Cardiovascular Anatomy and Physiology

1. Cardiovascular Anatomy and Physiology Daymar College Lisa H. Young, RN, BSN, MAE.

3. Dextrocardia

4. Skeleton of the heart

5. Anterior View of the Heart

6. Walls of the Heart

7. Heart Valves

8. Structures of the AV Valves

9. Heart Valves http://www.youtube.com/watch?v=39n4XWv7flQ

10. Left Ventricle Wall Surfaces

11. Heart Chambers

12. Left and Right Atrium Receives un-oxygenated blood from the body and the lungs. Expands to accommodate large volumes of blood from the body. • Left and Right Ventricles Thick muscular walls to forcefully expel blood to the body. Does not expand well. Heart Chambers

13. Blood flows from higher-pressure to lower pressure • Pressure order: highest to lowest • Left ventricle • Left atrium • Right ventricle • Right atrium Pressure Differences of the Heart

14. http://www.youtube.com/watch?v=FCimR_P9ID0 Animation of Blood Flow

15. Blood Flow

16. Fetal Blood Flow

17. Autonomic Nervous System (ANS) • Sympathetic Nervous System Adrenergic response Norepinephrine released Increased heart rate and blood pressure Decreases digestion Heart Rate

18. Parasympathetic Nervous System Cholinergic response Acetycholine released Decreases heart rate, blood pressure Increases digestion Heart Rate

19. Electrical Cells Automaticity Excitability Conductivity • Mechanical Cells Contractility Extensibility Cardiac Cells

20. Chemical Basis for Impulse Formation

21. http://www.youtube.com/watch?v=7EyhsOewnH4 Cardiac Action Potential Phases

22. Hypokalemia (low potassium levels) • http://www.youtube.com/watch?v=oXaff1vbFnA • Hyperkalemia (high potassium levels) • http://www.youtube.com/watch?v=xluHUcQbWXo • Hypocalcemia (low calcium levels) • http://www.youtube.com/watch?v=6_Khrzr0x_A • Hypercalcemia (high calcium levels) • http://www.youtube.com/watch?v=LIdAVjWwIFo Cardiac Electrolytes

23. Hypomagnesemia (low magnesium) • http://www.youtube.com/watch?v=e0APNC968MY • Hypermagnesemia (high magnesium) • http://www.youtube.com/watch?v=4Gv3JR4s_Gc Cardiac Electrolytes

24. Electrical Conduction Pathway

25. Cardiac Cycle

26. Phases of Systole

27. Ventricular Systole/Diastole

28. Heart Action during Systole A B

29. Atrial Kick

30. Compliance • Preload: L Ventricular Wall Stress at End Diastolic Volume • Afterload: L Ventricular Wall Stress During Systole (Ejection out L Ventricle) • Contractility Physiologic Control Mechanisms of Blood Pressure

31. Pressure differences in the left and right heart

32. Pressure Volume Loop http://www.youtube.com/watch?v=AnwPH5yU8rY

33. Right & Left heart pressures: • Right atria 2-6 mmHg • Right ventricle 25/0 mmHg • Pulmonary arteries 25/8 mmHg • Pulmonary veins 8 mmHg • Left atria 6 mmHg • Left ventricle 120/0 mmHg • Aorta 120/80 mmHg • Pulmonary Vascular Resistance • Less 2.5 mmHg/L/min or 200 Dynes • Systemic Vascular Resistance • less than 20 mmHg/L/ min or 1600 Dynes Normal Values

34. http://www.youtube.com/watch?v=7w6awkDREQM • http://www.youtube.com/watch?v=PUArUV4VdaY Cardiac Cycle (Pressure/Volume)

35. Heart rate X Stroke Volume = CO • 5 liters / min. (at rest) • 4- 8 liters / min when pumping • Frank –Starling Law • Decreased cardiac output signs and symptoms • Epinephrine, thyroxine, sympathetic nervous system, fever, fear, exercise, low BP increase CO Cardiac Output

36. Right heart oxygen saturation – 75% • Left heart oxygen saturation – 95% • Mean arterial pressure – 93 mmHg • Systemic blood pressure – 120/80 mmHg • Aortic pulse pressure – 40 mmHg • Cardiac output – 5L/min • Stroke volume – 60 – 130 mL/beat Normal Values

37. Baroreceptors • Specialized nerve tissue (sensors) • Detect changes in blood pressure • Increase / decrease sympathetic tone • Dilation of blood vessels Carotid Arteries and Aortic Arch

38. Chemoreceptors specialized nerve tissue (sensors) detect changes in concentration of pH, 02, C02 sympathetic or parasympathetic response Carotid Artery and Aortic Arch

39. Coronary Arteries & Veins

40. Systemic Vasculature Layers

41. Vascular Layers & Arterioles

42. Vascular Circulation

43. Coarctation of the Aorta (CoA) • Patent ductus arteriosus (PDA) • Septal defects • Tetralogy of Fallot • Transposition of the great arteries (TGA) http://www.youtube.com/watch?v=cgR_XmRJcIg http://www.youtube.com/watch?v=e46jtin-H50 http://www.youtube.com/watch?v=yePivAlbR4A http://www.youtube.com/watch?v=O83cYwKOKtI Congenital Heart Disease

44. Health History A. Chief complain B. Family History C. Coping and emotional history D. Medications E. Surgeries F. Activities of daily living http://www.youtube.com/watch?v=JLLUkiZZfBo Cardiovascular Assessment

45. General appearance • Inspection • Palpation • Percussion • Ausculatation http://www.youtube.com/watch?v=MIfmjFG6BTQ Assessing the Heart

46. Cardiac output X peripheral vascular resistance • Systolic measurement • Diastolic measurement • Korotkoff sound http://www.youtube.com/watch?v=ALqdHnD7c18 Blood Pressure

47. Location • Pressure points • Heave and Thrill • Pulse Pressure • Aortic Pulse Pressure • Mean Arterial Pressure http://www.youtube.com/watch?v=74v4mEWhOao Pulses

48. Process • 7 important aspects • Distal arteries • What affects measurement • Changes related to cuff size • Classifications http://www.youtube.com/watch?v=diG519dFVNs Measuring Blood Pressure

49. “Silent Killer” • Essential Hypertension • Malignant Hypertension • Secondary Hypertension • Pseudohypertension • Risk Factors Hypertension

50. Cause • Signs and symptoms • Diagnostic Tests • Treatment Hypertension