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Module 03 Lab Worksheet: Cardiovascular
System- Heart and Blood Vessels
Introduction
This week’s lab will focus on understanding the concepts of heart physiology and
blood vessels of the body.
Objectives
Objectives for this week’s lab include: 1) Describe and measure the changes to
cardiac output and blood pressure with aerobic activity, 2) Map out the major blood
vessels of the body, 3) Locate and palpate various pulses, 4) Map the flow of blood
throughout the body.
Overview
The cardiovascular system includes the heart and blood vessels of the body and has,
in a very general concept, the responsibility of transporting nutrients throughout
the body. The heart can be thought of as two pumps that work side by side that
pump blood out to two different circuits of the body- pulmonary and systemic
circuit. The pulmonary circuit pertains to blood flow to and from the lungs and the
systemic circuit pertains to blood flow to and from the body.
The cardiac cycle represents all of the events associated with one complete
heartbeat including the blood flow, cardiac conduction system, heart valves, and the
contraction of the heart muscle. Cardiac output and blood pressure are a result of
the cardiac cycle. Cardiac output is the amount of blood pumped out by a ventricle
in one minute. Blood pressure is the pressure placed or exerted on the walls of the
blood vessels during the cardiac cycle. It is measured in terms of systolic
(ventricular contraction) / diastolic (ventricular relaxation) and normal
measurement of blood pressure is 120/80 mmHg or less. A number of factors can
influence blood pressure including: Improper measurement technique, emotional
state, talking, stress, alcohol, caffeine, full bladder and smoking.
The blood vessels form a close circuit system that starts and ends at the heart and
allows for nutrients to be transported throughout the body. Blood vessels are
dynamic structures that can constrict and dilate, pulsate and even proliferate and
grow into new blood vessels.
There are three categories of blood vessels: Arteries, veins and capillaries. Arteries
carry blood away from the heart, contain oxygenated blood (with one exception),
and have the ability to constrict and dilate. Veins carry blood back to the heart,
contain deoxygenated blood (with one exception), and contain valves. Capillaries
are the smallest and thinnest blood vessels. Technically, capillaries only have an
endothelium allowing nutrients to diffuse from the capillaries to the surrounding
cells and from the body cells to the capillaries.
Determination of heart rate can be completed by palpation of an artery, typically the
carotid or radial artery. There are a number of factors that can influence the
palpation of blood vessel which include: Blood pressure, depth of blood vessel,
emotional state, illnesses, medications, and distance measurement is taken from the
heart.
Materials
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Automatic blood pressure cuff
Stethoscope
Large paper roll
Markers/Colored Pencils/Pens- Blue, Red, Black
Pre-Lab Evaluation Questions
The pre-lab evaluation questions must be answered prior to lab and demonstrated
to your lab instructor. You must read through the assigned chapter readings, lab
introduction, objectives, overview and procedure to answer these questions.
Please cite your work for any reference source you utilize in answering these
questions.
1. How does a condition like heart failure (congestive heart failure) influence
cardiac output?
2. Why is hypertension (high blood pressure) sometimes called the ‘silent
killer’? What are some of the complications of hypertension, specifically to
the blood vessels?
3. What do the Lub and Dub sounds of the heart represent specifically. How do
they relate to the cardiac cycle? When is a heart murmur heard within the
cardiac cycle?
4. How does vasoconstriction and vasodilation of an artery influence cardiac
output and blood pressure? What specific portion (section) of the nervous
system controls the mechanisms of vasoconstriction and vasodilation within
the arteries?
5. Compare and contrast the characteristics of the three types of blood vessels?
Part 01 Procedure: Cardiac Output and Blood Pressure
1. There are a number of factors that will influence cardiac output, blood
pressure and heart rate. We are going to examine some of these factors and
the relationship between cardiac output and blood pressure.
2. Locate the automatic blood pressure (BP) monitor unit. Review the
instructions on how to measure the BP with this unit. Make sure it also
measures and displays heart rate; if not, you will have to measure pulse rate
with the following blood pressure measurements too. Have a lab partner
assist in the measurement of the BP and pulse readings.
3. Take a base line BP reading after you have been sitting still for at least 60
seconds and measure the results in the chart below. Take the blood pressure
measurements preferably without a shirtsleeve underneath the blood
pressure cuff.
4. After your baseline BP measurement sitting, stand up for at least 60 seconds
and take a baseline BP measurement standing and record the results below.
