Cardiovascular System Objectives After studying this chapter you will be able to: •Name the parts of the cardiovascular system and discuss the function of each part. •Define combining forms used in building words that relate to the cardiovascular system. •Identify the meaning of related abbreviations. •Name the common diagnoses, clinical procedures, and laboratory tests used in treating the cardiovascular system. Objectives Part 2 •List and define the major pathological conditions of the cardiovascular system. •Explain the meaning of surgical terms related to the cardiovascular system. •Recognize common pharmacological agents used in treating the cardiovascular system. The Heart The Heart •Pumps blood through the blood vessels to all body cells. •Is divided into right and left sides by the •Is covered by a protective sac called the ____cardium which is divided into two layers the visceral and parietal pericardium. •Each side consists of an atria and a ventricle. __________ Layers of the Heart Layers of the Heart Inside the pericardium, the heart has three layers of tissue. •___cardium (outermost layer) endocardium •___cardium (middle layer of muscular tissue) •______cardium (inner layer) myocardium epicardium Heart Chambers Heart Chambers •Right and left atria are the ______ chambers of the heart. •Right and left ventricles are the lower chambers of the heart. •Fibers in the ventricles (_______ fibers) cause the ventricles to contract. •Blood flows through the heart in only one direction regulated by valves. Arteries and Veins ________ •Carry blood away from the heart. V e i n s •Carry blood ________ the heart. Valves of Valves ofthe theHeart Heart Atrioventricular Valves •________ valve (mitral) Semilunar Valves •Pulmonary valve •_______ valve •Tricuspid valve Cross Sectional Top View of Heart Control blood flow within the heart Prevent the backflow of blood into the heart Coronary Coronary Circulation Circulation Circulation of blood within the heart muscle by the _________ arteries. •Coronary arteries branch off of the _______, which is the largest artery in the body. •Coronary arteries encircle the heart to supply the heart muscle with about ______ gallons of blood daily. •The heart requires more _______ than any other organ in the body except the brain. Pulmonary Pulmonary Circulation Circulation of blood between the heart and lungs. •Pulmonary ________ are the only arteries to carry blood low in oxygen. •Pulmonary ______ are the only veins to carry oxygen rich blood. Circulation Systemic Systemic CirculationCirculation Flow of blood between the heart and the cells of the entire body. artery arteriole _________ venule •Blood travels through the body in a surge as a result of the heart contractions. •Blood vessels become smaller in diameter as the blood leaves the heart. vein •Remember arteries leave the heart and veins return to the heart. Capillaries are the ______ blood vessels and they serve as a transfer station between the arteries and veins. Blood Blood Pressure Pressure •Measures the force of the blood surging against the walls of the arteries. ________ Contraction phase of the heart ________ Relaxation phase of the heart Conduction System Conduction System Sinoatrial node (_________) Atrioventricular ______ _______ of His Right and Left ______ Branches ________ Fibers Conduction System Conduction System Part 2 The heart’s __________ causes regular contracting of the myocardium resulting in a regular heartbeat or pulse. Contraction Phases •Polarization (________) •Repolarization (______) •Depolarization (__________) Conduction System Conduction System Part Factors affecting the heart rate: 3 •______ status •Physical activity •__________ During ____ cardiac cycle the heart contracts and relaxes. Cardiac Cycle = 1 contraction + 1 relaxation Fetal Circulation Fetal Circulation Structures unique to the fetus: •Foramen ovale •Ductus arteriosus •Ductus venosus Note the umbilical cord contains two arteries and one vein. Combining Forms & Combining Form Meaning Abbreviations [angi(o)] angi (o) blood _______ aort (o) aorta arteri (o) ______ ather (o) fatty matter atri (o) _________ cardi (o) heart hemangi (o) Blood ______ Combining Forms & Combining Form Meaning Abbreviations [pericardi(o)] pericardium pericardi (o) phleb (o) ________ sphygm (o) pulse thromb (o) blood _____ vas (o) blood vessel ven (o) ____________ Combining Forms & Abbreviation Meaning Abrbeviations [AcG] AcG accelerator globulin AF atrial __________ AS aortic stenosis ASCVD _______sclerotic cardiovascular disease ASD atrial septal defect ASHD __________sclerotic heart disease AV atrioventricular Combining Forms & Meaning Abbreviations blood [BP] pressure Abbreviation BP CABG coronary artery ______ graft CAD coronary artery _______ cath catheter CCU ________ care unit CHD coronary heart disease CHF congestive heart ______ Combining Forms & Meaning Abbreviations [CO] cardiac ________ Abbreviation CO CPK creatine phosphokin____ CPR _______pulmonary resuscitation CVA Cerebro_______ accident CVD cardiovascular ______ DSA digital subtraction angiography DVT deep venous __________ Diagnostic, Procedural & Laboratory Cardiology is the treatment ofTests cardiovascular diseases and the physician who specializes in heart conditions is called a cardiolog_____. Auscultation may reveal the following abnormal heart sounds: •_______ •Bruit •_______ Common Diagnostic Tests Common Diagnostic Tests Exercise tolerance test (ETT) •Patients exercise on a ___________ and the technician monitors the heart rate and respiratory rate. Electrocardiography •Produces an electrocardiogram which measures the amount of ____________ that flows through the heart. •Electrodes placed on the skin at specific points detect the heart’s electrical impulses. Tests Involving X-Rays Tests involving x-rays •Angiocardiogram -injection of a ____ followed by x-rays of the heart and the heart’s large blood vessels Others Tests •angiogram •arteriogram •aortogram •venogram(phlebogram) •ventriculogram Ultrasound Tests Ultrasound tests produce images by using sound