A & P 2 Circulatory System CCC Handout

Pulmonary Valve Semilunar Valve

*A three-cusped valve guarding the exit from one of the cardiac ventricles; the pulmonary and aortic valves.

Systemic Circulation & major systemic arteries

*Image result for Systemic Circulationen.wikipedia.org Systemic circulation is the part of the cardiovascular system which carries oxygenated blood away from the heart to the body, and returns deoxygenated blood back to the heart. *Aorta

Pulmonary Circulation & major pulmonary arteries

*Pulmonary circulation is the portion of the cardiovascular system which carries deoxygenated blood away from the heart, to the lungs, and returns oxygenated (oxygen-rich) blood back to the heart. *Deoxygenated blood leaves through the right ventricle through the pulmonary artery. From the right atrium, the blood is pumped through the tricuspid valve into the right ventricle. Blood is then pumped from the right ventricle through semilunar valve and into the pulmonary trunk of the pulmonary artery.

path of circulation

*The superior (a) and inferior (b) vena cava are the main veins that receive blood from the body. *The superior vena cava drains the head and arms, and the inferior vena cava drains the lower body. *The right atrium receives blood from the body via the vena cavae. The atria are on the top in the heart. *The blood then passes through the right atrioventricular valve, which is forced shut when the ventricles contract, preventing blood from reentering the atrium. *The blood goes into the right ventricle (note that it has a thinner wall; it only pumps to lungs). The ventricles are on the bottom of the heart. *The right semilunar valve marks the beginning of the artery. Again, it is supposed to close to prevent blood from flowing back into the ventricle. The pulmonary artery or pulmonary trunk is the main artery taking deoxygenated blood to the lungs. Blood goes to the right and left lungs, where capillaries are in close contact with the thin-walled alveoli so the blood can release CO2 and pick up O2. From the lungs, the pulmonary vein carries oxygenated blood back into the heart. The left atrium receives oxygenated blood from the lungs. The blood passes through the left atrioventricular valve. The blood enters the left ventricle. Note the thickened wall; the left ventricle must pump blood throughout the whole body. The blood passes through the left semilunar valve at the beginning of the aorta. The aorta is the main artery to the body. One of the first arteries to branch off is the coronary artery, which supplies blood to the heart muscle itself so it can pump. The coronary artery goes around the heart like a crown. A blockage of the coronary artery or one of its branches is very serious because this can cause portions of the heart to die if they don't get nutrients and oxygen. This is a coronary heart attack. From the capillaries in the heart muscle, the blood flows back through the coronary vein, which lies on top of the artery. The aorta divides into arteries to distribute blood to the body. Small arteries are called arterioles. The smallest vessels are the capillaries. These join again to form venules, the smallest of the veins. These, in turn, join to form the larger veins, which carry the blood back to the superior and inferior vena cava.

Arteries - layers

*Tunica intima - (the thinnest layer): a single layer of simple squamous endothelial cells glued by a polysaccharide intercellular matrix, surrounded by a thin layer of subendothelial connective tissue interlaced with a number of circularly arranged elastic bands called the internal elastic lamina. *Tunica media (the thickest layer in arteries): circularly arranged elastic fiber, connective tissue, polysaccharide substances, the second and third layer are separated by another thick elastic band called external elastic lamina. The tunica media may (especially in arteries) be rich in vascular smooth muscle, which controls the caliber of the vessel. *Tunica adventitia: (the thickest layer in veins) entirely made of connective tissue. It also contains nerves that supply the vessel as well as nutrient capillaries (vasa vasorum) in the larger blood vessels. ***Serosa - serous membrane (or serosa) is a smooth membrane consisting of two layers of epithelial cells (as membranes), which secrete serous fluid.

