1. The Cardiovascular System
Chapter 5

2. Major Structures Heart card/o, cardi/o Blood Vessels angi/o, vas/o
[pumps blood into the arteries]
Blood Vessels angi/o, vas/o
[transports blood to and from all areas of the body]
Arteries arteri/o
[transport blood AWAY FROM the heart]
Capillaries capill/o
[waste and nutrient exchange between blood and cells]
Veins phleb/o, ven/o
[return blood from all body parts to the heart]
Blood hem/o, hamat/o
[brings O2 and nutrients to cells and carries away waste]

3. 3

4. Word Parts

5. Objectives
Describe the heart in terms of chambers, valves, blood flow, heartbeat and blood supply
Differentiate among the three different types of blood vessels and describe the major function of each
ID the major components of blood and the major fxns of each component
State the difference between pulmonary and systemic circulation
Recognize, define, spell, and pronounce the terms related to the pathology and the diagnostic and treatment procedures of the cardiovascular system

6. Functions of the Cardiovascular System
Consist of the heart, blood vessels and blood
Cardiovascular
Cardi/o means heart
Vascul means blood vessels
-ar means pertaining to
Blood is fluid tissue that transports O2 and nutrients thoughout body
Blood returns some waste products from these tissues to kidneys and carries CO2 back to the lungs

7. 7

8. (cardiovascular system)
Structures of the
CVS
(cardiovascular system)

9. The Heart A hallow, muscular organ located between the lungs
A very effective pump that supplies the power to maintain the necessary blood flow throughout the entire body

10. 8

12. The Pericardium Pericardial Sac
A double-walled membranous sac that encloses the heart
Peri- means surrounding, cardi means heart, and – um is a singular noun ending
Pareital Pericardium – the tough outer layer that forms a fibrous sac and protects the heart
Visceral Pericardium – the inner layer of the pericardium, forms the outer layer of the heart (the EPICARDIUM)
Pericardial fluid – found between the 2 layers; acts as a lubricant to prevent friction during heart beats

14. The Walls of the Heart
Epicardium – the external layer of the heart and inner layer of the pericardium
Myocardium – aka myocardial muscle; the middle and thickest; contains specialized cardiac muscle tissue
Blood Supply – cardiac muscle beats constantly and must have a continuous supply of O2. This is provided by the Cardiac Arteries.
Endocardium – consists of epithelial tissue; the inner lining of the heart

16. The Chambers of the Heart
Divided into L and R halves with a top and a bottom; 4 Chambers total
Atria – the 2 upper chambers; receiving chambers; all vessels coming into the heart enter here
Separated by interatrial septum
Ventricles – the two lower chambers; Pumping chambers; all blood leaving the heart emerge from here.
Separated by the interventricular septum

18. The Valves of the Heart 4 valves that control blood flow
The Tricuspid Valve – controls the opening between the R atrium and R ventricle
The Pulmonary Semilunar Valve – between the R ventricle and the pulmonary artery
The Mitral Valve – aka bicuspid valve, located between the L atrium and L ventricle
The Aortic Semilunar Valve – located between the L ventricle and the aorta

22. Blood Flow!!!!
The Bloodmobile!!!

23. Blood Flow Through the Heart
The RA receives O2-poor blood from all tissues, except the lungs, through the superior and inferior vena cava. Blood flows out of the RA through the tricuspid valve into the RV.
The RV pumps the O2-poor blood through that pulmonary semilunar valve and into the pulmonary artery, which carries it to the lungs.
The LA receives O2-rich blood from the lungs through the 4 pulmonary veins. The blood flows out of the LA, through the mitral valve, and into the LV
The LV receives O2-rich blood from the LA. Blood flows out of the LV through the aortic semilunar valve and into the aorta, which carries it to all parts of the body, except the lungs
O2-poor blood is returned by the venae cavae to the RA and the cycle begins again

