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The Cardiovascular System

The Cardiovascular System. & Cardiovascular Emergencies. Supplies oxygenated blood to all cells in the body!!. Components. Heart – pumps blood Vessels – Arteries carry blood away from the heart and veins carry blood back to the heart

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The Cardiovascular System

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  1. TheCardiovascular System & Cardiovascular Emergencies

  2. Supplies oxygenated blood to all cells in the body!!

  3. Components • Heart – pumps blood • Vessels – Arteries carry blood away from the heart and veins carry blood back to the heart • Blood – fluid that carries nutrients essential to cell function

  4. The Heart • Located in the thoracic cavity • 2nd intercostal space at right sternal border • 5th intercostal space at left midclavicular line • about size of your clenched fist • In mediastinum

  5. The Heart • 4 chambers • “2 sided” - divided by septum • 2 upper called atria • 2 lower called ventricles • surrounded by pericardium • system of one way valves

  6. Path of blood flow (Systemic circulation) • left ventricle • aorta • arteries, arterioles, capillaries, etc ... • Vena cava (superior and inferior) • Right atrium

  7. Path of blood flow (Pulmonary circulation) • right ventricle • pulmonary artery • lung ( pulmonary capillaries) • Pulmonary veins • Left atrium

  8. The Circulatory System

  9. Blood Flow Through the Heart

  10. The Heart • Electrical System • independent • stimulates contractions of heart • normally initiated in right atrium • if initiated from other areas = abnormal

  11. Electrical Conduction • Sinoatrial (SA) node • Atrioventricular node • Bundle of His (AV bundle) • Bundle branches • Purkinje fibers

  12. Vessels • Arteries • Arterioles • Capillaries • Veinioles • Veins

  13. Vessels Vasoconstriction Effect on Blood Pressure? Vasodilation Effect on Blood Pressure?

  14. Major Arteries and Veins • Aorta • Pulmonary • Carotid • Femoral • Brachial • Radial • Superior vena cava • Inferior vena cava • Pulmonary Look Up in TEXT!

  15. coronary arteries – Supply blood to heart muscle itself • The two main coronary arteries have openings immediately above the aortic valve at the beginning of the aorta where the pressures are highest

  16. Blood • Liquid Portion - Plasma • Solid Portion • Red blood cells • White blood cells • Platelets

  17. Blood Plasma - transports solids It is basically a salt solution

  18. Blood Red Blood cells - carry oxygen AKA - Erythrocytes Hemoglobin is the substance that combines with oxygen in a red blood cell

  19. Blood White Blood cells - fight infection AKA Leukocytes almost all blood cells (red or white) are made in the bone marrow.

  20. Blood Platelets – are essential for formation of blood clots. They perform coagulation. AKA - thrombocytes

  21. average amount of blood in an adult is 4-6 liters.

  22. note • Systemic Vs pulmonary circulation • Pulmonary artery • Pulmonary vein • Coronary arteries • Pericardium • Myocardium

  23. If the cardiovascular system is working as it should ...

  24. You get…Perfusion • Definition – Adequate flow of blood through body tissue or organs to meet the needs of the cell.

  25. Cardiovascular Emergencies

  26. Abnormal Heart Conditions • Angina Pectoris • Myocardial Infarction • Congestive Heart Failure

  27. Angina Pectoris • Decreased blood flow to heart muscle results in ischemia- lack of oxygen • Causes mild to moderate pain • Pain may radiate • Usually lasts 3-8 minutes (rarely longer than 15 mins) • IT GOES AWAY with no permanent damage to heart muscle • Can be difficult to differentiate from heart attack

  28. Acute Myocardial Infarction • decreased flow of blood to the myocardium leading to death of tissue • may not be provoked • moderate to severe pain • Can last between 30 minutes and several hours • May not go away with rest, O2 or nitroglycerin • Immediate transport is essential

  29. AMI • Signs and Symptoms • Sudden onset of weakness, nausea, and diaphoresis • Chest pain or discomfort • dyspnea • irregular pulse • Pain in lower jaw, arms, or back • Sudden fainting • Pulmonary edema • Sudden death • Feeling of impending doom

  30. there are always exceptions ... • Referred pain • Atypical pain • No pain

  31. Congestive Heart Failure • Causes • diseased heart valves and damaged ventricles • Chronic hypertension • obstructive pulmonary disease (emphysema, chronic bronchitis) • often a complication of an MI

  32. CHF • Heart tries to compensate. • Increased heart rate • Enlarged left ventricle • The heart can not efficiently pump the amount of fluid in the body and CHF develops • Fluid backs up into lungs or body as heart fails to pump

  33. Signs & Symptoms of CHF • Pedal edema • JVD • Ascites

  34. Critical CHF & Pulmonary Edema • dyspnea • rales & audible rales • pink frothy sputum • tachycardia • cyanosis • anxiety, restlessness

  35. Vascular emergencies • Atherosclerosis & arteriosclerosis • Thrombus • Embolus • Aneurysm

  36. Athero/arterio -sclerosis • build up of fatty deposits & calcium • causes narrowing of the lumen • can create rough inner surface that can lead to clot

  37. Athero/arterio -sclerosis • Results in: • restricted blood flow • high blood pressure • AMI

  38. Thrombus • formation of clot and debris in vessels from plaque • can become large enough to occlude vessel • partial blockage = distal reduction of O2 • complete blockage = distal tissue death

  39. Embolus • a thrombus that breaks off from vessel wall. • flows through blood vessels • may partially or completely occlude smaller artery • occlusion will result in decreased oxygen to tissue or tissue death

  40. Aneurysm • is a ballooning out of a weakened section of an artery • Possibility of rupture

  41. Ruptured aneurysm • Is a bursting of an aneurysm • can result in rapid, life threatening internal bleeding

  42. Abdominal Aortic Aneurysm (AAA) • Signs & Symptoms • “Tearing” abdominal or back pain • Pulsating mass in midline of abdomen • Unequal femoral pulses • Syncope

  43. AAA Treatment • Rapid transport • High flow O2 • Treat for shock

  44. Other Considerations • other causes of chest pain • pacemakers • defibrillator implants • CABG – coronary artery bypass graft

  45. RX for all • High flow oxygen (ventilate patient if needed!) • Position of comfort • Rapid transport

  46. medications • Lasix • Digoxin • Lanoxin • Inderal • NTG = nitroglycerin

  47. Cerebral Vascular Accidents AKA “Stroke” “Brain Attack”

  48. CVA - Cerebral Vascular Accidents • sudden change in neurological status caused by interference with blood supply to brain • obstructive • hemorragic

  49. CVA signs & symptoms • hypertension • altered mental status • hemiparesis & hemiparalysis • headache, blurred vision • one sided facial droop • aphasia • incontinence

  50. Transient Iscemic Attack • TIA’s • AKA “mini-stroke” • can have symptoms of CVA • temporary

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