Veins

*brings deoxegynated blood to the heart *most veins have valves to prevent back flow of blood *inflamed during phelbitis *contain more than half of the total blood volume *Superior Vena Cava -from arms and head Inferior Vena Cava - from the legs and abdomen

Regulation of blood pressure

*involves heart & blood vessels *What is a short-term response to blood pressure regulation? Baroreceptor reflex *What is a long-term response to blood pressure regulation? RAAS, Hormones

Blood Pressure

-The force exerted by the blood on the blood vessel walls -Changing constantly 1.) Systolic- peak/highest pressure= Ventricular contraction 2.) Diastolic- Lowest pressure= Ventricular relaxation 3.) Pulse pressure- difference b/w systolic and diastolic pressures= less than 40 mmHg ** 120/80 mmHg * usually measured along one of the muscular arteries, with systolic pressure measured during ventricular systole and diastolic pressure during ventricular diastole.

heart valves

1. bicuspid valve -the mitral valve 2. tricuspid valve, which are between the upper atria and the lower ventricles. Semilunar (SL) valves 3. aortic valve 4.pulmonary valve, which are in the arteries leaving the heart.

Normal blood pressure

120/80

Heatbeat

A heartbeat occurs from the contraction of the heart's upper chambers, called the atria, followed by a contraction of its lower chambers, called the ventricles. The contractions push the blood through the heart and into the lungs and rest of the body.

Angina pectoris

Angina pectoris, commonly known as angina, is the sensation of chest pain, pressure, or squeezing, often due to ischemia of the heart muscle from obstruction or spasm of the coronary arteries.[1] While angina pectoris can derive from anemia, cardiac arrhythmias and heart failure, its main cause is coronary artery disease, an atherosclerotic process affecting the arteries feeding the heart.

Arteriosclerosis

Arteriosclerosis degeneration of small arteries with loss of elasticity; development of thick hard walls & narrow lumens causing ischemia and possible local necrosis *- A normal aspect of CV aging - Loss of resilience in the arterial wall - Increase in systolic blood pressure with age - Hardening of the arteries: heart must work harder - 70's and 80's: No aortic elasticity: Elastin: becomes hardened *- Narrowing of arteries in specific locations - Deposits of fats and cells - Cholesterol = plaque: LDL (carries cholesterol) HDL (Reverses LDL effects) - Greatest cause of mortality in the US - Gender, genetics, lifestyle (diet, exercise), and smoking (decreases HDLs)

blood vessels

Artery arteriole capillary venule vein ***has smooth muscle fibers- elastin if constricted - an autonomic nerve stimulates if dilated - blood pressure decreases if dilated - cross section is enlarged

Path of blood in the heart

Blood enters the right atrium from the superior and inferior venae cavae, and the coronary sinus. 2. From right atrium, it goes through the tricuspid valve to the right ventricle. 3. From the right ventricle, it goes through the pulmonary semilunar valves to the pulmonary trunk 4. From the pulmonary trunk it moves into the right and left pulmonary arteries to the lungs. 5. From the lungs, oxygenated blood is returned to the heart through the pulmonary veins. 6. From the pulmonary veins, blood flows into the left atrium. 7. From the left atrium, blood flows through the bicuspid (mitral) valve into the left ventricle. 8. From the left ventricle, it goes through the aortic semilunar valves into the ascending aorta. 9. Blood is distributed to the rest of the body (systemic circulation) from the aorta.

Ischemic heart disease

Coronary artery disease (CAD), also known as ischemic heart disease (IHD),[1] atherosclerotic heart disease,[2] atherosclerotic cardiovascular disease,[3] and coronary heart disease,[4] is a group of diseases that includes: stable angina, unstable angina, myocardial infarction, and sudden coronary death.[5] It is within the group of cardiovascular diseases of which it is the most common type.[6] A common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw.[7] Occasionally it may feel like heartburn.[7] Usually symptoms occur with exercise or emotional stress, last less than a few minutes, and gets better with rest.[7] Shortness of breath may also occur and sometimes no symptoms are present.[7] The first sign is occasionally a heart attack.[8] Other complications include heart failure or an irregular heartbeat.[8]

