This document provides information on cardiovascular function and control. It discusses:
- The path of blood flow from the arm to the liver after injection
- Heart anatomy and the two sides of the heart that pump blood to the lungs and body
- How cardiac muscle cells fire through the opening and closing of ion channels
- The cardiac cycle of diastole and systole, including ventricle contraction and valve opening/closing
- Factors that affect blood pressure like cardiac output, peripheral resistance, and neural/hormonal regulation
- Hypertension causes, risk factors, target organ effects, and treatment options
- Secondary causes of hypertension like kidney disease and drugs
This presentation describes the heart and its normal functions; describes the various disease processes of the heart; discusses cardiac disorders in terms of 4 categories; identify criteria used to determine if the cardiac patient is hospice appropriate.
Affordable Stationery Printing Services in Jaipur | Navpack n PrintNavpack & Print
Looking for professional printing services in Jaipur? Navpack n Print offers high-quality and affordable stationery printing for all your business needs. Stand out with custom stationery designs and fast turnaround times. Contact us today for a quote!
What are the main advantages of using HR recruiter services.pdfHumanResourceDimensi1
HR recruiter services offer top talents to companies according to their specific needs. They handle all recruitment tasks from job posting to onboarding and help companies concentrate on their business growth. With their expertise and years of experience, they streamline the hiring process and save time and resources for the company.
Improving profitability for small businessBen Wann
In this comprehensive presentation, we will explore strategies and practical tips for enhancing profitability in small businesses. Tailored to meet the unique challenges faced by small enterprises, this session covers various aspects that directly impact the bottom line. Attendees will learn how to optimize operational efficiency, manage expenses, and increase revenue through innovative marketing and customer engagement techniques.
Tata Group Dials Taiwan for Its Chipmaking Ambition in Gujarat’s DholeraAvirahi City Dholera
The Tata Group, a titan of Indian industry, is making waves with its advanced talks with Taiwanese chipmakers Powerchip Semiconductor Manufacturing Corporation (PSMC) and UMC Group. The goal? Establishing a cutting-edge semiconductor fabrication unit (fab) in Dholera, Gujarat. This isn’t just any project; it’s a potential game changer for India’s chipmaking aspirations and a boon for investors seeking promising residential projects in dholera sir.
Visit : https://www.avirahi.com/blog/tata-group-dials-taiwan-for-its-chipmaking-ambition-in-gujarats-dholera/
RMD24 | Retail media: hoe zet je dit in als je geen AH of Unilever bent? Heid...BBPMedia1
Grote partijen zijn al een tijdje onderweg met retail media. Ondertussen worden in dit domein ook de kansen zichtbaar voor andere spelers in de markt. Maar met die kansen ontstaan ook vragen: Zelf retail media worden of erop adverteren? In welke fase van de funnel past het en hoe integreer je het in een mediaplan? Wat is nu precies het verschil met marketplaces en Programmatic ads? In dit half uur beslechten we de dilemma's en krijg je antwoorden op wanneer het voor jou tijd is om de volgende stap te zetten.
LA HUG - Video Testimonials with Chynna Morgan - June 2024Lital Barkan
Have you ever heard that user-generated content or video testimonials can take your brand to the next level? We will explore how you can effectively use video testimonials to leverage and boost your sales, content strategy, and increase your CRM data.🤯
We will dig deeper into:
1. How to capture video testimonials that convert from your audience 🎥
2. How to leverage your testimonials to boost your sales 💲
3. How you can capture more CRM data to understand your audience better through video testimonials. 📊
Putting the SPARK into Virtual Training.pptxCynthia Clay
This 60-minute webinar, sponsored by Adobe, was delivered for the Training Mag Network. It explored the five elements of SPARK: Storytelling, Purpose, Action, Relationships, and Kudos. Knowing how to tell a well-structured story is key to building long-term memory. Stating a clear purpose that doesn't take away from the discovery learning process is critical. Ensuring that people move from theory to practical application is imperative. Creating strong social learning is the key to commitment and engagement. Validating and affirming participants' comments is the way to create a positive learning environment.
