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The Cardiovascular System

This comprehensive overview covers the anatomy and function of the heart, located in the thoracic cavity, including its protective pericardium and three tissue layers: epicardium, myocardium, and endocardium. It details the heart's dual pumping action and blood flow pathways, distinguishing between oxygenated and deoxygenated blood. We explore the conduction system and factors influencing heart rate and cardiac output. Additionally, the guide emphasizes the importance of cardiac assessment, including vital signs, diagnostic tests, and lifestyle factors affecting heart health.

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The Cardiovascular System

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  1. The Cardiovascular System Chapters 15-18

  2. The Heart • Location: • Thoracic cavity • Behind sternum • Between the lungs

  3. The Heart: • Protective sac • PERICARDIUM • Layers of heart tissue • Epicardium • Myocardium • Endocardium

  4. The Heart • Function • Double pump • Right  • Receives blood from the body (pumps blood to) • Lungs • Left  • Receives blood from the lungs  • body

  5. The Heart: Blood flow • Inferior & Superior Vena cava  • Right Atrium  • Tricuspid valve • Right Ventricle  • Pulmonary valve • Pulmonary Arteries  • Pulmonary arterioles  • Pulmonary capillaries  • Pulmonary venules  • Pulmonary veins 

  6. The Heart: Blood flow • Pulmonary veins  • Left Atrium  • Bicuspid (mitral) valve  • Left ventricle  • Aorta  • Aortic Valve • (body) • Arteries • Capillaries  • Vein 

  7. The Heart: Blood flow • Veins  • Inferior & Superior Vena cava  • Right Atrium  • Tricuspid valve • Right Ventricle  • Pulmonary Arteries  • Pulmonary arterioles  • Pulmonary capillaries  • Pulmonary venules  • Pulmonary veins 

  8. Heart Beat • Lub-dub; lub-dub • First sound • S1 (lub) • “AV valves” close • (valves between the atriums & ventricles) • Tricuspid • Bicuspid • Second sound • S2 (dub) • “semilunar valves” close • Aortic valve • Pulmonary valve

  9. Conduction System • Cardiac muscle does not need the nervous system to generate an electrical impulse

  10. Conduction System • Heart beat is controlled by special cells in the myocardium • “Conduction system”

  11. Conduction Systemhttp://www.youtube.com/watch?v=te_SY3MeWys • Sinoatrial (SA) node  • AKA: Pacemaker • Internodal pathways  • Atrioventricular (AV) node  • Bundle of His  • Purkinje fibers

  12. Conduction SystemElectorcardiogram (EKG) • http://www.pennmedicine.org/encyclopedia/em_DisplayAnimation.aspx?gcid=000001&ptid=57

  13. Cardiac Cycle • Contraction & relaxation of the heart = • 1 heart beat • Diastole • Ventricles relax • Systole • Ventricles contact

  14. Normal Heart Rate • 70-90 / minute • > • tachycardia • < • bradycardia

  15. Cardiac output • Stroke Volume (SV) • Amount of blood pushed from the heart with each heart beat • @ 70 mL • Cardiac Output (CO) • Amount of blood pumped in 1 min. • CO = HR (pulse) x SV • @4-8 L/min

  16. Peripheral Vascular System • Network of blood vessels that carry blood to peripheral tissues and then return it to the heart • Arteries • carry blood away from the heart • Capillaries • Veins • carry blood towards the heart

  17. Capillaries • Where Oxygen & nutrients are exchanges • Very permeable

  18. Arteries & Veins • Aorta  • Arteries  • Arterioles • Capillaries • Venules • Veins  • Superior & Inferior Vena Cava

  19. Blood vessel structure • Inner layer • Slick surface • Middle layer • Smooth muscle • Out layer • Protection

  20. Blood Vessel Structure • Smooth muscle function • Constriction • Narrowing • Dilation • Widening

  21. Blood Vessel Structure • Veins have something Arteries don’t have! • Valves

  22. Blood Pressure (BP) • Force exerted by blood against the walls of the arteries • SYSTOLIC • Pressure exerted when the heart contracts • DIASTOLIC • Pressure when the heart is filling

