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Physical Therapy for Cardiovascular disorders

Physical Therapy for Cardiovascular disorders. RHPT 482 Credit hours: 2T+1C Course Instructor: Ahmad Osailan. Course Description . The course is designed to teach and perform clinical practice for the management of CVD. Anatomy and physiology of the cardiovascular system. Objectives :

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Physical Therapy for Cardiovascular disorders

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  1. Physical Therapy for Cardiovascular disorders RHPT 482 Credit hours: 2T+1C Course Instructor: Ahmad Osailan

  2. Course Description • The course is designed to teach and perform clinical practice for the management of CVD.

  3. Anatomy and physiology of the cardiovascular system • Objectives : • Be familiar with the anatomy of the heart and vascular system • Size of the heart • Location of the heart • Layers of the heart • Chambers of the heart • Vascular system and its layers • Brief physiology of cardiovascular system

  4. Cardiovascular system • Consist of : • Heart • Blood vessels • Lymphatic

  5. Overview of the heart • Heart Definition: “a pump that moves the entire body volume to and from the lungs and tissues.” • In Humans, Heart is 250 g in Male to 350 in Female. (Size of a fist) • It produces ~ 5 Litres of Blood every minute • Myogenic: ability to generate its own contraction

  6. Location of the heart • posterior to sternum • medial to lungs • anterior to vertebral column • base lies beneath 2nd rib • apex at 5th intercostal space • lies upon diaphragm

  7. posterior to sternum • medial to lungs • anterior to vertebral column • base lies beneath 2nd rib • apex at 5th intercostal space • lies upon diaphragm

  8. Heart Structure • Consist of : • Pericardium • Walls of the heart • Four champers • Four valves

  9. Covering of the Heart • Pericardium: • Def: Is a fibrous sac surrounds the heart and roots of great vessels. • Divided to : • Serous pericardium: smooth inner • Fibrous pericardium: Tough fibrous tissue outer

  10. Pericardium • Serous pericardium • Parietal layer: lines the inside of fibrous pericardium • Visceral layer: adheres to the surface of the heart. • Fibrous pericardium: Protects the heart and serous membrane

  11. Heart Wall layers • Epicardium: outer layer • Myocardium: Middle layer • Endocardium: Inner layer

  12. Endocardium • Inner lining • Smooth (Endothelial) surface that permits blood to move easily through the heart • Continuous with lining of blood vessels

  13. Myocardium • Middle layer made of cardiac muscle (Myocardium) • Forms the bulk of the heart wall • Contains the septum- a thick muscular wall that completely separates the blood in the right side of the heart from the blood in the left side.

  14. Epicardium • Protective, outer layer of the heart wall • same as the visceral pericardium • The coronary blood vessels that nourish • the heart wall are located here

  15. Champers of the Heart • Heart has Four Champers • 2 atria (atrium) 2 ventricles • 2 atria separated by interatrial septum • 2 ventricles separated by interventricular septum.

  16. Champers Right Atrium • Thinner wall than ventricles • Receives deoxygenated blood from vena cava • Passes blood through tricuspid valve into right • ventricle

  17. Right Ventricle • Thicker wall than atria • Comprises most of anterior surface of heart • Circulates deoxygenated blood to lungs through the pulmonic valve into pulmonary trunk

  18. Left atrium • Receives freshly oxygenated blood from pulmonary vein • Passes blood to left ventricle through mitral valve

  19. Left ventricle • Receives blood from left atrium • Thickest myocardial wall • Forms apex of heart • Sends blood to systemic circulation via aorta

  20. Valves of the heart • Function- prevent blood from flowing backwards • Responds to changes in pressure • Two types of valves in heart • Atrioventricular valves (AV) • Semi-lunar valves

  21. Semilunar valves • Located at exit of ventricles, originiate from endothelial lining of veins • Heart contains two semilunar valves • Pulmonic • Aortic (Frequently damaged by Htn)

  22. Atrioventricular Valves • Valve cusps are connected to papillary muscles • Chordaetendineae tiny collagen cords • that anchor cusps of valve to papillary muscles

  23. Atrioventricular Valves • Left AV valve (Mitral, bicuspid) • Contains 2 cusps • Subject to abuse • Right AV valve (Tricuspid) • Contains 3 cusps • Not subjected to great abuses

  24. Blood circulation • There are 2 circulatory pathways: • Pulmonary circuit • Systemic circuit

  25. Blood circulation • Pulmonary circuit: Deoxygented Blood received by Right Atrium from Superior and inferior vena cava-> pass through Tricuspid V-> Right Ventricle -> through Pulmonary V -> pulmonary trunk -> pulmonary arteries -> R + L Lung.

  26. Blood Circulation • Systemic Circuit: Oxygenated blood returns from lungs to heart through -> pulmonary veins -> Left Atrium -> pass through Mitral V -> Left ventricle -> pass through Aortic V -> aortic arch -> whole body

  27. Blood Vessels • Function: • Distribution of blood • Exchange of materials with tissues • Return of blood to heart • Structure: • Most have 3 layers surrounding a hollow lumen

  28. Blood Vessels • Arteries Veins • Arteriole Venule • Capillary network

  29. General structure of Blood Vessels • Arteries and Veins Have 3 Tunics: • Tunica Externa ( Adventetia ) • Tunica Media • Tunica Intema • Capillaries composed of endothelium ( tunica intema)

  30. Blood vessels • Tunica Intema: • Inner smooth layer • Simple squamous epithelium • Continous with endocardium • Present in all vessels

  31. Blood Vessels • Tunica Media: • Layer of smooth Muscles • Contain Elastin • Supplied by Sympathetic division of ANS • Area of vasoconstriction and Vasodilatation

  32. Blood Vessels • Tunica Externa • Layer of Connective tissue • Elastic and has collagen fibres

  33. Arteries • Characteristics: • Thick walled • Lots of Elastin in all tunics • Stretchable wall to recoil and propel blood • Withstand and regulate BP Fluctuations

  34. Veins • Characteristics: • Thin walled • Lumen is larger than arteries • Less stretchable than arteries

  35. Capillaries • Characteristics : • Smallest vessel • Large enough for 1red cell • One tunica only (tunica intema) • Very thin, Why?

  36. Blood supply to heart

  37. Coronary arteries • 2 Main Coronary Arteries •Right CA- branches into some marginal arteries; supplies RV and posterior of heart •Left CA- branches into • AIA (LAD) and • circumflex; supplies LV

  38. Arterial supply to heart • Originates from the base of aortic artery • Only 5% of ejected blood is received through to innervate the heart (Myocardium) • Many branches directed to the Left ventricle, Why? • Coronary arteries traverse the heart forming a vast network of capillaries

  39. Venous drainage • Transport deoxygenated blood to coronary sinus • Coronary Sinus drains into RA

  40. Discussion • Which chamber among ventricles is thicker? • Which one is thicker among blood vessels? • How many layers surrounding the heart? • How many valves and what is the type of each one? • How many Circuit in cardiovascular system?

  41. Physiology of cardiovascular system

  42. Mainly the heart is a pumping machine. • To pump it require force to generate contraction. • Since the heart is mainly composed of cardiac muscles (myocyte), • it has similar functions and structure like skeletal muscles with some variations

  43. Myocyte • Characteristics: • Striated cells • Short cells • Mononucleus (one nucleus only) • Very large mitochondria (Many ATP) • Has intercalated disks

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