25. Systemic and Pulmonary Circulation
Pulmonary Circulation - Blood flow ONLY between the heart and lungs
Pulmonary Arteries carry deoxygenated blood from the RV to the lungs
Pulmonary Veins carry oxygenated blood from the lungs to the LA
**the only place in the body this occurs!!**
Systemic Circulation – blood flow to the whole body except the lungs

27. The Heartbeat
Regulatory blood flow is maintained by the contraction and relaxation of the heart muscle.
This rate is determined by electrical impulses from the heart’s own conduction system
The SA Node, the AV Node and the Bundle of His (don’t worry about writing them now, we’ll discuss each)

28. The Heartbeat The Sinoatrial (SA) Node
Located in the posterior wall of the RA
Establishes the basic rhythm and rate of the heartbeat
Our natural pacemaker
It’s electrical impulses are what starts the wave of m contractions in the heart
The impulse causes the atria to contract 1st, forcing blood into the ventricles

29. The Heartbeat The Atrioventricular Node (AV)
The impulse from the SA node travels down to the AV node
Located on the floor of the RA
Transmits electrical impulse to the Bundle of His

30. The Heartbeat The Bundle of His Purkinje Fibers
A group of fibers within the interventricular septum.
Carry electrical impulses to the Purkinje fibers
Purkinje Fibers
Specialized conductive fibers in the walls of the ventricles
Relays electrical impulses to the ventricles causing them to contract
This contraction forces blood out of the heart and into the aorta and pulmonary arteries

32. The Heartbeat Electrical Waves
The conduction of electricity within the heart can be visualized as wave movements on monitor; aka an Electrocardiogram (ECG/EKG)
P wave – atria contraction
QRS complex – ventricular contraction (as the atria relax)
T wave – ventricular relaxation

34. The Blood Vessels Arteries
LARGE blood vessels that carry blood AWAY from the heart
Arterial blood is bright red because it is oxygen rich
The AORTA is the largest blood vessel in the body and is also the main trunk of the arterial system
The carotid arteries are the major arteries that carry blood upward to the head
Arterioles are the smaller, thinner branches that carry blood to the capillaries

37. Blood Vessels
Veins
They are a low pressure collecting system that returns oxygen-poor blood to the heart
The walls are thinner and less elastic than those of arteries
They have valves that enable blood to flow only toward the heart and prevent it from flowing away from the heart
Venules are the smallest veins
Superficial Veins – located near the body surface
Deep Veins – located within the tissues, away from the body surface

41. The Blood Vessels The Venae Cavae
Are the two largest veins in the body
The Superior Venae Cavae – transports blood from the upper portion of the body to the heart
The Inferior Venae Cavae – transports blood from the lower portion of the body to the heart

43. Blood Vessels They are one epithelial cell in thickness
Capillaries
They are one epithelial cell in thickness
The smallest blood vessels in the body
Form networks to make vascular beds that deliver oxygen and nutrients to the cells of the tissues
Slows blood flow so that plasma can flow into the tissues to exchange oxygen, nutrients and waste
90% of the fluid continues to flow as venous blood
The remaining 10% stays behind at lymph

45. Blood Vessels Pulse and Blood Pressure
Pulse – the rhythmic pressure against the walls of an artery cause by the contraction of the heart
Blood Pressure – the measurement of the amount of systolic and diastolic pressure exerted against the walls of the arteries
Systolic Pressure – caused by ventricular contraction, is the higher pressure
Systole – contraction of the heart
Diastolic Pressure – caused by ventricular relaxation, is the lowest pressure
Diastole – relaxation of the heart

47. Blood The fluid tissue of the body 55% liquid plasma
45% formed elements

48. Blood
Plasma – straw colored fluid that contains nutrients, hormones, and waste products
91% water
9% protein
Fibrinogen and Prothrombin – clotting proteins found in plasma
Serum – plasma fluid that is left after the blood cells and the clotting proteins have been removed

