Download Heart PPT - McCreary County Schools

Chapter 13
Heart
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2013 Cengage Learning. All Rights Reserved. May not be scanned, copied
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© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
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© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
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Draw the Pathway of Blood Flow
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AGAIN… Draw, Color & Label 
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Media Time 
https://www.youtube.com/watch?v=5tUW
OF6wEnk
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Functions of the
Circulatory System
• The heart is the pump that circulates blood
• Arteries, veins, and capillaries transport the
blood
• Blood carries oxygen and nutrients to the
cells and carries waste products away
• Lymph system functions
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Major Blood Circuits
• Blood leaves the heart through arteries and
returns by veins
• Blood circulation routes
– General or system circulation
– Cardiopulmonary circulation
• Changes in the composition of circulating
blood
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The Heart
• About the size of a closed fist
• Weighs about 1 pound
• Located in the thoracic cavity; the apex of
the heart lies on the diaphragm and points to
the left of the body
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The Heart
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The Heart
• After 4 to 5 minutes without blood flow,
brain cells are irreversibly damaged
• Can hear the heartbeat through a
stethoscope
• Cardiac arrest
• Cardiopulmonary resuscitation (CPR)
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Structure of the Heart
• Hollow, muscular, double pump
• Pericardium and pericardial fluid
• Myocardium
– Cardiac muscle tissue
•
•
•
•
•
•
Endocardium
Superior and inferior vena cava
Coronary sinus
Pulmonary artery
Pulmonary veins
Aorta
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Structure of the Heart
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N
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14
13
6
1
7
5
2
8
9
12
3
4
10
11
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Chambers and Valves
• Separated into right and left halves by the septum;
then each half separated into an upper and lower
chamber
• Upper chambers
• Left and right atria
• Lower chambers
• Left and right ventricles
• Valves keep blood flowing in one direction
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Valves
• Atrioventricular valves
– Tricuspid valve
– Bicuspid or mitral valve
• Semilunar valves
– Pulmonary semilunar valve
– Aortic semilunar valve
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© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.
© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
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Physiology of the Heart
• Double pump
• Right heart
– Deoxygenated blood
» POOR BLOOD
• Left heart
– Oxygenated blood
» RICH BLOOD
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Heart Rate and Cardiac Output
• Normal adult rate is between 72 and 80 beats per
minute (60 to 100 beats a minute)
• Stroke volume
– is the amount of blood ejected by the left ventricle in one contraction. Although stroke
volume can refer to either left or right side of the heart, it is most associated with the left
side.
• Calculating the cardiac output
– Cardiac output is the volume of blood pumped by the heart per minute (mL
blood/min). Cardiac output is a function of heart rate and stroke volume. The
heart rate is simply the number of heart beats per minute. The stroke volume is
the volume of blood, in milliliters (mL), pumped out of the heart with each beat.
• Exercise increases cardiac output
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Heart Sounds
• Valves make sounds when they close
• Called lubb dupp sounds
• Lubb
– Tricuspid and bicuspid valves (S1)
• Dupp
– Aortic and pulmonary valves (S2)
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Conduction System
• Electrical impulses cause rhythmic beating
of the heart
1. Sinoatrial (SA) node or pacemaker
2. Atrioventricular (AV) node
3. Bundle of His
4. Purkinje fibers
https://www.youtube.com/watch?v=fZT9vlbL
2uA
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The heartbeat happens as follows:
1. The SA node (called the pacemaker of
the heart) sends out an electrical
impulse.
2. The upper heart chambers (atria)
contract.
3. The AV node sends an impulse into
the ventricles.
4. The lower heart chambers (ventricles)
contract or pump.
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Conduction System
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ECG or EKG
• The electrocardiogram is a device to record
the electrical activity of the heart
• Systole
– Contraction
• Diastole
– Relaxation
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ECG or EKG
• Positive and negative deflection (change direction)
• P, QRS, and T waves
– Being able to interpretate these details allows
diagnosis of a wide range of heart problems.