The world of search engine optimization (SEO) is buzzing with discussions after Google confirmed that around 2,500 leaked internal documents related to its Search feature are indeed authentic. The revelation has sparked significant concerns within the SEO community. The leaked documents were initially reported by SEO experts Rand Fishkin and Mike King, igniting widespread analysis and discourse. For More Info:- https://news.arihantwebtech.com/search-disrupted-googles-leaked-documents-rock-the-seo-world/
"𝑩𝑬𝑮𝑼𝑵 𝑾𝑰𝑻𝑯 𝑻𝑱 𝑰𝑺 𝑯𝑨𝑳𝑭 𝑫𝑶𝑵𝑬"
𝐓𝐉 𝐂𝐨𝐦𝐬 (𝐓𝐉 𝐂𝐨𝐦𝐦𝐮𝐧𝐢𝐜𝐚𝐭𝐢𝐨𝐧𝐬) is a professional event agency that includes experts in the event-organizing market in Vietnam, Korea, and ASEAN countries. We provide unlimited types of events from Music concerts, Fan meetings, and Culture festivals to Corporate events, Internal company events, Golf tournaments, MICE events, and Exhibitions.
𝐓𝐉 𝐂𝐨𝐦𝐬 provides unlimited package services including such as Event organizing, Event planning, Event production, Manpower, PR marketing, Design 2D/3D, VIP protocols, Interpreter agency, etc.
Sports events - Golf competitions/billiards competitions/company sports events: dynamic and challenging
⭐ 𝐅𝐞𝐚𝐭𝐮𝐫𝐞𝐝 𝐩𝐫𝐨𝐣𝐞𝐜𝐭𝐬:
➢ 2024 BAEKHYUN [Lonsdaleite] IN HO CHI MINH
➢ SUPER JUNIOR-L.S.S. THE SHOW : Th3ee Guys in HO CHI MINH
➢FreenBecky 1st Fan Meeting in Vietnam
➢CHILDREN ART EXHIBITION 2024: BEYOND BARRIERS
➢ WOW K-Music Festival 2023
➢ Winner [CROSS] Tour in HCM
➢ Super Show 9 in HCM with Super Junior
➢ HCMC - Gyeongsangbuk-do Culture and Tourism Festival
➢ Korean Vietnam Partnership - Fair with LG
➢ Korean President visits Samsung Electronics R&D Center
➢ Vietnam Food Expo with Lotte Wellfood
"𝐄𝐯𝐞𝐫𝐲 𝐞𝐯𝐞𝐧𝐭 𝐢𝐬 𝐚 𝐬𝐭𝐨𝐫𝐲, 𝐚 𝐬𝐩𝐞𝐜𝐢𝐚𝐥 𝐣𝐨𝐮𝐫𝐧𝐞𝐲. 𝐖𝐞 𝐚𝐥𝐰𝐚𝐲𝐬 𝐛𝐞𝐥𝐢𝐞𝐯𝐞 𝐭𝐡𝐚𝐭 𝐬𝐡𝐨𝐫𝐭𝐥𝐲 𝐲𝐨𝐮 𝐰𝐢𝐥𝐥 𝐛𝐞 𝐚 𝐩𝐚𝐫𝐭 𝐨𝐟 𝐨𝐮𝐫 𝐬𝐭𝐨𝐫𝐢𝐞𝐬."
Discover the innovative and creative projects that highlight my journey throu...dylandmeas
Discover the innovative and creative projects that highlight my journey through Full Sail University. Below, you’ll find a collection of my work showcasing my skills and expertise in digital marketing, event planning, and media production.
Personal Brand Statement:
As an Army veteran dedicated to lifelong learning, I bring a disciplined, strategic mindset to my pursuits. I am constantly expanding my knowledge to innovate and lead effectively. My journey is driven by a commitment to excellence, and to make a meaningful impact in the world.
2. PATH OF BLOOD FLOW
Scenario:
• You inject a medication into the client’s arm
• Within a few minutes, some of that drug has
reached the client’s liver and is being
deactivated
Question:
• How did it get there?
7/1/2014 2
3. SIMPLIFIED PATH OF BLOOD FLOW
right
heart
lungs
left
heart
body
7/1/2014 3
5. QUESTION
Tell whether the following statement is true or
false:
The pulmonary circulation moves blood
through the left side of the heart.
7/1/2014 5
6. ANSWER
False
The right side of the heart pumps blood to the
lungs through the pulmonary arteries, where
gas exchange takes place. The left side of the
heart is considered systemic circulation
because blood is pumped to all body tissues.
