Download The Language of Medicine

The Language Of
Medicine
th
9
edition
Davi-Ellen Chabner
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
1
Chapter 11
Cardiovascular System
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
2
Chapter Goals



Name the parts of the heart and associated
blood vessels and their functions in the
circulation of blood.
Trace the pathway of blood through the heart.
Identify and describe major pathologic
conditions affecting the heart and blood
vessels.
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
3
Chapter Goals (cont’d)



Define combining forms that relate to the
cardiovascular system.
Describe important laboratory tests and
clinical procedures pertaining to the
cardiovascular system, and recognize
relevant abbreviations.
Apply your new knowledge to understand
medical terms in their proper context, such as
in medical reports and records.
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
4
Chapter 11
Lesson 11.1
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5
Introduction

Cardiovascular System: delivers oxygen
and nutrients to cells of body tissue


Heart (muscular pump)
Blood vessels (fuel line and transportation
network)
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6
Blood Vessels and the
Circulation of Blood



Arteries are the vessels that lead away from
the heart.
Veins are thinner walled vessels compared to
arteries. They move deoxygenated blood
toward the heart from the tissues.
Capillaries are the smallest vessels. They
form the point of exchange for oxygen and
nutrients into body cells and waste products
coming from body cells.
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7
Blood Vessels
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8
Blood Circulation / Systemic
Circulation
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9
Major Vessels
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10
Anatomy of the Heart
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11
Anatomy of the Heart
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12
Major Valves of the Heart




tricuspid valve (cusps are flaps of the
valves): between right atrium and right
ventricle
pulmonary valve: between right ventricle
and pulmonary artery
mitral valve: between left atrium and the left
ventricle
aortic valve: between left atrium and aorta
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
13
Pathway of Blood
through the Heart
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14
Heartbeat and Heart Sounds



Two phases of the heartbeat:
diastole: relaxation
systole: contraction


The diastole-systole cardiac cycle occurs between
70 to 80 times per minute (100,000 times per day).
The heart pumps 3 ounces of blood with each
contraction. This means that about 5 quarts are
pumped per minute (75 gallons an hour and about
2000 gallons a day).
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
15
Heart Sounds
Closure of valves associated with sounds
“lubb-dubb, lubb-dubb”
 lubb: closure of the tricuspid and mitral
valves at the beginning of systole
 dubb: closure of the aortic and pulmonary
valves at the end of systole
 murmur: abnormal heart sound caused by
improper valve closure
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16
Phases of the Heartbeat
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17
Phases of the Heartbeat
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18
Conduction System of the Heart

sinoatrial node (SA node): pacemaker of
the heart
pacemaker: origin of electrical impulse
causing walls of the atria to contract and
force blood into the ventricles (ending
diastole)
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19
Conduction System of the Heart
(cont’d)




Atrioventricular node (AV node): This sends the
excitation wave to a bundle of specialized fibers
called atrioventricular bundle or Bundle of His.
Bundle of His (pronounced “hiss”): Helps form
conduction myofibers that extend to ventricle walls
and stimulate them to contract, beginning systole. A
short rest period follows.
The pacemaker begins wave of excitation again.
ECG or EKG (electrocardiogram): The record used to
detect electrical changes in heart muscle as the heart
beats.
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20
Conduction System of the Heart
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21
Conduction System of the Heart
(cont’d)
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22
Electrocardiogram

P wave = spread of excitation wave over the atria just before
contraction; QRS wave = spread of excitation wave over the
ventricles as the ventricles contract; T wave = electrical
recovery and relaxation of ventricles. A heart attack
(myocardial infarction or MI) can be recognized by an
elevation in the S-T segment of the ECG. Thus, one type of MI
is an S-T elevation MI or STEMI.
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
23
Electrocardiogram (cont’d)
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24
Electrocardiogram (cont’d)
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25
Blood Pressure



Blood pressure: The
force that blood exerts
on arterial walls.
Measured using
sphygmomanometer
Expressed as a
fraction:
systolic pressure/
diastolic pressure

example: 120/80 mm Hg
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26
Combining Forms
and Terminology
Combining Form






angi/o
aort/o
arter/o
arteri/o
ather/o
atri/o
Meaning
vessel
aorta
artery
artery
yellowish plaque
atrium
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
27
Combining Forms
and Terminology (cont’d)
Combining Form






brachi/o
cardi/o
cholesterol/o
coron/o
cyan/o
myx/o
Meaning
arm
heart
cholesterol
heart
blue
mucus
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
28
Combining Forms
and Terminology (cont’d)
Combining Form






ox/o
pericardi/o
phleb/o
sphygm/o
steth/o
thromb/o
Meaning
oxygen
pericardium
vein
pulse
chest
clot
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
29
Combining Forms
and Terminology (cont’d)
Combining Form






