Chapter 10- Cardiovascular System Flashcards
The cardiovascular system is also called:
The circulatory system
What does the cardiovascular system bring?
Oxygen, nutrients, water, and other substances to the body’s cells
Closed systems include:
- Blood vessels (arteries, arterioles, capillaries, venules, and veins
- Heart (pumps blood)
- Blood (contains nutrients and waste products)
Arteries-
Strong and stretchy, carry blood from the heart
Arterioles:
small, moves blood to capillaries.
Capillaries-
Thin-walled vessels: allow for exchange of
oxysen, rustleras, waste products and other
substances
Venules:
Collect blood from capillaries; begin journey to the heart
Veins:
Collect blood from venules and return blood to the heart
Radial artery:
By the wrist: used to take pulse
Carotid artery:
In the neck, used to check for heartbeat in an unresponsive adult
Median cubital vein:
In the arm, commonly used for phlebotomy
The heart-
- complex muscular organ
- pumps blood around the body
-about the size of a person’s fist
-located; in the mediastinum of the thoracic cavity (slightly left of the midline)
Apex-
The pointed tip of the heart rests just above the diaphragm
Precordium-
Area of chest wall anterior to the heart and lower thorax
Four chambers:
Two Atria, and two ventricles
Atria:
Two upper chambers; smaller chambers with thinner walls.
Right atrium-
One of the four chambers of the heart. Receives blood from the body.
Left atrium-
Receives blood from the lungs.
Ventricles-
Two lower chambers; larger chambers with thick muscular walls.
Septum-
Thick muscular wall that divides the heart into right and left sections.
Interatrial septum:
Separates left and right atria
Inter-ventricular septum:
Divides right and left ventricles
Heart walls is composed of three layers:
Endocardium
Myocardium
Epicardium
Endocardium-
Inner thin endothelial layer that lines the chambers and valves.
Myocardium-
Middle and thickest layer; composed of cardiac muscle
Epicardium:
Outer layer that covers the heart
Heart valves-
Atrioventricular (AV): Bicuspid & Tricuspid
Semilunar (SL): Pulmonary & Aortic
Atrioventricular (AV) valves:
Bicuspid (mitral) & Tricuspid valve
Semilunar (SL) valve:
Pulmonary & aortic valve
Bicuspid (mitral) valves:
between the left atrium and the left ventricle
Tricuspid valve:
Between the right atrium and the right ventricle
Pulmonary valve:
between the right ventricle and the pulmonary artery
Aortic valve:
Between the left ventricle and the aorta
Heart beat-
- Normal sound is a (lup dup)
- a complete heartbeat (cardiac cycle) can be divided into diastole and systole phases.
Diastole phase:
Heart is at rest, atria filled with blood.
Systole phase:
Heart is contracting
Pulmonary circulation:
-deoxygenated blood is pumped from the right side of the heart to the lungs; gas exchange occurs; oxygenated blood returns to the heart.
- begins as the blood returns from the body.
- the superior vena cava and inferior vena cava bring deoxygenated blood from the body to the right atrium.
Systemic circulation:
-Oxygenated blood is pumped from the left side of the heart and moves through the body; oxygen, nutrients, and other substances are brought to the cells while the blood picks up waste products: deoxygenated blood returns to the heart.
-when the atria are full of blood, they contract
- oxygenated blood in the left atrium moves past the bicuspid or mitral valve; empties into the left ventricle.
Deoxygenated blood process:
superior and inferior venae cavae
Right atrium
Tricuspid valve
Right ventricle
Pulmonary valve
Pulmonary artery (to the lungs)
LUNGS- exchange of CO2 & O2
Oxygenated blood process:
lungs- exchange of CO2 and O2
Pulmonary veins
Left atrium
Bicuspid (mitral) valve
Left ventricle
Aortic valve
Aorta
Coronary circulation:
- the heart has its own blood vessels that support tissues.
- the coronary arteries bring nutrients and oxygen to the heart tissue.
- the coronary arteries have an important role of maintaining the myocardium:
Hepatic portal circulation:
Veins from the spleen, gallbladder, pancreas, stomach and intestines dump blood into the hepatic portal vein.
Liver:
has a special role in filtering the blood and metabolizes or breaks down substances.
The hepatic portal system advantages-
- Glucose absorbed can be filtered/stored in the liver (it will later be added back to the blood when the glucose levels are low).
- Toxic substances (alcohol and medications) can be partially filtered before moving to the rest of the body.
Fetal circulation:
- before birth, the baby’s lungs, GI tract, and kidneys are not functioning like they will after birth.
- the placenta attaches to the mother’s uterus and connects to the growing baby via the umbilical cord.