7/1/2014 6
8. THE BASICS OF CELL FIRING
• Cells begin with a
negative charge:
resting membrane
potential
• Stimulus causes
some Na+ channels
to open
• Na+ diffuses in,
making the cell
more positive
Threshold potential
Resting
membrane
potential
Stimulus
7/1/2014 8
9. THE BASICS OF CELL FIRING (CONT.)
• At threshold potential,
more Na+ channels
open
• Na+ rushes in, making
the cell very positive:
depolarization
• Action potential: the cell
responds (e.g., by
contracting)
Threshold potential
Resting
membrane
potential
Stimulus
Action potential
7/1/2014 9
10. THE BASICS OF CELL FIRING (CONT.)
• K+ channels open
• K+ diffuses out,
making the cell
negative again:
repolarization
• Na+/K+ ATPase
removes the Na+ from
the cell and pumps
the K+ back in
Threshold potential
Resting
membrane
potential
Stimulus
Action potential
7/1/2014 10
11. CARDIAC CELL FIRING
• Cells begin with a negative
charge: resting membrane
potential
• Calcium leak lets Ca2+
diffuse in, making the cell
more positive
Threshold potential
Resting
membrane
potential
Calcium leak
7/1/2014 11
12. CARDIAC MUSCLE FIRING (CONT.)
• At threshold potential,
more Na+ channels
open
• Na+ rushes in, making
the cell very positive:
depolarization
• Action potential: the
cell responds (e.g., by
contracting)
Threshold potential
Resting
membrane
potential
Action potential
Calcium leak
7/1/2014 12
13. CARDIAC MUSCLE FIRING (CONT.)
• K+ channels open
• K+ diffuses out, making
the cell negative again,
but Ca2+ channels are
still allowing Ca2+ to
enter
• The cell remains
positive: plateau
Threshold potential
PLATEAU
Action potential
Calcium leak
7/1/2014 13
14. CARDIAC MUSCLE FIRING (CONT.)
• During plateau,
the muscle
contracts
strongly
• Then the Ca2+
channels shut
and it repolarizes
Threshold potential
PLATEAU
Action potential
Calcium leak
7/1/2014 14
15. QUESTION
Which ion channels allow cardiac muscle to
fire without a stimulus?
a. Na+
b. K+
c. Ca2+
d. Cl-
7/1/2014 15
16. ANSWER
c. Ca2+
In the S-A node and A-V node, resting cardiac
muscle cells have open Ca2+ channels. This
allows Ca2+ to leak into the cells, making them
more positive (the cells reach threshold this
way without the need for a stimulus).
7/1/2014 16
18. HEART CONTRACTION
How would each of the following affect heart
contraction:
• A calcium-channel blocker
• A Na+ channel blocker
• A drug that opened Na+ channels
• A drug that opened K+ channels
7/1/2014 18
19. CARDIAC CYCLE—DIASTOLE
• Ventricles relaxed
• Blood entering atria
• Blood flows through AV valves into
ventricles
• Semilunar valves are closed
7/1/2014 19
22. CARDIAC CYCLE—SYSTOLE
• Ventricles contract
• Blood pushes against AV valves and they shut
• Blood pushes through semilunar valves into
aorta and pulmonary trunk
7/1/2014 22
23. QUESTION
Which of the following statements is true
about ventricular systole?
a. Atria contract
b. Ventricles contract
c. AV valves are open
d. Semilunar valves are closed
7/1/2014 23
24. ANSWER
b. Ventricles contract
During ventricular systole, the ventricles
contract. Because blood is being forced from
the ventricle, semilunar valves must be open
and AV valves, closed. The atria is in diastole
(relaxation) during ventricular systole.
7/1/2014 24
25. CARDIAC CYCLE
Discussion:
• Arrange these steps in the proper order:
– Ventricles relax – First heart sound
– Systole – Semilunar valves open
– Diastole – AV valves close
– AV valves open – Semilunar valves close
– Ventricles contract – Second heart sound
7/1/2014 25
26. PRESSURE, RESISTANCE, FLOW
• Fluid flow through a vessel depends on:
– The pressure difference between ends of the vessel
• Pressure pushes the fluid through
• Pressure keeps the vessel from collapsing
– The vessel’s resistance to fluid flow
• Small vessels have more resistance
• More viscous fluids have greater resistance
7/1/2014 26
27. PRESSURE, RESISTANCE, FLOW OF
BLOOD
• Blood flow through a vessel depends on:
– Heart creating pressure difference between ends
of the vessel
• Heart pushing the blood through
• Blood pressure keeping the vessels open
– The vessel’s resistance to fluid flow
• Constricting arterioles increasing resistance
• Increased hematocrit increasing resistance
7/1/2014 27
28. DISCUSSION
How will each of these factors affect
arteriole size and peripheral resistance?
