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Circulatory System Part 3 Begins The VAGUS nerve slows me down, while the ACCELERATOR nerve speeds me up. The heart rate can be controlled by two different mechanisms. The hormone acetylcholine slows the heart down, while the hormone epinephrine (adrenaline) speeds it up. HEART PACEMAKER SA node The muscles of the heart want to beat – an intrinsic contraction rhythm. I need to get them all beating at the same time. The SA SinoAtrial node (1) starts the beating of the two atria. The impulse travels to the AV node (2) and initiates the contraction of the two ventricles LOCATION NOTE Pacemaker is in wall of right atrium near entrance of superior vena cava 3 5 AV node sends signal to bundle of His (3) . Signal passes through septum on bundle branches. Signal arrives in ventricle muscle by Perkinje fibres. I’m mean but my heart is a NEUROGENIC HEART of arthropods. Motor neurons outside the heart control the heart rate I’m the MYOGENIC HEART of vertebrates. I have the pacemaker located inside the heart made of special muscle tissues I’m getting an ECG This is an ECG Electrocardiogram. It can show the electrical activity of the heart and can be used to tell if there is heart damage. PQ contraction of the atria Atria depolarization QRS contraction of ventricles Ventricle depolarization T – electrical repolarization Ventricle repolarization With the stethoscope, you can hear the heart sounds. The main sounds are LUB –DUB. The lub sound is the closing of the atrioventricular valves (tricuspid and mitral) and the DUB is the closing of the semilunar valves (pulmonary and aortic). If a hissing sound is heard it is called a heart Murmur and is the result of backflow of blood through a leaky and defective heart valve. Most heart murmurs, however, are not serious enough to need surgery. BLOOD PRESSURE You can determine this with the sphygmomanometer (BPCuff) and a stethoscope. Mercury above 120 mm 1st –Cut off arterial blood flow by inflating cuff above 120mmHg. Cuff pressure exceeds arterial pressurecauses mercury to rise 120mm+ in the column Read the step 2 scale and step 3 scale . Did you get 120mmHg systolic and 80 mmHg diastolic? 120/80 is average for a healthy male Listen with stethoscope 2nd Release pressure slowly and listen for sounds of blood flow. When sound is heard, this is the systolic pressure reading 3rd Loosen the cuff further until blood flows freely and the sounds disappear. This is the diastolic pressure. You might wonder why taking the blood pressure is so important. There are several reasons why. Blood pressure must be maintained for survival and is a direct result of the pumping action of the heart. CARDIAC OUTPUT Blood pressure also results from PERIPHERAL RESISTANCE. Contraction of smooth muscle around the arterioles reduces the blood vessel diameter, increasing blood pressure. Smooth muscle relaxation, causes the blood vessel to dilate and decrease blood pressure. BP is dropping Blood vessel diameter is affected by both nervous, hormonal action drugs and other signals. Ex stress elevates BP by increasing cardiac output and constricting blood vessels. Blood pressure decreases with blood loss. Internal bleeding or external haemorrhage can be detected by dropping blood pressure. A very low blood pressure can lead to cardiac arrest. So this information is very important for medical intervention Add more blood volume. Start the transfusion Extreme Hypertension at 200/120 mmHg very risky Blood pressure will be too high all the time if a person has chronic hypertension (high blood pressure). Blood pressure may be 160/100 mmHg on a regular basis. This is a danger for heart disease, heart failure, stroke, aneurysm, and kidney failure. The blood vessels narrow and lose their elasticity. PLATELET AGGREGATION AND THROMBOSIS PLATELETS STIMULATE the migration and growth of smooth muscle These cholesterol plaques are carried by LDL low density lipoproteins in the bloodstream. When they develop in the heart they can result in a coronary infarction (heart attack) as a result of a coronary artery thrombosis (blood clot) which blocks delivery of oxygen to the heart muscle. If this same even happens in the brain, it is a stroke. Take a look at these arteries. They have been narrowed considerably by the accumulation of cholesterol deposits. This would increase the blood pressure of the artery. It is increased even more as the cholesterol calcifies, hardening the artery and causing it to lose its flexibility . A thrombosis is a blood clot inside the blood stream usually caused by platelets adhesion to the rough surface of a plaque and the resultant clotting process. TODAY SHOW ANCHOR DAVID BLOOM IN IRAQ If you are sitting for a long time as on an airplane or in David Bloom’s case a cramped armoured personnel carrier, it is recommended that you get up and stretch regularly to avoid potential blood clots. The thrombosis does not even have to develop in the heart or brain to be fatal. David