- arteries carry fetal blood to the placenta.
- the umbilical vein carries oxygen and nutrient rich blood to the baby.
structures unique to growing the baby:
- Ductus venous
- Foramen ovale
- Ductus arteriosus
Ductus venous-
a shunt that allows oxygenated blood in the umbilical vein to bypass the liver and is essential for normal fetal circulation. [1] Blood becomes oxygenated in the placenta and travels to the right atrium via umbilical veins through the ductus venosus, then to the inferior vena cava.
Foramen ovale:
hole between the left and right atria (upper chambers) of the heart. This hole exists in everyone before birth, but most often closes shortly after being born. PFO is what the hole is called when it fails to close naturally after a baby is born.
Ductus arteriosus:
normal blood vessel that connects two major arteries — the aorta and the pulmonary artery — that carry blood away from the heart
-The lungs are not used while a fetus is in the womb because the baby gets oxygen directly from the mother’s placenta.
Cardiac Cells:
- Electrical & Myocardial
Electrical cells- (unique characteristics)
- Automaticity: create and discharge the electrical impulse.
- Excitability: respond to the electrical impulse
- Conductivity: transmit electrical impulses to other cells
Myocardial-
initiate and propagate the action potential (the electrical impulse) that travels throughout the heart and triggers the contractions that propel the blood.
Sinoatrial node:
the pacemaker of the heart.
Atrioventicular node:
Located at the base of the interatrial septum.
Bundle of His:
When an impulse leaves AV node, it moves here
Right and left bundle branches:
Located in the lower inter-ventricular system.
Purkinje fibers:
Transmit the impulse quickly and efficiently to the ventricular myocardial cells. This causes the ventricular chambers to contract.
States of the cardiac cell:
- polarized, depolarized, repolarized
Polarized state:
before the impulse hits cells: no electrical activity, “ waiting stage”.
Depolarized state;
When the impulse hits cells: cells units charge.
Repolarized state:
After the impulse passes over the cell; ions move back to original location “recover stage”.
Conduction system:
the electrical system of the heart.
- recoded on the ECG.
Electrical impulses from the conduction system cause the chambers of the heart to contract l.
- Mechanical action can be seen on echocardiography.
Blood pressure:
- the pressure of the blood is highest in the arteries and lowest in veins.
- BP can be defined as the result of blood against the walls of the arteries
- two measurements taken during the cardiac cycle-
systole (contractive phase)
diastole (relaxation phase)
Blood volume:
- the amount of circulating blood.
- has a direct influence on blood pressure.
- the greater the blood volume, the more force it makes on the arterial walls.
- can be raised by blood, plasma, and fluid transfusions, as well as increases sodium intake.
- fluid volume can decrease due to hemorrhage, dehydration, and diuretic medications.
What is digoxin?
Medication that decreases the heart rate; strengthens contractions of the heart.
- with heart disease, tests are done to check how well the left ventricle is functioning.
Stroke volume:
amount of blood that is pushed out of the left ventricle compared with the total volume of blood that filled the ventricle.
Strength of ventricular contractions-
- the left ventricle pumps blood to the body.
-the greater the force of contraction, the more blood is pumped into the arteries.
Blood flow-
any factor that increases resistance for blood flow through arteries will increase the blood pressure.
Factors that increase resistance-
-size of the lumen of arteries (inner opening)
-elasticity of arterial walls
-viscosity of blood
Decreased lumen size affected by:
-plaque buildup
-smoking
-constriction of smooth muscles causing vasoconstriction.
Cardiovascular diseases:
conditions that impact the heart or blood vessels.
Cardiovascular diseases signs & symptoms:
- Angina pectoris
– Bradycardia
– Cyanosis
– Murmur
– Nausea
– Shortness of breath
– Syncope
– Tachycardia
– Venous distention
Arrhythmias-
heart rate of rhythm is abnormal.
Arrhythmias caused by:
-Diseases like heart attacks, congenital heart
defects, heart failure, enlarged heart.
– Stress and substances
– Medications
Arrythmias signs & symptoms:
- Fast or slow heart rate
– Irregular, skipping, or uneven heart beats
– Lightheadedness, dizziness, shortness of breath
– Paleness, chest pain, sweating
Arrhythmias diagnostic procedures-
-ECG
- Heart monitoring devices
- Echocardiography, coronary angiography, electrophysiology study (EPS)
Arrythmias treatment-
- Defibrillation or cardioversion
– Implanting a pacemaker to help establish a
normal rate/rhythm
– Antiarrhythmic medications
– Cardiac ablation and implantable cardiac
defibrillator
Atherosclerosis-Related Diseases-
- condition in which plaque or atheroma’s build up in the arteries.
