THE

CARDIOVASCULAR
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Geraldine Rowena Sampedro Galang, RN, MAN ©
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SYSTEM

I. THE HEART

* Size of a person’s fist, hollow, cone-shaped, and weighs less than a pound. * Enclosed within inferior mediastinum. * Pointed apex, toward left hip, rests
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A. LOCATION AND SIZE

1. ANATOMY

I. THE HEART

A. LOCATION AND SIZE

1. ANATOMY

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I. THE HEART

B. COVERINGS AND WALL

1. ANATOMY

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I. THE HEART

B. CHAMBERS AND GREAT VESSELS

1. ANATOMY

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I. THE HEART

Delicate, flexible structures that consists of endothelium covered by fibrous tissue. They permit only unidirectional blood flow through the heart, from right to left. They open and close passively, and these movements depend on
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C. VALVES

1. ANATOMY

I. THE HEART

ATRIOVENTRICULAR VALVES

C. VALVES

1. ANATOMY

Lie between atria and ventricles. to edges are strong, fibrous filaments called chordae tendinae, which arise from papillary muscles on the ventricular walls. muscles and chordae 4/28/12 tendinae work together to prevent

Attaches

Papillary

I. THE HEART

C. VALVES

1. ANATOMY

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I. THE HEART

C. VALVES

1. ANATOMY

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I. THE HEART

D. CARDIAC CIRCULATION

1. ANATOMY

CORONARY ARTERIES (LEFT AND RIGHT) * Branch from base of aorta and encircle heart in the coronary sulcus (antrioventricular groove) at junction of atria and ventricles. * Compressed when ventricles are contracting and fill when the heart is relaxed. MAJOR BRANCHES LEFT - anterior interventricular and circumflex arteries RIGHT - posterior interventricular and marginal arteries CARDIAC VEINS * Empty into enlarged vessel on the posterior of the heart 4/28/12

I. THE HEART

D. CARDIAC CIRCULATION

1. ANATOMY

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I. THE HEART

A. INTRINSIC CONDUCTION

2. PHYSIOLOGY

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I. THE HEART

A. INTRINSIC CONDUCTION 1. SINOATRIAL NODE

2. PHYSIOLOGY

* The pacemaker of the heart is located at the junction of the superior vena cava and right atrium. * Under normal circumstances, the SA node initiates each heartbeat. * Generates electrical impulses approximately 60 to 100 times per 4/28/12 minute but can adjust its rate.

I. THE HEART

2. ATRIOVENTRICULAR NODE

A. INTRINSIC CONDUCTION

2. PHYSIOLOGY

* Located in the lower aspect of the atrial septum. * Receives electrical impulses from the SA node. * Within the AV node, the impulse is delayed 0.07 seconds while the atria contract.
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I. THE HEART

A. INTRINSIC CONDUCTION 3. BUNDLE OF HIS

2. PHYSIOLOGY

* Fuses with the AV node to form another pacemaker site. * If the SA node fails, the bundle of his can initiate and sustain a heart rate of 40 to 60 beats per minute. * Relatively short, branching 4/28/12 into right and left bundle

I. THE HEART

A. INTRINSIC CONDUCTION 4. PURKINJE FIBERS

2. PHYSIOLOGY

* Diffuse network of conducting strands beneath the ventricular endocardium. * They rapidly spread the wave of depolarization through the ventricles. * Activation of the ventricles begins in the septum and then moves from the apex of the heart upward. * Within the ventricular walls, depolarization proceeds from 4/28/12

I. THE HEART

SYSTOLE AND DIASTOLE CARDIAC CYCLE

B. CARDIAC CYCLE AND SOUNDS

2. PHYSIOLOGY

* One complete heartbeat, where atria and ventricles contract and then relax. * Beats 60 to 100 times per minute, 4/28/12 about 0.8 seconds per cycle.

I. THE HEART

1. MID-TO-LATE DIASTOLE

B. CARDIAC CYCLE AND SOUNDS

2. PHYSIOLOGY

* Heart in complete relaxation. * Pressure in heart is low, blood is flowing passively. * Semilunar valves closed and AV valves open.
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I. THE HEART

2. VENTRICULAR SYSTOLE

B. CARDIAC CYCLE AND SOUNDS

2. PHYSIOLOGY

* Pressure within ventricles increase rapidly, closing the AV valves. * When intraventricular pressure in ventricles are higher than pressure in large arteries leaving the heart, semilunar valves are forced open, and blood rushes out through them out of the ventricles. 4/28/12

I. THE HEART

3. EARLY DIASTOLE

B. CARDIAC CYCLE AND SOUNDS

2. PHYSIOLOGY

* Ventricles relax, semilunar valves snap shut, and for a moment, ventricles are completely closed chambers. * Intraventricular pressure drops, and when lower than atrial pressure, AV valves are 4/28/12 forced open.

