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Transcript
The Cardiovascular System Chapter 15 Human Circulation • Double loop circulation • Pulmonary circuit • Systemic circuit 15. 1 The Heart Size and Location of the Human Heart • Location: • Bordered laterally by the lungs • Posteriorly by the vertebrae • Anteriorly by the sternum Covering of the Heart • Pericardium • Fibrous pericardium – surrounds a more delicate membrane • Visceral pericardium (epicardium) • Parietal pericardium – epicardium folds to line inside of fibrous pericardium • Between the parietal and visceral layers is pericardial cavity • Contains serous fluid • Reduces friction Wall of the Heart • Epicardium • Myocardium • Endocardium Epicardium • Outermost layer of the heart • Corresponds with visceral pericardium • Contains • Capillaries and nerve fibers • Fat tissue along blood vessels Myocardium • Middle layer • Cardiac muscle to pump blood • Muscle tissue is arranged in layers, separated by vascular connective tissue Endocardium • Innermost layer • Epithelium, connective tissue • Blood vessels • Purkinje fibers • Specialized cardiac muscle fibers – propagate signal through heart • Lines all heart chambers, valves and lining extends into blood vessels Heart Chambers and Valves • 4 chambers • 2 atria • 2 ventricles Atrium (Atria) • Upper chambers of the heart • Receive blood • Thin walled Ventricles • Lower chambers • Very muscular • Right and Left Ventricles separated by the interventricular septum Valves of the Heart • Right Atrioventricular Valve (tricuspid) • Left Atrioventricular Valve (Mitral Valve) • Bicuspid valve • Pulmonary Valve • Tricuspid valve • NO chordae tendineae or papillary muscles • Aortic Valve Heart Chambers and Valves • Right atrium • Receives blood from the superior vena cava, inferior vena cava • Coronary sinus – from myocardium Valves • Chordae tendineae – attach to tricuspid on ventricular side • Originate from papillary muscles • Prevent tricuspid valve from flipping into the atrium Right Ventricle • Thinner walls than the left ventricle • Pumps blood to the lungs • Exits heart and into the pulmonary trunk • Divides into left and right pulmonary arteries Return to the heart… • From lungs, blood exits through pulmonary veins (4) • Two from right lung, two from left lung • Blood enters left atrium Left Atrium • Blood passes from left atrium to left ventricle through the mitral valve Left Ventricle and Aorta • Left ventricle contracts • Closing mitral valve • Sends blood to aorta through aortic valve Blood Supply to the Heart • Coronary arteries – from aorta • Right and left • Cardiac veins – drain deoxygenated blood from heart • Join at the coronary sinus • Empties into right atrium Label the Heart with Blood Flow 15.3 Heart Actions Heart Actions • Systole • Contraction • Depends on which part of the heart • Atrial systole • Ventricular systole • Diastole • Relaxation • Atrial diastole • Ventricular diastole Cardiac Cycle • Cycle of contractions between the atria and ventricles Heart Sounds • Lubb Dubb • Lubb – ventricular systole • AV valves are closing • Dubb – ventricular diastole • Pulmonary and aortic valves are closing Heart Sounds • Can tell you the condition of the heart valves • Murmur: some blood leaks back through the valve • Many murmurs are harmless • Some can be a sign of serious valve damage Electrocardiogram Electrocardiogram • ECG (EKG) • Measures electrical changes within the myocardium during cardiac cycle Steps of an ECG • P wave • QRS complex • Q wave • R wave • S wave • T wave P Wave • Depolarization of atrial fibers QRS Complex • Indicates depolarization of ventricular fibers prior to contraction T Wave • Repolarization of ventricular fibers after contraction ECG Uses • Assess heart’s ability to conduct impulses • PQ interval: time to travel from SA node through AV node SA Node • Coordinates events of the cardiac cycle • Sinoatrial node • Right atrium near opening to superior vena cava • Pacemaker: generates heart’s rhythmic contractions AV Node • Atrioventricular node • Coordinate contraction of ventricles together AND after the atria • Impulse travels to AV bundle (bundle of His) and move through ventricular myocardium • Through