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Essentials of Human Diseases and Conditions 4th edition Margaret Schell Frazier Jeanette Wist Drzymkowski Chapter 10 Diseases and Conditions of the Circulatory System Orderly Function of the Circulatory System Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 2 Orderly Function of the Circulatory System (cont’d.) Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 3 Cardiac Cycle Diastole - atria fill, all valves closed Diastole - valves open, ventricles fill Systole - atria contract and empty, ventricles are full Systole - ventricles begin to contract, valves close Systole - ventricles contract, aortic and pulmonary valves open, blood to aorta Diastole - ventricles empty, valves close Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 4 Coronary Artery Disease Coronary artery disease: A condition involving the arteries that supply the myocardium, in which the arteries become narrowed due to atherosclerotic deposits over time, causing temporary cardiac ischemia and eventually heart attack Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 5 Coronary Artery Disease (cont’d.) Angina pectoris: A condition of chest pain after exertion that is the result of reduced oxygen supply to the myocardium Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 6 Coronary Artery Disease (cont’d.) Myocardial infarction: (MI) - Death of myocardial tissue caused by the development of ischemia Most common cause is coronary thrombosis. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 7 Treatment Options for Myocardial Infarction Administer oxygen, give morphine for pain. Administer aspirin. Induce vasodilation by nitroglycerin drip. Administer lidocaine by intravenous drip. Administer thrombolytic drugs. Restore blood flow by angioplasty. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 8 Hypertensive Heart Disease Hypertensive heart disease: A condition caused by chronically elevated pressure throughout the vascular system. Most prevalent cardiovascular disorder in the U.S. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 9 Treatment of Hypertension Diuretics to reduce circulating blood volume Beta-adrenergic blockers to slow heartbeat Vasodilators to dilate vessels Angiotensin-converting enzyme (ACE) inhibitors to produce vasodilation and increase renal blood flow Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 10 Hypertensive Heart Disease Essential hypertension Malignant hypertension Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 11 Congestive Heart Failure Congestive heart failure (CHF): An acute or chronic inability of the heart to pump enough blood throughout the body Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 12 Signs of Congestive Heart Failure gradually increasing dyspnea cardiac and respiratory rates increase neck veins distend edema in ankles liver and spleen enlarge Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 13 Congestive Heart Failure (cont’d.) left-sided congestive heart failure left ventricle does not empty blood backs up in pulmonary circulation pulmonary congestion right-sided congestive heart failure right ventricle cannot empty blood backs up in systemic circulation edema in legs and digestive system Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 14 Congestive Heart Failure (cont’d.) Cor pulmonale (right-sided heart disease): Enlargement of the right ventricle as a sequela to primary lung disease Symptoms: dyspnea distended neck veins edema of the extremities enlarged, tender liver Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 15 Chapter 10 Lesson 10.2 Cardiomyopathy Cardiomyopathy: A noninflammatory disease of the cardiac muscle resulting in enlargement of myocardium and ventricular dysfunction three groups: dilated - degeneration of myocardial fibers hypertrophic - small left ventricle restrictive - thickening of myocardium Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 17 Inflammatory Heart Diseases Pericarditis: acute or chronic inflammation of the pericardium, the sac enclosing and protecting the heart Endocarditis: inflammation of the lining and valves of the heart Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 18 Rheumatic Fever Rheumatic fever: a systemic inflammatory and autoimmune disease involving the joints and cardiac tissue generally preceded by sore throat caused by group A beta-hemolytic streptococcus Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 19 Rheumatic Fever (cont’d.) Rheumatic heart disease: the cardiac manifestations that follow rheumatic fever usually affects mitral and aortic valves Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 20 Valvular Heart Disease Mitral valve prolapse (MVP): occurs when the valve cusps do not close completely Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 21 Valve Insufficiency and Stenosis Valve insufficiency: failure of valves to close completely, allows blood to be forced back into heart Stenosis: hardening of cusps of valves that prevents complete opening of valves, impedes blood flow into next chamber Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 22 Cardiac Arrhythmias Cardiac arrhythmias (irregular heartbeats): any