Coronary Circulation Blood supply to the Heart

Coronary circulation is the circulation of blood in the blood vessels of the heart muscle (myocardium). The vessels that deliver oxygen-rich blood to the myocardium are known as coronary arteries. The vessels that remove the deoxygenated blood from the heart muscle are known as cardiac veins. These include the great cardiac vein, the middle cardiac vein, the small cardiac vein and the anterior cardiac veins. As the left and right coronary arteries run on the surface of the heart, they can be called epicardial coronary arteries. These arteries, when healthy, are capable of autoregulation to maintain coronary blood flow at levels appropriate to the needs of the heart muscle. These relatively narrow vessels are commonly affected by atherosclerosis and can become blocked, causing angina or a heart attack. (See also: circulatory system.) The coronary arteries that run deep within the myocardium are referred to as subendocardial

Heart Sounds

Heart sounds are the noises generated by the beating heart and the resultant flow of blood through it. Specifically, the sounds reflect the turbulence created when the heart valves snap shut. In cardiac auscultation,

What does the P wave measure?

Measures atrial depolarization (pre big jump)

Stroke

Modifiable Risk Factors for Stroke - Hypertension, Smoking, including passive smoking, Lack of exercise, Inadequate treatment of atrial fibrillation, Carotid artery disease, Heart failure, Diabetes, Sleep apnea, Alcohol use, OCs in female smokers & Diet

Heart Attack (MI)

Most probable cause of death for most individuals Risk Factors: - Hypertension - High cholesterol (335) - Smoking - Diabetes (automatically places patient in a high risk category) - Abnormal electrocardiogram

Myocardial Infarction (MI) Heart Attack

Myocardial Infarction (MI) Results from total obstruction in a coronary artery, resulting in tissue necrosis and loss of function

Effects of aging heart

Number 1 cause of death in US: Cardiovascular disease - Leading cause of death for African Americans, Latinos, Asian Americans, Pacific Islanders, and American Indians - Smoking is number cause of CV disease - Risk factors: Smoking, Lack of exercise, Poor diet, Hypertension & Diabetes

Aging Heart

Older person may have maximum heart rates matching younger persons Maximum Cardiac Function decreases with age: - Oxygen consumption decreased - Maximal achievable heart rate decreased - Total heart output decreased - If in good shape, may avoid these things Resting cardiac output: - No change - Output of the heart Measures of heart function: No change: - Normal or Successful Aging - Resting state remains normal Systolic blood pressure: Increases

Vena Cava

One of the major veins delivering systemic blood to the right atrium; superior and inferior venae cavae.

plaque

Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque hardens and narrows your arteries. This limits the flow of oxygen-rich blood to your organs and other parts of your body.

What's the difference between preload and afterload?

Preload: extent of ventricular filling before contraction Aferload: resistance to ventricular emptying (decrease EDV = less full = decrease SV)

Tachycardia

Regular but rapid heartbeat 100-160 BPM

Bradycardia

Regular but slow heart rate, usually below 60 BPM

Chambers of the heart

Right Artium right Ventricle Left Atrium Left Ventricle - thicker walls to push blood to the toes

septum

That portion of the septum that separates the two upper chambers (the right and left atria) of the heart is termed the atrial (or interatrial) septum while the portion of the septum that lies between the two lower chambers (the right and left ventricles) of the heart is called the ventricular (or interventricular) septum.

aortic valve Semilunar valve

The aortic valve is located between the left ventricle (lower heart pumping chamber) and the aorta, which is the largest artery in the body. Valves maintain one-way blood flow through the heart. *A three-cusped valve guarding the exit from one of the cardiac ventricles; the pulmonary and aortic valves.

Cardiac Conduction System

The cardiac conduction system is a group of specialized cardiac muscle cells in the walls of the heart that send signals to the heart muscle causing it to contract. The main components of the cardiac conduction system are the SA node, AV node, bundle of His, bundle branches, and Purkinje fibers.