5. After your base line BP measurements, find a location where you can lay
supine for at 90 seconds. After 90 seconds take your BP measurement while
laying supine and record the measurement in the chart below. After the
supine BP measurement is taken, quickly stand up and measure your BP
right away and then after 90 seconds from when you initially stood up.
Measure the results below in the chart.
6. The next measurements will compare stress levels and BP. In a seated
position, close your eyes, think of relaxing items/environments and try to be
as relaxed as possible. After at least 60-90 seconds, measure and record your
BP. Next, try to solve the math questions on the handout from your lab
instructor while your lab partners are ‘harassing’ you to hurry up and finish
up. This is simulating a stressful environment. After about 45-60 seconds,
measure and record your BP measurement.
7. The next BP measurements will assess the changes in BP with mild exercise
and all will be taken in a seated position. Take a brisk walk (speed walk) to
one end of the campus and back and measure your BP. Next perform
jumping jacks or an exercise for 90 seconds. At 90 seconds, stop and
measure and record your BP in a sitting position.
8. Retake your BP after 1 minute and 3 minutes of rest after your BP exercise
measurement.
Situation
Position
Baseline
Seated
Baseline
Standing
Supine
Laying down
Standing
Standing
(Immediately)
Standing
Standing
Relaxed
Seated
Stressed
Seated
Brisk Walk
Seated
(90 seconds)
Exercise
(Immediately
after)
Post-Exercise
(1 minute)
Post-Exercise
(3 minutes)
Blood Pressure
Heart Rate
Cardiac Output
(Stroke Volume of 70ml)
Seated
Seated
Seated
A) Did any specific BP and/or pulse rate measurements surprise you?
Why or why not?
B) What did you notice with the BP when going from a supine position to a
standing or recumbent position? How does orthostatic hypotension
relate to this situation- going from supine to a standing position?
C) Explain how the changes in BP and HR relate to the cardiac output
specifically with the exercise and post-exercise measurements?
Part 02 Procedure: Auscultation of the Heart
1. Auscultation basically means to listen to internal organs to assist in the
diagnosis and treatment of conditions. Being able to auscultate the heart,
you must have a solid knowledge of the cardiac cycle and the heart valves.
Locate a stethoscope and carefully determine if the diaphragm side is
activated.
2. Utilizing the chart in Appendix B, locate and auscultate the four heart valves.
Your lab partner should be of the same sex. Have your lab partner sitting and
slightly lean forward. It is more effective to have the diaphragm of the
stethoscope directly against the skin but this technique will not be utlized in
our laboratory setting. Place the diaphragm side of the stethoscope directly
against the clothing and have your lab partner exhale and then hold their
breath while you listen to heart sounds.
3. Record your observations below:
Sounds
Observations
S1: Lub
S2: Dub
Extra sounds?
4. What sort of heart complication would be present if:
a. There was an extra sound between the Lub and Dub sounds?
b. There was an extra sound occurring after the Lub-Dub sound and
before the next Lub-Dub sound?
Part 03 Procedure: Mapping of the Blood Vessels
1. Locate the large paper roll and cut off a section of it long enough to trace the
outline of you or one of your lab partners. Roll out the section of paper you
collected and with a black marker, color pencil or pen, carefully trace the
outline of your lab partner’s body. Make sure not to get any of the marker on
your lab partner OR his/her clothing.
2. Once you have an outline of a human body, draw a rectangle in the
appropriate anatomical location and size to represent the heart. Draw
quadrants within the rectangle to represent the four heart chambers. Next,
draw a small circle to represent the umbilicus (belly button) in the correct
anatomical location.
3. Utilizing the blood vessels listed in Appendix A, map out the appropriate
arteries and veins. You may want to start drawing out the blood vessels with
a pencil in case you make a mistake. Eventually, you will want to use the red
marker to line (mark) the arteries and the blue marker to line (mark) the
veins listed in Appendix A. You will need to be able to locate these blood
vessels on your laboratory Mid-Term and/or Final.
4. It is recommend that you take a picture of your blood vessel mapping effort
to assist your studies with the identification of these blood vessels.
Part 04 Procedure: Palpation of Pulses
1. Prior to starting this procedure, make sure you have thoroughly cleaned
and/or sanitized your hands. Utilizing the chart below, palpate the pulses
and note any observations of them regarding: Strength, rate, and rhythm.
