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Medical Terminology: An Illustrated Guide, Eighth Edition (Cohen)
Lesson Plans
Chapter 9—Circulation: The Cardiovascular and Lymphatic Systems
Goals of the Lesson:
Cognitive: Students will be able to identify the structure and function of the cardiovascular and lymphatic system, in
its normal and clinical aspects. They will also learn different disorders, medical terms, and medical abbreviations
involving the cardiovascular and lymphatic system.
Motor: The students will be able to identify the various structures on models of the heart. They will also be able to identify
the location of the lymphatic structures.
Affective: The students will gain understanding of the complexity and interrelationship of the cardiovascular and lymphatic
system.
Learning Objectives:
The lesson plan for each objective starts on the page shown below.
9-1
Describe the structure of the heart ............................................................................................................................... 3
9-2
Trace the path of blood flow through the heart ............................................................................................................ 5
9-3
Trace the path of electrical conduction through the heart ............................................................................................ 7
9-4
Identify the components of an electrocardiogram ....................................................................................................... 9
9-5
Differentiate among arteries, arterioles, capillaries, venules, and veins. ..................................................................... 10
9-6
Explain blood pressure and describe how blood pressure is measured........................................................................ 12
9-7
Identify and use the roots pertaining to the cardiovascular and lymphatic systems. ................................................... 14
9-8
Describe the main disorders that affect the cardiovascular and lymphatic systems..................................................... 15
9-9
Define medical terms pertaining to the cardiovascular and lymphatic systems. ......................................................... 29
9-10
List the functions and components of the lymphatic system. ...................................................................................... 31
9-11
Interpret medical abbreviations referring to circulation .............................................................................................. 33
9-12
Analyze medical terms in case studies involving circulation. ..................................................................................... 34
You Will Need:
Gather the following materials and teaching aids for the following lessons:
Page 1 of 35
Copyright © 2017 Wolters Kluwer  Lippincott Williams & Wilkins
Selected Key Terms
The Cardiovascular System
aorta
aortic valve
apex
artery
arteriole
atrioventricular (AV)
node
atrioventricular (AV)
valve
atrium
AV bundle
blood pressure
bundle branches
capillary
cardiovascular
system
depolarization
diastole
electrocardiography
(ECG)
endocardium
epicardium
functional murmur
heart
heart rate
heart sounds
inferior vena cava
left AV valve
mitral valve
myocardium
pericardium
pulmonary artery
pulmonary circuit
pulmonary veins
pulmonary valve
pulse
Purkinje fibers
repolarization
right AV valve
septum
sinus rhythm
sinoatrial (SA) node
sphygmomanometer
superior vena cava
systemic circuit
systole
valve
vein
ventricle
venule
vessel
The Lymphatic System
appendix
lymph
lymph node
lymphatic system
Peyer patches
right lymphatic duct
spleen
thoracic duct
thymus
tonsils
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
9-1
1. An unlabeled poster of the heart, note cards labeled with the structures of the heart; 2. Animal hearts, dissection
tools, gloves, biohazard containers
9-2
Poster of the heart, red and blue arrows
9-3
1. Stethoscope and microphone; 2. Unlabeled version of Figure 9-3, poster size or projected.
9-4
Copies of ECG tracings
9-5
Anatomic model showing the arteries and veins
9-6
Sphygmomanometers, stethoscopes, alcohol prep pads, biohazard container
9-7
Stedman’s Medical Terminology Flash Cards, 2e (2009); Stedman’s Medical Dictionary for the Health Professions
and Nursing, Illustrated, 7th ed. (2011), one per small group
9-9
1. Stedman’s Medical Terminology Flash Cards, 2e (2009); 2. Small slips of paper with terms from the chapter, five
terms for each student
9-10
Poster boards and markers
9-11
Note cards
9-12
Stedman’s Medical Dictionary for the Health Professions and Nursing, Illustrated, 7th ed. (2011), one per small
group
Page 2 of 35
Copyright © 2017 Wolters Kluwer  Lippincott Williams & Wilkins
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
Objective 9-1
Describe the structure of the heart.
Date:
Lecture Outline
Content
 Layers of the heart (from
innermost to outermost)

Endocardium: a thin
membrane that lines the
chambers and valves

Myocardium: a thick muscle
layer that makes up most of
the heart wall

Epicardium: a thin
membrane that covers the
heart
 Pericardium: a fibrous sac that
contains the heart and anchors it
to surrounding structures
Text
page
164
PPt
slide
24–26
Figures, Tables, and
Features
Resources
Outside Assignments
9-1 The cardiovascular
system. The pulmonary
circuit carries blood to and
from the lungs; the
systemic circuit carries
blood to and from all other
parts of the body.
p. 164
Activities for Chapter 9 in
thePoint (SR).
Chapter Review
pp. 195–201
9-2 The heart and great
vessels. AV stands for
atrioventricular.
p. 165

Atria (singular: atrium)

The heart’s two upper
receiving chambers

Separated by the
interatrial septum
Ventricles (singular:
ventricle)

The heart’s two lower
pumping chambers

Separated by the
interventricular septum
Outside Assignments
Evaluation
Figures
 Chambers of the heart