Bloom died when a clot developed in his lungs and travelled to his heart. When the clot breaks off and travels it is called an embolus. This embolus can then clog a critical artery as it passes into the narrower lumen. He died as a result of a pulmonary embolism. It’s a sad state of affairs when components of the immune system(platelets) lead to death, but if the blood vessels would have been clear of plaques, this probably would not have happened. You may ask. “How do I know if I am having a heart attack.” Here are some of the main symptoms. Remember, not all are necessary to indicate a myocardial infarction Chest pain – gradual tightness pressure or squeezing due to ischemia (lack of blood flow to the heart). Often radiates to the left arm but sometimes the lower jaw, neck, back or epigastrium where it mimics heartburn. Shortness of breath Excessive sweating Grey skin tone Weakness Nausea Vomiting Sleep disturbances Anxiety If you have these symptoms, take it seriously. Do not push yourself. Contact medical services immediately. Here are some things that can be done immediately Take a baby aspirin – it will act as a blood thinner to stop blood clots from lodging in arterioles. Site of blood clot blockage. CPR can be conducted on an unconscious patient without a pulse. If a defibrillator is available, the heart beat may be restored with a burst of high voltage. Remember, the heart is not dead after a heart attack, it has just been allowed to vibrate out of rhythm. (called ventricular fibrillation) Site of heart damage due to blockage. This muscle is dead (replaced be scar tissue) and will no longer pump. The heart is weakened Once the suspected heart attack patient is at the hospital, an ECG can be done and abnormalities in the graph may reveal if a heart attack has occurred. We can also detect if there has been a heart attack by a blood test that checks for a particular blood protein found after a heart attack If we suspect that there may be a a blockage the angiograph can be done. This is an angiograph. A catheter with dye is inserted into an artery and a sequence of X rays are performed. The picture clearly shows coronary artery blood flow and blockage areas. If there is a blockage there are options. Angioplasty and stents Coronary bypass surgery Hidden Biology in intellectual literature and movies Original Willy Wonka and the Chocolate factory completed with input from the original book author Roald Dahl. When Violet Beauregarde is interviewed on T.V. upon discovering a Golden Ticket, she exclaims: Now this piece of gum here is one I've been chewing for three months solid, and that's a world record. It's beaten the record held by my best friend Miss Cornelia Prinzmetel, and was she mad! Hi, Cornelia, how are you sweetie? Prinzmetal's Angina, or coronary artery spasm, is an uncommon condition seen in both men and women. Episodes of typical (though severe) angina are triggered when one of the major coronary arteries suddenly goes into spasm, temporarily shutting off blood flow. Note: coronary arteries to feed the heart muscle Here are some very important blood vessels to the head. The carotid arteries lead through the neck up to the oxygen sensitive brain. Fresh blood is constantly delivered immediately after each heart beat. Subclavian arteries service the arms.. Blood returns to me from the head through the jugular veins. Carotid arteries Here are the rest of the blood vessels. The important ones are marked Dorsal aorta Renal artery Femoral artery Get yourself familiar with these blood vessels. Can you figure them out? A - pulmonary artery B- inferior vena cava C – hepatic portal vein D – renal vein E – pulmonary vein F - Aorta G – Hepatic arteries H – mesenteric arteries hepatic portal vein Deoxygenated blood B- inferior vena cava Deoxygenated blood Right atrium Deoxygenated blood Tricuspid valve Deoxygenated blood Right ventricle Deoxygenated blood Aortic valve Deoxygenated blood Pulmonary artery Deoxygenated blood Try to trace a blood cell from the hepatic portal vein to the left common carotid artery Lungs Pulmonary vein Oxygenated blood Left atrium Oxygenated blood Mitral valve Oxygenated blood Left ventricle Aortic valve Oxygenated blood Oxygenated blood Aorta Oxygenated blood Left common carotid Oxygenated blood You may also be asked when the blood is oxygenated or not oxygenated. Umbilical arteries(2) Deoxygenated blood placenta Umbilical vein Oxygenated blood Inferior vena cava Oxygenated blood All 4 heart chambers Vein with oxy blood Oxygenated blood You really have to know your stuff to understand fetal circulation. Here the fetus does not receive oxygen in the pulmonary cycle- the fetus is in the uterus and does not obtain oxygen through its lungs. It is totally dependent on the oxygen supply it receives when it sends blood to the placenta. Blood is actually diverted away from the useless lungs by the ductus arteriosis. Once the baby breathes, this artery degenerates. Well that’s all for now. Circulation ends