valvul/o
valv/o
vas/o
vascul/o
ven/o, ven/i
ventricul/o
Meaning
valve
valve
vessel
vessel
vein
ventricle
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30
QUICK QUIZ:
1. The double-layered membrane
surrounding the heart is the
___________.
A. pericardium
B. arteriole
C. endocardium
D. endothelium
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31
QUICK QUIZ: (cont’d)
2. The contraction phase of the
heartbeat is called _________.
A. diastole
B. vena cava
C. systole
D. septum
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32
Chapter 11
Cardiovascular System
Lesson 11.2
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33
Pathology:
the Heart and Blood Vessels
HEART
arrhythmias
• heart block (atrioventricular block)
• flutter
• fibrillation
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34
Pathology:
the Heart and Blood Vessels (cont’d)
HEART
congenital heart disease
• coarctation of the aorta (CoA)
• patent ductus arteriosus (PDA)
• septal defects (ASD and VSD)
• tetralogy of Fallot
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35
Pathology:
the Heart and Blood Vessels (cont’d)
HEART
congenital heart disease (CHF): The heart
is unable to pump the required amount of
blood.
• In U.S., primarily the result of high blood
pressure and coronary artery disease
(see next slide)
• Results in pulmonary edema
• Fatal if untreated
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36
Pathology:
the Heart and Blood Vessels (cont’d)
HEART
coronary artery disease (CAD)


Atherosclerosis
• thrombotic occlusion (occlusive/mural)
• ischemia
• necrosis
• infarction
Acute Coronary Syndromes (ACS)
• unstable angina
• myocardial infarction (MI)
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37
Pathology:
the Heart and Blood Vessels (cont’d)
HEART
Coronary artery disease
Drug therapies for CAD
• nitrates (nitroglycerin)
• aspirin
• beta-blockers
• ACE inhibitors
• calcium channel blockers
• statins
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38
Pathology:
the Heart and Blood Vessels (cont’d)
HEART
Coronary artery disease
Surgical therapies for CAD
• coronary artery bypass grafting (CABG)
• percutaneous coronary intervention (PCI)
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39
Pathology:
the Heart and Blood Vessels (cont’d)
HEART
Other Pathologic conditions
 endocarditis
(vegetations)
 hypertensive heart disease
 mitral valve prolapse (MVP)
 murmur
 pericarditis
 rheumatic heart disease
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40
Pathology:
the Heart and Blood Vessels (cont’d)
BLOOD VESSELS
 aneurysm
 deep vein thrombosis (DVT)
 hypertension (HTN)
 peripheral vascular disease (PVD)
 Raynaud disease
 varicose veins
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
41
QUICK QUIZ:
3. Which arrhythmia refers to rapid,
random, inefficient and irregular
contractions of the atria and ventricles
(350 beats or more per minute)?
A. fibrillation
B. flutter
C. bradycardia
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42
Chapter 11
Lesson 11.3
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43
Laboratory Tests




BNP test
lipid test profile
lipoprotein electrophoresis
serum enzyme tests
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44
Clinical Procedures:
Diagnostic
X-Ray




angiography and arteriography
computerized tomography angiography
digital subtraction angiography (DSA)
Electron beam computed tomography (EBCT
or EBT)
Ultrasound Tests


Doppler ultrasound
echocardiography (ECHO)
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45
Clinical Procedures:
Diagnostic (cont’d)
Nuclear Cardiology

positron emission tomography (PET) scan
 technetium (Tc) 99m Sestamibi scan
(Cardiolite)
 Thallium-201 scan
Magnetic Resonance Imaging (MRI)
 cardiac MRI
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
46
Clinical Procedures:
Diagnostic (cont’d)
Other diagnostic procedures:
 cardiac catheterization
 electrocardiography (ECG, EKG)
 Holter monitoring
 stress test
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
47
Clinical Procedures:
Diagnostic (cont’d)

Identify the normal sinus rhythm and arrhythmias
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48
Clinical Procedures: Treatment





cardioversion (defibrillation)
endarterectomy
extracorporeal circulation
heart transplantation
thrombolytic therapy
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49
Clinical Procedures: Treatment

Coronary artery bypass graft
(CABG) surgery. A: Section
of a vein is removed from the
leg and anastomosed to a
coronary artery to bypass an
area of arteriosclerotic
blockage. B: An internal
mammary artery is grafted to
a coronary artery to bypass
blockage.
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
50
Clinical Procedures:
Diagnostic (cont’d)
A Normal sinus rhythm. Notice the
regularity of the P, QRS, and T
waves.
B Atrial flutter. Notice the rapid atrial rate
(P wave) compared to the slower
ventricular rate (ARS).
C Atrial fibrillation. P waves are replaced
by irregular and rapid fluctuations.
There are no effective atrial
contractions.
D Ventricular tachycardia. Ventricular
rate may be as high as 250 beats per
minute. The rhythm is regular, but the
atria are not contributing to
ventricular filling and blood output is
poor.
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51
Treatment Procedures

percutaneous
coronary
intervention (PCI)

includes:
percutaneous
transluminal
coronary angioplasty
(PTCA), stent
placement, laser
angioplasty, and
atherectomy
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52
Abbreviations