• https://www.youtube.com/watch?v=RYZ4d
aFwMa8
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Prevention of Heart Disease
• Heart disease is the leading cause of death
– Coronary heart disease
• Risk factors
– High blood cholesterol and triglyceride levels (a type of fat found in the
blood)
– High blood pressure
– Diabetes and prediabetes
– Overweight and obesity
– Smoking
– Lack of physical activity
– Unhealthy diet
– Stress
– The risk factors you can't control are age, gender, and family history
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• Steps to lower risk or prevent heart disease
– Eat healthy
– Exercise
• Blood cholesterol levels and triglycerides
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Diagnostic Tests – Noninvasive
• Angiography
– visualize the inside of
blood vessels and organs
of the body, with particular
interest in the arteries,
veins, and the heart
chambers
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• Cardiac MRI
– Cardiac MRI is a common test. It's used to diagnose
and assess many diseases and conditions, including:
Coronary heart disease. Damage caused by a heart
attack. Heart failure.
• Coronary calcium scoring/heart scan
– Cardiac calcium scoring uses a special X-ray called a
computed tomography (CT) scan to find the buildup of
calcium on the walls of the arteries
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• Echocardiography
– Echocardiography uses standard two-dimensional,
three-dimensional, and Doppler ultrasound to create
images of the heart.
• Electrocardiogram
– Echocardiogram, often referred to as a cardiac echo or
simply an echo, is a sonogram of the heart. (ECG is an
abbreviation for an electrocardiogram.)
–Dx: fibrillation
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• Fibrillation - a muscular twitching, very rapid
irregular contractions of the muscle fibers of the heart
atrial fibrillation, ventricular fibrillation
•
Electrocardiogram to DX
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Diagnostic Tests – Noninvasive
• Exercise stress tests
– A stress test, sometimes called a treadmill test or
exercise test, helps a doctor find out how well your
heart handles work. As your body works harder during
the test, it requires more oxygen, so the heart must
pump more blood. The test can show if the blood
supply is reduced in the arteries that supply the heart.
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• Holter monitor
– A Holter monitor is a continuous tape recording of a
patient's EKG for 24 hours. Since it can be worn during
the patient's regular daily activities, it helps the
physician correlate symptoms of dizziness, palpitations
(a sensation of fast or irregular heart rhythm) or black
outs.
• MUGA (multiple gated acquisition scan)
– highly accurate test used to determine the heart's
pumping function, nuclear imaging test.
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Diagnostic Tests – Invasive
• Cardiac
catheterization
– Cardiac catheterization
(cardiac cath or heart
cath) is a procedure to
examine how well your
heart is working. A thin,
hollow tube called a
catheter is inserted into a
large blood vessel that
leads to your heart.
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• IVUS (intravascular
coronary ultrasound)
– test that uses sound
waves to see inside blood
vessels. It is useful for
evaluating the coronary
arteries that supply the
heart.
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Diagnostic Tests – Blood Tests
• Arterial blood gases
– measures the amounts of certain gases (such as oxygen and carbon
dioxide) dissolved in arterial blood. An ABG test involves
puncturing an artery with a thin needle and syringe and drawing a
small volume of blood.
• BNP
substance secreted from the ventricles or lower chambers of the
heart in response to changes in pressure that occur when heart
failure develops and worsens. The level of BNP in the blood
increases when heart failure symptoms worsen, and decreases
when the heart failure condition is stable.
– a
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• Lipid panel
– Lipids include cholesterol, high-density lipoprotein
(HDL), low-density lipoprotein (LDL), and
triglycerides. The basic lipid panel measures total
cholesterol, triglyceride levels, HDL and LDL
cholesterol.
• C-reactive protein
– produced by the liver. The level of CRP rises when
there is inflammation throughout the body. It is one of a
group of proteins called "acute phase reactants" that go
up in response to inflammation
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• Cardiac Troponin T
– indicators of damage to the heart muscle (myocardium).
They are measured in the blood to differentiate between
unstable angina and myocardial infarction (heart attack)
in people with chest pain.