51. Blood Formed Elements of the Blood
Erythrocytes – [red blood cells (RBCs)] mature red blood cells produced by red bone marrow
Transport O2 to tissues via hemoglobin (the iron-containing pigment of RBCs)

53. Blood Formed Elements of the Blood (continued)
Leukocytes – [white blood cells (WBCs)] the blood cells involved in our body’s defenses against infective organisms and foreign substances
Neutrophils – formed in red bone marrow; most common type
Basophils – formed in red bone marrow; least common type; responsible for the symptoms of allergies
Eosinophils – formed in red bone marrow; migrate to tissues through the body; destroy parasitic organisms; play major role in allergic reactions
Lymphocytes – formed in red bone marrow, lymph nodes and spleen; ID foreign substances/germs and produce antibodies that target them
Monocytes – formed in red bone marrow, lymph and spleen; provide immunological defenses against many infectious organisms

55. Blood Formed Elements of Blood (cont’d) Thrombocytes – platelets
the smallest of the formed elements; play important part in the clotting of blood
When a vessel is damaged, thrombocytes become sticky
They stick and clump together to form a clot that stops the bleeding

58. Blood Blood Types The Rh Factor
Classified according to the presence, or absence, of certain antigens (any substance the body regards as foreign)
4 Major Types
A, AB, B and O
Based on the presence of A and/or B antigens on the RBCs; in O, both are basent
The Rh Factor
Refers to the presence or absence of the Rh antigen on RBCs
~85% of Americans are Rh positive (Rh +), 15% are Rh-
Factored in during blood transfusions and can cause difficulties for a Rh- mom having a Rh+ baby

60. Blood
Blood Gases
Gases that normally dissolve in the liquid portion of blood
The major gases are:
Oxygen
Carbon Dioxide
Nitrogen

61. Medical Specialties Related to the Cardiovascular System

62. Medical Specialties
Cardiologist – a physician who specializes in the dx and tx of abnormalities, diseases and disorders of the heart
Hematologist – a physician who specializes in dx and tx abnormalities, diseases and disorders of the blood and blood forming tissues
Vascular Surgeon – a physician who specializes in the dx, medical management, and surgical tx of disorders of the blood vessels

63. Pathology of the Cardiovascular System

64. Congenital Heart Defects
Structural abnormalities cause by the failure of the heart to develop normally before birth
Congenital means present at birth
Some are apparent at birth, whereas other may not be detected until later in life

66. Coronary Artery Disease
It’s atherosclerosis of the coronary arteries that reduces the blood supply to the heart m.
Creates insufficient supply of O2 to the heart that can cause angina (p!), a myocardial infarction (MI/ heart attack) or death

67. Coronary Artery Disease
Atherosclerosis
Hardening and narrowing of the arteries caused by a buildup of cholesterol plaque on the interior walls of the arteries
The buildup can protrude inward or outward
An atheroma is a deposit of plaque on or within the arterial wall

69. Coronary Artery Disease
Ischemic Heart Disease
A group of cardiac disabilities resulting from an insufficient supply of oxygenated blood to the heart; usually associated with coronary artery disease
Ischemia is a condition caused by insufficient blood flow to any body part (isch means to hold back, -emia means blood)

70. Coronary Artery Disease
Angina
Know as angina pectoris, is a condition of episodes of seven chest pain due to inadequate flood flow to the myocardium

71. Coronary Artery Disease
Myocardial Infarction
aka a heart attack, is the occlusion of one of more coronary arteries caused by plaque buildup
Infarction means a sudden insufficiency of blood. An infarct is a localized area of dead tissue caused by a lack of blood
Most frequent S&S include pain in the middle of the chest that may spread to the back, jaw, or left arm

73. Heart Failure
aka Congestive Heart Failure occurs most commonly in the elderly
A chronic condition where the heart is unable to pump out all of the blood that it receives; decreased pumping causes congestion
Left-sided Heart Failure (Pulmonary Edema) causes an accumulation of fluid in the lungs
Right-sided Heart Failure causes fluid buildup beginning with the feels and legs; can also affect the liver, GI tract or arms
Cardiomegaly is the abnormal enlargement of the heart that is frequently associated with heart failure
Heart enlarges in an effort to compensate for the loss of its pumping ability

