assessing cardiovascular system:LICH
Terms
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- what is known as the lifeline of the body
- cardiovascular system
- primary function of cs
-
acts as transport system: 1.delivers red bld cells and nutrients, metabolites and hormones to every cell.
2. transports waste for detox and excretion. - primary function of white bld cells
- fight infection
- what is leading health prob in US
- cardiovascular disease
- the cardiovascular system is a_____ system consisting of ________ and _______.
- closed, heart and bld vesselss
- how long is the network of bld vessels
- 60000 miles
- what are the 2 main networks of the circulatory system?
- pulmonary circulation and systemic circulation. (coronary circulation is part of systemic circ and supplies heat itself)
- describe pulmonary circulation
- 1. unoxegenated bld enters rt and lt pulm art. 2.flows pulm arterioles to lung capi.(gas exchange) 3.oxegenated bld enters pulm venules lead to pulm veins. carried back to left atrium through rt and lt pulm veins.
- what does arterial system do
- supplies oxygen to every cell in body
- what does venous system do
- returns unoxygenated bld to heart
- what is the systemic circualation path
- O2 bld flow into lt atrium from Pcircuit 2.lt atrium pumps to lt vent pumps through aorta to arterial systemic circ.3. aorta-->small arterioles-->system capil. linked to art and ven syst.(gas exchange)unoxegen bld flow through venules--veins-- sup inf vena cava rt atr.
- what keeps heart oxygenated
- coronary circulation
- what does cor circ consist of?
- rt lt cor.art and cor sinus and cardiac veins.
- the first branches off the aorta are called
- left and right coronary arteries
- where do cardiac veins drain
- cardiac sinus which drains into rt atrium
- what effects sound of heart
- movement and pressure of bld, activity of electrical conduction system, and movement of valves
- 2 phases in cardiac cycle
-
systolic- contraction or emptying
diastollic- resting or filling - ventricular diastole
- pressure decrease below atria- mitral and tricuspid valves open to fill-
- atrial kick-
- atria contract to complete fill; responsible for 25% of total bld vol in ventr.
- ventricular systole
- pressure higher than atria closes valves; contraction--pressure opens aortic and pulmonic valves flow into systemic and pulmonic systems
- what is stroke volume
- amt of bld ejected form heart with each contraction. responds to pre-load(end of diastole) and afterload(end of systole)and contractiliy
- cardiac output
- amt of bld ejected each min.= stroke vol x heart rate.
- _____is the major regulator of cardiac output
- heart rate: internal pacemaker, ANS, and external factors.
- T/F: increase in afterload = decrease in stroke volume
- true
- Positive intotropes and Neg inotropes
- increase force of contraction and decrease "
- what happens in contractility is increased
- oxygen requirements are increased
- which side of the heart is slightly "ahead" in normal heart?
- left
- what are layers of the heart
- enodcardium, myocardium, epicardium and pericardium
- what are the structures of right side of heart
- atrium ventricle, tricuspid valve, pulm semilunar valve, main pulmonary artery and pulmonary veins
- what are the structures of left side of heart
- l atrium and ventricle, mitral or bicuspid valve, aortic valve, interventricular septum
- cardiac electrical conduction system-
- resonsible for initiating and maintaining rhythm of the heart
-
SA- sinoatrial node:
what is it, how many bpm, how -
pacemaker of heart in right atrium near sup vena cava
60-100 bpm
passes through atria=contract -
AV- atrioventricular node:
where, bpm, path -
base of rt atrium; 40 60 bpm;
AV node to bundle of His--split right and left bundle--follows septum turn to purkinje fibers=ventricles contract. - bundle of his pacemaker=
- 20-40 bpm
- bachmans bundle
- stimulates left atrium- branch of SA node
- S1 heart sounds caused by
- closure of mitral and tricuspid valves; .02 sec
- S2
- dub, end of systole
- S1=
- lub, beginning of systole
- where listen for S1
- apex or L lat sternal border w/ diaphragm of steth
- Accentuated S1 caused by
- anemia, hyperthyroidism and exercize. mitral and tricuspid stenosis; louder
- Diminished S1 caused by
- thick chest walls, emphysema, first degree heart block
- why would emphysema or thick chest walls cause diminished S1
- greater distance to traverse from myocardium to chest wall
- why would heart block dimish s1
- delay in conduction b/w atrial contraction and vent contar allows more time for valve to close
- very irregular s1
- complete heart block or atrial fibrilation.
- normal split s1
- can hear left closure and right closure very clearly; mitral is louder
- widely split s1 caused by
- RBBB,PVC,Ventricular tachychardia
- S2=
- dub, closure of aortic and pulmonic valves
- Accentuated S2
- exersize; A2- systemic hypertension, P2- pulmonary hypertension
- Diminished S2
- thick chest wall and chronic lung disease; A2 cacific aortic stenosis and P2 pulmonic stenosis
- Split S2
-
respiration variation:
inspiration: blub A2 than P2
expiration single dub - why the respiration variation?
-
1.neg intra thoracic pressure=
2.increased bld return to rt side
3.rt vent contraction time ups - during inspiration the cardiac rate ------- to accomodate ------in venous return.
- increases
- widely abnormal split caused by:
- RBBB
- reversed or paradoxical split
- P2 before A2 delayed contraction of left ventricle- blockagein left hearts elec nerve conduc sys.
- atrial septal defect
- fixed widely split S2, unaffected by respiration. split .04-.07 sec.
- early ejection click
- high pitched, short .03-.08 after S1 aortic and pulmonic valve. aorval-base and apex, pulm heard left sternal border 2nd and 3rd interspace
- midsystolic ejection click
- high pitch short MVP .14 after S1 apex or medial wide transmitt over precordium
- opening snap
- diastolic short high pitched .05-.14 after S2 mitral stenossi heard near apex patient in left lateral position midlate dias murmur of mitral stenosis
- normal heart sound 3
- after s2 soft low pitch filling sound of ventricle
- S3 gallop
- rapid, hemodynamic filling and failing of noncompliant ventricle= CHF; lilt of canter present- left lat sternal border
- S4 gallop
- atrial kick heard if ventricular resistance.08 sec before S1, HTN, MI, CAD, left sternal border or apex
- what is murmur
- series of audlible prolonged sounds turbulence created in system
- causes of murmur 5
- 1.increased flow 2 flow through constricted valve(aortic stenosis)3 flow into dilated bld vessel(whoosh)4backflow through incompetent valve 5.shunting
- how is murmur characterized (8)
- quality, frequency, intensity,duration, configuration, placement in cycle, location, and radiation of sound
- continuous murmur
-
patent ductus arteriousus.
crescendos in late systole decrescendos through diastole heard in infraclavicular area and second left interspace - venous hum
- neck and sup vena cava low pitched normal in kids glowing rough or musical heard over right internal jusgular fv3ein in supra clavicular area. light pressure; benign
- friction rub
- pericardial rub high pitched scrathcg leathery inflamation of parietal and visceral latyers pericardiitis MI accute. pain third interspace left sternal border.
- T/F pressure in venous system is higher than in arterial system.
- FALSE
- what is dicrotic notch
- in normal systole positve wave on decent- aortic valve closing
- what is the flow of blood in venous system regualated by
-
1.pressure gradient for venous return
2.resistance to bld flw
3.venous pumps - pressure gradient affected by:
- right arterial pressure and venous pressuer
- resistance to bld flow affects
- venous return
- venous pumps include
- skeletal muscle pum and resiratory pump