Resources and
In-Class Activities
Page 3 of 35
Copyright © 2017 Wolters Kluwer  Lippincott Williams & Wilkins
Evaluation
In-Class Activities
Test Bank (IR)
1. Pin an unlabeled poster
of the heart to a large soft
board. Divide the class into *Adaptive Learning
Powered by PrepU
small teams. Randomly
distribute labels of the heart Individualized, adaptive
to each team. Ask a person
learning through quizzing
from one team to go to the
and remediation is
poster and pin his or her
available for this chapter.
label at the correct position.
If the person gets the label
wrong, the label is passed
to the next team. Give the
SR
teams points for correctly
Have students work
labeling the parts.
through exercises for
Chapter 9 in thePoint (SR).
Materials
An unlabeled poster of the
heart, note cards labeled
with the structures of the
heart
2. Obtain several hearts
from a butcher. Divide
students into groups; give
Instructor’s Notes
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
each group a heart. Allow
the students to use
dissection tools to dissect
the hearts and identify the
various structures.
Materials
Animal hearts, dissection
tools, gloves, biohazard
containers
Legend: IR: Instructor’s Resources; SR: Student Resources (thePoint); PPt: PowerPoint
Page 4 of 35
Copyright © 2017 Wolters Kluwer  Lippincott Williams & Wilkins
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
Objective 9-2
Trace the path of blood flow through the heart.
Date:
Lecture Outline
Content
 The sequence of blood flow
through the heart


The right atrium receives
blood low in oxygen from all
body tissues through the
superior vena cava and the
inferior vena cava
Text
page
PPt
slide
165
27
Figures, Tables, and
Features
Blood returns from the lungs
high in oxygen and enters
the left atrium through the
pulmonary veins

Blood enters the left
ventricle and is forcefully
pumped into the aorta to be
distributed to all tissues
Resources
Outside Assignments
9-2 The heart and great
vessels. AV stands for
atrioventricular.
p. 165
Activities for Chapter 9 in
thePoint (SR).
Chapter Review
pp. 195–201
 One-way valves in the heart keep
blood moving in a forward
direction

The valves between the
atrium and ventricle on each
side are the atrioventricular
(AV) valves

The valve between the right
Outside Assignments
Evaluation
Figures
The blood then enters the
right ventricle and is pumped
to the lungs through the
pulmonary artery

Resources and
In-Class Activities
Page 5 of 35
Copyright © 2017 Wolters Kluwer  Lippincott Williams & Wilkins
Evaluation
In-Class Activities
Pin a poster of the heart to a
large soft board. Divide the
class into two teams.
Distribute red and blue
arrows to the teams. Ask
each team to pin the red
and blue arrows in the
correct sequence. Give the
teams points for correctly
pinning the arrows.
Materials
Poster of the heart, red and
blue arrows
Animations
View “Blood Circulation”
(IR, SR)
Test Bank (IR)
*Adaptive Learning
Powered by PrepU
Individualized, adaptive
learning through quizzing
and remediation is
available for this chapter.
SR
Have students work
through exercises for
Chapter 9 in thePoint (SR).
Instructor’s Notes
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
atrium and ventricle is the
right AV valve




This is also known as
the tricuspid valve
because it has three
cusps
The valve between the left
atrium and ventricle is the
left AV valve

This is a bicuspid valve
with two cusps

It is often called the
mitral valve
The valve at the entrance to
the pulmonary artery is the
pulmonary valve

It has three cusps

Each cusp is shaped like
a half-moon, so this
valve is described as a
semilunar valve
The valve at the entrance to
the aorta is the aortic valve

It also has three cusps
and is a semilunar valve
Legend: IR: Instructor’s Resources; SR: Student Resources (thePoint); PPt: PowerPoint
Page 6 of 35
Copyright © 2017 Wolters Kluwer  Lippincott Williams & Wilkins
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
Objective 9-3
Trace the path of electrical conduction through the heart.
Date:
Lecture Outline
Content
 Cardiac contractions are
stimulated by a built-in system
that regularly transmits electrical
impulses through the heart
 The components of this system
include the following (listed in
the sequence of action):


Sinoatrial (SA) node

Located in the upper
right atrium

Called the pacemaker
because it sets the rate
of the heartbeat
Atrioventricular (AV) node



PPt
slide
166
28–30 Figures
9-3 The heart’s electrical
conduction system.
Impulses travel from the
sinoatrial (SA) node to the
atrioventricular (AV) node,
then to the atrioventricular
bundle, bundle branches,
and Purkinje fibers.
Internodal pathways carry
impulses throughout the
atria.
p. 166
Boxes
9-1 Focus on Words: Name
That Structure
p. 167
Internodal fibers
between the SA and AV
nodes carry stimulation
throughout both atria
AV bundle (bundle of His)


Located at the bottom of
the right atrium near the
ventricle
Figures, Tables, and
Features
Text
page
Located at the top of the
interventricular septum
Left and right bundle
branches

These travel along the
Page 7 of 35
Copyright © 2017 Wolters Kluwer  Lippincott Williams & Wilkins
Resources and
In-Class Activities
Outside Assignments
Evaluation
Resources
Outside Assignments
Activities for Chapter 9 in
thePoint (SR).
Chapter Review
pp. 195–201
Evaluation
In-Class Activities
1. Ask a volunteer to step
forward. Listen to the
volunteer’s heartbeat using
a stethoscope. If the
heartbeat is normal, attach
the earphone of the
stethoscope to a
microphone. Ask the class
to listen to the heartbeat
and identify the systole and
diastole. Simultaneously,
ask the students to measure
the heart rate.
Materials
Stethoscope and
microphone
2. Display an unlabeled
version of Figure 9-3. Have
students take turns
attempting to label the
components of the
electrical conduction
Test Bank (IR)
*Adaptive Learning
Powered by PrepU
Individualized, adaptive
learning through quizzing
and remediation is
available for this chapter.
SR
Have students work
through exercises for
Chapter 9 in thePoint (SR).
Instructor’s Notes
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
left and right sides of
the septum