The rate is examining the overall pulses per minute. The rhythm is
examining the consistency of the pulse; is it regular or irregular. The
strength is examining the force at which the pulse can be palpated. Pulses
measured on blood vessels further away from the heart will be weaker when
compared to pulses taken closer to the heart.
Artery
Rate
Rhythm
Strength
Carotid
Temporal
Brachial
Radial
Ulnar
Femoral
Popliteal
Posterior tibial
Dorsalis pedis
Part 05 Procedure: Blood Flow and Cardiac Conduction System
1. Utilizing the picture found in Appendix C, describe how the intrinsic cardiac
conduction system relates to the cardiac cycle and cardiac output.
2. If an individual had the arrhythmia condition of atrial fibrillation, the most
common type of arrhythmia, what is going on with the intrinsic cardiac
conduction system AND how would the cardiac cycle and cardiac output be
affected? Atrial fibrillation is commonly referred to as afib and is when the
atria contract very rapidly and often irregularly to the point where the
ventricles do not fill up with blood effectively.
Post-Lab Evaluation Questions
The post lab evaluation questions must be completed prior to your submission of
the lab. Answers for these questions will be derived from the lab protocol, the
weekly concepts associated with the lab and possibly research content from the
book and/or online resources.
Please cite your work for any reference source you utilize in answering these
questions.
1. Describe how cardiac output and blood pressure relate to the cardiac cycle?
Can you have an increase of blood pressure and not an increase in cardiac
output? Why or why not?
2. In your own words describe the term angiogenesis. How is angiogenesis
important to the human to the human body? How does it relate to tumors
and cancer?
3. Individuals that have coronary artery disease (CAD), specifically
arteriosclerosis will undergo angioplasty and/or coronary artery bypass
graft procedures. Compare and contrast these procedures.
4. In your own words, define the term ischemia. Describe ways that ischemia
can occur in the body and the various complications that result because of it.
How do the terms ischemia, thrombus and necrosis relate to one another?
5. What is the electrocardiogram (EKG)? How does the EKG relate to the
cardiac cycle? In general, how can an EKG determine if an individual has had
a myocardial infarction (heart attack)?
Appendix A- Cardiovascular System
Vessels To Identify For The Laboratory Mid-Term and Final Exams
Great vessels of the Heart
 Aorta
 Pulmonary arteries
 Pulmonary veins
 Superior vena cava
 Inferior vena cave
Vessels of the Neck and Head
 Brachiocephalic trunk
 R/L Subclavian arteries
 R/L Common carotid arteries
 R/L Internal carotid arteries
 R/L External carotid arteries
 R/L Temporal arteries
 R/L Vertebral arteries
 R/L Internal jugular veins
 R/L External jugular veins
 R/L Subclavian veins
Vessels of the Arm
 R/L Subclavian arteries
 R/L Axillary arteries
 R/L Brachial arteries
 R/L Radial arteries
 R/L Ulnar arteries
 R/L Axillary veins
 R/L Brachial veins
 R/L Radial veins
 R/L Ulnar veins
Vessels of the Chest and Abdomen
 Aortic arch
 Descending aorta
 R/L Internal thoracic arteries
 R/L Renal arteries
 Superior mesenteric artery
 R/L Common iliac arteries
 Inferior vena cava
 R/L Renal veins
Vessels of the Leg
 R/L Common iliac arteries
 R/L External iliac arteries
 R/L Internal iliac arteries
 R/L Femoral arteries
 R/L Popliteal arteries
 R/L Posterior tibial arteries
 R/L Anterior tibial arteries
 R/L Dorsalis pedis arteries
 R/L Common iliac veins
 R/L External iliac veins
 R/L Internal iliac veins
 R/L Femoral veins
 R/L Great saphenous veins
 R/L Popliteal veins
 R/L Posterior tibial veins
 R/L Anterior tibial veins
Appendix B
Regions To Listen For Specific Heart Valves
1. Aortic Valve: Second intercostal space, right sternal border
2. Pulmonary Valve: Second intercostal space, left sternal border
3. Tricuspid Valve: Fourth/Fifth intercostal space, left sternal border
4. Mitral Valve: Fifth intercostal space, left midclavicular line
Heart Sounds
S1/Lub Sound: Closing of the atrioventricular valves
S2/Dub Sound: Closing of the semilunar valves
Appendix C