Download File

Heart
sounds
Use a
stethoscope
First heart sound
Lub
Closing of the
AV valves
Longer
Louder
Second heart sound
Dub
Closing of the
semilunar
valves at the
end of systole
Short
Sharp
Murmur
Abnormal
heart
sound
Factors Influencing Heart Rate
Autonomic
nervous
system
Factors Influencing Heart Rate
Stress
Factors Influencing Heart Rate
Hormones
Epinephrine
norepinephrine
Factors Influencing Heart Rate
Age
 in infants
 in elderly
Factors Influencing Heart Rate
Gender
Generally
higher in
females
Factors Influencing Heart Rate
Exercise
Increases
heat rate
Factors Influencing Heart Rate
Temperature
Increases
heart rate
Congestive Heart Failure
CHF
Weakening
of the heart
progressive
Congestive Heart Failure
CHF
Left sided failure
Pulmonary symptoms
Pulmonary edema
Congestive Heart Failure
CHF
Right sided
failure
Peripheral
symptoms
Edema in distal
extremities
Blood Vessels
Artery
Veins
Capillaries
Blood Vessels
Artery
Carries
oxygenated
blood AWAY
from the heart
Thicker walls
Blood Vessels
Veins
Carries poorly
oxygenated
blood TO the
heart
Larger lumen
Contains valves
Blood Vessels
Capillaries
Connects
arteries and
veins
One cell layer
thick
(tunica intima)
Blood Vessels
Structures
Tunica Externia
Tunica Media
Tunica Intima
Blood Vessels
Structures
Tunica
Externia
Outer most layer
Connective tissue
Supports and
protects vessel
Blood Vessels
Structures
Tunica
Media
Bulky middle coat
Mostly smooth
muscle
Helps change shape
Blood Vessels
Structures
Tunica
Intima
Inner most
layer
Lumen
Slick
Blood Vessels
Function of
Arteries
Carry blood
away from
the heart
Blood Vessels
Small
arteries:
arterioles
Largest
Artery: Aorta
Blood Vessels
Function of
Veins
Carry blood
To heart
Blood Vessels
Small:
Venules
Largest
Vein:
Vena Cava
Blood Vessels
Function of
capillaries
Connect veins
and arteries
Arteries
10
11
1, 10, 11 Carotid
1
2
12
3
13
4
5
6
7
8
9
14
15
2.
Subclavin
3.
Coronary
4.
Gastric
5.
Splenic
6.
Hepatic
7.
Radial
8.
Ulnar
9, 14
Femoral
12. Aorta
13. Brachial
16
15. Popliteal
16. Dorsalis pedis
Veins
8
9
10
11
12
13
14
15
6
7
16
17
18
1
2
3
4
5
1.
subclavin
2.
brachial
3.
splenic
4.
Median cubital
5. 13,
messenteric
6, 7,
jugular
8.
Superior vena cava
9
axillary
10
cardiac.
11, 12. hepatic
14. Ulner
15. Radial
16. Femoral
17. Saphenous
18. popliteal
Blood Vessels
Veins
Median
cubital
Used for routine blood draw
Blood Vessels
Veins
Saphenous
Longest vein
in body
Blood Vessels
Veins
Hepatic
portal
Liver
Digestion
Special Circulatory Routes
Hepatic Portal
Circulation
C. Blood flow
from pancreas,
stomach, small
intestines,
colon, spleen
and liver to
heart
Special Circulatory Routes
Pulmonary
Circulation
B. Blood flow
from heart
to lungs to
heart
Special Circulatory Routes
Systemic
Circulation
A. Blood
flow from
heart to body
to heart
Coronary Bypass Surgery
CABAG
Coronary
artery
bypass
and graft
Fetal Circulation
Lungs and
digestive system
are not yet
functioning so
nutrient and gas
exchange occurs
though the
placenta
Fetal Circulation
Nutrients
move from
mother’s
blood to
fetal blood
Fetal Circulation
2 umbilical
arteries
Smaller
Carries CO2 and
other waste
from fetus to
placenta
Fetal Circulation
Umbilical vein
Large
Carries blood rich
in nutrients and
O2 to fetus
Fetal Circulation
Placenta
The placenta develops
from the same sperm and
egg cells that form the
fetus.
For nine months the
placenta feeds and
nourishes the fetus while
also disposing of toxic
waste.
Without it the baby
could not survive.
