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The Cardiovascular System

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The Cardiovascular System

  1. 1. The Cardiovascular System
  2. 2. THE HEART
  3. 3. Anatomy <ul><li>Location and Size </li></ul><ul><ul><li>Fist size </li></ul></ul><ul><ul><li>Weights less than a pound </li></ul></ul><ul><ul><li>Located within the thorax flanked laterally by the lungs </li></ul></ul><ul><ul><li>Base: posterosuperior, 2 nd ICS </li></ul></ul><ul><ul><li>Apex: anteroinferior, 5 th ICS </li></ul></ul>
  4. 4. Anatomy <ul><li>Coverings </li></ul><ul><ul><li>Covered by serous membrane pericardium </li></ul></ul><ul><ul><ul><li>Two layers: </li></ul></ul></ul><ul><ul><ul><ul><li>Visceral pericardium </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Parietal pericardium </li></ul></ul></ul></ul><ul><ul><li>Serous fluid </li></ul></ul><ul><ul><ul><li>Pericarditis: results to decreased amount of serous fluid </li></ul></ul></ul>
  5. 5. Anatomy <ul><li>Wall Layers </li></ul><ul><ul><li>Epicardium </li></ul></ul><ul><ul><li>Myocardium </li></ul></ul><ul><ul><ul><li>Made up of cardiac muscle bundles twisted in a ring like arrangement </li></ul></ul></ul><ul><ul><ul><li>Contracting layer </li></ul></ul></ul><ul><ul><li>Endocardium </li></ul></ul><ul><ul><ul><li>Endothelial lining of heart chambers </li></ul></ul></ul><ul><ul><ul><li>Continuous with the endothelium of great vessels </li></ul></ul></ul>
  6. 8. Anatomy <ul><li>Valves </li></ul><ul><ul><li>Atrioventricular valves </li></ul></ul><ul><ul><ul><li>Left: BICUSPID/ Mitral </li></ul></ul></ul><ul><ul><ul><li>Right: TRICUSPID </li></ul></ul></ul><ul><ul><ul><li>Chordae tendinae </li></ul></ul></ul><ul><ul><li>Semilunar Valves </li></ul></ul><ul><ul><ul><li>Pulmonary </li></ul></ul></ul><ul><ul><ul><li>Aortic </li></ul></ul></ul><ul><ul><ul><li>Incompetent Valve </li></ul></ul></ul><ul><ul><ul><li>Valvular Stenosis </li></ul></ul></ul>
  7. 20. Anatomy <ul><li>Chambers </li></ul><ul><ul><li>Atria </li></ul></ul><ul><ul><ul><li>Receiving chambers </li></ul></ul></ul><ul><ul><li>Ventricles </li></ul></ul><ul><ul><ul><li>Discharging chambers </li></ul></ul></ul>
  8. 21. Anatomy <ul><li>Great Vessels </li></ul><ul><ul><li>Superior and inferior vena cava </li></ul></ul><ul><ul><li>Pulmonary arteries and veins </li></ul></ul><ul><ul><li>Aorta </li></ul></ul>
  9. 22. Anatomy <ul><li>Cardiac Circulation </li></ul><ul><ul><li>Coronary Arteries </li></ul></ul><ul><ul><ul><li>At AV groove from aorta </li></ul></ul></ul><ul><ul><ul><li>Other major branches: </li></ul></ul></ul><ul><ul><ul><ul><li>Left: </li></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>anterior interventricular </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>circumflex </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><li>Right </li></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>posterior interventricular </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>marginal </li></ul></ul></ul></ul></ul><ul><ul><li>Cardiac Veins draining to the Cardiac Sinus </li></ul></ul><ul><ul><li>Angina pectoris </li></ul></ul><ul><ul><li>Myocardial infarction </li></ul></ul>