Purkinje fibers

Carry stimulation
throughout the walls of
the ventricles
 Heartbeat generation

The heart itself generates the
heartbeat

Factors such as nervous
system stimulation,
hormones, and drugs can
influence the rate and the
force of contractions
system of the heart.
Materials
Unlabeled version of Figure
9-3, poster size or
projected.
Animation
View “Cardiac Cycle” (IR,
SR)
Legend: IB: IR: Instructor’s Resources; SR: Student Resources (thePoint); PPt: PowerPoint
Page 8 of 35
Copyright © 2017 Wolters Kluwer  Lippincott Williams & Wilkins
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
Objective 9-4
Identify the components of an electrocardiogram.
Date:
Lecture Outline
Content
 The P wave

Represents electrical change,
or depolarization, of the
atrial muscles
 The QRS component

Shows depolarization of the
ventricles
 The T wave

Shows return, or
repolarization, of the
ventricles to their resting
state

Atrial repolarization is
hidden by the QRS wave
Text
page
166
PPt
slide
31
Figures, Tables, and
Features
If present, this follows the T
wave

It is of uncertain origin
Outside Assignments
Evaluation
Figures
Resources
Outside Assignments
9-4 Electrocardiography
(ECG). A. ECG tracing
showing a normal sinus
rhythm. B. Components of
a normal ECG tracing.
Shown are the P, QRS, T,
and U waves, which
represent electrical activity
in different parts of the
heart. Intervals measure
from one wave to the next;
segments are smaller
components of the tracing.
p. 167
Activities for Chapter 9 in
thePoint (SR).
Chapter Review
pp. 195–201
 The small U wave

Resources and
In-Class Activities
 An interval measures the
distance from one wave to the
next
 A segment is a smaller
component of the tracing
Legend: IR: Instructor’s Resources; SR: Student Resources (thePoint); PPt: PowerPoint
Page 9 of 35
Copyright © 2017 Wolters Kluwer  Lippincott Williams & Wilkins
Evaluation
In-Class Activities
Divide the class into
groups. Give each group a
sample ECG tracing. Ask
students to work together to
label the components of an
ECG tracing.
Materials
Test Bank (IR)
*Adaptive Learning
Powered by PrepU
Individualized, adaptive
learning through quizzing
and remediation is
available for this chapter.
Copies of ECG tracings
SR
Have students work
through exercises for
Chapter 9 in thePoint (SR).
Instructor’s Notes
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
Objective 9-5
Differentiate among arteries, arterioles, capillaries, venules, and veins.
Date:
Lecture Outline
Content
 Arteries
Text
page
PPt
slide
168
32
Figures, Tables, and
Features
Resources
Outside Assignments
Activities for Chapter 9 in
thePoint (SR).
Chapter Review
pp. 195–201
In-Class Activities

Carry blood away from the
heart

All arteries, except the
pulmonary artery (and the
umbilical artery in the fetus),
carry highly oxygenated
blood
9-6 Principal systemic
veins.
p. 169
Evaluation
They are thick-walled,
elastic vessels that carry
blood under high pressure
 Arterioles

Using models, point out the
various arteries and veins
during discussion.
Materials
Anatomic model showing
the arteries and veins
Test Bank (IR)
*Adaptive Learning
Powered by PrepU
Individualized, adaptive
learning through quizzing
and remediation is
available for this chapter.
Vessels smaller than arteries
that lead into the capillaries
 Capillaries

The smallest vessels

Through these, exchanges
take place between the blood
and the tissues
 Venules

Outside Assignments
Evaluation
Figures
9-5 Principal systemic
arteries.
p. 168

Resources and
In-Class Activities
Small vessels that receive
blood from the capillaries
and drain into the veins
 Veins

Carry blood back to the heart

All veins, except the
Page 10 of 35
Copyright © 2017 Wolters Kluwer  Lippincott Williams & Wilkins
SR
Have students work
through exercises for
Chapter 9 in thePoint (SR).
Instructor’s Notes
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
pulmonary vein (and the
umbilical vein in the fetus),
carry blood low in oxygen

They have thinner, less
elastic walls and tend to give
way under pressure

They contain one-way
valves that keep blood
flowing forward
Legend: IR: Instructor’s Resources; SR: Student Resources (thePoint); PPt: PowerPoint
Page 11 of 35
Copyright © 2017 Wolters Kluwer  Lippincott Williams & Wilkins
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
Objective 9-6
Explain blood pressure and describe how blood pressure is measured.
Date:
Lecture Outline
Content
 Blood pressure (BP) is the force
exerted by blood against the wall
of a blood vessel


It falls as the blood travels
away from the heart
It is influenced by a variety
of factors, including cardiac
output, vessel diameters, and
total blood volume

Vasoconstriction
increases blood pressure
in a vessel; vasodilation
decreases pressure
 Measuring blood pressure