ARD risk factors-
– Smoking
– Unhealthy diet; high cholesterol
– Lack of physical activity
– High blood pressure
– Uncontrolled diabetes mellitus
ARD signs & symptoms-
In many cases, no symptoms until the artery is severely narrowed or blocked.
ARD diagnostic procedures-
- blood tests
- ECG, echocardiography, chest x-ray, CT scan, angiography, stress test
ARD treatment-
Goals: Lower the risk of blood clot formation,
prevent diseases, and widen the affected arteries
– Exercise, healthy diet, maintain healthy weight
– Medications
– Percutaneous coronary intervention
– Coronary bypass grafting (CABG)
– Carotid endarterectomy
Cardiomyopathy-
The heart muscle becomes abnormal.
Cardiomyopathy risk factors-
– Diabetes mellitus, metabolic diseases, or severe
obesity
– Family history
– Long-term alcoholism
– Long-term hypertension
Cardiomyopathy signs & symptoms:
– Shortness of breath, especially after activity
– Swelling of the legs, feet, ankles, and abdomen
– Swelling of neck veins
– Fatigue
Cardiomyopathy diagnostic procedure:
– Chest x-ray, ECG, echocardiography, stress test
– Cardiac catheterization, coronary angiography,
myocardial biopsy
Cardiomyopathy treatment:
– Antiarrthymics
– Antihypertensives
– Anticoagulants
– Diuretics
– Beta-blockers
– Surgery
– Pacemaker
Congenital Heart Defects:
cause may be genetic, chromosomal or unknown.
Congenital Heart Defects signs & symptoms:
-Cyanosis
-Difficulty feeding, tiredness with feeding,
weight loss
– Abnormal heart murmur
– Sweating with feeding or crying
Congenital Heart Defects Diagnostic Procedure:
Fetal echocardiography
Congenital Heart Defects Treatment:
Depends on the type and severity of the defect.
Types of Heart Failure:
Right sided, and Left sided.
Right sided heart failure:
Fluid may back up into the body.
Left sided heart failure:
Fluid may back up into the lungs.
CHF common causes:
- Coronary artery disease (CAD)
- High Blood Pressure
CHF signs & symptoms:
-Cough, shortness of breath with reclining or
activity
– Fatigue, faintness, weakness, loss of appetite
– Fast or irregular pulse, palpitations
– Swollen feet, legs, liver, or abdomen
CHF diagnostic procedures:
- Listen for abnormal heart/lung sounds
– Check for edema
– Echocardiography; other imaging tests
CHF treatment:
– Home care (monitoring weight)
– Dietary changes
– Surgery
– Pacemaker
– Implantable defibrillator
– Heart transplant
Deep Vein Thrombosis (DVT):
Occurs when a blood clot forms in a vein deep in the body.
- Blood clots form when the vein’s inner lining and valves are damaged.
DVT risk factors:
– Family history of blood clots
– Medical conditions
– Smoking; obesity
DVT signs & symptoms:
Leg pain, swelling, warmth, and redness
DVT diagnostic procedures:
– Ultrasound
– Blood tests: D-dimer blood test, antithrombin
levels, and complete blood count (CBC)
DVT treatments-
– The goals are to prevent any additional clots
and prevent current clots from getting larger.
– Compression stockings
– Surgery
Heart Valve Diseases-
Stenosis (Tricuspid, Pulmonic, Aortic, Mitral)
Insufficiency (Tricuspid, Pulmonary, Aortic, Mitral regurgitation)
Stenosis:
Occurs when the valve flaps are stiff or fused together, thus narrowing the valve.
Insufficiency:
When the valve does not close completely, and blood leaks backward across the valve into the prior chamber.
Hypertension:
High blood pressure
High blood pressure types:
Primary, Secondary, Malignant
High BP causes:
– Genetics
– Environmental factors
– Kidney fluid and salt balance
– Renin-angiotensin-aldosterone system
– Sympathetic nervous system
– Changes in blood vessels
Hypertension Symptoms:
No symptoms, just a blood pressure reading.
Hypertension treatment:
– Goals are to bring blood pressure down
– Medications
– Lifestyle changes
Hypertension diagnostic procedures:
Blood pressure is measured and recorded.
as two numbers (systolic and diastolic)
Myocardial infarction (MI)
Also known as heart attack
- a tear that occurs in the plaque causing a clot to form.
- plaque that slowly builds up and narrows the insides of the coronary artery.
MI signs and symptoms:
- Angina pectoris
– Upper body discomfort or pain on one or both
arms
– Shortness of breath with activity or rest
MI diagnostic procedures:
-ECG and blood tests
-Angiocardiography
MI treatment-
- Chewing aspirin to prevent additional clot.