  10. 24. Physiology <ul><li>Conduction System of the Heart </li></ul><ul><ul><li>Spontaneous and independent regular contraction </li></ul></ul><ul><ul><li>Atrial cells : 60 beats per minute </li></ul></ul><ul><ul><li>Ventricular cells : 20-40 beats per minute </li></ul></ul><ul><ul><li>Controlling system: </li></ul></ul><ul><ul><ul><li>ANS </li></ul></ul></ul><ul><ul><ul><li>INTRINSIC CONDUCTING SYSTEM OR NODAL SYSTEM </li></ul></ul></ul>
  11. 25. Physiology <ul><li>Intrinsic Conducting System </li></ul><ul><ul><li>Contraction rate NV: 75 beats per minute </li></ul></ul><ul><ul><li>Depolarizes fro atrium to ventricle </li></ul></ul><ul><ul><li>Parts: </li></ul></ul><ul><ul><ul><li>Sinoatrial node (right atrium) </li></ul></ul></ul><ul><ul><ul><li>Atrioventricular node (at AV junction) </li></ul></ul></ul><ul><ul><ul><li>Atrioventricular bundle or Bundle of His and bundle branches (at interventricular septum) </li></ul></ul></ul><ul><ul><ul><li>Purkinje fibers (ventricular walls) </li></ul></ul></ul>
  12. 26. Physiology <ul><li>Sinoatrial Node </li></ul><ul><ul><li>“ pacemaker” of the heart </li></ul></ul><ul><ul><li>With the highest rate of depolarization in the whole system </li></ul></ul><ul><ul><li>From atria to AV node -atrial contraction </li></ul></ul><ul><ul><li>Brief pause </li></ul></ul><ul><ul><li>AV node to bundle, then to branches, then to Purkinje fibers – ventricular contraction starting at apex </li></ul></ul><ul><ul><li>Heart Block – AV node damage </li></ul></ul><ul><ul><li>Fibrillation – cardiac “shuddering” due to ischemia </li></ul></ul><ul><ul><li>Tachycardia – over 100 beats </li></ul></ul><ul><ul><li>Bradycardia – less than 60 beats </li></ul></ul>
  13. 27. Physiology <ul><li>Cardiac Cycle </li></ul><ul><ul><li>Events of a complete heartbeat (0.8 sec) </li></ul></ul><ul><ul><li>Systole – heart (ventricular) contraction </li></ul></ul><ul><ul><li>Diastole – heart (ventricular) relaxation </li></ul></ul>
  14. 28. 1 2 3
  15. 29. Physiology <ul><li>Heart Sounds </li></ul><ul><ul><li>Lub (S1) and the dup (S2) </li></ul></ul><ul><ul><ul><li>S1 </li></ul></ul></ul><ul><ul><ul><ul><li>AV valves closing </li></ul></ul></ul></ul><ul><ul><ul><li>S2 </li></ul></ul></ul><ul><ul><ul><ul><li>Semilunar valves closing </li></ul></ul></ul></ul><ul><ul><li>murmurs – turbulence due to obstructions, valve incompetency or stenosis </li></ul></ul>
  16. 30. Physiology <ul><li>Cardiac Output </li></ul><ul><ul><li>Amount of blood pumped out by each ventricle in 1 minute </li></ul></ul><ul><ul><li>Stroke volume – volume of blood pumped out by each ventricle in one minute </li></ul></ul><ul><ul><li>Starling’s Law – the more stretched cardiac muscles are, the stronger their contraction would be (based on venous return) </li></ul></ul><ul><ul><ul><li>Congestive Heart Failure </li></ul></ul></ul><ul><ul><ul><li>Pulmonary congestion (edema in lungs) – LV weakens </li></ul></ul></ul><ul><ul><ul><li>Peripheral Congestion (edema in distal parts) – RV weakens </li></ul></ul></ul>
  17. 31. Cardiac Output Heart Rate Stroke Volume <ul><li>Sympathetic </li></ul><ul><li>Epinephrine and </li></ul><ul><li>Thyroxine </li></ul><ul><li>1/Parasympathetic </li></ul><ul><li>Age </li></ul><ul><li>Sex </li></ul>Preload 1/Afterload Contractility Venous Return Venous Tone Total Blood Volume

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