right and left bundle branches then to myocardium via Purkinje fibers • Allow ventricle to contract as one unit Nodes of the Heart Regulation of Cardiac Cycle • Vagus nerves: originate in the medulla oblongatta • Innervate and regulate heart 15.4 Blood Vessels Types of Blood Vessels • Arteries • Arterioles • Capillaries • Venules • Veins Blood Vessel Tunics • 3 layers (tunics) • Tunica interna (innermost) • Epithelial cells • Tunica media (middle) • Smooth muscle • Tunica externa (outermost) • Tougher connective tissue, elastin, collagen Arteries • Muscular • Very elastic • Carry blood AWAY from the heart • Smaller arteries = arterioles Veins • Little muscle • Large lumen (space for blood to pass through), less muscle • Brings blood to the heart • Contain valves • Flow through veins is assisted by skeletal muscle • Small veins = venules Arteries vs. Veins Capillaries • Smallest blood vessel • Extension of innermost layer of arteries/veins – tunica interna • Single layer of epithelial cells • Allow for easy exchange of materials from blood to tissues 15.7 Arterial System Leaving the heart… Leaving the heart… • Aorta • Largest artery (diameter) in body • Three major arteries come from the aortic arch • Brachiocephalic artery • Left common carotid artery • Left subclavian artery Brachiocephalic Artery • Supply blood to the upper limb, head • Divides to give rise to • Right common carotid artery • Right subclavian artery Descending Aorta • Extends from aortic arch down the body • Thoracic aorta • Bronchial arteries • Esophageal arteries More Descending Aorta • Abdominal Aorta • Celiac artery • Left gastric (upper digestive tract) • Splenic (spleen …duh…) • Hepatic (liver) • Phrenic artery (Diaphragm) • Superior mesenteric (Intestines (most)) Still the descending aorta… • And MORE from the Abdominal Aorta • • • • • • Suprarenal (adrenal glands) Renal (kidneys) Gonadal (gonads …duh…) Inferior Mesenteric (parts of the colon, rectum) Lumbar (muscle of skin of posterior abdominal wall) Medial Sacral (sacrum, coccyx) Arteries of the Brain, Neck, Head • Vertebral • Through transverse processes of cervical vertebrae • Enter skull through foramen magnum • External carotid • Internal carotid Arteries of the Shoulder and Upper Limb • From subclavian artery • Axillary artery (shoulder, upper chest) • Brachial artery (along the humerus) • Radial artery • Ulnar artery Arteries of the Lower Limb • Abdominal aorta splits to form common iliac arteries • Internal iliac artery (pelvic region) • External iliac artery (main blood supply to lower limbs) • Inferior epigastric artery • Deep circumflex iliac artery Arteries of the Lower Limb • External iliac artery becomes the femoral artery (deep femoral, superficial femoral) • Femoral artery becomes the popliteal artery as it passes over the patella • Divides • Anterior tibial artery • Posterior tibial artery Venous System How Veins Work • Capillaries join to form venules • Venules join to form small veins • Small veins join to form large veins Veins • Veins typically are paired with an artery • Renal artery and the renal vein • Bring blood to the kidney from the heart, take blood from the kidney to the heart • BUT not always • Venous blood flow is assisted by skeletal muscle contraction Veins • Superior Vena Cava • Inferior Vena Cava • Both lead to the right atrium from the body Veins from the Brain, Head, Neck • External jugular vein • Internal jugular vein • Brachiocephalic vein • Right subclavian vein • Right axillary vein Veins from the Upper Limb and Shoulder • Paired • Radial veins • Ulnar veins • Brachial veins Veins from the Abdominal Viscera • Originate in the capillaries of the stomach, intestines, pancreas, spleen • Merge at the hepatic portal vein to the liver • Superior mesenteric vein (small intestine, portions of colon) • Inferior mesenteric vein (colon and rectum) • Gastric veins (stomach) • Splenic vein (spleen, pancreas) Hepatic Portal System What happens in the liver? • Regulation of glucose within the body • Phagocytosis of microorganisms • Breakdown of toxins • After the liver, blood enters the hepatic veins and the inferior vena cava Veins from Lower Limb and Pelvis • Anterior tibial vein • Posterior tibial vein • Popliteal vein • Femoral vein • Great saphenous vein (largest vein in the body – extends from medial foot to the femoral vein) • External iliac vein Cardiovascular Diseases and Abnormalities 1. 