75. Carditis Inflammation of the heart
Endocarditis – inflammation of the inner lining of the heart
Bacterial Endocarditis – inflammation of the lining or valves of the heart caused by the presence of bacteria and the bloodstream; sometimes caused by bleeding during dental sx because it allows bacteria into the bloodstream

76. Carditis
Myocarditis – inflammation of the myocardium; usually stems from a viral infection
Pericarditis – inflammation of the pericardium causing an accumulation of fluid in the pericardial sac; restricts pumping action of the heart
Diseases of the Myocardium
Cardiomyopathy – the term used to describe all diseases of the heart m

78. Heart Valves
A hear murmur is an abnormal sound heard when listening to the human heart; often caused by defective valves
Valvulitis is an inflammation of a heart valve
Valvular Prolapse is the abnormal protrusion of a heart valve that results in the inability of the valve to close completely
Valvular Stenosis is a condition in which there is narrowing, stiffening, thickening or blockage of one or more valves of the heart

81. Cardiac Arrest and Arrythmias
Cardiac Arrest – an event in which the heart abruptly stops or develops a very abnormal arrythmia the prevents it from pumping blood
Bradycardia – an abnormally slow resting heart rate; usually < 60bpm
Tachycardia – an abnormally rapid resting heart rate; usually > 100bpm
Palpitations – a pounding or racing heart with or without irregularity in rhythm

82. Cardiac Arrest and Arrythmias
Atrial and Ventricular Fibrillation
Atrial Fibrillation (A fib) occurs when the normal rhythm of the atria are replace by rapid irregular twitching of the muscular heart wall
Ventricular Fibrillation (V fib) is the rapid irregular and useless contractions of the ventricles
The heart m quivers ineffectively
Ventricular Tachycardia (V tach) is a very rapid heart beat that begins within the ventricles
Potentially fatal because the heart is unable to adequately pump blood throughout the body

84. Blood Vessels Angitis (vasculitis) inflammation of blood of lymph
Angiostenosis – abnormal narrowing of blood vessels
Hemangioma – a benign tumor made up of newly formed blood vessels
Polyarteritis – a form of angitis involving several medium and small arteries at the same time

86. Blood Vessels
Peripheral Vascular Disease – refers to disorders of the blood vessels located outside the heart and brain
Peripheral Arterial Vascular Disease (peripheral artery disease – PAD) caused by artherosclerosis; causes impaired circulation to the extremities and vital organs
Raynaud’s Phenomenon – a peripheral arterial occlusive disease in which intermittent attacks are triggered by cold or stress
Symptoms – pallor (paleness), cyanosis, then redness of fingers and toes

87. Blood Vessels Arteries Veins
Aneurysm – a localized weak spot, or balloon-like enlargement, of the wall of an artery; their rupture can be fatal
Arteriosclerosis – hardening of the arteries; is any group of disease characterized by thickening and the loss of elasticity of the arterial walls
Veins
Phlebitis – inflammation of a vein
Varicose Veins – abnormally swollen veins, usually occurring in the superficial veins of the leg
Occur when the valves malfunction and allow blood to pool in the veins

90. Thromboses and Embolisms
Thrombosis – the abnormal condition of having a thrombus (clot)
Thrombus – a blood clot attached to the interior wall of an artery or vein
Thrombotic Occlusion – the blocking of an artery by a thrombus
Deep Vein Thrombosis – (DVT) having a small thrombus attached to the wall of a deep vein
Embolism – sudden blockage of a blood vessel by and embolus (a foreign object, such as a blood clot, quantity of gas, or a bit of tissue or tumor that is circulating the blood)