Cath
MR
PCI
PVC
HTN
ECG
LDL







BBB
CAD
CVP
Vfib
PDA
BP
SOB







LMWH
ICD
LVAD
ASD
CABG
ECHO
MVP
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53
QUICK QUIZ:
4. Which procedure involves
insertion of a balloon-tipped
catheter into a coronary artery?
A. thrombolytic therapy
B. coronary artery bypass grafting
C. percutaneous coronary intervention
D. endarterectomy
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54
Review Sheet
COMBINING FORMS
Combining Form






angi/o
aort/o
arter/o
arteri/o
ather/o
atri/o
Meaning
______________
______________
______________
______________
______________
______________
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
55
Review Sheet (cont’d)
COMBINING FORMS
Combining Form






angi/o
aort/o
arter/o
arteri/o
ather/o
atri/o
Meaning
vessel
aorta
artery
artery
yellowish plaque
atrium
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
56
Review Sheet (cont’d)
COMBINING FORMS
Combining Form






brachi/o
cardi/o
cholesterol/o
coron/o
cyan/o
myx/o
Meaning
______________
______________
______________
______________
______________
______________
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
57
Review Sheet (cont’d)
COMBINING FORMS
Combining Form






brachi/o
cardi/o
cholesterol/o
coron/o
cyan/o
myx/o
Meaning
arm
heart
cholesterol
heart
blue
mucus
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
58
Review Sheet (cont’d)
COMBINING FORMS
Combining Form








ox/o
pericardi/o
phleb/o
pulmon/o
rrhythm/o
sphygm/o
steth/o
thromb/o
Meaning
______________
______________
______________
______________
______________
______________
______________
______________
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
59
Review Sheet (cont’d)
COMBINING FORMS
Combining Form








ox/o
pericardi/o
phleb/o
pulmon/o
rrhythm/o
sphygm/o
steth/o
thromb/o
Meaning
oxygen
pericardium
vein
long
rhythmn
pulse
chest
clot
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
60
Review Sheet (cont’d)
COMBINING FORMS
Combining Form






valvul/o
valv/o
vas/o
vascul/o
ven/o, ven/i
ventricul/o
Meaning
______________
______________
______________
______________
______________
______________
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
61
Review Sheet (cont’d)
COMBINING FORMS
Combining Form






valvul/o
valv/o
vas/o
vascul/o
ven/o, ven/i
ventricul/o
Meaning
valve
valve
vessel
vessel
vein
ventricle
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
62
Review Sheet
SUFFIXES
Suffix






Meaning
-constriction
-dilation
-emia
-graphy
-lysis
-megaly
______________
______________
______________
______________
______________
______________
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63
Review Sheet (cont’d)
SUFFIXES
Suffix
Meaning

-constriction
-dilation
-emia
-graphy
-lysis

-megaly




narrowing
widening; stretching; expanding
blood condition
process of recording
breakdown; separation;
destruction; loosening
enlargement
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
64
Review Sheet (cont’d)
SUFFIXES
Suffix
Meaning

-meter
______________

-oma
-osis
-plasty
-sclerosis
-stonosis
-tomy
______________
______________
______________
______________
______________
______________





Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
65
Review Sheet (cont’d)
SUFFIXES
Suffix
Meaning

-meter
measure

-oma
-osis
-plasty
-sclerosis
-stonosis
-tomy
tumor; mass; fluid collection
condition; usually abnormal
surgical repair
hardening
tightening; structure
process of cutting





Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
66
Review Sheet (cont’d)
PREFIXES
Prefix
Meaning

a-, an
______________

brady-
______________

de-
______________

dys-
______________

endo-
______________

hyper-
______________
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
67
Review Sheet (cont’d)
PREFIXES
Prefix
Meaning

a-, an
no; not; without

brady-
slow

de-
lack of; down; less; removal of

dys-
bad; painful; difficult; abnormal

endo-
in; within

hyper-
above; excessive
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
68
Review Sheet (cont’d)
PREFIXES
Prefix
Meaning

hypo-
______________

inter-
______________

peri-
______________

tachy-
______________

tetra-
______________

tri-
______________
Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
69
Review Sheet (cont’d)
PREFIXES
Prefix
Meaning

hypo-
deficient; below; under; less than
normal

inter-
between

peri-
surrounding

tachy-
fast

tetra-
four

tri-
three
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70