waves. Doppler ultrasound •Measures _______ ______ in certain blood vessels Echocardiography •Records ______ _______ to show the structure and movement of the heart Other Noninvasive Tests Other Noninvasive Tests •Cardiac scan •Positron emission tomography (____) •Multiple-gated acquisition (_____) angiography •Magnetic resonance imaging (MRI) Other procedures require insertion of an actual device such as a catheter into a vein or artery, and the device is guided to the heart as with cardiac catheterizations. Laboratory Tests Laboratory Tests The flow of blood in the arteries is affected by the amount of cholesterol and triglycerides contained in the blood. LDL HDL •_____-density lipoproteins actually remove lipids from the arteries and protect from the formation of blockages. •___-density lipoproteins and very low-density lipoproteins cause cholesterol to form blockages in the arteries. Laboratory Test Part 2 Laboratory Tests Also help to diagnose myocardial infarction. •Troponin T and troponin I are proteins found in the heart and tests •Cardiac enzymes also called for these can serum enzyme tests measure the diagnose a amount of enzymes released into myocardial the blood by the damaged heart infarction faster muscle during a myocardial than most other lab infarction. tests. -CPK (creatine phosphokin___) -LDH (lactate dehydrogen___) -GOT (glutamic oxaloacetic transamin___) Risk Factors to Developing Cardiovascular Disease (CVD) Pathology poor diet smoking lack of _________ Heart Rhythm Abnormal rhythms are called arrhythmias. •______cardia •Flutter •Tachycardia •_______ •Atrial Fibrillation •Gallop •Premature atrial contractions (PAC) •Premature ventricular contractions (PVC) Blood Pressure Blood Pressure abnormalities can damage the heart and other body systems. •Hypertension (too _____) •Hypotension (too _____) •Essential hypertension occurs without any specific cause. •Secondary hypertension has a known cause, for example, high-_____ intake. Diseases of the Blood Vessels ________ _________ atheroma Diseases of the Blood Vessels embolus varicose veins phlebitis Coronary Artery Disease Coronary Artery Disease Refers to any condition that reduces the nourishment the heart receives from the _______ flowing through the arteries of the heart, such as: Aortic stenosis _______ Pectoris Coarctation of the aorta Pulmonary artery stenosis General Heart & Lung Diseases General Heart and Lung Diseases Myocardial infarction •Disruption of ______ ______ to the heart muscle; also called heart attack. Cardiac Arrest •Also known as __________, is the sudden stopping of the heart. Congestive Heart Failure •Occurs when the heart is unable to ______ the necessary amount of blood. Specific Inflammatory Heart Conditions Specific Inflammatory Conditions of the Heart •bacterial endocarditis •endocarditis •pericarditis •myocarditis Other Conditions •cardiomyopathy •intracardiac tumor Congenital Heart Conditions Congenital Heart Conditions •Patent ductus arteriosus •________ defect •Tetralogy of Fallot Valve Conditions •Aortic regurgitation •_________ insufficiency •Mitral valve prolapse •Tricuspid _________ •Valvulitis •Rheumatic heart disease Surgical Terms The goal of most cardiovascular surgery is to improve _____ ____ to all body cells. Percutaneous transluminal coronary angioplasty (_____) is a surgical procedure in which a balloon catheter is inserted into a blocked blood vessel to increase the blood flow of that vessel. PTCA Narrowed artery with balloon catheter positioned. Inflated balloon presses against arterial wall. Cardiac Catheterization Cardiac Catheterization is the most common type of operation performed in the United States. Other procedures involving catheters: Balloon valvuloplasty •Used to open narrowed cardiac ______ openings. Coronary angioplasty •Used to open a blood ___________. Angioscopy •Uses a fiberoptic catheter to view the interior of a blood vessel Coronary Bypass Surgery Some conditions require the creation of a bypass around blockages. ____________ bypass surgery •A vein from another part of the body is often used as a graft to bypass an arterial blockage. •Saphenous _____ and the mammary arteries are commonly used as grafts for this procedure. Fontan’s operation •Creates a bypass from the right atrium to the main ___________ artery. Removal & and Replacement Surgical removal replacementSurgery procedures •Heart transplant •Thrombectomy •Embolectomy •Atherectomy •Valve replacement •Endarterectomy •Arteriotomy •Valvotomy •Venipuncture Surgical reconstruction and repair procedures •Valvuloplasty •Anastomosis Pharmacology CARDIOVASCULAR Drug therapy for the cardiovascular system generally treats the following conditions: CONDITIONS •___________ •heart attack •high ______ pressure •high cholesterol •congestive heart ____________ •rhythm disorders •vascular problems Antianginals Relieve ____ and prevent attacks of angina Antianginals Three Categories of Drugs: •nitrates (nitroglycerine) •_____ blockers (atenolol) •calcium ________ blockers (nifedipine) Hypertension Medications for: High blood pressure may require treatment with one or more drugs. HYPERTENSION •Vaso______ •___________ •angiotensin converting enzyme (ACE) inhibitors Congestive HeartMedications Failure for: Congestive heart failure is treated with medications that increase myocardial _____. In certain situations the blood vessels may need to be narrowed as well. CONGESTIVE HEART FAILURE •ACE inhibitors •__________ •cardiotonics •Vaso___________ Rhythm Disorders Medications for: Rhythm disorders are treated with medications that _________ the heart rate by affecting the nervous system that controls the heart rate. RHYTHM DISORDERS •______ blockers •calcium channel blockers Pharmacology – Other Other Medications Medications drugs help the body excrete unwanted cholesterol. ________________ and antiplatelet medications inhibit the ability of the blood to ________. Medications used for vascular problems may include drugs that decrease the ___________ of the blood or drugs that increase the amount of blood the heart is able to pump.