– Nitroglycerin
– Oxygen therapy
MI prognosis:
Depends on the time frame from the attack to the medical intervention.
Postural Orthostatic Tachycardia
Syndrome (POTS):
A condition where the heart rate increases on changing the posture, such as lying to sitting up or standing. This will cause dizziness or fainting.
- most of the blood remains in the lower body when standing up.
POTS signs and symptoms:
– Fatigue, exercise intolerance, nausea,
headaches, and poor concentration
– Lightheadedness, blurred vision, syncope,
heart palpitations, chest pain, and shortness of
breath
– Fainting with blood draws or deep breathing
POTS diagnostic procedure:
– Orthostatic vital signs
– Tilt table tests
POTS treatment:
- Drinking plenty of fluids (2 to 3 L per day)
– Medicines to regulate the heart rate and blood pressure
– Reclined exercises
– Healthy diet
– Compression stockings
POTS prognosis:
Currently no cure
Shock:
Occurs when there is not enough blood and oxygen getting to the organs and tissues.
Shock sign and symptoms:
-Weak rapid pulse and rapid shallow respiration
– Changes in the level of consciousness, confusion,
lack of alertness
– Dizziness, lightheadedness, or faintness
– Sweaty, pale skin
– Decreased or no urine output
Shock diagnostic procedure:
Diagnosed based on history, exam, and vital signs.
Life Span Changes:
Special structures with fetal circulation: Ductus
venosus, ductus arteriosus, foramen ovale, and
umbilical vessels
- As child grows and matures, heart rate decreases
During pregnancy, the mother’s cardiovascular
system undergoes changes:
- Cardiac output increases
– Extracellular fluid volume increases
– Total peripheral resistance decreases
– Blood flow to various oxygen increases
– As pregnancy progresses into the third trimester, the blood
pressure increases
Echocardiography:
A noninvasive procedure that assesses the structure and movement of various parts of the heart.
The device used during transesophageal echocardiography:
Swallowed by the patient and emits sound waves to create a high- quality image of the heart.
Cardiac pacemakers:
ALSO, therapeutic heart device or procedure
uses electrodes to generate electrical impulses that are delivered to the heart.
Patients’ w/ arrhythmia benefit from pacemakers, lasts 5-10 years.
Biventricular pacemaker
specific type of pacemaker.
- used to restore a normal heartbeat.
Implantable Cardioverter- Defibrillator (ICD):
is a battery powered device that is implanted in the chest and attached to the heart using thin wires.
Angioplasty
uses a catheter with a balloon tip, which is guided to the point of blockage in the artery.
Angiography
a catheter is inserted into an artery and a radiopaque contrast medium is rapidly injected. X-ray images of the artery are taken simultaneously.
The procedure evaluates arterial pathways in the body and identifies occlusions of the aorta and arteries of the lower extremities.
Angiography is used to diagnose dilation of a vessel due to aneurysm, emboli, and arteriosclerotic disease.
Cardiac Catherization
In this procedure, a thin catheter is inserted into the heart through a peripheral vein or artery. Once in place, a contrast medium is injected to visualize heart chambers, valves, and coronary arteries using fluoroscopy. The procedure is used to detect occluded blood vessels.
Cardiac catheterization is recommended for patients who have chronic shortness of breath, vertigo or syncope, chest pain, heart palpitations, and arrhythmias. The procedure is also recommended for patients who have recently suffered an AMI.
Venography
Venography is an invasive diagnostic procedure in which a dye is injected into a large vein of the foot or ankle, and X-ray films of the veins are taken.
The procedure helps diagnose deep vein thrombosis (DVT).
Which procedures are invasive and diagnostic?
Venography and Cardiac Catherization
What does an angiography evaluate?
Arterial pathways in the body.
Sclerotherapy
the process that involves a chemical solution, which is injected directly into the vein. This chemical may cause irritation and scarring inside the vein, thus blocking it from further blood flow. Although this procedure is minimally invasive, it is not considered a surgery.
Which invasive procedures are used to repair blood vessels?
Vein stripping and ligation & Endovenous ablation therapy
What are non-surgical treatments performed on blood vessels?
Sclerotherapy, Dietary reductions, Warfarin Anticoagulant Therapy
What condition can be managed with consistent exercise and limiting heavy lifting?
Varicose Veins
Which disorder may necessitate the demand for ECG by the provider?
Cardiac Arrythmia
How does an echocardiogram detect cardiac activity?
High frequency sound waves bounce off the heart and echo back through a transducer.
EHR
Electronic Health Record