Fetal Circulation
Ductus
venosus
Shunt
Allows most of
blood to bypass
immature liver
and enter into
inferior vena
cava
Fetal Circulation
Foreman ovale
Blood from right
atrium flows to
left atrium
though this
opening
Bypasses lungs
Located in septum
Fetal Circulation
Ducterious
arteriosus
Shunt which
connects aorta
and pulmonary
trunk to allow
blood into body
circulation
Pulse and Blood Pressure
TPR and B/P are
called
Vital
signs
Pulse
Pulse rate
should =
Heart rate
Average pulse
rate
60- 100
Pulse
Pulse is felt
where artery
comes close to
the surface of
the skin
Pulse
To feel a
pulse?
Palpate
temporal
facial
Pulse sites
1
2
carotid 3
brachial 4
radial 5
femoral
popliteal
Posterior tibialis
Dorsalis pedis
6
7
8
9
Blood Pressure
Is measuring the
amount of
pressure in the
arterial wall when
the heart is
contracting and
when the heart is
relaxing
Blood Pressure
Normals
100 60 -
140
90
Blood Pressure
Instrument used
to listen
Stethoscope
Blood Pressure
Instrument used to
measure
Sphygmomanometer
Blood Pressure
Artery most often
used
brachial
Blood Pressure
To listen
auscultate
Blood Pressure
hypertension
High blood
pressure
150
98
Blood Pressure
hypotension
Low blood
pressure
80
40
Blood Pressure
Factors
influencing blood
pressure
Kidneys
Major role in regulating B/P
B/P =  Urine output
 B/P =  Urine output
Blood Pressure
Factors
influencing blood
pressure
Temperature
Cold =
vasoconstriction =  B/P
Hot =
vasodilatation =  B/P
Blood Pressure
Factors
influencing blood
pressure
Chemicals
Drugs:
Epinephrine  B/P
Nicotine
 B/P
Alcohol
 B/P
Blood Pressure
Factors
influencing blood
pressure
Diet
 Na,  Fat,  cholesterol =
 Na,  Fat,  Cholesterol =
 B/P
 B/P
Blood Pressure
Factors
influencing blood
pressure
Others?
•Age
•Gender
•Race
•Exercise
Disorders
Mitral Valve
Prolapse.
Leakage of
blood into the
left atrium
MVP
MVP
Most common form of valvular heart disease, occurring in 2 – 6% of the
population.
Causes:
Unknown
Thought to be linked to heredity.
May be due to:
•ischemic damage (caused by decreased blood flow as a result of coronary
artery disease)
•damage to valvular structures during acute myocardial infarction
•rheumatic heart disease
•hypertrophic cardiomyopathy (occurs when the muscle mass of the left
ventricle of the heart is larger than normal).
MVP
Prognosis?
Symptoms
May not cause any symptoms
Usually harmless and does
not shorten life expectancy.
May cause:
Healthy lifestyle behaviors
and regular exercise are
encouraged.
Palpitations
Chest pain
weakness
Fatigue
Shortness of breath.
Disorders
Coronary Artery
Disease
A # of disorders
involving the
cardiac vessels
CAD
Disorders
Hardening of the
arteries from
lipids and other
substances
arteriosclerosis
Disorders
Section of
arterial wall
widens due to
weakness
aneurysm
Disorders
Opening of a
narrowed portion
of a blood vessel
with a balloon like
instrument
angioplasty
Disorders
Cerebral
vascular
accident.
Stroke
CVA
Disorders
Enlarged veins in
the legs due to
pooling of the
blood
Varicose
veins
Disorders
Varicose veins in
the rectum
hemorrhoids
Disorders
Inflammation of a
vein
Can occur
spontaneously or
as a result of an
I.V. or trauma.
The most common
site is in the leg
veins
phlebitis
Disorders
Acute phlebitis
with clot
formation
thrombophlebitis
Disorders
Blockage of the
pulmonary artery (or one
of its branches). Usually
when a clot from a vein
becomes dislodged and
travels to the lungs.
Pulmonary
embolism (PE)
Review
Heart muscle
myocardium
Heart rate less then 60 beats
per minute
bradycardia
Review
How many umbilical vessels?
3
Wide, weak area in an arterial
wall?
aneurysm
Review
In the fetus, the left atrium receives
most of its blood through the?
Foramen ovale
Circulatory route that runs from
the digestive tract to the liver?
Hepatic portal
Review
Permits the exchange of nutrients and
gases between blood and tissue cells ?
capillaries
Oxygenated blood is located on
which side of the heart ?
left
Review
Where is the SA node located?
Upper right atria
All arteries carry oxygenated
blood.
True
False