2. 3. 4. 5. 6. 7. Cardiac Arrest Stroke Aneurysm Arteriosclerosis / Atherosclerosis Murmur Hypertension Myocardial Infarction • What causes the disease/abnormality? • What are some possible effects of the disease/abnormality? • How is it diagnosed? • Possible treatments? Cardiac Arrest • Cause: heart’s electrical system malfunctions, may be caused by abnormal or irregular heart rhythms • Effects: often results in death, brain death occurs within a few minutes if situation isn’t reversed, sudden cardiac arrest: death within 1 hr. of symptoms • Diagnosis: hard to detect because so sudden, but symptoms are- loss of consciousness, no breathing, no pulse, chest pain, weakness, pounding in chest, feeling faint • Treatments: CPR right away, defibulator Stroke Causes: Occurs when blood flow to the brain is interrupted or reduced • Arteries to brain become narrowed or blocked • Blood vessels in the brain leak Effects: • Brain damage • Impairment – loss of normal function of part of the body (may be permanent) • Death Diagnosis: • Blood tests • Physical examination • (CT) scan • MRI • Cerebral angiogram Treatments: • Aspirin • Mechanical clot removal • Angioplasty and stents • Blood vessel repair • Stoke recovery and rehabilitation Aneurysm • Part of the artery/cardiac chamber swells with blood forming a bubble • Most commonly found on the wall of the (left) aorta • Causes: atherosclerosis, smoking, hypertension, vaculities, cocaine usage, and/or genetic links • Effects: hemorrhage, other complications, or sudden death • Diagnosis: abdominal ultrasound, CT, MRI, regular screening • Treatment: wait and watch or surgery • All depends on the size of the aneurysm Arteriosclerosis / Atherosclerosis • Arteriosclerosis- it is caused by the thickening and hardening of the arteries • Atherosclerosis- this is caused by the build up of fatty plaques in the arteries • Effects- blood flow will decrease and pressure will increase • Diagnosis- your doctor may find signs of narrowed, enlarged or hardened arteries during a physical exam. • • • • • A weak or absent pulse below the narrowed area of your artery Decreased blood pressure in an affected limb Whooshing sounds (bruits) over your arteries, heard using a stethoscope Signs of pulsating bulge (aneurysm) in your abdomen or behind your knee Evidence of poor wound healing in the area where your blood flow is restricted Treatments- cholesterol medications, anti-platelet medication, beta blocker medications, calcium channel blockers, water pills, bypass surgery, thrombolytic therapy Murmur • Causes• Valve abnormalities: • Stenosis- narrowing of the heart valve. • Regurgitations- leaks blood backwards. • Sclerosis- mild narrowing. • Prolapse- Bowing of the heart valve. • Endocarditis- Infection of the heart. • Effects: Chest pain, shortness of breath, swelling of extremities. • Diagnosis: Patient history, physical examination. • Treatment: Monitored, antibiotics or surgery. murmur Hypertension • High Blood Pressure (HBP) • Causes: Smoking, being overweight, lack of physical activity, too much salt in diet, high alcohol consumption, stress, old age, genetics, chronic kidney disease, adrenal and thyroid disorders. • Effects: nervousness, sweating, difficulty sleeping, facial flushing, blood spots in the eyes, dizziness, stroke, death • Diagnosis: blood pressure test (optimal blood pressure is less than 120/80 mmHG) • Treatments: lifestyle changes (diet, exercise, stop smoking, managing stress, limit alcohol consumption) and medication. Myocardial Infarction • Heart Attack • Occurs when an artery leading to the heart is completely blocked off and the heart doesn’t get enough blood or oxygen, causing cells in that area to die( called an infarct) • Feeling of DOOM, squeezing pain, heaviness, tightness, pressure in center of chest, shortness of breath, death • ECG, blood tests, chest x-ray, stress test • Change lifestyle, medications, surgical treatments, nutrition and dietary supplements, diets for people with high blood pressure.
