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Transcript
11 CHAPTER SUMMARY The importance of the cardiovascular system cannot be overstated. This is one system that students frequently know something about, at least from a plumbing viewpoint, but they often don’t completely understand the complexity of the system and the magnitude of its tasks. An essential component of presentation of the material is then to outline in detail the role of the cardiovascular system and its significance to all other body systems. This chapter begins with the fundamental information about the heart by first discussing anatomy and then moving on to the more complex physiology. The section on anatomy covers the layers of the heart as well as its chambers, valves, and the vessels through which blood moves in and out of its various regions. A section on cardiac circulation explains the way the heart itself is supplied with oxygen-rich blood. The structural and mechanical characteristics of the heart are followed by a discussion of its unique electrical intrinsic activity. The conduction system is outlined and relevant homeostatic imbalances are discussed. Concepts related to the electrical conduction system of the heart are always difficult to grasp, and key demonstrations and activities help solidify the students’ understanding. Following the section on the heart itself is the portion of the chapter dealing with the blood vessels. Arteries, veins, and capillaries are compared for their structural and physiological similarities as well as their differences. Names of the major vessels are given, as the route of blood is traced from its point of exit from the heart through the aorta to all parts of the body and back to the heart via the superior and inferior venae cavae. A look into the various mechanisms involved in blood pressure precedes a discussion of the special circulatory routes that supply the brain, liver, and developing fetus. Finally, the developmental aspects of circulation are considered. SUGGESTED LECTURE OUTLINE I. THE HEART (pp. 347–360) A. Anatomy of the Heart (pp. 348–354) 1. Location and Size a. Mediastinum b. Apex c. Base 2. Coverings and Wall a. Pericardium b. Epicardium (visceral pericardium) c. Myocardium d. Endocardium 3. Chambers and Associated Great Vessels a. Atria b. Ventricles c. Interventricular (interactrial) septum d. Superior and Inferior Venae Cavae e. Pulmonary Arteries f. Pulmonary Veins g. Aorta 4. Valves a. Atrioventricular (AV) Valves i. ii. B. II. Bicuspid (Mitral) Valve Tricuspid Valve I. Chordae tendineae b. Semilunar Valves i. Pulmonary Valve ii. Aortic Valve c. Cardiac Circulation i. Coronary arteries ii. Cardiac veins d. Homeostatic Imbalances i. Endocarditis (p. 354) ii. Angina pectoris (p. 354) iii. Myocardial infarction (p. 354) iv. Ischemia (p. 357) v. Murmurs (p. 358) vi. Fibrillation (p. 357) vii. Congestive heart failure (CHF) (p. 360) viii. Pulmonary edema (p. 360) Physiology of the Heart (pp. 354–360) 1. Intrinsic Conduction System of the Heart: Setting the Basic Rhythm a. Nerves of the Autonomic Nervous System b. Intrinsic Conduction System (Nodal System) i. Sinoatrial (SA) Node (Pacemaker) ii. Atrioventricular (AV) Node iii. Atrioventricular Bundle (Bundle of His) iv. Bundle Branches v. Purkinje Fibers c. Electrocardiogram (ECG) i. P wave ii. QRS complex iii. T wave d. Heart Rate i. Bradycardia ii. Tachycardia 2. Cardiac Cycle and Heart Sounds a. Mid-to-Late Diastole b. Ventricular Systole c. Early Diastole 3. Cardiac Output (CO) a. Regulation of Stroke Volume (SV) b. Factors Modifying Basic Heart Rate (HR) c. Neural (ANS) controls i. Sympathetic Division ii. Parasympathetic Division BLOOD VESSELS (pp. 360–381) A. Microscopic Anatomy of Blood Vessels (pp. 360–364) 1. Tunics a. Tunica Intima b. Tunica Media c. Tunica Externa 2. Structural Differences between Arteries, Veins, and Capillaries a. Venous one-way valves B. C. Gross Anatomy of Blood Vessels (pp. 364–372) 1. Major Arteries of the Systemic Circulation (Figure 11.11) a. Arterial Branches of the Ascending Aorta i. Right and Left Coronary Arteries b. Arterial Branches of the Aortic Arch i. Brachiocephalic Artery ii. Left Common Carotid Artery iii. Left Subclavian Artery c. Arterial Branches of the Thoracic Aorta i. Intercostal Arteries ii. Bronchial Arteries iii. Esophageal Arteries iv. Phrenic Arteries d. Arterial Branches of the Abdominal Aorta i. Celiac Trunk ii. Superior Mesenteric Artery iii. Renal Arteries iv. Gonadal Arteries v. Lumbar Arteries vi. Inferior Mesenteric Artery vii. Common Iliac Arteries 2. Major Veins of the Systemic Circulation (Figure 11.12) a. Veins Draining into the Superior Vena Cava i. Radial and Ulnar Veins ii. Cephalic Vein iii. Basilic Vein iv. Subclavian Vein v. Vertebral Vein vi. Internal Jugular Vein vii. Brachiocephalic Vein viii. Azygos Vein b. Veins Draining into the Inferior Vena Cava i. Anterior and Posterior Tibial Veins ii. Great Saphenous Veins iii. Common Iliac Veins iv. Right Gonadal Vein v. Renal Veins vi. Hepatic Portal Vein vii. Hepatic Veins 3. Special Circulations (Figures 11.13–11.15) a. Arterial Supply of the Brain and the Circle of Willis b. Hepatic Portal Circulation c. Fetal Circulation Physiology of Circulation (pp. 372–381) 1. Arterial Pulse a. Pressure points 2. Blood Pressure a. Blood Pressure Gradient b. Measuring Blood Pressure c. Effects of Various Factors on Blood Pressure i. Peripheral Resistance ii. Neural Factors: The Autonomic Nervous System iii. Renal Factors: The Kidneys 3. III. iv. Temperature v. Chemicals vi. Diet d. Variations in Blood Pressure i. Orthostatic hypotension (low blood pressure) ii. Hypertension (high blood pressure) iii. Atherosclerosis Capillary Exchange of Gases and Nutrients (Figure 11.20) a. Interstitial (Tissue) Fluid b. Fluid Movements at Capillary Beds DEVELOPMENTAL ASPECTS OF THE CARDIOVASCULAR SYSTEM (pp. 381–383) A. Congenital Heart Defects B. Coronary Artery Disease