Text
page
168–
170
PPt
slide
33
Figures, Tables, and
Features
Resources
Outside Assignments
9-7 Blood pressure cuff
(sphygmomanometer).
Shown are the cuff, the
pump for inflating the cuff,
and the manometer for
measuring pressure.
p. 169
Activities for Chapter 9 in
thePoint (SR).
Chapter Review
pp. 195–201

He or she then uses a
stethoscope to listen for
blood flow in the vessel
as the pressure is slowly
released
Evaluation
In-Class Activities
Instruct the students on the
correct method to obtain a
blood pressure reading.
Boxes
9-2 Clinical Perspectives,
Hemodynamic Monitoring:
Measuring Blood Pressure
from Within
Materials
Sphygmomanometers,
stethoscopes, alcohol prep
pads, biohazard container
Test Bank (IR)
*Adaptive Learning
Powered by PrepU
Individualized, adaptive
learning through quizzing
and remediation is
available for this chapter.
p. 170
The process
The examiner inflates
the cuff to stop blood
flow in a vessel
Outside Assignments
Evaluation
Figures
Commonly measured with
an inflatable cuff called a
sphygmomanometer

Resources and
In-Class Activities
Page 12 of 35
Copyright © 2017 Wolters Kluwer  Lippincott Williams & Wilkins
SR
Have students work
through exercises for
Chapter 9 in thePoint (SR).
Instructor’s Notes
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems

The blood pressure reading

Includes the following:

Systolic pressure,
measured while the
heart is contracting

Diastolic pressure,
measured when the
heart relaxes

These are reported as
systolic then diastolic
separated by a slash,
such as 120/80

Pressure is expressed as
millimeters of mercury
(mm Hg)

This represents the
height to which the
pressure can push a
column of mercury
in a tube
Legend: IR: Instructor’s Resources; SR: Student Resources (thePoint); PPt: PowerPoint
Page 13 of 35
Copyright © 2017 Wolters Kluwer  Lippincott Williams & Wilkins
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
Objective 9-7
Identify and use the roots pertaining to the cardiovascular and lymphatic systems.
Date:
Lecture Outline
Content
 See Table 9-1 on p. 173 for roots
pertaining to the heart
 See Table 9-2 on p. 174 for roots
pertaining to the blood vessels
 See Table 9-3 on p. 187 for roots
pertaining to the lymphatic
system
Text
page
PPt
slide
173–
175,
187,
188
20,
21
Figures, Tables, and
Features
Tables
9-1 Roots for the Heart
p. 173
Resources and
In-Class Activities
Outside Assignments
Evaluation
Resources
Outside Assignments
Activities for Chapter 9 in
thePoint (SR).
Chapter Review
pp. 195–201
Evaluation
9-2 Roots for the Blood
Vessels
p. 174
9-3 Roots for the
Lymphatic System
p. 187
Exercises
Exercise 9-1
p. 173, 174
Exercise 9-2
pp. 174, 175
Exercise 9-3
pp. 187, 188
Legend: IR: Instructor’s Resources; SR: Student Resources (thePoint); PPt: PowerPoint
Page 14 of 35
Copyright © 2017 Wolters Kluwer  Lippincott Williams & Wilkins
In-Class Activities
Pull the cardiology and
lymphatic flash cards from
Stedman’s Medical
Terminology Flash Cards.
Randomly distribute the
cards among the students.
Ask students to determine
the meaning of each term
using their knowledge of
the roots, prefixes, and
suffixes. Allow students to
use a dictionary to verify
their answer.
Materials
Stedman’s Medical
Terminology Flash Cards,
2e (2009); Stedman’s
Medical Dictionary for the
Health Professions and
Nursing, Illustrated, 7th ed.
(2011), one per small group
Test Bank (IR)
*Adaptive Learning
Powered by PrepU
Individualized, adaptive
learning through quizzing
and remediation is
available for this chapter.
SR
Have students work
through exercises for
Chapter 9 in thePoint (SR).
Instructor’s Notes
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
Objective 9-8
Describe the main disorders that affect the cardiovascular and lymphatic systems.
Date:
Lecture Outline
Content
The Cardiovascular System
 Atherosclerosis

Accumulation of plaque
(fatty deposits) within the
lining of an artery

Plaque begins to form
when a vessel receives
tiny injuries, usually at a
point of branching

Plaques gradually
thicken and harden with
fibrous material, cells,
and other deposits

Plaques restrict the
vessel’s lumen
(opening) and reduce
blood flow to the tissues


This is known as
ischemia
A major risk factor for the
development of
atherosclerosis is
dyslipidemia

