contraction phase of heartbeat Ventricles contract Force blood out of heart,Blood Pressure Pressure exerted by blood on walls of arteries Systolic Pressure Maximum pressure reached w
13、ithin the ventricles Diastolic Pressure Minimum pressure reached within the ventricles Sphygmomanometer = blood pressure cuff Used to measure blood pressure,Blood Pressure,Common Signs and Symptoms,Symptoms that may indicate cardiovascular problems,PATHOLOGICAL CONDITIONS,Cardiovascular System,Angin
14、a Pectoris,Pronounced (an-JI-nah PECK-tor-is) (AN-jin-nah PECK-tor-is) Defined Severe pain and constriction about the heart, usually radiating to left shoulder and down left arm Creates feeling of pressure in anterior chest,Cardiac Tamponade,Pronounced (CAR-dee-ak TAM-poh-nod) Defined Compression of
15、 the heart caused by accumulation of blood or other fluid within the pericardial sac Accumulation of fluid in pericardial cavity prevents ventricles from adequately filling or pumping blood,Cardiomyopathy,Pronounced (car-dee-oh-my-OP-ah-thee) Defined Disease of the heart muscle itself, primarily aff
16、ecting pumping ability of the heart Noninflammatory disease of the heart Results in enlargement of the heart and dysfunction of the ventricles of the heart,Congestive Heart Failure,Pronounced (con-JESS-tiv heart failure) Defined Condition in which pumping ability of heart is progressively impaired t
17、o the point that it no longer meets bodily needs,Congestive Heart Failure,Left-sided cardiac failure Left ventricle unable to pump blood that enters from the lungs Characteristics: Dyspnea Moist sounding cough Fatigue Tachycardia Restlessness Anxiety,Congestive Heart Failure,Right-sided cardiac fail
18、ure Right side of heart cannot empty blood received from venous circulation Characteristics: Edema of lower extremities (pitting edema) Weight gain Enlargement of liver (hepatomegaly) Distended neck veins Ascites Anorexia Nocturia Weakness,Coronary Artery Disease,Pronounced (KOR-oh-nah-ree AR-ter-ee
19、 dih-ZEEZ) Defined Narrowing of the coronary arteries to the extent that adequate blood supply to the myocardium is prevented,Coronary Artery Disease,Treatments for occluded coronary arteries Medications Percutaneous Transluminal Coronary Angioplasty (PTCA) Directional Coronary Atherectomy Coronary
20、Bypass Surgery = Coronary Artery Bypass Graft (CABG),Endocarditis,Pronounced (en-doh-car-DYE-tis) Defined Inflammation of the membrane lining of the valves and chambers of the heart Caused by direct invasion of bacteria or other organisms Leads to deformity of valve cusps,Hypertensive Heart Disease,
21、Pronounced (high-per-TEN-siv heart dih-ZEEZ) Defined Heart disease as a result of long-term hypertension Heart must work against increased resistance due to increased pressure in the arteries,Mitral Valve Prolapse,Pronounced (MY-tral valve proh-LAPS) Defined Drooping of one or both cusps of the mitr
22、al valve back into the left atrium during ventricular systole Results in incomplete closure of the valve and mitral insufficiency,Myocardial Infarction,Pronounced (my-oh-CAR-dee-al in-FARC-shun) Defined Condition caused by occlusion of one or more of the coronary arteries = destruction of myocardial
23、 tissue Heart attack Life-threatening condition,Myocarditis,Pronounced (my-oh-car-DYE-tis) Defined Inflammation of the myocardium May be viral or bacterial infection May be result of systemic disease May be caused by fungal infections, serum sickness, or chemical agent,Pericarditis,Pronounced (per-i
24、h-car-DYE-tis) Defined Inflammation of the pericardium (saclike membrane) that covers the heart muscle May be acute or chronic,Rheumatic Fever,Pronounced (roo-MAT-ic fever) Defined Inflammatory disease that may develop as a delayed reaction to insufficiently treated Group A beta-hemolytic streptococ
25、cal infection of the upper respiratory tract,PATHOLOGICAL CONDITIONS,Blood Vessels,Aneurysm,Pronounced (AN-yoo-rizm) Defined Localized dilatation of an artery formed at a weak point in the vessel wall Weakened area balloons out with each pulsating of artery,Arteriosclerosis,Pronounced (ar-tee-ree-oh