91. Blood Disorders
Blood Dyscrasia – any pathologic condition of the cellular elements of blood
Hemochromatosis – iron overload disease; a genetic disorder in which the intestines absorb too much iron
Leukopenia – any situation where there is a lower than normal number of circulating leukocytes
Polycythemia – an abnormal increase in the # of RBCs due to an overproduction of them by the red bone marrow

92. Blood Disorders
Septicemia – blood poisoning; a systemic condition caused by the spread of microorganisms and toxins via the blood
Thrombocytopenia – a condition of abnormally small # of platelets in circulating blood
Thrombocytosis – and abnormal increase in the # of platelets
Hemorrhage – the loss of a large amount of blood in a short time
Transfusion Reaction – a serious, and potentially fatal complication of a blood transfusion in which a severe immune response occurs b/c the pt’s blood and the donated blood don’t match

93. Blood Disorders
Cholesterol – a fatty substance that travels through the blood and is found in all parts of the body
Aids in the production of cell membranes, some hormones, and vitamin D
Some comes from diet and some is created in the liver
Hyperlipidemia – general term for elevated levels of cholesterol

95. Blood Disorders Leukemia
Myelodysplastic Sundrome – prelukemia; a group of bone marrow disorders that are characterized by the insufficient production of one of more tupes of blood cells due to a dysfunction in the bone marrow
Leukemia – a type of cancer characterized by a progressive increase in the number of abnormal WBCs

96. Blood Disorders Anemia – lower than normal # of RBCs in the blood
Measured by the decreased amount of hemoglobin in the blood (decreased hemoglobin = decreased O2 levels = decreased energy)
Aplastic Anemia – characterized by the absence of ALL formed elements caused by a failure of blood cell production in the bone marrow
Hemolytic Anemia – a condition of inadequate RBC count due to premature destruction of RBCs by the spleen

97. Blood Disorders Anemias
Iron-deficiency Anemia – most ocmmon form; Iron is essential to hemoglobin, normally obtained from food, and without sufficient iron to help create hemoglobin, blood cannot carry O2 effectively
Megaloblastic Anemia – blood disorder characterized by larger than normal RBCs; usually from a folic acid and B12 deficiency
Pernicious Anemia – caused by a lack of the protein intrinsic factor (IF) that helps the body absorb B12 (B12 is necessary for the production of RBCs)

98. Blood Disorders Anemias (cont’d)
Sickle Cell Anemia – a genetic disorder that causes abnomarl hemoglobin, resulting in some RBCs to assume an abnormal sickle shape
Can interfere with normal blood flow
Thalassemia – an inherited blood disorder that causes mile or severe anemia due to reduce hemoglobin and fewer RBCs than normal
Sometimes referred to as Cooley’s Anemia

103. Hypertension
Hypertension (HTN) – high blood pressure; the elevation of arterial blood pressure to a level that is likely to cause damage to the CVS
Essential HTN – primary or idiopathic HTN; consistently elevated blood pressure of unknown cause
Secondary HTN – caused by different medical problems such as a kidney disorder or a tumor on the adrenal glands
Malignant HTN – characterized by very high BP; can be fatal and is usually accompanied by damage to the organs, brain and optic nerves or failure of the heart and kidneys

104. Hypotension Is a lower than normal arterial BP
Symptoms can include dizziness, lightheadedness, and/or fainting
Orthostatic Hypotension – postural hypotension; low BP that occurs upon standing up

105. Diagnostic Procedures of the CVS

106. Angiography – a radiographic (x-ray) study of blood vessels after the injection of a contrast medium (angiogram)
Cardiac Catheterization – a dx procedure in which a catheter is passed into a vein or artery and then guided into the heart; done for angiograms or during procedures
Digital Subtraction Angiography (DSA) – combines angiography w computerized components to clarify the view of the area of interest by removing the soft tissue and bones from the area

111. Duplex Ultrasound (US) – dx procuedure to image the structure of the blood vessels
Combines diagnostic US and Doppler US to show the movement of RBCs the vessels
Phlebography – venography; a radiographic test that provides an image of the leg veins after a contrast dye is injected; detects DVTs