This refers to
abnormally high levels
or imbalance in
lipoproteins that are
Text
page
PPt
slide
175–
181,
188
43–
51,
56–
59,
72–74
Figures, Tables, and
Features
Resources and
In-Class Activities
Outside Assignments
Evaluation
Figures
Resources
Outside Assignments
9-8 Coronary
atherosclerosis. A. Fat
deposits (plaque) narrow an
artery, leading to ischemia
(lack of blood supply). B.
Plaque causes blockage
(occlusion) of a vessel. C.
Formation of a blood clot
(thrombus) in a vessel leads
to myocardial infarction
(MI).
p. 176
Activities for Chapter 9 in
thePoint (SR).
Chapter Review
pp. 195–201
9-9 Dissecting aortic
aneurysm. Blood separates
the layers of the arterial
wall.
p. 176
9-10 Coronary
angiography. Coronary
vessels are imaged after
administration of a dye
during cardiac
catheterization. A.
Angiography shows
narrowing in the mid-left
anterior descending (LAD)
artery (arrow). B. The same
vessel after angioplasty, a
Page 15 of 35
Copyright © 2017 Wolters Kluwer  Lippincott Williams & Wilkins
Evaluation
Animation
View “Hypertension” and
“Heart Failure” (IR, SR)
In-Class Activities
Divide the class into small
groups or pairs. Assign
each group a different
disorder to research
(causes, treatments, etc.).
Have the groups report
their findings to the rest of
the class. To tie in a review
of Chapter 8, have students
include what generic and
brand name drugs are used.
Test Bank (IR)
*Adaptive Learning
Powered by PrepU
Individualized, adaptive
learning through quizzing
and remediation is
available for this chapter.
SR
Have students work
through exercises for
Chapter 9 in thePoint (SR).
Instructor’s Notes
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
carried in the blood

Other risk factors for
atherosclerosis include
smoking, high blood
pressure, poor diet,
inactivity, stress, and a
family history of the disorder

Atherosclerosis may involve
any arteries


Most of its effects are
seen in the coronary
vessels of the heart
aorta, the carotid
arteries in the neck, and
vessels in the brain
Atherosclerosis is the most
common form of a more
general condition known as
arteriosclerosis

With this condition,
vessel walls harden
from any cause

Plaque, calcium, salts,
and scar tissue may
contribute to arterial
wall thickening
 Thrombosis and embolism

Thrombosis is the formation
of a blood clot (thrombus)
within a vessel


This interrupts blood
flow to the tissues
supplied by that vessel,
resulting in necrosis
Blockage of a vessel by a
thrombus or other mass
procedure to distend
narrowed vessels. Note the
improved blood flow
through the artery distal to
the repair.
p. 177
9-11 Coronary
angioplasty (PTCA). A. A
guide catheter is threaded
into the coronary artery. B.
A balloon catheter is
inserted through the
occlusion. C. The balloon
is inflated and deflated until
plaque is flattened and the
vessel is opened.
p. 177
9-12 Arterial stent. A.
Stent closed, before balloon
inflation. B. Stent open,
balloon inflated; stent will
remain expanded after
balloon is deflated and
removed. C. Stent open,
balloon removed.
p. 178
9-13 Coronary artery
bypass graft (CABG). A.
A segment of the
saphenous vein carries
blood from the aorta to a
part of the right coronary
artery that is distal to an
occlusion. B. The
mammary artery is used to
bypass an obstruction in the
left anterior descending
Page 16 of 35
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Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
carried in the bloodstream is
embolism

The mass itself is called
an embolus


Often a venous thrombus
will travel through the heart
and then lodge in an artery
of the lungs


Can be a blood clot,
air, fat, bacteria, or
other solid
materials
This results in a lifethreatening pulmonary
embolism
An embolus from a carotid
artery often blocks a cerebral
vessel

This causes a
cerebrovascular accident
(CVA), commonly
called stroke
 Aneurysm

Formed when an arterial
wall weakened by
atherosclerosis,
malformation, injury, or
other changes balloons out

If an aneurysm ruptures,
hemorrhage results

Rupture of a cerebral artery
is another cause of stroke

The abdominal aorta
and carotid arteries are
also common aneurysm
sites
(LAD) coronary artery.
p. 178
9-14 Myocardial
infarction (MI). A blood
clot (thrombus) causes a
zone of necrosis (tissue
death). Surrounding tissue
suffers from lack of blood
supply (ischemia).
p. 178
9-15 Potential sites for
heart block in the
atrioventricular (AV)
portion of the heart’s
conduction system.
p. 179
9-16 Placement of a
pacemaker. The lead is
placed in an atrium or
ventricle, usually on the
right side. A dual-chamber
pacemaker has leads in
both chambers.
p. 179
9-17 Congenital heart
defects. A. Normal fetal
heart showing the foramen
ovale and ductus arteriosus.
B. Persistence of the
foramen ovale results in an
atrial septal defect. C. A
ventricular septal defect. D.
Persistence of the ductus
arteriosus (patent ductus
arteriosus) forces blood
back into the pulmonary
Page 17 of 35
Copyright © 2017 Wolters Kluwer  Lippincott Williams & Wilkins
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems

In a dissecting aneurysm
blood hemorrhages into the
arterial wall’s thick middle
layer, separating the muscle
as it spreads and sometimes
rupturing the vessel
 Hypertension (HTN; high blood
pressure)

Defined as a systolic
pressure greater than 140
mm Hg or a diastolic
pressure greater than 90 mm
Hg

Causes the left ventricle to
enlarge as a result of
increased work

Some cases of HTN are
secondary to other disorders,
such as kidney malfunction
or endocrine disturbance
artery. E. Coarctation of the
aorta restricts outward
blood flow in the aorta.
p. 180
9-18 Varicose veins.
p. 180
9-22 Lymphatic disorders.
A. Lymphangitis is
inflammation of lymphatic
vessels. Note the linear red
streak proximal to a skin
infection. B. Lymphedema
of the upper right extremity
following removal of
axillary lymph nodes and
blockage of lymph flow.
p. 189
9-23 Pitting edema. When
the skin is pressed firmly
with the finger (A), a pit
remains after the finger is
removed (B).
p. 190