26、-skleh-ROH-sis) Defined Arterial condition in which there is thickening, hardening and loss of elasticity of the walls of arteries (hardening of the arteries) Results in decreased blood supply, especially to lower extremities and cerebrum,Hypertension,Pronounced (high-per-TEN-shun) Defined Condition
27、 in which the patient has a higher blood pressure than judged to be normal Blood pressure persistently exceeds 140/90 mmHg,Hypertension,Essential hypertension Accounts for 90 percent of all hypertension No single known cause Secondary hypertension Due to underlying cause Malignant hypertension Sever
28、e and rapidly progressive Diastolic pressure higher than 120 mmHg,Peripheral Arterial Occlusive Disease,Pronounced (per-IF-er-al ar-TEE-ree-al occlusive disease) Defined Obstruction of the arteries in the extremities (predominantly the legs) Leading cause = atherosclerosis Classic symptom = intermit
29、tent claudication,Raynauds Phenomenon,Pronounced (ray-NOZ phenomenon) Defined Intermittent attacks of vasoconstriction of the arterioles Causes pallor of the fingers or toes, followed by cyanosis, then redness, before returning to normal color (white-blue-red) Initiated by exposure to cold or emotio
30、nal disturbance,Thrombophlebitis,Pronounced (throm-boh-fleh-BY-tis) Defined Inflammation of a vein associated with the formation of a thrombus (clot) Usually occurs in an extremity, most frequently a leg,Thrombophlebitis,Superficial Thrombophlebitis Usually obvious Accompanied by cordlike or thready
31、 appearance to the vessel Deep Vein Thrombosis (DVT) Occurs primarily in lower legs, thighs, and pelvic area Characterized by aching or cramping pain in legs,Varicose Veins,Pronounced (VAIR-ih-kohs veins) Defined Enlarged, superficial veins Twisted, dilated veins with incompetent valves,Varicose Vei
32、ns,Treatment Rest and elevation of affected extremity Use of elastic stockings Sclerotherapy Injection of a chemical irritant into the varicosed vein (sclerosing agent) Vein stripping,Venous Insufficiency,Pronounced (VEE-nuss in-syoo-FISH-in-see) Defined An abnormal circulatory condition characteriz
33、ed by decreased return of venous blood from the legs to the trunk of the body,PATHOLOGICAL CONDITIONS,Congenital Heart Diseases,Coarctation of the Aorta,Pronounced (koh-ark-TAY-shun of the aorta) Defined Congenital heart defect characterized by a localized narrowing of the aorta Results in increased
34、 blood pressure in upper extremities and decreased blood pressure in lower extremities,Patent Ductus Arteriosus,Pronounced (PAY-tent DUCK-tus ar-tee-ree-OH-sis) Defined Abnormal opening between the pulmonary artery and the aorta caused by failure of fetal ductus arteriosus to close after birth Defec
35、t seen primarily in premature infants,Pronounced (teh-TRALL-oh-jee of fal-LOH) Defined Congenital heart anomaly that consists of four defects Pulmonary stenosis Interventricular septal defect Dextraposition of aorta (shifts to the right) Hypertrophy of right ventricle,Tetralogy of Fallot,Transpositi
36、on of the Great Vessels,Pronounced (tranz-poh-ZIH-shun of the great vessels) Defined Condition in which the two major arteries of the heart are reversed in position Results in two non-communicating circulatory systems,PATHOLOGICAL CONDITIONS,Arrhythmias,Atrial Flutter,Pronounced (AY-tree-al flutter)
37、 Defined Condition in which the contractions of the atria become extremely rapid, at the rate of between 250 to 400 beats per minute,Fibrillation (Atrial Fibrillation),Pronounced (atrial fih-brill-AY-shun) Defined Extremely rapid, incomplete contractions of the atria resulting in disorganized and un
38、coordinated twitching of the atria Rate of contractions may be as high as 350 to 600 beats per minute,Fibrillation (Ventricular Fibrillation),Pronounced (ventricular fih-brill-AY-shun) Defined Rapid, tremulous (quivering like a bowl of Jell-O) and ineffectual contractions of the ventricles No audibl