I. THE HEART

B. CARDIAC CYCLE AND SOUNDS

2. PHYSIOLOGY

HEART SOUNDS

FIRST HEART SOUND closing of AV valves SECOND HEART SOUND 4/28/12

I. THE HEART

C. CARDIAC OUTPUT REGULATION OF STROKE VOLUME
Starling’s law of the heart says that the critical factor controlling stroke volume is how much the cardiac muscle cells are stretched just before they contract. Venous return is an important 4/28/12

2. PHYSIOLOGY

I. THE HEART

C. CARDIAC OUTPUT

2. PHYSIOLOGY

FACTORS MODIFYING BASIC HEART RATE 1. Neural (ANS)
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A. TUNICS

II. BLOOD VESSELS

1. MICROSCOPIC ANATOMY

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II. BLOOD VESSELS

B. ARTERIES, VEINS, CAPILLARIES

1. MICROSCOPIC ANATOMY

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B. ARTERIES, VEINS, CAPILLARIES ARTERIES

II. BLOOD VESSELS

1. MICROSCOPIC ANATOMY

* Has high pressure, and walls are thicker and heavier than veins. VEINS * Has low pressure, and walls are thinner and lighter than arteries. CAPILLARIES * Has transparent walls, and only one cell layer thick, the tunica intima. * Exchanges are easily made between blood and tissue cells. * Tiny capillaries form interweaving networks called 4/28/12 capillary beds.

B. ARTERIES, VEINS, MICROCIRCULATION CAPILLARIES
VESSELS IN A CAPILLARY BED

II. BLOOD VESSELS

1. MICROSCOPIC ANATOMY

Flow of blood from an arteriole to venoule, that is, through a capillary bed.

1. vascular shunt - directly connects arteriole and venoule at opposite ends of the bed 2. true capillaries - actual exchange vessels - spring from a terminal arteriole and empty into postcapillary venoule - a precapillary sphincter (cuff of smooth muscle fibers) surrounds roof of each capillary and acts as valve to regulate flow of blood into capillary 4/28/12

II. BLOOD VESSELS

AORTA 1. Ascending Aorta 2. Aortic Arch 3. Thoracic Aorta 4. Abdominal Aorta
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A. MAJOR ARTERIES

2. GROSS ANATOMY

II. BLOOD VESSELS

A. MAJOR ARTERIES

2. GROSS ANATOMY

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B. MAJOR SUPERIOR AND INFERIOR VENA CAVA VEINS

II. BLOOD VESSELS

2. GROSS ANATOMY

PAGES 380 AND 381 OF YOUR BOOK

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II. BLOOD VESSELS

1. ARTERIAL SUPPLY OF THE BRAIN AND CIRCLE OF WILLIS 2. FETAL CIRCULATION
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C. SPECIAL CIRCULATIONS

2. GROSS ANATOMY

C. SPECIAL CIRCULATIONS CIRCLE OF WILLIS 1. ARTERIAL SUPPLY OF THE BRAIN AND
a. internal carotid artery anterior, middle, and cerebral artery – cerebrum b. vertebral artery basilar artery – brainstem and cerebellum posterior cerebral artery – posterior part of cerebrum CEREBRAL ARTERIAL CIRCLE OR CIRCLE OF WILLIS
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II. BLOOD VESSELS

2. GROSS ANATOMY

C. SPECIAL CIRCULATIONS 2. FETAL CIRCULATION
a. PLACENTA

II. BLOOD VESSELS

2. GROSS ANATOMY

b. UMBILICAL CORD one umbilical vein two umbilical arteries

c. DUCTUS VENOSUS

d. FORAMEN OVALE

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C. SPECIAL CIRCULATIONS 3. HEPATIC PORTAL CIRCULATION

II. BLOOD VESSELS

2. GROSS ANATOMY

Veins of hepatic portal circulation drain the digestive organs, spleen, and pancreas, and deliver this blood to the liver through hepatic portal vein. When you have just eaten, hepatic portal blood contains large amounts of nutrients, this system now takes a detour to ensure that the liver processes these substances before they 4/28/12 enter systemic circulation.

II. BLOOD VESSELS

PULSE

A. ARTERIAL PULSE

3. CIRCULATION PHYSIOLOGY

A pressure wave that travels the entire arterial system created from alternating expansion and recoil of an artery that occurs with each beat of the left ventricle.
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II. BLOOD VESSELS

A. ARTERIAL PULSE

3. CIRCULATION PHYSIOLOGY

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II. BLOOD VESSELS

Pressure that the blood exerts against the inner walls of the arteries, and it is the force that keeps blood circulating continuously even between heartbeats.
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B. BLOOD PRESSURE

3. CIRCULATION PHYSIOLOGY

B. BLOOD PRESSURE 1. blood pressure gradient

II. BLOOD VESSELS

3. CIRCULATION PHYSIOLOGY

high to low pressure blood flow 2. measuring blood pressure SBP and DSP 3. effects of various factors on blood pressure BP = CO x HR peripheral resistance – amount of 4/28/12 friction the blood encounters as it

C. CAPILLARY EXCHANGE INTERSTITIAL FLUID

II. BLOOD VESSELS

3. CIRCULATION PHYSIOLOGY

1. lipid-soluble substances diffuse directly through plasma membranes. 2. Certain lipid-insoluble substances enter or leave blood and/or pass through plasma membranes of endothelial cells within vesicles by endocytosis or exocytosis.
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D. CAPILLARY BED FLUIDS As a rule, BP is higher than osmotic pressure
at arterial end of capillary bed and lower than osmotic pressure at venous end. Fluid moves out of capillary at the beginning of the bed (arteriole) and is reclaimed at the opposite (venule). However, not quite all of the fluid forced out of the blood is reclaimed at the venule end, and returning that fluid is the4/28/12 of the chore

II. BLOOD VESSELS

3. CIRCULATION PHYSIOLOGY

HOMEOSTATIC IMBALANCES 1. INFECTION OF HEART LAYERS 2. TACHYCARDIA 3. BRADYCARDIA 4. MURMUR 5. VALVULAR STENOSIS 6. ISCHEMIA 7. ANGINA PECTORIS
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END
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