Most of the time, the causes
are unknown (primary, or
essential, HTN)

Changes in diet and life
habits are the first line of
defense in controlling HTN

Drugs that are used include
the following:
9-3 Health Professions:
Vascular Technologists

Diuretics to eliminate
fluids
p. 181

Vasodilators to relax the
blood vessels

Drugs that prevent the
formation or action of
angiotensin
9-4 Clinical Perspectives:
Lymphedema: When
Lymph Stops Flowing

Boxes
p. 188
This is a substance
Page 18 of 35
Copyright © 2017 Wolters Kluwer  Lippincott Williams & Wilkins
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
in the blood that
normally acts to
increase blood
pressure
 Heart disease

Coronary artery disease
(CAD)

Results from
atherosclerosis in the
vessels that supply
blood to the heart
muscle

An early sign of CAD is
the type of chest pain
known as angina
pectoris


This is a feeling of
constriction around
the heart

Can also be pain
that may radiate to
the left arm or
shoulder, usually
brought on by
exertion

Often there is
anxiety,
diaphoresis, and
dyspnea
Diagnosis tools include
ECG, stress tests,
echocardiography,
coronary angiography,
coronary CT
angiography, coronary
calcium scan,
measurement of C-
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Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
reactive protein (CRP)
levels, and the hs-CRP
test


Treatments include
control of exercise and
diet, drug therapy, and
surgical intervention
when appropriate
Myocardial infarction (MI)

Development of an area
of myocardial necrosis,
or an infarct

Caused by
degenerative
changes in the
arteries leading to
thrombosis and
sudden coronary
artery occlusion
(obstruction)

Also called a “heart
attack”

Can cause sudden death

Symptoms include
precordial pain or
epigastric pain that may
extend to the jaw or
arms, pallor (paleness),
diaphoresis, nausea,
fatigue, anxiety, and
dyspnea

There may also be a
burning sensation
similar to
indigestion or
heartburn

In women, MI
Page 20 of 35
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Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
symptoms are often
more long-term and
more subtle and
diffuse


MI is diagnosed by
ECG and assays for
specific substances in
the blood



This is because
degenerative
changes more
commonly
affect multiple
small vessels
rather than the
major coronary
pathways
These substances
include creatine
kinase and troponin
Patient outcome is based
on the degree of damage
and the speed of
treatment
Arrhythmia

Any irregularity of heart
rhythm, such as an
altered heart rate, extra
beats, or a change in the
pattern of the beat

Bradycardia is a slowerthan-average rate

Tachycardia is a higherthan-average rate

Damage to cardiac
tissue, as by MI, may
result in an interruption
Page 21 of 35
Copyright © 2017 Wolters Kluwer  Lippincott Williams & Wilkins
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
in the heart’s electrical
conduction system
resulting in arrhythmia

If, for any reason, the
SA node is not
generating a normal
heartbeat or there is
heart block, an artificial
pacemaker may be
implanted to regulate
the beat

Fibrillation is an
extremely rapid,
ineffective heartbeat


Commonly caused
by MI

Especially
dangerous when it
affects the
ventricles
Cardioversion is the
general term for
restoration of a normal
heart rhythm with drugs
or application of an
electric current

Automated external
defibrillators detect
fatal arrhythmia and
automatically
deliver a correct
preprogrammed
shock

An implantable
cardioverter
defibrillator (ICD)
detects potential
Page 22 of 35
Copyright © 2017 Wolters Kluwer  Lippincott Williams & Wilkins
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
fibrillation and
automatically
shocks the heart to
restore normal
rhythm


Cardiac ablation is a
newer type of treatment
for arrhythmia
Heart failure

Any condition in which
the heart fails to empty
effectively


The resulting
increased pressure
in the venous
system leads to
edema

Left-side
failure results
in pulmonary
edema with
breathing
difficulties

Right-side
failure causes
peripheral
edema with
tissue swelling,
especially in
the legs, along
with weight
gain from fluid
retention
Heart failure is treated
with rest, drugs to
strengthen heart
contractions, diuretics to
Page 23 of 35
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Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
eliminate fluid, and
restriction of salt in the
diet

Heart failure is one
cause of shock


This is a severe
disturbance in the
circulatory system
resulting in
inadequate blood
delivery to the
tissues
Congenital heart disease

Any defect that is
present at birth

Septal defect

The most common
type of congenital
heart disease

This is a hole in the
septum (wall) that
separates the atria
or the septum that
separates the
ventricles

A septal defect
permits blood to
shunt from the left
to the right side of
the heart and return
to the lungs instead
of flowing out to
the body

The heart has
to work harder
to meet the
tissues’ oxygen
Page 24 of 35
Copyright © 2017 Wolters Kluwer  Lippincott Williams & Wilkins
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
needs



Patent ductus arteriosus

Also results from
persistence of a
fetal modification

In this case, a small
bypass between the
pulmonary artery
and the aorta fails
to close at birth

Blood then can flow
from the aorta to
the pulmonary
artery and return to
the lungs
Heart valve
malformation


Symptoms of septal
defect include
cyanosis, syncope,
and clubbing of the
fingers
Failure of a valve to
open or close
properly is
evidenced by a
murmur

A localized aortic
narrowing restricts
blood flow through that
vessel

Most congenital defects
described can be
corrected surgically
Rheumatic heart disease

Infection with a specific
Page 25 of 35
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Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
type of Streptococcus
sets up an immune
reaction that ultimately
damages the heart
valves