Conduction system of the heart

The cardiac conduction system is a group of specialized cardiac muscle cells in the walls of the heart that send signals to the heart muscle causing it to contract. The main components of the cardiac conduction system are the SA node, AV node, bundle of His, bundle branches, and Purkinje fibers. The SA node (anatomical pacemaker) starts the sequence by causing the atrial muscles to contract. From there, the signal travels to the AV node, through the bundle of His, down the bundle branches, and through the Purkinje fibers, causing the ventricles to contract. This signal creates an electrical current that can be seen on a graph called an Electrocardiogram (EKG or ECG)

Cardiac Cycle

The cardiac cycle refers to a complete heartbeat from its generation to the beginning of the next beat, and so includes the diastole, the systole, and the intervening pause. The frequency of the cardiac cycle is described by the heart rate, which is typically expressed as beats per minute.

AV (antiventicular) node

The electrical relay station between the upper and lower chambers of the heart. Abbreviated AV node. Electrical signals from the atria must pass through the AV node to reach the ventricles. The AV node, which controls the heart rate, is one of the major elements in the cardiac conduction system. The AV node serves as an electrical relay station, slowing the electrical current sent by the sinoatrial (SA) node before the signal is permitted to pass down through to the ventricles. This delay ensures that the atria have an opportunity to fully contract before the ventricles are stimulated. After passing the AV node, the electrical current travels to the ventricles, along special fibers embedded in the walls of the lower part of the heart.

Blood supply to the brain

The entire blood supply of the brain and spinal cord depends on two sets of branches from the dorsal aorta. The vertebral arteries arise from the subclavian arteries, and the internal carotid arteries are branches of the common carotid arteries.

Fetal Circulation

The fetal circulation works differently from that of born humans, mainly because the lungs are not in use. Instead, the fetus obtains oxygen and nutrients from the mother through the placenta and the umbilical cord

pericardial membrane

The fibrous sac that surrounds the heart; its inner, serous lining is continuous with the epicardium.

SA (Sinoatrial) node

The heart's natural pacemaker, one of the major elements in the cardiac conduction system, the system that controls the heart rate. Abbreviated SA node. The SA node consists of a cluster of cells that are situated in the upper part of the wall of the heart's right atrium, where the electrical impulses are generated. An electrical signal generated by the SA node moves from cell to cell, down through the heart, until it reaches the atrioventricular (AV) node, a cluster of cells situated in the center of the heart, between the atria and ventricles.

Pulse

The intermittent throbbing sensation felt when the fingers are pressed against an artery -The result of the alternate expansion and contraction of an artery as a wave of clood is forced out from the heart

Bicuspid Valve mitral valve

The left atrioventricular (AV) valve, also called mitral valve. best sound produced for heart sounds

Blood supply to the liver

The liver receives a blood supply from two sources. The first is the hepatic artery which delivers oxygenated blood from the general circulation. The second is the hepatic portal vein delivering deoxygenated blood from the small intestine containing nutrients

hepatic portal system

The portal venous system is responsible for directing blood from parts of the gastrointestinal tract to the liver. Substances absorbed in the small intestine travel first to the liver for processing before continuing to the heart.

Tricuspid valve

The right atrioventricular valve, which prevents the backflow of blood into the right atrium during ventricular systole.

Coronary Arteries

The right coronary artery supplies blood mainly to the right side of the heart. The right side of the heart is smaller because it pumps blood only to the lungs. The left coronary artery, which branches into the left anterior descending artery and the circumflex artery, supplies blood to the left side of the heart. The left side of the heart is larger and more muscular because it pumps blood to the rest of the body.

Pericardial cavity

The space between the parietal pericardium and the epicardium (visceral pericardium) that covers the outer surface of the heart.