deviation from the normal heartbeat, i.e., the normal sinus rhythm Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 23 Causes of Irregular Heartbeat Irregular heartbeat reflects disturbances in normal conduction system, including: the pacemaker (sinoatrial node) atrioventricular node bundle branches Purkinje fibers Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 24 Shock Shock: collapse of the cardiovascular system, including vasodilation and fluid shift accompanied by inefficient cardiac output Cardiogenic shock: inadequate output of blood by the heart when the myocardium fails to pump effectively Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 25 Causes of Shock anaphylaxis hemorrhage sepsis respiratory distress heart failure neurologic failure emotional catastrophe severe metabolic insult Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 26 The Vascular System Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 27 Functions of Vascular System transport system responsible for supplying blood tissues with blood containing oxygen and nutrients conveys waste products and carbon dioxide to organs for excretion arteries - carry blood away from heart veins - carry blood back to heart capillaries - exchange blood at cellular level Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 28 Vascular Conditions Emboli: clots of aggregated material (usually blood) that can lodge in a blood vessel and inhibit the blood flow Venous thrombosis: blood clot that has formed in the deep veins of the legs most common type of embolus Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 29 Vascular Conditions (cont’d.) Arteriosclerosis: a condition that occurs when the walls of the arterioles thicken, with loss of elasticity and contractility Atherosclerosis: a thickening and hardening of the arteries that occurs when plaques of cholesterol and lipids form in the arterial tunica intima Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 30 Risk Factors of Atherosclerosis heredity sedentary lifestyle diet rich in lipids and cholesterol-producing foods smoking diabetes mellitus hypertension obesity Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 31 Chapter 10 Lesson 10.3 Vascular Conditions (cont’d.) Aneurysm: a weakening and resulting local dilation of the wall of an artery Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 33 Vascular Conditions (cont’d.) Phlebitis: an inflammation of a vein that occurs most often in the lower legs, but any vein may be affected Thrombophlebitis: The result of an inflammation of a vein with the formation of a thrombus on the vessel wall Varicose veins: Swollen, tortuous, and knotted veins that usually occur in the lower legs Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 34 Vascular Conditions (cont’d.) Raynaud disease: a vasospastic condition of the fingers, hands, or feet, causing pain, numbness, and sometimes discoloration Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 35 Elements and Functions of Blood elements red blood cells white blood cells platelets plasma functions transports elements to body cells removes waste products helps to maintain homeostasis Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 36 Blood Dyscrasias (cont’d.) Anemia: a condition in which there is a reduction in the quantity of either red blood cells or hemoglobin, reducing the blood’s ability to carry oxygen to the cells Symptoms: fatigue, pale appearance Diagnostic factors: reduced red blood cell numbers, reduced hemoglobin levels, changes in morphology of corpuscles Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 37 Blood Dyscrasias (cont’d.) Classifications of Anemia Iron-deficiency anemia: Insufficient iron intake due to hemorrhage or condition of slow bleeding such as bleeding hemorrhoids Folic acid deficiency anemia: A condition in which insufficient amounts of folic acid are available for DNA synthesis, preventing maturation of blood cells Aplastic anemia: A condition resulting from an insult to the hematopoietic or stem cells in the bone marrow Sickle cell anemia: Chronic hereditary hemolytic form of anemia, in the U.S. found primarily in African-Americans Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 38 Leukemias Leukemias: malignant neoplasms of the blood-forming organs that produce an abnormal, uncontrolled clonal proliferation of one specific type of blood cell in the lymphoid or myeloid cell lines Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 39 Lymphatic Diseases Lymphedema: an abnormal collection of lymph, usually in the extremities Lymphagitis: an inflammation of the lymph vessels Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 40 Lymphatic Diseases (cont’d.) Lymphoma: malignant neoplasms that arise from uncontrolled proliferation of the cellular components of the lymph system Hodgkin disease: cancer of the body’s lymphatic system Non-Hodgkin lymphoma (NHL): describes a number of heterogeneous neoplasms of the lymphoid cells Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 41 Clotting Disorders Classic hemophilia: a hereditary bleeding disorder resulting from a deficiency of clotting factors Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 42