• Lactic acid • Low PO2
• Cold • Histamine
• Endothelin • Heat
• NO • Adenosine
7/1/2014 28
29. BLOOD PRESSURE
• BP = CO x PR
• Blood Pressure = Cardiac Output × Peripheral
Resistance
• CO = SV X HR
• In healthy adult
– Highest pressure(systolic)- < 120 mmHg
– Lowest pressure (diastolic) < 80 mmHg
• Difference between systolic and diastolic
pressure = pulse pressure
7/1/2014 29
30. REGULATION OF BP
Short term regulation of BP relies on neural and
hormonal mechanisms
A) Neural centers are located in the reticular
formation of lower pons and medulla of the
brain
• Area also called cardiovascular center
• ANS control of BP is mediated by intrinsic
circulatory reflexes, extrinsic reflexes, and higher
neural control centers
• Intrinsic mechanism involves Baroreceptors and
chemoreceptors
7/1/2014 30
31. REGULATION OF BP CON’T
• Baroreceptors
– Pressure sensitive receptors
– Located in the walls of blood vessels and heart
– Carotid & aortic baroreceptors are located in
strategically
– Send impulse to the cardiovascular centers
• Arterial chemoreceptors
– Sensitive to changes in oxygen, Carbondioxide, and
Hydrogen ion content of blood
– Located in carotid and aortic bodies
– Can also induce widespread vasoconstriction
7/1/2014 31
32. HORMONAL MECHANISMS
• Involves: renin- angiotensin- aldosterone mechanism,
Vasopressin, epinephrine
• Renin
– An enzyme found in the juxtaglomerula cells of the kidneys
– Released in blood where it converts
angiotensinogen(plasma protein) to angiotensin I
– Angiotensin I is converted to angiotensin II in the lungs by
Angiotensin Converting Enzyme (ACE) present in the
endothelium of the lung vessels
– Angiotensin II :
• Is a strong vasoconstrictor (arterioles and Veins)
• Stimulates aldosterone secretion from adrenal (cortex) gland
bringing about Na/water retention by kidneys
7/1/2014 32
33. VASOPRESSIN
• Released from the posterior pituitary gland in
response to decreased blood volume and BP,
increased osmolality of body fluids
• Has vasoconstrictor effect on blood vessels
especially those of the planchnic circulation
that supplies the abdominal viscera
7/1/2014 33
34. HYPERSTENSION
• Classified into Primary (essential) and
secondary hypertension
• Essential is the most common accounting for
90-95% of HT cases
7/1/2014 34
BP classification Systolic BP(mmHg) Diastolic BP (mmHg)
Normal < 120 And < 80
Pre-hypertension 120 – 139 And 80 – 89
Stage 1 Hypertension 140 – 149 And 90 - 99
Stage 2 Hypertension ≥ 160 ≥ 100
35. RISK FACTORS FOR HT
• Family history, race, age related increase
• Life style
– High sodium intake, excessive calorie intake and
obesity, physical inactivity, excessive alcohol intake
• Oral contraceptives
7/1/2014 35
36. MANIFESTATION
• Target organ damage affecting the following organs
• Heart
– Left ventricular hypertrophy
– Angina or prior myocardial infarction
– Prior coronary revascularization
– Heart failure
• Brain
– Stroke or transient ischemic attack
• Chronic kidney disease
• Peripheral vascular disease
• Retinopathy
7/1/2014 36
37. DIAGNOSIS
• Repeated BP measurement
• BP measurement should be taken when the
person is relaxed and has rested for at least 5
minutes and had not smoked or taken caffein
within 30 minutes
• Pharmacological treatment based on:
– severity of disease
– Presence of target organ disease
– Existence of other conditions and risk factors
7/1/2014 37
39. SECONDARY HYPERTENSION
• Most common causes are: Kidney disease,
adrenocortical disorder, phenochromocytoma,
coarctation of the aorta, drugs such as cocaine
• HT arising from kidney disease is usually a result of:
– Acute glomerulonephrites
– Acute renal failure
– End stage renal disease
• 80% of patients with Chronic renal failure have HT
• Most acute kidney disorders result in decreased urine
formation, retension of water & Na and HT
• Reduced renal blood flow causes the affected kidney
to release excess amounts of renin
7/1/2014 39
40. ORTHOSTATIC HYPERTENSION
• Read about its causes and management
• Also read about venous thrombosis especially
Deep Vein Thrombosis( DVT)
7/1/2014 40
41. QUESTION
Tell whether the following statements is true
or false:
In patients with hypertension (high blood
pressure), peripheral resistance is increased.
7/1/2014 41
42. ANSWER
True
In hypertension, blood vessels are
constricted/narrowed. Smaller vessels
increase resistance (it’s harder to push the
same amount of fluid/blood through a tube
that has become smaller).
7/1/2014 42