  23. Blood Pressure (BP) • Optimal Blood Pressure • <120 / 80

  24. Blood • Oxygenated • Blood that is carrying oxygen O2 • Deoxygenated • Blood that is not carrying oxygen • Carrying CO2

  25. Oxygenated &Deoxygenated • Inferior & Superior Vena cava  • Right Atrium  • Tricuspid valve • Right Ventricle  • Pulmonary valve • Pulmonary Arteries  • Pulmonary arterioles  • Pulmonary capillaries  • Pulmonary venules  • Pulmonary veins 

  26. Oxygenated & Deoxygenated • Pulmonary veins  • Left Atrium  • Bicuspid (mitral) valve  • Left ventricle  • Aorta  • Aortic Valve • (body) • Arteries • Capillaries  • Vein 

  27. The Heart: Blood flow • Veins  • Inferior & Superior Vena cava  • Right Atrium  • Tricuspid valve • Right Ventricle  • Pulmonary Arteries  • Pulmonary arterioles  • Pulmonary capillaries  • Pulmonary venules  • Pulmonary veins 

  28. Cardiac Assessment • Health History • Chest pain • Breathing problems • Short of breath • Changes in energy levels • Medication • Life style • Alcohol intake • Exercise • Smoking • Illicit drugs

  29. Cardiac Assessment • Skin Color • Pallor • Pale • Cyanosis • Blue

  30. Cardiac Assessment • Vital Signs • Peripheral pulses • Capillary refill • Edema? • Auscultate the heart

  31. Diagnostic Tests • Lipid profile • Cholesterol • Triglycerides • High-density lipoproteins (HDL’s) • Low-density lipoproteins (LDL’s) • Assess risk for atherosclerosis & coronary heart disease

  32. Diagnostic Tests • Serum Cardiac Markers (Cardiac enzymes) • Creatinephosphokinase • CK-MB • cTnT • cTn1 • Heart muscle cells that are dead or damaged release these proteins. • Increased levels = heart damage

  33. Diagnostic Test • Electrocardiogram (ECG) • Record of the electricity of the heart

  34. ECG • P-wave • Arial depolarization

  35. ECG • QRS complex • Ventricular depolarization

  36. ECG • T-wave • Ventricular repolization

  37. ECG • P-R interval

  38. ECG • P-R interval • Period of time from • SA node to • AV node & Bundle of His

  39. Imaging Techniques • CT scan • 3-D X-ray machine

  40. Imaging Techniques • MRI scan • Magnetic resonance imaging

  41. MRI: Rules • No METAL in the room with the machine • Assess for • Metal implants • Claustrophobia • http://www.youtube.com/watch?v=7g5UVrOt2CI • http://www.youtube.com/watch?v=6BBx8BwLhqg&NR=1

  42. Imaging Techniques • Angiography • INVASIVE • Insertion into an artery • X-rays + fluoroscopy

  43. Imaging Techniques • Angiography • INVASIVE • Risks – • Bleeding • Clot  • Assess: • Insertion site • Pedal pulses

  44. WARNING: Angiography • Closely monitory the client, the insertion site, the extremity after the procedure. Immediately report evidence of bleeding, pain or a pale pulseless extremity to the charge nurse & physician

  45. Coronary Heart Disease • AKA • Coronary Artery Disease • Definition • Narrowing of the arteries that supply blood to the heart muscles

  46. Arteriosclerosis & Atherosclerosis Arteriosclerosis Atherosclerosis Plaque buildup in the arteries #1 cause of CHD • Arteries that are • Thick • Non-elactic

  47. CHD: Risk Factors Changeable Non-changeable Age Gender Race Heredity • Smoking • Obesity • Physical inactivity • High fat diet • High blood pressure • Hypertension / HTN • High blood lipids • Hyperlipidemia • Diabetes Mellitus

  48. Atherosclerosis: Pathophysiology • Narrow arteries  • i blood flow  • ISCHEMIA • Not enough blood or oxygen for their metabolic needs • Infarction • Tissue death

  49. S&S of atherosclerosis • Due to • ISCHEMIA • Angina • Myocardial Infarction

  50. Atherosclerosis: IDT Interventions • Quit smoking • Diet • Low fat • Exercise • Control BP • Control DM

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