Cerebrovascular accident Stroke

The sudden death of some brain cells due to lack of oxygen when the blood flow to the brain is impaired by blockage or rupture of an artery to the brain. A CVA is also referred to as a stroke.

Systole

The time period when the heart is contracting. The period specifically during which the left ventricle of the heart contract

Cappilaries

Where the action is - gasses, nutrients, waste *Exchanges gasses -oxygen & carbon dioxide * walls can be one layer thick -microscopic * only one blood molecule can get thru some of them and must fold or twist and turn to get thru

Double Pump

Your heart is a single organ, but it acts as a double pump. The first pump carries oxygen-poor blood to your lungs, where it unloads carbon dioxide and picks up oxygen. It then delivers oxygen-rich blood back to your heart. The second pump delivers oxygen-rich blood to every part of your body.

arteriosclerosis

abnormal thickening, hardening and loss of elasticity of arterial walls

Hypertension

abnormally high blood pressure ** Huge risk factor: Stroke and M.I. - "Mild" hypertension carries more risk than "moderate" or "severe" - 2 X incidence of peripheral vascular disease, M.I., CHD, & sudden death - 4 X incidence of stroke

Arterioles

branches out from arteries to the capillaries

SL valves

closes during diastole and opens during systole

AV valves

closes during systole and opens in diastole

SA node-> AV node-> bundle of his-> bundle branches-> purkinje fibers

conduction pathway

myocardium

contains muscle fibers that is responsible for pumping action of the heart

Varicose veins

enlarged, twisted, from a leaflet valve in the vein is not working properly

Venule

from the veins to the capillary beds *extremely porous

Phelebitis

inflammation of the walls of the veins use compression stockings ibuprofen

endocardium

inner lining that lines the heart chambers where the coronary arteries are embedded

Coronary artery disease

major coronary arteries are partially or completely blocked due to coronary artery spasm, arteriosclerosis or atherosclerosis.

Depolarization

moves cell to cell producing electrical activity/exhange of electricity

SA node

pacemaker; part of the conduction pathway that causes the atria to contract and initiates an impulse

Purkinje fibers

part of the conduction pathway that causes the ventricles to contract

atherosclerosis

plaque building of the vessel by fatty streak, fibrous plaque, complicated lesions

SVC+IVC+coronary vein->RA ->tricuspid valve ->RV ->Pulmonic valve -> =Pulmonary artery ->Lungs ->Pulmonary vein -> LA-> Mitral valve-> LV-> Aortic valve-> Aorta

pulmonary and systemic blood circulation

What does the T wave measure?

repolarization of the ventricles (post big jump)

repolarization

resting state

pacemaker

restores regular rhythm, improve CO and tissue perfusion; impulses conducted from the power source to the heart stimulate contraction; makes SA node fire; NI: telemetry, ECG monitoring, pacemaker spike, VS, immobilize the arm

echocardiogram (cardiac sonogram)

study of electrical activity ultrasound of the heart, sees anterior part of heart's size, shape, position, behavior of internal structure, wall motion, valve function.

circle of willis

supplies blood to the brain

Pulmonary veins

take oxygenated blood from the lungs and deposits it into the left atrium

Pulmonary Arteries

takes de-oxygenated blood from the right ventricle into the lungs

Arteries

takes oxygenated blood AWAY from the heart highly elastic entrance controlled by sphincter muscles thick walled *Aorta

both atria and then both ventricles

the heart contracts in the following patterns

Diastole

the normal period in the heart cycle during which the muscle fibers lengthen, the heart dilates, and the cavities fill with blood, roughly the period of relaxation is called

murmur

turbulent blood flow across the valves, difficulty flow of blood to ventricles

S1 (lub)

ventricles contract (systole); mitral and tricuspid valves close

S2 (dub)

ventricles relax (diastole); aortic and pulmonic valves close

What does the Q wave measure?

ventricular depolarization (big jump on EKG)