Download Cardiovascular System

Cardiovascular System
Circulation and Blood Pressure
Cardiovascular Review
Stethoscope
•
A medical instrument
to listen to sounds
produced in the body,
especially those that
emanate from the
heart and lungs.
Stethoscope
Used to auscultate heart sounds (ie: normal heart
sounds, heart murmurs, irregular heart rhythms, or
abnormal heart sounds).
Used to auscultate the sound of air moving through
the lungs in order to detect abnormalities in the air
tubes and sacs found in the lung or abnormalities
outside the lung.
Used to auscultate and detect abnormalities in vessel
walls.
Used to auscultate BP (blood pressure).
Used to auscultate gastrointestinal sounds.
Stethoscope
Ear tips or Earpieces
Binaural or Ear Tubes
Acoustic Tubing
Chest Piece
Diaphragm (for high
pitched sounds)
Bell (for low pitched
sounds)
Cardiac Cycle
Is a sequence of events that occur when the
heart beats.
There are two phases of the cardiac cycle.
Diastole - the ventricles are relaxed and the
heart fills with blood.
Systole - the ventricles contract and pump
blood to the arteries.
Diastole
During the diastole phase, the atria and ventricles are
relaxed and the atrioventricular valves are opened.
Blood flows into the relaxed ventricles while the
atrioventricular valves are opened.
De-oxygenated blood from the superior and inferior
vena cava flows into the right atrium.
When the pressure in the ventricles gets lower than
the pressure in the atria the AV valves open, allowing
blood to flow into the relaxed ventricles.
The open AV valves allow blood to flow into the
ventricles.
Systole
During the systolic phase, the ventricles receive
impulses from the Purkinje fibers and contract.
The AV valves close due to ventricular
contraction and the semilunar valves open.
The blood is pumped into the Pulmonary artery
and Aorta.
Cardiac Cycle
One cardiac cycle is when the heart fills with
blood and the blood is then pumped from the
heart. The audible sounds that can be heard
from the heart are made by the closing of the
heart valves. These sounds are referred to as
the "lub-dub" or "lub-dupp".
The "lub" (S1) sound the are by the closing
of the AV valves.
The "dub" (S2) sound is made by the
semilunar valves closing.
Cardiac Cycle
Ejection Fraction (EF)
The amount of blood pumped (ejected) by your
heart with each beat
Measured with an echocardiogram
Normal EF is 50% or greater, which means at least
one-half of the blood in the heart is ejected with
each beat
Types of Circulation
Coronary - the circulation of blood within the
heart (coronary arteries branch off the aorta to
supply blood to the heart muscle)
Pulmonary - the flow of blood between the heart
and the lungs
Systemic - the flow of blood between the heart
and the cells of the body (arteries, arterioles,
capillaries, venules, veins)
CAD
Coronary Artery Disease
Also known as, ASHD- Artherosclerotic Heart
Disease
A result of the accumulation of plaques on the walls
of the coronary arteries (fat, cholesterol, calcium,
etc)
Blocks or reduces the flow of blood to the heart
muscle (myocardium)
Can cause a heart attack (myocardial infarction)
Myocardial Infarction
Occurs when blood flow is blocked to the heart muscle
causing ischemia (lack of O2) and cell death or damage
Symptoms can include:
Pressure
Pain (Angina)
Diaphoresis
Nausea
PAD/PVD
Peripheral Artery Disease/
Peripheral Vascular Disease
A condition of the blood vessels that leads to
narrowing and hardening of the arteries that
supplies the legs and feet.
The narrowing of the blood vessels leads to
decrease blood flow, which can injure nerves
and other tissues.
Common Carotid Arteries
Brachiocephalic Artery
Right Subclavian Artery
Right Subclavian Vein
Superior Vena Cava
Right Axillary Vein
Right Atrium
Right Ventricle
Hepatic Veins
Inferior Vena Cava
Internal Jugular Veins
Left Subclavian Artery
Left Subclavian Vein
Aortic Arch
Pulmonary (Trunk) Artery
Left Atrium
Ascending Aorta
Left Axillary Vein
LeftVentricle
Descending Aorta
Arterial & Venous Branches of
the abdominal area
Common Iliac Arteries
Right Internal Iliac Artery
Right External Iliac Artery
Femoral Veins
Femoral Arteries
Blood Pressure
The amount of pressure
exerted on the arterial walls
as blood pulsates through
them.
Blood Pressure
Blood pressure is typically recorded as two numbers.
Read as "117 over 76 millimeters of mercury“ (mmHg)
Systolic- the top number, which is also the higher of the
two numbers, measures the pressure in the arteries
when the heart muscle (ventricles) ______________
contracts
Diastolic - the bottom number, which is the lower of the
two numbers, measures the pressure in the arteries
when the heart muscle is ____________
between
resting
beats and refilling with blood
Healthy Blood Pressure
AHA recommendation
Systolic is < 120
Diastolic is < 80
Prehypertensive - systolic is 120-139 or diastolic
is 80-89
Blood Pressures
Prehypertension
Systolic Pressure - 120-139 mmHg
Diastolic Pressure - 80-89 mmHg
HTN Stage 1
Systolic Pressure - 140-159 mmHg
Diastolic Pressure - 90-99 mmHg
HTN Stage 2
Systolic Pressure > 160
Diastolic Pressure > 100
Hypotension
Low blood pressure
Systolic pressure is <
100 mmHg and
Diastolic is < mmHg
Orthostatic Hypotension
Postural Hypotension – occurs when there is
a sudden drop in both systolic and diastolic
pressure
This occurs when the individual moves form a
lying to a sitting or standing position
Caused by an inability of the blood vessels to
compensate quickly to the change in position
Sphygmomanometer
A sphygmomanometer ( or blood pressure meter )
is a device used to measure blood pressure,
composed of an inflatable cuff to restrict blood
flow, and a mercury or mechanical manometer to
measure the pressure. It is always used in
conjunction with a means to determine at what
pressure blood flow is just starting, and at what
pressure it is unimpeded.
Sphygmós means pulse, mano means pressure,
and meter means measuring device.
Sphygmomanometer
A sphygmomanometer
consists of an inflatable
cuff, a measuring unit
(the mercury manometer,
or aneroid gauge), and a
mechanism for inflation
which may be a manually
operated bulb and valve
or a pump operated
electrically.
Sphygmomanometer
Sphygmomanometer
The usual unit of measurement of blood
pressure is millimeters of mercury (mmHg) as
measured directly by a manual
sphygmomanometer.
Manual sphygmomanometers require a
stethoscope for auscultation. They are used by
trained practitioners, and cannot be used in
environments too noisy to permit hearing the
characteristic sounds. It is possible to obtain a
systolic reading through palpation.
Mercury Sphygmomanometer
Aneroid Sphygmomanometer
Recording Blood Pressure
Recorded as a fraction
Systolic is the top number
Diastolic is the bottom number
120/80
Procedure
Cuff appropriate size for patient
Arm free of restrictive clothing
Deflated cuff should be placed on the arm with
the center of the bladder directly over the
brachial artery
Lower edge of cuff should be 1-1½ inches
above the bend of the elbow
Place stethoscope (bell or diaphragm directly
over the brachial artery at the antecubital area
(bend in the elbow)
Procedure (continued)
Hold securely with slight pressure (DO NOT use
your thumb)
Chart BP correctly on graphic sheet
Do Not Use
Arm with an IV
Arm with paralysis
Surgical Arm – surgery has been done on the
arm, hand, etc.