The infection usually
begins as a “strep
throat”

Most often the mitral
valve is involved

Scar tissue fuses the
valve’s leaflets,
causing a narrowing
or stenosis that
interferes with
proper function

People with rheumatic
heart disease are subject
to repeated valvular
infections

Severe cases of
rheumatic heart disease
may require surgical
correction or even valve
replacement

The incidence of
rheumatic heart disease
has declined with the
use of antibiotics
 Disorders of the veins

Varicose veins

This results from
breakdown in the valves
of the veins in
combination with a
chronic dilatation of
Page 26 of 35
Copyright © 2017 Wolters Kluwer  Lippincott Williams & Wilkins
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
these vessels


The veins appear
twisted and swollen
under the skin, most
commonly in the legs

Contributing factors
include heredity,
obesity, prolonged
standing, and pregnancy

Varicosities can impede
blood flow and lead to
edema, thrombosis,
hemorrhage, or
ulceration

Treatment includes the
wearing of elastic
stockings and in some
cases, surgical removal
of the varicose veins

A varicose vein in the
rectum or anal canal is
referred to as a
hemorrhoid
Phlebitis

Any inflammation of the
veins

May be caused by
infection, injury, poor
circulation, or damage
to valves in the veins

Typically initiates blood
clot formation, resulting
in thrombophlebitis

A more serious
condition, deep
vein thrombosis,
Page 27 of 35
Copyright © 2017 Wolters Kluwer  Lippincott Williams & Wilkins
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
involves the deep
veins as opposed to
the superficial veins

The most
common sites
for DVT are
the deep leg
veins
The Lymphatic System
 Changes in the lymphatic system
are often related to infection

Lymphadenitis:
inflammation and
enlargement of the nodes

Lymphangitis: inflammation
of the vessels
 Lymphedema

Tissue swelling

Results from obstruction of
lymphatic vessels because of
surgical excision or infection
 Lymphoma: any neoplastic
disease involving lymph nodes is
termed

These neoplastic disorders
affect the white cells found
in the lymphatic system
Legend: IR: Instructor’s Resources; SR: Student Resources (thePoint); PPt: PowerPoint
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Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
Objective 9-9
Define medical terms pertaining to the cardiovascular and lymphatic systems.
Date:
Lecture Outline
Content
 See the Terminology: Key Terms
box on pp. 170–172 for terms
pertaining to the cardiovascular
system
 See the Terminology: Key Terms
box on pp. 181–184 for terms
pertaining to cardiovascular
disorders
 See the Terminology: Key Terms
box on pp. 186–187 for terms
pertaining to the lymphatic
system
 See the Terminology: Key Terms
box on p. 189 for terms
pertaining to lymphatic disorders
 See the Terminology:
Supplementary Terms box on pp.
189–193 for supplementary terms
related to the cardiovascular and
lymphatic systems
Text
page
PPt
slide
170–
172,
181–
184,
186,
187,
189–
193
36–
42,
6071,
75,
76,
78–
89
Figures, Tables, and
Features
Resources and
In-Class Activities
Outside Assignments
Evaluation
Boxes
Resources
Outside Assignments
Terminology: Key Terms
pp. 170–172
Activities for Chapter 9 in
thePoint (SR).
Chapter Review
pp. 195–201
Terminology: Key Terms
pp. 181–184
In-Class Activities
Terminology: Key Terms
pp. 186–187
Terminology: Key Terms
p. 189
Terminology:
Supplementary Terms
pp. 189–193
Evaluation
1. Place flash cards of
various terms face down in
a stack. Divide the class
into two groups. Instruct
students, one at a time, to
draw a flash card, read the
term, and correctly define
the word. If that individual
is incorrect, the other team
gets a chance. Give points
for correct definitions. The
team with the most points
wins.
Materials
Stedman’s Medical
Terminology Flash Cards,
2e (2009)
2. Divide students into
groups. Distribute to each
member of the group three
to five slips of paper with
terms from the chapter.
Page 29 of 35
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Test Bank (IR)
*Adaptive Learning
Powered by PrepU
Individualized, adaptive
learning through quizzing
and remediation is
available for this chapter.
SR
Have students work
through exercises for
Chapter 9 in thePoint (SR).
Instructor’s Notes
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
Have each student write
“fill in the blank” sentences
with context clues for their
words. Have students rotate
their papers to the right,
having each student in turn
complete one sentence until
all sentences are filled in.
The next student in line
may either complete a new
sentence or correct a
classmate’s response if
necessary.
Materials
Small slips of paper with
terms from the chapter, five
terms for each student
Legend: IR: Instructor’s Resources; SR: Student Resources (thePoint); PPt: PowerPoint
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Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
Objective 9-10
List the functions and components of the lymphatic system.
Date:
Lecture Outline
Content
 Functions of the lymphatic
system
 Return excess fluid and
proteins from tissues to
bloodstream
 Blind-ended lymphatic
capillaries pick up these
materials in the tissues
and carry them into
larger vessels
 Protect the body from
impurities and invading
microorganisms
 Lymph nodes filter
lymph as it passes
through
 Absorb digested fats from
the small intestine
 These fats are then
added to the blood with
the lymph that drains
from the thoracic duct
 Components of the system
 Lymph: the fluid carried in
the lymphatic system
 Thoracic duct: travels
upward through the chest
and empties into the left
subclavian vein near the
heart
Text
page
PPt
slide
184–
186
72–
74
Figures, Tables, and
Features
Resources and
In-Class Activities
Outside Assignments
Evaluation
Figures
Resources
Outside Assignments
9-19 Lymphatic system.
A. Lymphatic vessels drain
almost every area of the
body. Lymph nodes are
distributed along the path
of the vessels. Areas
draining into the right
lymphatic duct are shown
in purple; areas draining
into the thoracic duct are
shown in red. B. Lymph
nodes and vessels of the
head. C. Drainage of the
right lymphatic duct and
thoracic duct into the
subclavian veins. D. Lymph
nodes and vessels of the
breast, mammary glands,
and surrounding areas.
p. 185
Activities for Chapter 9 in
thePoint (SR).
Chapter Review
pp. 195–201
In-Class Activities
Evaluation
9-20 Lymphatic drainage
in the tissues. Lymphatic
capillaries pick up fluid and
proteins left in the tissues
and carry them back to the
bloodstream.
p. 186
Page 31 of 35
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Divide the class into small
groups. Instruct each group
to create an educational
poster illustrating the
lymphatic system.
Materials
Poster board, markers
Test Bank (IR)
*Adaptive Learning
Powered by PrepU
Individualized, adaptive
learning through quizzing
and remediation is
available for this chapter.
SR
Have students work
through exercises for
Chapter 9 in thePoint (SR).
Instructor’s Notes
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems







Right lymphatic duct: drains
the body’s upper right side
and empties into the right
subclavian vein
Lymph nodes: filter the
lymph as it passes through
the lymphatic vessels
 Concentrated in the
cervical (neck), axillary
(armpit), mediastinal
(chest), and inguinal
(groin) regions
Tonsils: filter inhaled or
swallowed materials and aid
in immunity early in life
Thymus: processes and
stimulates lymphocytes
active in immunity
Spleen: filters blood and
destroys old red blood cells
Appendix: may aid in the
development of immunity
Peyer patches: help protect
against invading
microorganisms
9-20 Location of lymphoid
tissue.
p. 186
Legend: IR: Instructor’s Resources; SR: Student Resources (thePoint); PPt: PowerPoint
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Copyright © 2017 Wolters Kluwer  Lippincott Williams & Wilkins
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
Objective 9-11
Interpret medical abbreviations referring to circulation.
Date:
Lecture Outline
Content
 See the Terminology:
Abbreviations box on pp. 193–194
for abbreviations referring to
circulation
Text
page
PPt
slide
193,
194
90–
97
Figures, Tables, and
Features
Resources and
In-Class Activities
Outside Assignments
Evaluation
Boxes
Resources
Outside Assignments
Terminology:
Abbreviations
Activities for Chapter 9 in
thePoint (SR).
Chapter Review
pp. 195–201
pp. 193, 194
Evaluation
In-Class Activities
For each abbreviation,
prepare two note cards: one
with the abbreviation and
one with the expansion.
Randomly distribute the
cards among the students
and instruct them to find
the cards corresponding to
their own. When all
students have found their
partners, ask them to read
aloud their abbreviations
and meanings.
Materials
Note cards
Legend: IR: Instructor’s Resources; SR: Student Resources (thePoint); PPt: PowerPoint
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Test Bank (IR)
*Adaptive Learning
Powered by PrepU
Individualized, adaptive
learning through quizzing
and remediation is
available for this chapter.
SR
Have students work
through exercises for
Chapter 9 in thePoint (SR).
Instructor’s Notes
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
Objective 9-12
Analyze medical terms in case studies involving circulation.
Date:
Lecture Outline
Content
 Case study



Chief complaint

19-year-old man

Passed out during two
long runs with his
platoon
Text
page
PPt
slide
163,
194,
202,
203
none
Figures, Tables, and
Features
Terms related to
examination

cardiologist

Holter monitor

arrhythmias
Additional terms related to
clinical course

atrial fibrillation

anticoagulants

blood clots

ablation

pulmonary vein

catheter
Resources and
In-Class Activities
Outside Assignments
Evaluation
Resources
Outside Assignments
Activities for Chapter 9 in
thePoint (SR).
Case Studies Questions
pp. 202, 203
In-Class Activities
Read the case studies as a
class, writing the various
terms on the board. Ask for
volunteers to define the
various medical terms in
the case studies. Allow the
students to use a dictionary
to verify their answers.
Materials
Stedman’s Medical
Dictionary for the Health
Professions and Nursing,
Illustrated, 7th ed. (2011),
one per small group
Instruct students to read a
professional medical article
and write a short essay
describing it. They should
include in their descriptions
5 to 7 terms found in the
article and their definitions.
Evaluation
Test Bank (IR)
*Adaptive Learning
Powered by PrepU
Individualized, adaptive
learning through quizzing
and remediation is
available for this chapter.
SR
Have students work
through exercises for
Chapter 9 in thePoint (SR).
Legend: IR: Instructor’s Resources; SR: Student Resources (thePoint); PPt: PowerPoint
Page 34 of 35
Copyright © 2017 Wolters Kluwer  Lippincott Williams & Wilkins
Instructor’s Notes
Cohen: Medical Terminology: An Illustrated Guide (Eighth Edition)
Chapter 9 — Circulation: The Cardiovascular and Lymphatic Systems
Page 35 of 35
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