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Effects of Aging
• Heart muscle fibers replaced by fibrous
tissue
• Heart valves increase in thickness
• Cardiac output decreases
• Changes become more significant when
elderly person becomes physically or
mentally stressed
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Diseases of the Heart –
Common Symptoms
•
•
•
•
Arrhythmia-change from normal rate/rhythm
Bradycardia-slow/heart beats less then 60 beats/min
Tachycardia- fast/heart beast more then 100 beats/min
Murmurs- valve fails to close properly (hissing sound
or gurgling sound) surg to replace if necessary
• Mitral valve prolapse- between LA & LV closes
imperfectly (s/s: fatigue, palpitations, HA, Chest Pain,
Anxiety)
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Diseases of the Coronary Artery
• Coronary artery disease (CAD)- narrowing of
the arteries, plaque builds up and causes Heart Attack
• Angina pectoris- Chest Pain (Call 911, lie down,
ASA, Nitro to open artery)
• Myocardial infarction- MI/Heart Attack (s/s: chest
pain, nausea, sweating, fatigue, dyspnea/difficulty
breathing) DAMAGE HEART MUSCLE CANT PUMP
BLOOD.
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or duplicated, or posted to a publicly accessible website, in whole or in part.
Infectious Diseases of the Heart
• Pericarditis- Inflammation outer member covering of
heart
• Myocarditis- Inflammation of heart muscle
• Endocarditis- Inflammation membrane that lines heart
valves & heart CAN lead to Fatal BLOOD CLOT)
• Rheumatic heart disease- result from frequent strep
throat, attack lining of heart
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Heart Failure
• When the ventricles of the heart are unable
to contract effectively and blood pools in
the heart
• Symptoms depend on which ventricle fails
– LEFT Ventricle=S/S: Dyspnea occurs
– RIGHT Ventricle=Organ fill with blood, S/S: edema,
lung congestion, coughing
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Heart Failure
• Left ventricle failure
– Dyspnea
• Right ventricle failure
– Engorgement of organs, edema, and ascites(serous fluid in abd
cavity)
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Congestive Heart Failure
• Similar to heart failure
• Left-sided failure
– pulmonary edema
• Right-sided failure
– fluid buildup throughout body
• Treatment
– medication & diuretics
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Rhythm/Conduction Defects
• Heart block
– First-degree block
– Second-degree block
– Third-degree block or complete heart block
• Premature contractions
– Atrial fibrillation
– PVCs
– Ventricular fibrillation
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Types of Heart Surgery
• Angioplasty
– surgical repair or unblocking of a blood vessel,
especially a coronary artery.
• https://www.youtube.com/watch?v=e13TGGccvT4
• Cardiac stents
– a tube-shaped device placed in the coronary arteries that
supply blood to the heart, to keep the arteries open in
the treatment of coronary heart disease
• https://www.youtube.com/watch?v=1aJ60DTnT2k
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• Coronary bypass
– During coronary artery bypass graft surgery (also called CABG), a
blood vessel is removed or redirected from one area of the body
and placed around the area or areas of narrowing to "bypass" the
blockages and restore blood flow to the heart muscle. This vessel
is called a graft.
• https://www.youtube.com/watch?v=7ZuU0uzRCDU
• Transmyocardial laser revascularization
– a new treatment aimed at improving blood flow to areas of the
heart that were not treated by angioplasty or surgery. A special
carbon dioxide (CO2) laser is used to create small channels in the
heart muscle, improving blood flow to the heart muscle.
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or duplicated, or posted to a publicly accessible website, in whole or in part.
Heart Transplants
• Used as a last resort
• Histocompatibility
– matching of tissue type
• Organ rejection
– https://www.youtube.com/watch?v=QGtLYtOwtxA
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Medical Highlights
Read in Class
• Pacemaker
– A pacemaker is a small device
that's placed in the chest or
abdomen to help control
abnormal heart rhythms. This
device uses low-energy electrical
pulses to prompt the heart to beat
at a normal rate. Pacemakers are
used to treat arrhythmias.
Arrhythmias are problems with
the rate or rhythm of the
heartbeat.
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or duplicated, or posted to a publicly accessible website, in whole or in part.
• Cardiac resynchronization therapy
– improves the heart's efficiency and increases blood
flow, patients have reported alleviations of some heart
failure symptoms
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or duplicated, or posted to a publicly accessible website, in whole or in part.
• Defibrillator
– a common treatment for lifethreatening cardiac
dysrhythmias and ventricular
fibrillation. Defibrillation
consists of delivering a
therapeutic dose of electrical
current to the heart with a
device called a defibrillator.
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• Heart pumps
– The left ventricular assist
device, or LVAD, is a
mechanical pump that is
implanted inside a person's
chest to help a weakened
heart pump blood
throughout the body.
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or duplicated, or posted to a publicly accessible website, in whole or in part.