39、e heartbeat No palpable pulse No respiration No blood circulation If prolonged, will lead to cardiac arrest,Heart Block (AV),Pronounced (Heart Block) Defined An interference with the normal conduction of electric impulses that control activity of the heart muscle,Ventricular Tachycardia,Pronounced (
40、ven-TRIK-yoo-lar tak-ee-CAR-dee-ah) Defined Condition in which the ventricles of the heart beat at a rate greater than 100 beats per minute Characterized by three or more consecutive premature ventricular contractions Also known as V-tach,DIAGNOSTIC TECHNIQUES, TREATMENTS AND PROCEDURES,Cardiovascul
41、ar System,Diagnostic Techniques, Treatments, and Procedures,Angiography X-ray visualization of internal anatomy of heart and blood vessels after introducing a radiopaque substance (contrast medium) Promotes imaging of internal structures that are otherwise difficult to see on X-ray film Substance is
42、 injected into an artery or a vein,Cardiac catheterization Diagnostic procedure in which a catheter is introduced into a large vein or artery, usually of an arm or a leg, and is then threaded through the circulatory system to the heart Used to obtain detailed information about the structure and func
43、tion of the heart chambers, valves, and the great vessels,Diagnostic Techniques, Treatments, and Procedures,Cardiac Enzymes Test Tests performed on samples of blood obtained by venipuncture to determine the presence of damage to the myocardial muscle (CAT) Computed Axial Tomography Diagnostic X-ray
44、technique that uses ionizing radiation to produce a cross-sectional image of the body Often used to detect aneurysms of the aorta,Diagnostic Techniques, Treatments, and Procedures,Echocardiography Diagnostic procedure for studying the structure and motion of the heart Useful in evaluating structural
45、 and functional changes in a variety of heart disorders Electrocardiogram (EKG, ECG) Graphic record of the electrical action of the heart as reflected from various angles to the surface of the skin,Diagnostic Techniques, Treatments, and Procedures,Exercise stress testing Means of assessing cardiac f
46、unction, by subjecting the patient to carefully controlled amounts of physical stress, for example, using the treadmill,Diagnostic Techniques, Treatments, and Procedures,Holter monitoring Small, portable monitoring device that makes prolonged electrocardiograph recordings on a portable tape recorder
47、 Continuous EKG (ambulatory EKG) is recorded on a magnetic tape recording while the patient conducts normal daily activities,Diagnostic Techniques, Treatments, and Procedures,Event monitor Similar to the Holter monitor in that it also records the electrical activity of the heart while patient goes a
48、bout usual daily activities Can be used for a longer period of time than a Holter monitor Usually a month,Diagnostic Techniques, Treatments,and Procedures,Implantable Cardioverter Defibrillator (ICD) Small, lightweight, electronic device placed under the skin or muscle in either the chest or abdomen
49、 to monitor the hearts rhythm If abnormal rhythm occurs, the ICD helps return the heart to its normal rhythm,Diagnostic Techniques, Treatments, and Procedures,Magnetic Resonance Imaging (MRI) Use of strong magnetic field and radiofrequency waves to produce imaging that is valuable in providing image
50、s of the heart, large blood vessels, brain, and soft tissue Used to examine the aorta, to detect masses or possible tumors, and pericardial disease Can also show the flowing of blood and the beating of the heart,Diagnostic Techniques, Treatments, and Procedures,Positron Emission Tomography (PET) Com
51、puterized x-ray technique that uses radioactive substances to examine the blood flow and the metabolic activity of various body structures, such as the heart and blood vessels Patient is given doses of strong radioactive tracers by injection or inhalation Radiation emitted is measured by the PET camera,
