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American College of Acupuncture and Oriental Medicine

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Overview: Join Dr. Faiza in this in-depth lecture on cardiac impulse and the rhythmical excitation of the heart. This presentation covers the intricate pathways and mechanisms that ensure the efficient conduction of electrical impulses through the heart, leading to coordinated myocardial contractions. Attendees will gain a comprehensive understanding of the normal sequence of cardiac depolarization, the specialized conductive pathways, and the ionic basis of pacemaker potentials. Learning Objectives: Trace the normal sequence of cardiac depolarization via specialized conductive pathways and cardiac myocytes. Illustrate the velocity of conduction of cardiac impulses through these pathways. Draw and label a typical pacemaker action potential. Describe the ionic basis of various phases of the pacemaker potential. Key Topics: Generation of Impulse: Mechanisms of rhythmical excitation in the heart. Conduction of Impulse: How impulses are transmitted and why atrial syncytium contracts ahead of ventricular syncytium. Specialized Excitatory & Conductive System: Detailed examination of the SA node, AV node, bundle branches, and Purkinje fibers. SA Nodal Action Potential: Phases of pacemaker potential, ionic movements, and self-excitation mechanisms. Transmission Pathways: Role of anterior and posterior fascicles, internodal, and interatrial pathways. Clinical Significance: Implications of delayed conduction and conditions like Stokes-Adams syndrome and ectopic pacemakers. Target Audience: This lecture is tailored for medical students, physiology scholars, healthcare professionals, and anyone interested in cardiac physiology and the mechanisms of cardiac impulse conduction. It is particularly beneficial for those preparing for exams or seeking to enhance their clinical knowledge in Applied physiology of cardiovascular system and internal medicine.

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Learning Objectives: Contrast the neural and local control of circulations through special regions. Compare the physiological significance of variation in circulations through special regions. Content Overview: This lecture provides a comprehensive exploration of circulation in specialized regions of the body, including coronary, cerebral, splanchnic, cutaneous, fetal, skeletal muscle, and pulmonary circulations. The physiological and anatomical considerations, regulation mechanisms, and unique features of each type of circulation are discussed. Key concepts such as autoregulation, local metabolic factors, and neural influences are covered in detail. Key Topics: Coronary Circulation: Anatomy and physiology of coronary blood supply. Phasic changes in blood flow during systole and diastole. Regulation by autonomic nervous system and local metabolic factors (hypoxia, adenosine). Cerebral Circulation: Control by local metabolic factors (CO2, H+). Autoregulation and hyperemia. Anatomy of cerebral blood supply and special features of cerebral blood vessels. Splanchnic Circulation: Anatomy and regulation of blood flow to the gastrointestinal organs. Role of sympathetic and parasympathetic nervous systems. Chemical factors and the concept of autoregulatory escape. Cutaneous Circulation: Thermoregulatory function and dense nervous innervation. Mechanisms of vasodilation and vasoconstriction. Blood reservoir function and responses to mechanical stimuli. Fetal Circulation: Unique aspects of fetal blood flow including umbilical vessels, ductus venosus, foramen ovale, and ductus arteriosus. Changes in circulation at birth and the stimuli for these changes. Skeletal Muscle Circulation: Regulation during rest and exercise. Role of nervous and local metabolic control. Circulatory adjustments during physical activity. Pulmonary Circulation: Characteristics and regulation of pulmonary blood flow. Zones of blood flow in the lungs and the effect of gravity. Response to hypoxia and other factors influencing pulmonary vascular resistance

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Title: Application of Checklist-Based Nursing Care Process in Patients Undergoing Intervention for Coronary Chronic Total Occlusion: A Quasi-Randomized Study Presenter: Sonia Pal, M.Sc. Nursing 2nd Year Journal: BMC Nursing (2023) Authors: Xia Ge, Haiyang Wu, Zhe Zang, and Jiayi Xie DOI: 10.1186/s12872-023-03627-8 Study Overview: This presentation focuses on the effectiveness of a checklist-based nursing care process for patients undergoing interventions for coronary chronic total occlusion (CTO). The study employs a quasi-randomized design to assess improvements in patient care outcomes. Key Points: Background: CTO interventions are complex, and traditional nursing methods have not been highly effective, necessitating the exploration of new approaches. Objective: To investigate the effectiveness of a checklist-based nursing care process in improving care quality, reducing patient anxiety, increasing patient satisfaction, and minimizing adverse events. Methodology: Design: Quasi-randomized study Setting: Department of Cardiology, Shengjing Hospital, China Medical University, Shenyang, China Participants: 120 patients undergoing CTO interventions Groups: Intervention group (checklist-based care) and control group (standard care) Tools: Preoperative and postoperative PCI nursing care checklists, Zung Self-Rating Anxiety Scale, satisfaction questionnaires for doctors and patients Ethical Considerations: The study adhered to the Declaration of Helsinki, with informed consent obtained from all participants. Results: The study aimed to demonstrate that checklist-based nursing care could enhance nursing efficiency and patient outcomes compared to conventional methods. Quality Control: A quality control team ensured adherence to the checklist and study protocol, with regular training and supervision of nursing staff. Conclusion: The presentation concludes with findings supporting the effectiveness of checklist-based nursing care in CTO interventions, suggesting improvements in patient care processes and outcomes. The study highlights the importance of structured nursing protocols in complex medical procedures.

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