115. Electrocardiography
Noninvasive process of recording the electrical activity of the myocardium
Electrocardiogram – (ECG/EKG) a recording of the electrical activity of the myocardium
Holter Monitor – a portable (EKG) that is worn by a patient to continuously monitor the heart rates and rhythms over a 24hr pd
Stress Test – performed to assess CV health and function during and after stress
Thallium Stress Test – performed to determine how well blood flows through the coronary arteries during exercise

117. Treatment Procedures of the CVS

118. Medications Antihypertensives – administered to lower BP
ACE Inhibitors (Angiotensin-Converting Enzyme) – blocks the enzymes that cause the blood vessels to contract resulting in HTN
Beta-blocker – reduces the workload of the heart by slowing the rate of the heart beat
Commonly Rx’d to lower BP, relieve angina or to treat heart failure
Calcium Channel Blocker – cause the heart and blood vessels to relax by decreasing the movement of Ca into the cells of these structures
Diuretic – used to stimulate the kidneys to increase urine secretion to rid the body of excess Na and H2O
Helps to treat HTN by reducing the amount of fluid circulating in the blood

119. Additional Meds Antiarrhythmic – controls irregular heartbeats
Anticoagulant – slows coagulation and prevents new clot formation
Aspirin – in a very small dose (baby aspirin), 81 mg/d, may reduce the risk of a heart attack or stroke by slightly reducing the ability of the blood to clot
Cholesterol-lowering Drugs – statins, help reduce undesirable cholesterol levels in the blood

120. Vasodilator – cause blood vessels to expand
Coumadin – warfarin; an anticoagulant that prevents new clots from forming or growing larger
Digitalis – digoxin; strengthens the contraction of the heart m, slows the heart rate and helps eliminate fluid from the body tissues
Vasoconstrictor – causes blood vessels to narrow; antihistamines and decongrestants
Vasodilator – cause blood vessels to expand
Nitroglycerin – a vasodilator that is prescribed to prevent or relieve the pain of angina by dilating the blood vessels to the heart
Can be administered sublingually, transdermally, or orally as a spray

122. Clearing Blocked Arteries
Percutaneous Transluminal Coronary Angioplasty – angioplasty or balloon angioplasty; a small balloon on the end of a catheter is used to open a partially blocked coronary artery by flattening the plaque deposit and stretching the lumen
Stent – a wire-mesh tube that is placed in an artery after its been opened
Restenosis – when an artery that has been opened by angioplasty closes again

125. Clearing Blocked Arteries
Atherectomy – the surgical removal of plaque buildup from the interior of an artery
Carotid Endarterectomy – the surgical removal of the lining of a portion of a clogged carotid artery

127. Coronary Artery Bypass Graft
CABG – bypass surgery; a piece of vein is implanted on the heart to replace a blocked coronary artery
Requires opening the chest
Minimally invasive coronary artery bypass – keyhole or buttonhole bypass; done via fiber optic camera and small openings through the ribs

129. Tx for Cardiac Arrhythmias
Defibrillation – cardioversion; the use of electrical shock to restore the heart’s normal rhythm
Automated External Defibrillator (AED) – designed for nonprofessional use when defibrillation is required
Artificial Pacemaker – used from bradycardia and atrial fibrillation; can be ext or implanted
Implantable Cardioverter Defibrillator – constantly regulated the heartbeat and if there’s a disruption of rhythm it acts as an automatic defibrillator

131. Blood Vessels, Blood and Bleeding
Aneurysmectomy – the surgical removal of an aneurysm
Aneurysmorraphy – the surgical suturing of an aneurysm
Arteriectomy – the surgical removal of part of an artery
Hemostasis – to stop or control bleeding
Plasmapheresis – the removal of whole blood and the separation of its cellular elements; RBCs and platelets are returned to the body